Prolonged disease-free survival and overall survival with CVP alternating with fludarabine in advanced follicular lymphoma

Abstract Follicular lymphoma arising in an extranodal site is uncommon and its natural history and treatment is poorly characterized in the literature. We retrospectively reviewed a large cohort of patients with stage I and II follicular lymphoma and analyzed the outcomes of patients with extranodal (EN-FL) presentations to identify sites of involvement and treatment outcome, and compared these to patients with nodal follicular lymphoma. From 1967 to 1999, 668 cases of limited stage follicular lymphoma (stage I and II) were treated at the Princess Margaret Hospital. Of these, 157 cases (23.5%) presented in extra-nodal sites. The most common site of presentation was in the head and neck area (42%) followed by gastro-intestinal tract (14.6%) then skin (10.8%). The majority of patients had stage I disease (61.8%). Pathological type was follicular grade I: 22.9%, grade II: 33.1%, and grade III: 43.9%. Treatment consisted of involved field radiation therapy in 72%, combined modality therapy in 22.3% and chemotherapy alone in 3.8%. The treatment changed over time with increased use of combined modality treatment (CMT) [1967–77: 10.5%, vs. 1989–99: 33%] mainly due to the adoption of CMT for follicular grade III lymphoma. Overall complete response rate (CR) to primary treatment was 93%; the CR rate for radiation alone was 97.3%. The cumulative incidence of relapse (RR) was 44% at 10 years. The RR at 10 years was higher for patients age >60 (62% vs. 49%; p =0.059) but did not vary according to stage, tumour bulk, gender or histologic grade. For extranodal lymphoma, the 10-year overall survival (OS) rate was 56% and the 10-year disease free survival (DFS) was 42% and was similar for major sites of presentation. Comparison of Stage I–II Nodal and Extra-nodal Follicular Lymphoma Nodal Follicular Lymphoma Extra-nodal Follicular Lymphoma 10 yr Overall Survival 61% 56% (p=0.97) 10 year Disease Free Survival 41% 42% (p=0.27) 10 yr Relapse Rate 50% 44% (p=0.11) In conclusion, a significant number of patients with localized FL present with extra-nodal disease, involving diverse sites. Patients with EN-FL were more likely to have follicular grade III histology. OS, DFS and RR were similar to nodal follicular lymphoma. These results suggest that the clinical management of stage I and II extra-nodal follicular lymphoma should be the same as for nodal, and that a significant proportion of patients have prolonged DFS with radiation-based therapy.

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COMPARISON IMMUNOCHEMOTHERAPY AND CHEMOTHERAPY EFFICASY IN FOLLICULAR LYMPHOMA

Russian Journal of Biotherapy ◽

10.17650/1726-9784-2017-16-1-24-31 ◽

2017 ◽

Vol 16 (1) ◽

pp. 24-31

Author(s):

N. A. Falaleeva

Keyword(s):

Overall Survival ◽

Regression Analysis ◽

Follicular Lymphoma ◽

Disease Free Survival ◽

Treatment Results ◽

Free Survival ◽

Cox Regression Analysis ◽

Multifactorial Analysis ◽

Hodgkin's Lymphomas ◽

Disease Free

Introduction. Immunochemotherapy is an obligate component in treatment of follicular lymphoma (FL). Monoclonal antibodies to CD20 antigen is the most well studied and frequently used drug. Chemotherapy department of Russian Cancer Research Center has a very good experience in FL treatment using rituximab. In the article we characterize and compare two methods of treatment of FL - polychemotherapy vs chemotherapy. Materials and methods. 286 patients with FL were included into analysis. In 125 (44 %) from 286 patients polychemotherapy was used as a first line of FL treatment. In 161 (56 %) patients rituximab was added to chemothrepy regimens. Analysis of survival and disease-free survival was done according to Kaplan-Meier. Analysis of treatment results has been done according to international criteria of treatment response in non-Hodgkin’s lymphomas. In statistical calculations SPSS program for Windows was used. Results. Responses to treatment were significantly better in immunochemotherapy group of patients, p = 0,002. In unifactorial analysis rituximab significantly improved both overall and disease-free sirvival. Taking in mind that groups of patients receiving chemotherapy and immunochemotherapy were not completely identical we performed multifactorial analysis, Coxs regression analysis. In that case (Cox regression analysis) significant advantages of immunochemotherapy were noted in improving disease-free survival in FL patients (р = 0,000); significant influence on overall survival was not noted (p = 0,44). Addition of rituximab did not improved overall and disease-free survival in a group (n = 88; 31 %) of refractory and early relapsing FL. Conclusion. Addition of rituximab to polychemotherapy in FL patients significantly improved treatment results. In multifactorial analysis immunochemotherapy was the most important prognostic factors of favourable prognosis of disease-free survival. In that analysis rituximab did not influenced on overall survival and on survival in refractory and early relapsing FL.

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Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyaa246 ◽

2021 ◽

Author(s):

Zhen Yang ◽

Hengjun Gao ◽

Jun Lu ◽

Zheyu Niu ◽

Huaqiang Zhu ◽

...

Keyword(s):

Overall Survival ◽

Postoperative Complications ◽

Propensity Score ◽

Propensity Score Matching ◽

Neuroendocrine Tumors ◽

Disease Free Survival ◽

Pancreatic Neuroendocrine Tumors ◽

Free Survival ◽

Estimated Blood Loss ◽

Disease Free

Abstract Objective There are limited data from retrospective studies on whether therapeutic outcomes after regular pancreatectomy are superior to those after enucleation in patients with small, peripheral and well-differentiated non-functional pancreatic neuroendocrine tumors. This study aimed to compare the short- and long-term outcomes of regular pancreatectomy and enucleation in patients with non-functional pancreatic neuroendocrine tumors. Methods Between January 2007 and July 2020, 227 patients with non-functional pancreatic neuroendocrine tumors who underwent either enucleation (n = 89) or regular pancreatectomy (n = 138) were included. Perioperative complications, disease-free survival, and overall survival probabilities were compared. Propensity score matching was performed to balance the baseline differences between the two groups. Results The median follow-up period was 60.76 months in the enucleation group and 43.29 months in the regular pancreatectomy group. In total, 34 paired patients were identified after propensity score matching. The average operative duration in the enucleation group was significantly shorter than that in the regular pancreatectomy group (147.94 ± 42.39 min versus 217.94 ± 74.60 min, P < 0.001), and the estimated blood loss was also significantly lesser (P < 0.001). The matched patients who underwent enucleation displayed a similar overall incidence of postoperative complications (P = 0.765), and a comparable length of hospital stay (11.12 ± 3.90 days versus 9.94 ± 2.62 days, P = 0.084) compared with those who underwent regular pancreatectomy. There were no statistically significant differences between the two groups in disease-free survival and overall survival after propensity score matching. Conclusion Enucleation in patients with non-functional pancreatic neuroendocrine tumors was associated with shorter operative time, lesser intraoperative bleeding, similar overall morbidity of postoperative complications, and comparable 5-year disease-free survival and overall survival when compared with regular pancreatectomy.

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The role of functional polymorphisms in oxidative stress-related genes on early-stage breast cancer survival

The International Journal of Biological Markers ◽

10.1177/17246008211011177 ◽

2021 ◽

pp. 172460082110111

Author(s):

Erika Korobeinikova ◽

Rasa Ugenskiene ◽

Ruta Insodaite ◽

Viktoras Rudzianskas ◽

Jurgita Gudaitiene ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Single Nucleotide Polymorphisms ◽

Early Stage ◽

Disease Free Survival ◽

Early Stage Breast Cancer ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Free Survival ◽

Disease Free

Background: Genetic variations in oxidative stress-related genes may alter the coded protein level and impact the pathogenesis of breast cancer. Methods: The current study investigated the associations of functional single nucleotide polymorphisms in the NFE2L2, HMOX1, P21, TXNRD2, and ATF3 genes with the early-stage breast cancer clinicopathological characteristics and disease-free survival, metastasis-free survival, and overall survival. A total of 202 Eastern European (Lithuanian) women with primary I–II stage breast cancer were involved. Genotyping of the single nucleotide polymorphisms was performed using TaqMan single nucleotide polymorphisms genotyping assays. Results: The CA+AA genotypes of P21 rs1801270 were significantly less frequent in patients with lymph node metastasis and larger tumor size ( P=0.041 and P=0.022, respectively). The TT genotype in ATF3 rs3125289 had significantly lower risk of estrogen receptor (ER), progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) positive status ( P=0.023, P=0.046, and P=0.040, respectively). In both, univariate and multivariate Cox analysis, TXNRD2 rs1139793 GG genotype vs. GA+AA was a negative prognostic factor for disease-free survival (multivariate hazard ratio (HR) 2.248; P=0.025) and overall survival (multivariate HR 2.248; P=0.029). The ATF3 rs11119982 CC genotype in the genotype model was a negative prognostic factor for disease-free survival (multivariate HR 5.878; P=0.006), metastasis-free survival (multivariate HR 4.759; P=0.018), and overall survival (multivariate HR 3.280; P=0.048). Conclusion: Our findings suggest that P21 rs1801270 is associated with lymph node metastasis and larger tumor size, and ATF3 rs3125289 is associated with ER, PR, and HER2 status. Two potential, novel, early-stage breast cancer survival biomarkers, TXNRD2 rs1139793 and ATF3 rs11119982, were detected. Further investigations are needed to confirm the results of the current study.

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Overexpression of NUAK1 is associated with disease-free survival and overall survival in patients with gastric cancer

Medical Oncology ◽

10.1007/s12032-014-0061-1 ◽

2014 ◽

Vol 31 (7) ◽

Cited By ~ 8

Author(s):

Xiao-tian Ye ◽

Ai-jun Guo ◽

Peng-fei Yin ◽

Xian-dong Cao ◽

Jia-cong Chang

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Disease Free Survival ◽

Free Survival ◽

Disease Free

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Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2021-002587 ◽

2021 ◽

pp. ijgc-2021-002587

Author(s):

Felix Boria ◽

Luis Chiva ◽

Vanna Zanagnolo ◽

Denis Querleu ◽

Nerea Martin-Calvo ◽

...

Keyword(s):

Cervical Cancer ◽

Overall Survival ◽

Quality Indicators ◽

Radical Hysterectomy ◽

Disease Free Survival ◽

Free Survival ◽

Operative Complications ◽

Early Cervical Cancer ◽

Disease Free

IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0–84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation.ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

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Neutrophil-lymphocyte index as prognostic factor for overall survival and disease-free survival in breast cancer patients

Revista de Senología y Patología Mamaria ◽

10.1016/j.senol.2020.06.004 ◽

2020 ◽

Vol 33 (4) ◽

pp. 137-144

Author(s):

Guillermo Peralta-Castillo ◽

Antonio Maffuz-Aziz ◽

Mariana Sierra-Murguía ◽

Sergio Rodriguez-Cuevas

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Prognostic Factor ◽

Cancer Patients ◽

Disease Free Survival ◽

Breast Cancer Patients ◽

Free Survival ◽

Disease Free

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Development of prognostic nomograms using institutional data for patients with triple-negative breast cancer

Future Oncology ◽

10.2217/fon-2021-0677 ◽

2021 ◽

Author(s):

Jie-Yu Zhou ◽

Kang-Kang Lu ◽

Wei-Da Fu ◽

Hao Shi ◽

Jun-Wei Gu ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Predictive Accuracy ◽

Area Under The Curve ◽

Disease Free Survival ◽

Discriminative Ability ◽

Free Survival ◽

Disease Free

Background: Triple-negative breast cancer (TNBC) is an aggressive disease. Nomograms can predict prognosis of patients with TNBC. Methods: A total of 745 eligible TNBC patients were recruited and randomly divided into training and validation groups. Endpoints were disease-free survival and overall survival. Concordance index, area under the curve and calibration curves were used to analyze the predictive accuracy and discriminative ability of nomograms. Results: Based on the training cohort, neutrophil-to-lymphocyte ratio, positive lymph nodes, tumor size and tumor-infiltrating lymphocytes were used to construct a nomogram for disease-free survival. In addition, age was added to the overall survival nomogram. Conclusion: The current study developed and validated well-calibrated nomograms for predicting disease-free survival and overall survival in patients with TNBC.

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Circulating Tumor Cells and Cancer Stem Cells: Clinical Implications in Nonmetastatic Breast Cancer

Breast Cancer Basic and Clinical Research ◽

10.4137/bcbcr.s40856 ◽

2016 ◽

Vol 10 ◽

pp. BCBCR.S40856 ◽

Cited By ~ 2

Author(s):

M. Sayed ◽

A.M. Zahran ◽

M.S.F. Hassan ◽

D.O. Mohamed

Keyword(s):

Breast Cancer ◽

Stem Cells ◽

Overall Survival ◽

Cancer Stem Cells ◽

Tumor Cells ◽

Circulating Tumor Cells ◽

Disease Free Survival ◽

Free Survival ◽

The Third ◽

Disease Free

Purpose Despite the therapeutic advances, disease recurrence remains an ever-present threat to the health and well-being of breast cancer survivors. Assessment of circulating tumor cells (CTCs) and cancer stem cells (CSCs) during and after treatment may be of value in refining treatment. Methods Three 5 mL blood samples were taken from each patient: the first, at diagnosis; the second, after completion of neoadjuvant anthracyclin-based chemotherapy; and the third, a month after surgery and completion of adjuvant radiotherapy. The absolute numbers of CTCs were identified as CD45-cytokeratin+ cells. CTCs per 5 mL of blood were determined by recording all events in the whole suspension. CSCs were identified as cytokeratin+CD44+CD24-/CD45- cells. The CSCs were expressed as a percentage of CTCs. Results Univariate analysis identified the measurements of baseline CTCs and CSCs, taken after chemotherapy and one month after the cessation of radiotherapy, as prognostic factors for both four-year disease-free survival and four-year overall survival. Multivariable analysis identified the third measurement of CSCs, taken one month after the completion of radiotherapy, as the only independent prognostic factor for the four-year disease-free survival (P < 0.002, hazard ratio [HR] = 1.231, 95% CI 1.077–1.407). The initial CTC measurement was the one factor that reached significance on multivariate analysis (P < 0.03, HR 1.969, 95% CI 1.092–3.551) for the four-year overall survival. Correlation was higher between CTC and CSC counts at diagnosis ( r = 0.654, P < 0.001) than after chemotherapy ( r = 0.317, P < 0.03), because of the more rapid decrease in the mean CTC count with chemotherapy. Conclusion The CTC count could be suitable as one of the measures for monitoring response to chemotherapy, while persistence of CSC after cessation of the treatment of nonmetastatic breast cancer, except hormonal therapy when indicated, may be a reason to consider additional therapy in the future. These findings need confirmation in larger randomized trials.

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