Multimodal therapy for synchronous bone oligometastatic NSCLC: The role of surgery

2021 ◽  
Author(s):  
Maria Teresa Congedo ◽  
Dania Nachira ◽  
Luca Bertolaccini ◽  
Marco Chiappetta ◽  
Edoardo Zanfrini ◽  
...  
Keyword(s):  
Multimodal Therapy

scholarly journals The role of perioperative radiotherapy in gastric cancer

2012 ◽  
Vol 6 (2) ◽  
pp. 23 ◽  
Author(s):  
Thales Paulo Batista ◽  
Lucas Marque De Mendonça ◽  
Ana Luiza Fassizoli-Fonte
Keyword(s):  
Gastric Cancer ◽  
Therapeutic Strategy ◽  
Multimodal Therapy ◽  
Early Stage ◽  
Locally Advanced ◽  
Early Stage Disease ◽  
Stage Disease ◽  
Locally Advanced Tumors ◽  
Related Mortality

Gastric cancer is one of the most common neoplasms and a main cause of cancer-related mortality worldwide. Surgery remains the mainstay for cure and is considered for all patients with potentially curable disease. However, despite the fact that surgery alone usually leads to favorable outcomes in early stage disease, late diagnosis usually means a poor prognosis. In these settings, multimodal therapy has become the established treatment for locally advanced tumors, while the high risk of locoregional relapse has favored the inclusion of radiotherapy in the comprehensive therapeutic strategy. We provide a critical, non-systematic review of gastric cancer and discuss the role of perioperative radiation therapy in its treatment.

Reassessing the Role of Cytoreductive Nephrectomy for Metastatic Renal Cell Carcinoma in 2019

2019 ◽  
pp. 276-283 ◽  
Author(s):  
Sarah P. Psutka ◽  
Steven L. Chang ◽  
David Cahn ◽  
Robert G. Uzzo ◽  
Bradley A. McGregor
Keyword(s):  
Multimodal Therapy ◽  
Systemic Treatment ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Therapeutic Approaches ◽  
Cytoreductive Nephrectomy ◽  
Free Survival ◽  
Surgical Interventions ◽  
Prospective Trials

Cytoreductive nephrectomy (CRN) has long been considered a standard of care in the management of mRCC. This is largely based on randomized trials in the era of interferon (IFN) that demonstrate an improvement in overall survival (OS). With the advent of targeted therapies, the role of CRN has been questioned and multiple retrospective analyses have shown a potential benefit, particularly in intermediate-risk disease. Two long-awaited prospective trials have been published in the past year that explore the role of CRN. The CARMENA trial randomly assigned patients to therapy with sunitinib with or without CRN, showing noninferiority of sunitinib alone versus sunitinib plus CRN with a median OS of 18.4 months versus 13.9 months, respectively (hazard ratio [HR] for mortality, 0.89; 95% CI, 0.71–1.1). The SURTIME trial randomly assigned patients to immediate CRN followed by sunitinib versus a deferred CRN after three cycles of sunitinib. Analysis is limited by early termination as a result of low accrual. Although there was no difference in progression-free survival (PFS), median OS was significantly improved among patients in the deferred CRN arm (HR, 0.57; 95% CI, 0.34–0.95; p = .032). Early systemic therapy is paramount, but there are patients who may derive benefit by incorporating the removal of the primary tumor in their multimodal therapy, perhaps in a deferred setting. As systemic treatment paradigms shift and immunotherapy again moves to the frontline setting with the potential for novel therapeutic approaches, the role of CRN will continue to evolve with the potential to offer surgical interventions with minimal, if any, delay in systemic treatment.

scholarly journals Role of systemic immune-inflammation index in patients treated with salvage radical prostatectomy

2021 ◽  
Author(s):  
Pawel Rajwa ◽  
Victor M. Schuettfort ◽  
Fahad Quhal ◽  
Keiichiro Mori ◽  
Satoshi Katayama ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Prognostic Value ◽  
Multimodal Therapy ◽  
Cox Regression ◽  
Cancer Specific Survival ◽  
Node Metastases ◽  
Immune Inflammation ◽  
Salvage Radical Prostatectomy ◽  
Predictive And Prognostic Value

Abstract Purpose To examine the predictive and prognostic value of preoperative Systemic Immune-inflammation Index (SII) in patients with radio-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP). Materials and methods This multicenter retrospective study included 214 patients with radio-recurrent PCa, treated with SRP between 2007 and 2015. SII was measured preoperatively (neutrophils × platelets/lymphocytes) and the cohort was stratified using optimal cut-off. Uni- and multivariable logistic and Cox regression analyses were performed to evaluate the predictive and prognostic value of SII as a preoperative biomarker. Results A total of 81 patients had high preoperative SII (≥ 730). On multivariable logistic regression modeling, high SII was predictive for lymph node metastases (OR 3.32, 95% CI 1.45–7.90, p = 0.005), and non-organ confined disease (OR 2.55, 95% CI 1.33–4.97, p = 0.005). In preoperative regression analysis, high preoperative SII was an independent prognostic factor for cancer-specific survival (CSS; HR 10.7, 95% CI 1.12–103, p = 0.039) and overall survival (OS; HR 8.57, 95% CI 2.70–27.2, p < 0.001). Similarly, in postoperative multivariable models, SII was associated with worse CSS (HR 22.11, 95% CI 1.23–398.12, p = 0.036) and OS (HR 5.98, 95% CI 1.67–21.44, p = 0.006). Notably, the addition of SII to preoperative reference models improved the C-index for the prognosis of CSS (89.5 vs. 80.5) and OS (85.1 vs 77.1). Conclusions In radio-recurrent PCa patients, high SII was associated with adverse pathological features at SRP and survival after SRP. Preoperative SII could help identify patients who might benefit from novel imaging modalities, multimodal therapy or a closer posttreatment surveillance.

scholarly journals Esthesioneuroblastoma: A case with prolonged disease control

2016 ◽  
Vol 2 (5) ◽  
pp. 284
Author(s):  
Andreia Coelho ◽  
Lúcia Águas ◽  
Lígia Osório ◽  
Paulo Linhares
Keyword(s):  
Disease Control ◽  
Multimodal Therapy ◽  
Retrospective Studies ◽  
Case Reports ◽  
Optimal Treatment ◽  
Controversial Issues ◽  
Rare Tumor ◽  
Single Treatment ◽  
Actual Treatment

<p>Esthesioneuroblastoma, a rare tumor arising from the olfactory vault, varies from being indolent to extremely aggressive. Owing to its rarity, the diagnosis, staging, and treatment of the disease are not well defined. According to a number of small observational retrospective studies and case reports, the disease’s actual treatment involves surgery, radiotherapy, and/or chemotherapy (either as a single treatment or used in combination), depending on the disease’s staging. Optimal treatment has not been standardized, particularly regarding the role of chemotherapy. We describe a case of advanced esthesioneuroblastoma with prolonged disease control, subjected to a multimodal therapy with surgery, radiotherapy, and chemotherapy, illustrating the benefits of this approach in managing a patient with esthesioneuroblastoma. Herein, we analyze the most important and controversial issues of this type of neoplasia.</p>

The Role of Multimodal Therapy in Patients With Local and Regional Neuroblastoma

1984 ◽  
Vol 132 (2) ◽  
pp. 418-418
Author(s):  
A.E. Evans ◽  
G.J. D’Angio ◽  
C.E. Koop
Keyword(s):  
Multimodal Therapy

Radical prostatectomy as a component of multimodal therapy for highly selected M1 prostate cancer patients.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 251-251
Author(s):  
Matthew O'Shaughnessy ◽  
James Andrew Eastham ◽  
Bernard H. Bochner ◽  
Vincent Paul Laudone ◽  
Brett Stewart Carver ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Disease Progression ◽  
Lymph Node Dissection ◽  
Systemic Therapy ◽  
Multimodal Therapy ◽  
Node Dissection ◽  
Metastatic Burden

251 Background: Men who present with limited metastasis at the time of prostate cancer (PCa) diagnosis are typically managed with systemic therapy alone and the primary site of disease is not addressed. Systemic therapy with recently approved agents has been shown to improve survival in men with metastatic PCa; however the role of local therapy remains untested. Here, we examine the role of definitive surgical treatment of the primary tumor in a multimodal approach to highly selected patients with oligometastatic disease to maximize local and systemic cancer control. Methods: 20 patients with limited metastatic burden underwent RP as a component of multimodal therapy. Baseline characteristics, details of management, surgical outcomes, and disease progression defined as initiation of chemotherapy, new metastasis, or reinitiation of ADT were characterized. Results: Median age at RP was 61 years. Metastatic burden was assessed with whole body imaging; 17 of 20 patients had bone metastases (mets) (median 1, IQR 1,3) and 7 of 20 patients had retroperitoneal node mets. No patients had visceral mets. All patients had RP and pelvic lymph node dissection; 4 patients also had retroperitoneal lymph node dissection. There was one grade III surgical complication. 75% of patients reported continence within 12 months of RP. Patients received RT to bone (n=10), bone and pelvis (n=4), or no RT (n=6). Median neoadjuvant ADT was 4 months (IQR 3, 5) for all patients and neoadjuvant + adjuvant ADT was 9 months (IQR 6, 10) in 11 patients who discontinued ADT. At median follow-up of 19 months (IQR 10, 33) since RP, 12-month PFS was 65% (95%CI 35, 84). Among the 11 patients who discontinued ADT, 5 were non-castrate and had no evidence of disease progression. 4 patients had continuous ADT due to disease progression. There were no local recurrences after surgery. Conclusions: Multimodal therapy that includes RP is feasible and well-tolerated with acceptable low rate of surgical complications and good return of urinary continence. ADT was discontinued in a limited number of patients without signs of disease progression at short-term follow-up. Further evaluation of this therapeutic strategy should be considered in a prospective clinical trial.

The Role of Metastasectomy and Immunochemotherapy in Multimodal Therapy for Metastatic Renal Cell Carcinoma

2008 ◽  
Vol 49 (1) ◽  
pp. 1 ◽  
Author(s):  
Sang-Wohn Chon ◽  
Seung Hyun Jeon ◽  
Sung-Goo Chang
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Metastatic Renal Cell Carcinoma ◽  
Renal Cell ◽  
Multimodal Therapy

The role of multimodal therapy in the treatment of hepatocellular carcinoma

Cancer ◽  
1994 ◽  
Vol 73 (11) ◽  
pp. 2669-2670 ◽  
Author(s):  
Douglas G. Farmer ◽  
Ronald W. Busuttil
Keyword(s):  
Hepatocellular Carcinoma ◽  
Multimodal Therapy

The management of colorectal liver metastases: Expanding the role of hepatic resection in the age of multimodal therapy

2009 ◽  
Vol 72 (1) ◽  
pp. 65-75 ◽  
Author(s):  
A. Chiappa ◽  
M. Makuuchi ◽  
N.J. Lygidakis ◽  
A.P. Zbar ◽  
G. Chong ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Hepatic Resection ◽  
Colorectal Liver Metastases ◽  
Multimodal Therapy

scholarly journals MicroRNA in Glioblastoma: An Overview

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Barbara Banelli ◽  
Alessandra Forlani ◽  
Giorgio Allemanni ◽  
Anna Morabito ◽  
Maria Pia Pistillo ◽  
...  
Keyword(s):  
Noncoding Rna ◽  
Multimodal Therapy ◽  
Epigenetic Factors ◽  
Predictors Of Outcome ◽  
Regulate Gene Expression ◽  
Rna Molecules ◽  
Complementary Sequences ◽  
Epigenetic Machinery ◽  
Potential Applications

Glioblastoma is the most aggressive brain tumor and, even with the current multimodal therapy, is an invariably lethal cancer with a life expectancy that depends on the tumor subtype but, even in the most favorable cases, rarely exceeds 2 years. Epigenetic factors play an important role in gliomagenesis, are strong predictors of outcome, and are important determinants for the resistance to radio- and chemotherapy. The latest addition to the epigenetic machinery is the noncoding RNA (ncRNA), that is, RNA molecules that are not translated into a protein and that exert their function by base pairing with other nucleic acids in a reversible and nonmutational mode. MicroRNAs (miRNA) are a class of ncRNA of about 22 bp that regulate gene expression by binding to complementary sequences in the mRNA and silence its translation into proteins. MicroRNAs reversibly regulate transcription through nonmutational mechanisms; accordingly, they can be considered as epigenetic effectors. In this review, we will discuss the role of miRNA in glioma focusing on their role in drug resistance and on their potential applications in the therapy of this tumor.

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