Evaluation of boost irradiation in patients with intermediate-risk stage III Wilms tumour with positive lymph nodes only: Results from the SIOP-WT-2001 Registry

10752 Background: Purpose of this study is to estimate impact of different prognostic factors and treatment procedures on overall survival of patients with stage III breast cancer, treated at the Institute of Radiotherapy and Oncology (IRO) in Skopje, Macedonia. Methods: Retrospective analysis of patient records of forty four patients with stage III breast was performed. Before admitting at IRO, each patient undergoes surgical treatment, which comprises of radical mastectomy with ipsilateral axillary dissection. Patients were classified according to TNM system of AJCC. All patients were divided in groups according to primary tumor size (unknown, less than 5 cm and more than 5 cm), positive lymph nodes (4–9 positive lymph nodes or more than 9 positive lymph nodes), adjuvant chemotherapy (CMF like, antracyclines based and taxanes based) and elective radiation of thoracic wall and regional lymph nodes (with or without radiation). Results: Statistical analysis of data was performed with Kaplan Meier estimation and log-rank test. In our series only tumor size has significant impact on overall survival of patient (p = 0.0134). Nodal status, type of adjuvant chemotherapy used and radiation has no significant impact on overall survival. Conclusions: Further analysis and longer follow up of this subgroup of patients is necessary to estimate value of different prognostic factors and treatment modalities. No significant financial relationships to disclose.

Download Full-text

Impact of lymph node evaluation on survival for small bowel adenocaricnoma: Analysis of the Surveillance, Epidemiology and End Results (SEER) database

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.4596 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 4596-4596

Author(s):

M. J. Overman ◽

C. Hu ◽

R. A. Wolff ◽

G. J. Chang

Keyword(s):

Small Bowel ◽

Lymph Nodes ◽

Stage I ◽

Stage Iii ◽

Small Bowel Adenocarcinoma ◽

Seer Database ◽

Chi Square ◽

Staging Systems ◽

The Impact ◽

Positive Lymph Nodes

4596 Background: Small bowel adenocarcinoma is a rare malignancy and is often associated with poor outcome. The impact that the number of positive and negative lymph nodes (LN) have upon survival following curative resection has not been studied. Methods: Patients aged 18–90 with adenocarcinoma of the small intestine diagnosed between 1988 and 2005 were identified from SEER data (ver. 2008). Disease-specific survival (DSS) outcomes were determined through 12/2005. Cox proportional hazards regression analyses were performed after adjusting for age, sex, race, T stage, grade, and primary site. Stage I-II cases were categorized by total LN examined (1–8, 9–12, and >12). Stage III cases were evaluated using cut-point analysis to determine the number of positive LN that predicted outcomes. This result was then compared to the predictive value of the ratio of positive to total LN (LNR) using the chi-square statistic. Results: 1,991 patients were identified in the SEER database. Survival among stage I/II patients (n=1,216) was dependent upon the total number of LN assessed. 5-year DSS for stage II patients was 66%, 82% (HR 0.52 95% CI .33-.84), and 88% (HR 0.38, 95% CI .23-.61) for 1–8, 9–12, >12 LN, respectively. The optimal cutpoint of positive LN for stage III disease (n=775) was <3 compard to ≥3 with 5 year DSS of 58% vs. 37% (HR 1.49, 95% CI 1.15–1.92, P=0.002), respectively. Among stage III patients, the LNR was even more predictive of survival than stratification by the number of positive lymph nodes as demonstrated by an improved chi-square statistic for the multivariate model (78.8 vs 63.1, P=0.0005). Conclusions: As noted in colon cancer, the total number of LN assessed has considerable influence upon survival in stage I, II and III small bowel adenocarcinoma. Stratifying stage III small bowel adenocarcinoma into those with <3 and ≥3 positive lymph nodes significantly improves prognostication for these patients and future staging systems should incorporate the number of positive nodes into nodal staging. The use of LNR may provide additional prognostic information. No significant financial relationships to disclose.

Download Full-text