Tumor Progression/Recurrence: Multimodal CT/MR Follow-Up in Anaplastic Astrocytoma

Abstract Objectives To retrospectively compare long-term outcomes of first-line drug-eluting particle (DEB)- transarterial chemoembolization (TACE) and lipiodol-TACE, in patients with unresectable hepatocellular (HCC). Methods We retrospectively reviewed our database to identify adult patients with treatment-naïve unresectable HCC, who underwent TACE from 2006 to 2013. Patients were excluded in the absence of complete medical records relative to first TACE, 1-month follow-up, and/or sufficient follow-up data. Periprocedural complications, duration of hospitalization, 1-month tumor response by mRECIST, time to tumor progression (TTP) and target tumor progression (TTTP), and overall survival (OS) were evaluated. Results Out of an initial series of 656 patients, 329 patients were excluded for unavailability of sufficient baseline and/or follow-up data. The remaining 327 patients underwent either lipiodol-TACE (n = 160) or DEB-TACE (n = 167). Patients treated with lipiodol-TACE had a significantly higher tumor burden. By propensity score, patients were matched according to baseline differences (BCLC stage, uninodular or multinodular HCC, and unilobar or bilobar HCC), resulting in 101 patients in each treatment group. Lipiodol-TACE was associated with a significantly higher incidence of adverse events (p = 0.03), and longer hospitalization (mean, 2.5 days vs 1.9 days; p = 0.03), while tumor response, TTP, and OS were comparable. In patients achieving 1-month complete response (CR) of target tumor, TTTP was significantly (p = 0.009) longer after DEB-TACE compared to lipiodol-TACE (median, 835 vs 353 days), resulting in a lower number of re-treatments during the entire follow-up (0.75 vs 1.6, p = 0.01). Conclusion Compared to lipiodol-TACE, DEB-TACE offers higher tolerability, reduced hospitalization, and more durable target tumor response after CR. Key Points • Compared to lipiodol-TACE, DEB-TACE is better tolerated and has reduced side effects, which translates into shorter hospitalization. • When complete radiological response according to the mRECIST is obtained 1 month after the procedure, DEB-TACE offers a more durable local tumor control compared to lipiodol-TACE. • In these patients, the longer duration of response after DEB-TACE translates into a lower number of re-interventions.

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Tumor Progression: Morphofunctional MR Follow-Up in Glioblastoma Multiforme

Imaging Gliomas After Treatment ◽

10.1007/978-3-030-31210-7_45 ◽

2019 ◽

pp. 215-219

Author(s):

Gabriele Polonara ◽

Lorenzo Alvaro ◽

Luana Regnicolo

Keyword(s):

Glioblastoma Multiforme ◽

Tumor Progression

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Tumor Progression: Morphofunctional MR Follow-Up in Glioblastoma Multiforme

Imaging Gliomas After Treatment ◽

10.1007/978-3-030-31210-7_44 ◽

2019 ◽

pp. 209-214

Author(s):

Gabriele Polonara ◽

Lorenzo Alvaro ◽

Francesco Sessa

Keyword(s):

Glioblastoma Multiforme ◽

Tumor Progression

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Stable Disease: Multimodal CT/MR Follow-Up in Glioblastoma Multiforme

Imaging Gliomas After Treatment ◽

10.1007/978-3-030-31210-7_28 ◽

2019 ◽

pp. 141-143

Author(s):

Alessandro Stecco ◽

Sara Zizzari ◽

Mariangela Lombardi ◽

Gerardo Di Nardo ◽

Francesco Fabbiano ◽

...

Keyword(s):

Glioblastoma Multiforme ◽

Stable Disease ◽

Multimodal Ct

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QOLP-08. THE LANDSCAPE OF EPILEPSY ASSOCIATED WITH DIFFUSELY INFILTRATIVE GLIOMAS

Neuro-Oncology ◽

10.1093/neuonc/noab196.729 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi184-vi184

Author(s):

Michael Drumm ◽

Jessica Templer ◽

Omar Bushara ◽

Dusten Unruh ◽

Jordain Walshon ◽

...

Keyword(s):

Tumor Progression ◽

Similar Pattern ◽

Cox Regression ◽

Idh Mutation ◽

Prior Work ◽

Regression Analyses ◽

Course Of Disease ◽

Kaplan Meier ◽

Extent Of Surgical Resection

Abstract Seizures are among the most prevalent co-morbidities associated with glioma, and pose a serious threat to patients. Our prior work showed that IDH mutation (IDHmut) was associated with much greater seizure frequency at the time of initial glioma diagnosis. However, less is known about the variables that contribute to seizure risk throughout the course of disease. We therefore collected data from 247 patients with grade 2–4 glioma, and determined seizure risk using Kaplan-Meier survival probabilities and multivariable cox regression analyses. Median follow-up of IDH wildtype (IDHwt) and IDHmut glioma patients was 15 months and 36 months, respectively. Incidence of pre-operative seizures for IDHwt and IDHmut patients was 75/168 (45%) and 60/79 (76%), and incidence of post-operative seizures was 70/168 (42%) and 43/79 (54%), respectively. Patients who had a pre-operative seizure had a shorter time to their first post-operative seizure than patients who never had a pre-operative seizure in both IDHwt (P< 0.0001) and IDHmut (P= 0.039) cohorts. Among IDHmut glioma patients, those with subtotal resections developed post-operative seizures faster (median time to first seizure= 9.9 months) than those with gross-total resections (median not reached) (P= 0.0005), but a similar pattern was not observed in IDHwt glioma patients (P= 0.20). Those with IDHmut astrocytomas more quickly developed post-operative seizures (median= 11.1 months), compared to those with IDHwt astrocytomas (24.9 months) or IDHmut oligodendrogliomas (median not reached) (P= 0.033). Tumor progression closely followed post-operative seizures in patients with IDHwt gliomas when either their first post-operative seizure occurred longer than 6 months following resection, or when their post-operative seizures worsened in quality. These data suggest the best predictors of post-operative seizures are as follows: the presence of pre-operative seizures; extent of surgical resection; IDHmut status. These data will help clinicians better manage glioma patients by identifying those at greatest risk of seizures.

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Testicular adrenal rest tumors in patients with congenital adrenal hyperplasia: 6 years of follow-up

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2018-0512 ◽

2019 ◽

Vol 32 (5) ◽

pp. 519-526 ◽

Cited By ~ 1

Author(s):

Gabriela Werneck ◽

Enda M.R. Rodrigues ◽

Rafael M. Mantovani ◽

Jovita S.S. Lane ◽

Ivani N. Silva

Keyword(s):

Congenital Adrenal Hyperplasia ◽

Tumor Progression ◽

Repeated Measures ◽

Laboratory Data ◽

Hormonal Control ◽

Adrenal Hyperplasia ◽

Testicular Adrenal Rest Tumors ◽

Adrenal Rest ◽

Testicular Adrenal Rest

AbstractBackgroundTesticular adrenal rest tumors (TARTs) leading to primary gonadal failure are the main etiology of infertility in congenital adrenal hyperplasia (CAH). We aimed at identifying the evolution of TART and related findings in young CAH patients.MethodsTwelve male patients (3–23 years old) with 21-hydroxilase deficiency (11 with classic salt-wasting form) were included. Testicular ultrasonography (US) was performed in two moments, by a single blinded specialist in pediatric diagnostic imaging. Tumor progression was classified according to the Response Evaluation Criteria in Solid Tumors (RECIST). The clinical and laboratory data were retrieved from medical records. Serum 17-OH-progesterone (17OHP) and androstenedione concentrations were evaluated during the whole period of follow-up, from the CAH diagnosis. A logistic regression model with repeated measures was developed for the analysis.ResultsThe prevalence of TART was 41.6% (n = 5) in the initial US evaluation and 66.6% (n = 8) after 6 years of follow-up. Tumor progression was detected in 4 of the 5 patients, and 1 presented with a stable tumor. Three patients presented with new tumors in the second evaluation. Most of the patients (n = 11) were pubertal, including a 7-year-old child with TART who presented with central precocious puberty. At regression analysis, it was observed that an inadequate hormonal control led to a 16 times greater chance of a patient to present with TART (OR = 16.08; confidence interval [CI] 95% = 2.38–108.81; p = 0.004).ConclusionsWe found a high prevalence of progressive TART in young pubertal subjects. US testicular screening should help in improving therapeutic optimization in CAH patients to reduce future impairment in fertility.

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Clinical Efficacy of Stent in Patients with Cervical Esophageal and/or Hypopharyngeal Stenosis after Total Laryngectomy

Otolaryngology ◽

10.1177/0194599820907893 ◽

2020 ◽

Vol 162 (5) ◽

pp. 776-779

Author(s):

GuoRui Zhao ◽

JianZhuang Ren ◽

XuHua Duan ◽

WenGuang Zhang ◽

FangZheng Li ◽

...

Keyword(s):

Tumor Progression ◽

Effective Treatment ◽

Success Rate ◽

Stent Implantation ◽

Total Laryngectomy ◽

Case Series ◽

Esophageal Stenosis ◽

Esophageal Stent ◽

Semi Solid

We retrospectively analyzed 17 patients with esophageal stent who underwent cervical esophageal and/or hypopharyngeal stenosis after total laryngectomy (TL) from January 2014 to January 2018. The success rate of stent implantation was 100%. Dysphagia in 16 patients improved to class 0 or 1 (16/17, 94.12%) after stent implantation and in 1 patient was improved to class 2 (1/17, 5.88%). Two patients died of tumor progression at 7 months and 11 months after stent implantation, respectively, but both could eat semi-solid/solid food before death. Dysphagia was resolved in the remaining 15 patients, and there was no recurrence of dysphagia including feeding obstruction during follow-up. Therefore, this case series concludes that the esophageal stent position after TL can be much higher than that of patients with normal pharyngeal structures. Esophageal stent implantation is a feasible and effective treatment for patients with laryngopharyngeal/esophageal stenosis following TL.

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Brachytherapy of recurrent malignant brain tumors with removable high-activity iodine-125 sources

Journal of Neurosurgery ◽

10.3171/jns.1984.60.1.0061 ◽

1984 ◽

Vol 60 (1) ◽

pp. 61-68 ◽

Cited By ~ 154

Author(s):

Philip H. Gutin ◽

Theodore L. Phillips ◽

William M. Wara ◽

Steven A. Leibel ◽

Yoshio Hosobuchi ◽

...

Keyword(s):

Brain Tumors ◽

High Activity ◽

Anaplastic Astrocytoma ◽

Tumor Regression ◽

Chemotherapeutic Agents ◽

Content Type ◽

Iodine 125 ◽

Initial Implantation ◽

Fine Print

✓ Thirty-seven patients harboring recurrent malignant primary or metastatic brain tumors were treated by 40 implantations of high-activity iodine-125 (125I) sources. All patients had been treated with irradiation and most had been treated with chemotherapeutic agents, primarily nitrosoureas. Implantations were performed using computerized tomography (CT)-directed stereotaxy; 125I sources were held in one or more afterloaded catheters that were removed after the desired dose (minimum tumor dose of 3000 to 12,000 rads) had been delivered. Patients were followed with sequential neurological examinations and CT scans. Results of 34 implantation procedures were evaluable: 18 produced documented tumor regression (response) for 4 to 13+ months; five, performed in deteriorating patients, resulted in disease stability for 4 to 12 months. The overall response rate was 68%. In 11 patients, implantation did not halt clinical deterioration. At exploratory craniotomy 5 to 12 months after implantation, focal radiation necrosis was documented in two patients whose tumor had responded initially and then progressed, and in three patients whose disease had progressed initially (four glioblastomas, one anaplastic astrocytoma); histologically identifiable tumor was documented in two of these patients. All improved after resection of the focal necrotic mass and are still alive 10, 15, 19, 24, and 25 months after the initial implantation procedure; only one patient has evidence of tumor regrowth. The median follow-up period after implantation for the malignant glioma (anaplastic astrocytoma and glioblastoma multiforme) group is 9 months, with 48% of patients still surviving. While direct comparison with the results of chemotherapy is difficult, results obtained in this patient group with interstitial brachytherapy are probably superior to results obtained with chemotherapy.

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