Locoregional Therapy: Cancer Interventions with and Without Radionuclides

2020 ◽  
pp. 89-109
Author(s):  
Steven Yevich ◽  
Armeen Mahvash
Keyword(s):  
Locoregional Therapy

scholarly journals Interventional Oncology Approach to Hepatic Metastases

2020 ◽  
Vol 37 (05) ◽  
pp. 484-491
Author(s):  
Cathal O'Leary ◽  
Michael C. Soulen ◽  
Susan Shamimi-Noori
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Interventional Oncology ◽  
Hepatic Metastases ◽  
Locoregional Therapy ◽  
Treatment Modalities ◽  
Patient Specific ◽  
Curative Intent ◽  
Locoregional Therapies ◽  
Metastatic Liver

AbstractMetastatic liver disease is one of the major causes of cancer-related morbidity and mortality. Locoregional therapies offered by interventional oncologists alleviate cancer-related morbidity and in some cases improve survival. Locoregional therapies are often palliative in nature but occasionally can be used with curative intent. This review will discuss important factors to consider prior to palliative and curative intent treatment of metastatic liver disease with locoregional therapy. These factors include those specific to the tumor, liver function, liver reserve, differences between treatment modalities, and patient-specific considerations.

scholarly journals Acute appendicitis as an unusual cause of invasive ductal breast carcinoma metastasis

2020 ◽  
Vol 2020 (12) ◽  
Author(s):  
Vincent De Pauw ◽  
Julie Navez ◽  
Stephane Holbrechts ◽  
Jean Lemaitre
Keyword(s):  
Abdominal Pain ◽  
Breast Carcinoma ◽  
Acute Appendicitis ◽  
Ductal Carcinoma ◽  
Hormonal Treatment ◽  
Locoregional Therapy ◽  
Invasive Ductal Breast Carcinoma ◽  
Ductal Breast Carcinoma ◽  
History Of ◽  
Anticancer Treatment

Abstract Acute appendicitis is one of the most common causes of abdominal pain at the emergency room. In rare cases, it can be caused by malignancy, even metastatic lesions from extra-abdominal neoplasia. Herein, we report a case of a 64-year-old female with a history of invasive ductal carcinoma of the breast treated by chemotherapy, surgery, radiotherapy and hormonotherapy, relapsing several years later as a bone and a pleura metastasis successfully cured by locoregional therapy and hormonal treatment. She presented with acute abdominal pain without signs of peritonitis. Abdominal computed tomodensitometry showed sign of appendicitis. Therefore, laparoscopic exploration and appendicectomy was performed. During surgery, multiple peritoneal nodules were found and harvested. Pathology showed metastatic nodules of invasive ductal breast carcinoma, including in the appendicular wall, concluding to peritoneal carcinomatosis. The postoperative course was uneventful, but the patient died 1 year later after refusing anticancer treatment.

Evaluation of Hepatocellular Carcinoma Treatment Response After Locoregional Therapy

2021 ◽  
Vol 29 (3) ◽  
pp. 389-403
Author(s):  
Rony Kampalath ◽  
Karen Tran-Harding ◽  
Richard K.G. Do ◽  
Mishal Mendiratta-Lala ◽  
Vahid Yaghmai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Locoregional Therapy

Breast Cancer in Young Women

2019 ◽  
Author(s):  
Lisa A Newman
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Triple Negative ◽  
Breast Conserving Surgery ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Disease Stage ◽  
Locoregional Therapy ◽  
Key Words Breast

The perception that breast cancer in young women is a growing problem in the United States is based on the fact that young women represent a demographic that has enlarged substantially over the past few decades. Population-based data actually reveal relatively stable incidence rates for breast cancer among women in the premenopausal age range. Young women are more likely to be diagnosed with biologically aggressive phenotypes such as triple-negative and HER2/neu-overexpressing breast cancer. Outcomes are optimized by treatment plans focusing on disease stage and targeted to phenotype. Locoregional therapy for breast cancer in young women should be based on patient preferences and disease pattern (as in older patients); young women with breast cancer can be managed safely with breast-conserving surgery. This review contains 3 figures, 2 tables, and 50 references. Key Words: breast cancer, fertility, ovarian suppression, premenopausal, young women; triple negative breast cancer

Outcomes of isolated distant lymph node metastases in colorectal cancer.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 84-84
Author(s):  
Vinod Kalapurackal Mathai ◽  
Soe Yu Aung ◽  
Vanessa Wong ◽  
Catherine Dunn ◽  
Jeremy David Shapiro ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Locoregional Therapy ◽  
Curative Intent ◽  
Palliative Intent ◽  
Radical Treatment ◽  
Node Metastases ◽  
Systemic Therapies

84 Background: The optimal management of isolated distant lymph node metastases (IDLNM) in metastatic colorectal cancer (mCRC) is not clearly established. Small case series and prior data from the TRACC (Treatment of Recurrent and Advanced Colorectal Cancer) registry support the use of radical treatment with curative intent (local resection, chemo-radiation or stereotactic radiotherapy), which may lead to better outcomes in mCRC patients with IDLNM. Aims: This study investigates the clinical characteristics and outcomes of mCRC patients with IDLNM treated with systemic therapies plus locoregional therapy with curative intent versus systemic therapies with palliative intent. Methods: Clinical data were collected and reviewed from the TRACC registry, a prospective, comprehensive registry for mCRC from multiple tertiary hospitals across Australia from 01/07/2009 to 30/06/2020. Clinicopathological characteristics, treatment modalities and survival outcomes were analyzed in patients with IDLNM and compared to patients with other organ metastases. Fisher exact test was used for significance tests and Kaplan Meier curves for survival analyses. Results: Of 3408 mCRC patients with a median follow-up of 38.0 months, 93 (2.7%) were found to have IDLNM. Compared to mCRC with other organ metastases, patients with IDLNM were younger (mean age: 62.1 vs 65.6 years, p=0.0200), more likely to have metachronous disease (57.0% vs 38.9%, p=0.0005), be KRAS wild-type (74.6% vs 53.9%, p=0.0012) and BRAF mutant (12.9% vs 6.2%, p=0.0100). There was no overall survival difference between with IDLNM and those with other organ metastases (median OS 27.24 vs 25.92 months, p=0.2300). Twenty-four patients (25.8%) with IDLNM received treatment with curative intent, with a trend towards improved overall survival compared to those with other organ metastases treated with curative intent (73.5 vs 62.7 months, p=0.8200). Amongst mCRC patients with IDLNM, those who received treatment with curative intent had a significantly better overall survival than those treated with palliative intent (73.5months vs 23.2 months, p=0.0070). Conclusions: Our findings suggest that there are differences in the patterns of presentation of IDLNM and other organ metastases. Radical treatment with curative intent options should be considered for mCRC patients with IDLNM where appropriate.

Small Intestine: Neuroendocrine and Miscellaneous Tumors

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Small Intestine ◽  
Small Bowel ◽  
Surgical Intervention ◽  
Distant Metastases ◽  
Somatostatin Analogues ◽  
Locoregional Therapy ◽  
Small Bowel Tumors ◽  
Small Bowel Tumor ◽  
Key Words Carcinoid Tumor ◽  
A Site

Carcinoid tumors are the most common nonduodenal small bowel tumors. Although the diagnosis of any small bowel tumor is challenging, serum tumor markers and specialized imaging can aid in the diagnosis of carcinoid. Localized carcinoids are treated with surgical resection, whereas metastatic tumors are treated with somatostatin analogues, although liver-directed therapies can improve disease-related symptoms. In contrast, small bowel lymphomas are primarily treated with chemotherapy and sometimes radiation, although surgical intervention may be necessary for diagnosis and resection for palliation of symptoms. Furthermore, there are many benign etiologies of small bowel tumors, including adenoma, leiomyoma, and lipoma. The small bowel can also be a site of distant metastases for which surgical management is reserved for the treatment of complications such as bleeding, obstruction, perforation, or pain. This review contains 3 figures, 3 tables and 17 references.   Key words: carcinoid tumor, desmoid tumor, locoregional therapy, mesentery, neuroendocrine tumor, small bowel, small bowel lymphoma, somatostatin  

Efficacy of anti-PD(L)1 therapy for patients (Pts) with advanced urothelial carcinoma (aUC) with primary resistance to platinum-based chemotherapy (PC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16515-e16515
Author(s):  
Tyler F. Stewart ◽  
Nikhil V. Kotha ◽  
Hannah Elizabeth Dzimitrowicz ◽  
Dimitrios Makrakis ◽  
Ali Raza Khaki ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Cox Regression ◽  
Single Agent ◽  
Objective Response ◽  
Locoregional Therapy ◽  
High Risk Population ◽  
Primary Resistance ◽  
Best Response ◽  
Platinum Based Chemotherapy ◽  
Line Of Therapy

e16515 Background: PC remains standard first-line (1L) therapy for aUC. Approximately 15% of pts exhibit primary resistance (P-R) to PC and ∼25% progress by 4 months. PD(L)1 inhibitors yield objective response rates (ORR) of ∼20% in pts with progression after PC; however, it is unclear if this benefit extends to pts with P-R to PC. We examined the efficacy of anti-PD(L)1 in pts with aUC who experienced P-R to 1L PC. Methods: We conducted a multi-institutional retrospective study of pts with aUC who experienced P-R to PC and were subsequently treated with single-agent anti-PD(L)1 therapy. Eligibility included pts with unresectable or metastatic disease diagnosed after January 1, 2017. P-R to PC was defined as radiographic progression by RECISTv1.1 within 12 weeks from initiation of PC. Pts who developed metastatic disease while receiving (neo)adjuvant PC were eligible. Clinicopathologic variables were collected. ORR to anti-PD(L)1 was the primary endpoint. Secondary endpoints included time to treatment failure (TTF, defined as time from start of anti-PD(L)1 therapy to next line of therapy, hospice or death) and overall survival (OS) were estimated using Kaplan-Meier method. Multivariate (MV) analysis using Cox regression evaluating factors associated with OS was performed. Results: Overall, 42 pts were included: 74% male, median age 65 (28-90); 79% ever smokers; 21% mixed histology; 31% received definitive locoregional therapy. Metastatic sites at diagnosis of aUC included: lymph node only (19%), liver (29%), bone (38%) and lung (33%). At diagnosis of aUC, ECOG PS was 0 in 26%, 1 in 52% and unknown in 21%. 1L PC included cisplatin (76%) and carboplatin (24%) based regimens. Anti-PD(L)1 was received either 2L (98%) or 3L (2%). Overall, ORR to anti-PD(L)1 was 17%: CR (2%), PR (14%), SD (14%), PD (57%) and unknown (12%). Of the 24 pts with PD as best response to anti-PD(L)1, only 9 (38%) received subsequent therapy. Overall, median TTF was 4.2 mo (95% CI 2.8-6.7 mo) and median OS was 7.4 mo (95% CI 4.2-11.1 mo). ORR in patients with a PDL1 combined positive score ≥ 10% (n=6) was 0%: 1 SD and 5 PD. MV analysis for OS from start of anti-PD(L)1 is shown (Table). Conclusions: P-R to PC portends a poor prognosis in pts with aUC. While a subset of patients may respond to anti-PD(L)1 therapy, the majority of pts do not derive benefit. Alternative agents, e.g. antibody drug conjugates and FGFR inhibitors, and combination-therapy should be investigated for this high risk population.[Table: see text]

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