Treatment Options for Peritoneal Tumor Recurrence

Retroperitoneal tumors, once considered uncommon, have been reported in the last years in such numbers that they cannot be considered anymore a rare condition. Tumor recurrence following surgical excision is quite common and a tumor that was considered originally as benign in many cases can recur as a malignant tumor. The purpose of this paper is to underline the difficulties in terms of establishing a correct diagnosis and a proper therapeutic protocol when facing a retroperitoneal mass of unknown origin, as well as to present the available data regarding prognosis, treatment options and tumor recurrence. Retroperitoneal tumors can be classified as benign or malignant; solid, cystic or both; single or multiple, and of varied histological types. A high percentage of patients with retroperitoneal tumors are discovered in advanced stages, usually seeking medical help for symptoms related to nearby organ compression/invasion. This pathology requires a prompt and adequate multidisciplinary management, in order to achieve disease control and to reduce the recurrence rate. Complete surgical resection is the potential curative treatment for retroperitoneal tumors and it is best managed in high-volume centers, by a multidisciplinary team. Complete oncological tumor resection and tumor grade remain the most important predictors for local recurrence and disease-specific survival. Further research is required in order to define the role of radiotherapy, as well as to discover new biological therapies that target various molecular pathways involved in retroperitoneal cancers.

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Long-Term Neurological and Neurosurgical Outcomes After Surgery Only in Children with Low-Grade Brain Tumors

Journal of Neurosurgery Pediatrics ◽

10.3171/ped/2008/1/4/paper16 ◽

2008 ◽

Vol 1 (4) ◽

pp. A354-A355 ◽

Cited By ~ 1

Author(s):

Liliana Goumnerova ◽

Dan Drzymalski ◽

Mark Kieran ◽

Scott Pomeroy ◽

R. Michael Scott ◽

...

Keyword(s):

Brain Tumors ◽

Tumor Recurrence ◽

Treatment Options ◽

Low Grade ◽

Neurological Sequelae ◽

Institutional Review ◽

Initial Surgery ◽

Extent Of Surgery

Introduction Brain tumors are the most common solid tumors of childhood. As treatment options such as surgery, chemotherapy, and radiotherapy improve, and affected children's survival increases, the focus has shifted toward understanding long-term outcomes. We hypothesized that tumor recurrence and long-term neurological outcomes can be correlated with age at diagnosis, site and size of tumor, histology, extent of surgery, and presence or absence of hydrocephalus. Thus, the aims of this study were to determine predictive factors for tumor recurrence and long-term morbidity in children who undergo surgery only for low-grade brain tumors. The study was approved by the institutional review board. Methods Medical records were reviewed for each child and information collected regarding sex, age at surgery, histology site, size of tumor, presence of hydrocephalus, extent of surgery, and date of tumor recurrence. Preoperative, postoperative, and last follow-up neurological exams were reviewed and patients were evaluated for ataxia, hemiparesis, impaired vision, cranial nerve deficits, presence of seizures or headaches, dysmetria, nystagmus, and depression. Results Forty-nine children (29 male, 20 female) ranging from 2.2 to 16.9 years of age at first operation were included; 31% had recurrence/progression. This was significantly correlated with tumors that were subtotally resected (p = 0.002) located in the supratentorial region (p = 0.017) and not astrocytoma or craniopharyngioma (p = 0.041). At last follow-up, 42% of children had no neurological sequelae, 53% had mild neurological sequelae, and 5% had moderate neurological sequelae. No children had experienced depression before or immediately after their initial surgery. However, 6 patients (16% of 38 patients) had depression at long-term follow-up. Conclusion These data indicate that we may be able to predict recurrence/progression of low-grade brain tumors based on extent of surgery location and histology. We also see that more than half of these children will experience a variety of surgical and neurological burdens throughout their lives.

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Cholangiocarcinomas: A study of patient and disease characteristics and the potential use of tumor molecular profiling.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.4_suppl.270 ◽

2017 ◽

Vol 35 (4_suppl) ◽

pp. 270-270

Author(s):

Petra Prins ◽

Jeff Riskin ◽

Karina Charipova ◽

Michelle Dea ◽

Ben Furlong ◽

...

Keyword(s):

Tumor Recurrence ◽

Early Stage ◽

Treatment Options ◽

Survival Rates ◽

Molecular Profiling ◽

Detection Methods ◽

Disease Stage ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Clinical Records

270 Background: There are approximately 12,000 new cases of cholangiocarcinoma in the US annually and, as for most GI cancers, the incidence is rising each year. Unfortunately treatment options are limited and surgery is only a possible curative option if the disease is diagnosed at an early stage (5 yr. survival, 20-30 %). Molecular profiling may play a crucial role in the discovery of new (early) biomarkers and treatment options for cholangiocarcinoma. Methods: Clinical records 104 cholangiocarcinoma patients (pts) at the Lombardi Comprehensive Cancer Center were reviewed. Only pts that had received surgical therapy were eligible for study. Variables collected included pt demographics, initial disease stage, tumor differentiation, and clinical (pre-existing) conditions. Tumor recurrence and pt survival from time of surgery was evaluated. Molecular profiling data was analyzed when present. Results: In our cohort we identified 41 pts with cholangiocarcinoma who underwent surgery at LCCC. Clinical data was as follows: 20 males and 21 females. Average BMI at diagnosis was 25.8 kg/m2. Twelve pts had extrahepatic cancer, 20 intrahepatic, 5 gallbladder, 3 Hilar and 1 combined hepatocellular and bile duct cancer. Most tumors were stage T2 or T3 (61%), and were moderately (71%) to poorly differentiated (22%). Vascular or perineural invasion was identified in 46% of cases. Thirty-four percent and 37% had diabetes and hyperlipidemia, respectively. Tumor recurrence had occurred in 13 cases (32%), and median time to recurrence was 8.5 months (m). Median OS from surgery was 10.5 m (to date, 4 pts > 36 m). Molecular profiles were obtained in 5 cases. Most frequently observed genetic mutations were related to tumor suppression (PTEN, 4 cases) and DNA synthesis, repair, and regulation (TOP2A [3x], TOPO1 [2x], TP53 [2x]). Conclusions: Five-year survival rates for cholangiocarcinomas are low. To improve outcomes, improved early detection methods and better treatment options are urgently needed. Increasing the frequency of molecular profiling can result in new prognostic biomarkers as well as the potential for new treatment ideas.

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How to live with a meningioma: experiences, symptoms, and challenges reported by patients

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa086 ◽

2020 ◽

Vol 2 (1) ◽

Cited By ~ 1

Author(s):

Farshad Nassiri ◽

Suganth Suppiah ◽

Justin Z Wang ◽

Jetan H Badhiwala ◽

Kyle Juraschka ◽

...

Keyword(s):

Tumor Recurrence ◽

Cognitive Impairments ◽

Treatment Options ◽

Initial Diagnosis ◽

The Internet ◽

Insufficient Information ◽

Disease Experience ◽

Tumor Association ◽

Self Administered Questionnaire

Abstract Background We aimed to explore gaps in the care of meningioma patients that could improve quality of care by better understanding symptoms experienced by patients at various stages of treatment, and afterwards. Methods A novel 19-item self-administered questionnaire was provided for patients with meningiomas to complete by the American Brain Tumor Association (ABTA) over a 3-month period. Results A total of 1852 unique respondents were included. Nearly one-third of all respondents felt they received insufficient information about meningiomas at initial diagnosis (N = 607, 32.9%) and 28.8% (N = 530) believed they received insufficient information about treatment options. In fact, 34.5% of respondents received the majority of their information from the internet and nonhealthcare professionals. The most common concerns after initial diagnosis were risks associated with surgery and/or treatment (36.5%) followed by how the tumor would impact daily life (25%) and the risk of tumor recurrence (12.4%). Respondents indicated that a list of resources available for patients with meningiomas (N = 597, 32.3%) would have been most beneficial in regards to their disease experience after their initial diagnosis. Moreover, we found that a substantial proportion of patients continued to report symptoms long after treatment, with fatigue being the most common compared to before treatment (38.2% vs. 57.7%, χ2 = 128, P < .001). Conclusions Patients with meningiomas exhibit symptoms that continue well after treatment with fatigue and cognitive impairments as the most bothersome. Moreover, patients report key communication gaps that can be addressed to improve their disease experience and care.

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The Collaborative Network Approach: a model for advancing patient-centric research for Castleman disease and other rare diseases

Emerging Topics in Life Sciences ◽

10.1042/etls20180178 ◽

2019 ◽

Vol 3 (1) ◽

pp. 97-105

Author(s):

Mary Zuccato ◽

Dustin Shilling ◽

David C. Fajgenbaum

Keyword(s):

Rare Diseases ◽

Treatment Options ◽

Castleman Disease ◽

High Impact ◽

Collaborative Network ◽

Network Approach ◽

Grant Applications ◽

Research Questions ◽

Novel Strategy ◽

Patient Centric

Abstract There are ∼7000 rare diseases affecting 30 000 000 individuals in the U.S.A. 95% of these rare diseases do not have a single Food and Drug Administration-approved therapy. Relatively, limited progress has been made to develop new or repurpose existing therapies for these disorders, in part because traditional funding models are not as effective when applied to rare diseases. Due to the suboptimal research infrastructure and treatment options for Castleman disease, the Castleman Disease Collaborative Network (CDCN), founded in 2012, spearheaded a novel strategy for advancing biomedical research, the ‘Collaborative Network Approach’. At its heart, the Collaborative Network Approach leverages and integrates the entire community of stakeholders — patients, physicians and researchers — to identify and prioritize high-impact research questions. It then recruits the most qualified researchers to conduct these studies. In parallel, patients are empowered to fight back by supporting research through fundraising and providing their biospecimens and clinical data. This approach democratizes research, allowing the entire community to identify the most clinically relevant and pressing questions; any idea can be translated into a study rather than limiting research to the ideas proposed by researchers in grant applications. Preliminary results from the CDCN and other organizations that have followed its Collaborative Network Approach suggest that this model is generalizable across rare diseases.

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Establishing a Group Educational Session for Hyperacusis Patients

American Journal of Audiology ◽

10.1044/2019_aja-18-0148 ◽

2019 ◽

Vol 28 (2) ◽

pp. 245-250

Author(s):

Ann E. Perreau ◽

Richard S. Tyler ◽

Patricia C. Mancini ◽

Shelley Witt ◽

Mohamed Salah Elgandy

Keyword(s):

Therapeutic Process ◽

Treatment Options ◽

Clinical Group ◽

Education Session ◽

Group Approach ◽

Treatment Protocols ◽

Educational Session ◽

Evidence Based Treatment ◽

Relationship Of ◽

The Relationship

Purpose Audiologists should be treating hyperacusis patients. However, it can be difficult to know where to begin because treatment protocols and evidence-based treatment studies are lacking. A good place to start in any tinnitus and hyperacusis clinic is to incorporate a group educational session. Method Here, we outline our approach to establishing a hyperacusis group educational session that includes specific aspects of getting to know each patient to best meet their needs, understanding the problems associated with hyperacusis, explaining the auditory system and the relationship of hyperacusis to hearing loss and tinnitus, describing the influence of hyperacusis on daily life, and introducing treatment options. Subjective responses from 11 adults with hyperacusis, who participated in a recent clinical group education session, were discussed to illustrate examples from actual patients. Conclusions Due to the devastating nature of hyperacusis, patients need to be reassured that they are not alone and that they can rely on audiologists to provide support and guidance. A group approach can facilitate the therapeutic process by connecting patients with others who are also affected by hyperacusis, and by educating patients and significant others on hyperacusis and its treatment options. Supplemental Material https://doi.org/10.23641/asha.8121197

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Surgery for Lung Cancer and the Consequences for the Swallow

Perspectives of the ASHA Special Interest Groups ◽

10.1044/persp1.sig13.162 ◽

2016 ◽

Vol 1 (13) ◽

pp. 162-168

Author(s):

Pippa Hales ◽

Corinne Mossey-Gaston

Keyword(s):

Lung Cancer ◽

Treatment Options ◽

Vocal Cord Palsy ◽

Subsequent Treatment ◽

Physiological Reserve ◽

Palliative Phase ◽

And Function ◽

The Impact ◽

Swallow Function

Lung cancer is one of the most commonly diagnosed cancers across Northern America and Europe. Treatment options offered are dependent on the type of cancer, the location of the tumor, the staging, and the overall health of the person. When surgery for lung cancer is offered, difficulty swallowing is a potential complication that can have several influencing factors. Surgical interaction with the recurrent laryngeal nerve (RLN) can lead to unilateral vocal cord palsy, altering swallow function and safety. Understanding whether the RLN has been preserved, damaged, or sacrificed is integral to understanding the effect on the swallow and the subsequent treatment options available. There is also the risk of post-surgical reduction of physiological reserve, which can reduce the strength and function of the swallow in addition to any surgery specific complications. As lung cancer has a limited prognosis, the clinician must also factor in the palliative phase, as this can further increase the burden of an already compromised swallow. By understanding the surgery and the implications this may have for the swallow, there is the potential to reduce the impact of post-surgical complications and so improve quality of life (QOL) for people with lung cancer.

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An Overview of Dementias

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.3.75 ◽

2012 ◽

Vol 21 (3) ◽

pp. 75-84

Author(s):

Venkata Vijaya K. Dalai ◽

Jason E. Childress ◽

Paul E Schulz

Keyword(s):

Clinical Presentation ◽

Treatment Options ◽

Current Treatment ◽

Great Variability ◽

Health Concern ◽

Public Health Concern ◽

Life Threatening ◽

The Common ◽

Neurodegenerative Dementias ◽

Made In

Dementia is a major public health concern that afflicts an estimated 24.3 million people worldwide. Great strides are being made in order to better diagnose, prevent, and treat these disorders. Dementia is associated with multiple complications, some of which can be life-threatening, such as dysphagia. There is great variability between dementias in terms of when dysphagia and other swallowing disorders occur. In order to prepare the reader for the other articles in this publication discussing swallowing issues in depth, the authors of this article will provide a brief overview of the prevalence, risk factors, pathogenesis, clinical presentation, diagnosis, current treatment options, and implications for eating for the common forms of neurodegenerative dementias.

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