How Can We Identify Local Relapse?

2012 ◽  
pp. 95-102
Author(s):  
Doenja M. J. Lambregts ◽  
Regina G. H. Beets-Tan
Keyword(s):  
Local Relapse

Surgery, Radio- and Chemo- therapy for Multimodal Treatment of Rectal Cancer

Swiss Surgery ◽  
2001 ◽  
Vol 7 (6) ◽  
pp. 256-274 ◽  
Author(s):  
Link ◽  
Staib ◽  
Kornmann ◽  
Formentini ◽  
Schatz ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Multimodal Treatment ◽  
Local Relapse ◽  
Phase Iii ◽  
Neoadjuvant Radiotherapy ◽  
Term Survival ◽  
Primary Tumors ◽  
Impact On Survival ◽  
Relapse Rates

The possibilities and results of multimodal treatment in rectal cancer were reviewed with respect to the results of surgical treatment only. Based on the results of 4 studies, reducing local relapse rates and increasing long term survival rates significantly, postoperative radiochemotherapy (RCT) + chemotherapy (CT) should remain the recommended standard for R0 resected UICC II and III rectal cancers. The addition of RT to adjuvant CT reduces local relapses without significant impact on survival (NSABP R-02). Vice versa, the addition of CT to RT or an improved CT in the RCT-concept prolongs survival. Preoperative neoadjuvant radiotherapy (RT) reduced local relapse rates in 9 studies, and extended survival in one study that evaluated all eligible patients. Preoperative RT reduced local relapse rates in addition to total mesorectal excision (TME) but did not extend survival. The preoperative RCT + CT downstages resectable and nonresectable tumors and induces a higher sphincter preservation rate. Phase III data justifying its routine use in all UICC II + III stages are not yet available. This treatment may be routinely applied in nonresectable primary tumors or local relapses. Preoperative RCT (or RT) may evolve as standard, if the patient selection is improved and postoperative morbidity and long term toxicity reduced. Intraoperative RT could be added to this concept or be used together with preoperative/postoperative RT at the same indications. Postoperative adjuvant RT reduced local relapses significantly in a single trial, and no impact on survival time is reported. Since postoperative RT is inferior to preoperative RT, this treatment cannot be recommended, if RT is chosen as a single treatment modality in adjunction to surgery. The results of local tumor excisions may be improved with pre- or postoperative RCT + CT. In the future, multimodal treatment of rectal cancer might be more effective, if individualized according to prognostic factors.

Validation of a Novel Nomogram for the Prediction of Local Relapse after Surgery for Invasive Breast Carcinoma

2019 ◽  
Author(s):  
Giovanni Corso ◽  
Patrick Maisonneuve ◽  
Giulia Massari ◽  
Alessandra Invento ◽  
Gabriella Pravettoni ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Local Relapse ◽  
Invasive Breast Carcinoma

scholarly journals Stereotactic lung reirradiation for local relapse: a case series

2021 ◽  
Author(s):  
Rémy Kinj ◽  
Alessio Casutt ◽  
Alexander Bennassi ◽  
Hasna Bouchaab ◽  
Véronique Vallet ◽  
...  
Keyword(s):  
Case Series ◽  
Local Relapse

scholarly journals Factors predicting local relapse and survival in patients treated with surgery for breast cancer

2019 ◽  
Vol 42 (7) ◽  
pp. 755-760
Author(s):  
Ana Alicia Tejera Hernández ◽  
Víctor Manuel Vega Benítez ◽  
Juan Carlos Rocca Cardenas ◽  
María Isabel Gutiérrez Giner ◽  
Juan Carlos Díaz Chico ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Local Relapse

Dermatofibrosarcoma Protuberans Treated at a Single Institution: A Surgical Disease With a High Cure Rate

2005 ◽  
Vol 23 (30) ◽  
pp. 7669-7675 ◽  
Author(s):  
Marco Fiore ◽  
Rosalba Miceli ◽  
Chiara Mussi ◽  
Salvatore Lo Vullo ◽  
Luigi Mariani ◽  
...  
Keyword(s):  
Reconstructive Surgery ◽  
Residual Disease ◽  
Dermatofibrosarcoma Protuberans ◽  
Distant Metastases ◽  
Local Relapse ◽  
Primary Group ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Significant Difference

Purpose Dermatofibrosarcoma protuberans (DFSP) is a rare, low-grade, cutaneous sarcoma with autocrine overproduction of the platelet-derived growth factor (PDGF) β-chain from gene rearrangement as a key pathogenetic factor, now susceptible of molecular-targeted therapy. The aim of this retrospective analysis was to explore the outcome of patients with primary or recurrent DFSP. Patients and Methods Two hundred eighteen patients surgically treated at the Istituto Nazionale per lo studio e la cura dei Tumori (Milan, Italy) over 20 years were reviewed. Local relapse, distant metastasis, and survival were studied. Results One hundred thirty-six patients (62.4%) presented with a primary DFSP, while 82 patients (37.6%) had a recurrent disease. In the primary group, margins were microscopically positive in 11.8%, while in the recurrent group they were positive in 14.6% (P =.613). In the primary group, patients undergoing re-excision after inadequate previous surgery had residual disease in 62% of cases. Reconstructive surgery was needed in 30%, significantly more frequently in patients with a recurrence or a head and neck tumor. The crude cumulative incidence of local relapses was 4% at 10 years, and 2% at 10 years for distant metastases. No significant difference was found between primary and recurrent patients, as well as between positive and negative margins. Conclusion This being one of the largest mono-institutional series of DFSP, we confirm that long-term outcome is excellent, in terms of both local and distant control, after a wide excision with negative margins. Reconstructive surgery is often needed. Novel medical therapies will be of use in a limited subgroup of patients.

Leiomyosarcoma of the larynx as a local relapse of squamous cell carcinoma-Report of an unusual case

Head & Neck ◽  
2009 ◽  
pp. NA-NA
Author(s):  
Hans-Ullrich Völker ◽  
Andreas Zettl ◽  
Eugenia Haralambieva ◽  
Bernd Blume ◽  
Rudolf Hagen ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Unusual Case ◽  
Local Relapse

Adjuvant radiotherapy plus systemic chemotherapy in resected head and neck mucosal melanoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18042-e18042
Author(s):  
Rong Duan ◽  
Bixia Tang ◽  
Zhihong Chi ◽  
Chuanliang Cui ◽  
Bin Lian ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Head And Neck ◽  
Distant Metastasis ◽  
Adjuvant Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Local Relapse ◽  
Mucosal Melanoma ◽  
Uicc Stage ◽  
Free Survival ◽  
Cox Analysis

e18042 Background: The median over survival (OS) of resected head and neck mucosal melanoma (HNMM) is 49.0 months. About 65% of patients experience local recurrence or distant metastasis after surgery. Therefore, adjuvant therapy is critical to improve the poor prognosis. Methods: Data regarding HNMMs with radical surgery (stage III-IVa, AJCC HNMM 8th version) between September 1, 2006 and February 28, 2020 at Peking University Cancer Hospital was collected retrospectively. Postoperative radiotherapy was usually prescribed as GTV 60-70Gy/CTV 60Gy/30f. Patients were divided into four groups by the adjuvant regimens: radiotherapy+chemotherapy (RC), chemotherapy (C), radiotherapy (R) and observation (O). Results: In total, 368 patients were enrolled, including 104 RC,114 C, 53 R, 97 O, respectively. After median follow-up of 63.9 mo (range: 0.9-146.7), the median local relapse-free survival (LRFS) was 10.1 mo (95%CI: 6.7-13.6) in the O group, as compared with 65.9 mo (95%CI: 31.7-100.1, P＜0.001) in the R group, 75.6 mo (95%CI: 50.1-101.0, P＜0.001) in the C group, and 84.6 mo (95%CI: 48.5-120.8, P＜0.001) in the RC group. The median distant metastasis-free survival (DMFS) was 13.7 mo (95%CI: 8.0-19.5) in the O group, 15.3 mo (95%CI: 8.7-21.9, P = 0.898) in the R group, as compared with 25.7 mo (95%CI: 14.6-36.8, P = 0.001) in the C group, 49.3 mo (95%CI: 32.6-66.0, P＜0.001) in the RC group. Estimated OS was 36.4 mo (95%CI: 24.0-48.8) in the O group, as compared with 30.8 mo (95%CI: 23.0-38.6, P = 0.733) in the R group, 40.8 mo (95%CI: 34.8-46.8, P = 0.289) in the C group, 58.2 mp (95%CI: 36.4-79.9, P = 0.002) in the RC group. Primary location, age, gender, UICC staging and adjuvant regimens were included for multivariate Cox analysis. With regard to OS, UICC stage and RC were the prognostic factors. With regard to DMFS, UICC stage, RC and C were the prognostic factors. With regard to LRFS, UICC stage, RC, R, C were the prognostic factors. Conclusions: It is the largest study on the role of adjuvant radiotherapy and chemotherapy on HNMM till now. The results demonstrate that postoperative radiotherapy improves LRFS but has no impact on DMFS, while adjuvant radiotherapy plus chemotherapy prolongs OS. It further validates the clinical practice of UICC stage of HNMM, which might shed lights on the study of the whole mucosal melanoma.

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