Retroperitoneal paraganglioma with multiple pulmonary metastases detected six years after complete resection of the primary tumor

Purpose Although intensive multimodal treatment has improved the prognosis of patients with metastatic neuroblastoma, the impact of primary tumor resection on outcome is a matter of medical debate. Patients and Methods Patients from the German prospective clinical trial NB97 with stage 4 neuroblastoma and age 18 months or older at diagnosis were included. Operation notes and imaging reports were reviewed by two independent experienced physicians. Finally, the extent of tumor resections was correlated with local control rate and outcome. Results A total of 278 patients were included in this study. Image-defined risk factors present at diagnosis were found to be predictive for the extent of tumor resection at first (P < .001) and best (P < .001) operation. No patient died from surgery. Before chemotherapy, complete resection, incomplete resection, and biopsy or no surgery were performed in 6.1%, 5.0%, and 88.5% of patients, respectively. The extent of first operation had no impact on event-free survival (EFS; P = .207), local progression–free survival (LPFS; P = .195), and overall survival (OS; P = .351). After induction chemotherapy, 54.7% of patients underwent complete resection of the primary tumor, 30.6% underwent incomplete resection, and 13.3% had only biopsy or no surgery of the primary tumor. The extent of best operation also had no impact on EFS (P = .877), LPFS (P = .299), and OS (P = .778). Moreover, multivariate analyses showed that surgery did not affect EFS, LPFS, and OS. Conclusion In intensively treated patients with stage 4 neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome.

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Prognostic factors for colorectal cancer patients with pulmonary metastases

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15107 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15107-e15107

Author(s):

W. Li ◽

W. Zhang ◽

S. Cai ◽

J. Yin ◽

J. Li

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Primary Tumor ◽

Pulmonary Metastases ◽

Good Survival ◽

Primary Tumor Site ◽

Disease Free Interval ◽

Metastatic Site ◽

Free Interval ◽

Disease Free

e15107 Background: Pulmonary is the second common metastastic site of CRC with a good survival after metastasectomy, however the general situation of pulmonary metastases from CRC has received little attention, especially for unresectable ones. The aim of this study was to determine factors that may influence survival and disease free interval from primary radical surgery to pulmonary metastases (DFI). Methods: From 01/2000 to 11/2008, a total of 206 pts with pulmonary metastases (colon72, rectal ca131, 3 unknown) were collected retrospectively and the clinical data were analyzed using Kaplan-Meier survival curves, univariate and multivariate analysis. Results: 128 pts (62.1%) had lung disease as the first metastatic site and 33 pts (26.7%) had synchronous liver involvement. Only 17 patients (8.3%) followed pulmonary metastatic resection, and others underwent palliative medical treatment including the chemotherapy and intervention. Median survival was 16.0 months (range 12.240–19.760) with a 18% 5-year survival. Of the totally 160 patients who had synchronous pulmonary metastases after radical primary tumor surgery, the mDFI was 20 months (range 16.738–23.262) months. Rectal cancer had a high chance (65%) for lung recurrence with longer DFI (21 vs 14 mo, P=0.02), but no difference of survival was shown compared to colon cancer. Factors that significantly predicted a poor prognosis on univariate analysis included vessel invasion (P=0.022) and high T stage (P=0.009), but neither of them was the independent prognostic factors after multivariate analysis. The factors influencing the DFI of metachronous pulmonary metastases included primary tumor site, pathological morphology, tumor infiltration stage and regional lymph node stage (P<0.05). There was a trend of better survival of patients receiving resection surgery after pulmonary metastases than receiving chemotherapy alone though no statistical significant was reached (mOS:34 vs 16 mo, P=0.125). But to patients who receiving metastatic site resection, chemotherapy after surgery improved the survival (P=0.042). Conclusions: No independent prognostic factors of survival had been found. The invasive tumor with high stage may have a shorter disease free interval of pulmonary metastases after primary surgery. No significant financial relationships to disclose.

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Concomitant immunity to pulmonary metastases of a murine fibrosarcoma: Influence of removal of primary tumor by radiation or surgery, of active specific immunization and treatment with Corynebacterium granulosum

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(76)90090-0 ◽

1976 ◽

Vol 1 (11-12) ◽

pp. 1171-1178 ◽

Cited By ~ 7

Author(s):

Luka Milas ◽

Nancy Hunter ◽

Rodney Withers

Keyword(s):

Primary Tumor ◽

Pulmonary Metastases ◽

Concomitant Immunity ◽

Active Specific Immunization ◽

Murine Fibrosarcoma

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Metastatic osteoblastic osteosarcoma in a captive scarlet macaw (Ara macao)

Brazilian Journal of Veterinary Pathology ◽

10.24070/bjvp.1983-0246.v13i3p602-608 ◽

2020 ◽

Vol 13 (3) ◽

pp. 602-608

Author(s):

Larissa Moreira ◽

Thaynara Carvalho ◽

Ayisa Oliveira ◽

Daniel Santos ◽

Nayara Paula ◽

...

Keyword(s):

Weight Loss ◽

Primary Tumor ◽

Pulmonary Metastases ◽

Distal Portion ◽

Cytological Examination ◽

Contralateral Limb ◽

Progressive Weight Loss ◽

Ara Macao ◽

Scarlet Macaw ◽

Osteoblastic Osteosarcoma

Osteosarcoma is a malignant primary tumor of the bone, which is considered rare in birds. This report describes an osteoblastic osteosarcoma in a scarlet macaw (Ara macao), which was apathetic with progressive weight loss, and had a tumor in the distal portion of the femur and proximal tibiotarsus with ulcerated pododermatitis in the contralateral limb. Euthanasia was elected due to poor diagnosis after radiographic and cytological examination. Histopathology and immunohistochemistry were performed and confirmed the diagnosis of an osteoblastic osteosarcoma with hepatic and pulmonary metastases.

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POCHER (preoperative chemotherapy for hepatic resection) with cetuximab (Cmab) plus CPT-11/5-fluorouracil (5-FU)/leucovorin(FA)/oxaliplatin (L-OHP) (CPT-11-FFL) in unresectable colorectal liver metastases (CLM)

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15020 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15020-e15020

Author(s):

C. Garufi ◽

A. Torsello ◽

S. Tumolo ◽

M. Mottolese ◽

C. Campanella ◽

...

Keyword(s):

Primary Tumor ◽

Gene Copy Number ◽

Clinical Results ◽

Median Number ◽

Complete Resection ◽

Gene Copy ◽

Resection Rate ◽

Toxicity Analysis ◽

Unresectable Colorectal Liver Metastases

e15020 Background: We have previously shown preliminary data with Cmab+ all active drugs, CPT-FFL, with primary end- point CLM resectability (Garufi C. et al ASCO GI 2008). Here we report definitive clinical results. Methods: Unresectability criteria: size>5 cm (a), multinodular (b), ilar location (c), extrahepatic disease (d), >3 stable mets after chemotherapy before surgery (e). Aim of the study was to have at least 30% liver resection rate (power of 80% for p0=10% and p1=25%). Pts received weekly Cmab 400 then 250 mg/m2/wk plus CPT-11, 130 mg/m2/d1, 6 h infusion, (peak at 13:00) and a 12-h, days 2–5, infusion of L-OHP 20 mg/m2/day (peak at 16:00), FA 150 mg/m2/day plus 5-FU 600 mg/m2/d (peak at 4:00), q 2 wks; after the first 17 pts 5-FU and L-OHP were reduced to 550 and 15 mg/m2 respectively. Results: Since 07/20/2006 we enrolled 43 pts, irrespective of EGFR, K-ras and gene copy number (gcn): M/F 27/16, median age 60,7 y (33–76), median PS 0. Primary tumor: colon/rectum 34/9, primary tumor resected 39 pts (79%), synchronous metastases: 35 pts (81%), liver <25%/25%: 9/34 ((21/79%); median CEA/CA19–9: 55 ng/ml (1–6,600)/91.8 U/L (2.66440); unresectability: (a): 9 (21%), (b):14 (33%), (c) 1, (d): 4 (9%), (e): 15 (35%). We had 34 partial responses (79%, CI 79.1–87.0), 5 SD (11.6%) and 4 patients not evaluable becouse of toxicity. Complete Resection of CLM was obtained in 27 pts (63%) with 4 pts still to be resected. Median number (n.) of courses (c) was 10 (2–18), median n. of c before surgery (s) was 5 (3–10) and after s was 6 (1–6); median time from last c to s was 2 wks (2–4), from s to recovery chemo was 10 wks (2–16). Median follow-up was12 months, median PFS 13 months (7–19), median OS not reached with 2-y survival of 61%, 8 pts alive without recurrence (19%), 11 deaths (25%).Major limiting toxicity was diarrhea, with no difference after dose reduction: Grade 0–1: 6% of pts, G2 6%, G3 76%, G4 12%; neutropenia G3 6% with no febrile neutropenia. Conclusions: This is the first phase II study with CPT-FFL + Cmab in pts with unresectable CLM. Complete resection was obtained in 63% of pts with diarrhea being limiting toxicity. Analysis of EGFR status, K-ras and gcn will be further presented. No significant financial relationships to disclose.

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