The POSCH trial: 13 year follow-up and disease-free interval analysis

1994 ◽  
Vol 109 (1-2) ◽  
pp. 354
Author(s):  
H. Buchwald ◽  
C.T. Campos ◽  
J.R. Boen ◽  
P. Nyugen ◽  
S.E. Williams
Keyword(s):  
Interval Analysis ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

Expression of A9 Antigen and Loss of Blood Group Antigens as Determinants of Survival in Patients with Head and Neck Squamous Carcinoma

1987 ◽  
Vol 96 (3) ◽  
pp. 221-230 ◽  
Author(s):  
Thomas E. Carey ◽  
Gregory T. Wolf ◽  
S. Hsu ◽  
J. Poore ◽  
K. Peterson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Blood Group ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Primary Tumor Site ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

The murine monoclonal antibody (A9), raised to the human squamous cell carcinoma (SCC) cell-line UM-SCC-1, defines a squamous cell antigen associated with aggressive biologic behavior of SCC cell lines in vivo and in vitro. In the present investigation, A9 antigen was detected in tissue sections from 37 consecutive, previously untreated patients with SCC of the head and nack. All tumors were positive for A9 binding, although three distinct patterns (reflecting different intensities of A9 expression) were identified. The intensity of A9 expression was independent of primary tumor site, tumor differentiation, keratinization, or growth pattern. The frequency of high expression (Pattern 1) grew with increasing T class, N class, and tumor stage, and was associated with loss of blood group expression in the tumor and with low levels of lymphocyte infiltration In the tumor. Strong A9 expression had a statistically signification association with low nuclear grade (i.e., tumors with more mature and fewer enlarged nuclei, P = 0.019), low vascular/stromal response (i.e., patchy response rather than continuous, P = 0.014), and impaired in vitro lymphokine production by peripheral blood leukocytes ( P = 0.0011). Of greatest interest, however, was the strong association of high A9 expression with shortened disease-free interval (DFI) ( P = 0.085) and survival ( P = 0.081) relative to patients with weak A9 tumor staining (Patterns 2 and 3). Similarly, the loss of blood group antigen expression was strongly associated with decreased DFI ( P = 0.038) and survival ( P = 0.062). While neither Pattern 1 A 9 expression nor loss of blood group reach statistical significance in prediction of survival, the combination of Pattern 1 A 9 expression and loss of blood group expression in primary tumors was significantly associated, both with decreased disease-free interval ( P = 0.017) and with decreased overall survival ( P = 0.011) (median length of follow-up = 22 months). The length of follow-up (LFU) ranged from 2 to 38 months, with a median LFU of 22 months. While the number of patients (37) is small, the significant association between the expression of these cell-surface markers with relapse and survival indicates that immunohistologic staining of the primary tumor will be an important prognostic indicator useful in identification of individual patients at greatest risk of recurrence or early death from head and neck cancer, independent of tumor size, site, or stage at presentation. These markers may thus provide means of selecting patients who should receive adjuvant therapy and more intensive monitoring for the early detection of recurrent disease.

Disease-free interval and estrogen receptor activity in tumor tissue of patients with primary breast cancer: analysis after long-term follow-up

1985 ◽  
Vol 6 (2) ◽  
pp. 123-130 ◽  
Author(s):  
J. M. M. Raemaekers ◽  
L. V. A. M. Beex ◽  
A. J. M. Koenders ◽  
G. F. F. M. Pieters ◽  
A. G. H. Smals ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Tumor Tissue ◽  
Disease Free Interval ◽  
Free Interval ◽  
Estrogen Receptor Activity ◽  
Long Term Follow Up ◽  
Disease Free

scholarly journals Medularni karcinom stitaste zlezde-uticaj postoperativne transkutane zracne terapije u lokalnoj kontroli i rezultatima lecenja

2003 ◽  
Vol 50 (3) ◽  
pp. 125-130
Author(s):  
Vesna Stankovic ◽  
Nenad Borojevic ◽  
Radan Dzodic ◽  
Ivana Golubicic
Keyword(s):  
Thyroid Gland ◽  
Randomized Study ◽  
Time Interval ◽  
Treatment Results ◽  
Disease Free Interval ◽  
Total Survival ◽  
Free Interval ◽  
Total Therapy ◽  
Disease Free

In the period of Octo. 01, 1987. up to Dec. 31, 1998. retrospective-prospective, non-randomized study was conducted at IORS, which included 36 patients diagnosed with thyroid gland medullar cancer. Our study had the following aims: evaluation of treatment results following probability of total survival, survival without signs of disease and disease-free interval until local reccurrence of the disease and influence of parameters of transcutaneous radiotherapy (intensity of total tumor dose and length of disease-free interval from date of performed operation to beginning of radiotherapy). After finished treatment, median of the patient follow-up was 37,75 months (3,5 up to 141 monts); probability of total five-year survival was 62,61% and of 10 year survival was 23,48%. Probability of 5-year survival, without signs of disease was 37,13%, and of 10-year survival 18,56%. As to radiotherapy parameters, intensity of total therapy dose was statisticaly insignificant, while time interval to beginning of transcutaneuos radiotherapy, shorter than 2 months, was statistically significant in relation to prognosis of disease outcome.

Our experience in the surgical treatment of renal carcinoma metastases

1996 ◽  
Vol 63 (4) ◽  
pp. 476-478
Author(s):  
A. Cozzoli ◽  
G. Cancarini ◽  
S. Cosciani Cunico
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Renal Carcinoma ◽  
Disease Free Interval ◽  
Free Interval ◽  
Synchronous Metastases ◽  
Disease Free ◽  
Metachronous Metastases ◽  
Unfavourable Prognostic Factor

The authors report their experience in the surgical treatment of synchronous and metachronous metastases from renal cell carcinoma. From January 1986 to December 1992, 47 nephrectomised patients (11.6%) out of 403 underwent contemporary or subsequent metastasectomy. Metastases were synchronous in 18 cases (38.3%), while metachronous metastases appeared in 29 (61.7%) after a mean disease-free interval of 28 months. After a mean follow-up of 36 months, out of the 18 cases with synchronous metastases, 9 died, 4 are in progression and 5 are still alive and NED; of the 29 patients with metachronous metastases, 3 died, 6 are in progression and 20 are still alive and NED. In conclusion, while the presence of synchronous metastases is an unfavourable prognostic factor even after their removal, results after surgery of metachronous metastases are encouraging.

scholarly journals High Expression of the Urokinase Plasminogen Activator and Its Cognate Receptor Associates with Advanced Stages and Reduced Disease-Free Interval in Papillary Thyroid Carcinoma

2011 ◽  
Vol 96 (2) ◽  
pp. 504-508 ◽  
Author(s):  
Salvatore Ulisse ◽  
Enke Baldini ◽  
Salvatore Sorrenti ◽  
Susi Barollo ◽  
Lucio Gnessi ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Urokinase Plasminogen Activator ◽  
Papillary Thyroid ◽  
Disease Free Interval ◽  
Cognate Receptor ◽  
Free Interval ◽  
Advanced Stages ◽  
Disease Free ◽  
Pai 1

abstract Context: The urokinase plasminogen activating system is implicated in neoplastic progression, and high tissue levels of urokinase plasminogen activating system components correlate with poor prognosis in various human cancers. Objective: The objective of the study was to investigate the prognostic relevance of the urokinase plasminogen activator (uPA), its cognate receptor (uPAR), and the plasminogen activator inhibitor 1 (PAI-1) in human papillary thyroid cancer (PTC). Design: The expression of uPA, uPAR, and PAI-1 genes was analyzed in PTC and normal matched tissues by quantitative RT-PCR. The case study consisted of 99 patients (21 males and 78 females) affected by PTC including 77 classical, 15 follicular, four tall cell, and three oncocytic variants. Forty-one patients had lymph node metastases at the time of diagnosis. All the patients underwent thyroidectomy and radioiodine therapy followed by thyroid hormone replacement therapy. Follow-up data were available for 76 patients up to 64 months. Results: The uPA, uPAR, and PAI-1 mRNA levels were significantly higher in PTC compared with normal matched tissues by 9.63 ± 1,29-, 4.82 ± 0.45-, and 5.64 ± 0.71-fold, respectively. The increased expression of uPA and uPAR correlated statistically with advanced pT and N status. The uPA was also significantly associated with advanced tumor node metastasis stages. The Kaplan-Meier analysis showed a significant association of uPA and uPAR levels with reduced patient disease-free interval (DFI), and this association was stronger in stage I patients. Conclusion: The study demonstrated that in PTC the increased gene expression of uPA and uPAR is associated with tumor invasiveness, advanced stages, and shorter DFI, suggesting their prognostic relevance. These observations warrant further investigation in larger patient populations with longer follow-up.

Intravesical sequential BCG and electromotive mitomycin versus BCG alone in high risk non-muscle invasive bladder cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4572-4572 ◽  
Author(s):  
Savino Mauro Di Stasi ◽  
Cristian Verri ◽  
Emanuele Liberati ◽  
Germano Zampa ◽  
Francesco Masedu ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Disease Free Interval ◽  
Free Interval ◽  
Muscle Invasive ◽  
Disease Free ◽  
Disease Specific

4572 Background: In 2006, we reported that intravesical sequential bacillus Calmette-Guérin (BCG) and electromotive mitomycin in high risk non-muscle invasive bladder cancer leads to higher disease-free interval, lower recurrence and progression, and to improved overall survival and disease-specific survival compared with BCG alone. After an additional 6 years of follow-up, we now report estimated 16-year results. Methods: From 1994 through 2002, we randomly assigned 212 patients with high risk non.muscle invasive bladder cancer to 81 mg BCG infused over 120 min once a week for 6 weeks (n=105) or to 81 mg BCG infused over 120 min once a week for 2 weeks, followed by 40 mg electromotive mitomycin (intravesical electric current 20 mA for 30 min) once a week as one cycle for three cycles (n=107). Complete responders underwent maintenance treatment: those assigned BCG alone had one infusion of 81 mg BCG once a month for 10 months, and those assigned BCG and mitomycin had 40 mg electromotive mitomycin once a month for 2 months, followed by 81 mg BCG once a month as one cycle for three cycles. The primary endpoint was disease-free interval. Analyses were done by intention to treat. Results: Median follow-up was 121 months (IQR 70.5–163.5). Patients assigned sequential BCG and electromotive mitomycin had higher disease-free interval than did those assigned BCG alone (79 months [95% CI 27–139] vs 26 months [11–113]; difference between groups 53 months [39–67], log-rank p=0.0002). Patients assigned sequential BCG and electromotive mitomycin also had lower recurrence (45% [35–55] vs 62% [50–72], difference between groups 17% [6–28], log-rank p=0.0002); progression (12% [3–21] vs 28% [17.5–38.5], difference between groups 16% [5–27], log-rank p=0.003); overall mortality (44% [33–55] vs 59% [43–75], difference between groups 15% [2–28], log-rank p=0.01); and disease-specific mortality (9% [2.5– 15.5] vs 23% [11–34], difference between groups 14% [4–24], log-rank p=0.0055). Conclusions: In patients with high risk non-muscle invasive bladder cancer intravesical BCG combined with electromotive mitomycin provided better results than BCG alone in terms of higher remission rates and longer remission times.

scholarly journals Metastatic Tumors to the Colon and Rectum: A Multi-Institutional Study

2012 ◽  
Vol 136 (11) ◽  
pp. 1397-1401 ◽  
Author(s):  
Najat Mourra ◽  
Anne Jouret-Mourin ◽  
Thierry Lazure ◽  
Virginie Audard ◽  
Laurence Albiges ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Malignant Tumors ◽  
Complementary Therapy ◽  
Colorectal Metastases ◽  
Disease Free Interval ◽  
Secondary Tumors ◽  
Colorectal Mucosa ◽  
Free Interval ◽  
Disease Free

Context.—Unlike the small bowel, the colorectal mucosa is seldom the site of metastatic disease. Objective.—To determine the incidence of truly colorectal metastases, and subsequent clinicopathologic findings, in a substantial colorectal cancer population collected from 7 European centers. Design.—During the last decade, 10 365 patients were identified as having colorectal malignant tumors, other than systemic diseases. Data collected included patient demographics, clinical symptoms, treatment, the presence of metastases in other sites, disease-free interval, follow-up, and overall survival. All secondary tumors resulting from direct invasion from malignant tumors of the contiguous organs were excluded, as well as those resulting from lymph node metastases or peritoneal seeding. Results.—Only 35 patients were included (10 men) with a median age of 59 years. They presented with obstruction, bleeding, abdominal pain, or perforation. The leading source of metastases was the breast, followed by melanoma. Metastases were synchronous in 3 cases. The mean disease-free interval for the remaining cases was 6.61 years. Surgical resection was performed in 28 cases. Follow-up was available for 26 patients; all had died, with a mean survival time of 10.67 months (range, 1–41 months). Conclusions.—Colorectal metastases are exceptional (0.338%) with the breast as a leading source of metastases; they still represent a late stage of disease and reflect a poor prognosis. Therefore, the pathologist should be alert for the possibility of secondary tumors when studying large bowel biopsies. Any therapy is usually palliative, but our results suggest that prolonged survival after surgery and complementary therapy can be obtained in some patients.

Patients With Initially Unresectable Colorectal Liver Metastases: Is There a Possibility of Cure?

2009 ◽  
Vol 27 (11) ◽  
pp. 1829-1835 ◽  
Author(s):  
René Adam ◽  
Dennis A. Wicherts ◽  
Robbert J. de Haas ◽  
Oriana Ciacio ◽  
Francis Lévi ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Survival Rates ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Disease Free Interval ◽  
Free Interval ◽  
Unresectable Colorectal Liver Metastases ◽  
Disease Free

Purpose Although oncosurgical strategies have demonstrated increased survival in patients with unresectable colorectal liver metastases (CLM), their potential for cure is still questioned. The aim of this study was to evaluate long-term outcome after combining downsizing chemotherapy and rescue surgery and to define prognostic factors of cure. Patients and Methods All patients with initially unresectable CLM who underwent rescue surgery and had a minimum follow-up of 5 years were included. Cure was defined as a disease-free interval ≥ 5 years from last hepatic or extrahepatic resection until last follow-up. Results Mean age of 184 patients who underwent resection (April 1988 through July 2002) was 56.9 years. Patients had a mean number of 5.3 metastases (bilobar in 76%), associated to extrahepatic disease in 27%. Surgery was possible after one (74%) or more (26%) lines of chemotherapy. Five- and 10-year overall survival rates were 33% and 27%, respectively. Of 148 patients with a follow-up ≥ 5 years, 24 patients (16%) were considered cured (mean follow-up, 118.6 months), six (25%) of whom were considered cured after repeat resection of recurrence. Twelve “cured” patients (50%) had a disease-free interval more than 10 years. Cured patients more often had three or fewer metastases less than 30 mm (P = .03) responding to first-line chemotherapy (P = .05). Multivariate analysis identified maximum size of metastases less than 30 mm at diagnosis, number of metastases at hepatectomy three or fewer, and complete pathologic response as independent predictors of cure. Conclusion Cure can be achieved overall in 16% of patients with initially unresectable CLM resected after downsizing chemotherapy. In addition to increased survival, this oncosurgical approach has real potential for disease eradication.

Clinical Outcome of Stem Cell Transplantation(SCT) in Patients with T Cell Prolymphocytic Leukaemia(T-PLL) Previously Treated with Alemtuzumab: A Multicentre Experience.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1127-1127 ◽  
Author(s):  
Biju Krishnan ◽  
John Swansbury ◽  
Bruno Cazin ◽  
Robin Ireland ◽  
Nicolas Ketterer ◽  
...  
Keyword(s):  
Conditioning Regimen ◽  
Poor Response ◽  
Published Data ◽  
Unrelated Donor ◽  
Disease Free Interval ◽  
Free Interval ◽  
Full Intensity ◽  
Disease Free ◽  
Reduced Intensity

Abstract T-PLL is a rare aggressive malignancy with poor response to conventional chemotherapy. In our previously published data on a series of mostly relapsed refractory disease patients treated with the anti CD 52 monoclonal antibody Campath -1H (alemtuzumab),60% of the patients achieved complete remission (CR) with an overall response rate of 76%. Median disease free interval (DFI) of 7 months (range 4–45 months). Therapy naive patients had higher CR rates (86%) rates than those who had received prior therapy. However, patients inevitably relapse. Consolidation with a SCT may prolong survival for patients able to undergo such procedures. We update here our experience of 16 patients, 10 males and 6 females, median age of 58 years (range 40–67 yrs), who had SCT following alemtuzumab therapy. 11 patients had an autograft and 5 patients had an allograft including 4 from sibling donors and 1 from an unrelated donor. Disease status at SCT showed 10 patients in 1st CR, 3 in 2nd CR and 2 patients in partial remission (PR). The conditioning regimen for autografts included melphalan/TBI, Cyclo/TBI and BEAM or BEAC. Of the allograft patients, 3 received full intensity Cyclo/TBI conditioning and the 2 remaining cases received reduced intensity Fludarabine/Melphalan/Campath conditioning. 7 patients remain alive with a median follow up of 60 months (24–78 months). Among the patients who underwent an autograft, 55% (6/11) remain alive. Of these, 62% had SCT in 1st CR and 33% in 2nd CR. Median disease free interval was 20 months (8–78 months). 4 out of the 5 deaths were disease related (36%). 2 of these patients showed initial PR to subsequent therapy but eventually died from progressive disease.1 patient had CNS relapse which was fatal. 1 patient relapsed with CD52 negative disease and failed further alemtuzumab therapy, dying from rapid disease progression. 1 patient died from pneumocystis pneumonia whilst her disease was in remission. In the 5 patients who had an allograft median DFI was 26 months (21 days-60 months). Only 1 patient is alive in CR at 60 months follow up. Transplant related mortality (TRM) in this series was 40 %( 2/5 pts), both receiving full intensity conditioning. 1 patient died of infection on D+21 and the other of severe graft versus host disease (GVHD). 2 patients had fulminant relapses, with one case of extramedullary bone disease and another of acute splenic rupture. We conclude that alemtuzumab therapy is able to induce remission in the majority of T-PLL patients with minimal toxicity enabling selected patients to proceed to consolidation with a SCT. Our results indicate that autograft increases the DFI, especially if performed in 1st CR. However, one third of these patients have relapsed. Allograft is an attractive option but is not often feasible in view of the older age group of patients with T-PLL. High rates of TRM were seen in patients receiving full intensity conditioning. Reduced intensity conditioning could offer better results and this need to be explored. For patients without an available donor, cord blood transplant may provide an alternative.

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