scholarly journals Adjuvant radiotherapy and local recurrence in vulvar cancer – a subset analysis of the AGO-CaRE-1 study

2021 ◽  
Author(s):  
Linn Woelber ◽  
Katharina Prieske ◽  
Christine zu Eulenburg ◽  
Stefanie Corradini ◽  
Cordula Petersen ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Adjuvant Radiotherapy ◽  
Vulvar Cancer ◽  
Subset Analysis

Prognosis after local recurrence in vulvar cancer: A subset analysis of the AGO-CaRE-1 study.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. 5595-5595
Author(s):  
Linn Lena Woelber ◽  
Christine Eulenburg ◽  
Jens Kosse ◽  
Petra Neuser ◽  
Christoph Heiss ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Vulvar Cancer ◽  
Subset Analysis

Spinal laser interstitial thermal therapy: single-center experience and outcomes in the first 120 cases

2020 ◽  
pp. 1-10
Author(s):  
Dhiego C. A. Bastos ◽  
Rafael A. Vega ◽  
Jeffrey I. Traylor ◽  
Amol J. Ghia ◽  
Jing Li ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Local Control ◽  
Thoracic Spine ◽  
Adjuvant Radiotherapy ◽  
Neurological Complications ◽  
Thermal Therapy ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Laser Interstitial Thermal Therapy ◽  
Hazard Ratios

OBJECTIVEThe objective of this study was to present the results of a consecutive series of 120 cases treated with spinal laser interstitial thermal therapy (sLITT) to manage epidural spinal cord compression (ESCC) from metastatic tumors.METHODSThe electronic records of patients treated from 2013 to 2019 were analyzed retrospectively. Data collected included demographic, pathology, clinical, operative, and imaging findings; degree of epidural compression before and after sLITT; length of hospital stay; complications; and duration before subsequent oncological treatment. Independent-sample t-tests were used to compare means between pre- and post-sLITT treatments. Survival was estimated by the Kaplan-Meier method. Multivariate logistic regression was used to analyze predictive factors for local recurrence and neurological complications.RESULTSThere were 110 patients who underwent 120 sLITT procedures. Spinal levels treated included 5 cervical, 8 lumbar, and 107 thoracic. The pre-sLITT Frankel grades were E (91.7%), D (6.7%), and C (1.7%). The preoperative ESCC grade was 1c or higher in 92% of cases. Metastases were most common from renal cell carcinoma (39%), followed by non–small cell lung carcinoma (10.8%) and other tumors (35%). The most common location of ESCC was in the vertebral body (88.3%), followed by paraspinal/foraminal (7.5%) and posterior elements (4.2%). Adjuvant radiotherapy (spinal stereotactic radiosurgery or conventional external beam radiation therapy) was performed in 87 cases (72.5%), whereas 33 procedures (27.5%) were performed as salvage after radiotherapy options were exhausted. sLITT was performed without need for spinal stabilization in 87 cases (72.5%). Post-sLITT Frankel grades were E (85%), D (10%), C (4.2%), and B (0.8%); treatment was associated with a median decrease of 2 ESCC grades. The local control rate at 1 year was 81.7%. Local control failure occurred in 25 cases (20.8%). The median progression-free survival was not reached, and overall survival was 14 months. Tumor location in the paraspinal region and salvage treatment were independent predictors of local recurrence, with hazard ratios of 6.3 and 3.3, respectively (p = 0.01). Complications were observed in 22 cases (18.3%). sLITT procedures performed in the lumbar and cervical spine had hazard ratios for neurological complications of 15.4 and 17.1 (p < 0.01), respectively, relative to the thoracic spine.CONCLUSIONSsLITT is safe and provides effective local control for high-grade ESCC from vertebral metastases in the thoracic spine, particularly when combined with adjuvant radiotherapy. The authors propose considering sLITT as an alternative to open surgery in selected patients with spinal metastases.

scholarly journals The Selection of Treatment Modality for Breast Ductal Carcinoma In Situ: Experience From a Single Institution

2021 ◽  
Vol 28 ◽  
pp. 107327482199742
Author(s):  
Kai-yun You ◽  
Zhuo-fei Bi ◽  
Yu-jia Ma ◽  
Yong-lin Mao ◽  
Wei-liang Zou ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Ductal Carcinoma In Situ ◽  
Adjuvant Radiotherapy ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Multivariable Analysis ◽  
Tumor Grade ◽  
Treatment Method ◽  
Free Survival

Purpose: Although breast conservation surgery(BCS) followed by adjuvant radiotherapy is now the mainstream treatment method for breast ductal carcinoma in situ(DCIS), mastectomy is still performed in some patients who refuse to undergo radiation. However, the most effective treatment method for these patients is still unknown. In the current study, we aimed to compare the survival rates between mastectomy and BCS plus adjuvant radiotherapy in patients with DCIS. Materials and Methods: We performed a retrospective study of 333 patients with DCIS from May 2004 to December 2016. There were 209 patents who were treated with BCS and adjuvant radiotherapy, while the remaining of 124 patients underwent mastectomy. The disease-free survival (DFS) and local recurrence-free survival(LRFS) rates were compared between the 2 treatment groups. Cox proportional hazards regression was performed to explore factors associated with DFS and LRFS. Results: The 10-year local recurrence(LR) rates in the mastectomy and BCS plus adjuvant radiotherapy groups were 2.6% and 7.5%, respectively. There was no difference in the LR rate between the 2 groups. Furthermore the DFS rate was also similar between the mastectomy and BCS plus adjuvant radiotherapy groups. Based on the multivariable analysis, age and tumor grade were significantly correlated with the LRFS and DFS rates. In the subgroup analysis based on the factors of age and tumor grade, patients with a tumor grade of III who underwent mastectomy had better LRFS and DFS rates compared to those who received BCS plus radiotherapy. Conclusion: In patients with DCIS, the long-term efficacy was similar between mastectomy and BCS followed by adjuvant radiotherapy. However, in the subgroup of patients with grade III tumors, mastectomy seems to offer a better LRFS and DFS than BCS plus radiotherapy.

scholarly journals Assessment of the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma based on pattern of post-surgical progression

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Peng Wang ◽  
Haihua Zhou ◽  
Gaohua Han ◽  
Qingtao Ni ◽  
Shengbin Dai ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Gastric Adenocarcinoma ◽  
Adjuvant Radiotherapy ◽  
Cox Regression ◽  
Radical Resection ◽  
Progression Rate ◽  
Cox Regression Analysis ◽  
T Stage ◽  
Local Progression ◽  
Degree Of Differentiation

Abstract Purpose To assess the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma and to investigate subgroups of patients suitable for adjuvant radiotherapy. Methods and materials Data from 785 patients with gastric adenocarcinoma who had undergone D1/D2 radical resection and adjuvant chemotherapy were collected, the site of first progression was determined, and the relationship between the rate of local recurrence and clinicopathologic features was analyzed. Results By the end of the follow-up period, progression was observed in 405 patients. Local recurrence was observed as the first progression in 161 cases. The local recurrence rate was significantly lower than the non-local progression rate (20.5% vs 31.5%, p=0.007). Multivariate Cox regression analysis showed a significant relationship among degree of differentiation, T stage, N stage, and rate of local recurrence. Conclusions Not all patients with gastric carcinoma required adjuvant radiotherapy. However, patients with poorly differentiated cancer cells, advanced T stage (T3/T4), and positive lymph nodes, which included patients in the T4N1-2M0 subgroup, were recommended for adjuvant radiotherapy.

Meta-analysis of the influence of surgical margin and adjuvant radiotherapy on local recurrence after resection of sporadic desmoid-type fibromatosis

2017 ◽  
Vol 104 (4) ◽  
pp. 347-357 ◽  
Author(s):  
M. L. Janssen ◽  
D. L. M. van Broekhoven ◽  
J. M. M. Cates ◽  
W. M. Bramer ◽  
J. J. Nuyttens ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Adjuvant Radiotherapy ◽  
Meta Analysis ◽  
Surgical Margin

PH-0445 Preliminary results of the Italian Retrospective Study on adjuvant radiotherapy for vulvar cancer

2021 ◽  
Vol 161 ◽  
pp. S344-S345
Author(s):  
C. Casà ◽  
G. Macchia ◽  
M. Ferioli ◽  
V. Lancellotta ◽  
M. Boccardi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Adjuvant Radiotherapy ◽  
Vulvar Cancer ◽  
Preliminary Results

Prognostic factors in adult patients with locally controlled soft tissue sarcoma. A study of 546 patients from the French Federation of Cancer Centers Sarcoma Group.

1996 ◽  
Vol 14 (3) ◽  
pp. 869-877 ◽  
Author(s):  
J M Coindre ◽  
P Terrier ◽  
N B Bui ◽  
F Bonichon ◽  
F Collin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Local Recurrence ◽  
Tumor Size ◽  
Adjuvant Radiotherapy ◽  
Tumor Depth ◽  
Cancer Centers ◽  
Grade 3 ◽  
Metastatic Risk ◽  
Deep Location

PURPOSE To define the prognostic factors in adult patients with locally controlled soft tissue sarcoma (STS) and to determine which patients should be considered for adjuvant treatment. PATIENTS AND METHODS Five hundred forty-six patients with a nonmetastatic and locally controlled STS, collected in a cooperative data base by the French Federation of Cancer Centers (FNCLCC) Sarcoma Group from 1980 and 1989, were studied. Histologic slides of all patients were collegially reviewed. Initial treatment consisted of complete tumor resection with amputation in only 4% of the patients. Adjuvant radiotherapy was administered to 57.9% and adjuvant chemotherapy to 31%. Relationships between tumor characteristics were analyzed, and univariate and multivariate analyses were performed using Cox models for the hazards rate of tumor mortality, development of distant metastasis, and strictly local recurrence. RESULTS Unfavorable characteristics with an independent prognostic value for tumor mortality were: grade 3 (P = 3 x 10(-10)), male sex (P = 1.5 x 10(-5)), no adjuvant chemotherapy (P = 5.4 x 10(-5)), tumor size > or = 5 cm (P = 3.8 x 10(-3)), and deep location (P = 4.6 x 10(-3)). Unfavorable characteristics for the development of distant metastasis were: grade 3 (P = 4 x 10(-12)), no adjuvant chemotherapy (P = 6.4 x 10(-4)), tumor size > or = 10 cm (P = 9.8 x 10(-4)), and deep location (P = 1.3 x 10(-3)). For the development of local recurrence, the unfavorable characteristics were: no adjuvant radiotherapy (P = 3.6 x 10(-6)), poor surgery (local excision) (P = 2 x 10(-4)), grade 3 (P = 7.6 x 10(-4)), and deep location (P = 10(-2)). Grade, depth, and tumor size were used to define groups of patients according to the metastatic risk. Adjuvant chemotherapy was beneficial in terms of overall survival and metastasis-free survival in grade 3 tumor patients only. Despite worse characteristics concerning tumor depth, tumor-node-metastasis (TNM) and American Joint Committee (AJC)/International Union Against Cancer (UICC) classifications and grade in patients with adjuvant radiotherapy, the latter experienced significantly fewer local recurrences than patients with no radiotherapy. CONCLUSION Grade, tumor depth, and tumor size could be used to select patients with a high metastatic risk, for which adjuvant chemotherapy could be beneficial.

Patterns of treatment failure in patients undergoing adjuvant or definitive radiotherapy for vulvar cancer

2019 ◽  
Vol 29 (5) ◽  
pp. 857-862
Author(s):  
Christina Steen Vorbeck ◽  
Anuja Jhingran ◽  
Revathy B Iyer ◽  
Annika Loft ◽  
Ann Klopp ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Clinical Decision Making ◽  
Vulvar Cancer ◽  
Recurrent Disease ◽  
Treatment Strategies ◽  
High Dose ◽  
Definitive Radiotherapy ◽  
Failure Patterns ◽  
Gynecology And Obstetrics ◽  
Dose Planning

ObjectivesKnowledge of the detailed pattern of failure can be useful background knowledge in clinical decision making and potentially drive the development of new treatment strategies by increasing radiotherapy dose prescription to high-risk sub-regions of the target. Here, we analyze patterns of recurrence in patients with vulvar cancer treated with radiotherapy according to original planning target volumes and radiation dose delivered.MethodsWe analyzed dose-planning and post-treatment recurrence scans from patients with vulvar cancer treated at two institutions from January 2009 through October 2014. We delineated the recurrences and merged the dose-planning and recurrence scans for each patient by using deformable co-registration. We estimated the center of each recurrence on the merged scans with the goal of relating them to the original dose plan.ResultsWe evaluated 157 patients who received radiotherapy for vulvar cancer. Median age was 68 years (range 29–91). Patients with International Federation of Gynecology and Obstetrics (FIGO) stage IA-IVB were included. Twenty-nine patients had recurrent disease; 156 patients had squamous cell carcinoma and one patient had adenosquamous carcinoma of the vulva. Among the 157 patients, 37 patients with recurrent disease had recurrence scans available for review, for a total of 80 recurrence sites; 53% of the recurrences were located in the region to which the highest dose (60–70 Gy) had been prescribed. Patients who received definitive radiotherapy developed failure primarily in the high-dose region (80.5%), whereas patients who received adjuvant radiotherapy had a more scattered failure pattern (p<0.0001). Among the latter group, 29.5% failed in the high-dose region.ConclusionsPatients who received definitive versus adjuvant radiotherapy had different failure patterns, indicating that separate approaches are needed to improve both adjuvant and definitive radiotherapy for vulvar cancer.

Predicting the course of disease in recurrent vulvar cancer – A subset analysis of the AGO-CaRE-1 study

2019 ◽  
Vol 154 (3) ◽  
pp. 571-576 ◽  
Author(s):  
Linn Woelber ◽  
Christine Eulenburg ◽  
Jens Kosse ◽  
Petra Neuser ◽  
Christoph Heiss ◽  
...  
Keyword(s):  
Vulvar Cancer ◽  
Course Of Disease ◽  
Subset Analysis
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