GP.05 The risk of malignancy after stereotactic radiosurgery

Background: A major concern of patients undergoing Gamma Knife radiosurgery (GKS) for benign tumors and other conditions is the risk of a separate secondary malignancy or malignant -transformation. The incidence of radiosurgery-associated malignancy based on long-term follow-up remains unknown. Methods: We conducted a population-based cohort study to estimate the incidence rate of both malignant transformation and a separate radiation-associated malignancy in patients undergoing GKS from 1987 to 2016 at 5 centers. Results: 11 527 patients underwent radiosurgery for meningioma (n=3261), arteriovenous malformation (n=2868), trigeminal neuralgia (n=1982), vestibular schwannoma (n=1957), pituitary adenoma (n=1193), other (n=266). The follow-up time ranged from 0.3 to 23.8 years. Four cases of malignant transformation and 3 new malignant brain tumors were reported, two of which were not within the irradiated field. The incidence of malignant transformation was 6.6 per 100 000 patient-years and of new malignancy, either locally or distant, was 5 in 100 000 patient-years. These risks are not higher than the Central Brain Tumor Registry of the United States derived annual incidence rate of all primary malignant CNS tumors of 7.15 per 100 000. Conclusions: Physicians can safely counsel patients that the risk of malignancy after stereotactic radiosurgery remains extremely low, even at long-term follow-up of greater than 10 years.

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Tufts Medical Center Experience with Long Term Follow up of Vestibular Schwannoma Treated with Gamma Knife Stereotactic Radiosurgery: Novel Finding of Delayed Pseudoprogression

Advances in Radiation Oncology ◽

10.1016/j.adro.2021.100687 ◽

2021 ◽

pp. 100687

Author(s):

Justin Wage ◽

John Mignano ◽

Julian Wu

Keyword(s):

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Vestibular Schwannoma ◽

Medical Center ◽

Long Term Follow Up ◽

Gamma Knife Stereotactic Radiosurgery

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Salvage Surgical Resection After Linac-based Stereotactic Radiosurgery and Radiotherapy for Newly Diagnosed Brain Metastasis

10.21203/rs.3.rs-272644/v1 ◽

2021 ◽

Author(s):

Ryosuke Matsuda ◽

Takayuki Morimoto ◽

Tetsuro Tamamoto ◽

Nobuyoshi Inooka ◽

Tomoko Ochi ◽

...

Keyword(s):

Brain Metastasis ◽

Survival Time ◽

Stereotactic Radiosurgery ◽

Surgical Resection ◽

Cyst Formation ◽

Histopathological Diagnosis ◽

Newly Diagnosed ◽

Long Term Follow Up

Abstract Purpose: This study aimed to assess the clinical outcomes of salvage surgical resection (SSR) after stereotactic radiosurgery and fractionated stereotactic radiotherapy (SRS/fSRT) for brain metastasis.Methods: Between November 2009 and December 2018, we treated 427 consecutive patients with 919 lesions with SRS/fSRT for newly diagnosed brain metastasis at our hospital. During the follow-up period, we treated 19 consecutive patients who underwent 21 SSRs for recurrence, radiation necrosis (RN), and cyst formation after SRS/fSRT for newly diagnosed brain metastasis. Two patients underwent multiple surgical resections. Brain metastasis originated from the lung (n=15, 78.9%), breast (n=3, 15.7%), and colon (n=1, 5.2%). Results: The median time from initial SRS/fSRT to SSR was 14 months (range: 2–96 months). The median follow-up after SSR was 15 months (range: 2–76 months). The range of tumor volume at initial SRS/SRT was 0.121–21.459 cm3 (median: 2.188 cm3). Histopathological diagnosis after SSR was recurrence, RN and cyst formation in 13 and 6 cases, respectively. The median survival time from SSR and from initial SRS/SRT was 17 months and 74 months, respectively. The cases with recurrence had a significantly shorter survival time than those without recurrence (p=0.0453).Conclusion: The patients treated with SRS/fSRT for brain metastasis need long-term follow-up. SSR is a safe and effective treatment for the recurrence, RN, and cyst formation after SRS/fSRT for brain metastasis.

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Long-term follow-up of neoplastic pancreatic cysts without high-risk stigmata: how often do we change treatment strategy because of malignant transformation?

Scandinavian Journal of Gastroenterology ◽

10.1080/00365521.2016.1179338 ◽

2016 ◽

Vol 51 (9) ◽

pp. 1138-1143 ◽

Cited By ~ 3

Author(s):

Selma J. Lekkerkerker ◽

Marc G. Besselink ◽

Olivier R. Busch ◽

Frederike Dijk ◽

Marc R. Engelbrecht ◽

...

Keyword(s):

High Risk ◽

Malignant Transformation ◽

Treatment Strategy ◽

Pancreatic Cysts ◽

Long Term Follow Up

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Long-Term Follow-Up of 32 Meningiomas of the Clivus and Foramen Magnum Subjected to Stereotactic Radiosurgery

Radiosurgery ◽

10.1159/000288731 ◽

2010 ◽

pp. 202-211

Author(s):

K. Sallabanda ◽

J.C. Bustos ◽

J.A. Gutiérrez-Díaz ◽

C. Beltrán ◽

C. Peraza ◽

...

Keyword(s):

Stereotactic Radiosurgery ◽

Foramen Magnum ◽

Long Term Follow Up

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Place of Gamma Knife Stereotactic Radiosurgery in Grade 4 Vestibular Schwannoma Based on Case Series of 86 Patients with Long-Term Follow-Up

World Neurosurgery ◽

10.1016/j.wneu.2018.03.175 ◽

2018 ◽

Vol 114 ◽

pp. e1192-e1198 ◽

Cited By ~ 10

Author(s):

Michel Lefranc ◽

Leila Maria Da Roz ◽

Anne Balossier ◽

Jean Marc Thomassin ◽

Pierre Hugue Roche ◽

...

Keyword(s):

Stereotactic Radiosurgery ◽

Gamma Knife ◽

Vestibular Schwannoma ◽

Case Series ◽

Long Term Follow Up ◽

Gamma Knife Stereotactic Radiosurgery

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Transurethral resection of a bladder trigone leiomyoma: a rare case report

BMC Urology ◽

10.1186/s12894-020-00722-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Athanasios Zachariou ◽

Maria Filiponi ◽

Fotios Dimitriadis ◽

Aris Kaltsas ◽

Nikolaos Sofikitis

Keyword(s):

Case Report ◽

Transurethral Resection ◽

English Literature ◽

Benign Tumors ◽

Macroscopic Hematuria ◽

Urinary Tract Symptoms ◽

Rare Case Report ◽

Long Term Follow Up

Abstract Background Bladder leiomyomas are rare and benign tumors of the bladder. They account for 0.43% of all bladder tumors, and only 250 cases have been reported in English literature. Based on the size and localization of the lesion, their symptoms vary considerably. Women seem to be more affected, and obstructive symptoms predominate. Surgical treatment is almost always highly effective, leaving a low recurrence rate. Case presentation We present a clinical case of a 52-year old man with macroscopic hematuria and obstructive lower urinary tract symptoms due to a large bladder trigone leiomyoma. CT and MRI showed a well-defined large bladder leiomyoma and cystoscopy established the initial findings. The patient underwent successful transurethral resection of the lesion, and pathology findings confirmed the diagnosis. Conclusions This case report demonstrates that transurethral resection of a large bladder trigone leiomyoma is a feasible and successful procedure. Long term follow-up proves that there is neither scarring distortion of the bladder trigone area nor damage in the ureteral orifices, even though there was a thorough removal of the trigone wall.

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T1 Top Line Results of the DETECT Enzymatic Debridement Multicenter Randomized Controlled Trial

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.000 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S1-S1

Author(s):

William L Hickerson ◽

Jeremy Goverman ◽

Sigrid A Blome-Eberwein ◽

Adam Singer ◽

Lucy Wibbenmeyer

Keyword(s):

Median Time ◽

Wound Closure ◽

The United States ◽

Acute Stage ◽

Phase Iii ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial ◽

Long Term Follow Up

Abstract Introduction Bromelain Based Debridement (BBD) of deep burns is approved for use in Europe, Argentina, Russia, South Korea, Peru and Israel. In the United States it is an investigational product and currently there are 2 multicenter RCTs (DETECT – adults, CIDS – children). Patient enrollment in the DETECT adult trial has been completed. The aim of this abstract is to present the acute stage top line results of the DETECT trial. Methods 175 adult patients suffering from deep burns were included in a phase III multicenter, multinational, randomized, controlled, assessor blinded trial. Patients were randomized to 3 arms – BBD, Standard of Care (SOC), or Gel vehicle (Placebo control) in a 3:3:1 ratio (75 BBD, 75 SOC, 25 Gel). The primary endpoint was the incidence of complete eschar removal (BBD vs Gel). Additional acute stage endpoints included the time to complete eschar removal, incidence of surgical eschar removal and eschar removal associated blood loss.Time to complete wound closure (BBD vs SOC) was assessed as a safety endpoint. Following the acute stage, a long-term follow up period of 2 years is being conducted. Results Patient demographics and wound baseline characteristics were comparable across study arms.The incidence of complete eschar removal was significantly higher for BBD vs Gel patients (93.3% vs 4%, p< 0.0001). The incidence of surgical eschar removal was significantly lower for BBD vs SOC patients (4% vs 72%, p< 0.0001). The median time to complete eschar removal was significantly shorter for BBD vs SOC patients (1 day vs 3.8 days, p< 0.0001). Calculated eschar removal associated blood loss was significantly lower for BBD vs SOC patients (14ml vs 815ml, p< 0.0001). The median time to complete wound closure was similar for BBD and SOC patients (27 and 28 days). The overall safety profile of BBD treated patients was good and consistent with the safety data known from previous studies.The results of the long term follow up period are not yet available. Conclusions The acute stage results of this robust phase III RCT demonstrate the safety and efficacy of BBD and are in line with previous trial results. Applicability of Research to Practice The results of this trial may help pave the way for US approval of BBD.

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A Novel Case of Fibroids after Menopause

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/9104719 ◽

2018 ◽

Vol 2018 ◽

pp. 1-2

Author(s):

Jade Edwards ◽

Hamza Katali

Keyword(s):

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Younger Women ◽

Benign Pathology ◽

Leiomyomatosis Peritonealis Disseminata ◽

Long Term Follow Up ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index

Fibroids are a condition commonly seen as part of routine gynaecological practice and generally present with menorrhagia, infertility, or pressure symptoms depending on their exact location. We report the case of a postmenopausal 57-year-old lady presenting with left-sided pain and frequency with a complex 15 cm mass mid pelvis and an adjacent additional 7 cm cyst but a risk of malignancy index suggesting benign pathology. She underwent total abdominal hysterectomy (TAH) and right-sided salpingo-oophrectomy (RSO) on recommendation of the multidisciplinary team (MDT) and histology confirmed leiomyomatosis peritonealis disseminata. This rare but important condition is often confused with peritoneal carcinomatosis on imaging. The mainstay of treatment involves lesion and omental excision followed by removal of hormonal stimuli although this approach must be personalised as many younger women may wish to retain their uteri. Long-term follow-up is essential due to the potential for malignant transformation.

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