Rhinectomy for the management of nasal malignancies

2011 ◽  
Vol 125 (10) ◽  
pp. 1033-1037 ◽  
Author(s):  
E Chipp ◽  
D Prinsloo ◽  
S Rayatt
Keyword(s):  
High Risk ◽  
Cell Carcinoma ◽  
Recurrent Disease ◽  
Surgical Excision ◽  
Salvage Procedure ◽  
Previous Surgery ◽  
Retrospective Case ◽  
Disease Free ◽  
Case Note Review

AbstractBackground:Tumours of nasal skin or mucosa are common, and can usually be treated with limited surgical excision or radiotherapy. This paper highlights a subset of high risk tumours which require rhinectomy for complete oncological clearance.Method:Retrospective case note review of 14 patients undergoing rhinectomy for nasal tumours. Clinical and histological findings, treatment and outcome are reviewed and discussed.Results:Forty-three per cent of patients had recurrent disease and underwent rhinectomy as a salvage procedure following previous surgery or radiotherapy. Most tumours (79 per cent) were basal cell carcinoma or squamous cell carcinoma. After a mean follow up of 30.1 months (range, zero to 96 months), seven patients (50 per cent) were alive and disease-free. Reconstruction was most commonly with a prosthesis.Conclusion:Rhinectomy is an oncologically sound procedure for the management of high risk nasal malignancies. Prosthetic rehabilitation can be an excellent alternative to surgery, particularly in those patients unsuitable for major reconstruction.

Effect of salvage radiofrequency ablation on local control of recurrent renal cell carcinoma.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 355-355
Author(s):  
S. P. Psutka ◽  
A. Daha ◽  
D. Gervais ◽  
A. S. Feldman
Keyword(s):  
Renal Cell Carcinoma ◽  
Radiofrequency Ablation ◽  
Cell Carcinoma ◽  
Local Control ◽  
Renal Cell ◽  
Recurrent Disease ◽  
Complete Response ◽  
Disease Recurrence ◽  
Disease Free

355 Background: Radiofrequency ablation (RFA) has emerged as a safe and efficacious option to manage small renal cell carcinoma (RCC) in patients for whom comorbidities preclude surgical treatment. Salvage surgical excision of disease recurrence after ablative therapy is often complicated by extensive perinephric fibrosis. There are no reports in the literature which assess salvage RFA (sRFA) of recurrent disease (RD). The aim of this study was to assess the overall efficacy, complications, and safety of sRFA. Methods: Between 1998 and 2008, 313 patients underwent RFA for RCC. RD was defined as detectable new enhancing tissue in the prior RFA-cavitation site after a documented complete response. We retrospectively compared patients who developed RD (RD+, n = 15, 5.1%) with patients who remained disease free after a complete response (RD−, n = 296, 95%), assessing tumor characteristics (size, location, biopsy pathology), complications, and disease-free survival. Mean follow-up was 3 years (SD 2.1). Results: RD+ and RD− groups did not differ significantly in age, gender, or tumor type. In tumors < 4cm, 3.3% were RD+. In tumors >= 4cm, 9.6% were RD+ (p<0.0001). RD+ groups were more likely to have central tumors (20% vs. 5.7%, p = 0.04). Mean time to disease recurrence was 1.47 years (SD 0.75, 0.5-3.5 yrs). Of the 15 patients with RD, 7 patients underwent sRFA, 6 patients elected observation due to comorbidities precluding further treatment, one patient received chemotherapy for widespread metastases and one patient underwent salvage partial nephrectomy, which was aborted due to extensive tumor burden and perirenal fibrosis. There were no complications related to sRFA. Of those who underwent sRFA, local recurrences were successfully ablated in 100% of cases with a single salvage RFA treatment. None of these sRFA cases developed locally recurrent disease at an average of 3 years follow-up. Conclusions: RD after RFA remains challenging to treat due to the significant comorbidities of the patients who are candidates for ablative treatment of RCC. RD was more likely to occur in centrally located tumors, > 4cm in size. Salvage RFA successfully can achieve local control in these patients without increased rates of complications. No significant financial relationships to disclose.

scholarly journals Congenital mesoblastic nephroma: a single-centre series

2020 ◽  
Vol 102 (1) ◽  
pp. 67-70
Author(s):  
M Pachl ◽  
GS Arul ◽  
I Jester ◽  
C Bowen ◽  
D Hobin ◽  
...  
Keyword(s):  
Recurrent Disease ◽  
Chemotherapeutic Agents ◽  
The Other ◽  
Case Review ◽  
Mesoblastic Nephroma ◽  
Retrospective Case ◽  
Congenital Mesoblastic Nephroma ◽  
Lung Irradiation ◽  
Disease Free

Background Congenital mesoblastic nephroma is a rare disease. Treatment is surgical in the first instance. Chemotherapy has traditionally been thought not to have a role. Recent literature suggests a 50% mortality rate for recurrent/metastatic disease. Materials and methods This study is a retrospective case review of prospectively collected data. Demographics, histopathology, treatment, outcomes and follow up were reviewed. Results Nine patients, 6 male and 3 female, were included. The median age at presentation was one month (range 0–7 months); follow-up was for a median of 21.5 months (range 16–79 months). Two patients had mixed and classical subtypes and the other five had the cellular subtype. Surgery was completed by an open procedure in eight patients and laparoscopically in one. There were three recurrences; two were local and one was pulmonary. Recurrences were treated with a combination of chemotherapy, radiotherapy and surgery. One patient with recurrent disease died from acute-on-chronic respiratory failure secondary to lung irradiation but was disease free. The other eight are disease free, alive and well with no sequelae at latest follow-up. Conclusions Surgery remains the mainstay of management with chemo- and radiotherapy reserved for unresectable tumours or adjuvant management of recurrent disease. Specimen-positive margins are not an indication for instituting chemotherapy. The tyrosine kinase pathway seems to be a potential target for future chemotherapeutic agents although it is too early to assess how that will impact on the management of congenital mesoblastic nephroma.

scholarly journals HE4 is superior to CA125 in the detection of recurrent disease in high-risk endometrial cancer patients

Tumor Biology ◽  
2018 ◽  
Vol 40 (2) ◽  
pp. 101042831875710 ◽  
Author(s):  
Karin Abbink ◽  
Petra LM Zusterzeel ◽  
Anneke J Geurts-Moespot ◽  
Antonius E van Herwaarden ◽  
Johanna MA Pijnenborg ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
High Risk ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Recurrent Disease ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Objective: To date, biomarkers are not routinely used in endometrial cancer diagnosis, prognosis, and follow-up. The purpose of this study was to evaluate whether serum HE4 was related to clinicopathological risk factors and outcome. Second, the role of serum HE4 and CA125 was assessed as indicator for recurrent disease during follow-up. Methods: A total of 174 patients with endometrial cancer between 1999 and 2009 were selected for this retrospective study. Serum HE4 and CA125 were analyzed at primary diagnosis, during follow-up, and at the time of recurrence. Correlations with clinicopathological factors were studied by univariate and multivariate survival analyses. Lead time was calculated in order to determine which serum marker was elevated prior to clinical detection of recurrent disease. Results: Serum levels of HE4 and CA125 were significantly associated with high tumor grade, myometrial invasion, lymph node involvement, and advanced stage (p < 0.01). HE4 was an independent prognostic factor for reduced disease-free survival and overall survival with hazard ratios of 2.96 (95% confidence interval: 1.18–7.99) and 3.27 (95% confidence interval: 1.18–9.02), respectively. At recurrence, 75% of the patients had an elevated HE4 compared to 54% with an elevated CA125. HE4 levels were more frequently elevated in patients with distant metastasis compared to local recurrences, 67% and 37%, respectively. Serum HE4 detected a recurrence with a median of 126 days earlier than clinical confirmation. Conclusion: Elevated serum HE4 is an independent risk factor for reduced disease-free survival and overall survival. HE4 seems to be superior to CA125 in the detection of recurrent disease during follow-up, mainly in high-risk endometrial cancer patients who are more prone to distant metastasis.

Acinic Cell Carcinoma of the Oral Cavity

1982 ◽  
Vol 90 (6) ◽  
pp. 696-699 ◽  
Author(s):  
William M. Keane ◽  
James C. Denneny Iii ◽  
Joseph P. Atkins ◽  
Francis McBrearty
Keyword(s):  
Oral Cavity ◽  
Cell Carcinoma ◽  
Minor Salivary Gland ◽  
Surgical Excision ◽  
Acinic Cell Carcinoma ◽  
Acinic Cell ◽  
Long Term Follow Up ◽  
Disease Free

A rare case of acinic cell carcinoma of minor salivary gland origin within the oral cavity is reported in a 62-year-old woman. These tumors most commonly arise in the parotid gland and follow an insidious course requiring long-term follow-up. The gross and histologic features of the patient's tumor include pseudoencapsulation, mixed solid and acinar architecture, microcyst formation, and the presence of conspicuous diastase-fast and PAS-positive cytoplasmic granules, characteristic of lesions that have been called acinic cell carcinoma by a variety of authors. Surgical excision is the treatment of choice. However, following an incisional biopsy, the patient refused further surgical treatment and has remained clinically disease-free three years postoperatively.

Squamous Cell Carcinoma of the External Ear: A Review of 75 Cases

1987 ◽  
Vol 97 (3) ◽  
pp. 308-312 ◽  
Author(s):  
William W. Shockley ◽  
Fred J. Stucker
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cancer Control ◽  
Surgical Excision ◽  
External Ear ◽  
Common Cancer ◽  
Node Metastases

Squamous cell carcinoma of the external ear can be a potentially lethal lesion. Although it is the most common cancer involving the pinna, the variables that have the greatest impact on prognosis are still in question. We reviewed 75 cases of squamous cell carcinoma of the external ear to determine patterns of occurrence and treatment failure. Forty patients had adequate follow-up for determination of cancer control rates. Local control was successful with initial treatment in 85% of the cases. The incidence of lymph node metastases was 10%, whereas distant metastasis occurred in only one patient (2.5%). This series differs from others in that most patients were unselected and most of the lesions treated were early (less than 1 cm). The significance of positive margins after surgical excision is also analyzed.

scholarly journals Effectivity of intravescical thermo-chemotherapy prophylaxis for patients with high recurrence and progression risk for non-muscle invasive bladder cancer

2017 ◽  
Vol 89 (2) ◽  
pp. 102 ◽  
Author(s):  
Ali Serdar Gözen ◽  
Paolo Umari ◽  
Walter Scheitlin ◽  
Fuat Ernis Su ◽  
Yigit Akin ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
High Risk ◽  
Recurrent Disease ◽  
Bladder Wall ◽  
Invasive Bladder Cancer ◽  
Outpatient Basis ◽  
High Grade ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Background&amp;Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (&gt; 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.

scholarly journals Clinical and radiological features that predict malignant transformation in cystic lesions of the pancreas: a retrospective case note review

2019 ◽  
Vol 1 ◽  
pp. 4
Author(s):  
Margaret G. Keane ◽  
Hannah R. Dadds ◽  
Ghassan El Sayed ◽  
Tu Vinh Luong ◽  
Brian R. Davidson ◽  
...  
Keyword(s):  
High Risk ◽  
Malignant Transformation ◽  
Cystic Lesions ◽  
Retrospective Case ◽  
Radiological Features ◽  
Multidisciplinary Meeting ◽  
Mucinous Neoplasms ◽  
Low Incidence ◽  
Immediate Surgery

Background: Pancreatic cystic lesions (PCL) are being detected with increasing frequency. Current methods of stratifying risk of malignant transformation are imperfect. This study aimed to determine the frequency of pancreatic malignancy in patients with PCL and define clinical and radiological features that predict malignant transformation in patients managed by surgery and/or surveillance. Methods: A retrospective cohort of adults who were evaluated in a tertiary hepatopancreaticobiliary centre between January 2000 - December 2013 with a confirmed PCL and followed up for at least 5 years. All cystic lesions were discussed at a weekly multidisciplinary meeting. Results: Of the 1,090 patients diagnosed with a PCL, 768 patients were included in the study: 141 patients were referred for immediate pancreatic resection, 570 entered surveillance while 57 had a malignant PCL which was unresectable at diagnosis (n=47) or were unfit for surgery (n=10). In those who were resected following presentation, malignancy was present in 38%. During follow-up 2% of those entering a surveillance programme underwent malignant transformation. Clinical and radiological features associated with a high-risk PCL included older age, symptoms, associated solid component or dilated main pancreatic duct. In intraductal papillary mucinous neoplasms, larger size was not a feature of malignant transformation (benign vs. malignant 30mm vs. 23mm; P= 0.012). Conclusion: The sensitivity of standard diagnostic tests leading to immediate surgery for high-risk PCL (malignant or mucinous) was 92% but with a specificity of just 5%. Surveillance of PCL without high-risk features within a multidisciplinary meeting was associated with a low incidence of cancer development, supporting the use of worrisome clinical and radiological features in the initial stratification of PCL.

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