Clinical and histopathological prognostic factors in locoregional advanced laryngeal cancer

2016 ◽  
Vol 130 (10) ◽  
pp. 948-953 ◽  
Author(s):  
T S Santos ◽  
R Estêvão ◽  
L Antunes ◽  
V Certal ◽  
J C Silva ◽  
...  
Keyword(s):  
Laryngeal Cancer ◽  
Growth Pattern ◽  
Perineural Invasion ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Extracapsular Extension ◽  
Free Survival ◽  
Infiltrative Growth Pattern ◽  
One Year ◽  
Disease Free

AbstractObjective:To evaluate the clinical and histopathological factors affecting the prognosis of patients with squamous cell locoregional advanced laryngeal cancer.Methods:A retrospective chart review was conducted of 121 patients with locoregional advanced laryngeal cancer, primarily treated with surgery from 2007 to 2011. Disease-free survival and overall survival rates were analysed as oncological outcomes. Prognostic variables, namely gender, pharyngeal invasion, pathological assessment of tumour and nodal stage, adjuvant therapy, margin status, nodal extracapsular extension, tumour differentiation, lymphovascular and perineural invasion, and predominant growth pattern, were also analysed.Results:One-year and three-year disease-free survival rates were 81.3 per cent and 63.5 per cent, respectively. One-year and three-year overall survival rates were 88.3 per cent and 61.4 per cent, respectively. Multivariate analysis showed that nodal extracapsular extension (p < 0.05) and an infiltrative growth pattern (p < 0.05) were associated with disease progression. Nodal extracapsular extension (p < 0.05) was associated with higher mortality.Conclusion:Nodal extracapsular extension and an infiltrative growth pattern were the main prognostic factors in locoregional advanced laryngeal cancer. The presence of pharyngeal invasion, pathologically confirmed node-positive stage 2–3 disease, close or microscopic positive margins, and lymphovascular and perineural invasion have a negative impact on prognosis.

scholarly journals EPEN-49. RESPONSE OF RECURRENT EPENDYMOMA TO MEMMAT BASED METRONOMIC ANTIANGIOGENIC COMBINATION THERAPY UTILIZING TAPERED BEVACIZUMAB AND MAINTENANCE THERAPY WITH CELECOXIB AND FENOFIBRATE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii317-iii317
Author(s):  
Eileen Gillan
Keyword(s):  
Combination Therapy ◽  
Maintenance Therapy ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Time To Progression ◽  
Free Survival ◽  
Dismal Prognosis ◽  
Recurrent Ependymoma ◽  
Disease Free

Abstract Recurrent ependymomas have a dismal prognosis (2 year survival rates 29% OS and 23% EFS) and are relatively resistant to conventional chemotherapy. We previously reported five relapsed ependymoma patients treated with a MEMMAT based metronomic antiangiogenic combination therapy. All patients are currently alive, including four patients who were multiply relapsed with at least three recurrences. These four patients received between 44–52 weeks of therapy with minimal toxicity. Three had recurrent disease within an average of 44 months (median 42 months) after discontinuation of therapy. One patient who received the following tapering bevacizumab schedule: q3 weeks x 3, q4 weeks x 4 and q5 weeks x 5 followed by maintenance therapy with fenofibrate and celecoxib is in complete remission 12 months post treatment. This regimen was well tolerated with good quality of life in this patient population. Our results suggest that the chosen anti-angiogenic drug combination prolonged the time to progression in these multiply relapsed patients and thus may be particularly beneficial for patients with recurrent ependymoma. Tapered bevacizumab and maintenance therapy with celecoxib and fenofibrate may be modifications worth further investigation for prolonged disease free survival in relapsed ependymoma patients.

Phase I Study of Fludarabine Plus Cyclophosphamide in Patients With Previously Untreated Low-Grade Lymphoma: Results and and Long-Term Follow-Up—A Report From the Eastern Cooperative Oncology Group

2000 ◽  
Vol 18 (5) ◽  
pp. 987-987 ◽  
Author(s):  
Howard S. Hochster ◽  
Martin M. Oken ◽  
Jane N. Winter ◽  
Leo I. Gordon ◽  
Bruce G. Raphael ◽  
...  
Keyword(s):  
Phase Ii ◽  
Bone Marrow Involvement ◽  
Survival Rates ◽  
Eastern Cooperative Oncology Group ◽  
Disease Free Survival ◽  
Low Grade ◽  
Survival Times ◽  
Free Survival ◽  
Disease Free

PURPOSE: To determine the toxicity and recommended phase II doses of the combination of fludarabine plus cyclophosphamide in chemotherapy-naive patients with low-grade lymphoma. PATIENTS AND METHODS: Previously untreated patients with low-grade lymphoma were entered onto dosing cohorts of four patients each. The cyclophosphamide dose, given on day 1, was increased from 600 to 1,000 mg/m2. Fludarabine 20 mg/m2 was administered on days 1 through 5. The first eight patients were treated every 21 days; later patients were treated every 28 days. Prophylactic antibiotics were required. RESULTS: Prolonged cytopenia and pulmonary toxicity each occurred in three of eight patients treated every 3 weeks. The 19 patients treated every 28 days, who were given granulocyte colony-stimulating factor as indicated, did not have undue nonhematologic toxicity. Dose-limiting toxicity was hematologic. At the recommended phase II/III dose (cyclophosphamide 1,000 mg/m2), grade 4 neutropenia was observed in 17% of all cycles and 31% of first cycles. Grade 3 or 4 thrombocytopenia was seen in only 1% of all cycles. The median number of cycles per patient was six (range, two to 11) for all patients enrolled. The response rate was 100% of 27 patients entered; 89% achieved a complete and 11% a partial response. Nineteen of 22 patients with bone marrow involvement had clearing of the marrow. Median duration of follow-up was more than 5 years; median overall and disease-free survival times have not been reached. Kaplan-Meier estimated 5-year overall survival and disease-free survival rates were 66% and 53%, respectively. CONCLUSION: The recommended dosing for this combination in patients with previously untreated low-grade lymphoma is cyclophosphamide 1,000 mg/m2 day 1 and fludarabine 20 mg/m2 days 1 through 5. The regimen has a high level of activity, with prolonged complete remissions providing 5-year overall and disease-free survival rates as high as those reported for other therapeutic approaches in untreated patients.

scholarly journals Perineural Invasion in Parotid Gland Malignancies

2018 ◽  
Vol 158 (6) ◽  
pp. 1035-1041 ◽  
Author(s):  
Phillip Huyett ◽  
Umamaheswar Duvvuri ◽  
Robert L. Ferris ◽  
Jonas T. Johnson ◽  
Barry M. Schaitkin ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Perineural Invasion ◽  
Tertiary Care ◽  
Case Series ◽  
Disease Free Survival ◽  
Facial Paresis ◽  
Duct Carcinoma ◽  
Free Survival ◽  
Cox Regression Analysis ◽  
Disease Free

Objectives To investigate the clinical predictors and survival implications of perineural invasion (PNI) in parotid gland malignancies. Study Design Case series with chart review. Setting Tertiary care medical center. Subjects and Methods Patients with parotid gland malignancies treated surgically from 2000 to 2015 were retrospectively identified in the Head and Neck Cancer Registry at a single institution. Data points were extracted from the medical record and original pathology reports. Results In total, 186 patients with parotid gland malignancies were identified with a mean follow-up of 5.2 years. Salivary duct carcinoma (45), mucoepidermoid carcinoma (44), and acinic cell carcinoma (26) were the most common histologic types. A total of 46.2% of tumors were found to have PNI. At the time of presentation, facial nerve paresis (odds ratio [OR], 64.7; P < .001) and facial pain (OR, 3.7; P = .002) but not facial paresthesia or anesthesia (OR, 2.8, P = .085) were predictive of PNI. Malignancies with PNI were significantly more likely to be of advanced T and N classification, be high-risk pathologic types, and have positive margins and angiolymphatic invasion. PNI positivity was associated with worse overall (hazard ratio, 2.62; P = .001) and disease-free survival (4.18; P < .001) on univariate Cox regression analysis. However, when controlling for other negative prognosticators, age, and adjuvant therapy, PNI did not have a statistically significant effect on disease-free or overall survival. Conclusions PNI is strongly correlated with more aggressive parotid gland malignancies but is not an independent predictor of worse survival. Facial paresis and pain were predictive of PNI positivity, and facial paresis correlated with worse overall and disease-free survival.

Young Age is not an Ominous Prognostic Factor in Breast Cancer Patients

1987 ◽  
Vol 73 (3) ◽  
pp. 233-235 ◽  
Author(s):  
Giuseppe Muscolino ◽  
Corrado Villani ◽  
Amedeo Vittorio Bedini ◽  
Alberto Luini ◽  
Bruno Salvadori
Keyword(s):  
Breast Cancer ◽  
Prognostic Factor ◽  
Cancer Patients ◽  
Young Women ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Young Age ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free

Analysis of a series of 137 women 20–30 years of age, operated for breast carcinoma, excluding patients pregnant, lactating or with inflammatory cancer, showed that disease-free survival rates were similar and not lower than those reported for a large series of 716 breast cancer patients of all ages, treated and followed at the same Institute. Ten-year disease-free survival rates for the two series of 137 young women and 716 patients of all ages were 43.7% and 47.1% respectively. Even when considering the subgroups of patients with and without nodal axillary involvement, the corresponding figures for the two series considered were 72.6% vs. 72.1% (N−) and 25.1% vs. 24.5% (N+). It can be concluded that young age cannot be considered as an unfavorable prognostic factor.

49. 1-, 5- and 10-year high-grade disease-free survival after laser ablation of biopsy proven AIN2/3: outcomes from a single centre prospective cohort

Sexual Health ◽  
2013 ◽  
Vol 10 (6) ◽  
pp. 594
Author(s):  
Sanjaya Wijeyekoon ◽  
John Thornhill ◽  
Mayura Nathan
Keyword(s):  
Laser Ablation ◽  
Laser Treatment ◽  
Prospective Cohort ◽  
Disease Free Survival ◽  
Study Entry ◽  
High Grade ◽  
Free Survival ◽  
Sex With Men ◽  
One Year ◽  
Disease Free

Objective To describe the characteristics and overall high-grade disease-free survival of 153 consecutive patients treated by laser ablation of biopsy proven high-grade anal neoplasia over an 18.5-year period. Design: Prospective cohort study. Study entry was at the first laser treatment for biopsy proven AIN 2/3. Outcome measures: The principal outcome was high-grade disease-free survival time. High-grade disease-free survival was defined as the time from entry into the cohort to the date of next laser treatment for biopsy-proven high-grade disease. Patients who did not have recurrent high-grade disease at their most recent clinic assessment were censored. Results: Data were evaluated for 153 consecutive patients who were treated by laser ablation of anal high-grade (AIN 2/3) disease between January 1996 and July 2013. These constituted 240 separate treatment episodes over 18.5 years. The majority of subjects were men (91.5%), 44.1% were smokers and 86.3% were classified as men who have sex with men (MSM). At the study entry 64.7% were HIV positive. The median high-grade disease-free survival was 716.5 days (range 11–4730). One year overall high-grade disease-free survival was 77.7% (95% CI 71.7–82.5). Five-year overall high-grade disease-free survival was 51.4% (43.6–58.5). The 10-year overall high-grade disease-free survival was 49.1% (40.5–57.1). There was no difference in high-grade disease-free survival when stratified by HIV positivity status (P = 0.394–log rank). Conclusions: Following laser ablation, recurrence of high-grade disease was low at 1, 5 and 10 years. There was no difference in disease-free survival based on HIV status.

scholarly journals The Evolving Role of Radiation Therapy in the Treatment of Biliary Tract Cancer

2020 ◽  
Vol 10 ◽  
Author(s):  
Eleni Gkika ◽  
Maria A. Hawkins ◽  
Anca-Ligia Grosu ◽  
Thomas B. Brunner
Keyword(s):  
Biliary Tract ◽  
Survival Rates ◽  
Disease Free Survival ◽  
R0 Resection ◽  
Anatomical Location ◽  
Free Survival ◽  
Tract Cancer ◽  
Complete Surgical Resection ◽  
One Year

Biliary tract cancers (BTC) are a disease entity comprising diverse epithelial tumors, which are categorized according to their anatomical location as intrahepatic (iCCA), perihilar (pCCA), distal (dCCA) cholangiocarcinomas, and gallbladder carcinomas (GBC), with distinct epidemiology, biology, and prognosis. Complete surgical resection is the mainstay in operable BTC as it is the only potentially curative treatment option. Nevertheless, even after curative (R0) resection, the 5-year survival rate ranges between 20 and 40% and the disease free survival rates (DFS) is approximately 48–65% after one year and 23–35% after three years without adjuvant treatment. Improvements in adjuvant chemotherapy have improved the DFS, but the role of adjuvant radiotherapy is unclear. On the other hand, more than 50% of the patients present with unresectable disease at the time of diagnosis, which limits the prognosis to a few months without treatment. Herein, we review the role of radiotherapy in the treatment of cholangiocarcinoma in the curative and palliative setting.

PS02.115: PERIOPERATIVE CHEMOTHERAPY VERSUS NEOADJUVANT CHEMORADIATION FOR PATIENTS WITH ADENOCARCINOMA OF THE DISTAL OESOPHAGUS IN AUSTRIA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 153-153
Author(s):  
Oliver Koch ◽  
Andreas Tschoner ◽  
Richard Partl ◽  
Alexander Perathoner ◽  
Philipp Gehwolf ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pathological Complete Response ◽  
Disease Free Survival ◽  
Complete Response ◽  
Neoadjuvant Chemoradiation ◽  
Type I ◽  
Perioperative Chemotherapy ◽  
Free Survival ◽  
One Year ◽  
Disease Free

Abstract Background The aim of this study is to compare the outcome of patients with adenocarcinoma of the distal oesophagus (AEG Type I) treated with perioperative chemotherapy or neoadjuvant chemoradiation. Methods A retrospective analysis of eligible patients from four Austrian centers was conducted. All patients with AEG type I treated between January 2007 and October 2017 with chemotherapy (EOX-protocol) or chemoradiation (CROSS-protocol, or 5-FU/Cisplatin), followed by oesophagectomy were included in the study. Primary outcomes overall survival, and disease free survival as well as secondary outcomes, achievement of pathological complete response pCR (ypT0N0M0) or downstaging of T- or N-stage were analyzed. Primary outcomes were calculated by the Kaplan-Meier-method. Results Data of 117 patients were analyzed, 59 received chemoradiation (50/59 CROSS and 9/59 5-FU/Cisplatin) and 58 patients received perioperative chemotherapy (EOX). Complete data at time of submission were available in 40 patients in the chemoradiation group and in 37 patients in the chemotherapy group. The median follow-up time in the chemoradiation group was 13,0 months (CI 95%: 11,0–15,0) and in the chemotherapy group 45,0 months (CI 95%: 28,8–61,3). Overall survival rate in the EOX group after ½, 1, 3 and 5 years was 92%, 83%, 63% and 34%. So far long term data are not available after chemoradiation, after ½ year overall survival was 84% and after one year 60%. Disease free survival rate in the EOX group after ½, 1, 3 and 5 years was 91%, 81%, 54% and 32%, in the chemoradiation group after ½ and one year 80% and 50%. A significant difference was found in the pathological complete response (pCR) rate, it was achieved in 19% of patients after chemoradiation and in 3% after chemotherapy (P = 0000). Conclusion Concerning major response of the primary tumor there are clear advantages for chemoradiation. In regards to systemic tumor control there seems a tendency in favor for chemotherapy. Disclosure All authors have declared no conflicts of interest.

Evaluating high-grade prostatic intraepithelial neoplasia as a predictor of outcome following radical prostatectomy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4612-4612
Author(s):  
P. M. Pierorazio ◽  
S. M. Lambert ◽  
T. R. McCann ◽  
A. E. Katz ◽  
C. A. Olsson ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Perineural Invasion ◽  
Disease Free Survival ◽  
Intraepithelial Neoplasia ◽  
High Grade ◽  
Free Survival ◽  
Pathologic Stage ◽  
Significant Difference ◽  
The Relationship ◽  
Disease Free

4612 Background: The presence of high-grade prostatic intraepithelial neoplasia (HGPIN) has been associated with future development of prostate cancer. High-grade intraepithelial neoplasia in other malignancies is associated with adverse outcome. This study examines the relationship between the presence of HGPIN in prostatectomy specimens, biochemical disease free survival (bDFS) and other cancer specific outcomes following radical retropubic prostatectomy (RRP). Methods: The Columbia University Urologic Oncology Database was reviewed and 2,522 were identified who had undergone radical prostatectomy from 1988 to 2005; 2,133 patients with or without HGPIN were included. Two-sample proportion analysis of means with 95% confidence intervals and ANOVA techniques were used to evaluate the relationship between HGPIN and pathologic stage, Gleason sum, perineural invasion, multifocality, extracapsular extension (ECE), margin status, and nodal status. Kaplan-Meier analysis with log-rank test and a multivariate Cox proportional hazard model controlling for preoperative PSA, Gleason sum and pathologic stage were used to assess differences in bDFS. Results: 1,885 of 2,133 (88.4%) patients demonstrated HGPIN. There was no significant difference in the distribution of pathologic stage or Gleason sum between the patients with and without HGPIN. The HGPIN-positive group had higher rates of perineural invasion (69.9 vs. 57.5%; p = 0.003), multifocality (63.0 vs. 38.4%; p = 0.000) and ECE (56.4% vs. 48.4%; p = 0.059). There was no statistically significant difference observed in nodal status or margin status between the two groups. Patients without HGPIN had an increased bDFS demonstrated by a predicted disease free survival of 73.6% versus 67.0% at 9 years (p = 0.045) with a median follow-up of 50 months. In the multivariate Cox hazard model HGPIN, PSA, Gleason sum and pathologic stage were validated as independent predictors of failure (p < 0.001). The risk of failure was 1.9 × greater in the HGPIN-positive group than the HGPIN-negative group (p=0.006). Conclusions: The presence of HGPIN in the radical prostatectomy specimen denotes a significantly higher rate of tumor multifocality, perineural invasion, ECE, and ultimately biochemical recurrence. No significant financial relationships to disclose.

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