Treatment outcomes of laryngectomy compared to non-surgical management of T3 laryngeal carcinomas: a 10-year multicentre audit of 179 patients in the northeast of England

AbstractObjectiveWide-ranging outcomes have been reported for surgical and non-surgical management of T3 laryngeal carcinomas. This study compared the outcomes of T3 tumours treated with laryngectomy or (chemo)radiotherapy in the northeast of England.MethodsThe outcomes of T3 laryngeal carcinoma treatment at three centres (2007–2016) were retrospectively analysed using descriptive statistics and survival curves.ResultsOf 179 T3 laryngeal carcinomas, 68 were treated with laryngectomies, 57 with chemoradiotherapy and 32 with radiotherapy. There was no significant five-year survival difference between treatment with laryngectomy (34.1 per cent) and chemoradiotherapy (48.6 per cent) (p = 0.184). The five-year overall survival rate for radiotherapy (12.5 per cent) was significantly inferior compared to laryngectomy and chemoradiotherapy (p = 0.003 and p < 0.001, respectively). The recurrence rates were 22.1 per cent for laryngectomy, 17.5 per cent for chemoradiotherapy and 50 per cent for radiotherapy. There were significant differences in recurrence rates when laryngectomy (p = 0.005) and chemoradiotherapy (p = 0.001) were compared to radiotherapy.ConclusionLaryngectomy and chemoradiotherapy had significantly higher five-year overall survival and lower recurrence rates compared with radiotherapy alone. Laryngectomy should be considered in patients unsuitable for chemotherapy, as it may convey a significant survival advantage over radiotherapy alone.

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The Role of Total Parenteral Nutrition in Patients with Peritoneal Carcinomatosis: A Systematic Review and Meta-Analysis

Cancers ◽

10.3390/cancers13164156 ◽

2021 ◽

Vol 13 (16) ◽

pp. 4156

Author(s):

Xing-Yi Sarah Ong ◽

Rehena Sultana ◽

Joey Wee-Shan Tan ◽

Qiu Xuan Tan ◽

Jolene Si Min Wong ◽

...

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Parenteral Nutrition ◽

Peritoneal Carcinomatosis ◽

Total Parenteral Nutrition ◽

Median Overall Survival ◽

Meta Analysis ◽

Significant Survival Advantage ◽

Significant Survival

Peritoneal carcinomatosis (PC) is often associated with malnutrition and an inability to tolerate enteral feeding. Although total parenteral nutrition (TPN) can be lifesaving for patients with no other means of nutritional support, its use in the management of PC patients remains controversial. Therefore, a systematic review and meta-analysis was performed to evaluate the benefit of TPN on the overall survival of PC patients, in accordance with PRISMA guidelines. A total of 187 articles were screened; 10 were included in this review and eight were included in the meta-analysis. The pooled median overall survival of patients who received TPN was significantly higher than patients who did not receive TPN (p = 0.040). When only high-quality studies were included, a significant survival advantage was observed in PC patients receiving TPN (p < 0.001). Subgroup analysis of patients receiving chemotherapy demonstrated a significant survival benefit (p = 0.008) associated with the use of TPN. In conclusion, TPN may improve survival outcomes in PC patients. However, further studies are needed to conclude more definitively on the effect of TPN.

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Radiotherapy plus concomitant and adjuvant temozolamide for newly diagnosed pediatric high-grade astrocytoma

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.9042 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 9042-9042

Author(s):

M. M. Abdel Wahab ◽

H. El-Hosseini ◽

L. R. Eezz El-Arab

Keyword(s):

Overall Survival ◽

Pediatric Patients ◽

Combined Treatment ◽

High Grade ◽

Newly Diagnosed ◽

Time To Progression ◽

High Grade Astrocytoma ◽

Significant Survival ◽

Radiotherapy Alone ◽

Grade 3

9042 Background: to evaluate the potential survival advantage of adding temozolamide (TMZ) concomitantly and adjuvant to radiotherapy (RT) as regard time to progression (TTP) and overall survival in addition to its safety and tolerability in pediatric high grade astrocytomas. Methods: A total of 29 pediatric patients newly diagnosed, histologically proven glioblastoma multiforme (GBM) or anaplastic astreocytoma (AA) were randomized, to radiotherapy alone (14 patients) or radiotherapy and concomitant (TMZ) 150mg/m2/d for 5 days every 28 days followed by up to 6 cycels of adjuvant TMZ (15 patients). Results: The median time to progression was significantly prolonged in patients treated with RT/TMZ compared to those treated with RT alone (14 months Vs 7 months respectively) (P<0.05). The median overall survival in the combined treatment Vs monotherapy was 23 months and 13 months respectively (P<0.01). Non hematologic adverse events were similar between both groups while grade 3 & 4 hematologic toxicities occurred in 20% only of the RT/TMZ arm (2 patients experienced grade 3 thrombocytopenia and 1 patient developed grade 4 neutropenia). Conclusions: This study demonstrate a significant survival benefit for the addition of TMZ to treatment of pediatric patients with high grade astrocytpoma and it’s safety, well tolerability which allows it to be given concurrently with RT, followed by additional adjuvant cycles. No significant financial relationships to disclose.

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RESECTION AND PRIMARY ANASTOMOSIS IN THE MANAGEMENT OF STENOSIS AND ATRESIA OF THE JEJUNUM AND ILEUM

PEDIATRICS ◽

10.1542/peds.26.2.265 ◽

1960 ◽

Vol 26 (2) ◽

pp. 265-272

Author(s):

Clifford D. Benson ◽

James R. Lloyd ◽

J. Dwight Smith

Keyword(s):

Overall Survival ◽

Survival Rate ◽

Surgical Management ◽

Primary Anastomosis ◽

Operative Procedures ◽

Overall Survival Rate ◽

Technical Aspects

An analysis of 38 cases of congenital jejunal and ileal stenosis and atresia is presented. There was an overall survival rate of 55%. Between the years 1952 and 1959, the survival rate was 62% compared to 33% for the years 1945 to 1951. Recent concepts of the etiology of these lesions are discussed. Physiologic and anatomic considerations are presented. The authors' program for the surgical management and technical aspects of the operative procedures are outlined.

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P.049 Repeat surgery in recurrent glioblastoma: a systematic review and meta-analysis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2018.151 ◽

2018 ◽

Vol 45 (s2) ◽

pp. S28-S28

Author(s):

JZ Wang ◽

F Nassiri ◽

JH Badhiwala ◽

G Zadeh

Keyword(s):

Systematic Review ◽

Overall Survival ◽

Meta Analysis ◽

Performance Status ◽

Recurrent Glioblastoma ◽

Repeat Surgery ◽

Significant Survival Advantage ◽

Initial Surgery ◽

Significant Survival

Background: Recurrent glioblastoma portends a poor prognosis and the role of repeat surgery in improving survival remains uncertain. Our systematic review and meta-analysis aims to address whether re-resection provides a meaningful survival benefit and to what degree. Methods: Articles were collected from Pubmed, -CINAHL, EMBASE, Medline and Cochrane from January 1990 to 2018. Studies in the temozolomide era with both single surgery and re-resection cohorts were included. Primary outcomes were odds ratio for survival at 6, 12, and 24 months following re-resection and initial surgery. Results: Fourteen articles were included for analysis (3048 patients). Meta-analysis showed improved overall survival following re-resection at 6- (OR 1.73, 95% CI 1.23-2.45, p<0.05), 12- (OR 1.71, 95% CI 1.20-2.45, p<0.05), and 24-months (OR 2.24, 95% CI 1.01-4.95, p<0.05). Overall survival from diagnosis or first surgery was also improved in patients who underwent re-resection at -recurrence, similarly at 6- (OR 8.22, 95% CI 5.23-12.93, p<0.01), 12- (OR 4.16, 95% CI 3.25-5.36, p<0.01), and 24- (2.35, 95% CI 1.77-3.11, p<0.05) months. Subgroup analyses were done for patients stratified by age, performance status, and number of re-resections. Conclusions: Repeat surgery for recurrent glioblastoma is associated with a significant survival advantage independent of other salvage therapies that include chemotherapy, radiation, and other antineoplastic regimens.

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Carbon Ion Radiotherapy for Oligo-Recurrence in the Lung

Pulmonary Medicine ◽

10.1155/2013/219746 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Naoyoshi Yamamoto ◽

Mio Nakajima ◽

Hirohiko Tsujii ◽

Tadashi Kamada

Keyword(s):

Colorectal Cancer ◽

Lung Cancer ◽

Overall Survival ◽

Survival Rate ◽

Local Control ◽

Local Control Rate ◽

Carbon Ion Radiotherapy ◽

Overall Survival Rate ◽

Carbon Ion ◽

Metastatic Lung

The clinical results after carbon ion radiotherapy for the metastatic lung tumors believed to be in the state of oligo-recurrence were evaluated. One hundred and sixteen lesions in 91 patients with lung cancer metastasis were treated with carbon ion radiotherapy at our institute from April 1997 to February 2011. Regarding the prescribed dose, total dose ranged between 40 gray equivalents (GyE) and 80 GyE, and fraction size ranged from 1 to 16 fractions. After a median followup period of 2.3 years (range, 0.3–13.1 years), the statistical overall survival rate and local control rate were 71.2% and 91.9% at 2 years after treatment, respectively. Treatment-related side effects were not a clinical problem. When classified by the primary organ, there were 49 cases of lung cancer, 20 cases of colorectal cancer, and 22 cases of others. The overall survival rate and local control rate for lung metastasis cases from lung cancer at 2 years after treatment were 81.5% and 92.4%, respectively, and 65.0% and 92.0% regarding lung metastasis from colorectal cancer. Carbon ion beam therapy for the metastatic lung tumors is a safe therapy, and the therapeutic effect is comparable to the outcome obtained from reported surgical resections.

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PREDICTORS OF OVERALL SURVIVAL IN MEN WITH CHRONIC LYMPHOCYTIC LEUKEMIA

Ulyanovsk Medico-biological Journal ◽

10.34014/2227-1848-2021-1-50-56 ◽

2021 ◽

pp. 50-56

Author(s):

M.V. Markovtseva ◽

E.N. Zgural'skaya

Keyword(s):

Overall Survival ◽

Glomerular Filtration Rate ◽

Survival Rate ◽

Glomerular Filtration ◽

Median Survival ◽

Filtration Rate ◽

Lymphocytic Leukemia ◽

Overall Survival Rate ◽

Patient Will ◽

Actual Survival

The generally accepted staging for chronic lymphocytic leukemia (CLL) suggested by K. Rai and J. Binet allows calculating the median survival depending on the size of the tumor mass. However, in real clinical practice, the overall survival rate may differ significantly from the calculated median. Thus, the search for parameters affecting the overall survival rate of CLL patients is really relevant. The aim of the study was to assess general clinical parameters as predictors of survival in CLL patients. Materials and Methods. The authors examined 60 CLL men (stages A–C according to Binet) with known overall survival rate. Data mining was used to identify significant factors affecting the overall survival in such patients. Patients were divided into two non-overlapping classes: K1 (actual survival was less than the predicted median survival) and K2 (actual survival was more or equal to the predicted median survival). Results. The most significant differences between the classes were obtained for glomerular filtration rate. If the parameter value is more than 76.5 ml/min/1.73 m2, we can say that the patient will overcome the median survival for the corresponding CLL stage according to Binet. Otherwise, the overall survival of a CLL patient will be less than the estimated one. Conclusion. If during diagnosing glomerular filtration rate of a CLL patient is more than 76.5 ml/min/1.73 m2, it can be considered as a predictor of overcoming the median survival according to Binet. The results of the studies obtained are patented. Patent RU 2725877 C1, July 7, 2020. Keywords: overall survival in CLL patients, men, glomerular filtration rate, data mining. Общепризнанные системы стадирования хронического лимфолейкоза (ХЛЛ) К. Rai и J. Binet позволяют рассчитать медиану выживаемости пациента в зависимости от величины опухолевой массы. Однако в реальной клинической практике параметр общей выживаемости пациента может значимо отличаться от расчетной медианы. Ввиду этого поиск параметров, влияющих на показатель общей выживаемости пациентов с ХЛЛ, представляет особую актуальность. Цель исследования – оценить возможность использования общеклинических параметров в качестве предикторов выживаемости больных ХЛЛ. Материалы и методы. Ретроспективно проанализированы данные 60 мужчин с ХЛЛ стадии A–C по Binet c известной общей выживаемостью. Для выявления значимых факторов, влияющих на общую выживаемость пациентов, использовали метод интеллектуального анализа данных. Пациенты были разделены на два непересекающихся класса: K1 (фактическая выживаемость меньше прогнозируемой медианы выживаемости) и K2 (фактическая выживаемость больше или равна прогнозируемой медиане выживаемости). Результаты. Наиболее значимые различия между классами были получены по показателю скорости клубочковой фильтрации. При значении параметра более 76,5 мл/мин/1,73 м2 можно говорить о том, что пациент преодолеет расчетные данные медианы выживаемости для соответствующей стадии ХЛЛ по Binet. В противном случае общая выживаемость пациента ХЛЛ будет меньше расчетной. Выводы. Наличие у пациента с ХЛЛ на момент постановки диагноза скорости клубочковой фильтрации более 76,5 мл/мин/1,73 м2 можно рассматривать в качестве предиктора преодоления расчетного параметра медианы выживаемости по Binet. Результаты полученных исследований запатентованы. Патент RU 2725877 C1 от 7.07.2020. Ключевые слова: общая выживаемость при ХЛЛ, мужчины, скорость клубочковой фильтрации, интеллектуальный анализ данных.

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Carbon Dioxide Laser Microsurgery for Early Supraglottic Carcinoma

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348949810700810 ◽

1998 ◽

Vol 107 (8) ◽

pp. 680-688 ◽

Cited By ~ 128

Author(s):

Petra Ambrosch ◽

Martina Kron ◽

Wolfgang Steiner

Keyword(s):

Carbon Dioxide ◽

Overall Survival ◽

Survival Rate ◽

Local Control ◽

Carbon Dioxide Laser ◽

Local Control Rate ◽

Overall Survival Rate ◽

Laser Microsurgery ◽

Supraglottic Carcinoma ◽

Free Rate

Forty-eight untreated patients with early supraglottic carcinoma (12 patients stage I and 36 patients stage II) had primary carbon dioxide laser microsurgery between 1979 and 1994 with the intent of complete tumor removal with preservation of functionally important structures of the larynx. Ninety-six percent of the patients were treated exclusively by surgery; 4% had laser microsurgery and postoperative radiotherapy. With a median follow-up of 55 months, the 5-year local control rate with the first treatment was 100% for pT1 cases and 89% for pT2 cases. The ultimate local control rate with voice preservation, including patients successfully salvaged after a local recurrence, was 97% for pT2 carcinomas. Five (10%) patients died of tumor (TNM)–related deaths. The 3-year recurrence-free rate and 3-year overall survival rate (Kaplan-Meier) were 87% and 85%; the 5-year recurrence-free rate and 5-year overall survival rate were 83% and 76%, respectively. The results achieved with transoral laser microsurgery in early supraglottic carcinoma are comparable to those of open supraglottic laryngectomy with respect to local control and survival. The functional results are superior, since clinically relevant aspiration did not occur.

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Randomized Trial of Preoperative Chemoradiation Versus Surgery Alone in Patients With Locoregional Esophageal Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2001.19.2.305 ◽

2001 ◽

Vol 19 (2) ◽

pp. 305-313 ◽

Cited By ~ 944

Author(s):

Susan G. Urba ◽

Mark B. Orringer ◽

Andrew Turrisi ◽

Mark Iannettoni ◽

Arlene Forastiere ◽

...

Keyword(s):

Esophageal Carcinoma ◽

Randomized Trial ◽

Median Survival ◽

Transhiatal Esophagectomy ◽

Preoperative Chemoradiation ◽

Survival Difference ◽

Significant Survival ◽

Significant Difference ◽

Resectable Esophageal ◽

Cervical Esophagogastric Anastomosis

PURPOSE: A pilot study of 43 patients with potentially resectable esophageal carcinoma treated with an intensive regimen of preoperative chemoradiation with cisplatin, fluorouracil, and vinblastine before surgery showed a median survival of 29 months in comparison with the 12-month median survival of 100 historical controls treated with surgery alone at the same institution. We designed a randomized trial to compare survival for patients treated with this preoperative chemoradiation regimen versus surgery alone.MATERIALS AND METHODS: One hundred patients with esophageal carcinoma were randomized to receive either surgery alone (arm I) or preoperative chemoradiation (arm II) with cisplatin 20 mg/m2/d on days 1 through 5 and 17 through 21, fluorouracil 300 mg/m2/d on days 1 through 21, and vinblastine 1 mg/m2/d on days 1 through 4 and 17 through 20. Radiotherapy consisted of 1.5-Gy fractions twice daily, Monday through Friday over 21 days, to a total dose of 45 Gy. Transhiatal esophagectomy with a cervical esophagogastric anastomosis was performed on approximately day 42.RESULTS: At median follow-up of 8.2 years, there is no significant difference in survival between the treatment arms. Median survival is 17.6 months in arm I and 16.9 months in arm II. Survival at 3 years was 16% in arm I and 30% in arm II (P = .15). This study was statistically powered to detect a relatively large increase in median survival from 1 year to 2.2 years, with at least 80% power.CONCLUSION: This randomized trial of preoperative chemoradiation versus surgery alone for patients with potentially resectable esophageal carcinoma did not demonstrate a statistically significant survival difference.

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Impact of metabolic indices of 18F-fluorodeoxyglucose positron emission tomography/computed tomography on post transplantation recurrence of hepatocellular carcinoma.

10.21203/rs.3.rs-1033896/v1 ◽

2021 ◽

Author(s):

Astrid Bauschke ◽

Annelore Altendorf-Hofmann ◽

Lukas Brückner ◽

Robert Drescher ◽

Martin Freesmeyer ◽

...

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Positron Emission Tomography ◽

Overall Survival ◽

Standardized Uptake Value ◽

Emission Tomography ◽

Fluorodeoxyglucose Positron Emission Tomography ◽

Recurrence Rates ◽

Positron Emission ◽

Fluorodeoxyglucose Positron Emission

Abstract Background Tumor recurrence is the leading cause of death after liver transplantation in patients with hepatocellular carcinoma. There is an ongoing debate as to whether metabolic indices such as tumor to liver standardized uptake value ratio in 18 F-fluorodeoxyglucose positron emission tomography/computed tomography of the primary tumor can identify patients outside the Milan criteria with as low recurrence rates as patients inside Milan and thus should be added to the established prognostic factors. Methods This retrospective study analyzes 103 consecutive patients who underwent 18 F fluorodeoxyglucose positron emission tomography/computed tomography before liver transplantation for hepatocellular carcinoma using data of clinical tumor registry. Primary endpoints were overall survival and 10-year cumulative recurrence rates. Results Tumor to liver standardized uptake value ratio of the primary tumor was statistically significant higher in Milan out tumors, “up-to-seven” out tumors, grade 3 tumors, alpha-fetoprotein level >400 ng/ml and lesions upwarts 5cm in diameter. Factors with statistically significant influence on the 10-year overall survival in the univariate analysis were Milan, up-to-seven” criteria, number of lesions and pT-category. COX regression analysis did not show independently statistically significant factors for 10-year overall survival. Milan, “up-to-seven” criteria, grade, pV, number of lesions, size of lesion, pT-category, tumor to liver standardized uptake value ratio influenced 10-year cumulative recurrence rates statistically significantly. Tumor to liver standardized uptake value ratio, grade and pT-category proved to be independently statistically significant factors for 10-year cumulative recurrence rates. Conclusions Our study suggests that tumor to liver standardized uptake value standardized uptake value ratio in 18 F-fluorodeoxyglucose positron emission tomography/computed tomography is an independent prognostic factor in transplanted patients with hepatocellular carcinoma and might be helpful in estimating the risk of recurrence for patients scheduled for liver transplantation.

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Histomorphological and Immunophenotypic Characterization of Feline Injection Site-Associated Sarcoma

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.109525 ◽

2021 ◽

Vol 49 ◽

Author(s):

Sílvia Teixeira Pereira ◽

Conrado Oliveira Gamba ◽

Rodrigo Santos Horta ◽

Rúbia Monteiro de Castro Cunha ◽

Gleidice Eunice Lavalle ◽

...

Keyword(s):

Overall Survival ◽

Tumor Grade ◽

Histologic Grade ◽

Biological Behavior ◽

Histological Subtypes ◽

Recurrence Rates ◽

Ki 67 ◽

Nerve Sheath ◽

Cox 2 ◽

Grade Iii

Background: Feline Injection Site-Associated Sarcoma (FISS) is a mesenchymal neoplasia of aggressive behavior that develops in sites where vaccine or drugs were administered. FISS is clinically characterized by the appearance of a solitary firm nodule or a diffuse mass, adhered to tissues, in regions associated to vaccine or drug applications. Despite low prevalence, tumor recurrence rates can reach 80%. FISS present more aggressive histological characteristics when compared to sarcomas not associated to injection sites. The aim of this paper is to contribute towards the understanding of the biological behavior of FISS.Materials, Methods & Results: Sixteen samples of FISS were analyzed. Fibrosarcomas were the most frequent histological subtype (62.5%). Malignant peripheral nerve sheath tumor was diagnosed in 18.75% cases. Ten (62.5%) FISS were classified as grade II; 4/16 (25%) grade I, and 2/16 (12.5%) grade III. Cox-2 overexpression occurred in 3/16 (18.75%) samples, with positive correlation between Cox-2 expression and cellularity (r = 0.696, P = 0.003). Mitotic index lower than 9 events was found in 11/16 (68.7%) samples and between 10 and 19 mitotic events in 5/16 (31.3%) cases. Mean Ki-67 expression was 2.39 ± 2.48%. FISS characterized as fibrosarcomas presented longer overall survival (median 545 days) than other histological subtypes (median 130.5 days) [P = 0.01].Discussion: Patients with FISS generally present with larger nodules than those with sarcomas not associated to injections, suggesting a challenge for pet owners to note subcutaneous tumors in the interscapular region, in addition to the aggressive biological behavior of FISS. The influence of size on prognosis remains controversial. An association between histologic grade and the development of metastasis has been observed, with patients with grade III FISS associated with an increase in the metastatic rate. The present study did not find a correlation between overall survival and histologic grade. A positive correlation between the presence of giant multinucleated cells and tumor grade has been observed.Despite the absence of such correlation in the present study, possibly due to a small sample, a trend for higher frequency of giant cells in advanced histologic grade was observed. Cox-2 expression in 81.75% and overexpression in 18.75% of our samples contrasts with the 64% Cox-2 expression and the absence of Cox-2 expression found by other authors. A positive moderate correlation between cellularity and Cox-2 expression was also observed, while another study did not find a correlation of Cox-2 expression with tumor grade, recurrence rates or overall survival. Cox metabolites such as prostaglandins can enhance cellular proliferation, inhibit apoptosis, induce angiogenesis, alter cellular adherence to facilitate metastatic development and inhibit immune surveillance. In the present study, no correlation was found between Cox-2 and angiogenesis in FISS. Our findings demonstrated low immunolabeling for Ki-67. A previous study analyzed 52 samples of FISS, 51% of them considered grade III, with a mean Ki-67 labeling of 14%. The lower Ki-67 staining in the samples of the present study may be related to the lower number of samples of grade III FISS or to a difference in the studied population. Fibrosarcomas are associated with better prognosis than other histological subtypes. Furthermore, malignant peripheral nerve sheath tumors were diagnosed as a possible histological subtype of FISS.

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