scholarly journals P-OGC65 Patterns and timing of recurrence following resection of oesophago-gastric adenocarcinoma

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
William Shen ◽  
Carol Craig ◽  
Andrew MacDonald ◽  
Colin MacKay ◽  
Matthew Forshaw ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Gastric Adenocarcinoma ◽  
Primary Tumour ◽  
Royal Infirmary ◽  
Common Site ◽  
Liver Recurrence ◽  
Molecular Features ◽  
Heterogenous Group ◽  
Recurrence Patterns ◽  
Poor Outcomes

Abstract Background Recurrence following resection of oesophago-gastric adenocarcinoma (OGA) is frequent and associated with poor outcomes. Predictors of site, timing and mechanisms driving recurrence is poorly defined, which limits the development of anti-metastatic agents. The aim of this study was to investigate the patterns and timing of recurrence following resection of OGA. Methods Retrospective review of a prospectively maintained resection database from the Glasgow Royal Infirmary oesophago-gastric unit of patients undergoing surgery for OGA. Primary outcomes were recurrence and cancer specific death following surgery. Recurrence patterns were defined as liver, lung, peritoneal, locoregional only and other distant groups. The latter is a heterogenous group that do not include any liver, lung, or peritoneal metastases.  Results N = 635 patients were identified having undergone surgical resection of OGA. Of these, n = 262 developed confirmed recurrent disease. Liver metastases (n = 86, 33%) were the most common site of recurrence, followed by peritoneal (n = 35, 13%), lung (n = 33, 13%) locoregional only (n = 51, 20%) and other distant sites (n = 57, 22%). Liver recurrence was associated with significantly worse disease specific (19.1 vs 28.2 months, P < 0.001) and recurrence free survival (P = 0.006). There was no association between site of recurrence and known prognostic clinicopathological factors, including anaerobic threshold (P = 0.810), nodal status (P = 0.088), pathological T-stage (P = 0.357), differentiation (P = 0.195), deprivation index (P = 0.996), perineural (P = 0.475) or lymphovascular (P = 0.422) invasion. Conclusions Liver metastases is the most common site of recurrence following surgery for OGA. Prognostic clinical and pathological factors do not determine the site of recurrence, suggesting that molecular features of the primary tumour determine and promotes recurrence patterns. Further study to delineate the molecular and microenvironment factors driving recurrence patterns is urgently required.

Repeat hepatic resection and chemotherapy for recurrent colorectal liver metastases

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 14590-14590
Author(s):  
D. Ferrari ◽  
E. Opocher ◽  
R. Santambrogio ◽  
A. Pisani ◽  
M. Barabino ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Liver Metastases ◽  
Hepatic Resection ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumour ◽  
Postoperative Mortality ◽  
Long Term Results ◽  
Liver Recurrence ◽  
Third Line ◽  
Metastatic Liver

14590 Background: An aggressive surgical approach combined with chemotherapy (CHT) is the best way to prolong survival in patients with colorectal cancer and synchronous resectable metastatic disease. Reintervention followed by systemic CHT is often a safe and effective procedure for fit patients with metastatic liver recurrence. Methods: Patients with resectable metastatic liver disease who underwent at least two surgical operations were included in the study. At diagnosis they had a median number of 6 measurable liver metastases (range 1–16), and median sum of largest diameters of lesions was 35 mm (range 10–70) from CT scan. Hepatic resection was followed each time by systemic CHT. Radiofrequency (RF) was added as needed to reach a curative intent . The aim of our study was to evaluate DFS and OS combining surgery, RF and CHT in this high-risk group. Results: Between November 2003 and July 2006 13 patients (median age 52 yrs, range 36–73; PS 0) with metastatic colorectal cancer underwent surgery on primary tumour and liver metastases followed by adjuvant CHT consisting of FOLFOX4 (oxaliplatin 85 mg/m2 and LV5FU) or FOLFIRI (irinotecan 180 mg/m2 and LV5FU) for 6 months. Free margins were obtained in 12 patients (92.3%). The second relapse was treated by liver surgery and systemic CHT (either FOLFIRI or FOLFIRI + Cetuximab in EGFR expressing tumours). Eight patients were offered concomitant radiofrequency (RF) for smaller lesions. Five patients (38.5%) underwent a third operation + RF followed by third-line CHT consisting of capecitabine alone or associated to oxaliplatin. After second and third hepatectomy there was no intraoperative or early postoperative mortality. With a median follow-up of 24 months (range 6–37) 6 patients are free of disease and all patients are still alive. Two-year DFS and OS are 46.2% and 100% respectively. Conclusions: Patients with metastatic colorectal cancer should be treated aggressively by surgery and CHT. In a small group of fit patients operated at least two times we obtained excellent 2-year DFS and OS. The benefit of adding adjuvant CHT as second-line or even third-line treatment seems to be justified by good long-term results. Our promising data from a single institution prompt further evaluation for aggressive surgery associated to CHT and new target molecules. No significant financial relationships to disclose.

scholarly journals Myogenic dedifferentiation is associated with poor outcomes in retroperitoneal dedifferentiated liposarcomas

Rare Tumors ◽  
2021 ◽  
Vol 13 ◽  
pp. 203636132098665
Author(s):  
Garcia-Ortega Dorian Yarih ◽  
Caro-Sánchez Claudia HS ◽  
Alvarez-Cano Alethia ◽  
Alvarez-Bojorquez Mario ◽  
Melgarejo-Estefan Emmanuel ◽  
...  
Keyword(s):  
Malignant Tumors ◽  
Myogenic Differentiation ◽  
Smooth Muscle Actin ◽  
Locally Advanced ◽  
Distant Recurrence ◽  
Differentiation Markers ◽  
Surgical Morbidity ◽  
Mesenchymal Differentiation ◽  
Heterogenous Group ◽  
Poor Outcomes

Sarcomas are a heterogenous group of malignant tumors with origin or mesenchymal differentiation, they comprise 1–2% of all solid tumors. Retroperitoneum is the second most frequent site affected. Prognosis is worse compared to the limbs, with a 5y OS of 36–58%, and 50–60% patients will relapse. Dedifferentiated liposarcomas (ddLPS) are more aggressive, it is known that presence of a de-differentiated component increases the probability of distant recurrence and lowers OS. There is little information about the specific impact of each type of de-differentiation. To determine if the presence of myogenic differentiation markers in DDLPS is an adverse prognostic factor. A retrospective, observational, analytic cohort study was performed. Cases identified from the electronic clinical files from the National Cancer Institute in Mexico City, we included cases from January 1st 2005 to December 31st 2016. We correlated the presence of expression of myogenic markers (Smooth muscle actin, Calponin, H-caldesmon, Desmin and Myogenin) in the dedifferentiated component of DDLPS with overall survival and surgical outcomes. One hundred and forty-three cases were analyzed. Eighty-two were liposarcomas, and 38 had a dedifferentiated component. Of these 38 cases, 21(55.3%) were males and, 17(44.7%) were females. Median age was 54.1(27–79) years, median tumor size was 28 cm (13–56). Most patients had locally advanced disease: 32(84.2%) were in stage IIIB. 2.6% had metastatic disease and 5(13.2%) had stage Ib at diagnosis. Myogenic marker expression was found in 18.4% of cases; these patients had a worse median survival than cases with no myogenic expression: 18 months (95% CI 15.4–20.5) vs 32 months (95% CI 21.8–42.1) p = 0.01, we also found a relation with higher postoperative morbidity in these cases ( p = 0.045). The presence of myogenic differentiation markers might be associated with a worse prognosis, in our series it corelated with worse OS, however it is not a common event. Relation with surgical morbidity is to be analyzed in further studies.

Breast tumour organoids: promising models for the genomic and functional characterisation of breast cancer

2019 ◽  
Vol 47 (1) ◽  
pp. 109-117 ◽  
Author(s):  
Charlotte Roelofs ◽  
Frédéric Hollande ◽  
Richard Redvers ◽  
Robin L. Anderson ◽  
Delphine Merino
Keyword(s):  
Breast Cancer ◽  
Primary Tumour ◽  
Three Dimensional ◽  
Breast Tumour ◽  
Functional Studies ◽  
Molecular Features ◽  
Functional Characterisation ◽  
Dimensional Growth ◽  
Organoid Cultures ◽  
Culture Strategies

Abstract Until recently, established cancer cell lines have been used extensively in breast cancer research, due largely to the difficulties associated with the manipulation and long-term maintenance in culture of primary tumour cells from patients. The recent development of organoid cultures has provided new opportunities to model and analyse patient samples, allowing the propagation of malignant cells under conditions that resemble the three-dimensional growth of breast tumours. They have proved efficacious in preserving the heterogeneity of primary samples and are emerging as a new model to further characterise the molecular features of breast cancer. Organoids formed from patient-derived cells are now in use for the evaluation of drug sensitivity and to validate disease-causing genomic variations. Here, the advantages and limitations of organoid cultures will be discussed and compared with the parallel development of other two- and three-dimensional culture strategies and with patient-derived xenografts. In particular, we will focus on the molecular characterisation of breast cancer organoids and provide some examples of how they have been used in functional studies.

Synchronous resection of the primary tumour and liver metastases?

2012 ◽  
Vol 14 (8) ◽  
pp. 915-916
Author(s):  
Jens G. Hillingsø ◽  
Peer Wille Jørgensen
Keyword(s):  
Liver Metastases ◽  
Primary Tumour ◽  
Synchronous Resection

scholarly journals Molecular Features and Targeted Therapies in Extrahepatic Cholangiocarcinoma: Promises and Failures

Cancers ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3256 ◽  
Author(s):  
Alessandro Rizzo ◽  
Simona Tavolari ◽  
Angela Dalia Ricci ◽  
Giorgio Frega ◽  
Andrea Palloni ◽  
...  
Keyword(s):  
Targeted Therapies ◽  
Anatomical Location ◽  
Therapeutic Approaches ◽  
Extrahepatic Cholangiocarcinoma ◽  
Future Directions ◽  
Molecular Features ◽  
Heterogenous Group ◽  
Systemic Treatments ◽  
Molecular Landscape ◽  
Hepatobiliary Tumors

Biliary tract cancers (BTCs) include a heterogenous group of aggressive malignancies with limited therapeutic options. According to their anatomical location, these hepatobiliary tumors are usually classified into intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), and gallbladder cancer (GBC). Unfortunately, BTCs are often diagnosed when already metastatic, and although the advent of genomic sequencing has led to a deeper understanding of iCCA pathogenesis, very little data are currently available about the molecular landscape of eCCA. Moreover, despite novel systemic treatments emerging in BTC, the grim prognosis of eCCA patients has not changed in the past decade, and no targeted therapies have been approved so far. The aim of the current review is to provide an overview regarding molecular features and potential targeted therapies in eCCA, together with novel therapeutic approaches and future directions of translational and clinical research on this highly aggressive disease that poses many unanswered questions.

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