Lung Metastasectomy in the Treatment of Rectal Cancer Gives Little if Any Benefit Compared With the Importance of Control at the Primary Cancer Site

2021 ◽  
Vol 44 (9) ◽  
pp. 503-504
Author(s):  
Chris Brew-Graves ◽  
Pauline Leonard ◽  
Tom Treasure
Keyword(s):  
Rectal Cancer ◽  
Cancer Site ◽  
Primary Cancer ◽  
Lung Metastasectomy ◽  
Primary Cancer Site

scholarly journals Changes in carnitine levels through induction chemotherapy in head and neck cancer patients as a potential cause of therapy-related malaise

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Ito ◽  
Kiyoaki Tsukahara ◽  
Hiroki Sato ◽  
Akira Shimizu ◽  
Isaku Okamoto
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Cancer Site ◽  
Primary Cancer ◽  
Analog Scale ◽  
Before And After ◽  
Primary Cancer Site ◽  
Total Carnitine

Abstract Background Carnitine is related to malaise, and cisplatin is associated with decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on free carnitine (FC). Methods This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS). Results All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7 ± 2.2 μM/mL, 56.7 ± 2.2 μM/mL, and 41.1 ± 1.9 μM/mL, respectively. Compared with the baseline before starting therapy, FC had significantly decreased on Day 21 (p = 0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5 ± 1.2 μM/mL, 13.6 ± 1.4 μM/mL, and 10.7 ± 0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2 ± 2.5 μM/mL, 70.2 ± 3.3 μM/mL, and 51.7 ± 2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise.

RADT-05. PROSPECTIVE LONG-TERM EVALUATION OF MRI- AND CLINICAL CHANGES FOLLOWING STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES – IS REPEAT SRS A CONSEQUENCE, OR ALSO A CAUSE OF LONG-TERM SURVIVAL?

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi41-vi42
Author(s):  
Bente Skeie ◽  
Per Øyvind Enger ◽  
Geir Olve Skeie ◽  
Jan Ingemann Heggdal
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Whole Brain Radiotherapy ◽  
Cancer Site ◽  
Response Patterns ◽  
Primary Cancer ◽  
Term Survival ◽  
Cover Ratio ◽  
Primary Cancer Site

Abstract The use of stereotactic radiosurgery (SRS) for brain metastases are increasing. Response assessment is challenging and the clinical significance of radiological response and retreatments are poorly defined. Ninety-seven patients with a total of 406 brain metastases were followed prospectively for 10 years or until death. Volume changes over time and clinical outcome in response to first time SRS and SRS retreatments were analyzed. Tumors grew significantly before (p = 0.004), but shrunk at 1 and 3 months (p = 0.001) following SRS. Four response-patterns of were observed; tumors either continuously reduced in size (A, 62%), pseudo-progressed (PP, B, 13%), temporarily reduced in size (C, 24%), or grew continuously (D, 2%); corresponding to 75% local control (LC) at initial SRS. Predictors for LC were primary cancer site (p = 0.001), tumor volume (p = 0.002) and target cover ratio (p = 0.005). Subsequent SRS for new lesions resulted in 94% LC (87% A) and repeat-SRS for local failures in 80% LC (57% B), predicted by higher prescribed dose, p = 0.001 and p = 0.042, respectively. Overall survival was only 4.5 months if A-response for all lesions, 13.3 months if at least one B-response, 17.1 months if retreated C- or D-response (p < 0.001), (7.5 and 4.7 months if untreated). Quality of life (p = 0.003), steroid use (p = 0.019) and prior whole brain radiotherapy (p = 0.026) were predictors for survival. There are 4 response patterns to SRS predicted by tumor size, primary cancer site, target cover ratio and prescribed dose. Long-term survivors experienced a higher incidence of PP and were more often retreated for new lesions and local failures. The immune response induced by PP seems beneficial but further studies are needed.

Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites

2016 ◽  
Vol 26 (4) ◽  
pp. 688-696 ◽  
Author(s):  
Veysel Sal ◽  
Fuat Demirkiran ◽  
Samet Topuz ◽  
Ilker Kahramanoglu ◽  
Ibrahim Yalcin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Residual Disease ◽  
Univariate Analysis ◽  
Ovarian Metastasis ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Cancer Site ◽  
Primary Cancer ◽  
Preoperative Serum ◽  
Primary Cancer Site

ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.Materials and MethodsAll patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients’ medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.ResultsThe primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph nodes, bladder, or the intestine. With a median follow-up of 33 months, the median survival time was 22 months. The estimated 5-year survival probability is 0.26. On univariate analysis, primary cancer site, combined metastasis outside the ovaries, residual disease, preoperative serum CA 125 and CA 19-9 levels, and histologic type were significant parameters for overall survival. Furthermore, residual disease, preoperative serum CA 19-9 level, and primary cancer site were found to be independent prognostic factors on multivariate analysis.ConclusionsThe most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.

Analysis of time from initial imaging study to definitive surgical diagnosis in patients with epithelial ovarian malignancies.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15536-e15536
Author(s):  
Thomas Bickley ◽  
Eericca Clegg ◽  
John Nash ◽  
Xiaowei (Sherry) Yan ◽  
Radhika Gogoi
Keyword(s):  
Ct Scan ◽  
Imaging Study ◽  
Initial Evaluation ◽  
Cancer Site ◽  
Advanced Stage ◽  
Primary Cancer ◽  
Imaging Studies ◽  
Time To Diagnosis ◽  
Primary Cancer Site ◽  
Initial Imaging

e15536 Background: It is well established that women diagnosed with advanced stage ovarian cancer have a significantly lower five-year survival rate. Often multiple imaging modalities are used in the initial evaluation. This is costly, often unnecessary, and may be a contributing factor to a delay in diagnosis. We sought to evaluate the time from initial imaging study to diagnosis. Methods: After IRB approval, a retrospective chart review was performed utilizing data from the electronic medical record at an integrated health care system. All patients who underwent surgery with a diagnosis of primary peritoneal, ovarian, or fallopian tube cancer between 7/2006 and 8/2011 were included. Data collected included age at time of surgery, number and dates of imaging studies performed within 180 days prior to surgery, primary cancer site, stage, and histology. Patients were excluded for recurrent disease, studies without dates, or imaging studies performed greater than 180 days prior to diagnosis. Statistical analysis was performed using the Cox Proportional Model. Results: A total of 146 patients were included in the study. The average number of imaging studies was 1.7 and the average time to diagnosis from initial imaging was 33.5 days. Time to diagnosis was shorter if patients ever had a CT scan (29.3 vs 73.3 days; P<0.001), and longer if patients ever had an ultrasound (40.4 vs 27.8 days; P=0.02). There was no difference in the overall number of imaging studies performed when controlling for stage <3C vs >3C. However, time to diagnosis was significantly less (29.1 vs 45.1 days; P=0.01) for more advanced stage disease. There was no difference in time to diagnosis or overall number of imaging studies performed when controlling for primary cancer site or age. Conclusions: The data suggest that performing a CT scan as the only imaging modality results in a significantly shorter time to diagnosis than when ultrasonography is included in the initial evaluation. Of patients who initially got an ultrasound most ultimately went on to have a CT scan, likely increasing the interval to diagnosis. We suggest that implementing an adnexal mass algorithm may allow patients quicker access to definitive diagnosis and treatment.

Multidisciplinary tumor board for improvement of oncology collaboration in advanced cancer patients.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 175-175
Author(s):  
Sanders Chang ◽  
Amish Doshi ◽  
Cardinale B. Smith ◽  
Bethann Scarborough ◽  
Stelian Serban ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Tumor Board ◽  
Cancer Site ◽  
Primary Cancer ◽  
Advanced Cancer Patients ◽  
Primary Cancer Site ◽  
Supportive Oncology ◽  
The Impact

175 Background: The Palliative and Supportive Oncology Tumor Board was developed in 2015 to provide an interdisciplinary forum for discussion and management of patients with complex or refractory symptoms from advanced cancer. The board meets monthly and consists of medical, surgical, and radiation oncologists, interventional radiologists, pain management, palliative care specialists, residents, and fellows. Here, we assess the impact of the tumor board on the care of these patients. Methods: Electronic records of advanced cancer patients discussed at the tumor board from January 2015 to December 2015 were analyzed. We extracted data regarding sociodemographics, primary cancer site, pain interventions delivered, palliative care services utilized, and readmissions. Results: Thirty-two patients were presented at the tumor board over twelve months. The median age was 60 years (range 26-89); 47% were male. Primary cancer site included multiple myeloma (n = 11), gastrointestinal (n = 9), genitourinary (n = 5), breast (n = 2), lung (n = 2), skin (n = 1), and unknown origin (n = 2). At the time of discussion, 16 patients were hospitalized and 18 were in the ambulatory setting. Recommendations from the tumor board included altering medication regimen (n = 4), discussing eligibility to receive an anesthetic block (n = 7), undergoing vertebroplasty (n = 9), and planning palliative radiation treatment (n = 19). Patients were seen by specialists from pain (n = 21), interventional radiology (n = 14), neurosurgery (n = 9), palliative care (n = 20), radiation oncology (n = 21), or medical oncology (n= 32) within one day of their case presentation at the tumor board. Seven patients were transferred to the inpatient palliative care unit within a day of their tumor board discussion. Five patients were readmitted to the hospital within 30 days due to uncontrolled pain or other symptoms. Conclusions: The palliative and supportive oncology tumor board was well received by clinicians overall. It fostered interdisciplinary collaboration and supported comprehensive management of pain and other symptoms, as evidenced by the mix of cases discussed and the short time within which patients were seen after presentation by the participating specialists.

Readmission with venous thromboembolism after surgical treatment by primary cancer site

2020 ◽  
Vol 35 ◽  
pp. 268-275
Author(s):  
Casey A. Jarvis ◽  
Phillip A. Bonney ◽  
Li Ding ◽  
Austin M. Tang ◽  
Steven L. Giannotta ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Surgical Treatment ◽  
Cancer Site ◽  
Primary Cancer ◽  
Primary Cancer Site

A Comparative Study of Terminally Ill Hospice and Hospital Patients

1986 ◽  
Vol 16 (3) ◽  
pp. 225-232 ◽  
Author(s):  
Janet G. Labus ◽  
Faye H. Dambrot
Keyword(s):  
Comparative Study ◽  
Group Membership ◽  
Terminally Ill ◽  
Cancer Site ◽  
Primary Cancer ◽  
Accuracy Rate ◽  
Time Period ◽  
Hospice Patients ◽  
Hospital Patients ◽  
Primary Cancer Site

This study investigated differences between twenty-eight hospice and twenty-eight hospital patients who died within a specified time period in one county of Northeastern Ohio. The comparison found that hospice patients were younger, had more people living in the home, and had a shorter disease history. Age, the number of people living in the home, and primary cancer site significantly discriminated between the hospice and hospital patients and predicted group membership with a 76.8 percent overall accuracy rate.

Effects of molecular targeting agents and immune-checkpoint inhibitors in patients with advanced cancer who are near the end of life

2021 ◽  
pp. 1-6
Author(s):  
Shuji Hiramoto ◽  
Tomohiko Taniyama ◽  
Ayako Kikuchi ◽  
Tetsuo Hori ◽  
Akira Yoshioka ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Cancer Site ◽  
Molecular Targeting ◽  
Primary Cancer ◽  
Related Factors ◽  
Primary Cancer Site ◽  
Ecog Ps ◽  
Molecular Targeting Agents

Abstract Background In recent years, the use of both molecular targeting agents (MTAs) and immune-checkpoint inhibitors (ICIs) tend to occupy important positions in systemic anticancer therapy (SACT). The objective of this study is to describe the predictors of SACT include both MTAs and ICIs near the end of life (EOL) and the effect on EOL care in patients with advanced cancer. Methods We analyzed all patients who died of advanced cancer from August 2016 to August 2019, and we analyzed the survival time of patients who underwent anticancer agents excluded due to the loss of information about the last administration of SACT. The primary endpoint of this study was to identify predictors during the last administration of SACT near EOL. Results In a multivariate analysis, the Eastern Cooperative Oncology Group performance status (ECOG-PS) (ORs 33.781) was significantly related factors within 14 days of death from the last administration of SACT. Age (ORs 0.412), ECOG-PS (ORs 11.533), primary cancer site of upper GI cancers (ORs 2.205), the number of comorbidities (ORs 0.207), MTAs (ORs 3.139), and ICIs (ORs 3.592) were significantly related factors within 30 days of death. The median survival time (MST) of patients with PS 3–4 was 29 days, while that of patients with both PS 0–2 was 76 days. The prevalence rate of delirium with MTAs was 17.5%, which was significantly lower than that of patients without it (31.8%). The prevalence rate of the mean dose of opioids in patients with ICIs was 97.9 mg/day, which was significantly higher than that of patients without it (44.9 mg/day). Conclusions Age, ECOG-PS, primary cancer site, the number of comorbidities, MTAs, and ICIs use were significant associated with SACT near EOL. Information on these factors may aid clinical decision making in referral to palliative care institutes.

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