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.

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.

scholarly journals The significance of blood cell biomarkers in the prognosis of gastric cancer

2020 ◽  
Author(s):  
Pu Huang ◽  
Yiran Zhang ◽  
Anqiang Wang ◽  
Zhao-de Bu
Keyword(s):  
Gastric Cancer ◽  
Prognostic Factors ◽  
Blood Cell ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Vascular Tumor ◽  
Tumor Differentiation ◽  
Chi Square ◽  
Preoperative Serum

Abstract Background Studies have shown that inflammation-associated blood cell markers are associated with prognoses in a variety of tumors. However, the prognostic significance of these markers for gastric cancer (GC) is still not very clear. This article aims to explore its value of GC prognostic assessment.Methods From July 2011 to July 2016, 353 GC patients with surgical treatment were enrolled in this retrospective study. Patients’ demographics were analyzed along with clinical and pathologic data. The chi-square test was used to evaluate relationships between the markers and other clinicopathological variables; The Kaplan–Meier method and Cox regression proportional hazard model were performed to evaluate prognostic factors.Results Univariate analysis indicated T stage, N stage, vascular tumor thrombus, tumor long diameter, Bormann Classification, preoperative MWR (monocyte/leukocyte ratio), preoperative serum CEA levels are prognostic factors for GC. Multivariate analysis showed that preoperative MWR, tumor differentiation, and tumor length were independent prognostic factors in patients with GC. The boundary value of MWR is 0.8.Conclusion Preoperative MWR was convenient, simple marker of gastric cancer, might be useful for the evaluation of prognosis of patients with GC. Comparing with TNM stage, tumor differentiation was a more reliable pathological factor evaluating recurrence.

Analysis of Metastatic Ovarian Tumors from Extragenital Primary Sites

2006 ◽  
Vol 92 (6) ◽  
pp. 491-495 ◽  
Author(s):  
Taner Turan ◽  
Burcu Aykan ◽  
Sevgi Koc ◽  
Nurettin Boran ◽  
Gokhan Tulunay ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Primary Tumor ◽  
Frozen Section ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Tumor Site ◽  
Primary Tumor Site ◽  
Adequate Treatment ◽  
Presenting Symptoms ◽  
Preoperative Serum

Aims and background The aim of this study was to evaluate patients with metastatic ovarian tumors from extragenital primary sites. Methods The medical records of 75 patients were reviewed retrospectively for age at diagnosis, presenting symptoms, preoperative tumor marker levels, preoperative diagnostic workup, operative technique, intraoperative evaluation, frozen-section and pathology results, laterality of metastasis, and primary tumor site. The specific impact of metastasis from colorectal and gastric primary sites on laterality, gross features and dimensions of ovarian mass, volume of ascites and tumor marker levels was investigated. Results Primary sites were stomach (37.3%), colorectal region (28%), lymphoma (12%), breast (6.7%), biliary system (2.7%), appendix (1.3%) and small intestine (1.3%). It was not possible to identify the primary tumor site in 8 (10.7%) patients. Bilateral metastasis was found in 86.4% patients; 42.7% of the metastatic ovarian tumors were Krukenberg tumors; 50.7% of the ovarian masses were solid. Frozen section was confirmed by postoperative pathological results in 98% of the patients. The mean preoperative serum levels of tumor markers were 298.7 U/mL, 178 U/mL and 113.3 U/mL for CA 125, CA 19-9 and CA 15-3, respectively. CA 125 levels were above 35 U/mL in 81.3% of the patients. The presence of ascites was more frequent in ovarian tumors originating from colorectal and gastric primaries. Conclusions Surgery is essential for the diagnosis of the primary tumor and necessary for relief of symptoms. The identification of the primary site is required to plan adequate treatment.

scholarly journals Borderline Ovarian Tumors: Fifteen Years’ Experience at a Scottish Tertiary Cancer Center

2018 ◽  
Vol 28 (9) ◽  
pp. 1683-1691 ◽  
Author(s):  
James May ◽  
Karolina Skorupskaite ◽  
Mario Congiu ◽  
Nidal Ghaoui ◽  
Graeme A. Walker ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Surgical Management ◽  
Early Stage ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Borderline Ovarian Tumors ◽  
Gynecology And Obstetrics ◽  
Preoperative Serum

ObjectivesSince the recognition of borderline ovarian tumors (BOTs) in the 1970s, the management of this subset of epithelial ovarian tumors has presented a challenge to clinicians. The majority present at an early stage, but their diagnosis is often only made following surgery, hence the heterogeneity of surgical management. Borderline ovarian tumors are morphologically diverse, and their behavior is subsequently also heterogeneous. We aimed to assess recurrence rates and the rate of malignant transformation in patients diagnosed with BOT. Secondary objectives included a review of current management and assessment of tumor markers, stage, cyst dimensions, and the presence of micropapillary features as prognostic indicators of recurrence.MethodsThis retrospective cohort study included all patients treated with BOT between 2000 and 2015 in the southeast region of Scotland. Clinical, surgicopathological, and follow-up data were collated. Data were analyzed with reference to recurrence and malignant transformation.ResultsTwo hundred seventy-five patients underwent treatment for BOT in the study period. Surgical management was highly variable. A diagnosis of recurrent/persistent BOT or ovarian malignancy following initial treatment of BOT was rare, with only 12 (4%) of 275 cases. There were 7 cases (3%) of ovarian malignancy. Advanced International Federation of Gynecology and Obstetrics stage was the most prominent prognostic factor. Elevated preoperative serum CA-125 and the presence of micropapillary features correlated with advanced stage at presentation. With a lack of clear guidance, follow-up was highly variable with a median of 43 months (0–136 months).ConclusionsTo our knowledge, this study is the largest BOT cohort in the United Kingdom. Recurrent disease is rare in optimally staged, completely resected, early-stage BOT, without high-risk features. Caution is needed in women electing not to undergo completion staging after diagnosis and in those opting for a fertility-preserving approach. Thorough informed consent and clear plans for surveillance and follow-up are needed with consideration of delayed completion surgery as appropriate.

Malignant peritoneal mesothelioma: Clinicopathological features, prognostic factors, and survival outcomes.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 650-650
Author(s):  
Meera Patel ◽  
Jonathan M. Loree ◽  
Melissa W. Taggart ◽  
Anais Malpica ◽  
Aurelio Matamoros ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Asbestos Exposure ◽  
Univariate Analysis ◽  
The United States ◽  
Peritoneal Mesothelioma ◽  
Age At Diagnosis ◽  
Ca 125 ◽  
Survival Outcomes ◽  
Histologic Subtype ◽  
Neutrophil Lymphocyte Ratio

650 Background: Peritoneal mesothelioma (PeM) is an orphan disease with approximately 300-400 cases diagnosed in the United States each year. Due to its rarity, data on its presentation and prognostic factors is limited. The purpose of this study was to investigate the clinicopathological profile and outcome of Malignant PeM (MPeM). Methods: We retrospectively reviewed 128 PeM patients (pts) seen at UTMDACC (2011 - 2017) comprised of 111 MPeM and 17 variants (VPeM) [9 well-differentiated papillary and 8 multicystic]. Kaplan-Meier method was used to estimate median overall survival (mOS) and compared with log-rank tests. Results: Median age at diagnosis was 57 yrs. with a higher proportion of women (61%). The mOS for MPeM was significantly shorter than VPeM (HR 3.7, 95% CI: 1.6 – 8.4, P = 0.002). Among pts with MPeM, median age at diagnosis was 56 yrs. and 58% were women. Only 22% had prior exposure to asbestos. Epithelioid subtype was seen in 94 (85%) pts. Calretinin and WT-1 IHC were positive in 98% and 96% of cases. BerEP4 and MOC-31 IHC were negative in 90% and 84% of cases. After median follow-up of 31 months (m), the mOS for MPeM cohort was 78 m. In univariate analysis, age, prior asbestos exposure, ECOG PS, histologic subtype, CA125, neutrophil-lymphocyte ratio (NLR) and cytoreductive surgery (CRS) were found to be associated with OS. In multivariate analyses, age ≥ 65 years (HR 4.5, 95% CI: 1.3 - 15.2, P = 0.02), prior asbestos exposure (HR 4.1, 95% CI: 1.1 – 15.6, P = 0.04), poor PS (ECOG 2/3) (HR 8.9, 95% CI: 1.7 – 47.7, P = 0.01), elevated CA125 ( > 3X upper limit of normal) (HR 4.5, 95% CI: 1.3 – 15.5, P = 0.02), and high NLR (HR 3.8, 95% CI: 1.1 – 12.6, P = 0.03) were found to be independently associated with poor OS. A total of 50 (45%) pts underwent CRS and among these the completion of cytoreduction score (CCS) was strongly associated with OS (mOS: 201 m, 53 m and 36 m for CCS 0, 1, 2/3, respectively, P = 0.005). Conclusions: MPeM is associated with poor survival outcomes. Prognostic factors include age, history of asbestos exposure, CA-125 level, NLR, and PS. CRS with CCS 0 results in favorable survival. Further understanding of molecular genetics is warranted to improve prognostication and outcomes.

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