Tumor Size, an Additional Risk Factor of Local Recurrence in Low-Risk Endometrial Cancer: A Large Multicentric Retrospective Study

2018 ◽  
Vol 28 (4) ◽  
pp. 684-691 ◽  
Author(s):  
Giulio Sozzi ◽  
Stefano Uccella ◽  
Roberto Berretta ◽  
Marco Petrillo ◽  
Francesco Fanfani ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Local Recurrence ◽  
European Society ◽  
Tumor Size ◽  
Low Risk ◽  
Postoperative Treatment ◽  
Intermediate Risk ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Local Recurrence Free Survival

ObjectiveThe identification of patients with endometrial cancer (EC) at higher risk for relapse is critical to individualize and better tailor postoperative treatment. No evidence is available regarding the possible association between tumor size (TS) and the risk of local recurrence. The purpose of this study was to analyze the correlation between TS and risk/type of recurrence in EC patients, stratified according to the new European Society of Medical Oncology-European Society of Gynecological Oncology-European Society for Radiotherapy and Oncology classification.MethodsData of patients with histologically proven EC who received primary surgical treatment between November 1999 and June 2015 were retrospectively retrieved from 5 institutions. Optimal TS cutoff was calculated using a receiver operating characteristic curve. Site of recurrence as a function of TS and groups of risk were analyzed. Local recurrence-free survival, recurrence-free survival, and overall survival were calculated using the Kaplan-Meier method.ResultsData of 1166 patients were analyzed. Among them, 514 (44.1%) had low-risk EC, 174 (14.9%) had intermediate risk EC, 173 (14.8%) had high–intermediate risk EC, and 305 (26.2%) had high-risk EC. A total of 134 (11.5%) women had recurrence: 47 (4%) of them had local relapse, 30 (2.6%) had locoregional relapse, and 57 (4.9%) had distant relapse. Tumor size 25 mm or greater emerged as the threshold for the prediction of a higher rate of local recurrence (P < 0.0001, hazard ratio = 18.2, P = 0.005) and a lower local recurrence-free survival and recurrence-free survival (P < 0.0001) only in patients with low-risk EC. There was no statistically significant correlation between TS and recurrence in the other risk groups.ConclusionsIn this very large series, tumor size emerges as an independent prognostic factor of local recurrence in women with low-risk EC and could be a valuable additional criterion to personalize the treatment approach to these patients.

The Impact of a Postmastectomy Chest Wall Scar Boost on Local Recurrence-free Survival in High-risk Patients

2019 ◽  
Vol 19 (5) ◽  
pp. 363-369
Author(s):  
Ashley Albert ◽  
Sophy Mangana ◽  
Mary R. Nittala ◽  
Toms Vengaloor Thomas ◽  
Lacey Weatherall ◽  
...  
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Chest Wall ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
High Risk Patients ◽  
Risk Patients ◽  
The Impact ◽  
Local Recurrence Free Survival

Intraoperative versus external beam boost for breast cancer: A matched-pair analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1120-1120 ◽  
Author(s):  
Elena Sperk ◽  
Daniela Astor ◽  
Grit Welzel ◽  
Axel Gerhardt ◽  
Marc Suetterlin ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Breast Conserving Surgery ◽  
Matched Pair ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Matched Pair Analysis ◽  
Pair Analysis ◽  
Local Recurrence Free Survival

1120 Background: After breast conserving surgery, radiotherapy leads to a better overall survival. In addition to whole breast radiotherapy (WBRT) a boost to the tumor bed leads to a better local control. The tumor bed boost is usually added after WBRT or can be done intraoperative (IORT). Belletti et al. (Clin Cancer Res., 2008) described positive effects, an antitumoral effect and modulation of microenvironment after IORT with 50kV x-rays. A matched pair analysis was performed to investigate the impact of IORT boost on overall survival compared to standard external beam boost. Methods: Between 2002 – 2009, 370 patients were treated for breast cancer with WBRT + boost (external beam (EBRT) boost n = 146, IORT boost n =224). A matched pair analysis (1:1 propensity score matching for age, TNM, grading, hormonal treatment and chemotherapy) for overall survival and local recurrence free survival could be done for 53 pairs. All patients underwent breast conserving surgery and WBRT with 46-50Gy. 53 patients received an EBRT boost with 16Gy (2Gy/fraction, dedicated linear accelerator) and 53 patients received an IORT boost with 20Gy (INTRABEAM system, 50kV x-rays). Median follow-up was 6 months (range, 1-77 months) for the EBRT boost patients and 56 months (range, 2-97 months) for IORT boost patients. Kaplan Meier estimates were performed for overall survival and local recurrence free survival. Results: IORT boost patients had a longer follow-up than EBRT boost patients. Despite the difference in follow-up times, there was a strong trend towards better overall survival after IORT boost (90.2% vs. 62.3%, p = 0.375). One local recurrence was present in each group (EBRT boost after 15 months, local recurrence free survival 95%; IORT boost after 12 months, local recurrence free survival 98.1%). Conclusions: IORT given as a boost seems to have a positive impact on overall survival in breast cancer patients after breast conserving surgery. To identify such an effect a prospective randomized trial should be conducted.

Role of radiotherapy in adenoid cystic carcinoma of the head and neck

2009 ◽  
Vol 123 (10) ◽  
pp. 1137-1144 ◽  
Author(s):  
T A Iseli ◽  
L H Karnell ◽  
S M Graham ◽  
G F Funk ◽  
J M Buatti ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Adenoid Cystic Carcinoma ◽  
Head And Neck ◽  
Distant Metastases ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Prognostic Features ◽  
Adenoid Cystic ◽  
Radiotherapy Alone ◽  
Local Recurrence Free Survival

AbstractThis study retrospectively reviewed 183 cases of adenoid cystic carcinoma treated over 40 years. The local recurrence free survival rate was 68.2 per cent at five years and 40.8 per cent at 10 years. At 10 years, local recurrence free survival was significantly worse following radiotherapy alone (0 per cent), compared with surgery alone (41.8 per cent, p = 0.004) or combined with post-operative radiotherapy (43.5 per cent, p = 0.001). Neither tumour stage three or four, perineural invasion, solid subtype nor involved margins predicted local recurrence. Treatment with radiotherapy alone resulted in worse survival than surgery alone (p = 0.002) or combined with post-operative radiotherapy (p = 0.001). Survival rates following local recurrence (n = 34) were higher following surgery (p = 0.006) but not significantly improved following radiotherapy (p = 0.139). Chemotherapy for distant metastases did not prolong survival (p = 0.747) but did result in improved eating and aesthetics scores, while decreasing overall physical health. These results indicate that surgery is preferable for primary and recurrent adenoid cystic carcinoma of the head and neck. The incidence of local recurrence following surgery and postoperative radiotherapy was similar to surgery alone cases although the latter had less adverse prognostic features. Contemporary chemotherapy may benefit quality of life but not survival in patients with distant metastases due to adenoid cystic carcinoma of the head and neck.

scholarly journals Tumour inflammasome‐derived IL‐1β recruits neutrophils and improves local recurrence‐free survival in EBV‐induced nasopharyngeal carcinoma

2012 ◽  
Vol 4 (12) ◽  
pp. 1276-1293 ◽  
Author(s):  
Lih‐Chyang Chen ◽  
Li‐Jie Wang ◽  
Nang‐Ming Tsang ◽  
David M. Ojcius ◽  
Chia‐Chun Chen ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Local Recurrence ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Local Recurrence Free Survival
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