scholarly journals Five-Year, Disease-Free Survival after Repeat Palliative Multimodality Therapy in a Patient with Recurrent Metastastic Bladder Cancer

2007 ◽  
Vol 7 ◽  
pp. 1736-1742
Author(s):  
Sebastian Fetscher ◽  
Jan Schmielau ◽  
Wolfgang Schulze-Seemann
Keyword(s):  
Bladder Cancer ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Term Treatment ◽  
Short Term ◽  
Course Of Disease ◽  
Free Survival ◽  
Long Term Treatment ◽  
Disease Free

In appropriately selected cases, palliative therapeutic strategies can be adapted to those special features of cancer biographies that indicate an atypical course of disease. Elucidating these features, and adapting multimodal treatment strategies to them, can lead to significantly superior effects when compared to the routine application of conventional treatment algorhythms. A case of regionally metastactic bladder cancer is presented that documents the value of repeat debulking-surgery and repeat radiotherapy leading to unexpected short-term and long-term treatment results.

Tamoxifen Adjuvant Treatment Duration in Early Breast Cancer: Initial Results of a Randomized Study Comparing Short-Term Treatment With Long-Term Treatment

2000 ◽  
Vol 18 (20) ◽  
pp. 3507-3512 ◽  
Author(s):  
Thierry Delozier ◽  
Marc Spielmann ◽  
Josette Macé-Lesec’h ◽  
Maud Janvier ◽  
Catherine Hill ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Term Treatment ◽  
Tamoxifen Treatment ◽  
Adjuvant Tamoxifen ◽  
Short Term ◽  
Free Survival ◽  
Long Term Treatment ◽  
Disease Free

PURPOSE: In 1986, The Fédération Nationale des Centres de Lutte Contre le Cancer Breast Group initiated a multicenter randomized trial to assess the usefulness of long-term adjuvant tamoxifen treatment. Short-term adjuvant tamoxifen treatment was to be compared with lifelong adjuvant tamoxifen treatment. PATIENTS AND METHODS: Patients who were disease-free after 2 to 3 years of adjuvant tamoxifen treatment were eligible for the trial. From September 1986 to May 1995, 3,793 patients were randomized from France, Belgium, and Argentina. A total of 1,882 patients stopped tamoxifen (short-term group), and 1,911 patients were to continue tamoxifen for life (long-term group) at the same dose as previously prescribed. The protocol was modified in February 1997, limiting tamoxifen treatment to 10 years after randomization, thus giving a comparison between a 2- to 3-year treatment and a 12- to 13-year treatment. To date, the median duration of tamoxifen treatment is 30 months in the short-term group, and 70 months in the long-term group. RESULTS: Overall, longer tamoxifen treatment induced a 23% reduction in relapse rates, leading to a 7-year disease-free survival rate of 78%, compared with 72% in the shorter-treatment group. In contrast, overall survival did not differ between the two groups, with a 79% overall survival rate in both groups. This improvement in disease-free survival could be observed in node-positive patients (P = .001); however, it was not found in node-negative patients. Prolonged tamoxifen treatment corresponded to a significant increase in disease-free survival in estrogen receptor–positive patients (P = .03) as well as in estrogen receptor–negative patients (P = .05). Furthermore, longer treatment reduced contralateral breast cancers and did not increase the number of endometrial cancers. CONCLUSION: : Although no survival advantage was noted, patients did benefit from longer tamoxifen treatment over 3 years and had significantly better disease-free survival compared with patients who stopped hormonal treatment. Long-term follow-up is needed to assess these results. Most patients in the long-term group are still receiving treatment. Comparison of results as time passes will enable conclusions to be made on the value of long-term treatment over 5 years compared with 2 to 3 years.

scholarly journals Long term disease free survival with multimodal therapy in small cell bladder cancer

2016 ◽  
Vol 21 (1) ◽  
Author(s):  
Isabel Heidegger ◽  
Gennadi Tulchiner ◽  
Georg Schäfer ◽  
Wolfgang Horninger ◽  
Renate Pichler
Keyword(s):  
Bladder Cancer ◽  
Multimodal Therapy ◽  
Disease Free Survival ◽  
Small Cell ◽  
Free Survival ◽  
Cell Bladder Cancer ◽  
Disease Free

scholarly journals Long-term and short-term outcomes of robot- versus video-assisted anatomic lung resection in lung cancer: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Han Wu ◽  
Runsen Jin ◽  
Su Yang ◽  
Bernard J Park ◽  
Hecheng Li
Keyword(s):  
Overall Survival ◽  
Thoracic Surgery ◽  
Open Surgery ◽  
Lung Resection ◽  
Disease Free Survival ◽  
Short Term ◽  
Free Survival ◽  
Anatomic Lung Resection ◽  
Disease Free

Abstract OBJECTIVES Minimally invasive thoracic surgery has evolved with the introduction of robotic platforms. This study aimed to compare the long-term and short-term outcomes of the robot-assisted thoracic surgery (RATS) and video-assisted thoracic surgery (VATS) for anatomic lung resection. METHODS We searched published studies that investigated RATS and VATS in anatomic lung resection. Long-term outcomes (disease-free survival and overall survival) and short-term outcomes (30-day mortality, postoperative complications, conversion rate to open surgery and lymph node upstaging) were extracted. The features were compared and tested as hazard ratios (HRs) and odds ratios (ORs) at a 95% confidence interval (CI). RESULTS Twenty-five studies with 50 404 patients (7135 for RATS and 43 269 for VATS) were included. The RATS group had a longer disease-free survival than the VATS group (HR: 0.76; 95% CI: 0.59–0.97; P = 0.03), and the overall survival showed a similar trend but was not statistically significant (HR: 0.77; 95% CI: 0.57–1.05; P = 0.10). The RATS group showed a significantly lower 30-day mortality (OR: 0.55; 95% CI: 0.38–0.81; P = 0.002). No significant difference was found in postoperative complications (OR: 1.01; 95% CI: 0.87–1.16; P = 0.94), the conversion rate to open surgery (OR: 0.92; 95% CI: 0.56–1.52; P = 0.75) and lymph node upstaging (OR: 0.89; 95% CI: 0.52–1.54; P = 0.68). CONCLUSIONS RATS has comparable short-term outcomes and potential long-term survival benefits for anatomic lung resection compared with VATS.

scholarly journals Robot-assisted minimally invasive thoracolaparoscopic esophagectomy versus open esophagectomy: long-term follow-up of a randomized clinical trial

2020 ◽  
Vol 33 (Supplement_2) ◽  
Author(s):  
Eline M de Groot ◽  
Sylvia van der Horst ◽  
B Feike Kingma ◽  
Lucas Goense ◽  
Pieter C van der Sluis ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Rank Test ◽  
Robot Assisted ◽  
Short Term ◽  
Free Survival ◽  
Log Rank Test ◽  
Disease Free

ABSTRACT Initial results of the ROBOT, which randomized between robot-assisted minimally invasive esophagectomy (RAMIE) and open transthoracic esophagectomy (OTE), showed significantly better short-term postoperative outcomes in favor of RAMIE. However, it is not yet clarified if RAMIE is equivalent to OTE regarding long-term outcomes. The aim of this study was to report the long-term oncological results of the ROBOT trial in terms of survival and disease-free survival. This study is a follow-up study of the ROBOT trial, which was a randomized controlled trial comparing RAMIE to OTE in 112 patients with intrathoracic esophageal cancer. Both the trial protocol and short-term results were previously published. The primary outcome of the current study was 5-year overall survival. Secondary outcomes were disease-free survival and recurrence patterns. Analysis was by intention to treat. During the recruitment period, 109 patients were included in the survival analysis (RAMIE n = 54, OTE n = 55). Majority of patients had clinical stage III or IV (RAMIE 63%, OTE 55%) and received neoadjuvant chemoradiotherapy (80%). Median follow-up was 60 months (range 31–60). The combined 5-year overall survival rates for RAMIE and OTE were 41% (95% CI 27–55) and 40% (95% CI 26–53), respectively (log rank test P = 0.827). The 5-year disease-free survival rate was 42% (95% CI 28–55) in the RAMIE group and 43% (95% CI 29–57) in the OTE group (log rank test P = 0.749). Out of 104 patients, 57 (55%) developed recurrent disease detected at a median of 10 months (range 0–56) after surgery. No statistically difference in recurrence rate nor recurrence pattern was observed between both groups. Overall survival and disease-free survival of RAMIE are comparable to OTE. These results continue to support the use of robotic surgery for esophageal cancer.

scholarly journals The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study

2020 ◽  
Author(s):  
Lei Zhao ◽  
JianGang Wang ◽  
JingXia Kong ◽  
Xing Zheng ◽  
Xin Yu
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Hepatectomy ◽  
Disease Free Survival ◽  
Normal Weight ◽  
Liver Carcinoma ◽  
Long Term Outcomes ◽  
Short Term ◽  
Free Survival ◽  
Disease Free

Abstract Background To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment. Methods Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI < 18.5 kg/ m2, Group1), normal (18.5 ≤ BMI < 23 kg/m2, Group2), overweight (BMI ≥ 23 kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories. Results Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44%. Conversion rate in the three groups was 14.29%, 21.54% and 20.69% (P = 0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85 ± 4.04, 11.57 ± 5.56, and 10.88 ± 5.70, P = 0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P = 0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P = 0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P = 0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P = 0.043). Conclusions Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.

scholarly journals The impact of body mass index on short-term and long-term surgical outcomes of laparoscopic hepatectomy in liver carcinoma patients, a retrospective study

2020 ◽  
Author(s):  
Lei Zhao ◽  
Gang Jian Wang ◽  
Jingxia Kong ◽  
Xing Zhen ◽  
Xin Yu
Keyword(s):  
Body Mass Index ◽  
Laparoscopic Hepatectomy ◽  
Disease Free Survival ◽  
Normal Weight ◽  
Liver Carcinoma ◽  
Long Term Outcomes ◽  
Short Term ◽  
Free Survival ◽  
Disease Free

Abstract Background: To investigate the influence of body mass index (BMI) on the short-term and long-term outcomes including disease free survival (DFS) and overall survival (OS) rate in patients with liver carcinoma who underwent laparoscopic hepatectomy (LH) as primary treatment.Methods: Data were collected from 137 patients with liver carcinoma who underwent attempted LH between August 2003 and April 2014. Patients were classified into three groups depending on their BMI according to the WHO’s definition of obesity for Asia-Pacific region: underweight (BMI< 18.5kg/ m2, Group1), normal (18.5≤BMI< 23kg/m2, Group2), overweight (BMI≥ 23kg/m2, Group3) respectively. Short-term and long-term outcomes including overall survival (OS) and disease free survival (DFS) were compared across the BMI categories.Results: Of the 137 patients, 14 were underweight, 65 were normal weight, and 58 were overweight. The overall conversion rate of 137 patients was 20.44 %. Conversion rate in the three groups was 14.29%, 21.54% and 20.69 % (P=0.8284). The median follow-up duration was 26 months, 30 months, and 28 months, respectively. The mean postoperative hospital stay in the three groups were comparable (10.85±4.04, 11.57±5.56, and 10.88±5.70, P=0.76). The complications rate was much higher in Group 1 (42.85%) than that in Group 2 and Group 3 (20.08% and 17.2%, P=0.048). Underweight patients were more likely to develop grade III or higher postoperative complications (Clavien-Dindo classification) as compared to normal and overweight patients (P=0.042). Overweight patients had a longer 3- and 5-years DFS (41.4%, 36.2%) than those for underweight (21.4%, 14.3%) and normal weight (28.1%, 21.9%) patients (P=0.048, and 0.025). Overweight patients had a longer 5-years OS (44.8%) than those for underweight (28.6%) and normal weight (28.0%) patients (P=0.043).Conclusions: Being underweight was associated with an increased perioperative complication and being overweight has a better 3-, 5-years DFS and 5-years OS than those in under and normal weight patients with liver carcinoma who underwent LH.

scholarly journals Fibrosis-4 Model Influences Results of Patients with Hepatocellular Carcinoma Undergoing Hepatectomy

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Haiqing Wang ◽  
Aixiang Liu ◽  
Wentao Bo ◽  
Xielin Feng ◽  
Yong Hu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Short Term ◽  
Prediction Ability ◽  
Free Survival ◽  
Laboratory Index ◽  
Disease Free

Background. Several noninvasive models based on routine laboratory index have been developed to predict liver fibrosis. Our aim is to discuss whether these indexes could predict prognosis in patients with hepatocellular carcinoma undergoing hepatectomy. Methods. This study retrospectively enrolled 788 consecutive hepatocellular carcinoma patients undergoing liver resection in the cohort. Univariate and multivariate analysis were used to identify the risk factors of complications, survival, and disease-free survival. Results. Fibrosis-4 index had the best prediction ability for cirrhosis among other noninvasive models. Both the univariate and multivariate analyses showed that fibrosis-4 was independent risk factor for survival and disease-free survival. With the optimal cutoff value of 3.15, patients with fibrosis-4 ⩾3.15 had higher postoperative hepatic insufficiency (P=0.006) and worse survival than the fibrosis-4<3.15 group. The corresponding 1-year, 3-year, and 5-year overall survival were 80.9%, 56.3%, and 44.6% in the High fibrosis-4 group and were 86.5%, 69.9%, and 63.2% in the Low fibrosis-4 group, respectively (P<0.001). Worse disease-free survival was also observed in the fibrosis-4 ⩾3.15 group; the corresponding 1-year, 3-year, and 5-year disease-free survival were 74.9%, 45.3%, and 24.6% for the fibrosis-4 ⩾3.15 group and were 81.8%, 54.9%, and 34.4% for the fibrosis-4<3.15 group (P=0.009). Conclusions. Fibrosis-4 is useful for assessing the short-term and long-term results for hepatocellular carcinoma patients with liver resection.

scholarly journals Laparoscopic vs open colorectal cancer surgery in elderly patients: short- and long-term outcomes and predictors for overall and disease-free survival

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sicheng Zhou ◽  
Xuewei Wang ◽  
Chuanduo Zhao ◽  
Qian Liu ◽  
Haitao Zhou ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Elderly Patients ◽  
Open Surgery ◽  
Perineural Invasion ◽  
Disease Free Survival ◽  
Short Term ◽  
Free Survival ◽  
Disease Free ◽  
Surgery In Elderly

Abstract Background Colorectal cancer is common in elderly patients. Laparoscopy is widely used to approach this kind of disease. This study was to examine short-term outcomes and long-term survival for laparoscopic and open surgery in elderly patients with colorectal cancer. Methods From January 2007 to December 2018, patients with colorectal cancer older than 80 operated at China National Cancer Center were included in the study. Propensity score matching (PSM) was used to minimize the adverse effects. The clinical data between open and laparoscopic surgery was compared, and the effect of factors on overall survival (OS) and disease-free survival (DFS) was analyzed by Cox proportional hazard model. Results Ninety-three pairs were selected after PSM. Patients in laparoscopic group had less intraoperative blood loss, postoperative complications, time to first flatus, time to oral feeding, postoperative hospital stay, and higher retrieved lymph node (P < 0.05). The OS and DFS rates were similar (P > 0.05), besides the CEA level, III/IV stage, and perineural invasion were independent predictors of survival (P < 0.05). Conclusion In elderly patients with colorectal cancer, laparoscopic surgery had better short-term outcomes than open surgery. CEA level, III/IV stage, and perineural invasion were reliable predictors for OS and DFS.

scholarly journals LongTerm Outcomes of Three-Port Laparoscopic Right Hemicolectomy Versus Five-Port Laparoscopic Right Hemicolectomy: A Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Tao Zhang ◽  
Yaqi Zhang ◽  
Xiaonan Shen ◽  
Yi Shi ◽  
Xiaopin Ji ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Right Hemicolectomy ◽  
Long Term Outcomes ◽  
Short Term ◽  
Free Survival ◽  
Oncological Outcomes ◽  
Short And Long Term ◽  
Laparoscopic Right Hemicolectomy ◽  
Disease Free

PurposeThe aim of this study is to compare the long-term outcomes of three-port laparoscopic right hemicolectomy (TPLRC) and five-port laparoscopic right hemicolectomy (FPLRC) with retrospective analysis.MethodsA total of 182 patients who accepted laparoscopic right hemicolectomy with either three ports (86 patients) or five ports (96 patients) from January 2012 to June 2017 were non-randomly selected and analyzed retrospectively.ResultsMore lymph nodes were harvested in the TPLRC group than in the FPLRC group [17.5 (7), 14 (8) ml, p &lt; 0.001]. There was less blood loss in the TPLRC group [50 (80) vs. 100 (125) ml, p = 0.015]. There were no significant differences in the other short-term or oncological outcomes between the two groups. The overall survival and disease-free survival were equivalent.ConclusionsTPLRC is recommendable as it guarantees short- and long-term equivalent outcomes compared with FPLRC.

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