High CD8+ tumour infiltrating lymphocyte density associates with unfavourable prognosis in oesophageal adenocarcinoma following poor response to neo‐adjuvant chemoradiotherapy

2021 ◽  
Author(s):  
W.J. Koemans ◽  
J.M. van Dieren ◽  
J. van den Berg ◽  
G. Meijer ◽  
P. Snaebjornsson ◽  
...  
2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
William Knight ◽  
Cara Baker ◽  
Nyree Griffin ◽  
Mark Kelly ◽  
Andrew Davies ◽  
...  

Abstract   A high Mandard score corresponds to a non-response to chemotherapy in the primary tumour in oesophageal adenocarcinoma. However, some patients experience tumour volume reduction and a nodal downstaging despite a high score. This study compares survival and recurrence patterns in these patients. Methods Clinicopathological factors were analysed using multivariable Cox regression assessing time to death and recurrence. CT estimated tumour volume change was examined in a subgroup of consecutive patients. Mean pre-chemotherapy and post chemotherapy tumour volumes were compared across Mandard groups and nodal responders. Results 555 patients were included. Median survival was 55 months (Mandard 1,2,3) and 21 months (Mandard 4,5). In the Mandard 4,5 group (332 patients), comparison between complete nodal responders and persistent nodal disease showed improved survival (90 vs 18 months), recurrence rates (locoregional 14.75% vs 28.74, systemic 24.59% vs 48.42%) and CRM positivity (22.95% vs 68.11). Complete nodal response independently predicted improved survival (HR 0.34(0.16–0.74). Post-chemotherapy tumour volume reduction was greater in patients with a complete nodal response (−16.3 cm3 vs −7.7 cm3 p 0.033) with no significant difference between Mandard groups. Conclusion: Patients with a complete nodal response to chemotherapy have significantly improved outcomes despite a poor Mandard score. High Mandard score does not correspond with a non-response to chemotherapy in all cases and patients with nodal downstaging may still benefit from adjuvant chemotherapy.


Author(s):  
William R. C. Knight ◽  
◽  
Cara R. Baker ◽  
Nyree Griffin ◽  
Wahyu Wulaningsih ◽  
...  

2003 ◽  
Vol 38 (0) ◽  
pp. 87-93 ◽  
Author(s):  
C. J. Buskens ◽  
Ristimäki A. ◽  
G. J. A. Offerhaus ◽  
D. J. Richel ◽  
J. J. B. van Lanschot

2008 ◽  
Author(s):  
Adriana Fiszman ◽  
Mauro V. Mendlowicz ◽  
Carla Marques-Portella ◽  
Eliane Volchan ◽  
Evandro S. F. Coutinho ◽  
...  

Phlebologie ◽  
2008 ◽  
Vol 37 (06) ◽  
pp. 297-300
Author(s):  
N. König ◽  
H. J. Stark ◽  
P.-M. Baier

SummaryWe present two case reports concerning patients who had to undergone surgical treatment according tp the diagnosis of thrombophlebitis with insufficiency of the greater saphenous vein and putative encapsulated haematoma in the lower left leg area. During the operation we found tumours with urgent suspicion of malignancy. The histological examination revealed the diagnosis of mesenchymal chondrosarcoma and malignant peripheral nerve sheath tumour which are extremely malignant, but very rare neoplasmas with unfavourable prognosis. Conclusion: Since both types of tumours are often located below the knee, phlebotomists and vascular surgeons should take them into account as differential diagnosis.


1988 ◽  
Vol 60 (02) ◽  
pp. 345 ◽  
Author(s):  
A D’Angelo ◽  
G Landi ◽  
L Candelise ◽  
E Nobile Orazio ◽  
S Vigano-D’Angelo ◽  
...  

1982 ◽  
Vol 48 (02) ◽  
pp. 156-161 ◽  
Author(s):  
E J P Brommer ◽  
M M Barrett-Bergshoeff ◽  
R A Allen ◽  
I Schicht ◽  
R M Bertina ◽  
...  

SummaryIntravenous infusion of desmopressin (DDAVP, 0.4 μg/kg b.w. in 12’) causes an increase in the level of extrinsic plasminogen activator, measured in plasma euglobulin fractions with added C1-inactivator on fibrin plates. A poor response or no response at all was elicited in two out of 21 patients with spontaneous thrombosis, 18/38 with hyperlipoproteinaemia and 10/14 with terminal renal insufficiency requiring haemodialysis.Haemodilution during the first 30’ after starting the DDAVP-infusion occurred both in responders and in non-responders; so did haemodynamic reactions: increase in heart rate, drop in diastolic blood pressure, facial flushing. The rise of fibrinolytic activity was shown not to be associated with decreased hepatic blood flow. Normal factor VIII-rises in “non-responders” indicate the responsiveness of the receptive organs, including the hypothalamus, to DDAVP.Despite a normal baseline level of fibrinolytic activity in the blood, as occurs for instance in terminal renal insufficiency, the vascular endothelium may be refractory to stimulation. In some patients, especially in type IV hyperlipoproteinaemia, a selective defect of the release of plasminogen activator is postulated. In subjects with low fibrinolytic activity at rest, as observed in spontaneous thromboembolism and in hypertriglyceridaemia, the failure to release plasminogen activator upon stimulation with DDAVP might be a consequence of an impairment of synthesis as well.


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