Bulky lymph node resection in patients with recurrent epithelial ovarian cancer: impact of surgery

2007 ◽  
Vol 17 (6) ◽  
pp. 1245-1251 ◽  
Author(s):  
P Benedetti Panici ◽  
G. Perniola ◽  
R. Angioli ◽  
M. A. Zullo ◽  
N. Manci ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Epithelial Ovarian Cancer ◽  
Radiographic Finding ◽  
Morbidity Rate ◽  
Disease Free Interval ◽  
Systematic Lymphadenectomy ◽  
Free Interval ◽  
Disease Free

The aim of this study was to evaluate the role of systematic lymphadenectomy, feasibility, complications rate, and outcome in epithelial ovarian cancer (EOC) patients with recurrent bulky lymph node disease. A prospective observational study of EOC patients with pelvic/aortic lymph node relapse was conducted between January 1995 and June 2005. After a clinical and laparoscopic staging, secondary cytoreduction, including systematic lymphadenectomy, were performed. The eligibility criteria were as follows: disease-free interval ≥6 months, radiographic finding suggestive of bulky lymph node recurrence, and patients' consent to be treated with chemotherapy. Forty-eight EOC patients with lymph node relapse were recruited. Twenty-nine patients were amenable to cytoreductive surgery. Postoperatively, all patients received adjuvant treatment. The median numbers of resected aortic and pelvic nodes were 15 (2–32) and 17 (8–47), respectively. The median numbers of resected aortic and pelvic positive lymph nodes were 4 (1–18) and 3 (1–17), respectively. The mean size of bulky nodes was 3.3 cm. Four patients (14%) experienced one severe complication. No treatment-related deaths were observed. After a median follow-up of 26 months, among cytoreduced patients, 18 women were alive with no evidence of disease, nine were alive with disease. Among the 11 patients not amenable to surgery, five women were alive with persistent disease, six patients died of disease, at a median follow-up of 18 months. Estimated 5-year overall survival and disease-free interval for operated women were 87% and 31%, respectively. In conclusion, patients with bulky lymph node relapse can benefit from systematic lymphadenectomy in terms of survival. The procedure is feasible with an acceptable morbidity rate

Expression of A9 Antigen and Loss of Blood Group Antigens as Determinants of Survival in Patients with Head and Neck Squamous Carcinoma

1987 ◽  
Vol 96 (3) ◽  
pp. 221-230 ◽  
Author(s):  
Thomas E. Carey ◽  
Gregory T. Wolf ◽  
S. Hsu ◽  
J. Poore ◽  
K. Peterson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Blood Group ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Primary Tumor Site ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

The murine monoclonal antibody (A9), raised to the human squamous cell carcinoma (SCC) cell-line UM-SCC-1, defines a squamous cell antigen associated with aggressive biologic behavior of SCC cell lines in vivo and in vitro. In the present investigation, A9 antigen was detected in tissue sections from 37 consecutive, previously untreated patients with SCC of the head and nack. All tumors were positive for A9 binding, although three distinct patterns (reflecting different intensities of A9 expression) were identified. The intensity of A9 expression was independent of primary tumor site, tumor differentiation, keratinization, or growth pattern. The frequency of high expression (Pattern 1) grew with increasing T class, N class, and tumor stage, and was associated with loss of blood group expression in the tumor and with low levels of lymphocyte infiltration In the tumor. Strong A9 expression had a statistically signification association with low nuclear grade (i.e., tumors with more mature and fewer enlarged nuclei, P = 0.019), low vascular/stromal response (i.e., patchy response rather than continuous, P = 0.014), and impaired in vitro lymphokine production by peripheral blood leukocytes ( P = 0.0011). Of greatest interest, however, was the strong association of high A9 expression with shortened disease-free interval (DFI) ( P = 0.085) and survival ( P = 0.081) relative to patients with weak A9 tumor staining (Patterns 2 and 3). Similarly, the loss of blood group antigen expression was strongly associated with decreased DFI ( P = 0.038) and survival ( P = 0.062). While neither Pattern 1 A 9 expression nor loss of blood group reach statistical significance in prediction of survival, the combination of Pattern 1 A 9 expression and loss of blood group expression in primary tumors was significantly associated, both with decreased disease-free interval ( P = 0.017) and with decreased overall survival ( P = 0.011) (median length of follow-up = 22 months). The length of follow-up (LFU) ranged from 2 to 38 months, with a median LFU of 22 months. While the number of patients (37) is small, the significant association between the expression of these cell-surface markers with relapse and survival indicates that immunohistologic staining of the primary tumor will be an important prognostic indicator useful in identification of individual patients at greatest risk of recurrence or early death from head and neck cancer, independent of tumor size, site, or stage at presentation. These markers may thus provide means of selecting patients who should receive adjuvant therapy and more intensive monitoring for the early detection of recurrent disease.

Disease-free interval and estrogen receptor activity in tumor tissue of patients with primary breast cancer: analysis after long-term follow-up

1985 ◽  
Vol 6 (2) ◽  
pp. 123-130 ◽  
Author(s):  
J. M. M. Raemaekers ◽  
L. V. A. M. Beex ◽  
A. J. M. Koenders ◽  
G. F. F. M. Pieters ◽  
A. G. H. Smals ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Tumor Tissue ◽  
Disease Free Interval ◽  
Free Interval ◽  
Estrogen Receptor Activity ◽  
Long Term Follow Up ◽  
Disease Free

The POSCH trial: 13 year follow-up and disease-free interval analysis

1994 ◽  
Vol 109 (1-2) ◽  
pp. 354
Author(s):  
H. Buchwald ◽  
C.T. Campos ◽  
J.R. Boen ◽  
P. Nyugen ◽  
S.E. Williams
Keyword(s):  
Interval Analysis ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

scholarly journals Medularni karcinom stitaste zlezde-uticaj postoperativne transkutane zracne terapije u lokalnoj kontroli i rezultatima lecenja

2003 ◽  
Vol 50 (3) ◽  
pp. 125-130
Author(s):  
Vesna Stankovic ◽  
Nenad Borojevic ◽  
Radan Dzodic ◽  
Ivana Golubicic
Keyword(s):  
Thyroid Gland ◽  
Randomized Study ◽  
Time Interval ◽  
Treatment Results ◽  
Disease Free Interval ◽  
Total Survival ◽  
Free Interval ◽  
Total Therapy ◽  
Disease Free

In the period of Octo. 01, 1987. up to Dec. 31, 1998. retrospective-prospective, non-randomized study was conducted at IORS, which included 36 patients diagnosed with thyroid gland medullar cancer. Our study had the following aims: evaluation of treatment results following probability of total survival, survival without signs of disease and disease-free interval until local reccurrence of the disease and influence of parameters of transcutaneous radiotherapy (intensity of total tumor dose and length of disease-free interval from date of performed operation to beginning of radiotherapy). After finished treatment, median of the patient follow-up was 37,75 months (3,5 up to 141 monts); probability of total five-year survival was 62,61% and of 10 year survival was 23,48%. Probability of 5-year survival, without signs of disease was 37,13%, and of 10-year survival 18,56%. As to radiotherapy parameters, intensity of total therapy dose was statisticaly insignificant, while time interval to beginning of transcutaneuos radiotherapy, shorter than 2 months, was statistically significant in relation to prognosis of disease outcome.

scholarly journals The Capacity of the Ovarian Cancer Tumor Microenvironment to Integrate Inflammation Signaling Conveys a Shorter Disease-free Interval

2020 ◽  
Vol 26 (23) ◽  
pp. 6362-6373 ◽  
Author(s):  
Kimberly R. Jordan ◽  
Matthew J. Sikora ◽  
Jill E. Slansky ◽  
Angela Minic ◽  
Jennifer K. Richer ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Tumor Microenvironment ◽  
Disease Free Interval ◽  
Free Interval ◽  
Cancer Tumor ◽  
Disease Free

Our experience in the surgical treatment of renal carcinoma metastases

1996 ◽  
Vol 63 (4) ◽  
pp. 476-478
Author(s):  
A. Cozzoli ◽  
G. Cancarini ◽  
S. Cosciani Cunico
Keyword(s):  
Renal Cell Carcinoma ◽  
Surgical Treatment ◽  
Renal Carcinoma ◽  
Disease Free Interval ◽  
Free Interval ◽  
Synchronous Metastases ◽  
Disease Free ◽  
Metachronous Metastases ◽  
Unfavourable Prognostic Factor

The authors report their experience in the surgical treatment of synchronous and metachronous metastases from renal cell carcinoma. From January 1986 to December 1992, 47 nephrectomised patients (11.6%) out of 403 underwent contemporary or subsequent metastasectomy. Metastases were synchronous in 18 cases (38.3%), while metachronous metastases appeared in 29 (61.7%) after a mean disease-free interval of 28 months. After a mean follow-up of 36 months, out of the 18 cases with synchronous metastases, 9 died, 4 are in progression and 5 are still alive and NED; of the 29 patients with metachronous metastases, 3 died, 6 are in progression and 20 are still alive and NED. In conclusion, while the presence of synchronous metastases is an unfavourable prognostic factor even after their removal, results after surgery of metachronous metastases are encouraging.

scholarly journals High Expression of the Urokinase Plasminogen Activator and Its Cognate Receptor Associates with Advanced Stages and Reduced Disease-Free Interval in Papillary Thyroid Carcinoma

2011 ◽  
Vol 96 (2) ◽  
pp. 504-508 ◽  
Author(s):  
Salvatore Ulisse ◽  
Enke Baldini ◽  
Salvatore Sorrenti ◽  
Susi Barollo ◽  
Lucio Gnessi ◽  
...  
Keyword(s):  
Plasminogen Activator ◽  
Urokinase Plasminogen Activator ◽  
Papillary Thyroid ◽  
Disease Free Interval ◽  
Cognate Receptor ◽  
Free Interval ◽  
Advanced Stages ◽  
Disease Free ◽  
Pai 1

abstract Context: The urokinase plasminogen activating system is implicated in neoplastic progression, and high tissue levels of urokinase plasminogen activating system components correlate with poor prognosis in various human cancers. Objective: The objective of the study was to investigate the prognostic relevance of the urokinase plasminogen activator (uPA), its cognate receptor (uPAR), and the plasminogen activator inhibitor 1 (PAI-1) in human papillary thyroid cancer (PTC). Design: The expression of uPA, uPAR, and PAI-1 genes was analyzed in PTC and normal matched tissues by quantitative RT-PCR. The case study consisted of 99 patients (21 males and 78 females) affected by PTC including 77 classical, 15 follicular, four tall cell, and three oncocytic variants. Forty-one patients had lymph node metastases at the time of diagnosis. All the patients underwent thyroidectomy and radioiodine therapy followed by thyroid hormone replacement therapy. Follow-up data were available for 76 patients up to 64 months. Results: The uPA, uPAR, and PAI-1 mRNA levels were significantly higher in PTC compared with normal matched tissues by 9.63 ± 1,29-, 4.82 ± 0.45-, and 5.64 ± 0.71-fold, respectively. The increased expression of uPA and uPAR correlated statistically with advanced pT and N status. The uPA was also significantly associated with advanced tumor node metastasis stages. The Kaplan-Meier analysis showed a significant association of uPA and uPAR levels with reduced patient disease-free interval (DFI), and this association was stronger in stage I patients. Conclusion: The study demonstrated that in PTC the increased gene expression of uPA and uPAR is associated with tumor invasiveness, advanced stages, and shorter DFI, suggesting their prognostic relevance. These observations warrant further investigation in larger patient populations with longer follow-up.

scholarly journals Electrochemotherapy Associated with Calcium Electroporation in Metastatic Feline Cutaneous Malignant Melanoma

2019 ◽  
Vol 47 ◽  
Author(s):  
Denner Santos Dos Anjos ◽  
Cecília Gomes Rodrigues ◽  
Nicilene Cardoso Silva ◽  
Andrigo Barboza De Nardi ◽  
Carlos Eduardo Fonseca-Alves
Keyword(s):  
Lymph Node ◽  
Malignant Melanoma ◽  
Lymph Node Metastasis ◽  
Cutaneous Malignant Melanoma ◽  
Disease Free Interval ◽  
Danger Signals ◽  
Node Metastasis ◽  
Submandibular Lymph Node ◽  
Free Interval ◽  
Disease Free

Background: Calcium electroporation (CaEP) is a novel therapeutic treatment that has been studied for cancer due to its selective killing cancer cells by necrosis and danger signals. Besides that, electrochemotherapy (ECT) is an effective local treatment that involves the administration of chemotherapeutic drugs followed by delivery of electrical pulses to the tumor. The combination with ECT and CaEP has been reported in literature suggesting that additional response of immune system could have been enhanced by electroporation with calcium. This case, report on the successful treatment with CaEP combined with ECT for treatment of a regional metastasis in a feline model of malignant melanoma.Case: A 9-year-old, mixed breed cat was referred to the veterinary clinic with a 2-month history of cutaneous peripalpebral plaque lesion (0.19 cm³) and a submandibular lymph node enlargement (0.5 cm³). Incisional biopsy of the cutaneous lesion and fine-needle aspiration of submandibular lymph node confirmed a cutaneous melanoma with submandibular lymph node metastasis. Tumor staging was set in T1N1M0 according to WHO staging criteria. ECT for the primary lesion and lymph node metastasis was proposed. For the ECT, bleomycin (15,000 UI/m²) application was performed intravenous followed by electroporation (8 pulses of 100 μs at 1000 V/cm, and 1 Hz) using a needle array electrode consisted of two parallel rows with six needles in each row. At 28-day post-ECT complete remission of the primary tumor and metastatic foci was achieved. However, 120 days after ECT, recurrence was observed in submandibular and retropharyngeal lymph nodes. A second ECT approach was performed adding to bleomycin the intra lymph nodal application of calcium gluconate. The dose of calcium gluconate was diluted in an isotonic 0.9% NaCl solution resulting in a low concentration at 9 mM, injected in both metastatic lymph nodes (submandibular total volume: 1.4 ml; retropharyngeal total volume: 0.5 mL) and pulses were delivered immediately after drug administration. No systemic adverse effects were observed. Local adverse effects were considered mild as transitory edema and ulceration post procedure. One-week post-ECT+CaEP, complete remission of local metastasis occurred. However, the patient achieved five months disease free interval, and died during a surgical approach, achieving nine months of survival time.Discussion: Feline cutaneous malignant melanoma is an aggressive disease with a short survival time for the patients with mean of 4.5 months. CaEP is a novel anticancer treatment that has been study in the past years due to its selective killing cancer cells by necrosis and danger signals. The CaEP induces supraphysiological calcium influx into neoplastic cells leading to acute ATP depletion and necrosis of tumor cells. This use could be an interesting therapeutic choice for both human and veterinary medicine. In this patient, it was demonstrated a good clinical response with its use, showing temporarily tumor remission from the case presented with disease free interval of five months when compared to other report of two months. This description showed that ECT associated with CaEP improved outcome of regional melanoma lymph node metastasis in a cat. However, further investigations are needed to understand the use of CaEP in patients for local control metastasis as well as evaluate the use of both modalities to determine its synergistic effect.

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