scholarly journals Systemic Lymphadenectomy Cannot Be Recommended for Low-Risk Corpus Cancer

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Takao Hidaka ◽  
Akitoshi Nakashima ◽  
Tomoko Shima ◽  
Toru Hasegawa ◽  
Shigeru Saito
Keyword(s):  
Medical Records ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Low Risk ◽  
Paraaortic Lymph Node ◽  
Free Survival ◽  
Lymph Node Swelling ◽  
Disease Free

Objective. The objective of this study is to ascertain whether omission of lymphadenectomy could be possible when uterine corpus cancer is considered low-risk based on intraoperative pathologic indicators.Patient and Methods. Between 1998 and 2007, a total of 83 patients with low risk corpus cancer (endometrioid type, grade 1 or 2, myometrial invasion 50%, and no intraoperative evidence of macroscopic extrauterine spread, including pelvic and paraaortic lymph node swelling and adnexal metastasis) underwent the total abdominal hysterectomy and bilateral salpingo-oophorectomy without lymphadenectomy. A retrospective review of the medical records was performed, and the disease-free survival (DFS), overall survival (OS), peri- and postoperative morbidities and complications were evaluated.Results. The 5-year DFS rates and the 5-year OS rates were 97.6% and 98.8%, respectively. No patient presented postoperative leg lymphedema and deep venous thrombosis.Conclusion. Omission of lymphadenectomy did not worsen the DFS or OS. The present findings suggest that systemic lymphadenectomy could be omitted in low-risk endometrial carcinoma.

LAPTM4B-35 Overexpression Is an Independent Prognostic Marker in Endometrial Carcinoma

2010 ◽  
Vol 20 (5) ◽  
pp. 745-750 ◽  
Author(s):  
Fan-ling Meng ◽  
Ming-zhu Yin ◽  
Hong-tao Song ◽  
Hua Yang ◽  
Ge Lou ◽  
...  
Keyword(s):  
Overall Survival ◽  
Endometrial Carcinoma ◽  
Cancer Progression ◽  
Histological Grade ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Normal Endometrium ◽  
Free Survival ◽  
Gynecology And Obstetrics ◽  
Disease Free

Background:Lysosomal protein transmembrane 4 β-35 (LAPTM4B-35), a novel oncoprotein that belongs to the mammalian 4-tetratransmembrane spanning protein superfamily, has been implicated in oncogenesis and cancer progression in several solid malignances. However, the expression of LAPTM4B-35 and its role in endometrial cancer progression remain unknown.Materials and Methods:We investigated the expression of the LAPTM4B-35 protein by immunohistochemistry in 30 normal endometrium specimens and 165 endometrial carcinomas and analyzed its correlation with various clinicopathologic features, including patient outcome.Results:LAPTM4B-35 immunoreactivity was overexpressed in endometrial carcinoma cases compared with normal endometrium (P < 0.001). High LAPTM4B-35 expression was found in 117 (70.91%) of these 165 carcinomas and was positively correlated with the International Federation of Gynecology and Obstetrics stage, histological grade, depth of myometrial invasion, lymph node metastasis, lymph vascular space involvement, and recurrence, but not with age and histological type. Patients with high LAPTM4B-35 expression had significantly poorer overall survival and disease-free survival compared with patients with low expression of LAPTM4B-35 (P = 0.001 and P = 0.002, respectively). Multivariate analysis showed that high LAPTM4B-35 expression was an independent prognostic factor for both overall survival and disease-free survival of patients with endometrial carcinoma (both P = 0.005).Conclusions:These results showed that high LAPTM4B-35 expression was associated with progression and prognosis of endometrial carcinoma.

Impact of the third and subsequent lines of chemotherapy in the cure rate of patients with high-risk gestational trophoblastic neoplasia (HR-GTN).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15521-e15521
Author(s):  
Gustavo Jankilevich ◽  
Maria Ines Bianconi ◽  
Silvina Otero ◽  
Lucia Alvarez ◽  
Claudio Storino
Keyword(s):  
Medical Records ◽  
Disease Free Survival ◽  
Gestational Trophoblastic Disease ◽  
Cure Rate ◽  
Curative Intent ◽  
Free Survival ◽  
The Third ◽  
Trophoblastic Disease ◽  
Disease Free ◽  
Line Chemotherapy

e15521 Background: Successful chemotherapy is the backbone of the treatment of patients with HR-GTN. However a percentage of this patients will recur to first treatment attempt. It is not defined how many lines of chemotherapy are required to achieve complete reponse and wether to continue with different chemotherapy regimens is beneficial for achieving the cure. Methods: We performed a review of medical records of consecutive patients with diagnosis of gestational trophoblastic disease (GTD) and HR-GTN by FIGO-OMS criteria between 1990-2011. All were treated in our hospital. Results: 365 patients were registrated with GTD diagnosis. Thirty-four patients had HRNTG, 23 patients (67.6%) had complete reponse with first and second line chemotherapy (EMA PE and EMA CO). Eight of eleven patients had complete reponse with additional regimens. Three patients died, one due toxicity. The reponse rate of third and more lines was 72%. Overall disease free survival was 91%. Conclusions: In patients with HRNTG three or more lines of treatment achieves the cure in a high percentage of patients. In this setting the therapy should always be with curative intent, regardless of the number of lines required to achieve this objective.

NRG Oncology RTOG 0415: A randomized phase III non-inferiority study comparing two fractionation schedules in patients with low-risk prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 1-1 ◽  
Author(s):  
W. Robert Lee ◽  
James J. Dignam ◽  
Mahul Amin ◽  
Deborah Bruner ◽  
Daniel Low ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Biochemical Recurrence ◽  
Disease Free Survival ◽  
Low Risk ◽  
Free Survival ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer ◽  
Grade 3 ◽  
Disease Free

1 Background: To determine whether the efficacy of a hypofractionated (H) schedule is no worse than a conventional (C) schedule in men with low-risk prostate cancer. Methods: From April 2006 to December 2009, one thousand one hundred fifteen men with low-risk prostate cancer (clinical stage T1-2a, Gleason ≤ 6, PSA < 10) were randomly assigned 1:1 to a conventional (C) schedule (73.8 Gy in 41 fractions over 8.2 weeks) or to a hypofractionated (H) schedule (70 Gy in 28 fractions over 5.6 weeks). The trial was designed to establish with 90% power and alpha = 0.05 that (H) results in 5-year disease-free survival (DFS) that is not lower than (C) by more than 7% (hazard ratio (HR) < 1.52). Secondary endpoints include freedom from biochemical recurrence (FFBR) and overall survival. At the third planned interim analysis (July 2015), the NRG Oncology Data Monitoring Committee recommended that the results of the trial be reported. Results: One thousand one hundred and one protocol eligible men were randomized: 547 to C and 554 to H. Median follow-up is 5.9 years. Baseline characteristics are not different according to treatment arm. At the time of analysis 185 DFS events have been observed; 99 in the C arm and 86 in the H arm. The estimated 7-year disease-free survival is 75.6% (95% CI 70.3, 80.1) in the C arm and 81.8% (77.5, 85.3) in the H arm. The DFS HR (C/H) is 0.85 (0.64, 1.14). Comparison of biochemical recurrence (HR = 0.77, (0.51, 1.17)) and overall survival (HR = 0.95, (0.65, 1.41)) also met protocol non-inferiority criteria. Grade ≥ 3 GI toxicity is 3.0% (C) vs. 4.6% (H), Relative risk (RR) for H vs. C 1.53, (95% CI 0.86, 2.83); grade ≥ 3 GU toxicity is 4.5% (C) vs. 6.4% (H), RR = 1.43 (0.86,2.37). Conclusions: In men with low-risk prostate cancer, 70 Gy in 28 fractions over 5.6 weeks is non-inferior to 73.8 Gy in 41 fractions over 8.2 weeks. Clinical trial information: NCT00331773.

scholarly journals A disintegrin and metalloprotease 23 hypermethylation predicts decreased disease‐free survival in low‐risk breast cancer patients

2019 ◽  
Vol 110 (5) ◽  
pp. 1695-1704 ◽  
Author(s):  
Iveta Zmetakova ◽  
Lenka Kalinkova ◽  
Bozena Smolkova ◽  
Viera Horvathova Kajabova ◽  
Zuzana Cierna ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Disease Free Survival ◽  
Low Risk ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Disease Free ◽  
Risk Breast Cancer

Evaluation of systemic and local immune responses in patients with endometrial cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5594-5594
Author(s):  
Martin Ore ◽  
Ignacio Romero ◽  
Zaida Garcia-Casado ◽  
Cristina Zorrero ◽  
Carmen Illueca ◽  
...  
Keyword(s):  
Immune Response ◽  
Endometrial Cancer ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Lower Grade ◽  
Roc Curve Analysis ◽  
Free Survival ◽  
Hematoxylin And Eosin ◽  
Infiltrating Lymphocytes ◽  
Disease Free

5594 Background: Several studies suggest that systemic immune response (SIR) and local immune response (LIR) have independent roles in multiple types of cancer. In endometrial cancer (EC), the correlation between SIR and LIR and its prognostic value remains unclear. Methods: A total of 146 EC patients (stage I-IV) who had undergone surgery from 2009 to 2015, were identified from a prospective institutional database. Lymphocyte/monocyte ratio (LMR) to represent SIR was calculated from preoperative blood samples. The presence of intratumoral and peritumoral infiltrating lymphocytes (TILs) on hematoxylin and eosin-stained slides was considered as a surrogate of LIR. LMR and TILs were correlated to pathological findings and survival outcomes (overall survival: OS, disease free survival: DFS). Results: A LMR cutoff value of 4.4 for survival was determined based on receiver operating characteristic (ROC) curve analysis. LMR high was significantly associated with endometrioid histology (p=0.03), lower grade (G1-2; p=0.003), < 50% myometrial invasion (p=0.01) and I-II stage (p=0.02). TILs were correlated with MSI-high (p<0.005), but not with LMR (p=0.3). Low LMR was associated with worse 5-year OS rates (64.5% vs 93.9%; p<0.01) and presence of TILs with better 5-years OS rates (72% vs 27%; p=0.04). On multivariate analysis (table 1) LMR, histology, stage and grade remained independent prognostic factors for OS (p=0.01). Using the combination of LMR and TILs, four groups with decreasing 5-years OS rates were identified: LMR-high/TILs+ (100%) > LMR-high/no-TILs (87%) > LMR-low/TILs+ (71%) > LMR-low/no-TILs (61%). Conclusions: In our series of resected EC patients, SIR (defined by LMR) constituted an independent prognostic factor for OS and LIR for DFS. We did not find any correlation between SIR and LIR, but the combination of both higher SIR and LIR showed better OS. [Table: see text]

scholarly journals Comparative efficacy and tolerability of adjuvant systemic treatments against resectable colon cancer: a network meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 175883592097419
Author(s):  
Ji Cheng ◽  
Xiaoming Shuai ◽  
Jinbo Gao ◽  
Guobin Wang ◽  
Kaixiong Tao ◽  
...  
Keyword(s):  
Colon Cancer ◽  
High Risk ◽  
Adverse Events ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Low Risk ◽  
Controlled Trials ◽  
Free Survival ◽  
Disease Free ◽  
Significant Superiority

Background: Currently, 6-month oxaliplatin-based chemotherapy has been recommended as the preferred adjuvant treatment against high-risk stage 2 and stage 3 colon cancer patients. Methods: Record retrieval was conducted in PubMed, Web of Science, Cochrane Central Register of Controlled Trials, American Society of Clinical Oncology and European Society for Medical Oncology meeting libraries from inception to November 2019. Regarding survival and tolerability, randomized controlled trials comparing different adjuvant systemic regimens against high-risk stage 2 and stage 3 colon cancer were eligible. Disease-free survival was primary endpoint. Network calculation was based on a random-effects model, and relative ranking of each node was numerically indicated by p score. Results: A total of 30 trials were included, corresponding to 54,109 patients. Regarding disease-free survival, none of the analyzed regimens displayed significant superiority against common comparator 6-month capecitabine plus oxaliplatin (XELOX), while 12-month [network hazard ratio (HR) 0.81 (0.60–1.10); 0.79 (0.57–1.10)] and 3-month XELOX [0.95 (0.86–1.04); 0.93 (0.83–1.05)] were top-ranking regimens showing non-inferiority among overall and stage 3 patients. Moreover, by pairwise meta-analysis, 3-month XELOX demonstrated significant superiority against 6-month XELOX among low-risk stage 3 patients [pairwise HR 0.78 (0.63–0.97)]. Concerning adverse events, 3-month oxaliplatin-based chemotherapy was significantly better than the 6-month counterpart with respect to peripheral sensory neuropathy, thrombocytopenia and fatigue. The 12-month capecitabine monotherapy failed to display non-inferiority among other major adverse events. Conclusions: The 3-month XELOX treatment could be an alternative option of the 6-month regimen among low-risk stage 3 patients. Among high-risk stage 3 patients, 6-month oxaliplatin-based regimens still seem more competitive. In addition, clinical application of 12-month capecitabine monotherapy should be cautious, despite its top rankings, especially among non-Asian countries.

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