scholarly journals Oncological Outcomes in Patients with Appendicular Myxofibrosarcomas: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yonghoon Lee ◽  
Michael P. Guertin ◽  
Spencer Summers ◽  
Sheila A. Conway ◽  
Mothasem Al Maaieh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Distant Metastasis ◽  
Negative Impact ◽  
Soft Tissue Sarcomas ◽  
Female Gender ◽  
Surgical Margins ◽  
Oncological Outcomes ◽  
Infiltrative Growth Pattern ◽  
The Impact

Background. Myxofibrosarcoma (MFS) is notorious for its infiltrative growth pattern, making wide excisions difficult to achieve. Our objective was to assess the impact of surgical margins and other factors that affected rates of local recurrence (LR), distant metastasis (DM), and overall survival (OS) of individuals undergoing resection for MFS. Methods. We retrospectively reviewed the medical records of 209 patients with appendicular soft tissue sarcomas between January 2012 and June 2018. Of these, 29 patients (14%) were diagnosed with myxofibrosarcoma. These patients underwent a total of 33 resections. The pathological analyses were conducted by an experienced musculoskeletal (MSK) pathologist. Demographics data, operative details, adjuvant therapy, and oncological outcomes were assessed. Results. Of the 29 patients (33 resections), the overall LR rate was 24% (7/29) and the 2-year LR rate was 17% (5/29). Factors associated with negative oncological outcomes were as follows: tumor size ≤10 cm (2-year local recurrence-free rates (LRFRs), 65%; 95% CI, 44–86%; p = 0.02 ) and positive surgical margins grouped with surgical margins ≤0.1 cm (hazard ratio (HR), 11.74; 95% CI, 1.41–97.74; p = 0.02 ). Chemotherapy and radiotherapy together increased the 2-year LRFR (LRFR, 100%; 95% CI, 100%, p = 0.001 ). Two-year DM and OS rates were 15% and 79%, respectively. Female gender was a predictor of distant metastasis. Local recurrence had a negative impact on overall survival. Intraoperative analysis of resection margin accuracy was 75% (12/16) when non-MSK pathologists were involved but 100% accurate (12/12) when analyzed by an MSK pathologist. Conclusion. Myxofibrosarcomas showed high LR rates after treatment. Close margins (≤0.1 cm) should be considered as a risk factor for LR, and LR is associated with negative overall survival. Neoadjuvant therapy in terms of combined chemotherapy and radiation therapy associates with decreased LR rates. If intraoperative assessment of margins is to be done, it should be performed by an experienced MSK pathologist.

scholarly journals High-grade soft tissue sarcomas of the extremities: surgical margins influence only local recurrence not overall survival

2015 ◽  
Vol 39 (5) ◽  
pp. 935-941 ◽  
Author(s):  
Julie Willeumier ◽  
Marta Fiocco ◽  
Remi Nout ◽  
Sander Dijkstra ◽  
William Aston ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Surgical Margins ◽  
High Grade

scholarly journals The problem of local recurrence and metastasis in soft-tissue sarcoma

2003 ◽  
Vol 11 (1) ◽  
pp. 9-11
Author(s):  
Aleksandar Kiralj ◽  
Zlata Janjic ◽  
Mladen Jovanovic ◽  
Nada Vuckovic
Keyword(s):  
Prognostic Factor ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Distant Metastasis ◽  
Soft Tissue Sarcomas ◽  
Radical Resection ◽  
Surgical Margins

BACKGROUND: The purpose of this study was to evaluate local recurrence of soft-tissue sarcomas as a prognostic factor reflecting adequate or inadequate excision. METHODS: We reviewed the cases of 53 patients who had soft-tissue sarcomas and were treated between 1991 and 2001. All patients were treated operatively, but 11 of them (20.75%), before being sent to us were operated elsewhere with inadequate surgical margins. The oncology status, including local recurrence and metastasis was determined at the follow-up evaluation. RESULTS: All of 11 patients treated with inadequate excision had palpably or histologically determined local recurrence. The most common histological diagnosis of local recurrence was dermatofibroma protuberans (7 patients, 63.63%). In patients who were treated with planned and adequate excision there were 4 (9.52%) recurrences. Five patients (45.45%) had metastases in the group of inadequate and only one patient (1.88%) in the group of adequate surgical margins. CONCLUSION: Our study demonstrated that excellent rates of survival and low rates of local recurrence and distant metastasis of soft-tissue sarcomas could be obtained with the use of carefully planned radical resection. The quality of operation is the most important factor.

Understanding the Impact of Bullying in a Unionized U.S. Public Sector Workforce

2019 ◽  
Vol 68 (3) ◽  
pp. 139-153 ◽  
Author(s):  
Mazen El Ghaziri ◽  
Shellie Simons ◽  
Jane Lipscomb ◽  
Carla L. Storr ◽  
Kathleen McPhaul ◽  
...  
Keyword(s):  
Public Sector ◽  
Organizational Climate ◽  
Negative Impact ◽  
Multinomial Logistic Regression ◽  
Female Gender ◽  
Bargaining Unit ◽  
Organizational Level ◽  
Organizational Impact ◽  
Cross Sectional ◽  
The Impact

Background: Workplace Bullying (WPB) can have a tremendous, negative impact on the victims and the organization as a whole. The purpose of this study was to examine individual and organizational impact associated with exposure to bullying in a large U.S. unionized public sector workforce. Methods: A cross-sectional Web-based survey was conducted among 16,492 U.S. state government workers. Survey domains included demographics, negative acts (NAs) and bullying, supportiveness of the organizational climate, and individual and organizational impacts of bullying. Multinomial logistic regression was used to assess the impact among respondents who reported exposure to bullying. Findings: A total of 72% participants responded to the survey (n = 11,874), with 43.7% (n = 5,181) reporting exposure to NAs and bullying. A total of 40% (n = 4,711) participants who experienced WPB reported individual impact(s) while 42% ( n = 4,969) reported organization impact(s). Regular NA was associated with high individual impact (negatively impacted them personally; odds ratio [OR] = 5.03) when controlling for other covariates including: female gender (OR =1.89) and job tenure of 6 to 10 years (OR = 1.95); working in a supportive organizational climate and membership in a supportive bargaining unit were protective of high impact (OR = 0.04 and OR = 0.59, respectively). High organizational impact (transferring to another position) was associated with regular NA and bullying (OR = 16.26), female gender (OR = 1.55), providing health care and field service (OR = 1.68), and protective effect of organizational climate (OR = 0.39). We found a dose-response relationship between bullying and both individual and organizational-level impact. Conclusion/Application to Practice: Understanding the impacts of WPB should serve to motivate more workplaces and unions to implement effective interventions to ameliorate the problem by enhancing the organizational climate, as well as management and employee training on the nature of WPB and guidance on reporting.

scholarly journals The prognostic impact of RAS on overall survival following liver resection in early versus late-onset colorectal cancer patients

2020 ◽  
Author(s):  
Alexandre A. Jácome ◽  
Timothy J. Vreeland ◽  
Benny Johnson ◽  
Yoshikuni Kawaguchi ◽  
Steven H. Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Resection ◽  
Age Of Onset ◽  
Negative Impact ◽  
Late Onset ◽  
Linear Regression Analysis ◽  
Multidisciplinary Treatment ◽  
Prognostic Impact ◽  
The Impact

Abstract Background The impact of molecular aberrations on survival after resection of colorectal liver metastases (CLM) in patients with early-age-onset (EOCRC) versus late-age-onset colorectal cancer (LOCRC) is unknown. Methods Patients who underwent liver resection for CLM with known RAS, BRAF and MSI status were retrospectively studied. The prognostic impact of RAS mutations by age was analysed with age as a categorical variable and a continuous variable. Results The study included 573 patients, 192 with EOCRC and 381 with LOCRC. The younger the age of onset of CRC, the greater the negative impact on overall survival of RAS mutations in the LOCRC, EOCRC, and ≤40 years (hazard ratio (HR), 1.64 (95% confidence interval (CI), 1.23–2.20), 2.03 (95% CI, 1.30–3.17), and 2.97 (95% CI, 1.44–6.14), respectively. Age-specific mortality risk and linear regression analysis also demonstrated that RAS mutations had a greater impact on survival in EOCRC than in LOCRC (slope: −4.07, 95% CI −8.10 to 0.04, P = 0.047, R2 = 0.08). Conclusion Among patients undergoing CLM resection, RAS mutations have a greater negative influence on survival in patients with EOCRC, more so in patients ≤40 years, than in patients with LOCRC and should be considered as a prognostic factor in multidisciplinary treatment planning.

CD56 Expression Is an Important Prognostic Factor in Multiple Myeloma Even with Bortezomib Induction

2018 ◽  
Vol 139 (4) ◽  
pp. 228-234 ◽  
Author(s):  
Matevz Skerget ◽  
Barbara Skopec ◽  
Vesna Zadnik ◽  
Darja Zontar ◽  
Helena Podgornik ◽  
...  
Keyword(s):  
Negative Impact ◽  
Progression Free Survival ◽  
Staging System ◽  
Female Gender ◽  
Induction Treatment ◽  
Hematopoietic Stem ◽  
Cd56 Expression ◽  
International Staging System ◽  
Elevated Creatinine ◽  
The Impact

Objectives: In this retrospective study, we evaluated the impact of CD56, CD117, and CD28 expression on clinical characteristics and survival in newly diagnosed myeloma patients treated with bortezomib-based induction therapy. Methods: We analyzed 110 myeloma patients. Immunophenotype was determined using panels consisting of CD19/CD38/CD45/CD56/CD138 and CD20, CD28, and CD117 were used additionally. All samples were tested for recurrent chromosomal aberrations. Results: CD56, CD117, and CD28 expression rates were 71, 6, and 68%, respectively. The lack of CD56 expression was associated with light chain myeloma. The lack of CD117 expression was associated with elevated creatinine levels (p = 0.037). We discovered the correlation between CD 28 expression and female gender. The median progression-free survival (PFS) for patients with revised International Staging System stage 2 disease with CD56 expression or the lack of CD56 expression was 20.5 vs. 13.8 months (p = 0.03). In patients undergoing autologous hematopoietic stem cell transplantation (aHSCT), we found no difference in PFS and overall survival regarding the CD56 expression. We found no impact of CD117 and CD28 expression on PFS in patients regarding aHSCT. Conclusions: Induction treatment incorporating bortezomib diminishes the negative impact of the lack of CD117 expression and aberrancy of CD28 but does not overcome the negative impact of the lack of CD56 expression.

Treatment-Induced Pathologic Necrosis: A Predictor of Local Recurrence and Survival in Patients Receiving Neoadjuvant Therapy for High-Grade Extremity Soft Tissue Sarcomas

2001 ◽  
Vol 19 (13) ◽  
pp. 3203-3209 ◽  
Author(s):  
Fritz C. Eilber ◽  
Gerald Rosen ◽  
Jeffery Eckardt ◽  
Charles Forscher ◽  
Scott D. Nelson ◽  
...  
Keyword(s):  
Overall Survival ◽  
Soft Tissue ◽  
Local Recurrence ◽  
Neoadjuvant Therapy ◽  
Independent Predictor ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Recurrence Rates ◽  
Pathologic Assessment

PURPOSE: To determine whether treatment-induced pathologic necrosis correlates with local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. PATIENTS AND METHODS: Four hundred ninety-six patients with intermediate- to high-grade extremity soft tissue sarcomas received protocol neoadjuvant therapy. All patients underwent surgical resection after neoadjuvant therapy and had pathologic assessment of tumor necrosis in the resected specimens. RESULTS: The 5- and 10-year local recurrence rates for patients with ≥ 95% pathologic necrosis were significantly lower (6% and 11%, respectively) than the local recurrence rates for patients with less than 95% pathologic necrosis (17% and 23%, respectively). The 5- and 10-year survival rates for the patients with ≥ 95% pathologic necrosis were significantly higher (80% and 71%, respectively) than the survival rates for the patients with less than 95% pathologic necrosis (62% and 55%, respectively). Patients with less than 95% pathologic necrosis were 2.51 times more likely to develop a local recurrence and 1.86 times more likely to die of their disease as compared with patients with ≥ 95% pathologic necrosis. The percentage of patients who achieved ≥ 95% pathologic necrosis increased to 48% with the addition of ifosfamide as compared with 13% of the patients in all the other protocols combined. CONCLUSION: Treatment-induced pathologic necrosis is an independent predictor of both local recurrence and overall survival in patients who receive neoadjuvant therapy for high-grade extremity soft tissue sarcomas. A complete pathologic response (≥ 95% pathologic necrosis) correlated with a significantly lower rate of local recurrence and improved overall survival.

Impact of chemotherapy dose-related factors on survival in breast cancer patients treated with adjuvant anthracycline-based chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 668-668 ◽  
Author(s):  
I. Chirivella ◽  
B. Bermejo ◽  
A. Insa ◽  
A. Perez-Fidalgo ◽  
A. Magro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Negative Impact ◽  
Histological Grade ◽  
Menopausal Status ◽  
Dose Intensity ◽  
Disease Stage ◽  
Related Factors ◽  
Ct Dose ◽  
The Impact

668 Background: The relationship between chemotherapy (CT) dose intensity and patient (pt) outcome in the management of early stage breast cancer (EBC) is still controversial. Although randomised clinical trials have provided evidence that supports the delivery of full standard doses of CT on schedule, precise thresholds for CT dose-related factors and their impact on survival-related endpoints have not yet been fully defined. The objective of this project is to assess the impact of CT dose-related factors on event-free and overall survival in a large group of EBC pts treated with anthracycline-based chemotherapy. Methods: A total of 1056 EBC (stage I-II-IIIA) cases diagnosed and treated from January 1980 to December 2000 were retrospectively studied. All of them received adjuvant anthracycline non-taxanes-based CT. Consecutive charts from 793 pts that were fully completed were included in the analysis. Survival-related endpoints were analysed through Kaplan-Meier estimates, log-rank tests, and Cox proportional hazards models. Results: With a median follow-up of 10.0 years, pts exposed to either > 2 cycle-delay (delay at any cycle defined as ≥ 3 days vs. plan), or ≥ 15 day-delay across the whole CT regimen, or < 95% relative dose intensity (RDI) showed significantly worse 10-year Event-Free Survival (EFS) and Overall Survival (OS) as compared to pts with no dose delay/reduction (data shown below). Controlling for age at diagnosis, disease stage, histological grade, menopausal status and year of treatment did not modify these results. Conclusions: Based on this preliminary analysis, CT dose delays and reductions in EBC pts treated with adjuvant anthracycline-based regimens have a significantly negative impact on EFS and OS. [Table: see text] No significant financial relationships to disclose.

Mood state and melanoma outcome in the Multicenter Selective Lymphadenectomy Trial

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9603-9603 ◽  
Author(s):  
J. R. Garreau ◽  
M. Faries ◽  
X. Ye ◽  
D. Morton
Keyword(s):  
Overall Survival ◽  
Negative Impact ◽  
Mood State ◽  
Disease Free Survival ◽  
Well Being ◽  
Mood States ◽  
Phase Iii ◽  
Selective Lymphadenectomy ◽  
The Impact ◽  
Disease Free

9603 Background: Emotional state has been linked to cancer survival, but its influence on the outcome of early melanoma is unclear. The Multicenter Selective Lymphadenectomy Trial (MSLT-I) randomized patients with clinically localized cutaneous melanoma to wide local excision (WEX) plus observation or to WEX plus sentinel lymph node biopsy (SNB). Clinical endpoints included disease-specific and disease-free survival. A substudy of this phase III trial evaluated the impact of mood state on survival, and the impact of recurrence on mood state. Methods: Patients were asked to complete a 65-question form within 6 months of enrollment (baseline) and every 12 months thereafter. This questionnaire measured 6 identifiable mood states (vigor-activity, tension-anxiety, depression, anger-hostility, fatigue-inertia, confusion-bewilderment) of the Profile of Mood States (POMS), a validated mood scale for assessing responses to therapy. Self-reported data from the questionnaires were linked to demographic and clinical variables. Results: Of 2,001 patients accrued to MSLT-I, 1,620 completed the questionnaire at baseline. The baseline distribution of POMS variables was similar in the two treatment arms (data not shown). Patients with more vigor at baseline had a significantly longer disease-free and overall survival ( Table ), even after adjusting for age, tumor thickness, site, and ulceration status (p <0.001). Among 136 patients who completed a questionnaire within 6 months after recurrence, comparison of baseline and post-recurrence responses revealed significant changes in mood state: tension, fatigue and confusion increased, whereas vigor decreased (p = 0.0004, 0.0171, 0.0089, and 0.0028, respectively). Conclusions: Vigor, a measure of energy and optimism, is directly correlated with disease-free and overall survival in early melanoma. The negative impact of recurrence on mood state suggests that SNB as a tool for preventing recurrence might also improve mood state and psychological well-being. Supported by NIH CA29605. [Table: see text] No significant financial relationships to disclose.

Impact of relapse site on oncological outcomes after radical nephroureterectomy for upper urinary tract urothelial carcinoma.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 426-426
Author(s):  
Shinichi Yamashita ◽  
Akihiro Ito ◽  
Koji Mitsuzuka ◽  
Yoshihide Kawasaki ◽  
Ichiro Shintaku ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Local Recurrence ◽  
Lymph Nodes ◽  
Multivariate Analyses ◽  
Survival Rates ◽  
Upper Urinary Tract ◽  
Radical Nephroureterectomy ◽  
Cancer Specific Survival ◽  
Oncological Outcomes ◽  
The Impact

426 Background: Most upper urinary tract urothelial carcinomas (UTUC) are invasive and advanced with a poor prognosis. Patients often relapse after treatment with radical nephroureterectomy (RNU). However, little is known about an association between sites of recurrence after RNU and oncological outcomes. The present study retrospectively evaluated the impact of a first recurrence site on survival. Methods: A total of 650 patients with UTUC treated by RNU at 12 institutions that participated in the Tohoku Urological Evidence-Based Medicine Study Group between 2000 and 2011 were initially enrolled. Patients who experienced relapse other than intravesical recurrence after RNU were included in this study. Those who had metastasis at the time of UTUC diagnosis or missing data regarding the time and location of relapse were excluded. Finally, 173 patients were eligible to participate in this study. Survival rates were analyzed using Kaplan-Meier curves and the log-rank test, and factors predicting survival were assessed using multivariate analyses. Results: The median follow-up after relapse was nine months. The cancer-specific survival rates at one and two years after relapse were 49% and 22%, respectively. Cancer in 59 (34%), 32 (18%), 23 (13%), and 94 (53%) patients recurred in the lung, liver, bone and lymph nodes, and 23 (13%) had local recurrence. The one-year cancer-specific survival rates were 44%, 27%, 22% and 52% among patients with metastasis of the lungs, liver, bone and lymph nodes respectively, and 41% among those with local recurrence. The survival rate was worse among 48 patients with metastasis at multiple sites, than in those with metastasis at a single site. Fourteen (8%) patients with a single lymph, lung or local recurrence survived for over three years after a first relapse. Multivariate analyses selected the liver, bone and local recurrence as critical factors for cancer-specific survival. Conclusions: Liver or bone metastasis was a negative prognostic factor for UTUC with relapse after RNU. Information about recurrence sites might be helpful for patient counseling.

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