scholarly journals Lumpectomy Combined with Adjuvant Radiotherapy Could Be a Treatment Option for Primary Squamous Cell Carcinoma of the Breast

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wei Xiang Qi ◽  
Lu Cao ◽  
Cheng Xu ◽  
Jiayi Chen
Keyword(s):  
Breast Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adjuvant Radiotherapy ◽  
Cox Regression ◽  
Radical Surgery ◽  
Primary Squamous Cell Carcinoma ◽  
The Impact

Background. To investigate the outcomes of primary squamous cell carcinoma (PSCC) of the breast undergoing radical surgery with or without adjuvant radiotherapy (RT). Materials and Methods. A population cohort with histologically diagnosed PSCC of the breast was identified from the SEER database. The Kaplan–Meier method and Cox-regression proportional hazards model was used to assess the impact of surgical types with or without adjuvant RT on the cause-specific survival (CSS) and overall survival (OS). A retrospective analysis of PSCC between Jan 2010 and Dec 2018 from our institute was performed. Results. A total of 515 patients with PSCC of the breast were included, 254 patients treated with mastectomy (MAST) alone, 78 with MAST + RT, 87 with lumpectomy (LUMP) alone, and 96 with LUMP + RT. The median follow-up time was 118 months (range: 0–379 months). In the multivariate Cox analyses, LUMP + adjuvant RT was an independent prognostic factor for CSS (p = 0.028) and OS (p = 0.048). Patients treated with LUMP + RT had better survival rates than patients who underwent lumpectomy (CSS, p = 0.034; OS, p = 0.0004), MAST alone (CSS, p = 0.0001; OS, p < 0.0001), and MAST + RT (CSS, p = 0.0001; OS, p = 0.0078), while postmastectomy RT did not significantly improve OS (p = 0.062) and CSS (p = 0.67) when compared to MAST alone. In addition, a total of 28 patients with PSCC of the breast were identified from our institute. All of these patients presented with estrogen receptor-negative type, and three of them had HER-2-positive PSCC; the median tumor size was 3 cm (range: 0.5–15 cm). Eight patients were treated with LUMP + adjuvant RT, thirteen with MAST, and seven with MAST + RT. Until the last follow-up of Sep 2021, 26 patients with PSCC were still alive and free of breast cancer, excepting that one patient treated with MAST and one patient with MAST + RT died from breast cancer. Conclusion. PSCC of the breast after radical surgery has a poor prognosis. Adjuvant RT after LUMP significantly improves survival of patients with PSCC of the breast. Further studies are still needed to investigate the role of adjuvant RT in PSCC of the breast after mastectomy.

scholarly journals The influence of red blood cell transfusions on the progression-free survival of patients with localized squamous cell carcinoma of the anus treated with definitive chemoradiation

2021 ◽  
Author(s):  
C.P. Zanella ◽  
M. Camandaroba ◽  
C.A. Mello ◽  
S. Kayano ◽  
M.D. Donadio ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Immune Modulation ◽  
Cox Regression ◽  
Progression Free Survival ◽  
Stage Iii ◽  
Free Survival ◽  
Definitive Chemoradiation ◽  
The Impact

Abstract Background: Red blood cells transfusions (RBCT) have been associated with worse oncological outcomes in distinct tumor types. Inhibition of the activities of Natural Killer (NK) and cytotoxic T cells are the supposed mechanisms underlying a transfusion-related immune modulation. Because the impact of RBCT on the outcomes of patients with squamous cell carcinoma of the anus (SCCA) is uncertain, we aimed to evaluate its influence on the progression-free survival of patients with SCCA treated with definitive chemoradiation (ChRT). Methodology: This was a retrospective study of consecutive SCCA patients treated with definitive ChRT. The primary endpoint was progression-free survival according to receipt of at least one unit of RBCT. Univariate and multivariate Cox regression analyses for progression-free survival were performed to evaluate prognostic factors. Results: From February 2003 to April 2018, 136 patients were included. The median age was 59 years, 77.2% was female and 13.9% had HIV infection. Transfused patients were more frequently female and had stage III tumors. Thirty-one (22.8%) patients received a RBCT, increasing the mean hemoglobin levels from 7.6 to 8.5g/dl. With a median follow-up time of 48 months, the median progression-free survival was 36.5 versus 146.9 months for transfused and non-transfused, respectively. In the multivariate analysis, RBCT ([HR]: 6.7 [IC] 95% 3.4-13.2, p<0.001) and stage III (HR: 3.0 [IC] 95% 1.4-6.5, p =0.005) were associated with inferior progression-free survival as compared to non-transfused and stage I-II, respectively. While the rates of complete responses and persistent local disease were similar between the groups, receipt of RBCT was significantly associated with progression (69.2% versus 14.9%; p < 0.00001).Conclusion: Our study suggests that the receipt of RBCT and clinical stage III disease were significantly associated with inferior progression free survival. RBCT or persistent anemia after transfusion did not influence the rates of complete response, but patients who received RBCT presented significantly higher rates of tumor progression.

scholarly journals EP-1313 Adjuvant radiotherapy for primary squamous cell carcinoma of the breast

2019 ◽  
Vol 133 ◽  
pp. S719-S720
Author(s):  
M. Ogita ◽  
K. Shiraishi ◽  
T. Chang ◽  
J. Kawamori ◽  
W. Takahashi ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adjuvant Radiotherapy ◽  
Primary Squamous Cell Carcinoma ◽  
Carcinoma Of The Breast

Chemotherapy use in early-stage anal canal squamous cell carcinoma and its impact on outcome.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 2-2
Author(s):  
Deanna Huffman ◽  
Thejus Thayyil Jayakrishnan ◽  
Rodney E. Wegner ◽  
Brittany Vannatter ◽  
Dulabh K. Monga ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Anal Canal ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Early Stage ◽  
Private Insurance ◽  
Propensity Matching ◽  
Multi Agent ◽  
The Impact

2 Background: The standard of care for non-metastatic squamous cell carcinoma of the anal canal (SCCA) is concurrent chemoradiotherapy with high rates of local control. There is some thought that perhaps chemotherapy can be omitted for the earliest stages without worse outcomes. We used the National Cancer Database (NCDB) to identify predictors of chemotherapy receipt or omission to assess the impact on outcomes. Methods: We queried the NCDB from 2004-2016 for patients with cT1N0M0 SCCA treated non-operatively with radiation with and without chemotherapy and at least 2 months of follow-up. Logistic regression was used to generate predictors of chemotherapy use. Cox regression identified predictors of survival. Propensity matching was done to help account for indication bias. Results: We identified 2,959 patients meeting eligibility, of which 8% (n = 237) were treated without chemotherapy. The vast majority (n = 2722, 92%) were recorded as having multi-agent chemotherapy. Median radiation dose was 50.4 Gy (IQR 45-54) in 28 fractions (IQR 49.4-59.4) with chemotherapy and 54.0 Gy (IQR 49.4-59.4) in 30 fractions (IQR 25-33) in those who had chemotherapy omitted. Predictors of omission of chemotherapy were older age (OR 0.66, 95% CI [0.49-0.90], P = 0.0087), higher comorbidity score (OR 0.62, 95% CI [0.38-0.99], P = 0.0442), African American race (OR 0.57, 95% CI [0.36-0.90], P = 0.0156) and more remote year of treatment (OR 1 1 for years 2004-2006). Predictors of survival were younger age (HR 1.73 for age > 58 years, 95% CI [1.41-2.11], P < 0.001), multi-agent chemotherapy use (HR 0.48, 95% CI [0.38-0.62], P < 0.0001), higher income (HR 0.57, 95% CI [0.40-0.81], P = 0.0016), female gender (HR 0.68, 95% CI [0.57-0.82], P = 0.0016), and private insurance (HR 0.54, 95% CI [0.34-0.87], P = 0.0104). After propensity matching, overall survival at 120 months for patients treated with and without chemotherapy was 86% and 65%, respectively (p < 0.0001). Conclusions: Chemotherapy is utilized the majority of the time in early stage SCCA. Being mindful of the limitations of a retrospective database analysis, our results suggest an association with worse survival outcomes when chemotherapy is omitted.

Pretreatment neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio to guide the treatment decision (radical surgery versus definitive chemoradiotherapy) for locally advanced squamous cell carcinoma located in the middle and upper esophagus

2020 ◽  
Author(s):  
Wang Chen ◽  
Jia Qi Tong ◽  
Meng Qiu Tang ◽  
Yun Yun Lu ◽  
Gao Feng Liang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Cox Regression ◽  
Radical Surgery ◽  
Survival Curve ◽  
Locally Advanced ◽  
Definitive Chemoradiotherapy ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Background: Various inflammatory biomarkers, such as the neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR), have been well authenticated to predict clinical outcomes in numerous types of cancer. The optimal treatment for patients with locally advanced esophageal squamous cell carcinoma (ESCC) located in middle or upper region is still inconclusive. The aim of the study was to examine pretreatment NLR and PLR to select from radical surgery or definitive chemoradiotherapy (dCRT) for these patients. The linkage between pretreatment NLR / PLR and prognosis was also analyzed.Methods: NLR and PLR were calculated in 113 locally advanced ESCC located in middle or upper esophagus of patients who underwent radical surgery or dCRT between January 2014 and December 2019. A receiver operating characteristic curve was plotted to select the best cut-off value of NLR and PLR for predicting survival. A survival curve was plotted using the Kaplan–Meier method. Univariate and multivariate Cox regression analyses were applied to assess predictors for survival. Results: NLR and PLR was both associated with the extent of lymph node metastasis (NLR: P = 0.045; PLR: P = 0.002). Additionally, high PLR and recurrence with distant organs metastasis were closely related (P = 0.014), and NLR was related to the tumor stage (P = 0.043). The results of multivariate analysis revealed that NLR (> 2.07) and PLR (> 183.06) were independently associated with poor prognosis. It is noteworthy that surgery was associated with a superior OS compared with dCRT in the low NLR population (P = 0.045). Conclusions: Low pretreatment NLR patients made a decision to undergo radical surgery with a substantial therapeutic benefit. Pretreatment NLR and PLR are independent predictors for patients with locally advanced ESCC located in the middle and upper esophagus who underwent radical surgery or dCRT.

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