Is the Oncological Outcome of Early Stage Uterine Carcinosarcoma Different from That of Grade 3 Endometrioid Adenocarcinoma?

Aim: The clinicopathologic characteristics, recurrence patterns, and survival of patients with grade 3 endometrial cancer (G3-EAC) and uterine carcinosarcoma (UCS) were compared. Materials and Methods: The medical records of patients treated for G3-EAC and UCS between January 1996 and December 2016 at 11 gynecologic oncology centers in Turkey and Germany were analyzed. Results: Of all patients included in the study, 161 (45.1%) were diagnosed with UCS and 196 (54.9%) with G3-EAC at FIGO stage I–II (early stage) disease. The recurrence rate was higher in patients with UCS than in those with G3-EAC (17.4 vs. 9.2%, p = 0.02). The 5-year disease-free survival (DFS; 75.2 and 80.8%, respectively; p = 0.03) and overall survival (OS; 79.4 and 83.4%, respectively; p = 0.04) rates were significantly lower in the UCS group compared to the G3-EAC group. UCS histology was an independent prognostic factor for decreased 5-year DFS (HR 1.8, 95% CI 1.2–3.2; p = 0.034) and OS (HR 2.7, 95% CI 1.3–6.9; p = 0.041) rates. Conclusions: The recurrence rate was higher in UCS patients than in G3-EAC patients, regardless of disease stage. DFS and OS were of shorter duration in UCS than in G3-EAC patients. Adequate systematic lymphadenectomy and omentectomy were an independent prognostic factor for increased 5-year DFS and OS rates.

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Plasma Epstein-Barr Viral Deoxyribonucleic Acid Quantitation Complements Tumor-Node-Metastasis Staging Prognostication in Nasopharyngeal Carcinoma

Journal of Clinical Oncology ◽

10.1200/jco.2006.07.7982 ◽

2006 ◽

Vol 24 (34) ◽

pp. 5414-5418 ◽

Cited By ~ 218

Author(s):

Sing-fai Leung ◽

Benny Zee ◽

Brigette B. Ma ◽

Edwin P. Hui ◽

Frankie Mo ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factor ◽

Nasopharyngeal Carcinoma ◽

Early Stage ◽

Independent Prognostic Factor ◽

Stage I ◽

Early Stage Disease ◽

Stage Disease ◽

Ebv Dna ◽

Epstein Barr

Purpose To evaluate the effect of combining circulating Epstein-Barr viral (EBV) DNA load data with TNM staging data in pretherapy prognostication of nasopharyngeal carcinoma (NPC). Patients and Methods Three hundred seventy-six patients with all stages of NPC were studied. Pretreatment plasma/serum EBV DNA concentrations were quantified by a polymerase chain reaction assay. Determinants of overall survival were assessed by multivariate analysis. Survival probabilities of patient groups, segregated by clinical stage (I, II, III, or IV) alone and also according to EBV DNA load (low or high), were compared. Results Pretherapy circulating EBV DNA load is an independent prognostic factor for overall survival in NPC. Patients with early-stage disease were segregated by EBV DNA levels into a poor-risk subgroup with survival similar to that of stage III disease and a good-risk subgroup with survival similar to stage I disease. Conclusion Pretherapy circulating EBV DNA load is an independent prognostic factor to International Union Against Cancer (UICC) staging in NPC. Combined interpretation of EBV DNA data with UICC staging data leads to alteration of risk definition of patient subsets, with improved risk discrimination in early-stage disease. Validation studies are awaited.

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Is Peritoneal Cytology an Independent Prognostic Factor in Early-Stage Endometrial Cancer?

Indian Journal of Gynecologic Oncology ◽

10.1007/s40944-021-00508-w ◽

2021 ◽

Vol 19 (2) ◽

Author(s):

A. K. Padhy ◽

Mahapatra Manoranjan ◽

Mishra Jagannath ◽

Subhashree Rout ◽

Mohapatra Janmejay ◽

...

Keyword(s):

Endometrial Cancer ◽

Prognostic Factor ◽

Early Stage ◽

Independent Prognostic Factor ◽

Peritoneal Cytology ◽

Early Stage Endometrial Cancer

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Residual ctDNA after treatment predicts early relapse in patients with early-stage NSCLC.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.8517 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 8517-8517

Author(s):

Davina Gale ◽

Katrin Heider ◽

Malcolm Perry ◽

Giovanni Marsico ◽

Andrea Ruiz-Valdepeñas ◽

...

Keyword(s):

Lung Cancer ◽

Deep Sequencing ◽

Early Stage ◽

Post Treatment ◽

Disease Stage ◽

Analytical Sensitivity ◽

Disease Relapse ◽

Clinical Progression ◽

Liquid Biopsies ◽

Early Stage Disease

8517 Background: Liquid biopsies based on circulating tumor DNA (ctDNA) analysis are being investigated for detection of residual disease and recurrence. Conclusive evidence for utility of ctDNA in early-stage non-small cell lung cancer (NSCLC) is awaited. Due to low ctDNA levels in early-stage disease or post-treatment, effective methods require high analytical sensitivity to detect mutant allele fractions (MAF) below 0.01%. Methods: We analysed 363 plasma samples from 88 patients with NSCLC recruited to the LUng cancer CIrculating tumour DNA (LUCID) study, with disease stage I (49%), II (28%) and III (23%). 62% were adenocarcinomas. Plasma was collected before and after treatment, and at 3, 6 and 9 months after surgery (N = 69) or chemoradiotherapy (N = 19). Additional plasma was collected at disease relapse for 17 patients. Median follow-up was 3 years, and 40 patients progressed or died of any cause. We employed the RaDaR™ assay, a highly sensitive personalized assay using deep sequencing of up to 48 tumor-specific variants. Variants identified by tumor exome analysis were tested by deep sequencing of tumor tissue and buffy coat DNA to verify somatic mutations and exclude clonal hematopoiesis. The RaDaR assay demonstrated 90% sensitivity at 0.001% MAF in analytical validation studies. Results: ctDNA was detected in 26% of samples, at median MAF of 0.047% (range: 0.0007% to > 2%), and prior to treatment in 87%, 77% and 24% for disease stage III, II and I respectively. For 62 patients, plasma was collected at a landmark timepoint, between 2 weeks and 4 months after initial treatment. ctDNA detection at the landmark timepoint was strongly predictive of clinical disease relapse, with Hazard Ratio of 20.7 (CI: 7.7-55.5, p-value < 0.0001). All 11 cases with ctDNA detected at landmark had disease progression, a median of 121 days after detection, and these included all 8 patients that relapsed within 300 days of treatment. Across 27 patients whose disease progressed during the study, ctDNA was detected at any timepoint post-treatment in 17 cases, with a median lead time of 203 days, and up to 741 days prior to clinical progression. ctDNA was detected post-treatment, in 13 of the 15 patients that progressed and had ctDNA detected prior to treatment. Conclusions: Our results support an emerging paradigm shift, by demonstrating that liquid biopsies can reliably detect recurrence of NSCLC at a preclinical stage, many months before clinical progression, thereby offering the opportunity for earlier therapeutic intervention. Clinical trial information: NCT04153526.

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The effects of season and devil facial tumour disease on the reproductive physiology of the male Tasmanian devil (Sarcophilus harrisii)

Reproduction Fertility and Development ◽

10.1071/rd11134 ◽

2012 ◽

Vol 24 (7) ◽

pp. 999 ◽

Cited By ~ 7

Author(s):

T. Keeley ◽

P. D. McGreevy ◽

J. K. O'Brien

Keyword(s):

Early Stage ◽

Reproductive Function ◽

Serum Testosterone ◽

Serum Cortisol ◽

Disease Stage ◽

Rapid Decline ◽

Tasmanian Devil ◽

Early Stage Disease ◽

Devil Facial Tumour Disease ◽

Disease Free

Devil facial tumour disease (DFTD) is the cause of the rapid decline of wild Tasmanian devils. Female devils are seasonal breeders with births peaking during autumn (i.e. March) but the degree of reproductive seasonality in male devils is unknown. The objective of this study was to examine the potential effects of season and DFTD on reproductive function in male devils (n = 55). Testicular (1.90 ± 0.23 g) and epididymal (0.90 ± 0.06 g) weights were maximal during autumn and spring (P < 0.05), whereas prostate (3.71 ± 0.74 g) and Cowper’s gland (0.68 ± 0.22; 0.52 ± 0.21 g) weights peaked during autumn (P < 0.001). The motility of spermatozoa from the cauda epididymides extracted post-mortem was similar (P > 0.05) across season and disease state (31.5 ± 13.1% total motility). Testicular and epididymal weights were no different between animals displaying late or early-stage DTFD signs or disease-free animals (P > 0.1). The accessory sex glands were larger in late-stage DFTD animals than in animals with early-stage disease signs or which were disease-free (P < 0.01) but effects of season on this result can’t be excluded. Serum testosterone concentrations peaked during summer (0.25 ± 0.18 ng mL–1) but values were not different from the preceding and subsequent seasons (P > 0.05), nor influenced by disease stage (P > 0.1). Seasonal and DFTD-related changes in serum cortisol concentrations were not evident (P > 0.1). Male devil reproduction does not appear to be restricted by season nor inhibited by DFTD.

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Tumor Location Is Not an Independent Prognostic Factor in Early Stage Non-Small Cell Lung Cancer

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2010.01.020 ◽

2010 ◽

Vol 89 (4) ◽

pp. 1053-1059 ◽

Cited By ~ 25

Author(s):

Varun Puri ◽

Nitin Garg ◽

Erin E. Engelhardt ◽

Daniel Kreisel ◽

Traves D. Crabtree ◽

...

Keyword(s):

Lung Cancer ◽

Prognostic Factor ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Early Stage ◽

Tumor Location ◽

Small Cell ◽

Independent Prognostic Factor ◽

Small Cell Lung

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International Study of Primary Mucinous Ovarian Carcinomas Managed at Tertiary Medical Centers

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000001263 ◽

2018 ◽

Vol 28 (5) ◽

pp. 915-924 ◽

Cited By ~ 4

Author(s):

Jennifer J. Mueller ◽

Henrik Lajer ◽

Berit Jul Mosgaard ◽

Slim Bach Hamba ◽

Philippe Morice ◽

...

Keyword(s):

Early Stage ◽

Statistical Tests ◽

Stage Iv ◽

Stage I ◽

Stage Iii ◽

Oncologic Outcomes ◽

Disease Stage ◽

Ovarian Carcinomas ◽

Early Stage Disease ◽

Medical Centers

ObjectiveWe sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes.MethodsThis was a retrospective review spanning 1976–2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis. Data were abstracted from medical records, and a deidentified dataset was compiled and processed at a single institution. Appropriate statistical tests were performed.ResultsTwo hundred twenty-two patients with PMOC were identified; all had undergone primary surgery. Disease stage distribution was as follows: stage I, 163 patients (74%); stage II, 8 (4%); stage III, 40 (18%); and stage IV, 10 (5%). Ninety-nine (45%) of 219 patients underwent lymphadenectomy; 41 (19%) of 215 underwent fertility-preserving surgery. Of the 145 patients (65%) with available treatment data, 68 (47%) had received chemotherapy—55 (81%) a gynecologic regimen and 13 (19%) a gastrointestinal regimen. The 5-year progression-free survival (PFS) rates were 80% (95% confidence interval [CI], 73%–85%) for patients with stage I to II disease and 17% (95% CI, 8%–29%) for those with stage III to IV disease. The 5-year PFS rate was 73% (95% CI, 50%–86%) for patients who underwent fertility-preserving surgery.ConclusionsMost patients (74%) presented with stage I disease. Nearly 50% were treated with adjuvant chemotherapy using various regimens across institutions. The PFS outcomes were favorable for those with early-stage disease and lower but acceptable for those who underwent fertility preservation.

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Lung Cancer in Homeless People: Clinical Outcomes and Cost Analysis in a Single Institute

Canadian Respiratory Journal ◽

10.1155/2016/3727689 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Koung Jin Suh ◽

Ki Hwan Kim ◽

Jin Lim ◽

Jin Hyun Park ◽

Jin-Soo Kim ◽

...

Keyword(s):

Lung Cancer ◽

Early Stage ◽

Medical Center ◽

Homeless People ◽

Stage Iv ◽

Disease Stage ◽

Curative Surgery ◽

Early Stage Disease ◽

Outpatient Visits

Introduction. To characterize the demographic and clinical features, outcomes, and treatment costs of lung cancer in homeless people. Methods. Medical records of 22 homeless patients with lung cancer at Seoul National University Boramae Medical Center in Seoul, South Korea, were retrospectively analyzed. Results. All patients were men (median age, 62 years). Most patients (78%) had advanced disease (stage IIIB, n=2; stage IV, n=15). Seven died during initial hospitalization (median survival, 1.5 months). Six were lost to follow-up after initial outpatient visits or discharges from initial admission (median follow-up, 13 days). Only 4 received appropriate treatment for their disease and survived for 1, 15, 19, and 28 months, respectively. Conversely, 4 of 5 patients with early stage disease (stage I, n=4; stage IIA, n=1) received curative surgery (median follow-up 25.5 months). The median treatment cost based on 29 days of hospitalization and 2 outpatient visits was $12,513, constituting 47.3% of the 2013 per capita income. Inpatient treatment accounted for 90% of the total costs. The National Health Insurance Service paid 82% of the costs. Conclusion. Among the homeless, lung cancer seems to be associated with poor prognosis and substantial costs during a relatively short follow-up and survival period.

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Expression of the Cancer-Testis Antigens, SEMG 1 and Protamine 1, in Early CLL: Their Relationship to Disease Stage and Zap 70 Expression.

Blood ◽

10.1182/blood.v110.11.4680.4680 ◽

2007 ◽

Vol 110 (11) ◽

pp. 4680-4680

Author(s):

Farouk Meklat ◽

Yana Zhang ◽

Zhiqing Wang ◽

Jian Zhang ◽

Sukhrob Mustalov ◽

...

Keyword(s):

Vaccine Development ◽

Tumor Vaccine ◽

Early Stage ◽

Disease Stage ◽

Early Disease ◽

Early Stage Disease ◽

Stage Disease ◽

Ct Antigen ◽

Cancer Testis ◽

Protamine 1

Abstract Despite advances in modern chemotherapy, CLL remains incurable. CLL is an indolent disease. It expresses a panel of Cancer-Testis (CT) antigens. CLL leukemia cells are susceptible to the cytotoxicity of T cells. CLL is, therefore, an ideal disease for immunotherapeutic approaches. Immunotherapy, in addition to being less toxic and more specific than chemotherapy, provides a different mode of cytotoxicity that may synergize with that induced by chemotherapeutic agents. Immunotherapy also offers the prospect of inducing immune memory that may be important for long term disease-free survival of patients with CLL. However, there are obstacles that may prevent successful immunotherapy. CLL patients are generally immunosuppressed even before any therapy is given and the immunosuppression increases as the disease progresses. Therefore, any immunotherapeutic approaches for CLL should be aplied in early disease when immunosuppression is least encountered. We previously demonstrated the expression of a CT antigen, SEMG 1, in 3/9 patients with CLL. Furthermore, we also demonstrated that the presence of high titer IgG in the serum of patients expressing SEMG 1, suggesting the in vivo immunogenicity of SEMG 1 in the cancer-bearing autologous host. We have also recently used SEMG 1 as the bait in a yeast two-hybrid system of testicular cDNA library and identified that Protamine 1 is the interacting ligand of SEMG 1 and that Protamine 1 is also a novel CT antigen, suggesting that both SEMG 1 and Protamine 1 may be suitable antigens for tumor vaccine development. However, the expression of SEMG 1 and Protamine 1 in early CLL is unknown. We have in this study set out to determine whether or not SEMG 1 and/or Protamine 1 could be used for the design of tumor vaccine for the targeting of patients with early CLL, in particular, those with poor risk disease, as predicted by Zap 70 expression. Using pairs of sequence-specific primers in RT-PCR on a cohort of CLL (41 Stage 0/I and 6 Stage II/III), we found that SEMG 1 gene is expressed in 24/47 (51%) and Protamine 1 in 16/47 (34%) of CLL patients. Gene expression in most cases was associated with the detection by immunocytochemistry of SEMG 1 and/or Protamine 1 in the CLL cells. The expression frequency of SEMG1 and Protamine 1 in CLL did not appear to differ between early and late stage disease. 19/41 of patients with early stage disease and 5/6 of patients with late disease expressed SEMG 1; 12/41 of patients with early stage disease and 4/6 patients with late disease expressed Protamine 1. Furthermore, the expression of these antigens was equally distributed between Zap 70+ and Zap 70− CLL. SEMG 1 was expressed in 4/6 of Zap 70+ CLL (all 6 had early disease) and 2/9 of Zap 70− CLL (1/8 early disease and 1/1 late disease). Interestingly, although Protamine 1 expression in CLL predicted for SEMG 1 co-expression, only 67% of SEMG 1+ CLL expressed Protamine 1. Our results, therefore, suggest that both SEMG 1 and Protamine 1 are suitable targets for tumor vaccine development for some patients with early CLL, especially those with high risk disease, as predicted by Zap 70 expression.

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Recurrence rates in patients with uterine papillary serous cancer with and without breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e16529 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e16529-e16529

Author(s):

Jessica E. Stine ◽

Stuart Pierce ◽

Paola A. Gehrig ◽

John Nakayama ◽

Laura Jean Havrilesky ◽

...

Keyword(s):

Breast Cancer ◽

Recurrence Rate ◽

Late Stage ◽

Early Stage ◽

Disease Stage ◽

Serous Carcinoma ◽

Recurrence Rates ◽

Increased Risk ◽

Risk Patients ◽

Papillary Serous Carcinoma

e16529 Background: Women with uterine papillary serous carcinoma (UPSC) are at increased risk for breast cancer and the converse is true. A genetic association between breast cancer and UPSC was recently described and counseling women faced with more than one cancer diagnosis can be difficult. Our objective was to evaluate recurrence rates of women with UPSC to those with UPSC and a personal history of breast cancer (UPSCBR). Methods: Data was collected for UPSCBR patients at two academic institutions between 7/1990 and 7/2012. Patient demographics, pathology, disease stage, and treatments were recorded. A UPSC literature review was performed focusing on recurrences per number of at-risk patients by stage. We used the fixed effect Mantel-Haenszel method to estimate the common pooled effect (recurrence rate) for the UPSC studies and compared these to UPSCBR patients. Results: Forty-three UPSCBR patients were identified. Median age at diagnosis was 72 (49-93). Twenty-six patients were Caucasian, 14 African-American and 3 other. Twenty-four (56%) had early stage at diagnosis (IA-IC) and 19 (44%) had late stage (III-IV). All but one underwent surgical staging/debulking; 36 (90%) were optimally debulked. Twelve (50%) early stage and 17 (89.5%) late stage patients underwent adjuvant therapy with radiation and/or chemotherapy. Nine studies were identified with available recurrence data for early stage UPSC; 8 for late stage. The recurrence rate for stage IA UPSCBR patients was 2/11 (18%) [95% CI: 2 to 52%] compared to 11% [95% CI: 9.8 to 13%] in the UPSC literature. In IB/IC UPSCBR patients we had 3/13 (23%) [95% CI: 5 to 54%] recur versus 21% [95% CI: 19 to 23%]. In later stages III/IV, 7/19 (37%) [95% CI:16 to 62%] UPSCBR patients had recurrences compared to 58% [95% CI: 56 to 60%] of UPSC patients. Conclusions: There is an association between breast cancer and UPSC with regard to incidence. We failed to find evidence of an appreciable difference in recurrence rates between our UPSCBR patients and UPSC patient groups from other reported studies. While diagnosis with two primary malignancies can be challenging for patients, this does not appear to impact their risk of recurrence.

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