Five-year Survival Data on the Role of Endoscopic Endonasal Nasopharyngectomy in Advanced Recurrent rT3 and rT4 Nasopharyngeal Carcinoma

2019 ◽  
Vol 129 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Eugene Hung Chih Wong ◽  
Yew Toong Liew ◽  
Siow Ping Loong ◽  
Narayanan Prepageran
Keyword(s):  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Survival Data ◽  
Disease Free Survival ◽  
Survival Outcome ◽  
Queen Elizabeth Hospital ◽  
Good Survival ◽  
Endoscopic Endonasal ◽  
Patient Size

Aim: Endoscopic endonasal nasopharyngectomy (EEN) for recurrent nasopharyngeal carcinoma (rNPC) is being increasingly used due to the added high magnification, reduced morbidities associated with open procedures and good survival outcomes. Most studies looked at usage of EEN in patients with lower recurrent staging (rT1 and rT2) although more and more surgeons are studying the outcome of EEN in advanced rNPC (rT3 and rT4). The aims of this study were to report the long-term 5-year survival outcome of EEN performed in patients with advanced rNPC, and to determine any prognostic factors for patients’ survival. Methods: All patients who underwent EEN for advanced rNPC between January 2003 and December 2015 inclusive were analyzed. All surgeries were performed in University Malaya Medical Centre in Kuala Lumpur and Queen Elizabeth Hospital in Sabah. We reported the 5-year overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and any related complications and significant prognostic factors. Results: Twelve patients with rNPC (2 rT3 and 10 rT4) were followed-up over a mean duration of 44.8 months (range, 40-440 weeks). The 5-year OS was 50.0% (mean 44.75 months), DFS was 25.0% (mean 35.25 months) and the DSS was 58.3% (mean 43.33 months). No severe operative complications were encountered and no independent prognostic factors for survival outcome were identified. Conclusion: This is the first report in English that exclusively described the long-term 5-year survival data in patients with both rT3 and rT4 recurrent NPC after EEN. The data suggest that EEN is a feasible treatment to improve survival with minimal morbidities in patients with rT3 and rT4 recurrent NPC. However, more studies with larger patient size is recommended.

Predictors of response to primary systemic therapy (PST) with docetaxel and trastuzumab in HER2-positive breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 11100-11100
Author(s):  
M. Rao ◽  
J. J. Griggs ◽  
L. M. Schiffhauer ◽  
P. Messina ◽  
P. Bourne ◽  
...  
Keyword(s):  
Survival Data ◽  
Disease Free Survival ◽  
Left Ventricular ◽  
Response To Therapy ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Er Positive ◽  
Her 2 ◽  
Disease Free

11100 Background: The purpose of this study was to assess the relationship between estrogen receptor (ER) status, amplification of HER-2, and tumor response to PST with docetaxel and trastuzumab in breast cancers positive for HER-2 by immunohistochemistry (IHC). Long-term disease-free survival data are also reported. Methods: Eligible patients were those with T2 or T3 tumors and overexpression of HER-2 via IHC. Docetaxel 100 mg/sq m q. 3 weeks × 4 with growth factor support and weekly trastuzumab × 12 were given before surgery. The Miller-Payne system was used to define pathologic responses (PR) in the excision specimen (0, 1, 2 - no/minimal response; 3 - 4 partial response, pPR; 5 - complete response, pCR). Adjuvant therapy was given at the discretion of the treating oncologist. Results: Of 22 enrolled patients, 19 were assessable. 17 of the 19 subjects had subsequent FISH confirmation of HER-2 status. Six subjects (31%) had a pCR. Of these, 5 had strong amplification of HER-2 and 5 had tumors that were ER-negative. A pPR occurred in an additional 2 subjects (10%). Of the 11 subjects who had no or minimal PR (Miller-Payne 0 - 2), 8 were found to have no amplification for HER-2 and 9 had tumors that were ER-positive. Postoperative (adjuvant) chemotherapy was given to 17 patients. All 12 patients with ER-positive tumors received adjuvant hormonal therapy. Three patients had an asymptomatic decline in left ventricular ejection fraction (LVEF) of 10 - 15% after anthracycline containing chemotherapy, and one had symptomatic non-ischemic cardiomyopathy of unclear etiology 4 years after completion of study therapy and an anthracycline. With a median follow up of 56 months, all 19 participants are alive and disease-free. Conclusion: PST with a 12-week course of trastuzumab and docetaxel is safe and effective, produces a substantial pCR rate, and may result in excellent long-term recurrence-free and overall survival. The subset of patients with tumors that were IHC-positive, but FISH-negative for HER-2, and ER-positive had minimal or no response to therapy, highlighting the importance of identifying patients most likely to respond to trastuzumab-based regimens. [Table: see text]

Nasopharyngeal carcinoma at the National Institute of Oncology

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17055-e17055
Author(s):  
E. Hassan ◽  
S. Afqir ◽  
N. Ismaili ◽  
H. M’rabti ◽  
S. Boutayeb ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Disease Free Survival ◽  
Staging System ◽  
Cancer Staging ◽  
Undifferentiated Carcinoma ◽  
Rank Test ◽  
Entire Group ◽  
Female Ratio ◽  
Response To Chemotherapy

e17055 Background: To evaluate the disease characteristics and outcome of patients with nasopharyngeal carcinoma treated at the National Institute of Oncology (NIO) Rabat, Morocco. Methods: Between 1999 and 2001, 468 patients with a diagnosis of nasopharyngeal carcinoma were treated at the NIO. The median age was 42 years (range 10 to 83). The male/female ratio was 2.5/1. Of the 468 patients, 88 (19%), and 380 (81%) had T1-T2, and T3- T4 (TNM International Union Against Cancer staging system, 1997), respectively. Ninety percent presented with nodal metastasis. 163 patients (35%) had lymph nodes >6 cm, and 229 (49%) had bilateral nodes at presentation. Histologically, 405 patients (86%) had undifferentiated carcinoma. Seventy-six percent received neoadjuvant multiagent chemotherapy containing cisplatin, followed by radiotherapy (RT). Results: After a median follow-up of 26 months, the disease-free survival (DFS) and overall survival (OS) rate for the entire group was 27% and 41%, respectively. Kaplan-Meier curves were used for evaluation of prognostic factors and were compared using the log-rank test. Nodal status had a significant impact on OS (p < 0.001). Complete responders to chemotherapy had superior DFS and OS. Conclusions: Combined modality management using chemotherapy and RT resulted in satisfactory locoregional control and OS in patients with nasopharyngeal carcinoma. Nodal involvement and response to chemotherapy were important prognostic factors. No significant financial relationships to disclose.

Secondary surgery with intraoperative chemohyperthermia in recurrent ovarian adenocarcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5075-5075
Author(s):  
Jean Marc Bereder ◽  
Mariangella Desantis ◽  
Emmanuel Benizri ◽  
Abakar Abakar-mahamat ◽  
jean-Louis Bernard ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prognostic Factors ◽  
Survival Data ◽  
Peritoneal Cancer Index ◽  
Cox Model ◽  
Disease Free Survival ◽  
Ovarian Adenocarcinoma ◽  
Secondary Surgery ◽  
Risk Of Death

5075 Background: Optimal treatment of peritoneal recurrences in ovarian cancer is debating with second line chemotherapies. We proposed association of secondary surgery with heated intraperitoneal per operative chemotherapy (HIPEC). The aim of study is to determine prognostic factors in a single center cohort. Methods: Retrospective study of consecutive 169 patients with peritoneal recurrence from ovarian cancer were performed to evaluate HIPEC and to identify prognostic factors. Peritoneal Cancer Index (PCI) assess tumor load and completeness cytoreductive score (CCS) were used to give quality of resection CCS0 (no visible tumor), CCS1 (persistent diffuse lesions < 2.5mm), CCS2 (2.5mm <CC2< 25mm) and over CCS3 status. HIPEC is performed with platinum based regimen. Endpoint was survival. Cox's regression model was used for multivariate survival analysis and extending Cox model for modelling survival data. Results: We have operated on 197 procedures (HIPEC) in 169 patients from 2000 to 2011. Mean age was 58 years old range [28-75]. Median PCI was 10. After completion of resection, allocation of CCS was CCS0=120, CCS1=70, CCS2 & CCS3 =7. Procedure related mortality was 1% and morbidity 21%, mean length of hospital stay was 17 days range [7-51]. 3 and 5 years overall survival were respectively 64.7% and 37.4 %. Median survival was 47.6 months and the median disease free survival was 20 months. PCI >10 (even if complete resection performed) and CCS2&3 were worse prognostic factors (HR respectively = 2.64 IC 95% [1.29-5.36] and = 3.31 IC 95 % [1.55-7.08]). Modelling of these factors, is very strong to predict risk of death over the 2 first years after HIPEC. Conclusions: The chemo-hyperthermia is a standardized and reproducible feasible method. Less extensive disease and the quality of cytoreduction remain an independent factor of better outcome. To date HIPEC allows to reach the longest median time survival in peritoneal recurrent ovarian cancer. Modelling survival data is useful to know the risk of dying.

scholarly journals Long-term outcomes of stenting as a bridge to surgery for acute left-sided malignant colonic obstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14032-e14032
Author(s):  
Fayez A. Quereshy ◽  
Jensen T.C. Poon ◽  
Wai Lun Law
Keyword(s):  
Overall Survival ◽  
Surgical Resection ◽  
Survival Data ◽  
Colonic Obstruction ◽  
Disease Free Survival ◽  
Bridge To Surgery ◽  
Long Term Outcomes ◽  
Short Term ◽  
Disease Free

e14032 Background: Stenting as a bridge to surgery has been increasingly applied in cases of acute left-sided colonic obstruction. This study aims to evaluate both the short and long-term outcomes associated with colonic stenting as a bridge to surgery in patients with obstructing adenocarcinoma of the colon. Methods: Patients with potentially curable acute left-sided colonic obstruction treated with stenting as a bridge to surgery (28) or with emergency surgical resection (39) from January 1998 to December 2008 were identified using a prospectively maintained database. Short-term data on post-operative mortality, morbidity, necessity of intensive care, and length of hospital stay were compared. Disease-free and overall survival data were also analyzed. Results: Patients within the two study arms had similar demographic profiles. Patients receiving preoperative stenting had a higher likelihood of a laparoscopic resection (p<0.001). Further, the emergency surgery group had a higher rate of post-operative complications (p=0.024), rate of ICU admission (p=0.013), and longer total length of stay (9 vs. 12 days, p=0.001). With a median follow-up of 26.5 and 31.3 months for the stenting and surgical resection groups respectively, there was no difference in overall and disease-free survival (overall survival = 30 vs. 31 months, p=0.858; DFS = 13 vs. 12 months, p=0.989). As well, there was no difference in the rate of systemic recurrences (8 vs. 13, p=0.991). Conclusions: Stenting as a bridge to surgery is a safe treatment strategy in the management of patients with acute left-sided colonic obstruction with improved short-term outcomes and comparable long-term oncologic results.

A Simulation Study Using Validated Prognostic Factors to Assess Expected Long-term Survival

2005 ◽  
Vol 44 (04) ◽  
pp. 577-583 ◽  
Author(s):  
J. Hasford ◽  
M. Pfirrmann
Keyword(s):  
Prognostic Factors ◽  
Interferon Alpha ◽  
Survival Data ◽  
Low Risk ◽  
Intermediate Risk ◽  
Survival Times ◽  
Term Survival ◽  
Survival Probabilities ◽  
Risk Patients

Summary Objectives: In chronic myeloid leukemia, after promising results in major cytogenetic remission (MCR), longterm survival data on imatinib treatment is of particular interest, especially in relation to former standard treatment based on interferon-alpha. However, data is still unavailable and due to high remission rates, most patients randomized to interferon-alpha in a clinical trial crossed over to imatinib. Therefore, to assess the expected long-term survival advantage with imatinib, a simulation study based on prognostic factors validated for interferon-alpha treatment was performed. Methods: In interferon-alpha-treated patients with intermediate-risk and low-risk according to the established New CML score, survival probabilities of patients with MCR were significantly higher than those of patients without MCR. Three samples with simulated survival data for imatinib-treated intermediate-risk patients were constituted by randomly drawing varying percentages of their survival times from interferon-alpha-treated intermediate-risk patients with MCR and the remaining data from intermediate-risk patients without MCR. The same procedure was applied to low-risk patients. Results: The 10-year survival probabilities of interferon-alpha-treated intermediate-risk and low-risk patients were 0.22 and 0.37. In the simulated samples, when 80%, 65%, and 50% of survival times were as favorable as for interferon-alpha-treated patients with MCR, respectively, the corresponding survival probabilities were 0.43 and 0.57, 0.36 and 0.49, and 0.30 and 0.42. Conclusions: In all simulation samples, increments of survival probabilities by imatinib were predicted, although survival probabilities of patients with MCR were assumed to be lower than with interferon-alpha. Prognosticated survival advantage with imatinib is backed by increasing observation time of imatinib-treated patients in real studies.

Prognostic factors and long-term outcomes of nasopharyngeal carcinoma in children and adolescents

2013 ◽  
Vol 60 (7) ◽  
pp. 1122-1127 ◽  
Author(s):  
Songliu Hu ◽  
Xiangying Xu ◽  
Jianyu Xu ◽  
Qingyong Xu ◽  
Shanshan Liu
Keyword(s):  
Prognostic Factors ◽  
Nasopharyngeal Carcinoma ◽  
Children And Adolescents ◽  
Long Term Outcomes
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