scholarly journals Supraglottic Laryngectomy with or without Postoperative Radiotherapy in Supraglottic Carcinomas

1995 ◽  
Vol 104 (5) ◽  
pp. 358-363 ◽  
Author(s):  
Carlos Suárez ◽  
Juan Pablo Rodrigo ◽  
José Luis Llorente ◽  
Jesús Herranz ◽  
José Antonio Martínez
Keyword(s):  
Overall Survival ◽  
Local Recurrence ◽  
Recurrence Rate ◽  
Retrospective Review ◽  
Postoperative Radiotherapy ◽  
Combined Therapy ◽  
Supraglottic Laryngectomy ◽  
Supraglottic Carcinoma ◽  
Significant Difference ◽  
Neck Recurrence

A retrospective review of 193 previously untreated patients with primary supraglottic carcinoma was undertaken to ascertain the efficacy of postoperative radiotherapy. All the patients received a supraglottic laryngectomy, and patients received a total of 284 elective or therapeutic neck dissections. Ninety-four (48.7%) of the patients received postoperative radiotherapy. The incidence of local recurrence was 8.2%, but the recurrence rate was unrelated to the use of postoperative radiotherapy. Neck recurrence was observed in 12.9% of patients, with no influence of postoperative radiotherapy in the dissected neck. The incidence of locoregional recurrences by stage in irradiated and nonirradiated patients did not reach significant difference. The 3-year survival was 74.3%. The overall survival of the whole series and by stage was not statistically altered in combined therapy compared to surgery.

scholarly journals Surgical Resection for Small Cell Lung Cancer: Pneumonectomy versus Lobectomy

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jiang Yuequan ◽  
Zhang Zhi ◽  
Xie Chenmin
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Local Recurrence ◽  
Recurrence Rate ◽  
Surgical Resection ◽  
Local Recurrence Rate ◽  
Overall Survival Rate ◽  
Significant Difference ◽  
The Right ◽  
Better Than

Background. There are some patients with SCLC that are diagnosed in the operating room by cryosection and surgeons had to perform surgical resection for these patients. The aim of this study is to compare the effective of pneumonectomy with lobectomy for SCLC. Methods. A retrospective study was undertaken in 75 patients with SCLC that were diagnosed by cryosection during surgery. 31 of them underwent pneumonectomy, 44 underwent lobectomy. Local recurrence rate and survival rate according to surgical procedures and cancer stages were analyzed. Results. There was significant difference in the overall survival rate between lobectomy and pneumonectomy groups (P=0.044). For patients with stage II SCLC, the overall survival rate after pneumonectomy was significantly better than after lobectomy (P=0.028). No significant difference in overall survival rate was found between the two surgical groups in patients with stage III SCLC (P=0.933). The local recurrence rate in lobectomy group was significant higher that in pneumonectomy group (P=0.0017). Conclusions. SCLC was responsive to surgical therapy. When surgeons have to select an appropriate method of operation for patients with SCLC during surgery, pneumonectomy may be the right choice for these patients. Pneumonectomy can result in significantly better local control and higher survival rate compare with lobectomy.

Supraglottic laryngectomy–series report and analysis of results

1997 ◽  
Vol 111 (8) ◽  
pp. 730-734 ◽  
Author(s):  
G. Adamopoulos ◽  
I. Yotakis ◽  
K. Apostolopoulos ◽  
L. Manolopoulos ◽  
D. Kandiloros ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Average Hospital Stay ◽  
Average Hospital ◽  
Supraglottic Laryngectomy ◽  
Significant Difference ◽  
Analysis Of Results ◽  
N Stage ◽  
Neck Recurrence ◽  
Series Report

AbstractBetween October 1987 and October 1993, 92 patients with squamous cell carcinoma of the supraglottis were treated by supraglottic laryngectomy and neck dissection in our department. There were 33 T1, 46 T2, six T3 and seven T4 cases. All patients with N+ necks and T3 or T4 tumours received post-operative radiotherapy (5,000–6,500 cGy). The patients were followed for a minimum of 36 months or until death. The incidence of local recurrence was 7.6 per cent. Neck recurrence was observed in 13 per cent of patients. Decannulation was achieved in 93.4 per cent of the cases with three patients undergoing gastrostomy because of aspiration. The average hospital stay was 26 days. The overall three-year survival was 83.6 per cent, with eight patients dying of unrelated causes. There was a significant difference in recurrence rate between patients in the N0 and the N+ stage.

scholarly journals The role of postoperative radiotherapy in pN1 oral cavity cancer without extranodal extension

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Tsung-You Tsai ◽  
Yenlin Huang ◽  
Andrea Iandelli ◽  
Shiao-Fwu Tai ◽  
Shao-Yu Hung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Oral Cavity ◽  
Recurrence Rate ◽  
Oral Cavity Cancer ◽  
Postoperative Radiotherapy ◽  
Survival Outcomes ◽  
Radiotherapy Group ◽  
Extranodal Extension ◽  
Significant Difference ◽  
Neck Recurrence

Abstract Background The administration of postoperative radiotherapy remains controversial in pN1 oral cavity cancer patients without extranodal extension. The aim is to determine whether postoperative radiotherapy reduces the neck recurrence rate and improves the survival outcomes of pN1 patients. Methods This study consecutively enrolled 1056 patients with newly diagnosed oral squamous cell carcinoma who underwent tumor wide excision and neck dissection from September 2002 to November 2019. One hundred two pN1 patients without extranodal extension were eligible for analysis. Then, a subgroup analysis of 40 patients was performed after patients with other adverse risk factors (positive margins, close margins, lymphovascular invasion, perineural invasion, tumor depth ≥ 10 mm, and poor histological differentiation) were excluded. Results Of the 102 eligible pN1 patients, 26 patients received surgery alone, and 76 received postoperative radiotherapy. No significant differences were observed in the neck recurrence rate (7.7% vs. 15.8%, p = 0.30). Similarly, in patients without other adverse risk factors, no significant differences were observed in the neck recurrence rate (5% vs. 20%, p = 0.15) between surgery alone group and postoperative radiotherapy group. Moreover, no significant difference was found in the neck recurrence-free survival rate, overall survival, and disease-specific survival (77.1% vs. 52.5%, p = 0.42, 83.5% vs. 64.5%, p = 0.81, and 88.2% vs. 67.9%, p = 0.34, respectively). Conclusion Postoperative radiotherapy did not significantly decrease the probability of neck recurrence and survival outcomes in pN1 patients without extranodal extension. Radical surgery alone may be considered sufficient treatment for pN1 patients without other adverse risk factors.

Morbidity of Combined Therapy for the Treatment of Supraglottic Carcinoma: Supraglottic Laryngectomy and Radiotherapy

1997 ◽  
Vol 106 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Joseph R. Steiniger ◽  
Steven M. Parnes ◽  
Glendon M. Gardner
Keyword(s):  
Postoperative Radiotherapy ◽  
Combined Therapy ◽  
Upper Airway ◽  
Supraglottic Laryngectomy ◽  
Supraglottic Carcinoma ◽  
Planning Treatment ◽  
Postoperative Irradiation ◽  
The Mean ◽  
Morbidity Index

Many surgeons find that patients have increased morbidity after supraglottic laryngectomy if postoperative irradiation is given, but this remains poorly documented. Twenty-nine patients undergoing supraglottic laryngectomy were retrospectively reviewed. Seventeen received postoperative radiotherapy, and 12 did not. The mean follow-up was 64 months. When compared to patients treated with supraglottic laryngectomy alone, irradiated patients had a significantly higher incidence of lifelong gastrostomy dependency (35% versus 0%; p = .03) and acute upper airway obstruction (29% versus 0%; p = .05). There was a trend toward greater tracheotomy dependency (24% versus 0%), aspiration pneumonia (35% versus 9%), and delayed independent swallowing (34.8 weeks versus 7.8 weeks) in the patients treated with combined therapy, but this difference was not significant. A morbidity index score was developed to evaluate the overall lifelong morbidity of these patients, and this was found to be significantly higher in patients treated with surgery and radiotherapy (2.29 versus 0.83; p = .04). Overall survival was equal in both groups. We have shown that radiotherapy increases the morbidity of supraglottic laryngectomy. This should be considered when planning treatment for patients with supraglottic carcinoma.

Incidence of local recurrence in patients after breast-conserving surgery and postoperative radiotherapy with or without a supplementary radiation.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 159-159
Author(s):  
Danijela D. Scepanovic ◽  
Andrea Hurakova ◽  
Martina Lukacovicova ◽  
Zuzana Dolinska ◽  
Andrea Masarykova ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Significant Influence ◽  
Postoperative Radiotherapy ◽  
Local Treatment ◽  
Breast Conserving Surgery ◽  
Low Risk ◽  
Surgical Margins ◽  
Complete Excision ◽  
Incomplete Excision ◽  
Significant Difference

159 Background: We evaluated the incidence of local recurrence (LR) among patients (pts) who received radiotherapy with/without a supplementary dose of radiation (boost) to the tumor bed after breast-conserving surgery (BCS) for early breast cancer (BC). Methods: In our retrospective analysis (from 2000-2004) 449 pts with stage I/II BC received 50Gy of radiation to the whole breast in 2Gy fractions over a five-week period after BCS. There were 328 pts (73%) with microscopically complete excision (>5mm margins) and 121 pts (27%) with a microscopically incomplete excision (≤5mm margins). Patients with a microscopically complete or incomplete excision were randomly assigned to receive either no further local treatment (190) or an additional localized dose (309) of 10-16Gy, usually given in 5-8 fractions (fr) by electrons/15Gy in 3 fr by HDR interstitial brachytherapy. Results: During a median follow-up period of 79 months (min 20, max 120), the cumulative incidence of LR was 3% for all group of pts (449). The LR was observed in 1 of 190 pts in group without boost and 13 of 309 pts in group with boost. There was statistically significant difference between two groups of pts regarding local recurrence rate (LRR) (p= 0.0218).The 5 year actuarial rates of LR were 1% in group of pts with negative surgical margins versus 8% in group of pts with positive margins [95% CI, 6% (1%-26%)] (p<0.001). Multivariate analysis showed that pts with negative surgical margins had strongly statistically significant influence (p<0.001) and pts with negative lymph/angioinvasion had statistically significant influence on low risk of LR (p = 0.007). The 5 year DFS was 90% and OS was 98% in all group of pts (449). There was no statistical significant difference between two groups of pts regarding DFS and OS. Conclusions: In our analysis, the incidence of LR is low. However, there was better result in no boost group of pts regarding LRR. The cause was in more frequent selection among worse group of pts with positive surgical margins for application of boost (73% vs 52%, p<0.0001). The strong criteria for identifying low risk group of pts for LR were: negative surgical margins and absence of lymph/angioinvasion.

A retrospective review of the effect of metformin in metastatic prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 62-62
Author(s):  
So Yi Lam ◽  
Chung-Shien Lee ◽  
Wingsze Liu ◽  
Cristina Sison ◽  
Emily Miao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Retrospective Review ◽  
Metastatic Prostate Cancer ◽  
Castration Resistant Prostate Cancer ◽  
Metformin Group ◽  
Study Results ◽  
Significant Difference ◽  
Risk Of Progression ◽  
Psa Response

62 Background: Current treatments of metastatic prostate cancer are mainly hormone therapy and chemotherapy. The anticancer potential of metformin on metastatic prostate cancer remains obscure. In this study, we aim to investigate the significance of patients with prostate cancer taking metformin in addition to their current treatment. Methods: An IRB approved retrospective review of metastatic prostate cancer patients was conducted. Patients were categorized into metastatic castration resistant prostate cancer (mCRPC) or hormone-sensitive prostate cancer (mHSPC). Patients were further stratified to those who received metformin vs. those who did not. Progression free survival (PFS) was evaluated based on PCWG3 and RECIST criteria. 6-month (6MO) PSA response and overall survival (OS) were also evaluated in this study. Results: A total of 281 subjects were included for analysis with a mean age of 70±10. Patients were known to have either mHSPC (n = 205) or mCRPC (n = 75), and taking metformin (n = 66) or not (n = 215). There was no significant difference between metformin groups with respect to PSA response at 6MO (p < 0.73). Among those with a recorded 6MO PSA response, 70.4% (38/54) had a response in the metformin group and 72.9% (140/192) had a response in the non-metformin group. Overall median PFS was estimated to be 17 months, with no significant difference in PFS between metformin groups (16.6 vs 17.3; p < 0.88). Within the mHSPC group, metformin users had a lower risk of progression relative to non-users (HR = 0.89; 95% CI: 0.62 to 1.29). Within the mCRPC group, metformin users had a significantly higher risk of progression relative to non-users (HR = 2.65; 95% CI: 1.4 to 5.0). Median overall survival was estimated to be 81.5 months. There was a significant difference in survival time between metformin groups (148.5 vs 69.4; p < 0.02). Conclusions: No significant differences were found in 6MO PSA response or PFS. There was a significant difference in OS amongst patients who were in the metformin group and those who were not.

scholarly journals Clinical Statistical Analysis with Comparison between Pelvic and Non-pelvic Chondrosarcoma

2021 ◽  
Vol 36 (3) ◽  
pp. e271-e271
Author(s):  
Sayed Abdulla Jami1, ◽  
Shi Jiandang ◽  
Brotendu Shekhar Roy ◽  
Zhanwen Zhou ◽  
Liu Chang Hao
Keyword(s):  
Prognostic Factors ◽  
Local Recurrence ◽  
Recurrence Rate ◽  
Local Recurrence Rate ◽  
Survival Rates ◽  
Significant Difference ◽  
Grade Ii ◽  
The Difference ◽  
Early Local Recurrence ◽  
Male To Female

Objectives: Chondrosarcomas are rare tumors with a variable biological characteristic. Their treatment clinically and surgically is controversial. Analysis of the clinical statistics and prognostic factors of pelvic chondrosarcoma provides a reference for clinical diagnosis and treatment. Methods: A total of 73 cases of chondrosarcoma were collected, including 24 pelvic samples, from 2008 to 2017 from the hospital database and divided into two groups: pelvic chondrosarcoma and non-pelvic chondrosarcoma. The clinical characteristics and prognostic factors of pelvic chondrosarcoma were analyzed using different statistical methods. Results: Among the 24 pelvic chondrosarcoma patients, the ratio of male to female was 1.4:1, and the median age was 43.5 years. According to the classification proposed by Enneking, there were five grade I, 14 grade II, and five grade III. Histological grading of chondrosarcoma was grade I in one case, II in 15 cases, and III in eight cases. The histological type was 17 conventional, three dedifferentiated, two secondary, one myxoid, and one mesenchymal. The overall survival rates for 24 cases at three, five, and 10 years were 82.2±8.1%, 77.3±8.9%, and 52.4±12.1%, respectively. The local recurrence rate of pelvic chondrosarcoma after surgical resection (83.3%) was significantly higher than that of other sites (34.7%), and the difference was statistically significant (p < 0.001). The final proportion of amputation rate (50.0%) was also higher than other parts (20.4%), with a statistically significant difference (p =0.010). The total survival of the two groups was not significantly different (p =0.216). Conclusions: Chondrosarcoma of bone generally has an excellent prognosis when optimally diagnosed and treated by an experienced team of specialists. Pelvic chondrosarcoma has a higher local recurrence rate than the other sites and tends to result in amputation. Early local recurrence after surgery indicates a poor prognosis.

scholarly journals Interruptions of Head and Neck Radiotherapy Across Insured and Indigent Patient Populations

2017 ◽  
Vol 13 (4) ◽  
pp. e319-e328 ◽  
Author(s):  
Kimberly Thomas ◽  
Travis Martin ◽  
Ang Gao ◽  
Chul Ahn ◽  
Holly Wilhelm ◽  
...  
Keyword(s):  
At Risk ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
Local Recurrence ◽  
Head And Neck ◽  
Neck Cancer ◽  
Treatment Interruption ◽  
Hospital System ◽  
Treatment Interruptions ◽  
Significant Difference

Purpose: Radiotherapy for head and neck cancer is a cornerstone of care, requiring 30 to 35 days of treatment over 6 to 7 weeks. Diligent patient compliance is crucial, and unplanned treatment interruptions reduce cure rates. We studied interruption rates in private carrier–insured and Medicare-insured populations versus indigent populations served by a single academic health system. Materials and Methods: A retrospective cohort study of electronic medical and billing records was performed analyzing treatment interruptions between January 2011 and December 2014. The study included 564 patients with head and neck cancer prescribed radiotherapy and referred from clinics run by University of Texas Southwestern Medical Center (UTSW) and the Parkland Health and Hospital System (PHHS), which provides indigent care to Dallas County, Texas. Results: Three-hundred sixteen patients (56%) had a treatment break; 114 patients missed a single session, and 202 patients missed multiple treatments. Seventy percent of PHHS patients had treatment delays compared with 47% of UTSW patients ( P < .001). The number of interrupted days in the PHHS population was nearly twice that observed in UTSW patients. PHHS patients most commonly missed treatment for nonmedical or logistical reasons. Delay was predictive for local recurrence ( P < .001) and overall survival ( P < .001). In compliant patients, there was no significant difference in local recurrence ( P = .43) or overall survival ( P = .27) across referral sites. However, among noncompliant patients, there was a higher likelihood for local recurrence in the PHHS cohort ( P = .016). Multivariable modeling suggested treatment interruption to be a key driver of outcome differences across referral sites. Conclusion: Survival outcomes in our at-risk population were inferior to those in patients insured by commercial carriers or Medicare. Treatment interruption predicted for poor outcome across all patients but was disproportionately experienced by at-risk patients. These results highlight cancer control needs specific to disadvantaged communities at risk for poor treatment compliance.

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