Evaluation of the Overall 5-Year Survival of Breast Cancer at INO: Data from the 5-Year Prospective Database

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 23-23
Author(s):  
NA Kaddi ◽  
NA Berrada ◽  
HA Errihani
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Metastatic Cancer ◽  
Stage Iv ◽  
Breast Cancer Survival ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Rank Test ◽  
Her2 Positive

Background: Breast cancer is both the most common and deadliest cancer among women in the world. The objective of this study was to assess breast cancer survival rates. Material and Methods: Prospective study conducted at the National Institute of oncology (INO) Sidi Mohamed Ben Abdellah Rabat .diagnosed patients with cancer from 2013 to 2015. The date of inclusion in the study is the date of histological confirmation of cancer. The survival assessment performed by the Kaplan Meier method, and the comparison between the different classes of a variable was performed by the Log Rank test. Results: 931 cases were collected during this study. According to molecular classification 59% of luminal patients, 25% positive human epidermal growth factor receptors (her2 positive) and 16% basal. The percentage of survival at 5 years, for luminal stage I 93%, stage II 92%, stage III 74% and stage IV 25% ;as well as for basal stage I 92%, stage II 80%, stage III 53% and stage IV 10% ; then the her2 positive stage I 100%, stage II 75% and stage III 70%. Conclusion: The discovery of metastatic cancer decreased breast cancer survival rate, hence the importance of Early Detection Awareness.

Triple-negative breast cancer: Epidemiology, characteristics, and survival in a Lebanese cohort

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22228-e22228
Author(s):  
M. Ghosn ◽  
C. Hajj ◽  
F. Nasr ◽  
F. El Karak ◽  
G. Abadjian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Ductal Carcinoma ◽  
Positive Family History ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
University Hospital ◽  
Stage Iii

e22228 Background: Breast cancer (BC) is the most common malignancy in women in Lebanon. Triple negative (TN) phenotype is known to be associated with an increased likelihood of recurrence and death. The purpose of this study is to determine the incidence, characteristics and survival of TN BC patients in a Medical Oncology department in a University Hospital in Lebanon. Methods: We retrospectively reviewed the pathology of all women with breast cancer that were seen in our institution between 1997 and 2008. TN BC patients (pts) were defined as those that were negative for all 3 receptors (estrogen, progesterone and HER2neu on immunohistochemistry). Pts' characteristics and survival of TN women were analyzed. Results: Of the 1599 breast cancer pts, 155 (9.7%) had a triple negative phenotype. Median age was 52 years. A positive family history of breast/ovarian cancer was found in 15 pts (10%). Pathology studies showed: invasive ductal carcinoma component in 138 pts (89%), pure medullary carcinoma in 7 pts (5%), pure invasive lobular carcinoma in 6 pts (4%), pure mucinous carcinoma in 3 pts (2%) and epidermoid carcinoma in 1 pt (1%). A grade III was found in 98 of specimens (63%). Twenty-six pts (17%) presented with stage I, 73 (47%) with stage II, 37 (24%) with stage III and 19 (12%) with stage IV. Twelve percent had inflammatory breast cancer. After a median follow up of 17 months (mths), 43 pts had relapsed (5 stage I, 18 stage II and 20 stage III). The most common sites of relapse were brain (in 20 % of cases), lungs (in 20% of cases) and bone (in 11% of cases). Five- year disease free survival and 5-year overall survival were respectively 75% and 88% for stage I, 58% and 72% for stage II and 40% and 63% for stage III. Adjuvant therapy was administered to 96% of pts among which a taxane-based regimen was used in 38% of cases . Median survival for stage IV was 19 mths with a first line taxane-based regimen used in 50% of cases. Conclusions: The incidence of TN BC in Lebanon is similar to that described in the literature. It has an aggressive course. Focus on understanding the biology of this particular BC subtype is essential for determining targets for future therapeutic options. No significant financial relationships to disclose.

scholarly journals Tumor-Infiltrating Lymphocytes in Breast Carcinoma: Immunohistochemical Analysis

2018 ◽  
Vol 3 (12) ◽  
Author(s):  
Dr. Amol R. R. Rajhans, MD ◽  
Dr. Deepak S. Howale
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
T Lymphocytes ◽  
Clinical Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Cd4 Cells ◽  
Infiltrating Lymphocytes

Breast cancer is the most common invasive cancer in women, and the second main cause of cancer death in women, after lung cancer. Breast cancer is cancer that develops from breast tissue. Signs of breast cancer may include a lump in the breast, a change in breast shape, dimpling of the skin, fluid coming from the nipple, a newly inverted nipple, or a red or scaly patch of skin. In those with distant spread of the disease, there may be bone pain, swollen lymph nodes, shortness of breath, or yellow skin. In 2017, around 252, 710 new diagnoses of breast cancer are expected in women, and around 40,610 women are likely to die from the disease. Awareness of the symptoms and the need for screening are important ways of reducing the risk. Material and Methods: This retrospective study was carried out in the department of Pathology, DCP Consultant Pathologist Shashwat Hospitals, Pune, a total of 38 retrospective breast carcinoma tissues were obtained from female patients. Representative paraffin blocks and haematoxylin and eosin (HandE)-stained sections were retrieved from the pathology department. The patients' records were reviewed to look for the patient age and the clinical stage of the disease. The stage of the cancer was reported according to the American Joint Committee of Cancer. As tissue and patient data was collected in an anonymous way no written or informed consent was required for the study purpose. Results and Observations: According to data by clinical staging Stage I, Stage II, Stage III and Stage IV were 16 (42.11%), 11(28.95%), 7 (18.42%) and 4 (10.53%) respectively. According to histology Stage I, Stage II, Stage III and Stage IV were 2 (5.26%), 11(28.95%), 24 (63.16%) and 1 (2.63%) respectively. Hand E-stained sections showed that tumour-infiltrating lymphocytes (TILs) were present in 31 of the 38 carcinomas (81.58%). Majority of theTILs were T lymphocytes and was present in all 31 cases. CD4+ cells were seen31 patients and CD 8+ were seen in 25 cases. B cells were seen in 21 cases. TILs were analysed according to the clinical stage of breast cancer, stages III and IV tumors showed significantly higher densities of total lymphocytes, T lymphocytes, and CD4+ lymphocytes as compared to stage II tumors. Lymphocyte immuno phenotypes and the total TILs also showed a high significantly positive correlation between each lymphocyte population/subpopulation and the total TILs. Conclusion: T and B lymphocytes were expressed in breast carcinoma with High prevalence of T lymphocytes CD4+ cells. However larger no of cases are required to confirm the findings and extensive large studies are required.

Clinical Prognostic Factors in Malignant Parotid Gland Tumors

2005 ◽  
Vol 133 (5) ◽  
pp. 702-708 ◽  
Author(s):  
Roberto A. Lima ◽  
Marcos R. Tavares ◽  
Fernando L. Dias ◽  
Jacob Kligerman ◽  
Marilene F. Nascimento ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Rank Test ◽  
Disease Specific Survival ◽  
Duct Carcinoma ◽  
Neck Lymph Node ◽  
Disease Specific

OBJECTIVE: To analyze the factors in parotid malignant epithelial tumors influencing recurrences and disease-specific survival. METHODS: We retrospectively reviewed the files of 150 patients treated at our institution, from 1974 to 1998. Twenty-four patients were not treated by surgery and were excluded from this study. The remaining 126 patients were treated with surgery and 74 patients had postoperative radiotherapy. Thirty-three patients were treated with parotidectomy plus neck dissection. Neck lymph node metastasis was found in 22 patients, 5 patients had occult neck metastasis, and 4 periparotid lymph nodes metastasis. The mean age was 49 years old. According to the UICC/1997 TNM Classification, 49 patients were stage I, 27 stage II, 22 stage III, and 28 stage IV. The influence of selected factors on the 10 year disease-specific survival was analyzed using the Kaplan-Meier actuarial method and the log-rank test. RESULTS: Forty patients had mucoepidermoid carcinoma, 18 patients adenocarcinoma NOS, 18 patients acinic cell carcinoma, 15 patients adenoid cystic carcinoma, 11 patients malignant mixed tumor, 11 patients salivary duct carcinoma, and 13 patients other pathology. Twenty-five patients had recurrences: 17 had local recurrences, 4 patients had neck recurrences, and 4 were loco-regional recurrences. Five factors influenced negatively the prognosis: 1) T stage (p.00001), 2) grade (p.00001), 3) + lymph nodes (p.0007), 4) facial nerve dysfunction (p.0001), and 5) age (p.004). Patients with high-grade tumors and high-stage tumors had the worst prognosis according to the multivariate analysis. The 10-year disease-specific survival was 97% for stage I, 81% for stage II, 56% for stage III, and 20% for stage IV. CONCLUSION: The grade of the tumor and stage were the most important prognostic factor.

scholarly journals Vyrų krūties vėžio diagnostika ir gydymas

2005 ◽  
Vol 3 (3) ◽  
pp. 0-0
Author(s):  
Algirdas Jackevičius ◽  
Leonarda Šarakauskienė ◽  
Valerijus Ostapenko ◽  
Saulius Bružas ◽  
Juozas Kurtinaitis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Male Breast Cancer ◽  
Stage Iv ◽  
Male Breast ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Male Breast Carcinoma

Algirdas Jackevičius, Leonarda Šarakauskienė, Valerijus Ostapenko, Saulius Bružas, Juozas Kurtinaitis, Algimantas MudėnasVilniaus universiteto Onkologijos institutas,Santariškių g.1, LT-08660 VilniusKauno medicinos universiteto Onkologijos ligoninė,Volungių g. 16, LT-45434 KaunasEl paštas: [email protected] Įvadas / tikslas Vyrų krūties vėžys yra reta onkologinė liga. Šiame straipsnyje pateikiame 75 ligonių, gydytų dviejose onkologijos ligoninėse, klinikinius duomenis, tiesioginius ir vėlyvuosius gydymo rezultatus. Ligoniai ir metodai Straipsnyje nagrinėjami Vilniaus universiteto Onkologijos instituto klinikoje ir Kauno universiteto Onkologijos ligoninėje1988–2003 metais gydytų 75 vyrų, sirgusių krūties vėžiu, klinikiniai duomenys. Ligonių amžiaus vidurkis – 69,2 metų (jauniausias 41, vyriausias 90 metų). Aštuoniems (10,7%) ligoniams diagnozuotas pirmos stadijos vėžys, 35 (46,7%) – antros, 22 (29,3%) – trečios, 10 (13,3%) ligonių – ketvirtos. Pagal histologinius vėžio tipus dažniausiai diagnozuota intraduktalinė karcinoma – 40 ligonių, 8 ligoniams – lobulinė karcinoma, tačiau 14 ligonių vėžio histologinis tipas nenustatytas. Dažniausiai, t. y. 53 ligoniams, buvo atlikta modifikuota Maddeno mastektomija, aštuoniems – paprastoji mastektomija, 8 ligoniams taikyta spindulinė terapija, 6 ligoniams dėl sunkių gretutinių ligų – simptominis gydymas. 37 ligoniai gydyti kombinuotu būdų: 30 – spinduline terapija, 5 – chemoterapija, 2 – abiem gydymo metodais. Rezultatai Vėlyvieji gydymo rezultatai nebuvo geri: iš 75 gyvena 28 liginiai, 47 mirė. Penkerius metus išgyveno 83,3% (95% PI 27,3–97,5) sergančiųjų pirmos stadijos krūties vėžiu, 69,6% (95% PI 49,1–83,1) – antros stadijos ir tik 6,2% (95% PI 4,2–24,2) – trečios. Nė vienas ligonis, kuriam diagnozuota ketvirta ligos stadija, neišgyveno penkerių metų. Išvados Lietuvoje vyrų sergamumas krūties vėžiu per pastaruosius metus nepakito. Nemažai vyrų buvo gydyti nuo IIIB stadijos krūties vėžio, kai navikas jau buvo lokaliai išplitęs ir susiformavo vėžinė opa. Vyrų, sergančių trečios stadijos krūties vėžiu, prognozė yra blogesnė negu moterų. Ligos stadija nulemia ligonių gyvenimo trukmę, tai patvirtina statistinis vėlyvųjų gydymo rezultatų skaičiavimas. Reikšminiai žodžiai: vyrų krūties vėžys, diagnostika, gydymas, vėlyvieji rezultatai The diagnostics and treatment of male breast carcinoma Algirdas Jackevičius, Leonarda Šarakauskienė, Valerijus Ostapenko, Saulius Bružas, Juozas Kurtinaitis, Algimantas MudėnasVilnius University Institute of Oncology,Santariškių str. 1, LT-08660 Vilnius, LithuaniaKaunas Medical University Oncological Hospital,Volungių str. 16, LT-45434, Kaunas, LithuaniaE-mail: [email protected] Background / objective Male breast cancer is an uncommon oncological disease. In this paper, we have analysed the results of treatment of 75 patients treated in two oncologycal clinics. Patients and methods We analysed 75 male patients treated in 1988–2003 in the clinics of the Institute of Oncology of Vilnius University and Hospital of Oncology of Kaunas University of Medicine. The mean age of patients was 69.2 years (range, 46–90 years). The staging of disease: stage I 8 (10.7%) patients, stage II 35 (46.7%), stage III 22 (29.3%). Ten (13.3%) patients were treated in stage IV of the disease. The most common method of treatment was radical mastectomy by Madden which was performed in 53 cases. In 8 cases mastectomy simplex was performed. Eight patients received radiotherapy. The patients received this conservative treatment in late stages of the disease. In seven cases the patients were in poor health state, and only palliative treatment was applied. 37 patients received combined treatment: 30 patients were treated with radiotherapy, two patients received radiotherapy and chemotherapy, in 5 cases after mastectomy the patients were treated with chemotherapy. Results The follow-up results were not satisfactory: from 75 patients 28 patients are alive and 47 died. The 5-year survival of the patients according to the stage of disease: 83.3% (95% CI 27.3–97.5) of patients in stage I, 69.6% (95% CI 49.1–83.1) in stage II, stage III 6.2% (95% CI 4.2–24.2). In this period, all patients in stage IV of the disease died. Conclusions The incidence of male breast cancer in Lithuania is low, and over the last years has remained at the same level. Many of our patients had ulceration of tumor and were treated in stage III B of the disease. The prognosis of male breast cancer in stage III of the disease is worse than of female breast cancer of the same stage. The stage of the disease was statistically significant for the survival of patients. Keywords: male breast carcinoma, diagnosis, treatment, follow-up results

Identification of biomarkers and functional modules from genomic data in stage-wise breast cancer

2020 ◽  
Vol 15 ◽  
Author(s):  
Athira K ◽  
Vrinda C ◽  
Sunil Kumar P V ◽  
Gopakumar G
Keyword(s):  
Breast Cancer ◽  
Expression Patterns ◽  
Differential Expression Analysis ◽  
Predictive Biomarkers ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Functional Modules ◽  
Incidence And Mortality ◽  
Multiple Stages

Background: Breast cancer is the most common cancer in women across the world, with high incidence and mortality rates. Being a heterogeneous disease, gene expression profiling based analysis plays a significant role in understanding breast cancer. Since expression patterns of patients belonging to the same stage of breast cancer vary considerably, an integrated stage-wise analysis involving multiple samples is expected to give more comprehensive results and understanding of breast cancer. Objective: The objective of this study is to detect functionally significant modules from gene co-expression network of cancerous tissues and to extract prognostic genes related to multiple stages of breast cancer. Methods: To achieve this, a multiplex framework is modelled to map the multiple stages of breast cancer, which is followed by a modularity optimization method to identify functional modules from it. These functional modules are found to enrich many Gene Ontology terms significantly that are associated with cancer. Result and Discussion: predictive biomarkers are identified based on differential expression analysis of multiple stages of breast cancer. Conclusion: Our analysis identified 13 stage-I specific genes, 12 stage-II specific genes, and 42 stage-III specific genes that are significantly regulated and could be promising targets of breast cancer therapy. That apart, we could identify 29, 18 and 26 lncRNAs specific to stage I, stage II and stage III respectively.

Differing from diseased stage in melanoma, the olfactory receptor gene OR56A4 is expressed

2021 ◽  
Author(s):  
Bronte Morse ◽  
Kobi Decker
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Olfactory Receptor ◽  
Receptor Gene ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Olfactory Receptor Gene ◽  
Breast Cancer Patients ◽  
Receptor Family

We have compared the global profiles of 100 tumors in Stage I, II and III with two independently releasedmicroarray datasets in order to understand their transcriptional behaviors accompanying a progression in breastcancer (1, 2). The olfactive receptor, family 56, subfamily A, member 4 OR56A4, was discovered to have beenone of the genes with the most varied expression when comparing initial tumors in stage I, stage II, and stageIII of breast cancer patients. In the stage III tumors, OR56A4 expression in comparison to the stage I tumorswas lower.

scholarly journals Breast Cancer Survival in the Mammography Era in Brazil: A Population-Based Analysis of 2,715 Cases

2021 ◽  
Author(s):  
Juliana Fernandes ◽  
Beatriz Machado ◽  
Cassio Cardoso-Filho ◽  
Juliana Nativio ◽  
Cesar Cabello ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Survival ◽  
Survival Rates ◽  
Population Based ◽  
Breast Cancer Survival ◽  
Stage I ◽  
Current Status ◽  
Breast Cancers ◽  
Risk Of Death ◽  
Significant Difference

Abstract Background This study aims to assess breast cancer survival rates after one decade of mammography in a large urban area of Brazil. Methods It is a population-based retrospective cohort of women with breast cancer in Campinas, São Paulo, from 2010 to 2014. Age, vital status and stage were accessed through the cancer and mortality registry, and patients records. Statistics used Kaplan-Meier, log-rank and Cox's regression. Results Out of the 2,715 cases, 665 deaths (24.5%) were confirmed until early 2020. The mean age at diagnosis was 58.6 years. Women 50-69 years were 48.0%, and stage I the most frequent (25.0%). The overall mean survival was 8.4 years (8.2-8.5). The 5-year survival (5yOS) for overall, 40-49, 50-59, 60-69, 70-79 years was respectively 80.5%, 87.7%, 83.7%, 83.8% and 75.5%. The 5yOS for stages 0, I, II, III and IV was 95.2%, 92.6%, 89.4%, 71.1% and 47.1%. There was no significant difference in survival in stage I or II (p=0.058). Compared to women 50-59 years, death's risk was 2.3 times higher for women 70-79 years and 26% lower for women 40-49 years. Concerning stage I, the risk of death was 1.5, 4.1 and 8.6 times higher, and 34% lower, respectively, for stage II, III, IV and 0. Conclusions In Brazil, breast cancers are currently diagnosed in the early stages, although advanced cases persist. Survival rates may reflect improvements in screening, early detection and treatment. The results can reflect the current status of other regions or countries with similar health care conditions.

scholarly journals PENGARUH REBUSAN DAUN SALAM TERHADAP PENURUNAN TEKANAN DARAH PADA LANSIA DENGAN HIPERTENSI

2018 ◽  
Vol 8 (2) ◽  
pp. 14-21
Author(s):  
Syaifurrahman Hidayat ◽  
Laylatul Hasanah ◽  
Dewi Herlina Susantin
Keyword(s):  
Stage Iv ◽  
T Test ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Test Design ◽  
Post Test

Daun salam (syzygiumpolyanthum) merupakan salah satu dari jenis terapi herbal yang digunakan untuk berbagai penyakit salah satunya yaitu untuk menangani penyakit hipertensi,untuk menurunkan hipertensi dibutuhkan 10 lembar daun salam dan 300 ml air lalu direbus hingga mendidih dan menyusut menjadi 200 ml dan dikonsumsi sebanyak 2 kali sehari pada pagi dan sore hari, masing-masing 100 ml. Penelitian ini bertujuan untuk mengetahui pengaruh air rebusan daun salam dalam menurunkan tekanan darah pada lansia di wilayah kerja UPT Puskesmas Guluk-Guluk. Penelitian ini menggunakan desain penelitian eksperimen Pre post test design, dimana pada rancangan ini berupaya mengungkapkan hubungan sebab akibat dengan cara melibatkan kelompok eksperimental, dengan sampel sebanyak 30 0rang Pengumpulan data menggunakan observasi tekanan darah langsung dan wawancara ke responden.  Hasil penelitian menunjukkan bahwa sebelum diberikan perlakuan pada responden sebagian besar berada pada stage III sebanyak 22 orang (73,3 %), lalu sebagian kecil berada pada stage IV dengan 2 orang (6,7 %). Setelah dilakukan penelitian menunujukkan sesudah diberikan perlakuan pada responden sebagian besar menempati stage II sebanyak 28 orang (93,3 %), sebagian kecil berada pada stage I hanya 2 orang (6,7 %). Hasil uji T test paried dan uji T test didapatkan nilai signifikan 0.000 yang nilainya lebih kecil dari taraf kesalahan α 0.05. sehingga H0 ditolak dan H1 diterima yang berarti ada pengaruh air rebusan daun salam terhadap penurunan tekanan darah pada lansia yang menderita hipertensi di wilayah kerja UPT Puskesmas Guluk-Guluk Kecamatan Guluk-Guluk. Daun salam mempunyai kandungan kimia seperti minyak atsiri, sitrat, euganol, tannin serta flavanoid yang dipercaya mampu untuk menurunkan tekanan darah, mekanisme kerja dari daun salam ini yaitu merangsang sekresi cairan empedu sehingga lemak akan keluar bersamaan dengan usus yang kemudian mengurangi gumpalan lemak yang mengendap dalam pembuluh darah sehingga aliran darah menjadi lancar dan tekanan darah akan normal.

scholarly journals Elevated levels of proinflammatory and anti-inflammatory cytokines in patients with bladder cancer depending on a tumor stage

2020 ◽  
Vol 93 (1) ◽  
Author(s):  
Viktor Dmytryk ◽  
Tetiana Luhovska ◽  
Pavel Yakovlev ◽  
Olexiy Savchuk ◽  
Ludmila Ostapchenko ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Stage Iv ◽  
Tumor Stage ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Common Disease ◽  
Tnf Α ◽  
Ifn Γ ◽  
Th 1

Bladder Cancer (BC) is a common disease worldwide. Chronic inflammation is one of the key mechanisms for the development of BC. This study enrolled 40 patients. Preoperative plasma levels of IL-1β, IL-4, IL-6, IL-10, IL-12β, TNF-α and IFN-γ were determined by ELISA. In our study, we observed diverse changes in the levels of cytokines in patients with BC Stage I, II, III and IV. The levels of IL-1β was increased for stage I, stage II, and stage III. The level of TNF-α was increased for stage II, stage III, stage IV. The levels of IL-4, IL-6, IL-10 and IL-12β were increased in patients with stage III and IV only. The levels of IFN- γ declined for stage II, stage III and stage IV with the lowest levels in patients with Stage IV. In our study, we investigated alteration in levels of Th-1 and Th-2-like cytokine profile, but some deficiency in Th1- status discovered in patients with BC.

Randomized Comparison of Cisplatin/Vincristine/Fluorouracil and Cisplatin/Continuous Infusion Doxorubicin for Treatment of Pediatric Hepatoblastoma: A Report From the Children’s Cancer Group and the Pediatric Oncology Group

2000 ◽  
Vol 18 (14) ◽  
pp. 2665-2675 ◽  
Author(s):  
Jorge A. Ortega ◽  
Edwin C. Douglass ◽  
James H. Feusner ◽  
Marleta Reynolds ◽  
John J. Quinn ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Treatment Strategies ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Excellent Outcome ◽  
Favorable Histology ◽  
Cancer Group ◽  
Initial Surgery

PURPOSE: Previous studies demonstrated that chemotherapy with either cisplatin, vincristine, and fluorouracil (regimen A) or cisplatin and continuous infusion doxorubicin (regimen B) improved survival in children with hepatoblastoma. The current trial is a randomized comparison of these two regimens. PATIENTS AND METHODS: Patients (N = 182) were enrolled onto study between August 1989 and December 1992. After initial surgery, patients with stage I–unfavorable histology (UH; n = 43), stage II (n = 7), stage III (n = 83), and stage IV (n = 40) hepatoblastoma were randomized to receive regimen A (n = 92) or regimen B (n = 81). Patients with stage I–favorable histology (FH; n = 9) were treated with four cycles of doxorubicin alone. RESULTS: There were no events among patients with stage I-FH disease. Five-year event-free survival (EFS) estimates were 57% (SD = 5%) and 69% (SD = 5%) for patients on regimens A and B, respectively (P = .09) with a relative risk of 1.54 (95% confidence interval, 0.93 to 2.5) for regimen A versus B. Toxicities were more frequent on regimen B. Patients with stage I-UH, stage II, stage III, or stage IV disease had 5-year EFS estimates of 91% (SD = 4%), 100%, 64% (SD = 5%), and 25% (SD = 7%), respectively. Outcome was similar for either regimen within disease stages. At postinduction surgery I, patients with stage III or IV disease who were found to be tumor-free had no events; those who had complete resections achieved a 5-year EFS of 83% (SD = 6%); other patients with stage III or IV disease had worse outcome. CONCLUSION: Treatment outcome was not significantly different between regimen A and regimen B. Excellent outcome was achieved for patients with stage I-UH and stage II hepatoblastoma and for subsets of patients with stage III disease. New treatment strategies are needed for the majority of patients with advanced-stage hepatoblastoma.

Sign in / Sign up

Export Citation Format

Share Document