Malignant Lymphoplasmacytoid Lymphomas. Clinical and Evolutive Data

1978 ◽  
Vol 64 (3) ◽  
pp. 327-334
Author(s):  
B. Hoerni ◽  
C. Meugé ◽  
H. Eghbali ◽  
A. De Mascarel ◽  
M. Durand ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Median Survival ◽  
Clinical Stage ◽  
Stage I ◽  
Cure Rate

A series of 31 cases of malignant lymphoplasmacytoid lymphomas (excluding Waldenstrom disease) is analyzed. Two-thirds of the patients initially had localizations elsewhere than in the lymph nodes and presented clinical stage I or II. The median survival is around 4 years and is particularly favorable for stage I and II patients who have received an association of radiotherapy and systematic chemotherapy; the estimated «cure rate » for these patients is around 80 %.

Use of surgery and stereotactic body radiotherapy (SBRT) in very elderly patients with early-stage non-small cell lung cancer (NSCLC): A national cancer database (NCDB) analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e20058-e20058
Author(s):  
Michael Kharouta ◽  
William Grubb ◽  
Tarun Kanti Podder ◽  
Tithi Biswas
Keyword(s):  
Elderly Patients ◽  
Median Survival ◽  
Early Stage ◽  
Clinical Stage ◽  
Cox Proportional Hazards ◽  
Stage I ◽  
Limited Information ◽  
Very Elderly ◽  
Large Hospital ◽  
Early Stage Nsclc

e20058 Background: SBRT treatment for very elderly ( > 80 years) patients with early stage NSCLC has been reported to be well tolerated with good short term efficacy. Using a large hospital based registry, we report a comparison of patterns of practice, outcomes, and prognostic factors for very elderly patients undergoing any treatment for early-stage NSCLC. Methods: The NCDB was queried for patients with clinical Stage I-IIA NSCLC with age ≥ 80 years diagnosed from 2001-2015 treated with surgery or SBRT alone. Patients were excluded if they received chemotherapy /immunotherapy or non-standard SBRT doses (i.e. > 5 fractions of RT, < 30 Gy or > 70 Gy total dose). Survival analyses were performed with propensity-matching, Kaplan-Meier estimates, Cox proportional hazards regression, and log rank testing. Results: 26039 patients met search criteria, median age 83 (80-90) years. 17141 (65.8%) patients underwent surgery, and 8898 (34.2%) underwent SBRT. Median follow up was 31 months. Median survival was 52 and 35 months for surgery and SBRT. Of patients receiving SBRT, 2044 (23%) had a contraindication to primary surgery due to patient risk factors. Age, clinical stage, tumor size, surgery type, CDCC score, BED, bronchial involvement, and type of treatment facility were predictive of median survival. BED > 154 Gy was associated with greater median survival (p < 0.01). Lobectomy was associated with greater median survival vs sub-lobar resection/pneumonectomy (p < 0.0001). For stage I tumors, surgery was associated with better median survival (56 vs. 35 months, p < 0.0001), but for stage IIA patients both modalities had similar median survival (30 vs 29 months, p = 0.04). Conclusions: Surgery remains the predominant treatment modality for early stage NSCLC in this very elderly population, and is associated with good outcomes for patients with stage I tumors. For elderly patients who are poor surgical candidates due to medical co-morbidities SBRT is associated with reasonable median survival. With limited information on patient comorbidities, more robust studies are needed to determine the effects of patient selection on treatment outcomes in this population.

Correlation of DNA Ploidy to Tumor Histologic Grade, Clinical Variables, and Survival in Dogs with Mast Cell Tumors

1992 ◽  
Vol 29 (5) ◽  
pp. 386-390 ◽  
Author(s):  
R. D. Ayl ◽  
C. G. Couto ◽  
A. S. Hammer ◽  
S. Weisbrode ◽  
J. G. Ericson ◽  
...  
Keyword(s):  
Mast Cell ◽  
Lymph Nodes ◽  
Clinical Stage ◽  
Stage I ◽  
Anatomical Site ◽  
Survival Times ◽  
Primary Tumors ◽  
Mast Cell Tumors ◽  
Significant Difference ◽  
Ploidy Status

By using flow cytometry, a retrospective analysis of the DNA content of 40 primary canine mast cell tumors and seven lymph nodes that contained metastatic mast cell tumor from 44 dogs of various breed, sex, and age was performed on formalin-fixed, paraffin-embedded samples of the tumors and nodes. These samples were chosen according to the following criteria: samples contained sufficient well-preserved tumor tissue in the paraffin block for processing, sufficient patient history data were available, clean and homogeneous cell suspensions were obtained after processing, and interpretable DNA histograms were produced on analysis. The ploidy data obtained were compared with the histopathologic grade, the anatomical site of occurrence, the clinical stage of the tumors, and the survival of the dogs. Over 70% (29/40) of the mast cell tumors were diploid. Three metastatic mast cell tumors in lymph nodes had the same ploidy status as their corresponding primary tumors. In five dogs, mast cell tumors from multiple sites in each dog displayed similar ploidy status. Of 26 dogs evaluated for survival times, 69% (18/26) had diploid tumors and 31 % (8/26) had aneuploid tumors. When numbers of diploid versus aneuploid tumors were compared, no significant difference was found between any two grades, clinical stages, or anatomic sites. A significant difference ( P = 0.02) was found, however, between aneuploid and diploid tumors when comparing Stage I and non-Stage I disease. The Kaplan-Meier survival plot indicated a tendency towards an increased survival within the first year in dogs with diploid versus aneuploid tumors ( P = 0.06).

scholarly journals Prognostic markers of canine mammary tumours: Retrospective study of 142 cases

2021 ◽  
Vol 12 (4) ◽  
pp. 649-654
Author(s):  
M. S. Kovalenko ◽  
D. D. Bilyi ◽  
P. M. Skliarov ◽  
S. N. Maslikov ◽  
N. I. Suslova ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Median Survival ◽  
Ductal Carcinoma ◽  
Clinical Stage ◽  
Mammary Glands ◽  
Biological Behaviour ◽  
Lymph Vessels ◽  
Mammary Tumours ◽  
Mechanisms Of Development ◽  
Metastatic Sites

Due to relevance of the problem, prediction of biological behaviour of neoplasias in mammary glands of dogs requires using contemporary approaches to the study, first of all, of ways of dissemination of tumour cells. One of them is studying the mechanisms of migration of cancer cells out of the neoplasm tissues with further dissemination and development of metastatic sites in the regional lymphatic nodes and remote tissues. We studied the survival period of bitches with tumours of the mammary glands following regional or unilateral mastectomy. Among malignant mammary tumours in bitches, the most often diagnosed were single tumours (57.5%), which histologically were classified to carcinomas – ductal (26.9%) and mixed type (21.9%). Probability of intratumoral invasion to blood vessels equaled 12.0%, to lymph vessels – 7.8%, lymph nodes – 12.8%. It depends on the histological type of the tumour, the most aggressive potentially being сomedocarcinoma, tubulopapillary carcinoma and ductal carcinoma. Parameters of life expectancy and survival level after mastectomy depend on clinical stage of the disease (increase in the stage from the first to the third was characterized by decrease from 12.8 ± 9.5 to 9.4 ± 7.8 months), presence of angio/lymphatic invasions, presence of angiolymphatic invasion, but had no correlation with the size of the tumours. An important predictor of tumour-related death of dogs suffering neoplasias of the mammary glands is index vet-NPI, which has significant correlation with the clinical stage according to Owen and median survival. In particular, median survival in patients with the index lower than 4 exceeded the corresponding values in dogs with the index above 4 by 1.3 times. A promising direction of further research would be studying biological mechanisms of development of tumour emboli in the blood and lymph vessels, metastatic sites in lymph nodes, and also determining their role in pathogenesis of canine mammary tumours.

Stage I nonseminomatous germ cell tumors of the testis: Clinical outcome of 45 patients on a surveillance protocol after orchiectomy alone at a single institution in Japan

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16165-e16165
Author(s):  
K. Kakimoto ◽  
Y. Ono ◽  
N. Meguro ◽  
K. Takezawa ◽  
T. Yoshida ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Lymph Nodes ◽  
Germ Cell ◽  
Embryonal Carcinoma ◽  
Clinical Stage ◽  
Germ Cell Tumors ◽  
Stage I ◽  
Single Institution ◽  
Surveillance Protocol

e16165 Background: In Japan, risk-adapted treatment for patients with clinical stage I nonseminomatous germ cell tumor of the testis (NSGCTT) has been performed in very few institutions. This retrospective study was performed to evaluate histopathologic prognostic factors with stage I NSGCTT for whom careful follow-up with a surveillance protocol was possible at a single institution. Methods: We included 45 patients with a median age of 31 years (range 16 - 58) who were managed with a surveillance strategy after orchiectomy in our department between 1972 and 2006. Mean duration of follow-up was 8.1 years (range 1.4 –30). The patients were monitored at follow-up evaluation for tumor marker (AFP, beta-hCG) levels and by abdominal CT scan, chest x-ray, and physical examination. Primary testis tumor samples were assessed for prognostic factors including lymphatic and/or vascular (LV) invasion and pathological components such as the presence of embryonal carcinoma. Log-rank analyses were performed to identify prognostic factors. Results: All patients were alive and disease-free. Relapses occurred in 16 (35.6%) patients after a median follow-up of 5.7 months (range 3–45). In 11 patients (68.8 %), relapse was detected in the retroperitoneal lymph nodes. Two patients (12.5%) had metastases in the retroperitoneal lymph nodes and lungs, two patients (12.5%) had metastases in the lungs alone, and one patient (6.2%) had metastases in the retroperitoneal lymph nodes, lungs, and brain. LV invasion was identified in 17 patients, 53% of whom had relapsed, and relapse was found in 25% of 28 patients without LV invasion (p<0.01). Of 31 patients with an embryonal carcinoma component, 13 patients (42%) developed metastases, whereas 21% of those without an embryonal carcinoma component developed metastases (p=0.04). After chemotherapy and/or surgical treatment for relapse, the 5-year overall survival rate was 100%. Conclusions: As in previous reports, the presence of an embryonal carcinoma component and LV invasion appeared to be factors suggesting a high likelihood of relapse. The surveillance protocol described here is a reliable strategy for stage I NSGCTT patients if careful long-term follow-up is possible. No significant financial relationships to disclose.

Survival impact of neoadjuvant therapy in resected pancreatic cancer.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 367-367
Author(s):  
Katelin Anne Mirkin ◽  
Christopher S Hollenbeak ◽  
Joyce Wong
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Median Survival ◽  
Clinical Stage ◽  
Stage I ◽  
Median Income ◽  
Stage Disease ◽  
Surgery First ◽  
The Impact

367 Background: Pancreatic cancer carries a dismal prognosis, with surgical resection and adjuvant therapy offering the only hope for long-term survival. In recent years, neoadjuvant therapy (NAT) has been employed to optimize outcomes. This study evaluates the impact of NAT on survival in patients with resected stage I-III pancreatic cancer. Methods: The National Cancer Data Base (2003-2011) was analyzed for patients with clinical stage I-III resected carcinoma of the pancreas who underwent NAT or surgery first +/- adjuvant therapy. Univariate statistics were used to compare characteristics between groups. Analysis of variance and Kaplan Meier analyses were used to compare median survival for each clinical stage of disease. Multivariate analyses were performed using a Cox proportional hazards model. Results: 16,122 patients who underwent NAT and 16,869 patients who underwent surgery-first were included. Patients who underwent NAT tended to be younger, covered by private insurance, have a higher median income, greater comorbidities, higher clinical stage disease, and undergo a whipple. Additionally, NAT patients had a greater number of positive regional lymph nodes (9 vs. 6, respectively), although a similar number of nodes retrieved, and higher pathological stage disease. In patients with clinical stage I disease, adjuvant therapy was associated with improved median survival than NAT and surgery-alone (24.8, 18.5, 17.9 months, p < 0.0001, respectively). However, in stage II, adjuvant and NAT offered similar median survival, which was improved over surgery-alone (20.5, 20.1, and 12.4 months, p < 0.0001, respectively). In stage III, NAT had improved median survival than the other groups (19.6, 14.2, 8.6 months, p < 0.0001, respectively). In the multivariate survival analysis, patients who received NAT had a 22% lower hazard of mortality up to 5 years as compared to adjuvant therapy (p < 0.0001). Conclusions: Neoadjuvant therapy in advanced stage pancreatic cancer confers a survival benefit and may allow more patients to undergo surgery; NAT appears to offer similar survival as adjuvant therapy in early stage pancreatic cancer.

Carcinoma of the Anterior Tongue

1982 ◽  
Vol 91 (1) ◽  
pp. 94-97 ◽  
Author(s):  
Bruce Leipzig ◽  
Charles W. Cummings ◽  
Jonas T. Johnson ◽  
Chung T. Chung ◽  
Robert H. Sagerman
Keyword(s):  
Lymph Nodes ◽  
Clinical Stage ◽  
Stage I ◽  
High Rate ◽  
Stage Iii ◽  
Clinical Staging ◽  
Management Problem ◽  
Cervical Lymph Nodes ◽  
Posterior Tongue ◽  
Therapy Treatment

We have reviewed 126 patients with squamous cell carcinoma of the anterior tongue. Our experience suggests that carcinoma of the anterior tongue is a highly aggressive disease. It is no less aggressive and dangerous than carcinoma of the posterior tongue. The clinically negative neck is a problem. Many clinical stage I and II cancers are, in fact, stage III when analyzed by the pathologist. This difficulty in clinical staging results in a significant management problem when stage III carcinomas are treated as stage I and stage II disease. Management, if it is to cure, must be aggressive. An adequate, wide surgical resection will control early carcinoma of the anterior tongue. Advanced cancers of the anterior tongue, clinical stages III and IV, should be widely excised; the cervical lymph nodes on the side of the primary lesion must be treated by surgery and radiation therapy. Treatment of the opposite side of the neck is indicated based on a high rate of metastases to contralateral lymph nodes in this series. Those patients treated with irradiation who had recurrence did so predominantly at the primary site of disease. Patients treated surgically tended to have recurrence in the regional cervical lymphatics.

Retrospective Analysis of Selective Lymphadenectomy in Apparent Early-Stage Endometrial Cancer

2005 ◽  
Vol 23 (16) ◽  
pp. 3668-3675 ◽  
Author(s):  
Janiel M. Cragun ◽  
Laura J. Havrilesky ◽  
Brian Calingaert ◽  
Ingrid Synan ◽  
Angeles Alvarez Secord ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Lymph Nodes ◽  
Proportional Hazards Model ◽  
Early Stage ◽  
Clinical Stage ◽  
Cox Proportional Hazards Model ◽  
Stage I ◽  
Selective Lymphadenectomy ◽  
Poorly Differentiated ◽  
Early Stage Endometrial Cancer

Purpose Selective lymphadenectomy is widely accepted in the management of endometrial cancer. Purported benefits are individualization of adjuvant therapy based on extent of disease and resection of occult metastases. Our goal was to assess effects of the extent of selective lymphadenectomy on outcomes in women with apparent stage I endometrial cancer at laparotomy. Patients and Methods Patients with endometrial cancer who received primary surgical treatment between 1973 and 2002 were identified through an institutional tumor registry. Inclusion criteria were clinical stage I/IIA disease and procedure including hysterectomy and selective lymphadenectomy (pelvic or pelvic + aortic). Exclusion criteria included presurgical radiation, grossly positive lymph nodes, or extrauterine metastases at laparotomy. Recurrence and survival were analyzed using Kaplan-Meier analysis and Cox proportional hazards model. Results Among 509 patients, the median number of lymph nodes removed was 15 (median pelvic, 11; median aortic, three). Pelvic and aortic node metastases were found in 24 (5%) of 509 patients and 11 (3%) of 373 patients, respectively. Patients with poorly differentiated cancers having more than 11 pelvic nodes removed had improved overall survival (hazard ratio [HR], 0.25; P < .0001) and progression-free survival (HR, 0.26; P < .0001) compared with patients having poorly differentiated cancers with 11 or fewer nodes removed. Number of nodes removed was not predictive of survival among patients with cancers of grade 1 to 2. Performance of aortic selective lymphadenectomy was not associated with survival. Three (27%) of 11 patients with microscopic aortic nodal metastasis are alive without recurrence. Conclusion These data add to the literature documenting the possible therapeutic benefit of selective lymphadenectomy in management of patients with apparent early-stage endometrial cancer.

CALGB 9761: A prospective analysis of IHC and PCR based detection of occult metastatic disease in stage I NSCLC

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 7030-7030 ◽  
Author(s):  
M. A. Maddaus ◽  
X. Wang ◽  
R. T. Vollmer ◽  
N. Z. Abraham ◽  
J. D’Cunha ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Nodes ◽  
Surgical Resection ◽  
Clinical Stage ◽  
Prospective Trial ◽  
Primary Objective ◽  
Stage I ◽  
Institutional Setting ◽  
Negative Group ◽  
Pathologic Analysis

7030 Background: CALGB 9761 was a prospective trial of tumor and lymph node collection during planned surgical resection in patients with clinical stage I NSCLC. The primary objective was to determine if occult micrometastases (OM) detected by immunohistochemistry (IHC) or real time PCR of CEA in histologically negative lymph nodes is associated with poorer survival. Methods: 502 patients with clinical stage I NSCLC were accrued. 302 (60%) were eligible for analysis. 200 were ineligible due to postoperative stage change or change in diagnosis. At surgical resection samples of primary tumor and N2 and N1 lymph nodes were harvested. Lymph nodes were split in half, one half was sent for standard surgical pathologic analysis and the other half snap frozen and sent for IHC analysis using a polyclonal anticytokeratin antibody cocktail. Results: Of 302 eligible patients, 173 were T1N0 and 129 T2N0 by routine postoperative pathology. The median follow-up time for eligible patients is 5.25 years. Overall survival at 5 years is 63.22%. Median survival is not yet estimable. 14% of patients had IHC positive tissue in lymph nodes, a rate lower than expected compared to published single institution studies. Overall survival for this group at 5 years is 55.96% compared to 65.65% for the IHC negative group (p=0.38). The failure free survival at 5 years is 41.74% for the IHC positive group and 60.25% for the IHC negative group (p=0.16). RT-PCR data is currently being analyzed. Data on the first 50 patients analyzed demonstrated presence of CEA in nodal tissues and potential upstaging in approximately 50% of the patients. Conclusions: In a multi-institutional setting, IHC detection of OM by use of a polyclonal cytokeratin cocktail in stage I NSCLC has limited capacity to detect OM and poorly predicts recurrence and survival. No significant financial relationships to disclose.

Laparoscopic lymphadenectomy for clinical stage I nonseminomatous testicular tumour

1996 ◽  
Vol 63 (3) ◽  
pp. 398-402
Author(s):  
S. Siracusano ◽  
C. Trombetta ◽  
G. Savoca ◽  
G. De Giorgi ◽  
M. Zanon ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Clinical Stage ◽  
Operating Time ◽  
Stage I ◽  
Testicular Tumour ◽  
Histological Findings ◽  
Retroperitoneal Lymphadenectomy ◽  
Laparoscopic Operation ◽  
The Mean

We report our experience in laparoscopic lymphadenectomy in non-seminomatous stage I testicular neoplasia. This technique is an alternative to the formal retroperitoneal lymphadenectomy. Between 1993 and 1996 we carried out 8 retroperitoneal laparoscopic lymphadenectomies in patients, aged 19–40 years, affected by non-seminomatous testicular neoplasia. We removed from 13 to 24 lymph nodes. Operating time ranged between 200 and 300 minutes. The mean stay in hospital was 5 days. Histological findings revealed micrometastatic lymph nodes in half the patients. No complications were reported except in one patient, who underwent TC-guided drain owing to voluminous lymphocele one week after the laparoscopic operation. Normal antegrade ejaculation was preserved in all cases and no retroperitoneal recurrence was noted at a mean 18 months follow-up.

Impact of number of resected and involved lymph nodes (LN) at the time of surgical resection on the survival of non-small cell lung cancer (NSCLC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7514-7514
Author(s):  
H. Saji ◽  
M. Tsuboi ◽  
K. Miyajima ◽  
Y. Shimada ◽  
T. Ohira ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Clinical Stage ◽  
Survival Rates ◽  
Stage I ◽  
Prognostic Impact ◽  
Relative Risks ◽  
Cox Proportional Hazard ◽  
Lymph Nodes Dissection ◽  
Tokyo Medical ◽  
Medical University

7514 Background: Total number of lymph-nodes has recently proven prognostic in early breast and colorectal cancer. In this study we retrospectively evaluated the prognostic impact of the number of resected and involved lymph-nodes on the survival of stage I-III NSCLC. Methods: A series of 928 consecutive NSCLC pts who underwent complete lobectomy, bilobectomy or pneumonectomy with lymph-nodes dissection from 1/2000 to 11/2007 at Tokyo Medical University was eligible. Log rank and Cox proportional hazard model was used to estimate survival rates and relative risks. Results: Demographics are as follows: median age: 65.0 (22–87yrs), sex: 547 males and 381 females, median follow-up time: 2.5 yrs, clinical stage: 765 stage I, 84 stage II and 76 stage III, histology: 684 adenocarcinoma, 182 squamous cell carcinoma, and 62 others, operation: 870 lobectomy, 42 bilobectomy and 16 pneumonectomy, mean number of resected LN: 15 (1–49), mean number of involved LN: 0.9 (0–22). We observed a statistically significant increasing trend in overall survival (OS) between 0–3 and 4 and more of number of involved LN (P<0.001). Although a significant increasing in OS of 0–9 of number of resected LN cases compared with 10 and more was observed in all stages (P=0.024), no significant differentiation was observed in clinical stage I cases. Conclusions: This data suggests that there is a significant decrease in OS with 10 and more number of resected LN examined at surgery in NSCLC pts. However, there is no significant different in stage I pts, which implies that selected LN sampling is enough in clinical stage I cases. Further study such as LN dissection vs LN sampling in clinical stage I will be needed. No significant financial relationships to disclose.

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