Hodgkin's Disease Stage I and II with Exclusive Subdiaphragmatic Presentation. The Experience of the Departments of Radiation Oncology and Hematology, University “La Sapienza” of Rome

1996 ◽  
Vol 82 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Riccardo Maurizi Enrici ◽  
Mattia Falchetto Osti ◽  
Anna Paola Anselmo ◽  
Enzo Banelli ◽  
Claudio Cartoni ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Oncology ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Stage I ◽  
Stage Ii ◽  
Disease Stage ◽  
Relapse Free Survival ◽  
Free Survival ◽  
Systemic Symptoms

During the period 1978 to 1994, 1054 patients with Hodgkin's disease were evaluated and treated at the Departments of Radiation Oncology and Hematology, University “La Sapienza”, Rome. A total of 549 patients presented with clinical or pathological stage I and II; 37 of these had Hodgkin's disease below the diaphragm (BDHD), and 512 above the diaphragm (ADHD). A comparison of patients with BDHD versus those with ADHD showed that the first group had a higher male to female ratio. A comparison of cases with stage II BDHD versus those with stage II ADHD showed that patients with BDHD were older (48 years vs 28 years), had different histologic features and a higher incidence of systemic symptoms (67% vs 33%). Stage II BDHD patients had a worse prognosis; in fact, there were significant differences in the overall survival and relapse-free-survival rates for cases with stage II BDHD versus those with stage II ADHD (overall survival, 46% vs 80%, P<0.001; relapse-free survival, 44% vs 69%, P<0.005). Stage was found to be the most important prognostic factor for BDHD cases without systemic symptoms treated with radiation therapy alone. The type of infradiaphragmatic presentation (intra-abdominal vs peripheral disease) did not influence outcome, probably due to the more aggressive therapy received by the intra-adbominal group. Treatment recommendations for BDHD cases should be tailored to the stage and the presence or absence of intra-abdominal localization. For patients with stage IA extended fields, irradiation (inverted Y) is sufficent. However, combined modality therapy should be the treatment of choice for stage II cases, particularly in the presence of intra-abdominal disease. Patients with systemic symptoms also require combined modalities.

Five-Year Outcomes of a Randomized Phase III Trial Comparing Adjuvant Chemotherapy With S-1 Versus Surgery Alone in Stage II or III Gastric Cancer

2011 ◽  
Vol 29 (33) ◽  
pp. 4387-4393 ◽  
Author(s):  
Mitsuru Sasako ◽  
Shinichi Sakuramoto ◽  
Hitoshi Katai ◽  
Taira Kinoshita ◽  
Hiroshi Furukawa ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Stage Ii ◽  
Disease Stage ◽  
Relapse Free Survival ◽  
Free Survival ◽  
End Point

Purpose The first planned interim analysis (median follow-up, 3 years) of the Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer confirmed that the oral fluoropyrimidine derivative S-1 significantly improved overall survival, the primary end point. The results were therefore opened at the recommendation of an independent data and safety monitoring committee. We report 5-year follow-up data on patients enrolled onto the ACTS-GC study. Patients and Methods Patients with histologically confirmed stage II or III gastric cancer who underwent gastrectomy with D2 lymphadenectomy were randomly assigned to receive S-1 after surgery or surgery only. S-1 (80 to 120 mg per day) was given for 4 weeks, followed by 2 weeks of rest. This 6-week cycle was repeated for 1 year. The primary end point was overall survival, and the secondary end points were relapse-free survival and safety. Results The overall survival rate at 5 years was 71.7% in the S-1 group and 61.1% in the surgery-only group (hazard ratio [HR], 0.669; 95% CI, 0.540 to 0.828). The relapse-free survival rate at 5 years was 65.4% in the S-1 group and 53.1% in the surgery-only group (HR, 0.653; 95% CI, 0.537 to 0.793). Subgroup analyses according to principal demographic factors such as sex, age, disease stage, and histologic type showed no interaction between treatment and any characteristic. Conclusion On the basis of 5-year follow-up data, postoperative adjuvant therapy with S-1 was confirmed to improve overall survival and relapse-free survival in patients with stage II or III gastric cancer who had undergone D2 gastrectomy.

Syncytial Variant of Nodular Sclerosing Hodgkin’s Disease.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4533-4533
Author(s):  
Kamran Darabi ◽  
William Tester ◽  
Ierachmiel Daskal ◽  
Jeffrey Cohn
Keyword(s):  
Overall Survival ◽  
Hodgkin's Disease ◽  
Chart Review ◽  
Median Overall Survival ◽  
Hodgkin’S Disease ◽  
Patient Characteristics ◽  
Free Survival ◽  
Medical Chart Review ◽  
Systemic Symptoms ◽  
Nodular Sclerosing

Abstract Background: Syncytial Variant is a subtype of nodular sclerosis Hodgkin’s disease (NSHD), reported to occur in younger patients (median age 25 years) who typically present with advanced disease and systemic symptoms. Objectives: To evaluate the pretreatment characteristics and outcomes of NSHD patients diagnosed with syncytial variant (SV), compared to other NSHD patients without this histology (non-SV). Methods: This is a retrospective medical chart review of all cases of NSHD seen at one institution over 2 decades. Pretreatment patient characteristics and outcomes data were analyzed. Results: Of 63 patients with NSHD, 10 (16%) had SV histology. In contrast to previous reports, a trend for older age was observed for patients with SV (median 35 years), compared to patients with non-SV (median 27 years) (p=0.545). No differences in the distribution of B-symptoms or stage were observed between the two groups. Median recurrence-free survival was 37 months for SV cases, compared to 79 months for non-SV cases (p=0.046). Median overall survival was 38 months for SV, compared to 81 months for non-SV patients (p=0.05). Conclusion: No significant differences were observed in pretreatment patient characteristics between SV and non-SV cases. However, we did observe a significantly worse recurrence-free and overall survival for SV patients, compared to non-SV cases. This is a limited retrospective study at a single institution and not all patients had received the same treatment. Therefore, further studies are needed to confirm these findings.

scholarly journals Low value of whole-body dual-modality [18f]fluorodeoxyglucose positron emission tomography/computed tomography in primary staging of stage I–II nasopharyngeal carcinoma: a nest case-control study

2021 ◽  
Author(s):  
Bei-Bei Xiao ◽  
Qiu-Yan Chen ◽  
Xue-Song Sun ◽  
Ji-Bin Li ◽  
Dong-hua Luo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Stage I ◽  
Relapse Free Survival ◽  
Retropharyngeal Lymph Node ◽  
Free Survival ◽  
Pet Ct ◽  
Pre Treatment

Abstract Objectives The value of using PET/CT for staging of stage I–II NPC remains unclear. Hence, we aimed to investigate the survival benefit of PET/CT for staging of early-stage NPC before radical therapy. Methods A total of 1003 patients with pathologically confirmed NPC of stages I–II were consecutively enrolled. Among them, 218 patients underwent both PET/CT and conventional workup ([CWU], head-and-neck MRI, chest radiograph, liver ultrasound, bone scintigraphy) before treatment. The remaining 785 patients only underwent CWU. The standard of truth (SOT) for lymph node metastasis was defined by the change of size according to follow-up MRI. The diagnostic efficacies were compared in 218 patients who underwent both PET/CT and CWU. After covariate adjustment using propensity scoring, a cohort of 872 patients (218 with and 654 without pre-treatment PET/CT) was included. The primary outcome was overall survival based on intention to treat. Results Retropharyngeal lymph nodes were metastatic based on follow-up MRI in 79 cases. PET/CT was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions (72.2% [62.3–82.1] vs. 91.1% [84.8–97.4], p = 0.004). Neck lymph nodes were metastatic in 89 cases and PET/CT was more sensitive than MRI (96.6% [92.8–100.0] vs. 76.4% [67.6–85.2], p < 0.001). In the survival analyses, there was no association between pre-treatment PET/CT use and improved overall survival, progression-free survival, local relapse-free survival, regional relapse-free survival, and distant metastasis-free survival. Conclusions This study showed PET/CT is of little value for staging of stage I–II NPC patients at initial imaging. Key Points • PET/CT was more sensitive than MRI in detecting neck lymph node lesions whereas it was significantly less sensitive than MRI in detecting retropharyngeal lymph node lesions. • No association existed between pre-treatment PET/CT use and improved survival in stage I–II NPC patients.

Alternating cycles of combination chemotherapy for patients with recurrent Hodgkin's disease following radiotherapy. A prospectively randomized study by the Cancer and Leukemia Group B.

1986 ◽  
Vol 4 (6) ◽  
pp. 838-846 ◽  
Author(s):  
V Vinciguerra ◽  
K J Propert ◽  
M Coleman ◽  
J R Anderson ◽  
L Stutzman ◽  
...  
Keyword(s):  
Overall Survival ◽  
Combination Chemotherapy ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Disease Free Survival ◽  
Complete Response ◽  
Free Survival ◽  
Group B ◽  
Leukemia Group ◽  
Disease Free

A randomized clinical trial of combination chemotherapy for patients who relapsed following primary radiation therapy for Hodgkin's disease was conducted from 1975 to 1981 by the Cancer and Leukemia Group B (CALGB). One hundred thirteen patients were prospectively randomized to receive 12 cycles of either CVPP (CCNU, vinblastine, procarbazine, and prednisone), ABOS (bleomycin, vincristine [Oncovin; Lilly, Indianapolis], doxorubicin [Adriamycin, Adria Laboratories, Columbus, Ohio], and streptozotocin), or alternating cycles of CVPP and ABOS. The median length of observation for patients in this report is 4 years. Toxicities of the three treatment programs were primarily hematologic. Frequencies of complete response were 72% for CVPP, 70% for ABOS, and 82% for CVPP/ABOS (P = .37). Females and patients who had nodular sclerosing disease at initial diagnosis had significantly higher complete response rates. The 5-year disease-free survival for the complete responders was 55%; the 5-year overall survival was 60%. There were no significant differences among the treatments on disease-free survival (P = .78) or overall survival (P = .18). Age under 40 years was the only significant positive prognostic factor for disease-free survival (P = .095) and overall survival (P = .003). This study demonstrates no statistically significant advantage for alternating cycles of combination chemotherapy in affecting complete response frequency, disease-free survival, or overall survival as compared with therapy with CVPP or ABOS alone. However, the power to detect differences in these outcome parameters is somewhat limited by the sample sizes.(ABSTRACT TRUNCATED AT 250 WORDS)

High-Dose Chemotherapy Followed by Autologous Hematopoietic Stem Cell Transplantation (AHSCT) for Lymphocyte Predominant Hodgkin’s Disease.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3061-3061 ◽  
Author(s):  
Philip Bierman ◽  
Hina Naushad ◽  
Fausto Loberiza ◽  
R. Gregory Bociek ◽  
Julie M. Vose ◽  
...  
Keyword(s):  
Overall Survival ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Progression Free Survival ◽  
High Dose ◽  
High Dose Therapy ◽  
Peripheral Blood Stem Cells ◽  
Free Survival ◽  
Nodular Sclerosis ◽  
Blood Stem Cells

Abstract Lymphocyte Predominant Hodgkin’s Disease (LPHD) is a B-cell lymphoma that may require different treatment and may have a different natural history than classical Hodgkin’s disease. Although AHSCT is accepted therapy for patients with relapsed and refractory classical Hodgkin’s disease, there is little information regarding transplantation for LPHD. We performed a retrospective analysis of 19 patients who were treated with AHSCT for relapsed or refractory LPHD at the University of Nebraska Medical Center between April, 1987 and October, 2002. Biopsies of all LPHD patients were reviewed to confirm the diagnosis according to the WHO classification. Patients with a prior or concurrent diagnosis of classical Hodgkin’s disease or non-Hodgkin’s lymphoma were excluded. There were 18 men and 1 woman. Median age was 33 years (range 19–52). Thirteen patients (68%) received 1–2 chemotherapy regimens prior to AHSCT, and 6 patients (32%) received 3 or more regimens. Nine patients (47%) received radiation therapy prior to AHSCT. Five patients (26%) had extranodal disease at the time of AHSCT. Five patients (26%) were transplanted with autologous bone marrow, and 14 patients (74%) received peripheral blood stem cells. Six patients (32%) were transplanted with BEAM (carmustine, etoposide, cytarabine, melphalan), and 13 patients (68%) were treated with CBV (cyclophosphamide, carmustine, etoposide). The results of AHSCT for the 19 patients with LPHD were compared with 229 patients in our database who received AHSCT for relapsed and refractory nodular sclerosis Hodgkin’s disease during the same time period. The characteristics of the groups were similar with respect to age, disease status at the time of AHSCT, stage at AHSCT, amount of treatment prior to AHSCT, and interval between diagnosis and AHSCT. Patients with LPHD were more likely to be males (p<0.001), less likely to have received radiation prior to AHSCT (p=0.06), and more likely to have been transplanted with peripheral blood stem cells (p=0.05). The actuarial 5-year progression-free survival following AHSCT for patients with LPHD and nodular sclerosis Hodgkin’s disease was 40% (95% CI 18% to 61%) and 39% (95% CI 33% to 45%), respectively (p=0.30). The actuarial 5-year overall survival following AHSCT for patients with LPHD and classical Hodgkin’s disease was 56% (95% CI 30% to 75%) and 53% (95% CI 46% to 59%), respectively (p=0.36). A multivariate analysis comparing patients with LPHD and those with nodular sclerosis Hodgkin’s disease was performed. The relative risk of treatment failure following AHSCT for patients with nodular sclerosis histology was 1.14 (95% CI 0.62 to 2.12; p=0.67), and the relative risk of death was 1.22 (95% CI 0.62 to 2.41; p=0.56). These results demonstrate that long-term progression-free survival and overall survival can be achieved following high-dose therapy and AHSCT for patients with LPHD. Furthermore, no significant differences in progression-free survival and overall survival were identified when results of AHSCT for LPHD and nodular sclerosis Hodgkin’s disease were compared. Although none of the LPHD patients were treated with newer agents such as gemcitabine or rituximab prior to AHSCT, this analysis suggests that high-dose therapy followed by AHSCT may be used for patients with relapsed and refractory LPHD as well as classical Hodgkin’s disease.

Blood and tumor inflammation markers in non-small cell lung cancer (NSCLC): Blood leukocytosis as an independent risk factor in early stage.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e21110-e21110
Author(s):  
Andreas Carus ◽  
Morten Ladekarl ◽  
Henrik Hager ◽  
Hans Pilegaard ◽  
Patricia Switten Nielsen ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factor ◽  
Stage I ◽  
Stage Ii ◽  
Recurrence Free Survival ◽  
Elevated Blood ◽  
Blood Leukocytes ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Cancer Inflammation

e21110 Background: Cancer inflammation is associated with impaired survival in a range of cancers. We reviewed blood and intratumoral inflammatory markers in NSCLC. Methods: At the Departmentof Thoracic Surgery, Skejby Hospital, Aarhus, Denmark, consecutive patients with resected NSCLC from 2000 to 2008 were reviewed, and 906 patients with complete clinical data were identified. A subset of 341 consecutive patients, resected between 2003 and 2006, also had intratumoral CD66b+ neutrophils and CD163+ macrophages measured by immunohistochemistry and evaluated by stereological assessment. Results: A total of 526, 197, and 183 patients had stage I, II, and III, respectively. Multivariate analysis stratified for tumor stage revealed elevated blood leukocytes above upper limit of normal as a significant prognostic factor for recurrence-free survival (RFS)(hazard ratio [HR] 1.9; 95% CI 1.4-2.6; p<0.0001), cancer specific survival (CSS)(HR 1.9; 95% CI 1.4-2.7; p<0.0001), and overall survival (OS)(HR 1.5; 95% CI 1.1-1.9; p<0.006) in stage I NSCLC, but not in stage II and III. No prognostic impact of intratumoral neutrophils or macrophages was seen on CSS, RFS, or OS, neither in the entire cohort, nor limited to stage I patients with elevated blood leukocytes or with normal counts. Controlling intratumoral neutrophils and macrophages for localization restricted to tumor tissue, stromal tissue, or blood vessels, respectively, were also with no statistically significant difference. Conclusions: Blood leukocytosis is an independent prognostic factor for short recurrence free survival, cancer specific survival, and overall survival in stage I NSCLC, but not in stage II and III. However, intratumoral neutrophils or macrophages did not impact prognosis. Further studies are needed to elucidate the role of cancer inflammation in NSCLC.

scholarly journals Relapse-Free Survival as a Surrogate for Overall Survival in the Evaluation of Stage II–III Melanoma Adjuvant Therapy

2017 ◽  
Vol 110 (1) ◽  
pp. 87-96 ◽  
Author(s):  
Stefan Suciu ◽  
Alexander M M Eggermont ◽  
Paul Lorigan ◽  
John M Kirkwood ◽  
Svetomir N Markovic ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Therapy ◽  
Stage Ii ◽  
Relapse Free Survival ◽  
Free Survival
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