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 A retrospective study on prophylactic regional lymphadenectomy versus nodal observation only in the management of dogs with stage I, completely resected, low-grade cutaneous mast cell tumors

2021 ◽  
Author(s):  
Silvia Sabattini ◽  
Matti Kiupel ◽  
Riccardo Finotello ◽  
Damiano Stefanello ◽  
Eugenio Faroni ◽  
...  
Keyword(s):  
Mast Cell ◽  
Stage I ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mast Cell Tumors ◽  
Regional Lymphadenectomy ◽  
Significant Difference ◽  
Cutaneous Mast Cell ◽  
Prophylactic Lymphadenectomy

Abstract Background. While lymphadenectomy of metastatic 27 lymph nodes (LNs) has been associated with improved outcome, the clinical utility of prophylactic lymphadenectomy in dogs with stage I cutaneous mast cell tumors (cMCTs) remains a controversial topic. To assess the therapeutic role of lymphadenectomy of uninvolved regional LNs, the long-term outcome of cMCT-bearing dogs with cytologically negative and surgically unresected regional LNs (observation only, OO) was compared with that of dogs with a surgically resected and histologically negative regional LNs (prophylactic regional lymphadenectomy, PRL).Results. A retrospective analysis of 64 dogs with a low-grade, completely resected stage I cMCT was performed: (54.7%) dogs were subjected to OO and 29 (45.3%) underwent PRL. Dogs were monitored for a median of 813 and 763 days in the OO group and PRL group, respectively. The number of dogs undergoing MCT progression was significantly higher in the OO group (P = 0.028) and curve comparison revealed a tendency to a better time to progression in the PRL group (P = 0.058). No significant difference in survival time (P = 0.294) was observed between dogs in the OO and PRL groups.Conclusions. Our results showed that lack of immediate lymphadenectomy was associated with a higher risk for tumor progression. This preliminary judgement, reinforced by the findings that lymphadenectomy was well tolerated in all cases, and that histopathology provides the definitive assessment of the nodal pathological status, may suggest that prophylactic lymphadenectomy is indicated in the management of stage I MCTs. Larger prospective studies are warranted for generating clinical evidence of this latter hypothesis.

scholarly journals Analysis of Radiation Therapy for the Control of Merkel Cell Carcinoma of the Head and Neck Based on 36 Cases and a Literature Review

2008 ◽  
Vol 87 (11) ◽  
pp. 634-643 ◽  
Author(s):  
Brian D. Lawenda ◽  
Michelle G. Arnold ◽  
Valerie A. Tokarz ◽  
Joshua R. Silverstein ◽  
Paul M. Busse ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Local Control ◽  
Clinical Stage ◽  
Local Control Rate ◽  
Stage I ◽  
Stage Iii ◽  
Regional Control ◽  
Kaplan Meier ◽  
Significant Difference

Merkel cell carcinoma (MCC) is a rare and aggressive epidermal cancer. We conducted a retrospective study and literature review to investigate the impact that radiation therapy has on local, regional, and distant control as part of the oncologic management of MCC of the head and neck and to further elucidate the role of radiation therapy with regard to regional control for the clinically uninvolved neck. We reviewed all registered cases of head and neck MCC that had occurred at four institutions from January 1988 through December 2005. Treatment and outcomes data were collected on patients with American Joint Committee on Cancer stage I, II, and III tumors. Local, regional, and distant control rates were calculated by comparing variables with the Fisher exact test; Kaplan-Meier analysis was used to report actuarial control data. Stage I to III head and neck MCC was identified in 36 patients— 22 men and 14 women, aged 43 to 97 years (mean: 71.6) at diagnosis. Patients with stage I and II tumors were combined into one group, and their data were compared with those of patients with stage III tumors. Twenty-sixpatients(72%) had clinical stage I/II disease and 10 patients (28%) had clinical stage III disease. Median follow-up was 41 months for the stage I/II group and 19 months for the stage III group. Based on examination at final follow-up visits, local recurrence was seen in 7 of the 36 patients (19%), for a local control rate of 81 %. The 2-year actuarial local control rate for all stages of MCC was 83%; by treatment subgroup, the rates were 95% for those who had undergone radiation therapy to the primary site and 69%) for those who had not— a statistically significant difference(p = 0.020). Based on information obtained at final follow-ups, 10 of the 36 patients (28%) experienced a regional recurrence, for a regional control rate of 72%. The 2-year actuarial regional control rate among all patients was 70%; by subgroup, rates were 82%) for patients who had undergone regional node radiation therapy and 60% for those who had not— not a statistically significant difference (p = 0.225). Nine patients (25%) overall developed a distant metastasis, for a distant control rate of 75%. Salvage therapies included chemotherapy and/or radiation therapy to the metastatic site, but neither had any significant effect on survival. Regardless of treatment, the Kaplan-Meier survival curves leveled off at 30 months with 82% survival for the stage I/II group and at 19 months with 60% survival for the stage III group. We conclude that radiation therapy to the primary tumor site (either following resection or definitively) results in a local control rate of more than 90% in patients with head and neck MCC. We also found a trend toward improved regional control of the clinically negative neck with the addition of radiation therapy.

The Prognostic Value of Lymph Node Metastasis with Grade 2 MCTs in Dogs: 55 Cases (2001–2010)

2014 ◽  
Vol 50 (2) ◽  
pp. 89-95 ◽  
Author(s):  
Heather Baginski ◽  
Garrett Davis ◽  
Richard P. Bastian
Keyword(s):  
Lymph Node ◽  
Prognostic Value ◽  
Surgical Excision ◽  
Tumor Location ◽  
Survival Times ◽  
Node Metastasis ◽  
Mast Cell Tumors ◽  
Poor Predictor ◽  
Significant Difference ◽  
Cutaneous Mast Cell

This study evaluates a series of dogs diagnosed with grade 2 cutaneous mast cell tumors (MCTs) with concurrent lymph node (LN) metastasis. All dogs had surgical excision of the primary tumor. The presence of metastasis was confirmed with either histopathology (n = 35) or cytology (n = 20). There was no significant difference in survival times (STs) between dogs with and without LN metastasis. Median survival time (MST) was not reached at 65.9 mo. LN palpation was a poor predictor of metastasis (sensitivity, .71; specificity, .54). Tumor location was the only prognostic factor for survival in this series of dogs. ST was greater for dogs that had removal of their metastatic LN. This study suggests that in dogs with grade 2 MCTs, outcome may not be affected by the presence of LN metastasis; however, removal of the metastatic LN may prolong survival.

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.

Esophagectomy versus definitive chemoradiotherapy as initial treatment for clinical stage I esophageal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Li-Xiang Mei ◽  
Jun-Xian Mo ◽  
Yong Chen ◽  
Lei Dai ◽  
Yong-Yong Wang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Initial Treatment ◽  
Tumor Recurrence ◽  
Clinical Stage ◽  
Stage I ◽  
Current Evidence ◽  
Cochrane Library ◽  
Definitive Chemoradiotherapy ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background Esophagectomy and definitive chemoradiotherapy are commonly used in the treatment of stage I esophageal cancer (EC). The present study aims to compare the efficacy and safety of esophagectomy and definitive chemoradiotherapy as the initial treatment for clinical stage I EC. Methods This study was registered with the International Prospective Register of Systematic Reviews (CRD42020197203). Relevant studies were identified through PubMed, Web of Science, EMBASE, and Cochrane Library from database inception to June 30, 2020. Hazard ratio (HR) with 95% confidence intervals (CI) was employed to compare overall survival (OS) and progression-free survival (PFS). Odds ratio (OR) with 95% CI was employed to compare treatment-related death, complications, and tumor recurrence. Results A total of 13 non-randomized controlled studies involving 3,346 patients were included. Compared with definitive chemoradiotherapy, esophagectomy showed an improved OS (HR 0.69, 95% CI 0.55–0.86; P &lt; 0.001), PFS (HR 0.47, 95% CI 0.33–0.67; P &lt; 0.001), and a lower risk of tumor recurrence (OR 0.43, 95% CI 0.30–0.61; P &lt; 0.001). There was no significant difference in the incidence of complications (OR 1.11, 95% CI 0.75–1.65; P = 0.60) and treatment-related death (OR 1.15, 95% CI 0.31–4.30; P = 0.84) between the two treatments. Conclusions Current evidence shows esophagectomy has superior survival benefits as the initial treatment for clinical stage I EC. It is still the preferred choice for patients with clinical stage I EC. However, future high-quality randomized controlled trials are needed to validate this conclusion.

scholarly journals Possible Risk Factors of Pulmonary Metastases in Patients With International Federation of Gynecology and Obstetrics Stage I Endometrioid-Type Endometrial Cancer

2017 ◽  
Vol 27 (6) ◽  
pp. 1206-1215 ◽  
Author(s):  
Wei Jiang ◽  
Jun Chen ◽  
Xiang Tao ◽  
Feifei Huang ◽  
Menghan Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endometrial Cancer ◽  
Tumor Size ◽  
Gene Mutations ◽  
Myometrial Invasion ◽  
Epithelial Differentiation ◽  
Stage I ◽  
Primary Tumors ◽  
Significant Difference ◽  
Deep Myometrial Invasion

ObjectiveLimited data have been obtained in regard to pulmonary metastasis (PM) in patients with stage I endometrial cancer. The aims of the study were (1) to present the clinical and pathological characteristics of patients with PM in the setting of stage I endometrioid-type endometrial cancer (EEC) and (2) to define possible factors that may be used to predict PM.MethodsSix hundred thirty patients with stage I EEC, including 12 with PM, 19 with extra-PM (EPM), and 599 with no recurrence, were observed. Paired samples of primary and metastatic tumors from a patient were used for exome sequencing to identify potential gene mutations associated with PM.ResultsThere was no significant difference in the age, Ki-67, lymphatic vascular space invasion, and grade 3 among the 3 groups (P > 0.05). More squamous epithelial differentiation was observed in PM (7/12), as compared with patients with EPM (1/19) (P < 0.05) and no recurrence (20/599) (P < 0.05). The tumor size of the patients with PM was bigger than that of nonrecurrent patients (29.8 ± 16.6 vs 18.5 ± 16.3 mm, P < 0.05). More percentage of patients with deep myometrial invasion (IB) were found in PM (6/12) (P < 0.05) as compared with patients with EPM (3/19) (P < 0.05) and no recurrence (76/599). CDH10, ARID1A, and EMT-associated gene mutations were identified in metastatic tumor tissue but not in primary tumors from a patient with EEC and lung metastases.ConclusionsSquamous epithelial differentiation, large tumor size, and deep myometrial invasion might be risk factors for PM in patients with stage I EEC. CDH10, ARID1A, and EMT-associated gene mutation may promote the initiation of lung recurrence. However, further studies are needed to determine the precise mechanisms associated with lung metastasis in these patients.

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.

VAC Protocol for Treatment of Dogs with Stage III Hemangiosarcoma

2013 ◽  
Vol 49 (6) ◽  
pp. 370-377 ◽  
Author(s):  
Francisco J. Alvarez ◽  
Kenji Hosoya ◽  
Ana Lara-Garcia ◽  
William Kisseberth ◽  
Guillermo Couto
Keyword(s):  
Clinical Stage ◽  
Complete Response ◽  
Stage I ◽  
High Rate ◽  
Stage Iii ◽  
Negative Prognostic Factor ◽  
Significant Difference ◽  
Chemotherapy Protocol ◽  
Aggressive Tumors ◽  
Anatomic Locations

Hemangiosarcomas (HSAs) are aggressive tumors with a high rate of metastasis. Clinical stage has been considered a negative prognostic factor for survival. The study authors hypothesized that the median survival time (MST) of dogs with metastatic (stage III) HSA treated with a vincristine, doxorubicin, and cyclophosphamide (VAC) chemotherapy protocol would not be different than those with stage I/II HSA. Sixty-seven dogs with HSA in different anatomic locations were evaluated retrospectively. All dogs received the VAC protocol as an adjuvant to surgery (n = 50), neoadjuvant (n = 3), or as the sole treatment modality (n = 14). There was no significant difference (P = 0.97) between the MST of dogs with stage III and stage I/II HSA. For dogs presenting with splenic HSA alone, there was no significant difference between the MST of dogs with stage III and stage I/II disease (P = 0.12). The overall response rate (complete response [CR] and partial response [PR]) was 86%). No unacceptable toxicities were observed. Dogs with stage III HSA treated with the VAC protocol have a similar prognosis to dogs with stage I/II HSA. Dogs with HSA and evidence of metastases at the time of diagnosis should not be denied treatment.

scholarly journals Clinicopathological retrospective analysis of thymoma in Serbia: Single center experience

2020 ◽  
Vol 77 (2) ◽  
pp. 140-150
Author(s):  
Natalija Samardzic ◽  
Dragana Jovanovic ◽  
Ljiljana Markovic-Denic ◽  
Sanja Sarac ◽  
Vesna Skodric-Trifunovic ◽  
...  
Keyword(s):  
Clinical Stage ◽  
Staging System ◽  
Stage I ◽  
World Health ◽  
Tumor Mass ◽  
Tumor Invasiveness ◽  
Single Center Experience ◽  
Significant Difference ◽  
Health Organization ◽  
Solitary Tumor

Background/Aim. Thymoma is the most common mediastinal tumor. The treatment procedures are based on the results from the research of retrospective studies because they are not frequent tumors. The aim of this work was to define common clinical features, therapeutic aspects, survival and recurrence free survival. Methods. This study was performed in the Clinic for Pulmonology, Clinical Centre of Serbia, Belgrade from January 1993 to December 2013. We analyzed 62 patients with histopathologically proven thymoma. The results were obtaind from medical history, physical exam, chest X-ray and/or computed tomography and operational findings or diagnostic procedure reports. Thymomas were clasiffied according to the World Health Organization classifying system, based on histopathological findings, and staged according to the Masaoka-Koga staging system. Results. There were more female (54.8%) patients. Patients were mostly in the seventh decade of life. One third (29%) of the patients were asymptomatic. Cough was the dominant symptom. Myasthenia gravis was the most common paraneoplastic syndrome (12.9%). Solitary tumor was the most common in our patients (61.3%), as well as the tumors larger than 5 cm (52.5%), and noninvasive thymomas (52.5%). The majority of patients (40%) were in the stage I of the disease. The operative approach was conducted in most of the patients (88.7%). A statistically significant difference in survival was in women, patients with solitary tumor, non-invasive thymomas, patients in the stage I of the disease, and those who were operated. The dimension of the tumor mass approached the conventional level of significance. Conclusion. In patients with thymomas, statistically significant survival rate predictors are gender, presence of solitary tumor mass, tumor invasiveness, clinical stage and surgical treatment of the disease.

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.

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