Surgical management of urachal tumors: Can the umbilicus be sparred in localized disease?

Urachal adenocarcinoma represents the third most common histological type of non-urotelial bladder cancer. A very low incidence of this disease and the lack of prospective studies have led to a rich and heterogeneous treatment history. Currently, the standard of care for these patients is represented by partial cystectomy en bloc with resection of the urachal ligament and total omphalectomy. The aim of this article is to present our experience and results in the management of patients with urachal adenocarcinoma. Between 2005 and 2015, 16 patients have undergone surgical treatment for urachal adenocarcinoma in “Fundeni” Clinical Institute and Madrid University Hospital “Infanta Sofia.” Partial cystectomy was performed in 11 (68.76%) patients, while radical cystectomy en bloc with omphalectomy was performed in 5 (31.25%) patients, which were not amendable to a limited resection. The Sheldon classification was used, as it provides appropriate disease staging and is the most commonly utilized. Postoperative pathological results showed that 7 (43.75%) patients had localized tumors, and more than one-third (37.5%) of the patients had locally advanced Sheldon III disease, while 3 patients had distant metastasis at the time of surgery. Lymph node involvement was present in 3 patients (18.75%). Mean follow-up time was 2.5 years, ranging from 4 months to 7.6 years. Three patients (18.75%) were lost to follow-up, without any documented signs of local or systemic recurrence and were cancer free at the time of the last evaluation. In cases with lymph node involvement, local recurrence or distant metastasis, patients underwent cisplatin- or 5-fluorouracil-based salvage chemotherapy. Surgical treatment represents the gold standard, while adjuvant chemotherapy has a limited impact on overall survival. The utility of navel resection is questionable due to the rarity of direct invasion or local recurrence.

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Relationship of immunohistochemical biomarker expression and lymph node involvement in patients undergoing surgical treatment of NSCLC with long-term follow-up

Tumor Biology ◽

10.1007/s13277-013-1599-9 ◽

2014 ◽

Vol 35 (5) ◽

pp. 4551-4559 ◽

Cited By ~ 1

Author(s):

Ana María Gómez ◽

Jose Ramón Jarabo Sarceda ◽

Jose Antonio L. García-Asenjo ◽

Cristina Fernandez ◽

Susana Hernandez ◽

...

Keyword(s):

Lymph Node ◽

Surgical Treatment ◽

Lymph Node Involvement ◽

Long Term Follow Up ◽

Node Involvement ◽

Relationship Of

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Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

Journal of Thyroid Research ◽

10.1155/2022/9944083 ◽

2022 ◽

Vol 2022 ◽

pp. 1-8

Author(s):

Agnes Stephanie Harahap ◽

Desty Gusti Sari ◽

Marini Stephanie ◽

Alvita Dewi Siswoyo ◽

Litta Septina Mahmelia Zaid ◽

...

Keyword(s):

Lymph Node ◽

Mortality Rate ◽

Thyroid Carcinoma ◽

Distant Metastasis ◽

Disease Recurrence ◽

Lymph Node Involvement ◽

Common Type ◽

Thyroid Malignancy ◽

Node Involvement

Introduction. Thyroid cancer is the third most common cancer that occurs in children and adolescents. Papillary thyroid carcinoma (PTC) is the most common type of thyroid malignancy. Although the mortality rate of thyroid malignancy in children is usually low, the disease recurrence is higher in children with more severe clinical presentation than in adults. This study aimed to determine the demographic and clinicopathological characteristics and outcome of pediatric and adolescent patients with thyroid malignancy in Indonesia. Methods. The retrospective study included all patients diagnosed with thyroid carcinoma aged <20 years, from January 1, 2015, to December 31, 2019. Twenty-nine subjects fulfilled the inclusion and exclusion criteria. We retrieved baseline characteristics, pathology features, TSH and fT4 status, radioactive iodine therapy data, and patients’ outcomes. Then, data were analyzed using the chi-square or Fisher’s exact method. Results. We identified 29 eligible subjects, including 3 boys and 26 girls. The most common type of thyroid carcinoma was PTC (96.5%), and follicular type (31%) was the predominant variant of PTC. Lymph node involvement occurred in 24% of patients, while distant metastasis occurred in 17.2% of patients with PTC. Twenty-four (82.7%) patients had stage 1 disease. Disease recurrence was recorded in 31% of patients during the study period with a median follow-up time of 24 months. Conclusion. PTC is the most frequent type of thyroid carcinoma among children and adolescents. This malignancy has a low mortality rate, but the recurrence rate remains high among younger patients than adults even during a short-term follow-up analysis. Distant metastasis and lymph node involvement are commonly found in this age group.

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Pelvic Radiotherapy versus Radical Prostatectomy with Limited Lymph Node Sampling for High-Grade Prostate Adenocarcinoma

Prostate Cancer ◽

10.1155/2016/2674954 ◽

2016 ◽

Vol 2016 ◽

pp. 1-8 ◽

Cited By ~ 3

Author(s):

Christopher B. Baker ◽

Andrew M. McDonald ◽

Eddy S. Yang ◽

Rojymon Jacob ◽

Soroush Rais-Bahrami ◽

...

Keyword(s):

Lymph Node ◽

Radical Prostatectomy ◽

Distant Metastasis ◽

External Beam Radiotherapy ◽

Lymph Node Involvement ◽

Prostate Adenocarcinoma ◽

Oncologic Outcomes ◽

Lymph Node Sampling ◽

Node Involvement

Purpose. To compare oncologic outcomes for patients with Gleason score (GS) ≥ 8 prostate adenocarcinoma treated with radical prostatectomy (RP) versus external beam radiotherapy combined with androgen deprivation (RT + ADT).Methods. Between 2001 and 2014, 121 patients with GS ≥ 8 were treated at our institution via RT + ADT (n=71) or RP (n=50) with ≥ 1 year of biochemical follow-up. Endpoints included biochemical failure (BF), distant metastasis, and initiation of salvage ADT.Results. The RT + ADT group was older, had higher biopsy GS, and had greater risk of lymph node involvement. All other pretreatment characteristics were similar between groups. Mean number of lymph nodes (LNs) sampled for patients undergoing RP was 8.2 (±6.18). Mean biochemical follow-up for all patients was 61 months. Five-year estimates of BF for the RT + ADT and RP groups were 7.2% versus 42.3%, (p<0.001). The RT + ADT group also had lower rates of distant metastasis (2% versus 7.8%) and salvage ADT (8% versus 33.8%).Conclusion. In this analysis, RT + ADT was associated with improved biochemical and metastatic control when compared to RP with limited LN sampling. How RT + ADT compares with more aggressive lymphadenectomy, as is currently our institutional standard, remains an important unanswered question.

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The Risk of Lymph Node Involvement in Malignant Cutaneous Adnexal Tumors

The American Surgeon ◽

10.1177/000313481408000322 ◽

2014 ◽

Vol 80 (3) ◽

pp. 270-274 ◽

Cited By ~ 3

Author(s):

Meredith Barnes ◽

Andrea Hestley ◽

Douglas R. Murray ◽

Grant W. Carlson ◽

Doug Parker ◽

...

Keyword(s):

Lymph Node ◽

Local Recurrence ◽

Treatment Algorithm ◽

Retrospective Chart Review ◽

Lymph Node Involvement ◽

Lymph Node Biopsy ◽

Sebaceous Carcinoma ◽

Node Involvement ◽

Adnexal Tumors

Malignant cutaneous adnexal tumors (MCATs) are rare neoplasms that do not have a well-studied treatment algorithm. They are generally treated by excision alone. Given its successful application in other cutaneous malignancies, sentinel lymph node biopsy (SLNB) has been advocated by some for use in MCATs. A retrospective chart review was performed. Clinicopathological factors, recurrence patterns, and long-term follow-up were documented. Survival analysis was performed. Forty-eight subjects were identified. Mean age was 69 years with locations on the face (52%), including periocular sites (16%), extremities (25%), and all other sites (7%). Histologic distribution was sebaceous carcinoma (56%), porocarcinoma (17%), eccrine carcinoma (13%), adenocarcinoma (10%), and hidradenocarcinoma (4%). Mean follow-up was 3.9 years (range, 0 to 17 years). Nine subjects (18.8%) recurred locally, and recurrence was inversely associated with age ( P = 0.04). Four (8.3%) demonstrated lymph node involvement, none without first developing local recurrence. Five-year disease-specific survival was 97 per cent (confidence interval, 81.4 to 99.6%). Despite being one of the largest reported analyses of MCATs, this study is limited by the small number of subjects. MCATs seemingly develop nodal recurrence only after demonstrating aggressive local biology. SLNB may best be applied selectively, possibly only in patients with local recurrence.

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Prognostic Factors in Dedifferentiated Chondrosarcoma: A Retrospective Analysis of a Large Series Treated at a Single Institution

Sarcoma ◽

10.1155/2019/9069272 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 4

Author(s):

Ruoyu Miao ◽

Edwin Choy ◽

Kevin A. Raskin ◽

Joseph H. Schwab ◽

Gunnlaugur Petur Nielsen ◽

...

Keyword(s):

Multivariate Analysis ◽

Prognostic Factors ◽

Lymph Node ◽

Local Recurrence ◽

Distant Metastasis ◽

Pathological Fracture ◽

Lymph Node Involvement ◽

Significant Prognostic Factor ◽

Increased Risk ◽

Node Involvement

Background. Dedifferentiated chondrosarcomas (DDCSs) are highly malignant tumors with a dismal prognosis and present a significant challenge in clinical management. Methods. In an IRB approved retrospective protocol, we identified 72 patients with DDCS treated at our institution between 1993 and 2017 and reviewed clinicopathological characteristics, treatment modalities, and outcomes to analyze prognostic factors. Results. Femur (44.4%), pelvis (22.2%), and humerus (12.5%) were most commonly involved sites. Twenty-three patients (31.9%) presented with distant metastasis, and 3 (4.2%) of them also had regional lymph node involvement. The median overall survival (OS) was 13.9 months. On multivariate analysis, pathological fracture, larger tumor size, lymph node involvement, metastasis at diagnosis, extraosseous extension, and undifferentiated pleomorphic sarcoma component correlated with worse OS, whereas surgical resection and chemotherapy were associated with improved OS. For progression-free survival (PFS), pathological fracture and metastasis at diagnosis showed increased risk, while chemotherapy was associated with decreased risk. Among patients who received chemotherapy, doxorubicin and cisplatin were significantly associated with improved PFS but not OS. Among patients without metastasis at diagnosis, 17 (34.7%) developed local recurrence. Thirty-one (63.3%) developed distant metastases at a median interval of 18.1 months. On multivariate analysis, R1/R2 resection was related with local recurrence, while macroscopic dedifferentiated component was associated with distant metastasis. Conclusions. The prognosis of DDCS is poor. Complete resection remains a significant prognostic factor for local control. Chemotherapy with doxorubicin and cisplatin seems to have better PFS. More prognostic, multicenter trials are warranted to further explore the effectiveness of chemotherapy in selected DDCS patients.

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Histology as a Prognostic Factor in Early Gastric Cancer

Tumori Journal ◽

10.1177/030089169207800307 ◽

1992 ◽

Vol 78 (3) ◽

pp. 181-184

Author(s):

Massimo Ferrari ◽

Enrico Ghislandi ◽

Giuseppe Landonio ◽

Margherita Majno ◽

Tiziano Porretta ◽

...

Keyword(s):

Risk Factors ◽

Gastric Cancer ◽

Lymph Node ◽

Prognostic Factor ◽

Early Gastric Cancer ◽

Lymph Node Involvement ◽

Depth Of Invasion ◽

Undifferentiated Histology ◽

Node Involvement

Of 431 patients with gastric cancer observed in our Istitution, 23 (5.3 %) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.

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Management of Adenoid Cystic Carcinoma of the Breast: A Single-Institution Study

Frontiers in Oncology ◽

10.3389/fonc.2021.621012 ◽

2021 ◽

Vol 11 ◽

Author(s):

Wenxiang Zhang ◽

Yi Fang ◽

Zhihui Zhang ◽

Jing Wang

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Local Recurrence ◽

Adenoid Cystic Carcinoma ◽

Distant Metastasis ◽

Hormone Receptor ◽

Clinical Presentation ◽

Hormone Receptor Positive ◽

Adenoid Cystic

ObjectiveThe purpose of our study was to analyze the clinicopathologic features and surgical and oncological outcomes of adenoid cystic carcinoma (ACC) of the breast and to provide the basis for a clinical therapeutic schedule.MethodsA total of 14 patients with primary breast adenoid cystic carcinoma treated at Cancer Hospital of the Chinese Academy of Medical Sciences from January 2000 to December 2017 were included. Data on clinical presentation, treatment strategy, and outcome, as well as the pathological features of ACC, were reviewed and analyzed.ResultsFourteen patients were diagnosed with ACC of the breast, out of 23205 total patients treated for breast cancer (0.06%). All but three patients were postmenopausal, with a median age at diagnosis of 60.5 years (range, 39–73 years). The most common clinical presentation was a palpable mass (85.7%), and the imaging characteristics of all patients on color Doppler ultrasound and mammography were nonspecific. Six patients (42.9%) were suspected of having ACC by fine-needle aspiration cytology (FNAC) and were confirmed by postoperative histology and immunohistochemistry. All 14 patients underwent surgery, and no patient had a positive lymph node status. Median tumor size was 1.75 cm (range, 1–3 cm). Eight/14 (57.1%) patients were hormone receptor negative (HR−) and HER-2/neu (−) (HER2−). The remaining patients were hormone receptor positive (HR+). There was no significant difference in clinicopathological characteristics between the HR+ group and the HR- group (P>0.05). The mean follow-up period was 57 months. Local recurrence occurred in 14.3% of patients, 1.7% of patients had distant metastasis, all patients with local recurrence or distant metastasis were in the HR (-) group, and all patients were alive at the last follow-up.ConclusionACC of the breast cannot be simply summarized as triple-negative breast cancer because it also includes a small number of hormone receptor-positive breast cancers. Establishing a preoperative diagnosis is difficult on the basis of clinical imaging examination, FNAC may be useful tool in the diagnosis. the final diagnosis can only be assessed based on the results of the histopathological and immunohistochemical examination. Breast-conserving surgery may be an alternative treatment strategy, and axillary lymph node dissection or sentinel node biopsy may not be necessary in some cases.

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Lymph Node Involvement and the Surgical Treatment of Thymic Epithelial and Neuroendocrine Carcinoma

The Annals of Thoracic Surgery ◽

10.1016/j.athoracsur.2019.01.006 ◽

2019 ◽

Vol 107 (6) ◽

pp. 1632-1638 ◽

Cited By ~ 1

Author(s):

Danjouma Housmanou Cheufou ◽

Daniel Valdivia ◽

Stephan Puhlvers ◽

Benjamin Fels ◽

Gerhard Weinreich ◽

...

Keyword(s):

Lymph Node ◽

Surgical Treatment ◽

Neuroendocrine Carcinoma ◽

Lymph Node Involvement ◽

Node Involvement

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Is local lymph node involvement a prognostic factor in paediatric renal cell carcinoma?

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.20014 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 20014-20014

Author(s):

P. Indolfi ◽

G. Bisogno ◽

G. Cecchetto ◽

A. Ferrari ◽

L. Piva ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Lymph Node ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Renal Cell ◽

Lymph Node Involvement ◽

Number Of Patients ◽

Node Involvement ◽

Local Lymph Node

20014 Background: RCC in childhood is rare. Children with RCC tend to have a similar overall prognosis when compared with adults, where prognosis worsens with increasing stage, although direct comparisons of adult and paediatric data isn’t easy. The aim of our study is to identify the prognostic significance of local lymph node involvement in children with Renal Cell Carcinoma (RCC). Methods: On the basis of a retrospective study, the recently founded Italian Association for Paediatric Hematology and Oncology-Rare Tumors Paediatric Age (AIEOP-TREP) identified 16 patients (9 females) with RCC and local lymph node involvement at 10 of these centers. The cases were observed among 59 paediatric RCC, corresponding to 27.1% of RCC presenting in Italy from January 1973 to May 2006. Results: Overall, 9 patients were alive and disease free at last follow-up: eight patients had regional lymph node dissection (RLND) from the diaphragm at the aortic bifurcation, and one had the para-aortic lymph nodes removal. Six patients died: one had RLND (died from progression of disease), three had the renal hilum lymph nodes removal, and two the para-aortic lymph nodes dissection. One patient was lost to follow-up after relapse: this patient had para-aortic lymph node removal at diagnosis. Estimated 25-year DFS and OS rates for all patients were 64.2% and 50.5%, respectively. Given the small number of patients, little can be said about the value, if any, of adjuvant immunotherapy in this group of RCC. Conclusions: Children with lymph node positive RCC had a relatively unfavourable long- term prognosis. In our experience the RLND improves the prognosis. Further investigation of the biologic differences is warranted. Because of the very low incidence of paediatric RCC, an international clinical trial will be required to establish optimal therapy for children with RCC. No significant financial relationships to disclose.

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