scholarly journals Prognostic factors and the role of pelvic lymphadenectomy in uterine leiomyosarcomas

2019 ◽  
Vol 7 ◽  
pp. 205031211985681
Author(s):  
Tounsi Nesrine ◽  
Zemni Ines ◽  
Nawel Abdelwahed ◽  
Ayadi Mohamed Ali ◽  
Boujelbene Nadia ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Menopausal Status ◽  
Disease Free Survival ◽  
Pelvic Lymphadenectomy ◽  
Free Survival ◽  
Disease Free ◽  
Lymphovascular Space Invasion

Objectives: Leiomyosarcomas are relatively rare uterine smooth muscle tumors. Surgery is the most common therapy choice for uterine leiomyosarcomas. However, controversy exists over the appropriate initial surgical management, especially about the role of lymph node sampling. The aim of our study is to analyze the prognostic factors and the role of lymphadenectomy in overall survival and in disease-free survival. Methods: We analyzed retrospectively 31 patients suffering from uterine leiomyosarcomas at Institute of Salah Azaiez during 2000–2014. Demographic and clinical features such as age, menopausal status, stage, tumor size, and management options were examined, and pathological characteristics such as mitotic count, lymphovascular space invasion, and tumor necrosis were evaluated. Results: Out of 31 patients treated for uterine leiomyosarcomas, pelvic lymphadenectomy was done for 18 patients. No para-aortic lymphadenectomy was performed. Median number of resected lymph nodes was 13 ± 7 (range: 3–27). Lymphatic metastasis was observed in 2 out of 18 patients with clinical stage IA and IIIB. The distribution of different variables (age, International Federation of Gynecology and Obstetrics stage, tumor size, mitotic count, and adjuvant treatment) between the group of patients, who had or had not lymphadenectomy done, had no significant difference. The 5-year overall survival and disease-free survival were 61% and 50%, respectively. Clinical stage, presence of lymphovascular space invasion, and lymph nodal dissection were found to be relevant for disease-free survival on univariate analysis. Only age and menopausal status were found to be a prognostic factor for overall survival. Conclusion: Hence, routine lymph node dissection was not generally recommended. Our study demonstrates that lymphadenectomy has a statistically significant effect on disease-free survival but not on overall survival.

scholarly journals Determination of prognostic factors of surgically treated pathological Stage IIIA non-small cell lung cancer

2020 ◽  
Vol 28 (3) ◽  
pp. 496-504
Author(s):  
Muhammet Sayan
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Disease Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Disease Free

Background: This study aims to identify the prognostic factors in Stage IIIA non-small cell lung cancer and to investigate whether there was a significant difference in terms of overall survival and disease-free survival among the subgroups belonging to this disease stage. Methods: Between January 2010 and December 2018, a total of 144 patients (125 males, 19 females; median age 60 years; range, 41 to 80 years) who were operated for non-small cell lung cancer in our clinic and whose pathological stage was reported as IIIA were retrospectively analyzed. Data including demographic and clinical characteristics of the patients, histopathological diagnosis, the standardized uptake value of the mass on positron emission tomography-computed tomography, tumor diameter, type of surgery, lymph node metastasis status, visceral pleural invasion, and overall and disease-free survival rates were recorded. Results: The median survival was 39 (range, 27.8 to 46.1) months and the five-year overall survival rate was 28%. The mean tumor diameter was 4.3±2.7 cm. The median disease-free survival was 37 (range, 28.1 to 48.6) months and the five-year disease-free survival rate was 26.9%. In the multivariate analysis, overall survival and disease-free survival in T2N2M0 subgroup were significantly worse than the other subgroups. The other poor prognostic factors of survival were the standardized uptake value of the tumor, pneumonectomy, and histopathological subtypes other than squamous cell carcinoma and adenocarcinoma. Parietal pleural invasion was significantly associated with worse disease-free survival rates. Conclusion: Our results showed that there may be significant survival differences between subgroups created by tumor histopathology, lymph node invasion and the type of surgery in a heterogeneous lung cancer stage.

Postoperative Adjuvant Chemotherapy for Node-Positive Cervical Adenocarcinoma

2009 ◽  
Vol 19 (2) ◽  
pp. 277-280 ◽  
Author(s):  
Nobuhiro Takeshima ◽  
Kuniko Utsugi ◽  
Katsuhiko Hasumi ◽  
Ken Takizawa
Keyword(s):  
Adjuvant Chemotherapy ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Pelvic Lymphadenectomy ◽  
Cervical Adenocarcinoma ◽  
Postoperative Chemotherapy ◽  
Postoperative Adjuvant Chemotherapy ◽  
Free Survival ◽  
Node Positive

We examined the effectiveness of postoperative adjuvant chemotherapy for node-positive cervical adenocarcinoma. During the period from 1994 to 2002, 98 consecutive patients with clinical stage I and II cervical adenocarcinoma were treated surgically without having undergone any prior treatment. Surgical procedures included radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Postoperatively, 21patients were found to have lymph node metastasis, and all were treated with chemotherapy in the absence of radiotherapy. All patients were followed up for at least 5 years. Recurrence developed in 9 of the 21 patients, all 9died of the disease. Six of the 9 recurrences were extrapelvic lesions. Five-year disease-free survival and overall survival were 57% and 67%, respectively. Recurrence was more common in patients with 6 or more positive nodes than in those with fewer than 3 positive nodes. These data suggest the potential role of postoperative chemotherapy for treatments of cervical adenocarcinoma. However, the effectiveness of chemotherapy alone in node-positive cervical adenocarcinoma was likely not as high as that in squamous cell carcinoma. Despite our use of postoperative chemotherapy in the absence of pelvic radiation, the disease recurred predominantly at distant sites.

Efficacy trend of hepatic resection for hepatocellular carcinoma with large multinodular tumor or macrovascular invasion.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 427-427 ◽  
Author(s):  
Jian-Hong Zhong ◽  
Le-Qun Li ◽  
Xin-Ping Ye ◽  
Yang Ke ◽  
Lin Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Liver Function ◽  
Hepatic Resection ◽  
Tertiary Care ◽  
Disease Free Survival ◽  
Recent Decade ◽  
Free Survival ◽  
Disease Free

427 Background: Official guidelines and retrospective studies have different view on the role of hepatic resection (HR) for patients with large (≥5 cm) multinodular (≥2) hepatocellular carcinoma (HCC) and those involving macrovascular invasion (MVI). We aim to evaluate the efficacy and its variation trend and the safety of HR for these patients in three tertiary care settings. Methods: A consecutive sample of 1,824 patients with Child-Pugh A liver function and large/multinodular HCC or involving MVI and who underwent initial HR were divided into four groups: large/multinodular HCC of the previous (2000-2004, n = 496) and recent five years (2005-2010, n = 765), involving MVI of the previous (n = 242) and recent five years (n = 321). Results: Among our patient sample, the hospital mortality was less than 5% and had a downward trend. Moreover, patients in recent five years have statistically significant longer survival time. Among patients with large/multinodular HCC, patients in recent five years showed a significantly better overall survival than those in previous five years at 1-year (92% vs. 84%), 3-year (69% vs. 61%), and 5-year (45% vs. 40%) (P = 0.004). Moreover, among patients involving MVI, overall survival in recent five years was significantly higher at 1-year (83% vs. 78%), 3-year (50% vs. 41%), and 5-year (25% vs. 17%) (P= 0.033). However, the disease-free survival of recent five years was only slightly higher than that of the previous five years in the two subgroups. Conclusions: HR offers good overall survival for patients with resectable large/multinodular HCC or those involving MVI and with preserved liver function. Outcomes have tended to improve in recent decade.

scholarly journals Outcome in Advanced Ovarian Cancer following an Appropriate and Comprehensive Effort at Upfront Cytoreduction: A Twenty-Year Experience in a Single Cancer Institute

2010 ◽  
Vol 2010 ◽  
pp. 1-8 ◽  
Author(s):  
Anne Marszalek ◽  
Séverine Alran ◽  
Suzy Scholl ◽  
Virginie Fourchotte ◽  
Corinne Plancher ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Prognostic Factor ◽  
Surgical Procedure ◽  
Menopausal Status ◽  
Disease Free Survival ◽  
Tumor Type ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

Objectives. The purpose of this retrospective evaluation of advanced-stage ovarian cancer patients was to compare outcome with published findings from other centers and to discuss future options for the management of advanced ovarian carcinoma patients.Methods. A retrospective series of 340 patients with a mean age of 58 years (range: 17–88) treated for FIGO stage III and IV ovarian cancer between January 1985 and January 2005 was reviewed. All patients had primary cytoreductive surgery, without extensive bowel, peritoneal, or systematic lymph node resection, thereby allowing initiation of chemotherapy without delay. Chemotherapy consisted of cisplatin-based chemotherapy in combination with alkylating agents before 2000, whereas carboplatin and paclitaxel regimes were generally used after 1999-2000. Overall survival and disease-free survival were analyzed by the Kaplan-Meier method and the log-rank test.Results. With a mean followup of 101 months (range: 5 to 203), 280 events (recurrence or death) were observed and 245 patients (72%) had died. The mortality and morbidity related to surgery were low. The main prognostic factor for overall survival was postoperative residual disease (P<.0002), while the main prognostic factor for disease-free survival was histological tumor type (P<.0007). Multivariate analysis identified three significant risk factors: optimal surgery (RR=2.2for suboptimal surgery), menopausal status (RR=1.47for postmenopausal women), and presence of a taxane in the chemotherapy combination (RR=0.72).Conclusion. These results confirm that optimal surgery defined by an appropriate and comprehensive effort at upfront cytoreduction limits morbidity related to the surgical procedure and allows initiation of chemotherapy without any negative impact on survival. The impact of neoadjuvant chemotherapy to improve resectability while lowering the morbidity of the surgical procedure is discussed.

Prognostic value of systemic inflammatory marker in patients with head and neck squamous cell carcinoma undergoing surgical resection

2020 ◽  
Vol 16 (10) ◽  
pp. 559-571
Author(s):  
Shichao Zhou ◽  
Haihua Yuan ◽  
Jiongyi Wang ◽  
Xiaohua Hu ◽  
Feng Liu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Survival Analysis ◽  
Prognostic Value ◽  
Inflammatory Marker ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free ◽  
Systemic Inflammatory Marker

Aim: To explore the prognostic value of the systemic inflammatory marker (SIM) based on neutrophil, lymphocyte and monocyte counts in head and neck squamous cell carcinoma (HNSCC) patients. Patients & methods: We retrospectively collected the data of 367 patients with HNSCC who underwent surgery. The Kaplan–Meier survival analysis and Cox regression analysis were conducted on disease-free survival and overall survival. Results: A high SIM (>1.34) was associated with larger tumor size, advanced clinical stage and shorter survival time. The survival analysis showed that only clinical stage and SIM were independent prognostic indicators of disease-free survival and overall survival. Conclusion: The SIM positively correlated with tumor progression and might be a powerful prognostic indicator of poor outcome in patients with HNSCC.

Role of adjuvant therapy in resected gallbladder cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 452-452
Author(s):  
Mohamed Abdelrahim Muddathir Hassan ◽  
Nicha Wongjarupong ◽  
Cristobal T. Sanhueza ◽  
Mindy L. Hartgers ◽  
Fatima Hassan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Therapy ◽  
Gallbladder Cancer ◽  
Cancer Patients ◽  
Surgical Resection ◽  
Adjuvant Treatment ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

452 Background: Surgical resection is the only curative treatment for patients with gallbladder cancer, despite surgical advances many patients ultimately develop recurrent disease. Management of resected gallbladder cancer mostly relies on single-arm trials and retrospective observations. The purpose of our study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer patients who have undergone surgical resection. Methods: Clinical data were collected on 251 patients who underwent surgical resection for stage I-III gallbladder cancer and presented to Mayo clinic from January 2000-December 2015. Patients were then classified into adjuvant treatment group and surveillance only group. Overall survival and recurrence were compared between the two groups. Results: 78 (31.1%) patients received adjuvant therapy while 173 patients were observed only. Patients who received adjuvant tended to be younger (63.0[SD 11] vs 66.2 [SD 13.1]), have higher stage, and underwent extended surgery. Most patients received chemoradiotherapy (55) with 5-Fluorouracil (67.3%) and capecitabine (25.5%) as radiosensitizing agents. 21 patients received additional adjuvant chemotherapy. 27% of patients received chemotherapy as the sole adjuvant treatment. The most common chemo regimens included gemcitabine (52.3%) and gemcitabine plus cisplatin combination (23.8%). On multivariate analysis patients > 65 years(HR 1.53 [1.07-2.19], p = 0.02), males (HR 1.7 [1.2-2.4], p = 0.003), positive margins (2.77 [1.69-4.38], p < 0.01), and stage III (HR 1.91 [1.35-2.70], p < 0.01) had worse overall survival. Patients who underwent extended radical resection (HR 0.73 [0.51-1.05], p = 0.09) had better overall survival. Adjuvant therapy had no statistical significant effect on overall survival (HR 1.10 [0.75-1.59], p = 0.63 or disease free survival (HR 1.05 [0.69-1.59], p = 0.81) on overall population. However, in stage IIIB, patients receiving adjuvant therapy had better overall survival (HR 0.51 [0.25-1.01], p = 0.05) and disease free survival (HR 0.45 [0.19-1.09], p = 0.06). Conclusions: In our study, adjuvant treatment, especially chemoradiation therapy, was only beneficial in patients with stage IIIb gallbladder cancer patients.

R406 – Treatment of Squamous Cell Carcinoma of the Hypopharynx

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P179-P179
Author(s):  
Helma Maria Chedid ◽  
Carlos Neutzling Lehn
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Postoperative Radiotherapy ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Developed Countries ◽  
Free Survival ◽  
Disease Free

Problem Squamous cell carcinoma of the hypopharynx has been diagnosed at a late stage, including in developed countries, thus denoting worse prognosis. An association between surgery and radiotherapy is the standard treatment for advanced clinical stages. Our aim was to assess the clinical and treatment factors of tumors of the hypopharynx that were treated surgically and with postoperative radiotherapy. Methods This was a retrospective study on 174 patients, among whom two patients were in clinical stage (CS) I, four in CS II, 46 in CS III, and 122 in CS IV. Among these, 222 neck dissections were performed, of which 48 were bilateral. Statistic analysis: Kaplan-Meier methods. Results The mean follow-up was 31 months, and histological examinations showed that two patients were pT1, 15 pT2, 100 pT3 and 57 pT4. With regard to lymph nodes, 25 patients were pN0 and 149 patients were pN+. The disease-free survival in CS III was 75%, versus 28% in CS IV (p=0.001). The disease-free survival was 35% and the overall survival was 28%. Conclusion Surgical treatment for tumors of the hypopharynx occurred in advanced CS, with disease-free survival of 35%. Significance The overall survival and disease free-survival among patients with squamous cell carcinoma of the hypopharynx undergoing surgery.

The long-term outcome of gastrointestinal stromal tumors treatment

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Putticha Keawmanee ◽  
◽  
Wisit Kasetsermwiriya ◽  
Pakkapol Sukhvibul ◽  
Suphakarn Techapongsatorn ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Gastrointestinal Stromal Tumors ◽  
Disease Free Survival ◽  
Mitotic Figure ◽  
R0 Resection ◽  
Long Term Outcome ◽  
Free Survival ◽  
Stromal Tumors ◽  
Disease Free

Background: To evaluate the overall survival, disease free survival, clinicopathological characteristics and prognostic factors of patients with gastrointestinal stromal tumors (GISTs) who were treated at Faculty of Medicine Vajira Hospital. Methods: A retrospective review data of 39 GISTs patients who underwent surgery at Vajira hospital from 2007 to 2011 was performed. The patient characteristics, overall survival, disease-free survival of patients and prognostic factors were evaluated. Results: The median age of patients was 60 years (22-90 years), 54% were female and the main presenting symptom was abdominal pain (33%). Stomach (62%) and small intestine (30%) were the most common locations of tumor respectively. Complete resections (R0) were performed in 31 patients (80% ). All patients (100%) were positive for CD117 and 84.6% for CD34. According to the Armed Forces Institute of Pathology criteria, 56.4% of patients were characterized as a high risk. With a median follow-up time of 46 months (1-139 months). The overall survival and disease-free survival at 5 years were 84.6% and 66.7%, respectively. Two patients received Imatinib in neoadjuvant setting while 10 patients for disease control. Eight patients (20.5%) developed recurrences. R0 resection, mitotic figure and location of tumor were the significant prognostic factors. Conclusions: The overall survival and disease-free survival at 5 years were 84.6% and 66.7%, respectively. R0 resection, mitotic figure and location of tumor were the significant prognostic factors. Keywords: gastrointestinal stromal tumor; gists; prognostic factors; survival.

The Grading of Lymphovascular Space Invasion in Epithelial Ovarian Carcinoma

2010 ◽  
Vol 20 (5) ◽  
pp. 895-899 ◽  
Author(s):  
Xueya Qian ◽  
Xiaowei Xi ◽  
Yubiao Jin
Keyword(s):  
Ovarian Carcinoma ◽  
Histological Grade ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Epithelial Ovarian Carcinoma ◽  
Poor Correlation ◽  
Advanced Clinical Stage ◽  
Free Survival ◽  
Disease Free ◽  
Lymphovascular Space Invasion

Introduction:To assess the prognostic value of lymphovascular space invasion (LVSI) in epithelial ovarian carcinoma.Methods:We reexamined single representative hematoxylin and eosin-stained sections of 66 patients with epithelial ovarian carcinoma to identify LVSI. A 4-grade system was used to classify LVSI: absent (no LVSI), mild (1-2 foci of LVSI), moderate (3-8 foci of LVSI), and severe (≥9 foci of LVSI). We investigated the possible associations between the grade of LVSI and clinicopathologic factors.Results:Lymphovascular space invasion was present in 36 patients (54.5%) and absent in 30 (45.5%). Statistical analysis indicated that LVSI was significantly associated with advanced clinical stage, poor histological grade, and lymph node metastasis. Follow-up studies indicated that the disease-free survival time for patients without LVSI was significantly longer than that for patients with moderate LVSI (P = 0.01) and severe LVSI (P = 0.001). The overall survival (OS) time for patients with moderate or severe LVSI was significantly shorter than that for patients with mild or no LVSI. The grade of LVSI was found to be significantly associated with OS (P = 0.004). The grade of LVSI showed poor correlation with disease-free survival and OS.Conclusions:The grade of LVSI is an important predictive factor for disease recurrence and poor survival of patients with epithelial ovarian carcinoma.

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