scholarly journals Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

BMC Cancer ◽  
2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Stefan Rieken ◽  
Timo Gaiser ◽  
Angela Mohr ◽  
Thomas Welzel ◽  
Olaf Witt ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Multidisciplinary Treatment ◽  
Treatment Concept ◽  
Desmoplastic Medulloblastoma

scholarly journals Efficacy of Surgery for the Treatment of Gastric Cancer Liver Metastases: A Systematic Review of the Literature and Meta-Analysis of Prognostic Factors

2021 ◽  
Vol 10 (5) ◽  
pp. 1141
Author(s):  
Gianpaolo Marte ◽  
Andrea Tufo ◽  
Francesca Steccanella ◽  
Ester Marra ◽  
Piera Federico ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Liver Metastases ◽  
Meta Analysis ◽  
Multidisciplinary Treatment ◽  
Review Of The Literature ◽  
Term Survival ◽  
The Impact

Background: In the last 10 years, the management of patients with gastric cancer liver metastases (GCLM) has changed from chemotherapy alone, towards a multidisciplinary treatment with liver surgery playing a leading role. The aim of this systematic review and meta-analysis is to assess the efficacy of hepatectomy for GCLM and to analyze the impact of related prognostic factors on long-term outcomes. Methods: The databases PubMed (Medline), EMBASE, and Google Scholar were searched for relevant articles from January 2010 to September 2020. We included prospective and retrospective studies that reported the outcomes after hepatectomy for GCLM. A systematic review of the literature and meta-analysis of prognostic factors was performed. Results: We included 40 studies, including 1573 participants who underwent hepatic resection for GCLM. Post-operative morbidity and 30-day mortality rates were 24.7% and 1.6%, respectively. One-year, 3-years, and 5-years overall survival (OS) were 72%, 37%, and 26%, respectively. The 1-year, 3-years, and 5-years disease-free survival (DFS) were 44%, 24%, and 22%, respectively. Well-moderately differentiated tumors, pT1–2 and pN0–1 adenocarcinoma, R0 resection, the presence of solitary metastasis, unilobar metastases, metachronous metastasis, and chemotherapy were all strongly positively associated to better OS and DFS. Conclusion: In the present study, we demonstrated that hepatectomy for GCLM is feasible and provides benefits in terms of long-term survival. Identification of patient subgroups that could benefit from surgical treatment is mandatory in a multidisciplinary setting.

Multidisciplinary treatment of 99 adult osteosarcoma (OST) patients (pts) with synchronous and metachronous metastases (mets): A retrospective series of the French Sarcoma Group (FSG).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11030-11030
Author(s):  
Elise Lavit ◽  
Mihaela Aldea ◽  
Nicolas Isambert ◽  
Jean-Emannuel Kurtz ◽  
Corinne Delcambre ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Prognostic Factors ◽  
Medical Records ◽  
Poor Prognosis ◽  
Multidisciplinary Treatment ◽  
Progression Free Survival ◽  
Surgical Removal ◽  
Free Survival ◽  
Adult Osteosarcoma

11030 Background: Treatment (trt) options for metastatic OST are scarce. Following failure of standard 1st line therapy pts who relapse present a challenging trt dilemma, and have poor prognosis. Surgical removal of all mets is essential. Currently, there are no standardized 2nd line trt options in relapsed OST. Methods: Pts were identified from 2 sarcoma databases; Netsarc and ConticaBase. Clinical data prospectively registered in the databases were supplemented with retrospective review of the medical records. Results: From January 2009 to December 2016, we identified 99 pts, in 12 FSG centers; 30 with synchronous (SC) and 69 with metachronous (MC) mets, with 62 males. Median age was 25 years (18-53). Total number of mets was 1 for 31 pts, 2-5 for 26 and > 5 for 42. Mets sites were lung, bone and other in 77, 14 and 22 pts respectively. Median time to first MC mets was 22 months (mo) (4-97). All pts except 10 with MC mets received a 1st line systemic trt for relapse, 65 a 2d-line, 38 a 3d-line, and 20 a 4th line, with 27 pts included in a clinical trial. Sixty five pts had local trt of distant mets (surgery for 54, irradiation for 5 and radioablation for 6). Eighteen pts had repeated thoracotomies (2 for 13 pts, 3 for 5, 1 for 1 pt). Nine of 10 MC mets pts (with ≤ 5mets) who never received any systemic trt had complete mets resection, 1 had mets radioablation, all were alive at last follow-up (FU). Median FU was 16.5 mo (2-132). Median progression free survival (PFS) and overall survival (OS) were 5.5 (95%CI 4-7) and 16.5 mo (95%CI 10-25) respectively. In multivariate analysis; > 5 mets, time to 1st mets < 24 mo, were negative prognostic factors on OS and PFS (p= 0.03, 0.01 and p=0.013, 0.00 respectively). Bone mets and absence of mets surgery were negative prognostic factors on OS only (with p=0.012, 0.008). Conclusions: Adult OST pts with distant mets are heterogeneous with poor prognosis. Complete surgery of distant mets remains essential. In reference sarcoma center, OST pts at relapse with > 1 mets commonly receive >1st line of systemic trt, and are included in clinical trial. Multidisciplinary trt combining complete mets local trt and systemic therapy seems to be rational.

Clear cell sarcoma of tendons and aponeuroses: An analysis of 75 cases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 9572-9572
Author(s):  
A. Kawai ◽  
R. Nakayama ◽  
A. Matsumine ◽  
S. Matsumoto ◽  
T. Ueda ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Clear Cell ◽  
Univariate Analysis ◽  
Multidisciplinary Treatment ◽  
Objective Response ◽  
Surgical Margin ◽  
Clear Cell Sarcoma ◽  
Significant Prognostic Factor ◽  
Cell Sarcoma ◽  
Response To Chemotherapy

9572 Background: Clear cell sarcoma (CCS) of tendons and aponeuroses is a rare malignant tumor that occurs most commonly in the extremities of young adults. Because of the rarity of the disease (1% of all soft tissue sarcomas), most reports about CCS have dealt with a few cases during a long time period. We conducted a multi-institutional study of CCS to clarify the clinical findings and prognostic factors of CCS treated during the era of modern multidisciplinary treatment. Methods: The records of 75 consecutive patients with histologically confirmed CCS treated at the JMOG affiliated institutions between 1980 and 2004 (follow-up; average 44 months) were reviewed. There were 41 men and 34 women with an average age of 36 years (range, 10–71 years). 65 tumors were in the extremities (foot 22, hand 13, thigh 9, others 21) and 10 were in the trunk. The tumor size ranged from 1 to 11 cm (mean, 4 cm). 52 patients presented with localized disease (M0) and 23 with metastatic disease (M1). Results: Surgical excision of the primary tumor was performed in 71 patients (limb-sparing surgery; 56, amputation; 15). Microscopic surgical margin was negative in 60 and positive in 11. 56 patients received chemotherapy (30 with measurable disease) and 17 had radiotherapy. Local recurrence occurred in 16 patients and 48 patients developed metastasis. The 5-year overall survival rate was 47% (M0; 55%, M1; 20%). On univariate analysis, sex (p=0.02), size (p=0.001), depth (p=0.002), TNM stage (p=0.001), IRS group (p=0.001) and surgical margin (p=0.04) were prognostic factors. On multivariate analysis, size (p=0.02) remained to be a significant prognostic factor. Objective response to chemotherapy was observed in 8 (27%) patients. In the group of M0 patients, those who received adjuvant chemotherapy had better prognosis (5-year survival, 65%) than those without chemotherapy (5-year survival, 23%)(p=0.03). Conclusions: The results support the contention that early diagnosis and initial excision with negative surgical margin are essential for favorable outcome of CCS. The role of chemotherapy for CCS should be further investigated. No significant financial relationships to disclose.

scholarly journals Clinical Benefits of Conversion Surgery for Unresectable Pancreatic Ductal Adenocarcinoma: A Single-Institution, Retrospective Analysis

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1057
Author(s):  
Yuko Mataki ◽  
Hiroshi Kurahara ◽  
Tetsuya Idichi ◽  
Kiyonori Tanoue ◽  
Yuto Hozaka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Multidisciplinary Treatment ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Ductal Adenocarcinoma ◽  
Conversion Surgery ◽  
Clinical Benefits ◽  
Resectable Cancer

Background: Unresectable pancreatic ductal adenocarcinoma (UR-PDAC) has a poor prognosis. Conversion surgery is considered a promising strategy for improving the prognosis of UR-PDAC. This study aimed to investigate the clinical benefits of conversion surgery in patients with UR-PDAC. Methods: We retrospectively evaluated patients with PDAC who were referred to our department for possible surgical resection between January 2006 and December 2019. Conversion surgery was performed only in patients with UR-PDAC who could expect R0 resection. We analyzed the prognostic factors for overall survival among patients who underwent conversion surgery. Results: Overall, 638 patients with advanced pancreatic cancer were enrolled in this study. According to resectability, resectable cancer (R) was present in 180 patients, borderline resectable cancer (BR) was present in 60 patients, unresectable locally advanced cancer (UR-LA) was present in 252 patients, and unresectable cancer with distant metastasis (UR-M) was present in 146 patients. Conversion surgery was performed in 20 of the 398 UR cases (5.1%). The median period between the initial therapy and conversion surgery was 15.5 months. According to the Response Evaluation Criteria in Solid Tumors (RECIST) evaluation, the treatment response was CR in one patient, PR in 13, SD in five, and PD in one. Downstaging was pathologically determined in all cases. According to the Evans grading system, grade I was observed in four patients (20%), grade IIb was observed in seven (35%), III was observed in seven (35%), and IV was observed in two (10%). We compared the overall survival period from initial treatment among patients undergoing conversion surgery; the median overall survival durations in the conversion surgery, R, BR, UR-LA, and UR-M groups were 73.7, 32.7, 22.7, 15.7, and 8.8 months, respectively. Multivariate analysis revealed that the presence or absence of chemoradiotherapy (CRT) and the RECIST partial response (PR)/complete response (CR) for the main tumor were statistically significant prognostic factors for overall survival among patients undergoing conversion surgery (p = 0.004 and 0.03, respectively). Conclusion: In UR-PDAC, it is important to perform multidisciplinary treatment, including CRT with conversion surgery.

Prognostic factors for actual long-term survival in the era of multidisciplinary treatment for pancreatic ductal adenocarcinoma

2018 ◽  
Vol 403 (6) ◽  
pp. 693-700 ◽  
Author(s):  
Kenji Nakagawa ◽  
Takahiro Akahori ◽  
Satoshi Nishiwada ◽  
Minako Nagai ◽  
Kota Nakamura ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Multidisciplinary Treatment ◽  
Ductal Adenocarcinoma ◽  
Term Survival ◽  
Long Term Survival

Prognostic factors for primary gastrointestinal stromal tumours: are they the same in the multidisciplinary treatment era?

2014 ◽  
Vol 399 (3) ◽  
pp. 323-332 ◽  
Author(s):  
Ferdinando C. M. Cananzi ◽  
Bruno Lorenzi ◽  
Ajay Belgaumkar ◽  
Charlotte Benson ◽  
Ian Judson ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Multidisciplinary Treatment ◽  
Gastrointestinal Stromal Tumours

scholarly journals 213P: Epithelial tumors of the thymus: Prognostic factors and multidisciplinary treatment

2016 ◽  
Vol 11 (4) ◽  
pp. S149
Author(s):  
A.K. Ghimessy ◽  
Á. Kelemen ◽  
K. Török ◽  
M. Gyugos ◽  
B. Döme
Keyword(s):  
Prognostic Factors ◽  
Multidisciplinary Treatment ◽  
Epithelial Tumors ◽  
Tumors Of The Thymus

scholarly journals Clinical Benefits of Conversion Surgery for Unresectable Pancreatic Ductal Adenocarcinoma: A Single-Institution, Retrospective Analysis

2021 ◽  
Author(s):  
Yuko Mataki ◽  
Hiroshi Kurahara ◽  
Tetsuya Idichi ◽  
Kiyonori Tanoue ◽  
Yuto Hozaka ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Multidisciplinary Treatment ◽  
Locally Advanced ◽  
Advanced Pancreatic Cancer ◽  
Ductal Adenocarcinoma ◽  
Conversion Surgery ◽  
Clinical Benefits ◽  
Resectable Cancer

BackgroundUnresectable pancreatic ductal adenocarcinoma (UR-PDAC) has a poor prognosis. Conversion surgery is considered a promising strategy for improving the prognosis of UR-PDAC. This study aimed to investigate the clinical benefits of conversion surgery in patients with UR-PDAC.Methods: We retrospectively evaluated patients with PDAC who were referred to our department for possible surgical resection between January 2006 and December 2019. Conversion surgery was performed only in patients with UR-PDAC who could expect R0 resection. We analyzed the prognostic factors for overall survival among patients who underwent conversion surgery. Results: Overall, 638 patients with advanced pancreatic cancer were enrolled in this study. According to resectability, resectable cancer (R) was present in 180 patients, borderline resectable cancer (BR) in 60, unresectable locally advanced cancer (UR-LA) in 252, and unresectable cancer with distant metastasis (UR-M) in 146. Conversion surgery was performed in 20 of the 398 UR cases (5.1%). The median period between the initial therapy and conversion surgery was 15.5 months. According to the RECIST evaluation, the treatment response was CR in one patient, PR in 13, SD in five, and PD in one. Downstaging was pathologically determined in all cases. According to the Evans grading system, grade I was observed in four patients (20%), grade IIb in seven (35%), III in seven (35%), and IV in two (10%). We compared the overall survival period from initial treatment among patients undergoing conversion surgery; the median overall survival durations in the conversion surgery, R, BR, UR-LA, and UR-M groups were 73.7, 32.7, 22.7, 15.7, and 8.8 months, respectively. Multivariate analysis revealed that the presence or absence of CRT and the RECIST PR/CR for the main tumor were statistically significant prognostic factors for overall survival among patients undergoing conversion surgery (p = 0.004 and 0.03, respectively).Conclusion: In UR-PDAC, it is important to perform multidisciplinary treatment, including CRT with conversion surgery.

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