scholarly journals Long-term outcomes of surgical resection for T1b gallbladder cancer: an institutional evaluation

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Kizuki Yuza ◽  
Jun Sakata ◽  
Pankaj Prasoon ◽  
Yuki Hirose ◽  
Taku Ohashi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Gallbladder Cancer ◽  
Surgical Resection ◽  
Surgical Approach ◽  
Survival Rates ◽  
Radical Resection ◽  
Disease Specific Survival ◽  
Simple Cholecystectomy ◽  
Disease Specific

Abstract Background There is no comprehensive agreement concerning the overall performance of radical resection for T1b gallbladder cancer (GBC). This research focused on addressing whether T1b GBC may spread loco-regionally and whether radical resection is necessary. Methods A retrospective analysis was conducted of 1032 patients with GBC who underwent surgical resection at our centre and its affiliated institutions between January 1982 and December 2018. A total of 47 patients with T1b GBC, 29 (62%) of whom underwent simple cholecystectomy and 18 (38%) of whom underwent radical resection with regional lymph node dissection, were enrolled in the study. Results GBC was diagnosed pre-operatively in 16 patients (34%), whereas 31 patients (66%) had incidental GBC. There was no blood venous or perineural invasion in any patient on histology evaluation, except for lymphatic vessel invasion in a single patient. There were no metastases in any analysed lymph nodes. The open surgical approach was more prevalent among the 18 patients who underwent radical resection (open in all 18 patients) than among the 29 patients who underwent simple cholecystectomy (open in 21; laparoscopic in 8) (P = 0.017). The cumulative 10- and 20-year overall survival rates were 65 and 25%, respectively. The outcome following simple cholecystectomy (10-year overall survival rate of 66%) was akin to that following radical resection (64%, P = 0.618). The cumulative 10- and 20-year disease-specific survival rates were 93 and 93%, respectively. The outcome following simple cholecystectomy (10-year disease-specific survival rate of 100%) was equivalent to that following radical resection (that of 86%, P = 0.151). While age (> 70 years, hazard ratio 5.285, P = 0.003) and gender (female, hazard ratio 0.272, P = 0.007) had a strong effect on patient overall survival, surgical procedure (simple cholecystectomy vs. radical resection) and surgical approach (open vs. laparoscopic) did not. Conclusions Most T1b GBCs represent local disease. As pre-operative diagnosis, including tumour penetration of T1b GBC, is difficult, the decision of radical resection is justified. Additional radical resection is not required following simple cholecystectomy provided that the penetration depth is restricted towards the muscular layer and that surgical margins are uninvolved.

Sinonasal Osteosarcoma: Report of 14 New Cases and Systematic Review of the Literature

2020 ◽  
Author(s):  
Christopher M. Low ◽  
Nelson R. Gruszczynski ◽  
Eric J. Moore ◽  
Daniel L. Price ◽  
Jeffrey R. Janus ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Survival Rate ◽  
Care Center ◽  
Tertiary Care ◽  
Survival Rates ◽  
Disease Specific Survival ◽  
Review Of The Literature ◽  
Presenting Symptoms ◽  
Disease Specific

Abstract Objective The objective of this study is to describe the clinical presentation, tumor characteristics, natural history, and treatment patterns of sinonasal osteosarcoma. Methods Fourteen patients who had been treated for osteosarcoma of the nasal cavity and paranasal sinuses at a tertiary care center were reviewed. In addition, a systematic review of the literature for osteosarcoma of the sinonasal cavity was performed. Results In a systematic review, including 14 patients from the authors' institution, 53 total studies including 88 patients were assessed. Median follow-up was 18 months (interquartile range: 8–39 months). The most common presenting symptoms were facial mass or swelling (34%), and nasal obstruction (30%). The most common paranasal sinus involved by tumor was the maxillary sinus (64%), followed by the ethmoid sinuses (52%). The orbit (33%), dura (13%) and infratemporal fossa (10%) were the most common sites of local invasion. The majority of patients underwent surgery followed by adjuvant therapy (52.4%). Increasing age was associated with decreased overall survival rate (unit risk ratio [95% confidence interval (CI)] = 1.02 [1.003–1.043]; p = 0.0216) and T4 disease was associated with decreased disease-specific survival rate (hazard ratio [HR] = 2.87; p = 0.0495). The 2- and 5-year overall survival rates were 68 and 40%, respectively, while 2- and 5-year disease-specific survival rates were 71% and 44%, respectively. Conclusions Sinonasal osteosarcomas are uncommon tumors and can pose a significant therapeutic challenge. Increasing age and T4 disease are associated with worse prognosis. This disease usually warrants consultation by a multidisciplinary team and consideration of multimodality therapy.

Evaluation of obstructive jaundice as a poor prognostic factor after curative resection of advanced gallbladder cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 340-340
Author(s):  
Y. Nasu ◽  
S. Kondo ◽  
S. Hirano ◽  
E. Tanaka ◽  
T. Tsuchikawa ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Obstructive Jaundice ◽  
Gallbladder Cancer ◽  
Curative Resection ◽  
Survival Rates ◽  
Radical Resection ◽  
Pathological Examination ◽  
Disease Specific Survival ◽  
Advanced Gallbladder Cancer ◽  
Disease Specific

340 Background: Gallbladder cancer (GBC) is one of the most common malignancies of the biliary tract. Because of the lack of specific presentations, this condition is frequently diagnosed only at an advanced stage. Obstructive jaundice is generally regarded as an indicator of far advanced disease, unresectability, and poor prognosis. The aim of this study was to evaluate clinicopathological factors, especially jaundice, influencing outcome after radical resection of gallbladder cancer, in order to identify the patients benefiting from radical surgery. Methods: Seventy-five patients with GBC underwent surgical resection between 1998 and 2008. A retrospective analysis was conducted on sixty-four patients with UICC T2 or more tumors. Clinicopathologic features, extents of resection, and survival rates were investigated retrospectively. Obstructive jaundice was defined that serum T-bil level was more than 2.0 mg/ml. Patients with jaundice underwent ENBD or PTBD and curative resection was performed when serum T-Bil level decreased below 2.0 mg/ml. Right after laparotomy, para-aortic lymphadenectomy and frozen section pathology were performed to convert a radical resection to a palliative procedure when a para-aortic lymph node was positive. Results: The three and five-year disease-specific survival rates were 47% and 41%, respectively. Nine patients survived for more than five years.Univariate analysis showed that blood loss during operation, hepatic invasion, portal vein invasion, N category, M category after postoperative pathological examination and residual tumor were significant prognostic factors (p<0.05), but multivariate analysis showed that M category only was independent prognostic factor (p<0.05). Five-year disease-specific survival rates for patients with (n=37) and without (n=27) obstructive jaundice were 47% and 35%, respectively (p=0.69). Conclusions: Obstructive jaundice had no impact on postoperative survival as long as metastatic disease was exclueded and adequate resection of the hepatic hilum was performed. Aggressive surgery might bring long-term survival in selected patients even with obstructive jaundice by advanced gallbladder cancer. No significant financial relationships to disclose.

scholarly journals A Cross Sectional Study on Loco-Regional Recurrences and Overall Survival Rate among Patients with Stage II (T2N0M0) Glottis Carcinoma Treated with Chemoradiation and Surgery

2021 ◽  
Vol 8 (04) ◽  
pp. 219-223
Author(s):  
Niharika Darasani
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Squamous Cell ◽  
Stage Ii ◽  
Overall Survival Rate ◽  
Disease Specific Survival ◽  
Free Survival ◽  
Tertiary Teaching ◽  
Voice Preservation ◽  
Disease Specific

BACKGROUND Single modality treatment for stage I and stage II squamous cell carcinomas of glottis region gave excellent results. Since a long time these are treated either with definitive radiation therapy or surgical excision with endoscopes. There was not much difference with regard to voice preservation, local recurrence and disease-free survival period. Our aim was to study the clinical presentation and management protocol of glottis carcinoma in a tertiary hospital and observe the final outcome of stage II (T2N0M0) glottis carcinoma and specific factor for survival in patients treated with surgery, radiotherapy and concurrent chemoradiation. METHODS 43 patients of glottis carcinoma stage II (T2N0M0) attending a tertiary teaching hospital between May 2015 and April 2017 were included in the study. Demography and smoking status of subjects were recorded. Staging of the disease was according to American Joint Committee on Cancer (AJCC) Staging System 7th edition. Paraglottic space infiltration was taken as a criteria to upgrade the staging. The overall survival rate, recurrence free survival, disease specific survival rate and laryngeal function preservation rate were calculated. RESULTS Out of 43 patients, males were 90.69 % and 09.30 % were females. Male to female ratio was 10.57 : 1. Mean age was 58.62 ± 2.35 years. 67.44 % were current smokers, 27.90 % were former smokers and 02.32 % were non-smokers. The overall survival scores and disease specific survival was 100 % with 11.62 % locoregional recurrences. The voice preservation was 86.04 %. Radiotherapy was used in 72.09 %, chemoradiation in 18.60 % patients and 11.62 % patients underwent surgery. 11.62 % patients presented with locoregional recurrence during 24 months of follow up. 02.32 % patients had to undergo tracheostomy. CONCLUSIONS The overall survival scores and disease specific survival were 100 % with 11.62 % loco-regional recurrence. Voice preservation was 86.04 %. Proactive prevention rather than escalation of treatment protocol gives better prognosis. KEYWORDS Glottis, Larynx, Supra Glottis, Sub Glottis, Squamous Cell Carcinoma, Chemo Radiation and Trans Oral Laryngeal Surgeries

Meta-analytic comparison of robotic and transoral laser surgical procedures in supraglottic carcinoma

2019 ◽  
Vol 133 (05) ◽  
pp. 404-412 ◽  
Author(s):  
M B Asik ◽  
B Satar ◽  
M Serdar
Keyword(s):  
Overall Survival ◽  
Robotic Surgery ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Survival Rates ◽  
Published Data ◽  
Disease Specific Survival ◽  
Success Rates ◽  
Surgery Group ◽  
Disease Specific

AbstractObjectiveTo assess published reports of oncological surgical success rates in patients who underwent transoral laser supraglottic surgery and robotic surgery for supraglottic cancer.MethodsA systematic review of the literature was conducted and a meta-analysis of published data was performed. PubMed, Sage, Medline and Cochrane data sources were investigated. Overall survival rates, disease-specific survival rates, additional treatments and recurrence rates were investigated to determine the success of the surgical procedures.ResultsThe meta-analysis included 24 studies; 1617 studies were excluded. There were no statistically significant differences between the transoral laser supraglottic surgery and transoral robotic supraglottic surgery groups in terms of overall survival (77.0 per cent and 82.4 per cent respectively) and disease-specific survival (75.8 per cent and 87.0 per cent respectively). There was recurrence in 164 out of 832 patients (19.7 per cent) in the transoral laser supraglottic surgery group and in only 6 out of 66 patients (9 per cent) in the transoral robotic supraglottic surgery group.ConclusionTransoral laser surgery and robotic surgery appear to have comparable and acceptable oncological success rates.

Comparison of survival rates in carcinoma in situ of the breast treated with total mastectomy to breast-conserving surgery and radiotherapy

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 519-519 ◽  
Author(s):  
M. N. Ibrahim ◽  
Z. Abdullah ◽  
L. Healy ◽  
C. Murphy ◽  
I. Y. Yousif ◽  
...  
Keyword(s):  
Overall Survival ◽  
Proportional Hazards ◽  
Survival Rates ◽  
Breast Conserving Surgery ◽  
Cox Proportional Hazards ◽  
Disease Specific Survival ◽  
Total Mastectomy ◽  
Kaplan Meier ◽  
Disease Specific

519 Background: Carcinoma in situ (CIS) of the breast is a precancerous lesion with the potential to progress to invasive cancer. In 2003, CIS accounted for 19% of all newly diagnosed invasive and non-invasive breast lesions combined in the United States. Current treatment options are mastectomy ± tamoxifen, and breast-conserving surgery with radiotherapy ± tamoxifen. As there are no randomized comparisons of these 2 treatments, data from the Surveillance Epidemiology and End Results (SEER) database was used to compare their survival rates. Methods: 88,285 patients were identified with CIS from 1988 - 2003. Of these, 27,728 patients were treated with a total mastectomy, and 25,240 patients received breast-conserving surgery with radiotherapy. Kaplan-Meier survival analyses and Cox proportional hazards regression were used to compare overall survival and disease specific survival at 5 and 10 years. Results: Kaplan-Meier analyses demonstrated 5 year overall survival rates for total mastectomy vs. breast conserving surgery with radiotherapy of 95.46% vs. 97.59% respectively (Log-rank P < 0.0001). The 5 year rates for disease specific survival were 99.16% vs. 99.72% respectively (Log-rank P < 0.0001). At 10 years the overall survival rates had fallen to 91.96% vs. 96.09% respectively (Log-rank P < 0.0001). The 10 year disease specific survival rates were 98.61% vs. 99.50% respectively (Log-rank P < 0.0001). Cox proportional hazards regression demonstrated a relative risk of 0.847 (95% confidence interval (CI) 0.790 - 0.907) and 1.110 (95% CI 0.931 - 1.324) for 5 year overall survival and disease specific survival respectively, when total mastectomy was compared with breast conserving surgery and radiotherapy. At 10 years, the relative risks were 0.865 (95% CI 0.820 - 0.913) and 1.035 (95% CI 0.900 - 1.190) for overall survival and disease specific survival respectively. Conclusions: Overall, when looking at disease-specific survival rates by multi-variate analysis, there does not appear to be a significant difference between total mastectomy and breast-conserving surgery with radiotherapy in the treatment of CIS. No significant financial relationships to disclose.

scholarly journals Clinicopathologic characteristics and prognosis of upper tract urothelial carcinoma complicated with aristolochic acid nephropathy after radical nephroureterectomy

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hongli Shan ◽  
Wen Tian ◽  
Yazhao Hong ◽  
Bo Xu ◽  
Chunxi Wang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Aristolochic Acid ◽  
High Grade ◽  
Recurrence Free Survival ◽  
Disease Specific Survival ◽  
Radical Nephroureterectomy ◽  
Clinicopathologic Characteristics ◽  
Free Survival ◽  
Disease Specific

Abstract Background The purpose of this study was to identify the clinicopathologic characteristics and prognosis of upper tract urothelial carcinoma (UTUC) patients complicated with aristolochic acid nephropathy(AAN) after radical nephroureterectomy (RNU). Methods The clinical data of 42 UTUC patients with AAN (AAN group) and 238 UTUC patients without AAN (Non-AAN group) were retrospectively reviewed. All patients received a RNU with excision of bladder cuff. Demographic and clinical data, including preoperative indexes, intraoperative indexes and surgical outcomes were compared. Results There were no significant differences in age, tumor location, surgery approach, tumor pathologic grade, stage, the mean operative time and estimated blood loss between the two groups (all p > 0.05). There were more female patients in the AAN group (p < 0.001), and 57.1% were high grade tumors. The AAN group showed a higher complications rate (p = 0.003). The median follow-up time was 43.2 months. The AAN group showed a worse estimated 5-year overall survival rate (35.1% vs. 63.0%, p = 0.014), however, no significant difference was found between the two groups with regard to disease specific survival (63.5% vs. 81.5%, p = 0.091). Multivariate binary logistic regression analysis showed that AAN was an independent factor related with overall and disease specific survival. 38.9% of all patients experienced any types of recurrence, and the estimated 5-year recurrence-free survival rate was lower in the AAN group (37.1% vs. 63.7%, p = 0.001). In the comparison of subgroups stratified by recurrence type, the AAN group had a higher intravesical (p = 0.030) and contralateral recurrence rate (p = 0.040). Conclusion UTUC with AAN occurred more frequently in female patients who were more likely to develop high-grade tumors. However, these patients showed a worse overall survival and a lower recurrence-free survival rate than the other patients. AA-related UTUC might be associate with an increased risk of intravesical and contralateral recurrence after RUN.

scholarly journals VEGF overexpression predicts poor survival in hepatocellular carcinoma

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 430-439 ◽  
Author(s):  
Sae Byeol Choi ◽  
Hyung Joon Han ◽  
Wan Bae Kim ◽  
Tae Jin Song ◽  
Sang Yong Choi
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Surgical Resection ◽  
Immunohistochemical Staining ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Overall Survival Rate ◽  
Free Survival ◽  
Disease Free ◽  
Capsule Invasion

AbstractObjectiveThe aim of this study was to investigate the clinicopathological and immunohistochemical (including VEGF, Akt, HSP70, and HSP20 expression) factors that affect the overall and disease-free survival of HCC patients following surgical resection.Methods234 patients with HCC following surgical resection were enrolled. Clinicopathological and survival data were analyzed, and immunohistochemical staining was performed on tissue microarray sections using the anti-VEGF, anti-Akt, anti-HSP70, and anti-HSP27 antibodies.ResultsThe 3- and 5-year overall survival rates were 86.5 and 81.54%, respectively. Multivariate analysis revealed that VEGF expression (P = 0.017, HR = 2.573) and T stage (P < 0.001, HR = 4.953) were independent prognostic factors for overall survival. Immunohistochemical staining showed that the expression of Akt, HSP70, and HSP27 did not affect the overall survival rate. The 3- and 5-year disease-free survival rates were 58.2 and 49.4%, respectively. Compared to the VEGF(−)/(+) group, the VEGF(++)/(+++) group demonstrated significantly higher proportion of patients with AFP levels > 400 ng/mL, capsule invasion, and microvascular invasion.ConclusionVEGF overexpression was associated with capsule invasion, microvascular invasion, and a poor overall survival rate.

Long-Term Survival After Cisplatin-Based Induction Chemotherapy and Radiotherapy for Nasopharyngeal Carcinoma: A Pooled Data Analysis of Two Phase III Trials

2005 ◽  
Vol 23 (6) ◽  
pp. 1118-1124 ◽  
Author(s):  
Daniel T.T. Chua ◽  
Jun Ma ◽  
Jonathan S.T. Sham ◽  
Hai-Qiang Mai ◽  
Damon T.K. Choy ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Nasopharyngeal Carcinoma ◽  
Induction Chemotherapy ◽  
Phase Iii ◽  
Disease Specific Survival ◽  
Two Phase ◽  
Significant Difference ◽  
Disease Specific

Purpose To evaluate the long-term outcome in patients with nasopharyngeal carcinoma (NPC) treated with induction chemotherapy and radiotherapy (CRT) versus radiotherapy alone (RT). Patients and Methods The data from two phase III studies comparing CRT with RT in NPC were updated and pooled together for analysis. A total of 784 patients were included for analysis, with an equal number of patients in both arms. Induction chemotherapy consisted of two to three cycles of cisplatin, bleomycin, and fluorouracil, or cisplatin and epirubicin. RT was given to the nasopharynx and neck using megavoltage radiation (median dose, 70 Gy). The median follow-up time for surviving patients was 67 months. Analysis was based on intention to treat. Results The addition of induction chemotherapy to RT was associated with a decrease in relapse by 14.3% and cancer-related deaths by 12.9% at 5 years. The 5-year relapse-free survival rate was 50.9% and 42.7% in the CRT and RT arm, respectively (P = .014), and the 5-year disease-specific survival rate was 63.5% and 58.1% in the CRT and RT arm, respectively (P = .029). The 5-year overall survival rate was 61.9% and 58.1% in CRT and RT arm, respectively (P = .092). The incidence of locoregional failure and distant metastases was reduced by 18.3% and 13.3% at 5 years, respectively, with induction chemotherapy. There was no significant difference in the treatment failure patterns between the two arms. Conclusion The addition of cisplatin-based induction chemotherapy to RT was associated with a modest but significant decrease in relapse and improvement in disease-specific survival in advanced-stage NPC. However, there was no improvement in overall survival.

scholarly journals Aggressive surgical management of gallbladder cancer: Long-term results from a retrospective study of 315 Chinese patients

2018 ◽  
Author(s):  
Nengwen Ke ◽  
Yong Zeng
Keyword(s):  
Surgical Treatment ◽  
Survival Rate ◽  
Postoperative Complications ◽  
Mortality Rate ◽  
Gallbladder Cancer ◽  
Operative Mortality ◽  
Radical Surgery ◽  
Survival Rates ◽  
Radical Resection ◽  
Surgery Group

Objective: To investigate which is the best surgical treatment for the gallbladder cancer patient. Summary Background Data: Up to now, the aggressive surgery for advanced gallbladder cancer is controversial. In this study, we analyzed gallbladder cancer patients' data retrospectively and want to find out which is the best surgical treatment for the patient. Methods: From 2009 to 2013, 315 cases of gallbladder carcinoma were identified. Data were analyzed retrospectively. The review included analysis of survival rate, postoperative complications, operative mortality rate, and correlation between local extent of the primary tumor and frequency of nodal metastases. Results: Postoperative complications occurred in 15 (6.2%) patients. 3% of patients who underwent a radical surgery procedure had complications, but in extended radical surgery group, it was 9.8%. Operative mortality rate is 4.94%. No lymph node metastases were found in patients with T1 tumors. Nodal involvement in patients with T3 (55.22%) and T4 (82.50%) tumors was significantly higher than that in patients with T2 (44.12%) tumors. In stage I and II patients, radical resection group had a better survival rate than simple cholecystectomy. In stage III patients, extend radical surgery group and radical surgery group showed a better survival rates than others. In stage IV patients, extend radical surgery group showed 4% survival rate at 2 year, but other group was 0. Conclusions: Simple cholecystectomy may decrease the long survival rates in stage I and II patients. In more advanced stages, extended radical resection should be performed if the R0 resections could be achieved.

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