Treatment of brain metastases in patients with testicular cancer.

PURPOSE Despite improved cure rates for patients with metastatic testicular cancer with cisplatin-based combination chemotherapy, patients who develop brain metastases are generally considered to possess a poor prognosis. This report summarizes the long-term results in 44 patients with brain metastases from testicular cancer treated between 1978 and 1995 at Hannover University Medical School. PATIENTS AND METHODS Histologically, 42 patients (95%) had a nonseminomatous germ cell cancer and two patients (5%) a seminoma. Thirty-nine patients (89%) had lung metastases and 37 (84%) fulfilled the criteria for advanced disease according to the Indiana University classification even without considering the brain metastases. Eighteen patients (41%) presented with brain metastases at primary diagnosis (group 1), four (9%) developed brain metastases at relapse after a previous favorable response to combination chemotherapy (group 2), and 22 (50%) developed brain metastases during or directly after cisplatin-based chemotherapy. Chemotherapy consisted of cisplatin-based combination treatment and radiotherapy was given as whole-brain irradiation of 30 to 40 Gy and in single cases combined with a boost of 10 Gy to single lesions. RESULTS Overall, 10 patients achieved long-term survival (23%; 95% confidence interval [CI], 10.1% to 35.4%). The prognosis was significantly better for patients in groups 1 and 2, with six of 18 (33%) and three of four (75%) patients alive, compared with only one of 22 (5%) in group 3 (P < .01). Patients treated with either chemotherapy or radiotherapy alone did not achieve long-term survival, while nine of 28 (32%) who received treatment with both modalities with or without surgery achieved sustained long-term survival. During univariate analysis, patients with the diagnosis of brain metastases at first presentation (P < .01), patients with a single brain lesion (P < .02), and patients who received combined chemotherapy and radiotherapy (P < .03) had a significantly improved outcome. CONCLUSIONS Long-term survival can be achieved in approximately 25% of patients with brain metastases from testicular cancer by combined treatment with brain irradiation and aggressive cisplatin-based chemotherapy. Patients who develop brain metastases during systemic treatment should receive only palliative radiation therapy, since sustained survival will not be reached.

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An unusual response with long term survival using erlotinib in NSCLC lung with brain metastases

BMJ Case Reports ◽

10.1136/bcr-2015-213239 ◽

2016 ◽

pp. bcr2015213239 ◽

Cited By ~ 1

Author(s):

Madhup Rastogi ◽

Sambit Swarup Nanda ◽

Chandra Prakash ◽

Dinkar Kulshreshtha

Keyword(s):

Brain Metastases ◽

Term Survival ◽

Long Term Survival

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Long-term survival in a patient with brain metastases of papillary thyroid carcinoma

BMJ Case Reports ◽

10.1136/bcr-2015-213824 ◽

2016 ◽

pp. bcr2015213824

Author(s):

Daniela Guelho ◽

Cristina Ribeiro ◽

Miguel Melo ◽

Francisco Carrilho

Keyword(s):

Papillary Thyroid Carcinoma ◽

Thyroid Carcinoma ◽

Brain Metastases ◽

Papillary Thyroid ◽

Term Survival ◽

Long Term Survival

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Long-term survival in a patient with corticotroph pituitary carcinoma and brain metastases

Endocrine Abstracts ◽

10.1530/endoabs.73.aep547 ◽

2021 ◽

Author(s):

Izabella Czajka-Oraniec ◽

Maria Stelmachowska-Banas ◽

Arnika Szostek ◽

Agnieszka Baranowska-Bik ◽

Wojciech Zgliczynski

Keyword(s):

Brain Metastases ◽

Pituitary Carcinoma ◽

Term Survival ◽

Long Term Survival

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Long-term Survival of Stage IV Melanoma Patients Treated with BOLD Combination Chemotherapy and Intermediate-dose Subcutaneous Interferon-alpha

Anticancer Research ◽

10.21873/anticanres.12999 ◽

2018 ◽

Vol 38 (11) ◽

pp. 6393-6397 ◽

Cited By ~ 1

Author(s):

KALLE MATTILA ◽

PIRITA RAANTA ◽

VALTTERI LAHTELA ◽

SEPPO PYRHÖNEN ◽

ILKKA KOSKIVUO ◽

...

Keyword(s):

Interferon Alpha ◽

Combination Chemotherapy ◽

Stage Iv ◽

Term Survival ◽

Long Term Survival ◽

Melanoma Patients ◽

Stage Iv Melanoma ◽

Intermediate Dose

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A New Aortic Arch Dissection Classification: The Fuwai Classification

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.710281 ◽

2021 ◽

Vol 8 ◽

Author(s):

Juntao Qiu ◽

Xinjin Luo ◽

Jinlin Wu ◽

Wei Pan ◽

Qian Chang ◽

...

Keyword(s):

Carotid Artery ◽

Aortic Arch ◽

Survival Rates ◽

Innominate Artery ◽

Long Term Results ◽

Surgical Mortality ◽

Left Carotid Artery ◽

Term Survival ◽

Long Term Survival

Aims: We describe a new aortic arch dissection (AcD) classification, which we have called the Fuwai classification. We then compare the clinical characteristics and long-term prognoses of different classifications.Methods: All AcD patients who underwent surgical procedures at Fuwai Hospital from 2010 to 2015 were included in the study. AcD procedures are divided into three types: Fuwai type Cp, Ct, and Cd. Type Cp is defined as the innominate artery or combined with the left carotid artery involved. Type Cd is defined as the left subclavian artery or combined with the left carotid artery involved. All other AcD surgeries are defined as type Ct. The Chi-square test was adopted for the pairwise comparison among the three types. Kaplan-Meier was used for the analysis of long-term survival and survival free of reoperation.Results: In total, 1,063 AcD patients were enrolled from 2010 to 2015: 54 patients were type Cp, 832 were type Ct, and 177 were type Cd. The highest operation proportion of Cp, Ct and Cd were partial arch replacement, total arch replacement, and TEVAR. The surgical mortality in type Ct was higher compared to type Cd (Ct vs. Cd = 9.38 vs. 1.69%, p < 0.01) and type Cp (Ct vs. Cp = 9.38 vs. 1.85%, p = 0.06). There was no difference in surgical mortality of type Cp and Cd (p = 0.93). There were no significant differences in the long-term survival rates (p = 0.38) and free of aorta-related re-operations (p = 0.19).Conclusion: The Fuwai classification is used to distinguish different AcDs. Different AcDs have different surgical mortality and use different operation methods, but they have similar long-term results.

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Long-Term Survival After Stereotactic and Hypofractionated Radiation Therapy in Patients With Metastatic Melanoma Brain Metastases

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2017.06.750 ◽

2017 ◽

Vol 99 (2) ◽

pp. E67

Author(s):

D.L. Casey ◽

Y. Yamada ◽

T.A. Chan ◽

T.J. Yang ◽

J.D. Wolchok ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Metastases ◽

Metastatic Melanoma ◽

Term Survival ◽

Long Term Survival ◽

Melanoma Brain Metastases ◽

Hypofractionated Radiation Therapy ◽

Hypofractionated Radiation

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Long‐Term Survival and Risk of Institutionalization in Onco‐Geriatric Surgical Patients: Long‐Term Results of the PREOP Study

Journal of the American Geriatrics Society ◽

10.1111/jgs.16384 ◽

2020 ◽

Vol 68 (6) ◽

pp. 1235-1241

Author(s):

Monique G. Huisman ◽

Federico Ghignone ◽

Giampaolo Ugolini ◽

Grigory Sidorenkov ◽

Isacco Montroni ◽

...

Keyword(s):

Surgical Patients ◽

Long Term Results ◽

Term Survival ◽

Long Term Survival

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Evolving impact of long-term survival results on metastatic melanoma treatment

Journal for ImmunoTherapy of Cancer ◽

10.1136/jitc-2020-000948 ◽

2020 ◽

Vol 8 (2) ◽

pp. e000948 ◽

Cited By ~ 1

Author(s):

Olivier Michielin ◽

Michael B Atkins ◽

Henry B Koon ◽

Reinhard Dummer ◽

Paolo Antonio Ascierto

Keyword(s):

Targeted Therapies ◽

Survival Data ◽

Long Term Results ◽

Tumor Type ◽

Term Survival ◽

Long Term Survival ◽

The Past ◽

Number Of Patients ◽

Melanoma Treatment

Melanoma treatment has been revolutionized over the past decade. Long-term results with immuno-oncology (I-O) agents and targeted therapies are providing evidence of durable survival for a substantial number of patients. These results have prompted consideration of how best to define long-term benefit and cure. Now more than ever, oncologists should be aware of the long-term outcomes demonstrated with these newer agents and their relevance to treatment decision-making. As the first tumor type for which I-O agents were approved, melanoma has served as a model for other diseases. Accordingly, discussions regarding the value and impact of long-term survival data in patients with melanoma may be relevant in the future to other tumor types. Current findings indicate that, depending on the treatment, over 50% of patients with melanoma may gain durable survival benefit. The best survival outcomes are generally observed in patients with favorable prognostic factors, particularly normal baseline lactate dehydrogenase and/or a low volume of disease. Survival curves from melanoma clinical studies show a plateau at 3 to 4 years, suggesting that patients who are alive at the 3-year landmark (especially in cases in which treatment had been stopped) will likely experience prolonged cancer remission. Quality-of-life and mixture-cure modeling data, as well as metrics such as treatment-free survival, are helping to define the value of this long-term survival. In this review, we describe the current treatment landscape for melanoma and discuss the long-term survival data with immunotherapies and targeted therapies, discussing how to best evaluate the value of long-term survival. We propose that some patients might be considered functionally cured if they have responded to treatment and remained treatment-free for at least 2 years without disease progression. Finally, we consider that, while there have been major advances in the treatment of melanoma in the past decade, there remains a need to improve outcomes for the patients with melanoma who do not experience durable survival.

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