Variates of Survival in Metastatic Uveal Melanoma

2005 ◽  
Vol 23 (31) ◽  
pp. 8076-8080 ◽  
Author(s):  
Petra Rietschel ◽  
Katherine S. Panageas ◽  
Christine Hanlon ◽  
Ami Patel ◽  
David H. Abramson ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Initial Diagnosis ◽  
Screening Tests ◽  
Cancer Center ◽  
Common Site ◽  
Asymptomatic Patients ◽  
Diagnosis Date ◽  
Single Organ

Purpose The course and outcome of metastatic uveal melanoma are not well described. We evaluated the survival of our patients with metastatic uveal melanoma, described factors that correlated with survival, and evaluated the influence of screening tests on time of detection and survival. Patients and Methods All patients with metastatic uveal melanoma seen at Memorial Sloan-Kettering Cancer Center between 1994 and 2004 were identified from our database. We recorded date of initial diagnosis, date of metastatic disease, date of last follow-up, site of the first metastasis, how the first metastasis was discovered, treatment, and outcome of therapy. Results The estimated median survival of the 119 patients analyzed was 12.5 months; 22% of patients were alive at 4 years. Five variates correlated independently with prolonged survival: Lung/soft tissue as only site of first metastasis, treatment with surgery or intrahepatic therapy, female sex, age younger than 60, and a longer interval from initial diagnosis to metastatic disease. Discovering metastatic disease in asymptomatic patients did not correlate with overall survival; 89% of patients had a single organ as the site of first metastasis. Although liver was the most common site, 39.5% of patients had nonliver sites, most commonly lung, as the first site of metastasis. Conclusion A substantial subset of patients with metastatic uveal melanoma survive more than 4 years with metastatic disease. Data on variates of survival and site of first metastasis may guide strategies for screening patients, although our data failed to show a survival advantage in discovering asymptomatic metastatic disease.

Long-term survival after distant metastasis in oropharyngeal carcinoma.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5594-5594
Author(s):  
Sean M McBride ◽  
Paul M. Busse ◽  
John Ross Clark ◽  
Ron J. Parambi ◽  
Lori J. Wirth ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Distant Metastasis ◽  
Cox Regression ◽  
Massachusetts General Hospital ◽  
Initial Diagnosis ◽  
Oropharyngeal Carcinoma ◽  
Term Survival ◽  
Hpv Status ◽  
Single Organ

5594 Background: The possibility of cure after distant metastases (DM) in oropharyngeal carcinoma (OPC) is uncertain. We conducted a retrospective cohort study to determine outcome and factors predictive of survival after metastasis in patients with OPC. Methods: From 2003-2010, 24 patients definitively treated (96% with concurrent chemo-radiation) at the Massachusetts General Hospital for OPC subsequently developed DM. At initial diagnosis, HPV status was available in 13 patients, 12 of whom were positive; six patients had T4 and 12 N2c-3 disease. Imaging studies pertinent to the diagnosis of DM were re-reviewed; 83% of patients had DM pathologically confirmed. Overall survival (OS) was defined from 1st radiographic evidence of DM to either death or last follow-up. Cox regression was used to evaluate factors predictive of OS after DM. Results: Median time to DM after initial treatment was 8.25 months (range, 1.6-24). Twenty (83%) patients had isolated distant failure; of these, 6 had limited (1 lesion or 2 adjacent lesions) single-organ disease. Eighteen (75%) had treatment after DM (83% had chemotherapy, 61% radiation, and 33% surgery). Median survival after distant metastasis was 19.2 months. Median follow-up for survivors was 23.5 months (range, 7.9-60.3). In multivariate analysis, limited single-organ disease (HR=0.14, p=0.01, 95% CI 0.031, 0.67) was predictive of improved survival after DM; T4 disease at initial diagnosis predicted for decreased OS after DM (HR=3.9, p=0.01, 95% CI 1.31, 11.89). For patients with limited single-organ disease, the 2-year OS was 82% compared to 32% with extensive metastases (p = 0.006). Of the 6 patients with limited, single-organ metastatic disease, two remained alive at 59.4 and 60.5 months without evidence of disease; both had HPV-positive tumors. One patient had a solitary hepatic failure and received neoadjuvant chemotherapy followed by partial hepatectomy; the other had a solitary lung metastasis and received wedge resection followed by radiation. Conclusions: Limited, single-organ metastatic disease predicts improved survival after DM in OPC. Cure is possible in this group. Patients with limited, single-organ distant disease should be considered for aggressive, local salvage treatment.

scholarly journals 66. CLINICAL CHARACTERISTICS AND RESULTS OF PEDIATRIC SOLID TUMORS WITH BRAIN METASTASES: EXPERIENCE FROM A SINGLE REFERRAL CANCER CENTER

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii14-ii14
Author(s):  
Clarissa Aguilar ◽  
Víctor Toro ◽  
Rina Medina
Keyword(s):  
Brain Metastases ◽  
Childhood Cancer ◽  
Solid Tumors ◽  
Metastatic Disease ◽  
Cancer Center ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pediatric Solid Tumors ◽  
Low Middle Income Countries

Abstract BACKGROUND 80% of childhood cancer are located in low- and middle-income countries (LMIC). The most common form of presentation is disseminated or metastatic disease. The rate of survival has not been equitable across the world, since in these countries only 1 of 5 children are cured. OBJECTIVE To evaluate the clinical and histopathological features of patients with metastatic pediatric solid tumors, in a single referral cancer center in Honduras. METHODS We conducted a retrospective review of patients diagnosed with pediatric solid tumors from January 2010 to April 2020. Among the 260 patients through a collection form, we obtained: sociodemographic characteristics, clinical presentation at diagnosis, common histological subtypes, sites of metastasis, treatment and outcome at the time of follow-up. RESULTS During the last 10 years, 260 cases of childhood cancer were referred to our center for treatment. 127 patients (48.8%), have a solid tumor, patients ranged in age from 1 to 18 years and distribution for sex were 38% for males and 62% females. At the time of initial diagnosis 40/127 (31%) have advanced disease (stages III and IV). We found brain metastases in 22/40 cases (55%), the primary cancer was localized at CNS in 13/22 (59%) and the most common extracranial tumors causing brain metastases were neuroblastoma (4/22), rhabdomyosarcoma (3/22), retinoblastoma (2/22). Currently in the follow-up there were 18/22 (82%) died and 4/22 (18%) are in treatment with palliative intent. CONCLUSION There is a lack of information about the epidemiology of brain metastases among children with solid tumors in the low/middle income countries (LMIC) where the prognosis of metastatic disease is very poor, despite efforts, multimodal therapy and multidisciplinary management, in absence of other options like bone marrow transplantation, and reliable access to high-quality medicines. For our countries, timely diagnosis is still the main determining factor for cure.

scholarly journals Immunoexpression of Macroh2a in Uveal Melanoma

2019 ◽  
Vol 9 (16) ◽  
pp. 3244 ◽  
Author(s):  
Salvatorelli ◽  
Puzzo ◽  
Bartoloni ◽  
Palmucci ◽  
Longo ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Cutaneous Melanoma ◽  
High Expression ◽  
Melanoma Metastasis ◽  
Proper Treatment ◽  
Immunohistochemical Expression ◽  
Prognostic Role

MacroH2A is a histone variant whose expression has been studied in several neoplasms, including cutaneous melanomas (CMs). In the literature, it has been demonstrated that macroH2A.1 levels gradually decrease during CM progression, and a high expression of macroH2A.1 in CM cells relates to a better prognosis. Although both uveal and cutaneous melanomas arise from melanocytes, uveal melanoma (UM) is biologically and genetically distinct from the more common cutaneous melanoma. Metastasis to the liver is a frequent occurrence in UM, and about 40%–50% of patients die of metastatic disease, even with early diagnosis, proper treatment, and close follow-up. We wanted to investigate macroH2A.1 immunohistochemical expression in UM. Our results demonstrated that mH2A.1 expression was higher in metastatic UM (21/23, 91.4%), while only 18/32 (56.3%). UMs without metastases showed mH2A.1 staining. These data could suggest a possible prognostic role for mH2A.1 and could form a basis for developing new pharmacological strategies for UM treatment.

scholarly journals Expression of the Metastasis Suppressor KAI1 in Uveal Melanoma

2013 ◽  
Vol 2013 ◽  
pp. 1-4
Author(s):  
Shawn C. Maloney ◽  
Bruno F. Fernandes ◽  
Rafaella Cleto Penteado ◽  
Emilia Antecka ◽  
Vasco Bravo-Filho ◽  
...  
Keyword(s):  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Staining Intensity ◽  
Suppressor Gene ◽  
Metastasis Suppressor ◽  
Efficacious Treatment ◽  
Therapeutic Value ◽  
Group 2 ◽  
Group 1

Introduction. Uveal melanoma (UM) is an intraocular tumor that leads to metastatic disease in approximately 50% of afflicted patients. There is no efficacious treatment for metastatic disease in this cancer. Identification of markers that can offer prognostic and therapeutic value is a major focus in this field at present. KAI1 is a metastasis suppressor gene that has been reported to play a role in various human malignancies, although it has not previously been evaluated in UM.Purpose. To investigate the expression of KAI1 in UM and its potential value as a prognostic marker.Materials and Methods. 18 cases of human primary UM were collected and immunostained for KAI1 expression. A pathologist evaluated staining intensity and distribution semiquantitatively. Each case was categorized as group 1 (low staining) or group 2 (high staining).Results. In group 2, two of the 12 cases presented with metastasis. Conversely, in group 1, five out of 6 cases had metastasis. The mean follow-up of patients who did not develop metastasis was 81.81 months (median: 75 months) versus 42.14 months (median: 44 months) for patients with metastasis.Conclusions. KAI1 is a promising candidate marker that may offer prognostic value in UM; it may also represent a therapeutic target in metastatic disease.

Prevalence of recurrent thrombosis in cancer patients with isolated gonadal vein thrombosis: A retrospective study.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19645-e19645
Author(s):  
Suebpong Tanasanvimon ◽  
Naveen Garg ◽  
Chitra Viswanathan ◽  
Milind M. Javle ◽  
Mylene Truong ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Metastatic Disease ◽  
Vena Cava ◽  
Cancer Center ◽  
Vein Thrombosis ◽  
Gonadal Vein ◽  
Radiology Reports ◽  
Recurrent Vte ◽  
Active Cancer

e19645 Background: The natural history of isolated gonadal vein thrombosis (GVT) occurring in cancer patients (pts) is not well described in the medical literature. GVT in cancer pts it is of uncertain clinical significance. Methods: Utilizing a software program allowing a searchable database of radiology reports, the computerized tomographic scan (CT) reports of pts at a single cancer center from January 1, 2004 to June 30, 2011, were searched for the term “gonadal vein thrombus”. Pts included in this analysis had a diagnosis of cancer, isolated GVT (i.e. no evidence of thrombosis at another site), and at least six months of follow-up information. Results: 162 cancer pts with GVT were identified for analysis [median age 57.8 ± 12 years, right GVT 89 pts (54.9%), left GVT 59 pts (36.4%), bilateral 14 pts (8.6%)]; the majority of the pts (96, 59.3%) had a non-gynecologic malignancy. At the time of diagnosis of GVT the majority of pts were receiving chemotherapy (84, 51.9%); 70 pts (43.2%) had surgery within the prior six months (the most common being hysterectomy, 127 pts, 78.6%). The majority of pts in this study had metastatic disease (93, 57.4%) as well as active cancer (138, 85.1%, defined as GVT occurring at the time of cancer diagnosis, disease recurrence, metastatic disease, or treatment for cancer within the prior six months); median follow-up time was 22 months. A minority of pts received anticoagulation (28pts, 17.2%). Twenty-two pts (13.6%) developed a recurrent venous thromboembolic event (VTE); these events were pulmonary embolism (12 pts, 7.4%), deep venous thrombosis (5 pts, 3.1%), inferior vena cava thrombosis (4 pts, 2.5%). Median time to development of re-thrombosis was 7 months (range 2-13.5 months). Active cancer was the only risk factor significantly associated with recurrent VTE (p = 0.047); pts with prior hysterectomy had a significantly reduced risk of recurrent VTE (p = 0.036). Conclusions: Incidental isolated GVT identified in cancer pts has a high risk of recurrent VTE (13.6%). Based upon specific pts risk factors for VTE, treatment of an incidentally detected GVT in cancer pts with anticoagulation, as per guidelines for other VTE sites, may be indicated.

scholarly journals Patterns of metastasis in follicular thyroid carcinoma and the difference between early and delayed presentation

2017 ◽  
Vol 99 (2) ◽  
pp. 151-154 ◽  
Author(s):  
R Parameswaran ◽  
J Shulin Hu ◽  
N Min En ◽  
WB Tan ◽  
NK Yuan
Keyword(s):  
Metastatic Disease ◽  
Thyroid Surgery ◽  
Survival Data ◽  
External Beam Radiotherapy ◽  
Good Prognosis ◽  
Delayed Presentation ◽  
Common Site ◽  
Significant Difference ◽  
The Difference

Introduction Follicular thyroid cancer (FTC) has a good prognosis if treated early. The aim of this study was to look at the difference in outcomes in those who presented with metastasis early or late in their disease. Methods A retrospective cohort study was conducted of patients diagnosed with FTC (n=91) treated between 2000 and 2013. Demographic, laboratory, pathological and survival data were collected and analysed. Results Metastatic FTC was diagnosed in 20 cases (22%). The median age at diagnosis was 65 years (range: 17–86 years) and 65% of the patients were female. Twelve patients (60%) were diagnosed with metastatic disease at presentation, with the bones being the most common site (75%). In the remaining eight cases (40%), metastasis developed at a median of 4.5 years (range: 2–8 years) after initial thyroid surgery, lungs being the most common site (50%). Eighteen patients (90%) underwent surgical intervention for the primary disease. Sixteen patients (80%) received adjuvant radioactive iodine and eight (40%) received external beam radiotherapy. Widely invasive follicular cancer was the predominant histological diagnosis (90%). No prognostic association was observed with any of the parameters studied. The overall disease specific mortality rate was 40%. There was no significant difference in mortality between those who presented with metastatic disease and those who developed metastasis during the follow-up period (33% vs 50%, p=0.61). Conclusions The clinical outcome and prognosis for cases with metastatic disease is generally poor. Despite this, almost half of the patients in our study were still alive at a median follow-up of 5.5 years, regardless of whether they were diagnosed with metastatic disease on initial presentation or whether they developed metastasis after initial thyroid surgery.

Disparities in COVID-19 severity and risk of death in cancer patients: Experiences from a U.K. cancer center.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 285-285
Author(s):  
Beth Russell ◽  
Charlotte L Moss ◽  
Sophie Papa ◽  
Harriet Wylie ◽  
Anna Haire ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Severe Disease ◽  
Ethnic Disparities ◽  
Cox Proportional Hazards ◽  
Initial Diagnosis ◽  
Cancer Center ◽  
Asian Ethnicity ◽  
Risk Of Death ◽  
Diagnosis Of Cancer

285 Background: There has been widespread evidence emerging regarding disparities between COVID-19 outcomes in patients of varying ethnicities and background. It is, however, unclear how various patient characteristics affect COVID-19 severity and risk of death in a cancer population. Methods: Our Cancer Centre was at the epicentre of the COVID-19 outbreak in the UK. A total of 156 cancer patients had a confirmed COVID-19 diagnosis between the 29th of February through the 12th of May 2020. Logistic/Cox proportional hazards models were used to identify which demographic and/or clinical characteristics were associated with COVID-19 severity/death. The regression models were defined through a directed acyclic graph (DAG) to decide upon the minimal adjustments required for each statistical model. Results: Of the 156 COVID-19 positive cancer patients, the most frequently reported tumour types were urological/gynaecological (29%), followed by haematological (18%) and breast (15%). 128 (82%) presented with mild/moderate COVID-19 and 28 (18%) with severe disease. Initial diagnosis of cancer >24m before COVID-19 (OR:1.74 (95%CI: 0.71-4.26)), presenting with fever (6.21 (1.76-21.99)), dyspnoea (2.60 (1.00-6.76)), gastro-intestinal symptoms (7.38 (2.71-20.16)), or higher levels of CRP (9.43 (0.73-121.12)) were linked with greater COVID-19 severity. During median follow-up of 37 days, 34 patients had died of COVID-19 (22%). Asian ethnicity (3.73 (1.28-10.91), palliative treatment (5.74 (1.15-28.79), initial diagnosis of cancer >24m before (2.14 (1.04-4.44), dyspnoea (4.94 (1.99-12.25), and increased CRP levels (10.35 (1.05-52.21)) were positively associated with COVID-19 death. Socioeconomic status (SES) was not found to be associated with either COVID-19 severity or risk of death. We will present updated data with more mature follow-up. Conclusions: In cancer patients, Asian ethnicity was found to be positively associated with COVID-19 death compared to Caucasian patients. However, SES was not associated with COVID-19 severity or risk of death thereby implying this was not due to poor access to healthcare. Future studies hence need to identify the underlying biological and/or societal reasons explaining these ethnic disparities in COVID-19 outcomes for cancer patients.

Patterns of Relapse and Value of Follow up Procedures in Patients with Diffuse Large B Cell Lymphoma (DLBCL) Who Achieve a Complete Remission (CR)

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5306-5306
Author(s):  
Yasuhiro Oki ◽  
Dai Chihara ◽  
Yoshitoyo Kagami ◽  
Shouji Ine ◽  
Harumi Kato ◽  
...  
Keyword(s):  
Ct Scan ◽  
Median Time ◽  
Optimal Schedule ◽  
Elevated Serum ◽  
B Cell Lymphoma ◽  
Initial Diagnosis ◽  
Ct Scans ◽  
Imaging Studies ◽  
Asymptomatic Patients

Abstract Purpose: Optimal follow up schedule and choice of diagnostic modalities have not been well studied in patients with DLBCL who achieve CR after initial treatment. We analyzed patterns of relapse in patients with DLBCL who were treated with CHOP±R therapy and achieved CR in our institution between 1999 and 2007. We generally follow such patients with physical exam and blood tests including LDH every 3 months and CT scans every 3 to 6 months for the first two years. Follow up schedule varied afterwards. Patients and methods: Thirty-eight patients experienced relapse, in whom we first determined if relapse was detected by symptoms which prompted diagnostic processes such as imaging studies and/or biopsy or by prescheduled follow up blood test or systemic CT scans. Other characteristics of these patients including time from diagnosis to relapse, time from last systemic CT scan that showed no evidence of disease to relapse, and time from relapse to death were analyzed. Results: Twenty-seven patients (71%) presented with symptoms (“symptomatic patients”); 12 with palpable superficial masses, 5 with local pain, 5 with neurological symptoms due to central nervous system (CNS) involvement, 2 with persistent fever, 1 with gastrointestinal bleed, 1 with nasal congestion and 1 with persistent cough. Eleven patients (29%) were asymptomatic when relapse was detected (“asymptomatic patients”). Two showed elevated serum LDH levels which prompted imaging studies leading to the diagnoses. Nine were found to have relapsed diseases by prescheduled systemic CT scans. Among 27 symptomatic patients, 7 (18% of all relapses) had diseases that were not detectable by CT scans (5 isolated CNS relapses, 1 GI relapse, and 1 subcutaneous relapse in upper extremity). Patient characteristics at the time of initial diagnosis were similar in the two groups. Median time from initial diagnosis to relapse in symptomatic and asymptomatic patients were 11.9 months (range 3.8–98.1) and 12.5 months (range 7.2–50.7), respectively (p=0.635). Median time from last systemic CT scan to relapse were 2.9 months (range 0.1–33.0) and 5.2 months (range 1.9–10.8), respectively (p=0.895). Time from relapse to death of any cause were similar in the 2 groups (log-rank p=0.423) but the median time was longer in asymptomatic patients (16.6 months vs 39.8 months). Since late relapses potentially tend to be detected by symptoms due to infrequent CT scans, analyses were next limited only to those who relapsed within 2 years after diagnosis. The results were similar between symptomatic and asymptomatic group. Conclusions: This study showed that more than two thirds of patients were symptomatic at the time of relapse. And up to 18% of relapsed diseases were undetectable by routine CT scans. Half of “symptomatic” patients noticed their symptoms less than three months after last CT scan, suggesting that even every 3 months CT would miss these relapses before patients were symptomatic. Longer median survival (though the overall difference was not significant) in “asymptomatic patient” could be attributed in part to “early detection of relapse and intervention” but in contrast, asymptomatic patients might have had less aggressive diseases allowing prescheduled CT scans to detect the diseases before they are symptomatic. Important question is whether delaying detection of relapse and treatment till patient is symptomatic would be associated with worse clinical outcome. This question is also translated into whether routine CT scan is even necessary, and if so, what is the optimal schedule of imaging studies. Answers to these questions may depend on the estimated risk of relapse based on various prognostic factors. Larger scale studies are needed in this area.

Single-center experience of PD1 inhibition in metastatic uveal melanoma.

2017 ◽  
Vol 35 (7_suppl) ◽  
pp. 87-87
Author(s):  
Tan Xu ◽  
Jung Min Song ◽  
Michael J. McNamara ◽  
Brian Gastman ◽  
Arun D Singh ◽  
...  
Keyword(s):  
Overall Survival ◽  
Median Time ◽  
Median Survival ◽  
Uveal Melanoma ◽  
Metastatic Disease ◽  
Median Overall Survival ◽  
Initial Diagnosis ◽  
Response To Therapy ◽  
Single Center ◽  
Single Center Experience

87 Background: Metastatic uveal melanoma (MUM) is a rare histology with poor prognosis. Therapies used in cutaneous melanoma with success have limited to no efficacy in uveal melanoma. Limited data exists regarding the efficacy of PD-1 inhibition in this disease. Methods: Patients carrying a diagnosis of MUM that had been treated with any PD1 inhibitor at the Cleveland Clinic were analyzed. Median overall survival from the diagnosis of metastatic disease and from the start of PD-1 inhibition were calculated. RECIST 1.1 criteria were used to assess response to therapy. Results: 10 patients with MUM have been treated with a PD1 inhibitor. Mean age at initiation of PD1 inhibition was 74. Five (50%) were female. Median time from initial diagnosis to metastatic disease was 67 months (range, 5-204). All 6 patients with a genetic profiling result available were classified as poor risk either by cytogenetics or gene expression profiling. Median overall survival from diagnosis of metastatic disease was 24 months (range, 9-46). Six patients had also been treated with ipilimumab, 4 had prior treatment, 1 had PD-1 prior to ipilimumab, and one had concurrent treatment with combination ipilimumab/nivolumab. Adjunct local radiation occurred in 6 patients: 5 of the liver (4 embolization, 1 SBRT), one of osseous metastases. Median time on PD1 treatment was 2 months (range, 1-6). Two patients had SD, 6 PD, 3 have not yet been reevaluated. Median survival from initiation of PD1 inhibition was 9 months (range, 7-12). Adverse events were as expected from published experiences with PD-1 inhibition. All patients with median survival from initial diagnosis of metastatic disease over one year received both PD-1 and CTLA-4 inhibition as well as radiation. Conclusions: In this single center experience, no patients had tumor response to PD-1 inhibition. Combination therapies may be worth exploring in the treatment of MUM.

The use of CA15.3 in breast cancer: A single institution experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21017-21017
Author(s):  
R. Sheikh ◽  
A. T. Behbehani ◽  
M. Peader ◽  
J. McCaffrey
Keyword(s):  
Breast Cancer ◽  
Metastatic Disease ◽  
Disease Recurrence ◽  
Prognostic Information ◽  
Chemotherapeutic Regimen ◽  
Transmembrane Glycoprotein ◽  
Asymptomatic Patients ◽  
Metastatic Setting ◽  
Group B

21017 Background: Breast cancer is a significant cause of morbidity and mortality worldwide. Recent advanced its treatment are promising. Gathering prognostic information may optimise treatment delivery. In addition to clinical parameters, the use of tumour markers may aid this process. CA 15.3, is a transmembrane glycoprotein.. Its clinical application varies from detecting disease recurrence in asymptomatic patients, assessing response in metastatic setting and monitoring the clinical course of the disease. Methods: A retrospective analysis was conducted evaluating medical record data of all the patients treated for breast cancer in our institution between 1999- 2005. CA15.3 was carried out using Roche 2010 (Elecsys system). Results: A total of 176 patients were identified. Table (1) Group A, one hundred patients remained disease free at follows up (58%). 95 patients had their CA15.3 within normal range, a diagnostic specificity of 95%. Group B, 61 patients developed metastatic/recurrent disease at follow up. 39 patients (64%) developed metastatic disease later. Group C, 15 patients had metastatic disease at diagnosis. We found that CA15.3 has a sensitivity value of 64% and a specificity of 95% in our institution.. This correlates well with ASCO review 67% and 92% respectively. In patients with no evidence of metastatic disease at diagnosis, a postive CA15.3 during follow up is strongly suggestive of disease recurrence. Giving a positive predictive value of 89%. In Two patients (5%) CA15.3 was the first predictor of recurrence. Radiology was the first indicator of recurrence in six cases (15%), while both radiological and serological correlation was noted in 31 patients (80%). Conclusions: We found CA15.3 a reliable marker in assessing response for therapy. In clinical practice, raised CA15.3 can be incorporated in decision making to change current chemotherapeutic regimen whenever there is a delay in obtaining prompt radiological evaluation. [Table: see text] No significant financial relationships to disclose.

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