lymphadenectomy for liver tumors: A safe procedure in a tertiary center which improves the staging of the disease

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3622-3622
Author(s):  
M. Ravaioli ◽  
G. Ercolani ◽  
G. Grazi ◽  
M. Cescon ◽  
G. Varotti ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Liver Tumors ◽  
Wedge Resection ◽  
Colorectal Metastases ◽  
Safe Procedure ◽  
Regional Lymphadenectomy ◽  
Tertiary Center ◽  
Node Metastases ◽  
The Mean

3622 Background: the role of regional lymphadenectomy for liver metastases and primary liver tumors, but not extra-hepatic bile duct cancer, is debated. Methods: from April ’99 to December ’04, we prospectively evaluated 142 patients treated with liver resections and with the following pre-operative diagnosis: 63 (44.4%) colorectal metastases (M-CR), 48 (33.8%) hepatocellular carcinoma (HCC), 16 (11.3%) non-colorectal metastases (M-NCR) and 15 (10.6%) intra-hepatic cholangiocellular carcinoma (CCC). The regional lymphadenectomy of the hepato-duodenal ligament and of the common hepatic artery was performed in all cases. The incidence and the influence on survival of lymph node metastases were analyzed. Results: 42 “wedge” resection (29.6%), 55 segmentectomies (38.7%) and 45 major hepatectomies (31.7%) were performed. The mean operative time was 292±131 minutes and 96 cases (67.6%) had no blood transfusions during the procedures. Operative mortality (within 30 days) was 3.5%, 48 cases (33.8%) developed post-operative complications and the most common was ascites. The mean hospital stay was 9±5 days. The mean number of nodes (LN) removed were 6.5±5 (range 6–30) and 63 LN (6.5%) had micro-metastases. The incidence of lymph node metastases (LN+) according to the pre-operative diagnosis was: 15.9% M-CR, 4.2% HCC, 37.5% M-NCR and 40% CCC. The mean follow-up was 37.4±22.6 months, 107 patients (75.4%) are alive and 44 (31.7%) developed tumor recurrence, which was more frequent in LN+ (54.2% vs. 27%, p<0.05). The 1-and 3-years patient survival was significantly affected by lymph node metastases: 92% and 85% LN- vs. 79% and 64% LN+, p<0.05. Conclusions: the regional lymphadenectomy for liver tumors is a safe procedure in tertiary referred centers. The presence of lymph node metastases was an important prognostic factor, which should be evaluated to improve the treatment strategies. No significant financial relationships to disclose.

Cytoreductive radical prostatectomy (CRP) in patients with prostate cancer (PCA) and low-volume osseous metastases.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 272-272
Author(s):  
Axel Heidenreich ◽  
Andrea K. Thissen ◽  
Charlotte Piper ◽  
David J. K. P. Pfister ◽  
Daniel Porres
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
Radical Prostatectomy ◽  
Lymph Node Metastases ◽  
Adjuvant Radiation ◽  
Common View ◽  
Osseous Metastases ◽  
Node Metastases ◽  
The Mean ◽  
Low Volume

272 Background: Androgen deprivation (ADT) represents the standard treatment in men with prostate cancer (PCA) and osseous metastases. Unlike therapeutic approaches in other solid tumors, RP is usually ignored due to the common view that the biology of the disease is attributed to preexisting metastases. Recently, it has been shown that potentially lethal cancers persist even after neoadjuvant ADT and chemotherapy. We explored the outcome of patients with PCA and low volume skeletal metastases who were subjected to ADT and cytoreductive radical prostatectomy (CRP). Methods: Eighteen patients with biopsy proven, completely resectable PCA, minimal osseous metastases (equal to or less than three hot spots on bone scan), absence of visceral or extensive lymph node metastases were included in the pilot study. All patients (pts) underwent neoadjuvant ADT with luteinizing hormone-releasing hormone (LHRH) analogues for 6 months. If the PSA serum level decreased to less than 0.4 ng/ml and osseous lesions disappeared on control scan, pts were considered suitable for extended RP followed by 2 years adjuvant ADT. Results: Mean age was 61 (42 to 69), the mean PSA was 96.3 (72 to 139) ng/ml and 0.29 (0 to 0.39) ng/ml at recruitment and at 6 months, respectively. Mean number of bone lesions was 1.9 (1 to 3) and all lesions disappeared after 6 months of ADT. Pathohistology revealed pT2c in 4 (22.2%), pT3a and pT3b in 3 (16.7%) and 11 (61.11%) pts, respectively. Seven (38.9%) pts and three (16.7%) pts had lymph node metastases or positive surgical margins (PSM). PSM were treated with adjuvant radiation therapy ad 66.6Gy. No Clavien grade 3 to 5 complications occurred. The mean follow-up is 29 (3 to 52) months, three (16.7%) pts relapsed. The remainder is without evidence of disease. Conclusions: CRP is feasible in well selected men with low volume osseous metastases who respond well to neoadjuvant ADT. These men have a life expectancy of around 7 years and CRP reduces the risk of locally recurrent PCA and local complications. CRP might be a new treatment option in the multimodality management of PCA and minimal metastatic disease.

scholarly journals Volumetric assessment of lymph node metastases in patients with non-seminomatous germ cell tumors treated with chemotherapy

2015 ◽  
Vol 9 (5-6) ◽  
pp. 247 ◽  
Author(s):  
Carlos Basilio ◽  
Christian Villeda ◽  
Carolina Culebro ◽  
Francisco Rodríguez-Covarrubias ◽  
Ricardo Castillejos-Molina
Keyword(s):  
Lymph Node ◽  
Germ Cell ◽  
Lymph Node Metastases ◽  
Response Rate ◽  
Response Rates ◽  
Volumetric Analysis ◽  
Retroperitoneal Lymph Node ◽  
Residual Masses ◽  
Node Metastases ◽  
The Mean

Introduction: We evaluate volumetry and RECIST (Response Evaluation Criteria In Solid Tumors) as methodologies for response after chemotherapy for non-seminomatous germ cell tumour with retroperitoneal lymph node metastases.Methods: We performed a retrospective analysis of non-seminomatous testicular tumours and concurrent retroperitoneal lymph node metastases, which received chemotherapy and had computed tomography scans before and after treatment. Volumetric analysis and RECIST criteria were used to calculate response rates. We included a new category (favourable response) for patients with response rates between 70%. We calculated the correlation between volumetric and RECIST criteria with histological and clinical variables.Results: In total, 18 patients met the inclusion criteria. Histopathologic analysis of orchiectomy showed teratoma in 55.5% of patients, and those without teratoma had predominantly embryonal carcinoma. The mean baseline volume of retroperitoneal metastases was 447 cc, the mean post-chemotherapy volume was 33.6 cc, and the response rate was 62.6%. According to RECIST criteria, the mean baseline diameter was 4.93 cm, the mean post-chemotherapy diameter was 2.39 cm, and the response rate was 42.4%. Large post-chemotherapy residual masses correlated in both classifications with teratoma. The response rate was associated with the need for surgical treatment and the volumetric classification correlated with the need for lymphadenectomy.Conclusions: This study evaluated volumetry as a way to measure clinical response in lymph node metastases of non-seminomatous germ cell tumours. Volumetric analysis is the next step in the evaluation of response rate; its accuracy remains to be determined. Teratoma had greater residual masses and our classification correlated with the need for lymphadenectomy.

scholarly journals Feasibility and Safety of Laparoscopic Radical Colectomy for T4b Colon Cancer at a University Hospital in Vietnam

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Thinh H. Nguyen ◽  
Hung X. Tran ◽  
Truc T. Thai ◽  
Duc M. La ◽  
Huy D. Tran ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Lymph Node Metastases ◽  
Operating Time ◽  
University Hospital ◽  
Colon Cancers ◽  
Node Metastases ◽  
The Mean

Background. The choice of optimal treatment strategies for T4b colon cancers has still been discussed, particularly the initiation of neoadjuvant therapy or surgery. We conducted this study to evaluate the safety and feasibility of laparoscopic multivisceral resection for T4b colon cancers. Methods. We used the retrospective design to include all 43 patients with T4b colon cancer at a university hospital in Vietnam from March 2017 to March 2019. All patients were followed 30 days after the surgery, and information about the day of the first flatus, length of hospital stay, iatrogenic complications, postoperative morbidity, mortality, and adjuvant chemotherapy was collected. Results. The mean operating time was 187 minutes (ranging from 80 to 310), the mean blood loss was 64.3 ml (5-200), and the conversion rate was 2.3%. The mean number of lymph nodes harvested was 15.5 ( SD = 8.06 ), and 33 patients (76.7%) had at least 12 lymph nodes harvested. A total of 21 patients (48.8%) had lymph node metastases with a mean number of lymph node metastases of 1.89 ( SD = 3.4 ). The radial resection margin was R0 in all 43 patients (100%). The median time until the first flatus and hospital stay were 3 days (2–5) and 7.1 (6–11) days, respectively. There was no mortality at 30 days postoperatively, and one patient had iatrogenic complication (2.3%). Conclusion. Laparoscopic radical colectomy was feasible and safe for patients with T4b colon cancer except those requiring major and complicated reconstruction.

The Safety and Feasibility of Robotic-Assisted Lymph Node Staging in Early-Stage Ovarian Cancer

2014 ◽  
Vol 24 (8) ◽  
pp. 1493-1498 ◽  
Author(s):  
John V. Brown ◽  
Alberto A. Mendivil ◽  
Lisa N. Abaid ◽  
Mark A. Rettenmaier ◽  
John P. Micha ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Cancer Patients ◽  
Lymph Node Metastases ◽  
Early Stage ◽  
Lymph Node Staging ◽  
Robotic Assisted ◽  
Node Metastases ◽  
The Mean ◽  
Early Stage Ovarian Cancer

ObjectivesThe purpose of this study was to report on the safety and feasibility of robotic-assisted systematic lymph node staging in the management of early-stage ovarian cancer.MethodsWe retrospectively reviewed the charts of presumed early-stage (International Federation of Gynecology and Obstetrics (FIGO) stages I and II) ovarian cancer patients who underwent robotic-assisted surgery that incorporated a systematic pelvic and para-aortic lymphadenectomy from January 2009 until December 2013. Patient demographics, operative characteristics, pathology, lymph node counts, surgical complications, and hospital stay were evaluated.ResultsA total of 26 early-stage ovarian cancer patients were identified. The mean operating time was 2.90 hours, and the estimated blood loss was 63 mL; there were no intraoperative complications although 1 patient’s surgery was significantly prolonged due to pelvic adhesions. The mean number of pelvic and para-aortic lymph nodes removed was 14.6 (2.3% incidence of pelvic lymph node metastases) and 5.8 (3.3% incidence of para-aortic lymph node metastases), respectively. The patients’ mean duration of hospital stay was 18.4 hours, and 2 patients were readmitted for either a postoperative wound infection or vaginal dehiscence.ConclusionsThe results from this study suggest that robotic-assisted surgical staging in the management of presumed early-stage ovarian cancer is both feasible and associated with a minimal patient complication rate. We encountered a low incidence of lymph node metastases, and the readmission rate was favorable. Nevertheless, because the prevalence of lymph node metastases can approach 20% in select patients, physicians should consider a systematic lymph node resection to confer an optimal clinical assessment.

scholarly journals Improved cancer detection in Waldeyer’s tonsillar ring by 68Ga-FAPI PET/CT imaging

2020 ◽  
Author(s):  
S. Serfling ◽  
Y. Zhi ◽  
A. Schirbel ◽  
T. Lindner ◽  
T. Meyer ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Fdg Pet ◽  
Detection Rate ◽  
Cup Syndrome ◽  
Primary Tumors ◽  
Pet Ct ◽  
Node Metastases ◽  
The Mean ◽  
Fdg Pet Ct

Abstract Purpose In cancer of unknown primary (CUP), positron emission tomography/computed tomography (PET/CT) with the glucose analog [18F]FDG represents the standard imaging approach for localization of the malignant primary. Frequently, however, [18F]FDG PET/CT cannot precisely distinguish between small occult tumors and chronic inflammation, especially in Waldeyer’s tonsillar ring. To improve the accuracy for detecting primary tumors in the Waldeyer’s tonsillar ring, the novel PET tracer [68Ga]Ga-FAPI-4 for specific imaging of fibroblast activation protein (FAP) expression was used as a more specific target for cancer imaging. Methods Eight patients with suspicion of a malignant tumor in Waldeyer’s tonsillar ring or a CUP syndrome were examined. PET/CT scans with [18F]-FDG and [68Ga]Ga-FAPI-4 were performed for pre-operative tumor localization. After surgical resection, histopathological and immunohistochemical results were compared to PET/CT findings. Results Histopathology revealed a palatine or lingual tonsil carcinoma in all patients. In case of lymph node metastases smaller than 7 mm in size, the [18F]FDG PET/CT detection rate of cervical lymph node metastases was higher than that of [68Ga]FAPI PET/CT, while both tracers identified the primary tumors in all eight cases. The size of the primary and the lymph node metastases was directly correlated to the respective FAP expression, as detected by immunohistochemistry. The mean SUVmax for the primary tumors was 21.29 ± 7.97 for 18F-FDG and 16.06 ± 6.29 for 68Ga-FAPI, respectively (p = 0.2). The mean SUVmax for the healthy contralateral tonsils was 8.38 ± 2.45 for [18F]FDG and 3.55 ± 0.47 for [68Ga]FAPI (p < 0.001). The SUVmax ratio of [68Ga]FAPI was significantly different from [18F] FDG (p = 0.03). Mean TBRmax for the [68Ga]Ga-FAPI-4 tracer was markedly higher in comparison to [18F]FDG (10.90 vs. 4.11). Conclusion Non-invasive imaging of FAP expression by [68Ga]FAPI PET/CT resulted in a better visual detection of the malignant primary in CUP, as compared to [18F]FDG imaging. However, the detection rate of lymph node metastases was inferior, presumably due to low FAP expression in small metastases. Nevertheless, by offering a detection method for primary tumors with the potential of lower false positive rates and thus avoiding biopsies, patients with CUP syndrome may benefit from [68Ga]FAPI PET/CT imaging.

1321: Delineating Genetic Signatures of Lymph Node Metastases in Bladder Cancer Using Oligonucleotide Microarrays

2005 ◽  
Vol 173 (4S) ◽  
pp. 359-359
Author(s):  
Marta Sanchez-Carbayo ◽  
Lee Richstone ◽  
Nicholas Socci ◽  
Wentian Li ◽  
Nille Behrendt ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Oligonucleotide Microarrays ◽  
Node Metastases ◽  
Genetic Signatures
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