Osteosarcoma pulmonary metastasis: Prognostic factors of 88 patients submitted to surgical resection

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20502-20502
Author(s):  
F. A. Schutz ◽  
R. N. Younes ◽  
J. A. Borges ◽  
J. L. Gross
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Pulmonary Metastasis ◽  
Primary Tumor ◽  
Cox Regression ◽  
Complete Resection ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

20502 Background: Pulmonary metastasis from Osteosarcoma occurs in 30% to 40% of cases. Chemotherapy and surgical resection are the current preferred options for these patients, although overall outcome remains poor, with few patients achieving long term overall survival. Prognostic factors for better selecting these patients are needed. Methods: We reviewed the survival and the prognostic factors from 88 consecutive patients with pulmonary metastasis from osteosarcoma, submitted to metastasectomy at a single institution. Clinical and demographic variables, related to the primary tumor as well as to the pulmonary metastases and treatment procedures were registered. Univariate ( Log-rank and Breslow tests) and multivariate analysis (Cox-regression) were performed to identify significant prognostic factors related to overall survival. Results: Median follow-up time was 34 months, and 12.5% were alive without disease, 14.8% were alive with disease, 58% were dead of disease, 1,1% were dead from other causes, and 14.8% were lost to follow-up. The overall 5- year survival was 19%. Disease free interval (DFI), number of thoracotomies and complete resection at last thoracotomy were significant prognostic factors at univariate analysis. Median survival from first thoracotomy for patients with DFI = 12 months was 24.6 months, compared to 9.6 months for DFI < 12 months (p= 0.0014). Complete resection at last thoracotomy significantly improved median overall survival (19.1 versus 9.6 months) (p=0.0117). Cox-regression analysis showed only disease free interval more than 12 months (p=0.014) and complete resection at last thoracotomy (p=0.003) to be independent significant prognostic factors. Sex, age, site and stage of primary tumor, number of lung nodules, bilateral nodules, and chemotherapy treatment for lung metastases did not significantly impact on survival. Conclusion: Disease free interval and complete resection at last thoracotomy are significant prognostic factors for patients with resected pulmonary metastasis from osteosarcoma. No significant financial relationships to disclose.

scholarly journals The Significance of Metastasectomy in Patients with Metastatic Renal Cell Carcinoma in the Era of Targeted Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaoteng Yu ◽  
Bing Wang ◽  
Xuesong Li ◽  
Gang Lin ◽  
Cuijian Zhang ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Targeted Therapy ◽  
Renal Cell ◽  
Complete Resection ◽  
Disease Free Interval ◽  
Free Interval ◽  
Metastatic Sites ◽  
Disease Free

Objective. To investigate the efficacy of surgery in the treatment of metastatic renal cell carcinoma (mRCC) and to identify prognostic factors. Methods. A single center retrospective study of 96 patients with mRCC from December 2004 to August 2013. Results. The median follow-up time was 45 months. Thirty-one (32.3%) of the patients received complete resection of metastatic sites, 11 (11.5%) of the patients underwent incomplete resection of metastatic sites, and 54 (56.3%) of the patients received no surgery. In the univariate Kaplan-Meier analysis, the median overall survival times of the three groups were 52 months, 16 months, and 22 months, respectively (p<0.001). The difference in the overall survival time was statistically significant between complete resection and no surgery groups (HR = 0.43, p=0.009), while there was no significant difference between the incomplete metastasectomy and no surgery groups (HR = 1.80, p=0.102). According to the multivariate Cox regression analysis, complete metastasectomy (HR = 0.49, p=0.033), T stage > 3 (HR = 1.88, p=0.015), disease free interval <12 months (HR = 2.34, p=0.003), and multiorgan involvement (HR = 2.00, p=0.011) were significant prognostic factors. Conclusion. In the era of targeted therapy, complete metastasectomy can improve overall survival. Complete metastasectomy, T stage > 3, disease free interval <12 months, and multiorgan involvement are independent prognostic factors.

Expression of A9 Antigen and Loss of Blood Group Antigens as Determinants of Survival in Patients with Head and Neck Squamous Carcinoma

1987 ◽  
Vol 96 (3) ◽  
pp. 221-230 ◽  
Author(s):  
Thomas E. Carey ◽  
Gregory T. Wolf ◽  
S. Hsu ◽  
J. Poore ◽  
K. Peterson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Blood Group ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Primary Tumor Site ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

The murine monoclonal antibody (A9), raised to the human squamous cell carcinoma (SCC) cell-line UM-SCC-1, defines a squamous cell antigen associated with aggressive biologic behavior of SCC cell lines in vivo and in vitro. In the present investigation, A9 antigen was detected in tissue sections from 37 consecutive, previously untreated patients with SCC of the head and nack. All tumors were positive for A9 binding, although three distinct patterns (reflecting different intensities of A9 expression) were identified. The intensity of A9 expression was independent of primary tumor site, tumor differentiation, keratinization, or growth pattern. The frequency of high expression (Pattern 1) grew with increasing T class, N class, and tumor stage, and was associated with loss of blood group expression in the tumor and with low levels of lymphocyte infiltration In the tumor. Strong A9 expression had a statistically signification association with low nuclear grade (i.e., tumors with more mature and fewer enlarged nuclei, P = 0.019), low vascular/stromal response (i.e., patchy response rather than continuous, P = 0.014), and impaired in vitro lymphokine production by peripheral blood leukocytes ( P = 0.0011). Of greatest interest, however, was the strong association of high A9 expression with shortened disease-free interval (DFI) ( P = 0.085) and survival ( P = 0.081) relative to patients with weak A9 tumor staining (Patterns 2 and 3). Similarly, the loss of blood group antigen expression was strongly associated with decreased DFI ( P = 0.038) and survival ( P = 0.062). While neither Pattern 1 A 9 expression nor loss of blood group reach statistical significance in prediction of survival, the combination of Pattern 1 A 9 expression and loss of blood group expression in primary tumors was significantly associated, both with decreased disease-free interval ( P = 0.017) and with decreased overall survival ( P = 0.011) (median length of follow-up = 22 months). The length of follow-up (LFU) ranged from 2 to 38 months, with a median LFU of 22 months. While the number of patients (37) is small, the significant association between the expression of these cell-surface markers with relapse and survival indicates that immunohistologic staining of the primary tumor will be an important prognostic indicator useful in identification of individual patients at greatest risk of recurrence or early death from head and neck cancer, independent of tumor size, site, or stage at presentation. These markers may thus provide means of selecting patients who should receive adjuvant therapy and more intensive monitoring for the early detection of recurrent disease.

Prognostic factors for colorectal cancer patients with pulmonary metastases

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15107-e15107
Author(s):  
W. Li ◽  
W. Zhang ◽  
S. Cai ◽  
J. Yin ◽  
J. Li
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Primary Tumor ◽  
Pulmonary Metastases ◽  
Good Survival ◽  
Primary Tumor Site ◽  
Disease Free Interval ◽  
Metastatic Site ◽  
Free Interval ◽  
Disease Free

e15107 Background: Pulmonary is the second common metastastic site of CRC with a good survival after metastasectomy, however the general situation of pulmonary metastases from CRC has received little attention, especially for unresectable ones. The aim of this study was to determine factors that may influence survival and disease free interval from primary radical surgery to pulmonary metastases (DFI). Methods: From 01/2000 to 11/2008, a total of 206 pts with pulmonary metastases (colon72, rectal ca131, 3 unknown) were collected retrospectively and the clinical data were analyzed using Kaplan-Meier survival curves, univariate and multivariate analysis. Results: 128 pts (62.1%) had lung disease as the first metastatic site and 33 pts (26.7%) had synchronous liver involvement. Only 17 patients (8.3%) followed pulmonary metastatic resection, and others underwent palliative medical treatment including the chemotherapy and intervention. Median survival was 16.0 months (range 12.240–19.760) with a 18% 5-year survival. Of the totally 160 patients who had synchronous pulmonary metastases after radical primary tumor surgery, the mDFI was 20 months (range 16.738–23.262) months. Rectal cancer had a high chance (65%) for lung recurrence with longer DFI (21 vs 14 mo, P=0.02), but no difference of survival was shown compared to colon cancer. Factors that significantly predicted a poor prognosis on univariate analysis included vessel invasion (P=0.022) and high T stage (P=0.009), but neither of them was the independent prognostic factors after multivariate analysis. The factors influencing the DFI of metachronous pulmonary metastases included primary tumor site, pathological morphology, tumor infiltration stage and regional lymph node stage (P<0.05). There was a trend of better survival of patients receiving resection surgery after pulmonary metastases than receiving chemotherapy alone though no statistical significant was reached (mOS:34 vs 16 mo, P=0.125). But to patients who receiving metastatic site resection, chemotherapy after surgery improved the survival (P=0.042). Conclusions: No independent prognostic factors of survival had been found. The invasive tumor with high stage may have a shorter disease free interval of pulmonary metastases after primary surgery. No significant financial relationships to disclose.

scholarly journals Prognostic significance of histopathological factors in survival and recurrence of atypical carcinoid tumours

2021 ◽  
Author(s):  
Eva-María García-Fontán ◽  
Miguel-Ángel Cañizares-Carretero ◽  
Montserrat Blanco-Ramos ◽  
Jose-María Matilla-González ◽  
Rommel Carrasco-Rodríguez ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Mitotic Index ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Nodal Involvement ◽  
Ki 67 ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

Abstract OBJECTIVES Atypical carcinoids are neuroendocrine neoplasms of intermediate degree and low frequency. The aim of this study is to analyse their clinical characteristics and the importance of different histopathological factors in their prognosis. METHODS Multicentre cooperative group EMETNE prospectively reviewed 153 patients operated on between 1998 and 2016 with diagnosis of atypical carcinoids. Clinical variables and histopathological features were assessed. RESULTS Mean age was 54.36 years, similar for both genders. Concerning pathological study, mean tumour size was 31.7 mm. Rosettes were presented in 17% of the cases and tumoural necrosis in 23.3%. The cell proliferation factor Ki-67 index was 10.7%. The 2- and 5-year overall survival rates were 95.8% and 88.9%, respectively. In the univariate study, statistically significant differences in survival were found for each of the categories of T, N and M factors. Mitotic index and quantification of expression of Ki-67 showed influence in overall survival, although without statistical significance. In the multivariate analysis, factors N, M and mitotic index behaved as independent prognostic factors related to survival. Median disease-free interval in the series was 163.35 months. In cases with loco-regional recurrence, 53% had positive hiliar or mediastinal nodal involvement at the time of the surgery. In the univariate analysis, we observed statistically significant differences in disease-free interval in patients with nodal involvement (P = 0.024) and non-anatomical resections (P = 0.04). Histological characteristics showed no statistically significant differences in disease-free interval. CONCLUSIONS Lymph node involvement, the development of distant metastasis and mitotic index, more than Ki-67 determination, were shown as independent prognostic factors related to survival of these patients.

scholarly journals Response, disease-free interval and overall survival of cats with nasal planum squamous cell carcinoma treated with a fractionated vs a single-dose protocol of strontium plesiotherapy

2018 ◽  
Vol 21 (4) ◽  
pp. 306-313 ◽  
Author(s):  
Davide Berlato ◽  
Sue Murphy ◽  
Silja Laberke ◽  
Sara Verganti
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Single Dose ◽  
Prognostic Factors ◽  
Cell Carcinoma ◽  
Complete Response ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free ◽  
Single Dose Treatment

Objectives The main aim of the study was to establish response, disease-free interval (DFI) and overall survival of cats with nasal planum squamous cell carcinoma (SCC) treated with Sr90 plesiotherapy. A secondary aim was to determine whether a fractionated protocol is more effective than a single-dose protocol in terms of response, DFI and overall survival. The third aim was to evaluate whether we can identify prognostic factors that influence overall survival. Methods This was a retrospective study that included cats with a diagnosis of nasal planum SCC treated with Sr90 plesiotherapy at a single institution. Results Seventy-four cats were included in the study. Thirty-two were treated with a fractionated protocol and 42 with a single-dose treatment. Sr90 plesiotherapy was able to induce complete response in 74% of cats with nasal planum SCC. The median DFI was 780 days (95% confidence interval [CI] 383–1177), with 17% of cats experiencing local recurrence. The overall survival for all cats was 1039 days (95% CI 55–1528). The DFI of cats treated with the fractionated Sr90 was significantly longer compared with the single-dose treatment, whereas response and overall survival were not statistically different. Other prognostic factors that influenced the overall survival were early-stage disease, absence of concurrent problems and complete response to the treatment. Acute and long-term toxicity associated with the treatment were minimal and the aesthetic outcome was pleasing in almost all cases. Conclusions and relevance Strontium plesiotherapy is a safe and effective treatment of nasal planum SCC in cats.

Para-aortic lymph node recurrence after curative radiotherapy for cervical cancer

2019 ◽  
Vol 29 (7) ◽  
pp. 1116-1120
Author(s):  
Won Kyung Cho ◽  
Young Im Kim ◽  
Won Park ◽  
Kyungmi Yang ◽  
Haeyoung Kim ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Disease Free Interval ◽  
Lymph Node Recurrence ◽  
Free Interval ◽  
Curative Radiotherapy ◽  
Aortic Lymph Node ◽  
Disease Free

ObjectiveThe para-aortic lymph nodes are one of the most common sites in recurrent cervical cancer. However, treatment strategies for para-aortic lymph node recurrence have not yet been established.This study aimed to evaluate the prognostic factors and treatment outcomes in patients with para-aortic lymph node recurrence after curative radiotherapy for cervical cancer.MethodsWe retrospectively reviewed patients who developed para-aortic lymph node recurrence following curative radiation therapy for cervical cancer from January 2001 and December 2014 at the Samsung Medical Center. Prognostic factors for overall survival after recurrence were analyzed by univariate and multivariate analyses.ResultsA total of 67 patients were included in the analysis. After a median follow-up of 24.0 months (range 4–155), the 3-year overall survival rate was 42.7%. 32 patients had isolated para-aortic lymph node recurrence (group 1), 21 patients had para-aortic lymph node recurrence combined with other lymph node recurrence (group 2), and 14 patients developed para-aortic lymph node recurrence with distant organ metastasis (group 3). The 3-year overall survival rates in groups 1, 2, and 3 were 60.8%, 42.1%, and 7.7%, respectively (p<0.001). In multivariate analysis, histologic type of squamous cell carcinoma (p=0.028), non-symptomatic recurrence (p=0.024), isolated para-aortic lymph node recurrence (p=0.008), and disease-free interval (p=0.008) were significant factors for survival. Among the patients with isolated para-aortic lymph node recurrence, survival rates differed significantly according to disease-free interval; the 3-year overall survival in patients with disease-free interval ≥12 months and disease-free interval <12 months was 69.6% and 37.5%, respectively (p<0.001).ConclusionsIn patients with para-aortic lymph node recurrence from cervical cancer, histologic type, presence of symptoms, extent of disease, and disease-free interval were the prognostic factors for survival. Patients with isolated para-aortic lymph node recurrence with disease-free interval ≥12 months had higher survival outcomes at 3 years.

Surgical treatment of pulmonary metastasis: report from a tertiary care center

2018 ◽  
Vol 26 (4) ◽  
pp. 296-301 ◽  
Author(s):  
Waleed Saleh ◽  
Abdullah AlShammari ◽  
Jumana Sarraj ◽  
Omniyah AlAshgar ◽  
Mohamed Hussein Ahmed ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Confidence Interval ◽  
Primary Tumor ◽  
Lung Metastases ◽  
Pulmonary Metastasectomy ◽  
Disease Free Interval ◽  
Free Interval ◽  
Disease Free

Objective This retrospective analysis aimed to determine the factors influencing prognosis in adult patients who presented to our thoracic surgery service with lung metastases and were eligible for pulmonary metastasectomy. Methods We retrospectively reviewed the data of 296 patients who underwent resection of 575 lung metastases from January 2000 to January 2016. Univariate and multivariate analyses were performed based on age, sex, histology of the primary tumor, disease-free interval, number and size of metastases. Results Sixty-eight (22.97%) patients developed lung metastases from bone sarcoma, 68 (22.97%) from soft-tissue sarcoma, 56 (18.9%) from head and neck cancers, 46 (15.5%) from colorectal cancer, and 58 (19.6%) from other epithelial tumors. The mean size of the lung nodules was 2.48 cm. Open surgical resection was performed in 217 (73.3%) patients. After a mean follow-up of 43 months, 120 (40.7%) patients had died or were lost to follow-up. Univariate analysis confirmed that patients with bone cancer, soft tissue sarcoma, or colorectal carcinoma had a worse prognosis ( p = 0.0003). Moreover, those with a disease-free interval >24 months had a better 5-year survival ( p = 0.0001). The number and size of metastases, age, and sex had no effect on prognosis. The actuarial survival after complete metastasectomy was 71.6% (95% confidence interval: 66–75) at 2 years and 59.3% (95% confidence interval: 56–64) at 5 years. Conclusions Pulmonary metastasectomy provides good long-term survival. The type of primary tumor and disease-free interval are independent prognostic factors for survival.

Non-surgical Treatments for Lung Metastases in Patients with soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA)

2020 ◽  
Vol 16 ◽  
Author(s):  
Cecilia Tetta ◽  
Maria Carpenzano ◽  
Areej Tawfiq J Algargoush ◽  
Marwah Algargoosh ◽  
Francesco Londero ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Stereotactic Body Radiation Therapy ◽  
Lung Metastases ◽  
Disease Free Interval ◽  
Stereotactic Body Radiation ◽  
Free Interval ◽  
Disease Free

Background: Radio-frequency ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two emerging therapies for lung metastases. Introduction: We performed a literature review to evaluate outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). Method: After selection, seven studies were included for each treatment encompassing a total of 424 patients: 218 in the SBRT group and 206 in the RFA group. Results: The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. : In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease-free interval from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. : Local control showed high percentage for both procedures. Conclusion: SBRT is recommended in patients unsuitable to surgery, in synchronous bilateral pulmonary metastases, in case of deep lesions and in patients receiving high-risk systemic therapies. RFA is indicated in case of a long disease-free interval, in oligometastatic disease, when only the lung is involved, in small size lesions far from large vessels. : Further large randomized studies are necessary to establish whether these treatments may also represent a reliable alternative to surgery.

scholarly journals Analysis of the immunohistochemical expressions of p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and their correlations with the prognostic factors

2010 ◽  
Vol 47 (2) ◽  
pp. 141-147 ◽  
Author(s):  
Hunaldo Lima de Menezes ◽  
Mário Jorge Jucá ◽  
Edmundo Guilherme de A. Gomes ◽  
Benício L. Bulhões B. P. Nunes ◽  
Henrique Oliveira Costa ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cell Differentiation ◽  
Colorectal Adenocarcinoma ◽  
Sao Paulo ◽  
Immunohistochemical Expression ◽  
Ki 67 ◽  
Disease Free Interval ◽  
Free Interval ◽  
Specific Mortality ◽  
Disease Free

CONTEXT: Search of tumors markers that allow treatment with higher survival rates, and indicate the response to treatment and recurrence of cancer OBJECTIVE: To analyze the immunoexpression of the proteins p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and correlate them with the clinical-pathological prognostic factors. METHOD: Tissue microarray paraffin blocks were made from colorectal adenocarcinoma tissue resected from 82 patients who had undergone surgery but not chemotherapy or radiotherapy, at "Hospital São Paulo", São Paulo, SP, Brazil, between 2002 and 2005. Thin sections (4 µm) were subjected to immunohistochemical reactions, and immunoexpression staining scores were obtained. The scores were correlated with the degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The study variables were analyzed using the chi-square and Kaplan-Meier tests to investigate associations with the markers. The significance of the differences between the curves of the disease-free interval and survival was analyzed using the Logrank and Wilcoxon tests. RESULTS: The immunohistochemical expression of p53 was positive in 70 tumors (85.4%) and negative in 12 (14.6%). The expression of bcl-2 was positive in 26 (31.7%) and negative in 56 (68.3%). The expression of Ki-67 was positive in 62 (75.6%) and negative in 20 (24.4%). There was no statistically significant correlation between the expressions of these markers separately or in conjunction, in relation to the degree of cell differentiation, staging, disease-free interval, survival and specific mortality. In relation to recurrence, there was a statistically significant correlation with positive expression of Ki-67 (P = 0.035). CONCLUSION: The immunohistochemical expression of Ki-67 in colorectal cancer is associated with recurrence of this disease.

Sign in / Sign up

Export Citation Format

Share Document