Adjuvant therapy with imatinib in gastrointestinal stromal tumor (GIST) patients with intermediate or high risk: Analysis from a single-center contrast study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10556-10556
Author(s):  
J. Li ◽  
F. J. Gong ◽  
J. Li ◽  
W. A. Wu ◽  
L. Shen
Keyword(s):  
High Risk ◽  
Adjuvant Therapy ◽  
Therapy Group ◽  
Tumor Resection ◽  
Control Group ◽  
Contrast Study ◽  
Complete Tumor Resection ◽  
Free Survival ◽  
Complete Tumor

10556 Background: Imatinib benefits the patients with metastatic GIST but whether it is effective in the adjuvant setting after complete tumor resection of primary GIST is questionable. Methods: Patients who had undergone complete tumor resection with intermediate or high risk of recurrence (define) were enrolled in a single-center non-randomized open contrast study. Patients had adjuvant therapy with imatinib (400mg once a day) for 3 years commencing within 12 weeks of tumor resection, or had follow-up alone. We performed c-kit and PDGFRA mutation analysis for patients with archival tumor samples. The primary objective was recurrence-free survival (RFS) and the second objective was correlation of gene mutation profile with efficacy of adjuvant therapy. Results: One hundred and five patients were enrolled: 56 patients in adjuvant therapy group and 49 patients in control group. Median follow-up was 30 months (range 12–62); Median treatment duration in adjuvant therapy group were 20 months (range 12–36); There was relatively higher 1-year and 2-year RFS in the adjuvant therapy group compared with the control group (100% vs 89.8%,94.4% vs 60.0%) (Log-RankP< 0.001). Hazard risk was 0.13 (95% CI 0.039–0.438, P= 0.001) in Cox proportional hazard regression model. For further sub-group analysis, Log-rank and Cox regression analysis showed that adjuvant therapy could significantly decrease recurrence risk in patients with high risk disease (define)(2-year RFS: 91.5% vs 46,2%, Log-Rank: P<0.001, HR:0.107 (95%CI 0.031–0.370), P<0.001). c-kit and PDGFRA mutation were analyzed in forty-nine patients. There was a better survival benefit from adjuvant therapy for patients with c-kit exon 11 mutation. Conclusions: Adjuvant therapy with imatinib can improve 1-year and 2-year recurrence-free survival for patients with an intermediate or high risk of recurrence after complete tumor resection. No significant financial relationships to disclose.

scholarly journals Management of a primary cardiac leiomyosarcoma in a young woman

2021 ◽  
Vol 29 (2) ◽  
pp. 267-270
Author(s):  
Mehmet Akif Önalan ◽  
Ahmet Demirkaya ◽  
Kemal Behzatoglu ◽  
Ersin Erek
Keyword(s):  
Pulmonary Veins ◽  
Tumor Resection ◽  
Complete Tumor Resection ◽  
The Right ◽  
Tumor Remnant ◽  
Invasive Techniques ◽  
Right Lower Lobectomy ◽  
Pathological Confirmation ◽  
Complete Tumor

Cardiac leiomyosarcoma is an extremely rare tumor with a poor prognosis. An 18-year-old female patient was admitted to our clinic with a left atrial leiomyosarcoma extending to the right lower pulmonary veins. We performed complete tumor excision by the right anterolateral mini-thoracotomy approach using minimally invasive techniques. After pathological confirmation of the tumor, right lower lobectomy was performed with the same incision one week later to prevent recurrence. Although no tumor remnant was found in the lobectomy specimen, adjuvant chemotherapy was started. No recurrence was detected during the 12-month follow-up. In conclusion, the right submammarian minithoracotomy approach has the advantages of its less invasive nature and suitability for complete tumor resection with lobectomy.

scholarly journals Thumb Reconstruction with Arthrodesis to the Second Metacarpal following Sarcoma Excision

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Christopher Hein ◽  
Barry Watkins ◽  
Lee M. Zuckerman
Keyword(s):  
Hand Function ◽  
Proximal Phalanx ◽  
Tumor Resection ◽  
Thumb Reconstruction ◽  
Complete Tumor Resection ◽  
Metacarpal Shaft ◽  
Malignant Lesions ◽  
Graft Reconstruction ◽  
Complete Tumor

Primary sarcomas of the thumb metacarpal are rare malignant lesions. Surgical treatment involves amputation versus tumor resection with thumb reconstruction. If complete tumor resection is possible, thumb preservation may be considered, as the thumb is vital to hand function. Following tumor resection, previous reports have described graft reconstruction with fusion to the trapezium or scaphoid. We present two cases of sarcoma necessitating resection of the thumb metacarpal that were reconstructed with an arthrodesis of the proximal phalanx to the second metacarpal shaft. Arthrodesis to the second metacarpal allows robust bony contact for fusion as well as improved resting position of the thumb. At 2- and 4-year follow-up, both patients have a stable, pain-free thumb without evidence of local recurrence.

Pituitary Adenomas with Changing Phenotype: A Systematic Review

2020 ◽  
Vol 128 (12) ◽  
pp. 835-844
Author(s):  
Fernando Guerrero-Pérez ◽  
Agustina Pia Marengo ◽  
Noemi Vidal ◽  
Carles Villabona
Keyword(s):  
Systematic Review ◽  
Cushing’S Disease ◽  
Pituitary Adenomas ◽  
Tumor Resection ◽  
Cushing's Disease ◽  
Complete Tumor Resection ◽  
Null Cell ◽  
Acth Secreting ◽  
Complete Tumor

Abstract Purpose and Methods Phenotype transformation in pituitary adenomas (PA) is a little known and unexpected clinical phenomenon. We describe two illustrative cases and performed a systematic review of cases reported in literature. Results Case 1: A 24-year-old woman underwent surgery because of Cushing’s disease. A complete tumor resection and hypercortisolism resolution was achieved. Two years later, tumor recurred but clinical and hormonal hypercortisolism were absent. Case 2: A 77-year-old woman underwent surgery due to acromegaly. A complete tumor resection and GH excess remission was achieved. Four years later, tumor recurred but clinical and hormonal acromegaly was ruled out. Search of literature: From 20 patients (including our cases), 75% were female with median age 45 (19) years. Ten patients (50%) had initially functioning PA: 8 switched to NFPA (5 ACTH-secreting PA, 2 prolactinomas and 1 acromegaly) and 2 exchanged to acromegaly from TSH-secreting PA and microprolactinoma. One patient developed a pituitary carcinoma from ACTH-secreting PA. Ten patients (50%) initially had NFPA; 9 developed Cushing’s disease (4 silent corticotroph adenomas, 4 null cell PA and 1 managed conservatively). One patient with silent somatotroph PA changed to acromegaly. Treatments before transformation were surgery (80%), radiotherapy (40%), pharmacological (40%) and in 2 patients switching happened without any treatment. Median follow-up until transformation was 72 months (range 12–276). Conclusion PA can change from functioning to (NF) non-functioning (vice versa) and even exchange their hormonal expression. Clinicians should be aware and a careful lifelong follow-up is mandatory to detect it.

Hepatocellular Carcinoma in Children: Does Modified Platinum- and Doxorubicin-Based Chemotherapy Increase Tumor Resectability and Change Outcome? Lessons Learned From the SIOPEL 2 and 3 Studies

2016 ◽  
Vol 34 (10) ◽  
pp. 1050-1056 ◽  
Author(s):  
Maciej Murawski ◽  
Víola B. Weeda ◽  
Rudolf Maibach ◽  
Bruce Morland ◽  
Derek J. Roebuck ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Patient Outcomes ◽  
Tumor Resection ◽  
Lessons Learned ◽  
Complete Tumor Resection ◽  
Primary Surgery ◽  
New Treatment ◽  
Platinum Agents ◽  
Complete Tumor

Introduction The aim of this article is to present an experience of two prospective studies from the International Childhood Liver Tumor Strategy Group (SIOPEL 2 [S2] and SIOPEL [S3]) trials and to evaluate whether modified platinum- and doxorubicin-based chemotherapy is capable of increasing tumor resectability and changing patient outcomes. Methods Between 1995 and 2006, 20 patients with hepatocellular carcinoma (HCC) were included in the S2 trial and 70 were included in the S3 trial. Eighty-five patients remained evaluable. Results Response to preoperative chemotherapy was observed in 29 of 72 patients (40%) who did not have primary surgery, whereas 13 patients underwent upfront surgery. Thirty-three patients had a delayed resection. Thirty-nine tumors never became resectable. Complete tumor resection was achieved in 34 patients (40%), including seven of those treated with liver transplantation (LTX). After a median follow-up period of 75 months, 63 patients (74%) had an event (a progression during treatment, a relapse after treatment, or death from any cause). Sixty patients died. Twenty-three of 46 patients (50%) who underwent tumor resection died. Eighteen of 27 patients (63%) with complete tumor resection (without LTX) and 20 of 34 patients (59%) with LTX survived. Only one of seven patients (14%) with microscopically involved margins survived. Overall survival at 5 years was 22%. Conclusion Survival in pediatric HCC is more likely when complete tumor resection can be achieved. Intensification of platinum agents in the S2 and S3 trials has not resulted in improved survival. New treatment approaches in pediatric HCC should be postulated.

scholarly journals Reconstruction With 3D-Printed Prostheses After Sacroiliac Joint Tumor Resection: A Retrospective Case-Control Study

2022 ◽  
Vol 11 ◽  
Author(s):  
Feifei Pu ◽  
Jianxiang Liu ◽  
Deyao Shi ◽  
Xin Huang ◽  
Jingtao Zhang ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Operation Time ◽  
Control Group ◽  
Intraoperative Bleeding ◽  
Free Survival ◽  
3D Printed ◽  
Disease Free

BackgroundSacroiliac joint tumor is rare, and the reconstruction after tumor resection is difficult. We aimed to analyze and compare the clinical effects of three-dimensional (3D) printed prostheses and bone cement combined with screws for bone defect reconstruction after sacroiliac joint tumor resection.MethodsTwelve patients with sacroiliac joint tumors who underwent tumor resection and received 3D-printed prostheses to reconstruct bone defects in our hospital from January 2014 to December 2020 were included in the study group Twelve matched patients who underwent sacroiliac joint tumor resection and reconstruction with bone cement and screws in the same time period were selected as the control group.ResultsIn the 3D-printing group, six cases were extensively excised, and six cases were marginally excised. All patients were followed up for 6–90 months, and the median follow-up time was 21 months. Among them, nine patients had disease-free survival, two survived with tumor recurrence, and one died due to tumor metastasis. The MSTS-93 score of the surviving patients was 24.1 ± 2.8. The operation time was 120.30 ± 14.50 min, and the intraoperative bleeding was 625.50 ± 30.00 ml. In the control group, seven cases were extensively excised, and five cases were marginally excised. All patients were followed up for 6–90 months, with a median follow-up time of 20 months. Among them, nine patients had disease-free survival, one survived with tumor recurrence, and two died due to tumor metastasis. The MSTS-93 score of the patients was 18.9 ± 2.6. The operation time was 165.25 ± 15.00 min, and the intraoperative bleeding was 635.45 ± 32.00 ml. There was no significant difference in survival status, intraoperative blood loss, or complications between the two groups (P&gt;0.05). However, there were statistically significant differences in operative time and postoperative MSTS-93 scores between the two groups (P&lt;0.05).ConclusionsAfter resection of the sacroiliac joint tumor, reconstruction using 3D printed prostheses was shorter and resulted in better movement function.

scholarly journals Congenital orbital teratoma: a case report with preservation of the globe and 18 years of follow-up

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Panagiotis A. Tsoutsanis ◽  
George C. Charonis
Keyword(s):  
Surgical Management ◽  
Tumor Resection ◽  
Clinical Findings ◽  
Complete Tumor Resection ◽  
Case Presentation ◽  
Cell Layers ◽  
The Times ◽  
Facial Development ◽  
Complete Tumor

Abstract Background Congenital orbital teratomas are extremely rare, usually benign neoplasms, comprised of cells originating from all three germ cell layers. Clinically the tumor appears solid, most of the times is intraconal and presents as a rapidly growing mass leading to a massive unilateral axial proptosis, chemosis, exposure keratopathy, markedly distended eyelids and often, loss of vision. To prevent these complications, tumor excision usually involves enucleation or even orbital exenteration. Case presentation We report a case of a 1-day old infant who presented with dramatic proptosis at birth due to a true congenital orbital teratoma. We describe the clinical findings, the preoperative neuroimaging, the surgical management which included complete tumor resection with preservation of the globe to allow for optimal orbital growth, the histopathological evaluation, and the clinical course during 18 years of follow up. Conclusion Every effort to salvage the globe should be made to achieve the best possible orbito-facial development. Furthermore, the value of prompt surgical management with a less invasive transconjunctival globe sparing procedure can be appreciated in our case.

scholarly journals Ossifying Fibromyxoid Tumor: An Update

2016 ◽  
Vol 140 (4) ◽  
pp. 371-375 ◽  
Author(s):  
David Bakiratharajan ◽  
Bharat Rekhi
Keyword(s):  
Tumor Resection ◽  
Distant Metastases ◽  
Uncertain Malignant Potential ◽  
Complete Tumor Resection ◽  
Soft Tissue Neoplasm ◽  
Molecular Features ◽  
Characteristic Imaging ◽  
Ossifying Fibromyxoid Tumor ◽  
Complete Tumor

Ossifying fibromyxoid tumor (OFMT) is a rare soft tissue neoplasm of uncertain differentiation, initially described by Enzinger and colleagues. Until now, nearly 300 such cases have been reported worldwide. The histogenesis of these tumors remains controversial. These tumors show characteristic imaging findings and exhibit a spectrum of histopathologic features, including classical and atypical subtypes. Local recurrences and, occasionally, distant metastases have also been reported. A complete tumor resection forms the preferred treatment modality for these tumors, along with follow-up, as these tumors have an uncertain malignant potential. Lately, certain “molecular signatures” underlying OFMTs have been described that can further aid in reaching an accurate diagnosis for these tumors and unraveling their pathogenesis. This article is a review of the clinical, radiologic, histopathologic, and molecular features of OFMTs.

Early stage EGFR-mutated lung cancer gets a targeted treatment

2020 ◽  
Vol 12 (567) ◽  
pp. eabf2637
Author(s):  
Ecaterina Ileana-Dumbrava
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Tumor Resection ◽  
Disease Free Survival ◽  
Small Cell Lung ◽  
Complete Tumor Resection ◽  
Free Survival ◽  
Egfr Mutated ◽  
Disease Free ◽  
Complete Tumor

Osimertinib improves disease-free survival for patients with early stage EGFR-mutated non-small cell lung cancer after complete tumor resection.

scholarly journals Treatment and outcome of the patients with rhabdomyosarcoma of the biliary tree: Experience of the Cooperative Weichteilsarkom Studiengruppe (CWS)

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cristian Urla ◽  
Steven W. Warmann ◽  
Monika Sparber-Sauer ◽  
Andreas Schuck ◽  
Ivo Leuschner ◽  
...  
Keyword(s):  
Tumor Resection ◽  
Biliary Tree ◽  
Radical Resection ◽  
Tumor Biopsy ◽  
Free Survival ◽  
Primary Surgery ◽  
Tumor Entity ◽  
Almost All ◽  
Complete Tumor

Abstract Background Biliary rhabdomyosarcoma (RMS) is the most common biliary tumor in children. The management of affected patients contains unique challenges because of the rarity of this tumor entity and its critical location at the porta hepatis, which can make achievement of a radical resection very difficult. Methods In a retrospective chart analysis we analysed children suffering from biliary RMS who were registered in three different CWS trials (CWS-96, CWS-2002P, and SoTiSaR registry). Results Seventeen patients (12 female, 5 male) with a median age of 4.3 years were assessed. The median follow-up was 42.2 months (10.7–202.5). The 5-year overall (OS) and event free survival (EFS) rates were 58% (45–71) and 47% (34–50), respectively. Patients > 10 years of age and those with alveolar histology had the worst prognosis (OS 0%). Patients with botryoid histology had an excellent survival (OS 100%) compared to those with non-botryoid histology (OS 38%, 22–54, p = 0.047). Microscopic complete tumor resection was achieved in almost all patients who received initial tumor biopsy followed by chemotherapy and delayed surgery. Conclusion Positive predictive factors for survival of children with biliary RMS are age ≤ 10 years and botryoid tumor histology. Primary surgery with intention of tumor resection should be avoided.

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