Experience with endometrial carcinoma (EC): A population-based study in Tarragona Province (Spain)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16550-e16550
Author(s):  
M. Arenas Prat ◽  
A. Rovirosa ◽  
S. Sabater ◽  
A. Ameijide ◽  
I. Henríquez ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Nodes ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Population Based ◽  
Failure Patterns ◽  
Poor Outcome ◽  
Deep Myometrial Invasion ◽  
Lymph Nodes Dissection

e16550 Background: To evaluate outcome, failure patterns, prognostic factors and radiotherapy (RT) toxicity after postoperative RT for EC in Tarragona Province (Spain). Methods: A retrospective population-based review on 232 patients (pts) between 1997 and 2000 from different gynaecological Dpt. and in a single oncologist institution with RT Units. Multivariate analysis of disease-free survival (DFS), overall survival (OS), adjuvant RT, RT toxicity (RTOG), prognostic factors for survival, and the distance in Km to the RT Units. Results: Mean age: 64 years (35–88). Distance to RT Units >70 Km in 15% pts. Median follow-up: 70 months (2–132). FIGO Stage (S): 8.2% IA; 36.2% IB; 19% IC; 7.8% IIA; 6.5% IIB; 7.3% IIIA; 1.3% IIIB; 3.4% IIIC; 2.6% IVA; 2.2 IVB. Pathology: endometrioid 74.5%, papillary 3.9%, serous 3.4%, clear-cell 2.2%, squamous cell 3%, adenosquamous 1.3%, mixed 3.9%. Grade (G): 35.7% G1, 45.3% G2, 19% G3; miometrial invasion: 44.1% >50%, 46% <50%, 9.9% not invasion. Treatment: 1) Surgery in 93.5%, 49.6% lymph nodes dissection. 2) RT in 73.5%: 47% external beam radiotherapy (EBI) and brachytherapy (BT), 9.4% BT alone, 17.1% EBI alone. 3) Chemotherapy in 11.1% and hormonal treatment in 6.9%. 3). Grade 3 and 4 toxicity: 12 (9%) pts, 6 early and 6 late. Relapses: 26/232 (11.6%), S-I: 11/26 (42%), S-II: 1/26 (3.8%), S-III: 5/26 (19.2%), S-IV: 3/26 (11.5%). Metastasis: 28/232 (12.5%). Survivals at 5 years: 1) OS in all stages was 78.8% and 83%, 89.6%, and 76% for SI, SII, and SIII, respectively. 2) DFS was 76.5% for all pts and 82.3%, 86.22%, and 68.24% for SI, SII, and SIII, respectively. Multivariate analysis: significant prognostic factors for poor outcome were age (p < 0.01), lymph nodes dissection (p < 0.001), pathologic subtype (p < 0.001), grade of differentiation (p < 0.001), and deep myometrial invasion (p < 0.005). Conclusions: Survivals, RT toxicity and relapse sites were similar to the other reported series. Predictors of poor outcome were age, lymph nodes dissection, pathology subtype, grade of differentiation, and deep myometrial invasion. Patients of Tarragona Province are in need of a better accessibility to the radiation units. No significant financial relationships to disclose.

scholarly journals Association Between Maximum Standardize Uptake Value and Prognostic Factors at Endometrioid Type Endometrial Carcinoma

2019 ◽  
pp. 1
Author(s):  
Varol Gulseren ◽  
Mustafa Kocaer ◽  
Isa Aykut Ozdemir ◽  
Ilker Cakir ◽  
Mehmet Gokcu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Roc Curve ◽  
Standardize Uptake Value ◽  
Gynecologic Oncology ◽  
Myometrial Invasion ◽  
Advanced Stage ◽  
Large Tumor ◽  
Uterine Tumor ◽  
Maximum Standardize Uptake ◽  
Deep Myometrial Invasion

<p><strong>Objective:</strong> Investigate the relationship between the maximum standardize uptake value (SUVmax) values and the prognostic factors in endometrioid-type endometrial cancer (EEC) patients undergoing preoperative positron emission tomography / computed tomography (PET/CT).</p><p><strong>Study Design:</strong> We reviewed retrospectively the records of patients with EEC diagnosis who underwent hysterectomy in Gynecologic Oncology Clinic of Tepecik Training and Research Hospital between January 2010 and January 2017 in this retrospective study. Receiver operating characteristic (ROC) curve analysis was performed to determine the cut-off values of SUVmax for predicting clinical parameters. The area under the ROC curve (AUC) is presented as a measure of discrimination.</p><p><strong>Results:</strong> It was calculated that the SUVmax values in the uterine tumor were higher and statistically significant in the presence of advanced stage (III-IV), histologic grade III, deep myometrial invasion (≥1 / 2) and large tumor size (≥4 cm) from prognostic factors. The SUVmax values of the groups with and without cervical invasion did not different from each other. In order to use the SUVmax value as a diagnostic test in the ROC analysis, the AUC values were as follows; the grade of advanced stage tumor was 0,685, the grade 3 tumor was 0,797, the depth of myometrial invasion was 0,781, and the size of the large tumor was 0,905.<br /><strong></strong></p><p><strong>Conclusion:</strong> SUVmax value in primary uterine tumor was found to be higher in prognostic factors in patients with advanced stage, high grade, deep myometrial invasion and large tumor.<br /><br /></p>

Metastasectomy in colorectal carcinoma (CRC) patients (pts) with mBRAF: Prospective database analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15549-e15549
Author(s):  
Mikhail Fedyanin ◽  
Kheda Elsnukaeva ◽  
Irina Demidova ◽  
Daniil Stroyakovskiy ◽  
Yuri Shelygin ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Lung Resection ◽  
Disease Free Survival ◽  
Local Relapse ◽  
R0 Resection ◽  
Mutational Status ◽  
Primary Endpoints ◽  
Lymph Nodes Dissection ◽  
Practice Methods

e15549 Background: Role of metastasectomy in pts with mBRAF metastatic CRC is still controversial. We performed analysis of prospective multicentric database of pts with mBRAF mCRC to evaluate the efficacy of metastasectomy in such group of pts in the real clinical practice. Methods: We analyzed a database of pts with mCRC in 7 cancer clinics in Russia and chose pts with metastasectomy with different mutational status. The primary endpoints were disease free survival (DFS) and overall survival (OS), which were calculated from the time of metastasectomy. Analysis was performed with the SPSS v.20 software package. Results: The study included 126 pts: 26 pts with mBRAF, 57 pts with mRAS and 43 pts with wtRAS/BRAF. Pts with mBRAF more often had synchronous metastases (50%/19,3/11,6%, p<0,01), N2 status (38,5%/11%/19,6%, p=0,04). In mBRAF cohort all but 1 pt had V600 mutations; peritonectomy performed in 19,2%, liver resection – in 34,6%, lung resection, ovariectomy, metastasectomy in brain and retroperitoneal lymph nodes dissection with removal of the local relapse – over 11,5%; R0 resection was achieved in 88,5%. Median DFS was 7 months in mBRAF pts, 14 months in mRAS and not achieved in wtRAS/BRAF group treated (HR 2,1, 95%CI 1,5-3.1, p<0.01). Median OS was 26 months in mBRAF, 38 months in mRAS and not achieved in wtRAS/BRAF group (HR 1,5, 95%CI 1,0-2,4, p=0.06). Perioperative chemotherapy didn’t improve DFS in pts with mBRAF (HR 1,9, 95%CI 0,67-5,7, p=0,2). The best median DFS were in pts after ovariectomy – 10 months, the worst - after retroperitoneal lymph nodes dissection with removal of the local relapse – 2 months. Conclusions: Prognosis of pts with mBRAF after metastasectomy is worse than with other mutational phenotypes. However in selected cases metastasectomy might be considered in such aggressive mCRC.

Is Hepatic Resection Justified After Chemotherapy in Patients With Colorectal Liver Metastases and Lymph Node Involvement?

2008 ◽  
Vol 26 (22) ◽  
pp. 3672-3680 ◽  
Author(s):  
René Adam ◽  
Robbert J. de Haas ◽  
Dennis A. Wicherts ◽  
Thomas A. Aloia ◽  
Valérie Delvart ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Liver Metastases ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Regional Lymph Node ◽  
Young Patients ◽  
Disease Free Survival ◽  
High Risk Group

Purpose For patients with colorectal liver metastases (CLM), regional lymph node (RLN) involvement is one of the worst prognostic factors. The objective of this study was to evaluate the ability of a multidisciplinary approach, including preoperative chemotherapy and hepatectomy, to improve patient outcomes. Patients and Methods Outcomes for a consecutively treated group of patients with CLM and simultaneous RLN involvement were compared with a cohort of patients without RLN involvement. Univariate and multivariate analysis of clinical variables was used to identify prognostic factors in this high-risk group. Results Of the 763 patients who underwent resection at our institution for CLM between 1992 and 2006, 47 patients (6%) were treated with hepatectomy and simultaneous lymphadenectomy. All patients had received preoperative chemotherapy. Five-year overall survival (OS) for patients with and without RLN involvement were 18% and 53%, respectively (P < .001). Five-year disease-free survival rates were 11% and 23%, respectively (P = .004). When diagnosed preoperatively, RLN involvement had an increased 5-year OS compared with intraoperative detection, although the difference was not significant (35% v 10%; P = .18). Location of metastatic RLN strongly influenced survival, with observed 5-year OS of 25% for pedicular, 0% for celiac, and 0% for para-aortic RLN (P = .001). At multivariate analysis, celiac RLN involvement and age ≥ 40 years were identified as independent poor prognostic factors. Conclusion Combined liver resection and pedicular lymphadenectomy is justified when RLN metastases respond to or are stabilized by preoperative chemotherapy, particularly in young patients. In contrast, this approach does not benefit patients with celiac and/or para-aortic RLN involvement, even when patients’ disease is responding to preoperative chemotherapy.

Prognostic factors for intrathyroidal papillary carcinomas – a multivariate analysis

2016 ◽  
Vol 62 (5) ◽  
pp. 56-57
Author(s):  
Nada Miroslav Santrac ◽  
Ivan Zoran Markovic ◽  
Merima Ramiz Goran ◽  
Marko Nikola Buta ◽  
Igor Dusan Djurisic ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Total Thyroidectomy ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Disease Free Survival ◽  
Adequate Treatment ◽  
Ptnm Classification ◽  
Quality Life ◽  
Poorly Differentiated

Aim: to examine prognostic significance of patient-related, tumor-related and treatment-related factors for intrathyroidal papillary thyroid carcinomas (PTC), via multivariate analysis.Material and methods. This study included 153 patients with intrathyroidal PTCs (pT1/pT2/pT3) surgically treated in our Institution during two-decade period. Patients with locally invasive tumors (pT4) and initial distant metastases (M1) were excluded. Parameters of interest were: gender (male; female), age (<=45; >45 years), tumor size (pTNM classification WHO 1984), multifocality (no; yes), histological type of PTC (pure; microcarcinoma; follicular; poorly differentiated), presence of lymphonodal metastases (pN1a; ipsilateral-pN1b; contralateral-pN1b; total), surgery extent (total thyroidectomy; total thyroidectomy with lymphonodal dissections). Univariate and multivariate analysis of all parameters was performed in order to distinguish factors of significance for disease-free survival (DFS) and cancer-specific overall survival (cs-OS).Results. In the follow-up, 10% of patients had locoregional or distant relapse, while 5.2% died due to PTC. Univariate analysis distinguished older age, male gender, tumors over 4cm in diameter, multifocality and poorly differentiated PTC-types as unfavorable prognostic factors for cs-OS. DFS was significantly shorter in males vs. females, as well as in patients with multifocal vs. solitary PTC. Tumor multifocality was unfavorable prognostic factor for both DFS and cs-OS. Independent prognostic factors for intrathyroidal PTCs, based on Cox multivariate analysis, were multifocality and gender for DFS, and multifocality and age at diagnosis for cs-OS.Conclusions. Prognostic factors define risk groups within population of differentiated PTCs providing timely, adequate treatment and opportunity for longer quality life of patients with PTCs.

Population-based outcomes of patients (pt) with early-stage HER2-positive breast cancer treated with adjuvant trastuzumab (T).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11079-e11079
Author(s):  
Krista Noonan ◽  
Joy S. McCarthy
Keyword(s):  
Breast Cancer ◽  
Prognostic Factors ◽  
Early Stage ◽  
Tumour Size ◽  
Disease Free Survival ◽  
Clinical Effectiveness ◽  
Population Based ◽  
The Body ◽  
Phase Iii ◽  
Her2 Positive

e11079 Background: Phase III trials have shown clinical efficacy of T when combined with chemotherapy in HER2-positive early stage breast cancer, decreasing recurrence by 50% and increasing survival by 30%. 15-20% of early stage breast cancers demonstrate amplification of the HER2 gene, which is associated with a poor prognosis. The aims of this study were to evaluate the clinical effectiveness of T, and explore potential prognostic factors. Methods: Pts with stage I-III breast cancer overexpressing HER2 from 2005 to 2010, assessed in Newfoundland and Labrador’s cancer centre were retrospectively identified from the Provincial Tumour Registry. Pt, treatment, and tumour characteristics were extracted. Kaplan-Meier curves were used for survival analysis, and Cox Proportional Hazards Models were used to identify prognostic factors and evaluate their impact on outcomes. Results: A total of 148 pts were identified. The median age was 56 years, and 76% received T. At a median follow-up of 25 months, overall survival (OS) was 97% (p=0.0002), and disease-free survival was 96% (p<0.00) for pts receiving T. Younger age, smaller tumour size, and lymph node negativity were favorable prognostic factors. There was an 83% decrease in risk of breast cancer recurrence in the patients receiving T. Discontinuation of T occurred in 6.2% of patients due to a decreased ejection fraction. Conclusions: This population-based analysis demonstrates T’s favorable impact on 25-month DFS, OS, and safety. This adds to the body of literature, showing clinical effectiveness and tolerability of T. [Table: see text]

scholarly journals Postoperative radiotherapy of cervival carcinoma: Treatment results and analysis of prognostic factors

2009 ◽  
Vol 56 (4) ◽  
pp. 195-200
Author(s):  
V. Plesinac-Karapandzic ◽  
N. Borojevic ◽  
Z. Milosevic ◽  
B. Markovic ◽  
M. Nikitovic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prognostic Factors ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Early Stage ◽  
Postoperative Radiotherapy ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Residual Tumor ◽  
Positive Surgical Margin

The purpose of the study was to evaluate the efficacy of postoperative radiotherapy (RT) and to investigate prognostic factors for early-stage cervical cancer patients. We reviewed the medical records of 162 cervical cancer patients treated by RT during 2003 year. RT included 30- 45Gy of external photons to pelvis in 12-25 fractions. Brachytherapy with 192Ir was delivered in 3-5 fractions to a dose of 27-32 Gy. The mean age was 49 years (range 27-71). Majority of patients 130 had Stage Ib. Radical hysterectomy with lymphadenectomy was performed in 122pts. and simple hysterectomy in 40 pts. The 5-year actuarial overall survival (OS) for all patients was 92,6% and disease-free survival (DFS) was 90,9%.There was statistically significant differences in OS and DFS in pat. with positive vs. negative pelvic lymph nodes; tumor 4cm vs. tumor <4cm; positive vs. negative surgical margin/residual tumor (p<0,05). Late GIT complications were determined in 35,8% and UT in 12,3%. In conclusion, postoperative radiotherapy has achieved high-satisfactory survival with acceptable complications. The survival benefit was less evident among patients with positive lymph nodes, tumor > 4cm and positive surgical margin/ residual tumor.

LAPAROSCOPIC DISTAL GASTRECTOMY WITH LYMPH NODES DISSECTION FOR THE TREATMENT OF GASTRIC CANCER

2014 ◽  
pp. 24-28
Author(s):  
Hai Thanh Phan ◽  
Nhu Hiep Pham ◽  
Loc Le ◽  
Van Lieu Nguyen ◽  
Anh Vu Pham ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Nodes ◽  
Distal Gastrectomy ◽  
Average Length ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Stage I ◽  
Lymph Nodes Dissection

Objective: The goal of this study was to investigate the feasibility, safety, and associated survival outcomes of laparoscopy-assisted distal gastrectomy (LADG) with lymph nodes dissection for gastric cancer. Methods: we analyzed the clinical data from 64 consecutive patients with gastric cancer who received LADG at our department of abdominal emergency surgery-Hue central hospital from January of 2007 to January of 2013. Results: LADG was successfully carried out in 62 patients; 2 cases were converted to open surgery. The mean operation time was 210 minutes (150-300 minutes), and mean number of dissected lymph nodes was 13 (5-25). The average length of hospital stay were 9,1 days (7-16 days). The morbididity and mortality was 15% and 1,5%. A total of 62 patients were followed for a subsequent 6-71 months (median, 24 months). The 3-year disease-free survival (DFS) and overall survival (OS) rates were 71,3% and 83,2%, respectively. When divided by stage, the 3-year DFS for stage I, II, and III were 88%, 84,9%, and 41%, respectively; and the 3-year OS for stage I, II, and III were 100%, 86%, and 45%, respectively. Conclusion: In this preliminary report, LADG was found to be a safe, feasible, and efficacious procedure for the treatment of gastric cancer with encouraging 3-year overall and stage-by-stage survival rates

Clinico-Biological Characteristics and Prognosis of Non-M3 Acute Myeloid Leukemia with High Percentage of Myeloperoxisase Positive Blasts. Single Center Experience.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4462-4462
Author(s):  
Pau Montesinos ◽  
Lorenzo Algarra ◽  
Jaime Sanz ◽  
Mari Luz Perez ◽  
Leonor Senent ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Myeloid Leukemia ◽  
De Novo ◽  
Disease Free Survival ◽  
Favourable Outcome ◽  
Biological Characteristics ◽  
Prognostic Impact ◽  
Acute Myeloid

Abstract Introduction: It has been suggested that acute myeloid leukemia (AML) showing mature phenotype is associated with favourable outcome. In a study recently published by JALSG, myeloperoxidase (MPO) positivity in over 50% of blasts had favourable prognostic impact, independent from karyotype, on achieving complete remission (CR), overall survival (OS) and disease free survival (DFS). No other studies have established the independent prognostic value of MPO expression. Objectives: Analyze the clinico-biological characteristics of AML with high percentage of MPO+ blasts and its impact on CR, OS and DFS. Material and methods: Between 1986 and 2005, 418 adult patients (median 53 years, range 15–80) were diagnosed with de novo non-APL AML and evaluated for percentage of MPO+ blasts. All patients received intensive chemotherapy. Diagnosis was made by optic microscopy of bone marrow (BM) aspirates stained with May-Grumwald giemsa, MPO, butyrate esterase and or non specific esterase. Cytogenetic and immunophenotype analysis was evaluated in 66% and in 76% of the cases respectively. Results: 118 patients (28%) showed a percentage of MPO+ blasts >75%. AML with MPO+ blasts >75% was associated with M1-M2-M4 subtypes, leucocytes >50×109/L, blasts in BM >70% and HLA-DR negativity (p<0.01). It was also significantly associated with favourable karyotype (11% vs 3% favourable, 52% vs 48% intermediate and 3% vs 15% unfavourable). Patients with AML and MPO+ blasts >75% obtained higher CR rate (71% vs 55%), due to less resistant disease (9% vs 22%, p<0.01). In multivariate analysis favourable karyotype, leukocytes <50×109/L and age <60 were favourable prognostic factors for CR. Median OS and DFS was higher in patients with AML and MPO+ blasts >75% (15 vs 7 months, p<0.001, y 41 vs 12 months, p<0.001, respectively). ). In multivariate analysis, favourable karyotype, leukocytes <50×109/L, age <60 years and MPO+ >50% were favourable prognostic factors for OS; and age <60 and MPO+ >75% were the only independent factors for DFS. Median DFS was higher in patients with AML and MPO+ blasts >75% in the intermediate cytogenetic risk group (59 vs 13 months, p=0.015), age <60 (109 vs 15 months, p=0.003), age >60 (13 vs 7 months, p=0.03), autologous stem cell transplantation (100 vs 9 months, p=0.04) and chemotherapy alone (16 vs 8 months, p=0.003). Conclusion: In our series, patients with AML and MPO+ blasts >75% show less chemoresistant disease and a longer remission duration, the latter independently from the karyotype. This biological characteristic could be useful in designing therapeutic strategies in patients that lack other prognostic markers.

Early-stage carcinosarcoma of the uterus: the significance of lymph node count

2007 ◽  
Vol 17 (1) ◽  
pp. 215-219 ◽  
Author(s):  
S. M. Temkin ◽  
M. Hellmann ◽  
Y.-C. Lee ◽  
O. Abulafia
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Early Stage ◽  
Disease Free Survival ◽  
Myometrial Invasion ◽  
Lymph Node Count ◽  
Pathologic Features ◽  
Node Count ◽  
Disease Free

Carcinosarcoma is a rare tumor of the uterus with a poor prognosis, even when identified and treated at an early stage. The purpose of this study was to identify and analyze prognostic pathologic features and treatment outcomes in patient with stages I and II carcinosarcoma of the uterus. Patients with carcinosarcoma of the uterus who received primary surgical treatment between 1984 and 2004 were identified through an institutional tumor registry. Inclusion criteria were clinical stage I/II disease following hysterectomy and selective pelvic and para-aortic lymph node sampling. Regression analysis was used to determine risk factors for recurrence and survival. Disease-free and overall survival were then determined using Kaplan–Meier analysis. Forty-seven patients with stages I and II carcinosarcoma of the uterus were identified. Age, heterologous or homologous histology, and type of adjuvant treatment were not associated with recurrence or survival. Depth of myometrial invasion was found to correlate to disease-free survival but not overall survival. The number of lymph nodes collected correlated to risk of recurrence and survival. Disease-free and overall survival were greater in patients with higher lymph node count. We conclude that the number of lymph nodes collected was the only risk factor that was found to be correlated to recurrence and survival in patients with early-stage carcinosarcoma. These results support mounting evidence that lymphadenectomy is crucial in patients with carcinomas of the uterus in order to discover occult metastatic disease and potentially provide patients with a therapeutic benefit

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