Recurrence rates of resected appendix carcinoid tumors: A 20-year experience at Memorial Sloan Kettering Cancer Center.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 221-221
Author(s):  
Jennifer Murphy ◽  
Andrew Rosowicz ◽  
Leonard Saltz ◽  
Philip Paty ◽  
Michael P. La Quaglia ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Lymph Node Involvement ◽  
Right Hemicolectomy ◽  
Carcinoid Tumors ◽  
Cancer Center ◽  
Single Institution ◽  
Recurrence Rates ◽  
Incidental Appendectomy ◽  
Average Size

221 Background: NETs of the appendix are rare neoplasms most often discovered during incidental appendectomy. Risk of nodal metastases based on single institution series has suggested that appendix carcinoid tumors > 2 cm should undergo a right colectomy. Unlike other tumors, lymph node involvement does not change management given the lack of adjuvant therapies. We sought to evaluate our experience of patients with resected appendix carcinoid, the risk of recurrence, and the benefit of surveillance following resection. Methods: A single institution database of all patients with diagnosis of neuroendocrine tumors was queried for all resected appendix carcinoid tumors. Excluded were patients with large and small cell neuroendocrine tumors, goblet carcinoid, and patients with inaccessible patient records. Results: 88 patients were included from August, 1994 through December, 2013. The mean age at diagnosis was 37.1(9.9-75.8). There were 19 (22%) children (less than 18 years of age) and 69 (78%) adults. Females represented 72% of all patients. All patients had well differentiated tumors. Median follow-up was 2.5 years (1-16.5 years, 45% of which had longer than 3-year follow-up). 43/88 (49%) patients underwent right hemicolectomy (average size 2 cm) and 45/88 (51%) simple appendectomy (average size 0.9 cm). Most patients were followed with CT scans and laboratory evaluations and frequency of surveillance was inconsistent. There were no recurrences (0/88). Ten-year survival was 100%. Conclusions: This is one of the largest series of resected appendix carcinoid reported and no patients recurred. Prognosis was excellent and in the absence of metastatic disease, excessive imaging and/or laboratory testing should be avoided. We question the use of routine right hemocolectomy in these patients.

Single-institution outcomes with less than two-year anti-PD-1 antibody therapy in metastatic melanoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22001-e22001
Author(s):  
Tsering G. Lama Tamang ◽  
John P. Fruehauf ◽  
Samuel Ejadi
Keyword(s):  
Adverse Events ◽  
Metastatic Melanoma ◽  
Antibody Therapy ◽  
Progression Free Survival ◽  
Cancer Center ◽  
Single Institution ◽  
Antibody Treatment ◽  
Clinical Criteria ◽  
Number Of Patients

e22001 Background: Optimal duration of anti-PD-1 antibody therapy remains undefined. Currently, treatment is given up to two years in metastatic melanoma based on clinical trials. However, recent observations suggest that anti-PD-1 antibodies may work as well if given for shorter time periods. To better understand duration of anti-PD-1 antibody treatment, we reviewed outcomes for patients who discontinued immunotherapy earlier than 2 years in our Cancer Center. Methods: This is a retrospective, single-institution review of metastatic melanoma patients who received anti-PD-1 antibodies from January 2010 to December 2019. We further identified the patients discontinuing treatment before completion of 2 years for reasons other than disease progression. Duration was categorized into three groups: < 6 months (A), 6-12 months (B) and > 12 months (C) and outcomes were analyzed. Progression free survival (PFS) was defined as the time from the initiation of anti-PD1-therapy to the date of progression as determined by treating physician based on radiological, biochemical and/or clinical criteria. Results: 25 patients with mean age 69 years (49-91; N = 19 > 60yo) were identified. Number of patients who received anti-PD-1 antibodies were N = 8, N = 9 and N = 8 in in groups A, B and C respectively. 44% of patients discontinued treatment after achieving either partial or near complete remission, whereas the remaining 66% of patients discontinued treatment due to adverse events. Majority of patients who stopped treatment due to adverse events were older than 60 (71.4%). In 29 months of median follow up (range 11-54), none of patients who received treatment in group B progressed, whereas in groups A and C, 25% percentage progressed in each group with 80% PFS at 12.8 months and 88% PFS at 26 months respectively. 12.5% of patients in group A had progression at 12 months follow up, where no progression was noticed in groups B and C during the same time period. Conclusions: Retrospective analysis of our experience supports other retrospective findings that treatment with anti-PD-1 antibodies more than 12 months might not add further benefit in responding or non-progressing older patients though further study with longer follow up is required.

scholarly journals High expression of 5-hydroxymethylcytosine is associated with a more favorable hepatoblastoma prognosis in Chinese patients

2021 ◽  
Author(s):  
Junting Huang ◽  
Yang Hu ◽  
Huadong Chen ◽  
Binbin Chen ◽  
Yu Zhang ◽  
...  
Keyword(s):  
Cox Regression ◽  
Prognostic Indicator ◽  
Chinese Patients ◽  
Cancer Center ◽  
Event Free Survival ◽  
Recurrence Rates ◽  
Tissue Samples ◽  
Free Survival ◽  
Kaplan Meier

Abstract Background To analyze associations between the strength of expression of 5-hydroxymethylcytosine (5hmC) and survival outcomes of Chinese hepatoblastoma patients. Methods We collected and analyzed clinical data of hepatoblastoma patients aged <15 years treated at the Sun Yat-Sen University Cancer Center or the First Affiliated Hospital of Sun Yat-sen University from Feb 2010 to Sept 2018. Patients were treated according to the Children's Oncology Group protocol. Specimens for pathology were collected by biopsy or surgical resection before initiation of chemotherapy. The level of expression of 5hmC was analyzed in tissue samples from 100 patients by immunohistochemistry. The prognostic value of 5hmC was evaluated by Cox regression and Kaplan-Meier analyses. Results We enrolled 100 patients with hepatoblastoma (median follow-up, 43.0 months; range, 18.4–131.6). The total recurrence rate was 30.0%. Three-year overall survival (OS) rates of high and low 5hmC expressors was 92.6%±3.6% and 80.3%±5.9%, respectively. Three-year event-free survival (EFS) of high and low expressors was 84.4%±5.1% and 49.8%±7.7%, respectively. Thus, high levels of 5hmC expression are associated with more favorable OS and EFS. Multivariate analysis indicated that 5hmC expression level was an independent prognostic indicator for OS and EFS. Conclusions Our findings showed that strong hepatoblastoma 5hmC expression was associated with lower recurrence rates and longer EFS and OS. Thus, 5hmC expression may have prognostic relevance in hepatoblastoma.

scholarly journals Predictors of Treatment Response and Survival Outcomes in Meningioma Recurrence with Atypical or Anaplastic Histology

Neurosurgery ◽  
2017 ◽  
Vol 82 (6) ◽  
pp. 824-832 ◽  
Author(s):  
Muhammad O Chohan ◽  
Christopher T Ryan ◽  
Ranjodh Singh ◽  
Ryan M Lanning ◽  
Anne S Reiner ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Extent Of Resection ◽  
Cancer Center ◽  
Tumor Control ◽  
Subtotal Resection ◽  
Recurrence Rates ◽  
Risk Of Progression ◽  
Anaplastic Histology ◽  
First Recurrence

Abstract BACKGROUND Recurrence rates for atypical and anaplastic meningiomas range between 9% and 50% after gross total resection and between 36% and 83% after subtotal resection. Optimal treatment of recurrent meningiomas exhibiting atypical/anaplastic histology is complicated because they are often refractory to both surgery and radiation. OBJECTIVE To evaluate clinical determinants of recurrence and treatment-specific outcomes in patients with recurrent meningiomas exhibiting atypical/anaplastic histology at our institution. METHODS A cohort study was conducted using clinical data of all patients treated for meningiomas with atypical/anaplastic histology at first recurrence between January 1985 and July 2014 at a tertiary cancer center. Predictors of second recurrence were analyzed using competing risks regression models. RESULTS Nine hundred eighteen patients with meningioma were screened, of whom 60 (55% female) had recurrent disease with atypical/anaplastic histology at a median age of 58.1 yr at diagnosis. The median follow-up from the time of first recurrence was 36.7 mo, with 32 (53%) patients alive at last follow-up. There was no effect of extent of resection at first recurrence on time to a subsequent recurrence. Inclusion of radiation as primary or adjuvant therapy at first recurrence reduced the risk of progression or subsequent recurrence compared to surgery alone (P = .07). CONCLUSION Treatment of recurrent meningiomas with atypical/anaplastic histology remains challenging. Our data, from one of the largest cohorts, suggest better tumor control with the addition of radiation and challenges the importance of extent of resection at first recurrence. A multicenter effort is needed to confirm these findings and propose treatment guidelines.

scholarly journals RADICAL SURGICAL TREATMENT OF NEUROENDOCRINE TUMORS OF APPENDIX IN CHILDREN – Polish multicenter study

2021 ◽  
Author(s):  
Małgorzata Panek ◽  
Marek Szymczak ◽  
Wojciech Górecki ◽  
Jerzy Niedzielski ◽  
Piotr Kaliciński
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Neuroendocrine Tumors ◽  
Right Hemicolectomy ◽  
Ileocecal Resection ◽  
Overall Survival Rate ◽  
Secondary Surgery ◽  
Extended Surgery ◽  
Well Differentiated

IntroductionThe aim of study was to examine management of pediatric appendiceal neuroendocrine tumors (ANET) in Poland.Material and methodsRecords of 27 patients with ANET diagnosed incidentally after appendectomy in last decade.ResultsWell-differentiated NET G1/G2 was diagnosed in 25 and well-differentiated neuroendocrine carcinoma G3 in 2 patients. Extended surgery was performed primary in one instance and secondary in 10 patients (right hemicolectomy in 9, ileocecal resection in one) without adjuvant chemotherapy. Follow-up ranged 1-121 months. Recurrence after secondary surgery was observed in one patient (3,7%).ConclusionsApplying ENETS guidelines resulted in 100% overall survival rate of patients with NET.

Right Hemicolectomy is not Routinely Indicated in Pseudomyxoma Peritonei

2012 ◽  
Vol 78 (2) ◽  
pp. 171-177 ◽  
Author(s):  
Jason M. Foster ◽  
Prateek K. Gupta ◽  
Joseph H. Carreau ◽  
Travis E. Grotz ◽  
Joseph V. Blas ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Pseudomyxoma Peritonei ◽  
Tumor Recurrence ◽  
Performance Status ◽  
Retrospective Chart Review ◽  
Tumor Grade ◽  
Lymph Node Involvement ◽  
Right Hemicolectomy ◽  
Recurrence Rates ◽  
And Performance

Pseudomyxoma peritonei (PMP) is primarily the result of a ruptured mucinous appendix neoplasm (MAN). Often MAN is lumped with but biologically distinct from intestinal appendiceal adenocarcinoma. Nodal and systemic dissemination are rare with the peritoneal cavity being the primary site of recurrence. Routine performance of right hemicolectomy (RHC) for PMP/MAN has been extensively debated without consensus. Our objective was to ascertain whether RHC has a survival advantage over appendectomy. We hypothesize if RHC is mandatory, then increased tumor recurrence and mortality should be observed in appendectomy only. Retrospective chart review was carried out in patients with tumors that met the Ronnett classification for PMP/MAN. Demographics, tumor grade, extent, recurrence, and progression were recorded. We report the rate of nodal involvement/recurrence in patients treated with RHC versus appendectomy as well as the rate of systemic and peritoneal recurrence and survival. Multivariate logistic regression was done to identify factors that impact survival. Of 120 patients, 48 had appendectomy and 72 had RHC. Seven per cent of patients undergoing RHC had positive lymph nodes and no nodal failures (0%) in patients undergoing appendectomy. Appendectomy versus RHC recurrence rates (21 vs. 28%, P = 0.12) and death resulting from disease (8 vs. 22%, P = 0.27) were similar. Logistic regression revealed that the type of surgery had no impact on recurrence and mortality, only optimal resection score and performance status. There was no difference in tumor recurrence or survival based on treatment by appendectomy or RHC. Performance status and complete cytoreduction are the only factors associated with survival. Lymph node involvement is rare and selective RHC is safe in PMP/MAN.

Is Interval Appendectomy Indicated after Non-Operative Management of Acute Appendicitis in Patients with Cancer? A Retrospective Review from a Single Institution

2015 ◽  
Vol 81 (5) ◽  
pp. 532-536 ◽  
Author(s):  
Tushar Samdani ◽  
Tiffany T. Fancher ◽  
Frederic M. Pieracci ◽  
Soumitra Eachempati ◽  
Laila Rashidi ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Cancer Progression ◽  
Total Duration ◽  
Operative Management ◽  
Cancer Center ◽  
First Episode ◽  
Interval Appendectomy ◽  
Single Institution ◽  
End Stage

Interval appendectomy (IA) is a controversial subject, with little consensus on its use in patients undergoing treatment for malignancy. We sought to determine the frequency of recurrent appendicitis in cancer patients managed nonoperatively (NOM) during index hospitalization (IHA) for acute appendicitis (AA). Clinical presentation, cancer treatment, and follow-up were collected from electronic medical records of patients with CT scan-confirmed AA treated at a single institution between August 1999 and August 2009. Seventy-two of 109 AA patients underwent appendectomy during IHA;34ofthese 109 wereNOM during IHA.Medianindex lengthofNOM patients'staywas six days (0–55), median age was 59 (18–80) years. Indications for NOM were presence of abscess or phlegmon (14), mild symptoms (13), high surgical risk (3), end-stage cancer (3), and patient declining surgery (1). Eight NOM patients underwent percutaneous drainage of abdominal abscess (median total duration of intravenous + oral antibiotics = 12 days [0–55]). There were six deaths (1 IHA, 5 NOM): four sepsis and two cancer progression. At a median of 19-month follow-up (range 1–103), four NOM patients surviving IHA had recurrent AA (11.7%) at two (n = 2) and three months (n = 2) after the first episode. Overall, six had IA (17.6%) one to seven months post AA; 25 remained asymptomatic, without IA. In conclusion, among NOM patients at a cancer center at IHA for AA, recurrent AA was early (< 4 months) but uncommon. IA should be offered to those with recurrent symptoms, but appears to have a very limited role after several months of asymptomatic follow-up.

scholarly journals Surgical excision of wrist ganglia; literature review and nine-year retrospective study of recurrence and patient satisfaction

2009 ◽  
Vol 1 (1) ◽  
pp. 5 ◽  
Author(s):  
Surjit Lidder
Keyword(s):  
Retrospective Study ◽  
Hand Surgery ◽  
Surgical Excision ◽  
Consecutive Series ◽  
Single Institution ◽  
Recurrence Rates ◽  
The Mean ◽  
Open Excision

The main options for the treatment of wrist ganglia are reassurance, aspiration, arthroscopic resection and open excision. Variations within each option have been described and the literature is clouded by widespread variability in the results reported. We present the results of our own long-term retrospective study, review the literature and question the surgical risks and demands placed on healthcare resources. A retrospective review of the surgical results of dorsal and volar wrist ganglia excision between January 1998 and March 2005 was undertaken at a single institution. Of the 152 patients in this consecutive series, 117 (77%) patients responded to a telephone questionnaire. The mean length of follow-up in this series of 117 patients was 4.2 years (range 1.5-8.7 years). The overall recurrence rate following excision of all wrist ganglia in this series was 41.8 %. When looking just at volar ganglia, the risk of recurrence is higher at 46.8%. Should the ganglion recur, the risk of developing a moderate to severely tender scar is 34.6% and the risk of developing an unsightly scar is 8.2%. This study questions the effectiveness of surgical excision in the treatment of wrist ganglia when performed by a mixture of surgeons in that the recurrence rates are very similar to the rates seen in studies that merely observe or aspirate wrist ganglia. We propose that for symptomatic ganglia, specialists in hand surgery may be more appropriate at treating such a pathology.

scholarly journals Childhood carcinoid tumors: description of a case series in a Brazilian cancer center

2006 ◽  
Vol 124 (1) ◽  
pp. 21-25 ◽  
Author(s):  
Gustavo Ribeiro Neves ◽  
Paulo Chapchap ◽  
Simone Treiger Sredni ◽  
Cristiano Ribeiro Viana ◽  
Wellington Luiz Mendes
Keyword(s):  
Primary Tumor ◽  
Early Stage ◽  
Case Series ◽  
Right Hemicolectomy ◽  
Good Prognosis ◽  
Carcinoid Tumors ◽  
Cancer Center ◽  
Primary Tumor Site ◽  
Morphological Findings ◽  
Main Complaint

CONTEXT AND OBJECTIVE: Carcinoid tumors are very rare both in children and adults. About 85% of these tumors develop in the gastrointestinal tract. The objective of the present study was to describe our experience with children treated of carcinoid tumors, and investigate the frequency morphological findings and results. DESIGN AND SETTING: Report on case series, at the Department of Pediatrics of Centro de Tratamento e Pesquisa Hospital do Câncer, São Paulo. METHODS: This was a retrospective analysis of clinical pathological data and outcomes among children (< 18 years old) with carcinoid tumors admitted from January 1, 1990, to December 31, 2001. RESULTS: Nine patients (mean age 12.2 years) were included: six girls and three boys (2:1), all of them Caucasian. In eight cases (89%), the primary tumor site was the appendix and in one (11%) it was the left bronchus. For those with primary tumor in the appendix, the main complaint was abdominal pain, which led to appendectomy. Only one patient underwent right hemicolectomy due to tumor extension into the serosa. The patient with bronchial tumor underwent left pneumonectomy. All patients had localized disease and are alive and free of disease. They have had follow-ups lasting from 1 to 11 years (mean of 3.5 years). CONCLUSION: Although the majority of carcinoid tumors arise from the appendix, these tumors can also occur in other primary sites. Surgical resection at an early stage allows for good prognosis without the need for any adjuvant treatment.

scholarly journals HCV Eradication with Direct-Acting Antivirals Does Not Impact HCC Progression on the Waiting List or HCC Recurrence after Liver Transplantation

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Juliet A. Emamaullee ◽  
Mariusz Bral ◽  
Glenda Meeberg ◽  
Aldo J. Montano-Loza ◽  
Vincent G. Bain ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Virologic Response ◽  
Direct Acting Antivirals ◽  
Single Institution ◽  
Recurrence Rates ◽  
Patient Demographics ◽  
Direct Acting ◽  
The Impact ◽  
Hcc Recurrence

Background. The introduction of direct-acting antivirals (DAA) for HCV has led to high rates of HCV eradication. Treatment of patients awaiting liver transplantation (LT) has been controversial. Recent data suggests that DAA treatment may accelerate recurrent HCC. The impact of DAA on delisting for HCC progression or recurrent HCC post-LT has not been well characterized. Methods. A retrospective review of both waitlist patients and LT recipients at a single institution was performed. Patient demographics, HCV treatment, HCC features and treatments, biopsy results, and graft and patient survival were evaluated. Patients on the LT waitlist or who were transplanted between January 2014 and December 2015 were included. Data was collected through December 2017 to have a minimum of two years of follow-up. Results. In the study period, 128 adult LT were performed. 44 patients were HCV+, and 68.2% (N=30) also had HCC. 38.6% (N=17) of HCV+ patients received DAA pre-LT, and 94.1% (N=16/17) achieved sustained virologic response (SVR) pre-LT. Among untreated HCV+ patients who underwent LT, 81.5% (N=22/27) received DAA post-LT, with 82.6% achieving SVR post-LT (N=18/22). 82.1% (N=23/28) of untreated post-LT patients underwent liver biopsy prior to therapy, and 52.2% had at least F1 METAVIR fibrosis. 87.5% (N=14/16) of active waitlist patients received DAA and achieved SVR. HCV eradication did not result in higher rates of delisting for HCC progression. Due to local HCC listing criteria of total tumor volume and AFP, 60% (N=18/30) of HCV+/HCC patients were beyond Milan criteria at the time of LT. Despite this, there was no difference in HCC recurrence rates post-LT, whether patients achieved SVR pre- or post-LT. Conclusions. These data suggest that HCV eradication pre-LT does not significantly impact waitlist time for HCV+ patients with HCC. HCV eradication does not impact rates of delisting for HCC progression or rates of HCC recurrence post-LT.

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