Oncological outcomes in extended intervals time betweeen preoperative chemoradiation with capecitabine and surgery in operable rectal adenocarcinoma: Experience at the National Cancer Institute of Peru.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15158-e15158
Author(s):  
Miguel Angel Muñoz ◽  
Manuel Giancarlo Palacios ◽  
Jenny Malca ◽  
Paola Catherine Montenegro ◽  
Iván Chávez ◽  
...  
Keyword(s):  
Overall Survival ◽  
National Cancer Institute ◽  
Rectal Adenocarcinoma ◽  
Disease Free Survival ◽  
Time Interval ◽  
Time Intervals ◽  
Free Survival ◽  
Distal Edge ◽  
The Mean ◽  
Disease Free

e15158 Background: The literature reports that longer interval between the end of neoadjuvantchemoradiotherapy (CRT) and surgery is associated with a better rate of pathologic complete response (pCR) in rectal cáncer. Optimal interval remains to be defined. The effects of the extended time intervals on the prognosis are not clear. The objective was to assess whether extended time intervals ( < 8, 8-12, > 12-20 and > 20 weeks) between the end of neoadjuvant CRT and surgery improve overall survival (OS), disease-free survival (DFS) and pathological outcomes Methods: Aretrospective study was conducted for 124 patients with rectal adenocarcinoma without evidence of metástasis (T1-4/N0-2/M0) at the time of diagnosis that underwent surgery with curative intent after neoadjuvant CRT with capecitabine and obtained R0 or R1 resection between January 2010 to December 2014 at National Cancer Institute of Peru. Patients undergoing emergency surgery and R2 resection have been excluded. Survival curves were calculated according to Kaplan-Meier method and compared with log-rank test Results: Of the 124 patients, 72 were women (58.1%). The average age was 59.5 years. All received neoadjuvant CRT. Rates of pCR in the four groups were 25.0%, 10.3%, 7.7% and 17.2%, respectively. No significant difference was found between the association of the radial (P = 0.418) and distal edge (P = 0.487), with time interval groups and similarly with resected (P = 0.308) and compromised nodules (p = 0.783). The median OS follow-up time was 39.5 months and for DFS was 34 months. No significant differences were observed in OS (p = 0.739) and DFS (p = 0.902) according to the four groups studied. Conclusions: We found that amplifying the time interval at 31.9 weeks did not change the mean radial and distal edge. It does not affect the mean of resected and compromised nodules and does not improve overall survival and disease-free survival. The present study is the only one that reports these results at these time intervals. It allows to extend the intervals of time for future studies that finally will define the best time interval for the surgery.

A Systematic Review of Prognosis and Therapy of Anal Malignant Melanoma: A Plea for More Precise Reporting of Location and Thickness

2012 ◽  
Vol 78 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Ziad Kanaan ◽  
Aaron Mulhall ◽  
Suhal Mahid ◽  
Marla L. Torres ◽  
Michael McCafferty ◽  
...  
Keyword(s):  
Systematic Review ◽  
Overall Survival ◽  
Malignant Melanoma ◽  
Median Survival ◽  
Disease Free Survival ◽  
Lymph Node Status ◽  
Free Survival ◽  
Node Status ◽  
The Mean ◽  
Disease Free

Anal malignant melanoma (AMM) is a rare tumor with poor prognosis. We performed a systematic review of reports on wide local excision (WLE) and abdominoperineal resection (APR) for treatment of AMM in an attempt to define a precise set of reporting measures for outcomes of treatment of AMM. A systematic review of the literature was performed. Demographic data, surgical treatment, pathology, and survival rates were recorded. We compared WLE versus APR in terms of the overall survival time, the disease-free survival, and overall survival at 60 months. Twenty-one reports met the inclusion criteria. Notably, of these, 10 did not specify thickness of the primary melanoma. Interestingly, groin lymph node status was described in 19 of 21 reports, whereas location was specified in only 12 papers and thickness (depth in mm) in only 11. The median survival times of patients undergoing WLE (n = 324) and those undergoing APR (n = 369) are comparable (20 and 21 months, respectively). The mean median survival at 60 months was 15 per cent for WLE and 14 per cent for APR. The mean disease-free survival at 60 months was found to be 10 per cent for WLE and 6 per cent for APR. Patient selection for such a rare neoplasm yields very similar outcomes for both conservative and radical treatments. There is a wide variation in the reporting of both clinical and treatment outcomes. More uniformity of reporting of pathologic features and node status is essential before rational assessment of results can be done.

Conjunctival and uveal melanoma: Survival and risk factors following orbital exenteration

2021 ◽  
pp. 112067212199513
Author(s):  
Sven Holger Baum ◽  
Henrike Westekemper ◽  
Nikolaos Emmanouel Bechrakis ◽  
Christopher Mohr
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Uveal Melanoma ◽  
Disease Free Survival ◽  
Orbital Exenteration ◽  
Free Survival ◽  
The Mean ◽  
Disease Free ◽  
Worse Prognosis

Purpose: This study aims to analyse disease-free survival, overall survival and risk factors after orbital exenteration in patients with conjunctival and uveal melanoma. Methods: Patients who underwent orbital exenteration due to conjunctival and uveal melanoma were included in this retrospective study (March 2000 to March 2018). Results: A total of 76 patients were enrolled in this study: 60 patients had a conjunctival melanoma and 16 had a uveal melanoma. In conjunctival melanoma, the mean age was 68.4 years. The overall survival rate was 82% after 1 year and 52% after 5 years. Univariate analysis of overall survival found that the following parameters were predictive of a worse prognosis: gender, extent of the primary tumour, lymph node metastases, distant metastases, adjuvant chemotherapy or radiotherapy and relapse. In multivariate analysis, relapse and adjuvant radiotherapy appeared to contribute to a significantly worse prognosis. In uveal melanoma, the mean age was 63.6 years. Eleven patients died during follow-up (mean follow up 30.7 months). The overall survival and disease-free survival rates after 1 year were 62% and 57%, respectively. An analysis of risk factors was not possible due to the small number of cases. Conclusion: Orbital exenterations in conjunctival and uveal melanoma are rarely necessary, but can be performed as an ultima ratio treatment with curative intent. Disease-free survival and overall survival are significantly lower for both groups due to the advanced stage of the disease compared to patients treated without exenteration in the literature. If a recurrence occurs after exenteration, the prognosis is poor in both groups.

Impact of Chronic Graft Versus Host Disease in the Overall Survival and Disease Free Survival of Patients with Hematologic Disorders Submitted to Allogeneic Bone Marrow Transplantation

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4305-4305
Author(s):  
Emmerson de Sousa Eulalio ◽  
Elizabeth Schulz ◽  
José Salvador Rodrigues de Oliveira
Keyword(s):  
Bone Marrow ◽  
Overall Survival ◽  
Graft Versus Host Disease ◽  
De Novo ◽  
Disease Free Survival ◽  
Extensive Form ◽  
Free Survival ◽  
Graft Versus Host ◽  
The Mean ◽  
Disease Free

Abstract The management of the chronic graft versus host disease (C-GVHD) in the allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still challenging and does not follow a consensus. This disease can manifest as auto-immune phenomena, often affecting multiple organs, and it is considered as a determinant factor for higher post transplant mortality and detrimental quality of life, although conversely associated with a strong graft versus tumor effect which determines a beneficial biological response in patients with haematological pathologies. The aim of this study was to determine the impact of the C-GVHD in the overall survival (OS) and disease free survival (DFS) in patients with hematologic pathologies who underwent allo-HSCT with HLA identical donors in the BMT Hospitals Sao Paulo and Santa Marcelina, in Sao Paulo, Brazil. We performed a retrospective study of historical cohort including 233 allo-HSC transplants, 151 patients aged 9 to 63 years old (median 31) with survival superior to 100 days, from August 1993 to December 2004. The classification of DECH-C followed the criteria of Seattle (Shulman et al. 1980) revised by Lee et al (2003). Our series was composed of 97 patients with chronic myeloid leukemia (CML), 54 with acute leukemias (AL), 42 with marrow failure (MF) and 40 with lymphoproliferative diseases (LPD). Forty one percent of the patients exhibited the advanced disease at HSCT time and the main source of HSC was bone marrow (n=174, 74.7%). The diagnosis of C-GVHD was performed in 166 procedures (71.2%). Seventy one patients (42.8%) were classified as C-GVHD quiescent, 69 (41.6%) as de novo, and 25 (15.1%) as progressive. The extensive form occurred in 95 cases (57.2%) and the limited form in 70 cases (42.2%). The mean OS for our cohort was 34.5 months (m) and the mean DFS was 29.5 m. The mean OS of patients with C-GVHD was 42 m, significantly higher than than 33.8m OS of patients without C-GVHD (p=0.05). Similarly, the DFS was 38.6m for C-GVHD patients, against 22.6m of DFS for patients without C-GVHD (p=0.0001). The OS of those patients with C-GVHD de novo (47m) and quiescent (44.8m) were superior than the OS of patients without C-GVHD (33.8%) or with the progressive form of C-GVHD (20.8m), p=0.002. The same effect was observed for the DFS in the de novo form (42.6m) and quiescent form (41.4m) of C-GVHD, with a DFS twice superior than the progressive form (19.8m) and than the C-GVHD absent (22.6m), p=0.001. When compared with cases without C-GVHD, the clinical severity of the C-GVHD (limited or extensive) showed a strong correlation with a higher DFS. Patients with limited C-GVHD had a DFS of 38.3m and the extensive form a DFS of 38.9m, significantly superior than the DFS of patients without C-GVHD with a DFS of 22.6m (p=0.002). Hence, this study shows the existence of a correlation between the presence of C-GVHD and higher OS and DFS in patients with haematological disorders submitted to allo-HCT. The diagnosis of progressive C-GVHD was associated to a deleterious effect over the outcome of allo-HCT, therefore inactivating the benefits of the graft versus tumour effect observed in the clinical presentations de novo and quiescent of C-GVHD.

Neoadjuvant Chemotherapy with Taxotere-Epirubicin-5-Fluorouracil (TEF) in Local-Regionally Advanced Breast Cancer: A Preliminary Report

2002 ◽  
Vol 88 (6) ◽  
pp. 474-477 ◽  
Author(s):  
Eşmen Baltali ◽  
M Kadri Altundağ ◽  
Demir Ali Onat ◽  
Osman Abbasoğlu ◽  
Yavuz Özişik ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Chemotherapy Regimen ◽  
Disease Free Survival ◽  
Advanced Breast ◽  
Free Survival ◽  
The Mean ◽  
Disease Free

Aims and background Sixty-three patients with local-regionally advanced breast cancer were treated with neoadjuvant chemotherapy consisting of docetaxel (Taxotere), epirubicin, and 5-fluorouracil (TEF). Methods and study design Preoperatively, patients received four cycles of Taxotere (80 mg/m2), epirubicin (60 mg/m2), and 5-fluorouracil (500 mg/m2), repeated every 21 days. Following completion of four cycles of chemotherapy, appropriate surgery was performed. After the surgery, patients received one cycle of the TEF chemotherapy regimen; following chemotherapy, radiotherapy was applied, and at the end two more cycles of TEF chemotherapy regimen were given. Results Sixty-three patients with locally advanced breast cancer were treated. Three patients were excluded from the study before the evaluation of response. Median age of the patients was 50 years (range, 25–77). Twenty-seven and 33 patients were premenopausal and postmenopausal, respectively. Thirty-nine patients were in stage IIIA and 21 in stage IIIB. Complete and partial responses were observed in 15 (25%) and 42 (70%) of the patients following four cycles of preoperative TEF chemotherapy regimen, respectively. Overall response was 95%, and primary lesion progressed only in 3 (5%) patients. The mean disease-free survival was 15.9 ± 6.8 (range, 3.5–28) months and the mean overall survival was 18.6 ± 7.2 (range, 5–30) months. The most frequent side effects were nausea-vomiting, mucositis, alopecia and leukopenia. Conclusions TEF therapy is a treatment with a high overall response rate and toxicities similar to other taxotere combinations. A longer follow-up of patients is necessary for the determination of disease-free survival and overall survival.

scholarly journals Comprehensive Analysis of IGFBPs as Biomarkers in Gastric Cancer

2021 ◽  
Vol 11 ◽  
Author(s):  
Qi Liu ◽  
Jianwu Jiang ◽  
Xiefu Zhang ◽  
Meixiang Zhang ◽  
Yang Fu
Keyword(s):  
Gastric Cancer ◽  
Extracellular Matrix ◽  
Overall Survival ◽  
Prognostic Value ◽  
Expression Patterns ◽  
Rectal Adenocarcinoma ◽  
Disease Free Survival ◽  
Comprehensive Analysis ◽  
Free Survival ◽  
Disease Free

ObjectiveGastric cancer is the fifth most common cancer worldwide and the third leading cause of cancer-related deaths. Insulin-like growth-factor-binding proteins (IGFBPs) were initially identified as passive inhibitors that combined with insulin-like growth factors (IGFs) in serum. However, more recent data have shown that they have different expression patterns and a variety of functions in the development and occurrence of cancers. Thus, their various roles in cancer still need to be elucidated. This study aimed to explore the IGFBPs and their prognostic value as markers in gastric cancer.MethodsOncomine, Gene Expression Profiling Interactive Analysis (GEPIA), Kaplan–Meier Plotter, cBioPortal, GeneMANIA, and TIMER were used to analyze the differential expression, prognostic value, genetic alteration, and association with immune cell infiltration of IGFPBs in gastric cancer.ResultsExpression levels of IGFBP3, IGFBP4, and IGFBP7 were significantly elevated in gastric cancer tissues, whereas those of IGFBP1 were reduced in normal tissues. IGFBP1/5/7 expression was significantly associated with overall survival whereas IGFBP6/7 expression was significantly correlated with disease-free survival in gastric cancer patients. IGFBP3/5/6/7 were associated with clinical cancer stage. Gene ontology and Kyoto Encyclopedia of Genes and Genome analyses showed that IGFBP3/5/7 were mainly enriched in focal adhesion, extracellular matrix structural constituent, cell-substratist junction, extracellular structure, and matrix organization. Stomach adenocarcinoma (STAD) and gastric cancer had more IGFBP1–7 mutations than other tumor types. Hub gene analysis showed that TP53 and IGF2 expression was significantly elevated in STAD patients; PLG, PAPPA, AFP, and CYR61 were associated with overall survival rate; and IGFALS, PLG, IGF1, AHSG, and FN1 were associated with disease-free survival. Finally, IGFBP3–7 were all associated with cancer-associated fibroblast infiltration in STAD, colon adenocarcinoma, and rectal adenocarcinoma.ConclusionOur study provides a comprehensive analysis and selection of IGFBPs as prognostic biomarkers in STAD. This was the first bioinformatic analysis study to describe the involvement of IGFBPs, especially IGFBP7, in gastric cancer development through the extracellular matrix.

Comparison of clinical outcomes between enucleation and regular pancreatectomy in patients with non-functional pancreatic neuroendocrine tumors: a retrospective multicenter and propensity score-matched study

2021 ◽  
Author(s):  
Zhen Yang ◽  
Hengjun Gao ◽  
Jun Lu ◽  
Zheyu Niu ◽  
Huaqiang Zhu ◽  
...  
Keyword(s):  
Overall Survival ◽  
Postoperative Complications ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Neuroendocrine Tumors ◽  
Disease Free Survival ◽  
Pancreatic Neuroendocrine Tumors ◽  
Free Survival ◽  
Estimated Blood Loss ◽  
Disease Free

Abstract Objective There are limited data from retrospective studies on whether therapeutic outcomes after regular pancreatectomy are superior to those after enucleation in patients with small, peripheral and well-differentiated non-functional pancreatic neuroendocrine tumors. This study aimed to compare the short- and long-term outcomes of regular pancreatectomy and enucleation in patients with non-functional pancreatic neuroendocrine tumors. Methods Between January 2007 and July 2020, 227 patients with non-functional pancreatic neuroendocrine tumors who underwent either enucleation (n = 89) or regular pancreatectomy (n = 138) were included. Perioperative complications, disease-free survival, and overall survival probabilities were compared. Propensity score matching was performed to balance the baseline differences between the two groups. Results The median follow-up period was 60.76 months in the enucleation group and 43.29 months in the regular pancreatectomy group. In total, 34 paired patients were identified after propensity score matching. The average operative duration in the enucleation group was significantly shorter than that in the regular pancreatectomy group (147.94 ± 42.39 min versus 217.94 ± 74.60 min, P &lt; 0.001), and the estimated blood loss was also significantly lesser (P &lt; 0.001). The matched patients who underwent enucleation displayed a similar overall incidence of postoperative complications (P = 0.765), and a comparable length of hospital stay (11.12 ± 3.90 days versus 9.94 ± 2.62 days, P = 0.084) compared with those who underwent regular pancreatectomy. There were no statistically significant differences between the two groups in disease-free survival and overall survival after propensity score matching. Conclusion Enucleation in patients with non-functional pancreatic neuroendocrine tumors was associated with shorter operative time, lesser intraoperative bleeding, similar overall morbidity of postoperative complications, and comparable 5-year disease-free survival and overall survival when compared with regular pancreatectomy.

scholarly journals The role of functional polymorphisms in oxidative stress-related genes on early-stage breast cancer survival

2021 ◽  
pp. 172460082110111
Author(s):  
Erika Korobeinikova ◽  
Rasa Ugenskiene ◽  
Ruta Insodaite ◽  
Viktoras Rudzianskas ◽  
Jurgita Gudaitiene ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Single Nucleotide Polymorphisms ◽  
Early Stage ◽  
Disease Free Survival ◽  
Early Stage Breast Cancer ◽  
Nucleotide Polymorphisms ◽  
Single Nucleotide ◽  
Free Survival ◽  
Disease Free

Background: Genetic variations in oxidative stress-related genes may alter the coded protein level and impact the pathogenesis of breast cancer. Methods: The current study investigated the associations of functional single nucleotide polymorphisms in the NFE2L2, HMOX1, P21, TXNRD2, and ATF3 genes with the early-stage breast cancer clinicopathological characteristics and disease-free survival, metastasis-free survival, and overall survival. A total of 202 Eastern European (Lithuanian) women with primary I–II stage breast cancer were involved. Genotyping of the single nucleotide polymorphisms was performed using TaqMan single nucleotide polymorphisms genotyping assays. Results: The CA+AA genotypes of P21 rs1801270 were significantly less frequent in patients with lymph node metastasis and larger tumor size ( P=0.041 and P=0.022, respectively). The TT genotype in ATF3 rs3125289 had significantly lower risk of estrogen receptor (ER), progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) positive status ( P=0.023, P=0.046, and P=0.040, respectively). In both, univariate and multivariate Cox analysis, TXNRD2 rs1139793 GG genotype vs. GA+AA was a negative prognostic factor for disease-free survival (multivariate hazard ratio (HR) 2.248; P=0.025) and overall survival (multivariate HR 2.248; P=0.029). The ATF3 rs11119982 CC genotype in the genotype model was a negative prognostic factor for disease-free survival (multivariate HR 5.878; P=0.006), metastasis-free survival (multivariate HR 4.759; P=0.018), and overall survival (multivariate HR 3.280; P=0.048). Conclusion: Our findings suggest that P21 rs1801270 is associated with lymph node metastasis and larger tumor size, and ATF3 rs3125289 is associated with ER, PR, and HER2 status. Two potential, novel, early-stage breast cancer survival biomarkers, TXNRD2 rs1139793 and ATF3 rs11119982, were detected. Further investigations are needed to confirm the results of the current study.

Overexpression of NUAK1 is associated with disease-free survival and overall survival in patients with gastric cancer

2014 ◽  
Vol 31 (7) ◽  
Author(s):  
Xiao-tian Ye ◽  
Ai-jun Guo ◽  
Peng-fei Yin ◽  
Xian-dong Cao ◽  
Jia-cong Chang
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

Radical hysterectomy in early cervical cancer in Europe: characteristics, outcomes and evaluation of ESGO quality indicators

2021 ◽  
pp. ijgc-2021-002587
Author(s):  
Felix Boria ◽  
Luis Chiva ◽  
Vanna Zanagnolo ◽  
Denis Querleu ◽  
Nerea Martin-Calvo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Quality Indicators ◽  
Radical Hysterectomy ◽  
Disease Free Survival ◽  
Free Survival ◽  
Operative Complications ◽  
Early Cervical Cancer ◽  
Disease Free

IntroductionComprehensive updated information on cervical cancer surgical treatment in Europe is scarce.ObjectiveTo evaluate baseline characteristics of women with early cervical cancer and to analyze the outcomes of the ESGO quality indicators after radical hysterectomy in the SUCCOR database.MethodsThe SUCCOR database consisted of 1272 patients who underwent radical hysterectomy for stage IB1 cervical cancer (FIGO 2009) between January 2013 and December 2014. After exclusion criteria, the final sample included 1156 patients. This study first described the clinical, surgical, pathological, and follow-up variables of this population and then analyzed the outcomes (disease-free survival and overall survival) after radical hysterectomy. Surgical-related ESGO quality indicators were assessed and the accomplishment of the stated recommendations was verified.ResultsThe mean age of the patients was 47.1 years (SD 10.8), with a mean body mass index of 25.4 kg/m2 (SD 4.9). A total of 423 (36.6%) patients had a previous cone biopsy. Tumor size (clinical examination) <2 cm was observed in 667 (57.7%) patients. The most frequent histology type was squamous carcinoma (794 (68.7%) patients), and positive lymph nodes were found in 143 (12.4%) patients. A total of 633 (54.8%) patients were operated by open abdominal surgery. Intra-operative complications occurred in 108 (9.3%) patients, and post-operative complications during the first month occurred in 249 (21.5%) patients, with bladder dysfunction as the most frequent event (119 (10.3%) patients). Clavien-Dindo grade III or higher complication occurred in 56 (4.8%) patients. A total of 510 (44.1%) patients received adjuvant therapy. After a median follow-up of 58 months (range 0–84), the 5-year disease-free survival was 88.3%, and the overall survival was 94.9%. In our population, 10 of the 11 surgical-related quality indicators currently recommended by ESGO were fully fulfilled 5 years before its implementation.ConclusionsIn this European cohort, the rate of adjuvant therapy after radical hysterectomy is higher than for most similar patients reported in the literature. The majority of centers were already following the European recommendations even 5 years prior to the ESGO quality indicator implementations.

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