The clinicopathologic features and optimal surgical treatment of duodenal gastrointestinal tumor.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 519-519
Author(s):  
Seungjae Lee ◽  
Ki Byung Song
Keyword(s):  
Multivariate Analysis ◽  
Surgical Treatment ◽  
Surgical Resection ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Mitotic Count ◽  
Perioperative Outcomes ◽  
Survival Outcomes ◽  
Clinicopathologic Features ◽  
Duodenal Gist

519 Background: Because of unclear clinicopathologic features, the optimal surgical procedure for duodenal gastrointestinal stromal tumor (GIST) remains poorly defined. We analyze clinicopathological features and recommend optimal surgical treatment of duodenal GIST. Methods: From July, 2000 to April 2017, 118 patients who had localized duodenal GIST were treated by curative surgical resection at a single institution. We retrospectively reviewed the clinicopathological characteristics and survival outcomes. Results: In survival analysis of all patients, 5-year overall survival (OS) and disease-free survival (DFS) rate were 94.9 and 79.2%, respectively. 19 patients developed recurrent disease at a median of 26.1 months from surgery and most common recurrence site was liver (63.2%). In multivariate analysis, mitotic count was the statistically significant prognostic factors of DFS. Our 20 cases of duodenal GIST in 1st or 4th portion were completely resected by limited resection(LR), regardless of tumor size. 98 patients with GISTs in 2nd or 3rd portion of duodenum underwent LR (n = 53) or pancreaticoduodenectomy (PD) (n = 45). Patients in the LR group had a smaller median tumor size (4.0 vs 5.3 cm, p = 0.026), more antimesenteric-sided location (41 vs 7cases, p < 0.001), less late complications (1 vs 7 cases, p = 0.014) and no postoperative newly developed diabetes mellitus (0 vs 4 cases, p = 0.027) than those in the PD group. When 53 patients in LR group further divided into minimal invasive LR (MILR) (n = 12) and open-LR (n = 41), MILR group had shorter operation time (155.0 vs 218.8 minutes, p = 0.013) and postoperative hospital stay (12.0 vs 19.4 days, p = 0.036). Conclusions: Patients with duodenal GIST who underwent complete surgical resection have favorable survival outcomes. Predictor of disease recurrence at multivariate analysis was mitotic count. LR is feasible and effective surgical treatment for the patients with small-sized, and anti-mesenteric sided duodenal GIST in terms of long-term oncologic outcomes and quality of life. MILR has better perioperative outcomes than open LR. Therefore, we should consider MILR as optimal surgical treatment for the selected patients with duodenal GIST.

Clinicopathologic characteristics and survival outcomes in multifocal and multicentric breast cancer.

2013 ◽  
Vol 31 (26_suppl) ◽  
pp. 41-41
Author(s):  
Atsushi Fushimi ◽  
Atsushi Yoshida ◽  
Osamu Takahashi ◽  
Naoki Hayashi ◽  
Hiroshi Yagata ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Survival Outcomes ◽  
Breast Cancers ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

41 Background: Although multifocal and multicentric (MF/MC) breast cancers are a common entity, their clinical behaviors are not well characterized. We evaluated the impact of MF/MC on the disease-free survival (DFS) and distant disease free survival (DDFS) of breast cancer patients and compared clinicopathological characteristics between MF/MC breast cancers and breast cancers with single lesion. Methods: We retrospectively analyzed 734 consecutive patients who had invasive breast carcinoma and underwent definitive surgery at the St Luke’s International Hospital from January 2004 to December 2006. MF or MC ware defined as more than one lesion in the same quadrant or in separate quadrants, respectively. DDFS and DFS ware calculated by The Kaplan–Meier method. Univariate analysis was performed using the log rank test and multivariate analysis by Cox proportional hazards models. Results: Of 734 patients, 136 (18.5%) had MF/MC disease. MF/MC disease was associated with smaller tumor size (P <0.001). Multivariate analysis shows that MF/MC disease did not have an independent impact on DDFS or DFS adjusting by age, ER status, tumor size, lymphovascular invasion, lymph node metastases and nuclear grade. Conclusions: MF/MC breast cancers were not associated with poor prognostic factors, and were not independent predictors of worse survival outcomes. Our findings support the current TNM staging system of using the diameter of the largest lesion to assign T stage.

Gastrointestinal Stromal Tumors: A “Benign” Tumor with Hepatic Metastasis after 11 Years

1998 ◽  
Vol 84 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Carlo Ballarini ◽  
Mattia Intra ◽  
Andrea Pisani Ceretti ◽  
Francesco Prestipino ◽  
Filippo Maria Bianchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Metastasis ◽  
Tumor Size ◽  
Gastrointestinal Stromal Tumors ◽  
Cellular Proliferation ◽  
Malignant Potential ◽  
Mitotic Count ◽  
Proliferation Index ◽  
Ki 67 ◽  
Stromal Tumors

Gastrointestinal stromal tumors (GIST) constitue the largest category of primary non-epithelial neoplasms of the stomach and small bowel. They are characterized by a remarkable cellular variability and their malignant potential is sometimes difficult to predict. Very recent studies, using mitotic count and tumor size as the best determinants of biological behavior, divide GISTs into three groups: benign, borderline and malignant tumors. We report on a male patient who underwent a right hepatectomy for a large metastasis 11 years after the surgical treatment of an antral-pyloric gastric neoplasm, histologically defined as leiomyoblastoma and with clinical, morphological and immunohistochemical features of benignity (low mitotic count, tumor size < 5 cm, low cellular proliferation index). Histological and immunohistochemical analysis of the hepatic metastasis showed the cellular proliferation index (Ki-67) to be positive in 25% of neoplastic cells, as opposed to the primary gastric tumor in which Ki-67 was positive in only 5% of neoplastic cells. In conclusion, although modern immunohistochemical techniques are now available to obtain useful prognostic information, the malignant potential of GISTs is sometimes difficult to predict: neoplasms clinically and histologically defined as benign could metastasize a long time after oncologically correct surgical treatment. Therefore, benign GISTs also require consistent, long-term follow-up.

An Update on the Surgical Treatment of Temporal Bone Paraganglioma

2000 ◽  
Vol 13 (1_suppl) ◽  
pp. 179-188
Author(s):  
Kris S. Moe ◽  
Daqing Li ◽  
Thomas E. Linder ◽  
Stephan Schmid ◽  
Ugo Fisch
Keyword(s):  
Surgical Treatment ◽  
Temporal Bone ◽  
Surgical Resection ◽  
Infratemporal Fossa ◽  
Cranial Nerves ◽  
Disease Free Survival ◽  
Current Therapy ◽  
Intracranial Extension ◽  
Tumor Excision ◽  
Intradural Tumor

In 1982, Fisch described his results for the surgical treatment of 74 paragangliomas of the temporal bone, 5 years after his description of the infratemporal fossa approaches (types A and B). This study reviews the subsequent experience of the Department of Otolaryngology—Head and Neck Surgery of the University of Zürich with more than 136 surgically treated cases of paraganglioma of the temporal bone and discusses our current therapy 20 years after the initial description. One hundred nineteen (90%) of the patients had advanced tumors (Fisch class C or C+D), and 81 (68%) had intracranial extension. Total tumor excision was possible in 109 (82%) patients. Subtotal excision was performed in 22 (17%) patients, 21 of whom had intradural tumor invasion. In these cases, the resection was limited not by actual tumor size but by the degree of intracranial intradural tumor extension. Partial tumor excision was undertaken in only 1 patient with a C4De2Di2 tumor. The success rate in preservation of function of the lower cranial nerves was encouraging. Of the 69 patients whose facial nerve status was followed postoperatively, 81% maintained Fisch grade 76 to 100% (House-Brackman grades I and II). Analysis of follow-up data ranging from 2 to 11 years demonstrated 98% disease-free survival when total tumor extirpation was possible. In the patients who underwent subtotal or partial surgical resection there has been no subsequent tumor growth detected by either clinical or neuroradiological evaluation. We have confirmed after more than 20 years of experience that the infratemporal fossa approaches are a safe, highly effective means of surgical management of paragangliomas of the temporal bone, allowing eradication or arrest of disease with minimal morbidity. Limited intradural surgical resection in cases of very extensive tumors can greatly benefit patients for whom complete excision is not an option.

scholarly journals Radical Hysterectomy After Neoadjuvant Chemotherapy for Locally Bulky-Size Cervical Cancer: A Retrospective Comparative Analysis between the Robotic and Abdominal Approaches

2019 ◽  
Vol 16 (20) ◽  
pp. 3833 ◽  
Author(s):  
Chia-Hao Liu ◽  
Yu-Chieh Lee ◽  
Jeff Chien-Fu Lin ◽  
I-San Chan ◽  
Na-Rong Lee ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Radical Hysterectomy ◽  
Disease Free Survival ◽  
Figo Stage ◽  
Lower Percentage ◽  
Perioperative Outcomes ◽  
Survival Outcomes ◽  
Agent Based ◽  
Multi Agent

Radical hysterectomy (RH) is the standard treatment for early stage cervical cancer, but the surgical approach for locally bulky-size cervical cancer (LBS-CC) is still unclear. We retrospectively compared the outcomes of women with LBS-CC treated with neoadjuvant chemotherapy (NACT) and subsequent RH between the robotic (R-RH) and abdominal approaches (A-RH). Between 2012 and 2014, 39 women with LBS-CC FIGO (International Federation of Gynecology and Obstetrics) stage IB2–IIB were treated with NACT-R-RH (n = 18) or NACT-A-RH (n = 21). Surgical parameters and prognosis were compared. Patient characteristics were not significantly different between the groups, but the NACT-R-RH group had significantly more patients with FIGO stage IIB disease, received multi-agent-based NACT, and had a lower percentage of deep stromal invasion than the NACT-A-RH group. After NACT-R-RH, surgical parameters were better, but survival outcomes, such as disease-free survival (DFS) and overall survival (OS), were significantly worse. On multivariate analysis, FIGO stage IIB contributed to worse DFS (p = 0.003) and worse OS (p = 0.012) in the NACT-A-RH group. Women with LBS-CC treated with NACT-R-RH have better perioperative outcomes but poorer survival outcomes compared with those treated with NACT-A-RH. Thus, patients with FIGO stage IIB LBS-CC disease might not be suitable for surgery after multi-agent-based NACT.

Synovial sarcoma: Retrospective analysis of treatment outcome and prognostic factors

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 20517-20517
Author(s):  
M. A. Memon ◽  
A. A. Allam ◽  
A. M. El-Enbaby ◽  
M. El-Sebaie ◽  
Y. M. Khafaga ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Treatment Outcome ◽  
Prognostic Factors ◽  
Synovial Sarcoma ◽  
Surgical Resection ◽  
Local Control ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Tumor Stage ◽  
Stage Iii

20517 Introduction and Objectives: Synovial Sarcoma (SS) account for approximately 10 % of soft tissue sarcoma. Despite numerous case reports and several relatively large series, debate still exists about the prognostic factors for this disease, the biologic behavior and role of adjuvant chemotherapy. The purpose of this study is to analyze the variable prognostic factors that may affect the treatment outcome in patients with SS. Patient and Methods: Sixty-six patients with SS (36 males and 30 females) were seen in institution between January 1985 and December 2000. Median age at diagnosis was 29 years. Site of involvement include, lower extremities 43/66 cases; (65%), upper extremity 16/66 (24%), trunk 3/66 (5%), others 4/66 (include larynx, thyroid, neck, and hypopharynx).Tumor size: = 10 cm 42/66 (64%), = 10 cm 24/66 (36%). Patients with stage III and IV disease represented 58% of all patients (38/66), stage I and II 42%(28/66). All patients underwent surgery and adequate resection margins(= 2 cm) were achieved in 52% of cases. Histopathology: Biphasic 36/66, Monophasic 16/66, spindle cell 12/66 and not otherwise specified 2/66. Radiation therapy was given 44/66 cases (67%). Chemotherapy was delivered to 11/66 patients (17%). Results: With a median follow up of 50 months, the 5-year overall survival (OS) for all patients was 45%, while the 5- year relapse free survival (RFS) for patients treated with radical intent was 32%. Prognostic factors that significantly affected OS on univariate analysis were tumor size (≤ 10 cm vs > 10cm), tumor stage (stages I and II vs stage III), adequacy of surgical resection and local control. On multivariate analysis, tumor size and local control were the only independent factors that did affect OS. For RFS, sex, tumor size, tumor grade, tumor stage, and adequacy of surgical resection were the prognostic factors of significance on univariate. Tumor stage and sex were the only independent prognostic factors of significance on multivariate analysis for RFS. Conclusion: Tumor size, stage, grade, and adequacy of surgical resection are the main prognostic factors affecting OS and RFS. These parameters can help to identify the high risk patient who may qualify for aggressive treatment. No significant financial relationships to disclose.

Does tumor size in T1-T2 early breast cancer (EBC) still have a prognostic role?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12087-e12087 ◽  
Author(s):  
Anaid Anna Kasangian ◽  
Anna Moretti ◽  
Elena Biagioli ◽  
Elena Bernardin ◽  
Andrea Cordovana ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Tumor Size ◽  
Molecular Subtype ◽  
Univariate Analysis ◽  
Disease Free Survival ◽  
Tnm Staging ◽  
Tumor Diameter ◽  
Histological Grading ◽  
Her2 Positive ◽  
Worse Prognosis

e12087 Background: Theprognosis of EBC patients (pts) depends on pts characteristics and tumor biological/ histopathological features. The correlation between tumor size, expressed as the largest diameter in TNM staging, and overall survival (OS) and disease free survival (DFS) is well recognized. According to TNM, tumors classified as T2, could have different volumes (V); e.g. a tumor of 2,1 cm has a V of 4500 mm3, while a tumor of 4,9 cm has a V of 60000 mm3. Despite belonging to the same class, the two different V may have a different prognosis. The aim of the study is to establish if the role of tumor size has been surpassed by other factors. Methods: The purpose is to evaluate the correlation between V and DFS/OS, in a T1-T2 population, who underwent breast surgery and sentinel lymph node biopsy, in our institution from 01.01.2005 to 30.09.2013. V was evaluated with the measurement of three half-diameters of the tumor (a, b and c), and calculated with this formula: 4/3 * π * a * b * c. Results: 341 pts with T1-T2 EBC who underwent surgery were included. 86,5% were treated with conservative surgery. 85,1% had a luminal subtype, 9,1% triple negative (TN) and 7,4% Her2 positive (+). Median V was 942 mm3 (range 0,52-31651,2). 44 pts (12,9%) relapsed and 23 pts died. With a median follow-up of 6,5 years, the univariate analysis for DFS showed a correlation between age (p 0,016), tumor size (p 0,032), V (p 0,078), histological grading (p 0,001), molecular subtype (p < 0,001). The multivariate analysis confirmed the statistically significant correlation only for molecular subtype (p 0,005), showing a worse prognosis for TN and Her2+ subtypes. Regarding OS, a statistically significant correlation was shown by the univariate analysis both for histological grading (p 0,018) and molecular subtype (p 0,001). The multivariate analysis confirmed that TN and Her2+ subtypes negatively influence OS (p 0,005). Conclusions: In our study neither V nor tumor diameter seem to correlate with DFS and OS in T1-T2 tumors; the only parameter that strongly influences DFS and OS, is molecular subtype, confirming the worse prognosis of TN and Her2+ versus luminal tumors. These findings encourage clinics to choose adjuvant treatment not based on dimensional criteria but on biological features.

scholarly journals Surgical Approaches and Oncological Outcomes in the Management of Duodenal Gastrointestinal Stromal Tumors (GIST)

2021 ◽  
Vol 10 (19) ◽  
pp. 4459
Author(s):  
Nikolaos Vassos ◽  
Aristotelis Perrakis ◽  
Werner Hohenberger ◽  
Roland S. Croner
Keyword(s):  
High Risk ◽  
Surgical Approach ◽  
Tumor Size ◽  
Gastrointestinal Stromal Tumors ◽  
Tumor Biology ◽  
Disease Free Survival ◽  
Extended Resection ◽  
Stromal Tumors ◽  
Duodenal Gist ◽  
Increased Risk

Background: Duodenal gastrointestinal stromal tumors (GIST) are a rare subset of GIST. Their surgical management in this anatomically complex region consists of varied approaches, and the administration of imatinib mesylate (IM) has not been clarified. Methods: We retrospectively reviewed patients with duodenal GIST treated during a 10-year-period. We analysed the clinicopathological characteristics and survival factors and evaluated the perioperative and long-term outcomes based on the extent of resection ((ocal-resection (LR) versus pancreaticoduodenectomy (PD)) and the IM-administration. The median follow-up period was 60 months (range, 12–140). Results: A total of thirteen patients (M:F = 7:6) with median age of 64 years (range, 42–77) underwent resection of duodenal GIST. Median tumor size was 5.2 cm (range, 1.5–13.3). Eight patients (61.5%) underwent LR and five patients (38.5%) PD. R0-resection was achieved in 92.5%. Neoadjuvant IM-therapy was administered in five patients leading to tumor downsizing and in 40% to less-extended resection. The PD group consisted of larger tumors with higher mitotic count, mostly located in D2 (p = 0.031). The PD group had longer operative time (p = 0.026), longer hospital stay (p = 0.016), and higher rate of postoperative complications (p = 0.128). The actuarial 1-, 3-, and 5-year overall survival were 92.5%, 84%, and 73.5%, respectively, whereas the disease-free survival rates at 1, 3, and 5 years were 91.5%, 83%, and 72%, respectively. A tendency towards increased risk of disease recurrence was demonstrated for patients with tumor >5 cm and high-risk potential. There was not statistic survival benefit for one or the other surgical approach. Conclusion: The type of resection depends on duodenal site of origin and tumor size. LR can be the treatment of choice for duodenal GIST whenever technically feasible. Recurrence of duodenal GIST is dependent on tumor biology rather than surgical approach. Administration of IM in neaodjuvant setting should be considered in cases with high-risk GIST scheduled for PD since it might facilitate less-extended resection.

Elevated preoperative serum level of tumor markers CEA and CA 15–3 in breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 621-621
Author(s):  
B. Park ◽  
H. Kim ◽  
J. Oh ◽  
S. Kim ◽  
K. Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Multivariate Analysis ◽  
Cancer Patients ◽  
Tumor Markers ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Breast Cancer Patients ◽  
Free Survival ◽  
Node Metastases ◽  
Disease Free

621 Background: Serological tumor markers: Cancer Antigen 15–3 (CA 15–3), Carcinoembryonic Antigen (CEA), have been investigated as useful markers for monitoring of response to treatment and for predicting outcome in breast cancer patients. Methods: A total of 820 breast cancer patients, treated over the period April 1999 through December 2003, had preoperative CA15–3 and CEA concentrations measured. The stage of the primary tumor ranged from 0 to IV. The median age of the patients was 47years (range 20–88 years old). The concentration of markers was investigated with regard to clinico-pathological parameters and patients outcome by both univariate and multivariate analysis. We determined the range of normality by the mean + 2 standard deviations of the markers distribution in populations of healthy females, who took an annual health screening program. Survival curves for disease free survival and death from disease were estimated by the method of Kaplan-Meier method and differences between groups in survival were tested using the log-rank test. All statistical analyses were carried out using SPSS statistics software (ver 10.5). Results: Among 820 patients, elevated preoperative level of CA15–3 and CEA was identified in 100 (12.2%) and 83 (10.1%) patients, respectively. Tumor size (>5cm), lymph node metastases (≥4), advanced stage (stage III and IV) were associated with significantly higher level of both preoperative CA15–3 and CEA. Elevated preoperative values of CA15–3 and CEA were associated with poor disease free survival (DFS, p=0.0019, p=0.0001, respectively) and distant relapse-free survival (DRFS, p=0.011, p=0.0034), but the level was marginal for overall survival (OS, p=0.0848, p=0.0895). By Cox’s multivariate analysis, younger age (<35 years), larger tumor size(>2cm), axillary node metastases, negative ER expression, elevated preoperative values of CA15–3 and CEA were independent prognostic factors for DFS and DRFS. Conclusions: High level of preoperative CA 15–3 and CEA might reflect a tumor burden, and is associated with advanced disease condition and disease-free survival. Measuring preoperative levels of CA 15–3 and CEA might be helpful for predicting the outcome and for planning the adjuvant therapy in breast cancer patients. No significant financial relationships to disclose.

Impact of vascular endothelial growth factor (VEGF) and hypoxia-inductible factor-1 alpha (HIF-1) expression on the prognosis of locally advanced cervical carcinoma (LACC) treated with radiochemotherapy.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17023-e17023
Author(s):  
Julia Madani ◽  
Beatriz Eizaguirre ◽  
Vicente Alonso ◽  
Teresa Puertolas ◽  
Esther Millastre ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Tumor Size ◽  
Univariate Analysis ◽  
Locally Advanced ◽  
Local Treatment ◽  
Disease Free Survival ◽  
Post Treatment ◽  
Strong Expression ◽  
Platinum Based Chemotherapy ◽  
The Impact

e17023 Background: Combination of radiotherapy plus platinum-based chemotherapy (RT-CT) is considered the standard treatment in LACC. The risk of recurrence after local treatment is around 50-70%. The role of angiogenesis in tumor progression has been shown in large series. The aim of this study was to determinate the impact of the expression of VEGF and HIF-1 on disease-free survival (DFS) and overall survival (OS) in patients with LACC receiving RT-CT. Methods: Expression of VEGF and HIF–1 was assessed by an immunohistochemistry (IHC) assay in 115 cases. Inmunostainning was considered negative (< 10% of cells), slightly positive (< 25%), moderate (26%-50%) and strongly positive (> 50%). A univariate analysis was carried out for each variable using the log-rank test. Subsequently, a multivariate analysis was performed employing Cox’s proportional hazards model. Results: 115 patients (p) with LACC were included and received RT-CT between January/2003 and December/2012. IHC revealed absence of expression of VEGF in 12 (10,4%) cases, slightly positive in 34 (29,6%), moderate in 30 (26,1%) and strongly positive in 39 (33,9%). The expression of HIF-1 was negative in 63 (54,8%) cases and positive (weak or moderate) in 52 (45,2%). 76p (66,1%) showed a complete clinical response (CR), 26p (22,6%) partial response and 13p (11,3%) stable disease or progression. The median follow–up was 35 months (1-140). 56p (48,7%) relapsed. Univariate analysis indicate that ECOG > 1, tumor size ≥ 4,5 cm, FIGO stage III-IVA, lymph nodes positive, non CR, CA125 post-treatment ≥ 35 U/mL, hemoglobin levels <11 mg/dl (basal, nadir and post-treatment), strong expression VEGF and positive expression of HIF – 1 were all associated with a significant lower OS and DFS. In multivariate analysis strong expression of VEGF remained statistically significant, as tumor size, non CR and hemoglobin level post-treatment < 11g/dL. Conclusions: IHC-assessed strong expression of VEGF was independent prognostic factor of shorter OS and DFS in patients with LACC treated with RT-CT. IHC determination of VEGF could be useful in clinical practice.

Pathologic Tumor Size as a Predictor of the Survival Outcomes of Patients With Glottic Carcinoma

2020 ◽  
pp. 019459982093729
Author(s):  
Hongli Gong ◽  
Liang Zhou ◽  
Haitao Wu ◽  
Lei Tao ◽  
Ming Zhang ◽  
...  
Keyword(s):  
Tumor Size ◽  
Cox Regression ◽  
Tertiary Care ◽  
Disease Free Survival ◽  
Hazard Ratio ◽  
University Hospital ◽  
Survival Outcomes ◽  
Glottic Carcinoma ◽  
Free Survival ◽  
Tumor Area

Objectives The purpose of this study was to evaluate the potential predictor of tumor size on rates of overall and disease-free survival (OS and DFS) as determined by postoperative pathologic examination in patients with glottic carcinoma. Study Design Retrospective cohort study. Setting Tertiary care university hospital. Subjects and Methods In this study, 1337 consecutive patients with glottic carcinoma who underwent surgical treatment from 2005 to 2010 were retrospectively reviewed. The influence of tumor size that was evaluated by tumor area (tumor length × tumor width) on OS and DFS outcomes was assessed by Cox regression analyses. Results In all, 1303 (97.5%) patients were male, and 34 (2.5%) were female, with a mean ± SD age of 60.4 ± 10 years. The 10-year OS and DFS rates were 72.9% and 69.9%, respectively. The tumor area cutoff values that best discriminated OS and DFS rates were both 1.80 cm2. Patients with glottic carcinoma with a larger tumor area had inferior OS and DFS rates. Based on the results of multivariate analyses, tumor area was an independent prognostic factor for rates of OS (hazard ratio, 1.87; 95% CI, 1.37-2.56; P < .001) and DFS (hazard ratio, 1.79; 95% CI, 1.34-2.38; P < .001) in patients with glottic carcinoma. Conclusions The results of this study indicate that patients with glottic carcinoma with a tumor area >1.8 cm2 have inferior survival outcomes, and this factor independently predicts survival outcomes in these patients.

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