Management of stage I seminomatous germ-cell cancer (SGCC): Results from 4 different risk-adapted strategies in a single institution.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16047-e16047
Author(s):  
Mariona Riudavets ◽  
Georgia Anguera ◽  
Daniela Camacho ◽  
Aida Bujosa ◽  
Raul Terés ◽  
...  
Keyword(s):  
Tumor Size ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Rete Testis ◽  
Stage I ◽  
Treatment Burden ◽  
National Guidelines ◽  
Single Institution ◽  
Significant Difference ◽  
Disease Free

e16047 Background: Management of stage I SGCC depends on pathological findings after orchiectomy. Four risk-adapted strategies were sequentially applied in a single institution during a 24-year (yr) period according to national guidelines. Here, we compare treatment burden and outcomes of each of them. Methods: From 1/1994 to 1/2018, 208 patients with stage I SGCC were prospectively included in 4 cohorts. Those without risk criteria underwent close surveillance. Patients received active treatment as follow: Group 1: 1994-1999, only patients with T > pT1 received 2 cycles of carboplatin (CBDCA AUC7 x2); Group 2: 1999-2003, patients received CBDCA AUC7 x2 if either tumor size > 4cm or rete testis invasion; Group 3 : 2004-2009, CBDCA AUC7 x2 if both tumor size > 4cm and rete testis invasion were present; Group 4 : ≥2010, CBDCA AUC7 x1 if either tumor size > 4cm or rete testis invasion. Kaplan Meier and log-rank tests were used to evaluate disease-free survival (DFS), Kruskal-Wallis test to compare amount of chemotherapy received per patient. Results: At a median follow-up of 108 months [range 3-423], 19 (9.1%) relapses had occurred. Global 3 and 5-yr DFS were 92.3% and 90%. All relapsing patients were rendered disease-free with 4 cycles of cisplatin (CDDP) - etoposide. Table 1 summarizes results by cohort: Conclusions: A risk-adapted program provided an overall specific survival of 100%. A clinically significant difference in RR was observed when 1 or 2 courses of CBDCA were given. In our series and considering treatment burden, vascular invasion was a better criteria for patient selection to adjuvant chemotherapy, showing a similar DFS but a lower no of total platinum cycles per patient.[Table: see text]

Clinicopathologic features and prognostic analysis of stage I ovarian clear cell cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17090-e17090
Author(s):  
Tian Tian Wang ◽  
Ning Li ◽  
Lingying Wu
Keyword(s):  
Tumor Size ◽  
Clear Cell ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Stage I ◽  
Initial Symptom ◽  
Free Survival ◽  
Pathologic Features ◽  
Stage Ia ◽  
Disease Free

e17090 Background: Ovarian clear cell carcinoma is one kind of Epithelial ovarian carcinoma and is considered high-grade tumor. This retrospective analysis aimed to evaluate the clinical and pathologic features and to determine prognostic variables in patients with stage I ovarian clear cell cancer. Methods: 378 patients with ovarian clear cell cancer were treated in National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, from February 1999 to December 2018. And 214(56.6%) had stage I disease. We retrospectively analyzed the prognostic relevance of different clinicopathological variables in 102 patients underwent surgery treatment, specifically including age, initial symptom, endometriosis, stage, tumor size, serum CA125 and CA199, chemotherapy regimens and treatment course. Results: The median age was 51 years old. 64(62.7%) patients presented with large pelvic mass (median diameter:12.0cm). 82.4% patients had no more than 200U/ml elevation of serological CA125(median: 50.76U/ml). 81.8% patients had no more than 100U/ml elevation of serological CA199(median: 24.8U/ml). The median follow-up time was 40.5 months. The 5-year disease-free survival was 82.8%. All patients were restaged using the 2014 FIGO staging system. 31(30.4%), 17(16.7%), 25(24.5%), 17(16.7%)patients had stage IA, IC1, IC2, IC3, respectively. Univariate analysis showed that tumor size(P = 0.045) and serum CA199(P = 0.025) were related with poor disease-free survival. 5-year disease-free survival (86.9%) of patients with four course chemotherapy was comparable to that (80.2%) with five or more. Patients at stage IC1 or IC2/IC3(rupture before surgery) had the similar outcomes compared with patients at stage IA. And the results of multivariate statistical analysis showed there was no independent, statistically significant prognostic variable. Conclusions: Tumor size and serum CA199 were related with prognosis. Disease-free survival at stage IC1 or IC2/IC3 was comparable to that at stage IA. Five course chemotherapy or more may not improve the 5-year disease-free survival than four.

Risk-Adapted Management for Patients With Clinical Stage I Seminoma: The Second Spanish Germ Cell Cancer Cooperative Group Study

2005 ◽  
Vol 23 (34) ◽  
pp. 8717-8723 ◽  
Author(s):  
Jorge Aparicio ◽  
José R. Germà ◽  
Xavier García del Muro ◽  
Pablo Maroto ◽  
José A. Arranz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Stage ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Rete Testis ◽  
Stage I ◽  
Risk Criteria ◽  
Stage I Seminoma ◽  
Disease Free Survival Rate ◽  
Disease Free

Purpose To assess the efficacy of a risk-adapted treatment policy for patients with stage I seminoma by using universally accepted risk criteria. Patients and Methods Between 1999 and 2003, 314 patients with clinical stage I seminoma after orchiectomy were prospectively included. One hundred patients (31.8%) presented no risk factors and were managed with surveillance. In contrast, 131 patients (41.7%) had tumors larger than 4 cm, 33 patients (10.5%) had rete testis involvement, and 50 patients (15.9%) had both risk factors. All the latter received two courses of adjuvant carboplatin. Results Chemotherapy was well tolerated, as only 17 patients (7.9%) presented grade 3 to 4 toxicity. Relapses were observed in six patients (6.0%) on surveillance and in seven patients (3.3%) treated with carboplatin (0.8% of tumors larger than 4 cm, 9.1% of those involving the rete testis, and 6.0% of patients with both risk criteria). All were located at the retroperitoneum, except for one at the spermatic cord. Median tumor size was 25 mm (range, 11 to 70 mm), and median time to relapse was 9 months (range, 4 to 28 months). All patients were rendered disease-free with chemotherapy (etoposide plus cisplatin). Median follow-up was 34 months (range, 12 to 72 months). The actuarial 5-year disease-free survival rate was 93.4% for patients on surveillance and 96.2% for patients treated with adjuvant chemotherapy. Overall 5-year survival was 100%. Conclusion Adjuvant carboplatin is effective in reducing the relapse rate in patients with stage I seminoma and risk factors. A risk-adapted strategy is safe and feasible and should be considered an alternative to systematic approaches, such as irradiation, chemotherapy, or surveillance.

scholarly journals The Influence of Pregnancy on the Recurrence of Cutaneous Malignant Melanoma in Women

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
M. Albersen ◽  
V. I. Westerling ◽  
P. A. M. van Leeuwen
Keyword(s):  
Malignant Melanoma ◽  
Disease Free Survival ◽  
Recurrence Risk ◽  
Cutaneous Malignant Melanoma ◽  
Stage I ◽  
Free Survival ◽  
Medical Databases ◽  
Significant Difference ◽  
History Of ◽  
Disease Free

Objective. The aim of this study was to determine whether pregnancy increases the recurrence risk of cutaneous malignant melanoma (CMM) in women with a history of stage I CMM.Methods. The electronic medical databases of Medline and Embase were explored. All 1084 obtained articles were screened on title and abstract using predetermined inclusion and exclusion criteria. A critical appraisal of relevance and validity was conducted on the remaining full text available articles.Results. Two studies were selected. Both studies revealed no significant difference in disease-free survival between women with stage I CMM and the control population.Conclusion. Pregnancy does not increase the recurrence risk of CMM in women with a history of stage I CMM.

Prognostic factors for relapse in stage I seminoma managed by surveillance or adjuvant carboplatin: A multivariate analysis on 588 cases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 4552-4552 ◽  
Author(s):  
J. Aparicio ◽  
J. Garcia-Puche ◽  
M. Lomas ◽  
F. Carabantes ◽  
S. Vazquez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Tumor Size ◽  
Cox Regression ◽  
Clinical Stage ◽  
Disease Free Survival ◽  
Rete Testis ◽  
Stage I ◽  
Histologic Subtype ◽  
Stage I Seminoma

4552 Background: The availability of reliable prognostic factors for relapse in stage I seminoma would allow a better patient stratification for individually tailored therapies. We performed a pooled analysis of patients included in two consecutive risk-adapted protocols. Methods: Between 1994 and 2004, 588 cases were prospectively registered. Median patient age was 33 years, median tumor size was 45 mm, serum BHCG levels were elevated preoperatively in 14.6%, and rete testis invasion was present in 26.9%. Three hundred and four patients (51.7%) with risk factors received two courses of adjuvant carboplatin, whereas 284 (48.3%) without these criteria were managed by surveillance. After a median follow-up of 48 months (range, 12–144), 43 relapses (7.3%) have occurred. Five-year disease-free survival was 92.3%. Univariate (log rank) and multivariate (Cox regression) analyses of prognostic factors for relapse were performed. Results: Relapses were less frequent after carboplatin treatment (3% vs 12%, p < 0.0001). Statistically significant, independent predictors of relapse were: 1) rete testis invasion and age (<30 years) in the whole series; 2) rete testis invasion for patients treated with adjuvant chemotherapy; and 3) tumor invasion beyond the albuginea and microvessel neoplastic invasion (defining 1997 AJCC pT2–4 staging) for patients managed by surveillance. In contrast, tumor size, histologic subtype (anaplastic), and serum preoperative BHCG levels were not associated with prognosis. Conclusions: Invasion of the rete testis and age (<30 years) represent high-risk factors for patients with clinical stage I testis seminoma, independently of the treatment selected. These two features, in combination with pathologic T2–4 staging, could improve patient selection for risk-adapted therapies. No significant financial relationships to disclose.

scholarly journals Outcome of Men With Relapse After Adjuvant Carboplatin for Clinical Stage I Seminoma

2017 ◽  
Vol 35 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Stefanie Fischer ◽  
Torgrim Tandstad ◽  
Matthew Wheater ◽  
Emilio Porfiri ◽  
Aude Fléchon ◽  
...  
Keyword(s):  
Overall Survival ◽  
Clinical Stage ◽  
Cell Cancer ◽  
Disease Free Survival ◽  
Stage I ◽  
Collaborative Group ◽  
Free Survival ◽  
Stage I Seminoma ◽  
Disease Free

Purpose Adjuvant carboplatin is one of three management strategies that may follow inguinal orchiectomy in clinical stage I seminoma. However, little is known about the outcome of patients who experience a relapse after such treatment. Patients and Methods Data from 185 patients who relapsed after adjuvant carboplatin between January 1987 and August 2013 at 31 centers/groups from 20 countries were collected and retrospectively analyzed. Primary outcomes were disease-free survival and overall survival. Secondary outcomes were time to, stage at, and treatment of relapse as well as rate of subsequent relapses. Results With a median follow-up of 53 months (95% CI, 48 to 60 months) the 5-year disease-free survival was 82% (95% CI, 77% to 89%), and the 5-year overall survival was 98% (95% CI, 95% to 100%). The median time from orchiectomy to relapse was 19 months (95% CI, 17 to 23 months); 15% (95% CI, 10% to 21%) of relapses occurred > 3 years after treatment. The majority of relapses were detected by computed tomography scan during routine follow-up, 98% in the International Germ Cell Cancer Collaborative Group good prognosis group. Chemotherapy was administered to 92% of patients, mostly as standard first-line treatment corresponding to stage; 8% of patients had additional local treatments. Only 28 patients experienced a second relapse. At last follow-up, 174 (94%) of 185 patients were alive without disease, and four patients with disease. Seven patients died, three of whom due to progressive disease. Conclusion Within the limitations of a retrospective analysis, the results suggest that the majority of patients who experience a relapse after adjuvant carboplatin for clinical stage I seminoma can be successfully treated with a cisplatin-based chemotherapy regimen adequate for stage. Because 15% of the relapses occurred > 3 years after adjuvant treatment, a minimum of 5 years follow-up is recommended.

Retrospective analysis of 132 patients with stage I seminoma: Observation versus adjuvant radiation or chemotherapy in a single institution.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15033-e15033
Author(s):  
Estela Vega ◽  
Almudena Cascales ◽  
Guillermo De Velasco ◽  
Maria Angeles Cabeza Rodriguez ◽  
Lucia Parrilla ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Tumor Size ◽  
Vascular Invasion ◽  
Rete Testis ◽  
Stage I ◽  
Adjuvant Radiation ◽  
Free Survival ◽  
Stage I Seminoma ◽  
Disease Free

e15033 Background: Classically, radiotherapy (RT) has been the standard adjuvant treatment for stage I seminoma patients. Improvements in early relapse diagnosis have led high cure rates. Two cycles of adjuvant carboplatin present similar efficacy to radiotherapy with less toxicity have led to re-examination of the standard treatment approach. Methods: Retrospective study of 132 patients diagnosed with stage I seminoma from 1980-2010 who received whether treatment with RT, chemotherapy (Cht) or active surveillance (AS) after orchiectomy at one Universitary Hospital. The objective was to determine the relapse-free survival (RFS), overall survival (OS), and disease -specific survival (DSS). Results: Of the 132 patients, 68 were treated with prophylactic irradiation (paraaortic ± pelvic nodes, the median total dose radiation 26 Gy at 2 Gy per fraction), 33 with adjuvant chemotherapy (31 had carboplatin x 2, 2 had BEP x 2), and 31 underwent surveillance. Among the RT patients (median follow-up 121months), mean age was 40 years (range: 20-70) with mean tumor size of 5.5 cm (range: 1-14). 6% of them had rete testis involvement and 15% vascular invasion. There was 1 relapse with a median disease-free survival (DFS) of 103 months and no deaths from seminoma. RFS was 98% at 10 years. OS and DSS were 100% at 10years. Among the chemotherapy patients mean age was 30 years (range: 18-66) with mean tumor size of 6,18cm (range: 1,5-10). 9% of them had rete testis involvement and 60 % vascular invasion. With a median follow-up of 66 months, there was 1 relapse. Five-year RFS was 97%, OS and DSS were 100%. Among the observation patients (median follow-up 148 months), mean age was 35 years (range: 20-78) with mean tumor size of 3,7cm (range: 1,3-7). 6% of them had rete testis involvement and 6 % vascular invasion. There were 6 relapses with no deaths from seminoma. RFS was 80%, specific OS and DSS was 100% at 10 years. Of the patients who relapsed, all were rendered disease-free with chemotherapy; with non evidence disease at last follow-up. Conclusions: Consistent with published trials both radiotherapy, chemotherapy or active surveillance are safe and effective treatments with similar oncologic results.

scholarly journals Oxaliplatin Increases Disease-Free Survival in Rectal Cancer: A Single-Institution Experience

2016 ◽  
Vol 96 (2) ◽  
pp. E168-E169
Author(s):  
A. Roy ◽  
J.R. Olsen ◽  
R.J. Myerson ◽  
S. Markovina ◽  
T.A. DeWees ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Disease Free Survival ◽  
Single Institution ◽  
Free Survival ◽  
Disease Free

A randomized study with or without intensified maintenance chemotherapy in patients with acute promyelocytic leukemia who have become negative for PML-RARα transcript after consolidation therapy: The Japan Adult Leukemia Study Group (JALSG) APL97 study

Blood ◽  
2007 ◽  
Vol 110 (1) ◽  
pp. 59-66 ◽  
Author(s):  
Norio Asou ◽  
Yuji Kishimoto ◽  
Hitoshi Kiyoi ◽  
Masaya Okada ◽  
Yasukazu Kawai ◽  
...  
Keyword(s):  
Complete Remission ◽  
Acute Promyelocytic Leukemia ◽  
Randomized Study ◽  
Disease Free Survival ◽  
Promyelocytic Leukemia ◽  
Consolidation Therapy ◽  
Maintenance Chemotherapy ◽  
Free Survival ◽  
Significant Difference ◽  
Disease Free

To examine the efficacy of intensified maintenance chemotherapy, we conducted a prospective multicenter trial in adult patients with newly diagnosed acute promyelocytic leukemia treated with all-trans retinoic acid and chemotherapy. Of the 302 registered, 283 patients were assessable and 267 (94%) achieved complete remission. Predicted 6-year overall survival in all assessable patients and disease-free survival in patients who achieved complete remission were 83.9% and 68.5%, respectively. A total of 175 patients negative for PML-RARα at the end of consolidation were randomly assigned to receive either intensified maintenance chemotherapy (n = 89) or observation (n = 86). Predicted 6-year disease-free survival was 79.8% for the observation group and 63.1% for the chemotherapy group, showing no statistically significant difference between the 2 groups (P = .20). Predicted 6-year survival of patients assigned to the observation was 98.8%, which was significantly higher than 86.2% in those allocated to the intensified maintenance (P = .014). These results indicate that the intensified maintenance chemotherapy did not improve disease-free survival, but rather conferred a significantly poorer chance of survival in acute promyelocytic leukemia patients who have become negative for the PML-RARα fusion transcript after 3 courses of intensive consolidation therapy.

Long-Term Outcomes and Factors Related to the Prognosis of Pure Ovarian Dysgerminoma: A Retrospective Study of 107 Cases

2021 ◽  
pp. 1-8
Author(s):  
Tianyun Xu ◽  
Fei Sun ◽  
Yanfang Li
Keyword(s):  
Retrospective Study ◽  
Survival Rate ◽  
Disease Free Survival ◽  
Small Sample ◽  
Stage I ◽  
Long Term Outcomes ◽  
Free Survival ◽  
Disease Free Survival Rate ◽  
Disease Free

<b><i>Objective:</i></b> The aim of this study was to evaluate the long-term outcomes and the factors related to patient prognosis. <b><i>Materials and Methods:</i></b> We retrospectively analyzed patients treated at the Department of Gynecology, Sun Yat-sen University Cancer Center, between January 1, 1968, and December 12, 2018. <b><i>Results:</i></b> A total of 107 patients were identified. Of all patients, 79 (73.8%) presented with stage I disease, 14 (13.1%) stage II, 13 (12.2%) stage III, and 1 (0.9%) stage IV. All patients received surgery, with 70 (65.4%) undergoing fertility-sparing surgery (FS) and 37 (34.6%) nonfertility-sparing surgery (NFS). Ninety patients received postoperative chemotherapy. Nine of the 43 cases with a lymphadenectomy had metastasis (20.9%). The median follow-up time was 132 months (range, 1–536 months). The overall 5-year and 10-year survival was 95.1% and 91.7%, respectively. The 10-year survival rate for stage I and II–IV patients was 96.1% and 79.1%, respectively (<i>p</i> = 0.008). For the patients undergoing FS and NFS, the 10-year disease-free survival rate was 82.3% and 88.0%, respectively (<i>p</i> = 0.403). The 10-year disease-free survival rate for patients with or without lymphadenectomy was 95.1% and 78.4%, respectively (<i>p</i> = 0.040), and it was 92.5% and 76.0%, respectively (<i>p</i> = 0.041), for those with or without omentectomy. Fifteen patients relapsed, and 4 of them (26.7%) had recurrence in the lymph nodes. Eleven of the 15 relapsed patients (73.3%) had been successfully salvaged. <b><i>Limitations:</i></b> As a study of a rare disease, our analysis was limited by its small sample size and the deemed disadvantage of a retrospective study. <b><i>Conclusion:</i></b> Excellent treatment results can be achieved in dysgerminoma patients who received proper treatment. Lymphadenectomy may improve patient survival. Relapsed patients can also be successfully salvaged.

Correlation between outcomes and tumor size in >7 cm T4 non-small cell lung cancer patients: A tumor size-based comparison study

2021 ◽  
Vol 29 (8) ◽  
pp. 784-791
Author(s):  
Volkan Erdoğu ◽  
Necati Çitak ◽  
Celal B Sezen ◽  
Levent Cansever ◽  
Cemal Aker ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Tumor Size ◽  
Disease Free Survival ◽  
Small Cell ◽  
Small Cell Lung ◽  
Free Survival ◽  
Lung Cancer Patients ◽  
Disease Free

Background We investigated whether all size-based pathological T4N0–N1 non-small cell lung cancer patients with tumors at any size >7 cm had the same outcomes. Methods We reviewed non-small cell lung cancer patients with tumors >7 cm who underwent anatomical lung resection between 2010 and 2016. A total of 251 size-based T4N0–N1 patients were divided into two groups based on tumor size. Group S ( n = 192) included patients with tumors of 7.1–9.9 cm and Group L ( n = 59) as tumor size ≥10 cm. Results The mean tumor size was 8.83 ± 1.7 cm (Group S: 8.06 ± 0.6 cm, Group L: 11.3 ± 1.6 cm). There were 146 patients with pathological N0 and 105 patients with pathological N1 disease. Mean overall survival and disease-free survival were 64.2 and 51.4 months, respectively. The five-year overall survival and disease-free survival rates were 51.2% and 43.5% (five-year OS; pT4N0:52.7%, pT4N1:47.9%, DFS; pT4N0:44.3%, pT4N1: 42.3%). No significant differences were observed between T4N0 and T4N1 patients in terms of five-year OS or DFS ( p = 0.325, p = 0.505 respectively). The five-year overall survival and disease-free survival rates were 52% and 44.6% in Group S, and 48.5% and 38.9% in Group L. No significant difference was observed between the groups in terms of five-year overall survival or disease-free survival ( p = 0.699, p = 0.608, respectively). Conclusions Above 7 cm, any further increase in tumor size in non-small cell lung cancer patients had no significant effect on survival, confirming it is not necessary to further discriminate among patients with tumors in that size class.

Sign in / Sign up

Export Citation Format

Share Document