Locally advanced scrotal squamous cell carcinoma: Does chemotherapy affect survival?

3 Background: Scrotal squamous cell carcinoma (SSCC)thoughrare, represents the most common forms of scrotal malignancies.40-50% of patients present with locally advanced disease, and treatment is extrapolated from penile cancer. Here we report practice trend and overall survival (OS) outcome of locally advanced SSCC patients who underwent surgery with or without chemotherapy. Methods: We performed a retrospective analysis using the national cancer center database (NCDB) (2004-2016). All patients aged ≥ 18 years with locally advanced SSCC who underwent surgery with or without chemotherapy were included. OS is estimated with Kaplan-Meier curves, with an adjusted hazard ratio (aHR) calculated from Cox proportional hazard regression model. Results: 638 patients were identified with SSCC without distant metastasis. Of these 49 underwent surgery with perioperative chemotherapy and 589 underwent surgery alone. At the median follow up of 39.9 months (mo), median OS is 41.4 mo and 145.7 mo for surgery with chemotherapy group versus surgery alone respectively (P-value <0.0001), with aHR for OS 1.673 (95%CI 0.966-2.897). Patients age ≥ 65 (HR= 3.081, 95% CI=2.107- 4.505, p<0.001), Charlson-Deyo Score (CCI) 2 or more (HR=3.441, 95% CI=2.140- .533, p <0.0001), moderately-poorly differentiated carcinoma (HR=1.713, 95% CI=1.038- 2.829, p=0.0352), and higher clinical nodal status N1,N2 and N3 (HR=2.543, 95% CI=1.42-4.548, p=0.0016)were observed to do worse with surgery and chemotherapy. Patients with CCI of 2 or more, moderate to poorly differentiated carcinoma, higher clinical T and N stage (T2- T4 and N1-N3 respectively) were observed more likely to receive surgery and chemotherapy. Conclusions: No OS improvement was seen in locally advanced SSCC with addition of chemotherapy to surgery. Patients who received chemotherapy along with surgery are observed to have higher risk of mortality vs surgery alone. The study is limited by retrospective nature, lack of randomization, patient selection bias, patient’s choice of therapy, small sample size, and missing information.

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PS02.232: BASALOID CARCINOMA OF THE ESOPHAGUS: MULTIMODAL APPROACH

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps02.232 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 188-188

Author(s):

Marta De Vega ◽

Carlos Miliani ◽

Juan Rodriguez Vitoria ◽

Juan Antonio Martinez-Piñeiro ◽

Fernando Pereira

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Multimodal Treatment ◽

Locally Advanced ◽

Distal Esophagus ◽

Lower Esophagus ◽

Carcinoma Of The Esophagus ◽

Basaloid Cell ◽

Poorly Differentiated

Abstract Background Basaloid cell carcinoma of the esophagus (BSCCE) is a rare (0.07–4%) poorly-differentiated variety of squamous cell carcinoma (SCC), more aggressive and with a worse prognosis than typical SCC. There are no published studies on the best therapeutic option for these tumors or on of the effectiveness of Neoadjuvant chemoradiotherapie; so there is no standard treatment. We describe the characteristics and the therapeutic strategy applied to a patient with an avanced basaloid squamous cell carcinoma of the distal esophagus. Methods A 70-year-old woman with dysphagia and severe malnutrition was diagnosed with locally advanced esophageal cáncer of lower esophagus The biopsy indicated moderately differentiated basaloid cell carcinoma. The clinical diagnosis was cT4NxM0, We decided multimodal treatment with curative intent: Neoadjuvant chemoradiotherapie at a dose of 41.4 Gy and concomitant carboplatin and pacliotaxel 5 cycles (CROSS scheme) plus surgery. Results PET-TAC post-neoadjuvant re-evaluation showed partial morphological response (reduction of tumor metabolism in 34.7%). 6 weeks after radiochemotherapy we performed a three fields total esophagectomy. Postoperative course without incidents. The pathological diagnosis was BASALOID cell CARCINOMA located in distal esophagus of 10 cm long with 30% tumor residual; it affects gastro-oesophageal junction. Stage TNM 7th ed: ypT3 N0 (0/17) L0V1R0 Our patient is fine and without evidence of recurrence after 15 meses. Conclusion Basal squamous cell carcinoma is more common in men around 60 years old, being rare in older women. They are located more frequently in the middle than in lower esophagus. They are tumors of poor prognosis (poorly differentiated, locally advanced and with an aggressive biological behavior that predisposes to early metastasis) although the latest publications relate the prognosis especially with the stage of the tumor. There are no published data about the use of Neoadjuvant treatment for these tumors. We have carried out a multimodal treatment (Cross scheme) followed by surgery with clinical, radiological (PET-TAC) and pathological response (30% of residual tumor in the piece) CONCLUSION The multimodal treatment with Cross scheme and surgery was useful in patients with Basaloid tumor of the esophagus can be considered for patients with this type of tumor. Disclosure All authors have declared no conflicts of interest.

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Progression of Intravesical Condyloma Acuminata to Locally Advanced Poorly Differentiated Squamous Cell Carcinoma

Urology Case Reports ◽

10.1016/j.eucr.2016.04.016 ◽

2016 ◽

Vol 7 ◽

pp. 61-63

Author(s):

A. Khambati ◽

Y. Bhanji ◽

D.T. Oberlin ◽

X.J. Yang ◽

R.B. Nadler ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Locally Advanced ◽

Condyloma Acuminata ◽

Poorly Differentiated

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Outcomes of multidisciplinary treatment in penile cancer: Experience from Thailand.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.555 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 555-555

Author(s):

Wichien Sirithanaphol ◽

Kachit Pachirat ◽

Ukrit Rompsaithong ◽

Pakorn Kiatsopit ◽

Supanut Lumbiganon ◽

...

Keyword(s):

Overall Survival ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Squamous Cell ◽

Survival Data ◽

Penile Cancer ◽

Multidisciplinary Treatment ◽

Locally Advanced ◽

P Value

555 Background: Penile cancer is relatively more common in Thailand compared to western countries. We report multidisciplinary treatment outcomes of penile squamous cell carcinoma at a regional center in northeast of Thailand. Methods: Using an institutional database, a total of 68 patients with squamous cell carcinoma of penis treated during 2009-2015 were identified. Patient demographics, pathological data, and treatment modality were reviewed. Survival data was calculated using the Kaplan-Meier method. Results: Median age was 53 years (25-89 years) and the median follow-time was 2.7 years. At presentation, 39 patients (57.4%) were node positive, and 9 (13.2%) had metastatic disease. Management was penile preserving surgery in 13 patients, partial penectomy in 36 patients, total penectomy in 15 patients, and palliative with radiation and/or chemotherapy in 4 patients. The 3-year overall survival for patients with N0-1 and N2-3 was 86% and 35% respectively. For those with high risk (N2/N3) non-metastatic disease, multimodality treatment improved overall survival significantly compared with surgery alone (13.7 mo vs 8.6 mo; HR 0.32, p-value = 0.04) Conclusions: Patients present with locally advanced disease had a poor prognosis. Multidisciplinary management improved overall survival N2/N3 patients.

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Comparison of the outcomes between locally advanced cervical squamous cell carcinoma and adenocarcinoma patients treated with definitive chemoradiation

10.1055/s-0039-1685252 ◽

2016 ◽

Author(s):

P. Ahlawat ◽

S. Mitra ◽

M. K. Sharma ◽

U. Saxena ◽

I. K. Wahi ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Locally Advanced ◽

Small Sample ◽

Response Evaluation ◽

Free Survival ◽

Regional Control ◽

Definitive Chemoradiation ◽

Significant Difference

Objective: To present comparison of survival outcomes between locally advanced adenocarcinoma and squamous cell carcinoma patients treated with definitive chemoradiation. Methods: It is a retrospective analysis and direct comparison between adenocarcinoma and squamous cell carcinoma cervix treated from January 2011 to December 2015. Of 73 patients analyzed 61 had squamous carcinoma histology and remaining 12 had adenocarcinoma. Inclusion criteria were patients with locally advanced stage (IIA) who have completed definitive chemoradiation and were available for response evaluation at 3 months of completion of treatment. Endpoints for the study were disease response evaluation at 3 months, progression rate, median progression free survival, median recurrence free survival, median loco-regional control, median distant metastasis free survival, median overall survival. Results: There was no significant difference between the two histology groups with respect to rate of achieving complete response (78.6 vs 75%, p = 0.718) and rate of disease progression (36% vs 50%, p = 0.517). There was no significant difference between median PFS (57.75 vs 17.74 months; p = 0.964), median RFS (NR vs 66.03 months; p = 0.876), median loco-regional control (not reached for both; p = 0.315), median DMFS (NR vs 66.03 months; p = 0.438) and median OS (NR vs 66.13 months; p = 0.884). Conclusions: Locally advanced squamous cell carcinoma and adenocarcinoma treated with definitive chemoradiation have similar outcomes. Small sample size is the limitation of this study.

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A comparative study of monoclonal antibody against EGFR (nimotuzumab) used in combination with chemoradiation versus chemoradiation alone in the treatment of locally advanced inoperable squamous cell carcinoma of the head and neck.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e16012 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e16012-e16012

Author(s):

Aseem Rai Bhatnagar ◽

Dharam Pal Singh ◽

Rameshwaram Sharma ◽

Om Prakash Sharma ◽

Shantanu Sharma ◽

...

Keyword(s):

Monoclonal Antibody ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Tumor Response ◽

Locally Advanced ◽

Acute Radiation ◽

P Value ◽

Significant Difference

e16012 Background: To determine the efficacy, safety and tolerability of concurrent Nimotuzumab (monoclonal antibody against epidermal growth factor receptor) used in combination with chemoradiation versus chemoradiation (CRT) alone in advanced inoperable squamous cell carcinoma of the head and neck (SCCHN). Methods: 56 patients were randomly assigned to either of the two treatment arms, nimotuzumab + CRT arm and CRT alone arm. Both arms received concurrent cisplatin 30 mg/m2 repeated weekly for 6-7 cycles along with external beam radiotherapy 64-70 Gy (200cGy/day for 5 days a week for 6-7 weeks). Nimotuzumab arm additionally received nimotuzumab 200 mg weekly for 6-7 cycles. The patients were followed for 6 months after completion of CRT. The study end points were tumor response evaluation according to the RECIST Criteria version 1.1 and safety analysis using RTOG Acute Radiation Morbidity Scoring Criteria. Patients were evaluated weekly with hematologic tests and for adverse events like mucositis and dermatitis during the CRT. Tumor assessment was performed with clinical and endoscopic methods regularly during the CRT and then at 1 month, 3 month and 6 month interval after CRT. One MR imaging was done before starting the CRT to evaluate the baseline tumor characteristics and another was done after the completion of CRT either at 3 months or 6 months or at both the intervals. Results: 25 patients each were evaluable in both the arms who completed the 6 months study. The overall response rate (complete response + partial response) was 96% in Nimotuzumab + CRT arm whereas it was only 72% in CRT alone arm after 6 months of completion of CRT, which is statistically significant (p-value = 0.0206 by chi square test). Additionally, nimotuzumab did not potentiate toxicities of CRT and there was no significant difference in the acute radiation mucositis, dermatitis or hematological toxicities in both the groups (p-value>>0.05). Conclusions: Nimotuzumab can be safely added to the standard CRT treatment for advanced inoperable SCCHN, to achieve better tumor response without potentiating toxicity.

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A comparative study of a monoclonal antibody against EGFR (nimotuzumab) used in combination with chemoradiation versus chemoradiation alone in the treatment of locally advanced inoperable squamous cell carcinoma of the head and neck.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.30_suppl.51 ◽

2012 ◽

Vol 30 (30_suppl) ◽

pp. 51-51 ◽

Cited By ~ 8

Author(s):

Aseem Rai Bhatnagar ◽

Dharam Pal Singh

Keyword(s):

Monoclonal Antibody ◽

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Tumor Response ◽

Locally Advanced ◽

Acute Radiation ◽

P Value ◽

Significant Difference

51 Background: To determine the efficacy, safety and tolerability of concurrent nimotuzumab (monoclonal antibody against epidermal growth factor receptor) used in combination with chemoradiation versus chemoradiation (CRT) alone in advanced inoperable squamous cell carcinoma of the head and neck (SCCHN). Methods: 56 patients were randomly assigned to either of the two treatment arms, nimotuzumab + CRT arm and CRT alone arm. Both arms received concurrent Cisplatin 30 mg/m2 repeated weekly for 6-7 cycles along with external beam radiotherapy 64-70 Gy (200cGy/day for 5 days a week for 6-7 weeks). Nimotuzumab arm additionally received nimotuzumab 200 mg weekly for 6-7 cycles. The patients were followed for 6 months after completion of CRT. The study end points were tumor response evaluation according to the RECIST Criteria version 1.1 and safety analysis using RTOG Acute Radiation Morbidity Scoring Criteria. Patients were evaluated weekly with hematologic tests and for adverse events like mucositis and dermatitis during the CRT. Tumor assessment was performed with clinical and endoscopic methods regularly during the CRT and then at 1 month, 3 months, and 6 months intervals after CRT. One MR imaging was done before starting the CRT to evaluate the baseline tumor characteristics, and another was done after the completion of CRT either at 3 months or 6 months or at both the intervals. Results: 25 patients each were evaluable in both the arms who completed the 6-month study. The overall response rate (complete response + partial response) was 96% in nimotuzumab + CRT arm, whereas it was only 72% in CRT alone arm after 6 months of completion of CRT, which is statistically significant (p value = 0.0206 by Chi Square test). Additionally, nimotuzumab did not potentiate toxicities of CRT, and there was no significant difference in the acute radiation mucositis, dermatitis, or hematological toxicities in both the groups (p value>>0.05). Conclusions: Nimotuzumab can be safely added to the standard CRT treatment for advanced inoperable SCCHN, to achieve better tumor response without potentiating toxicity.

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Co-existence of lung carcinoma metastasis and enchondroma in the femur of a patient with Ollier disease

Virchows Archiv ◽

10.1007/s00428-020-02936-z ◽

2020 ◽

Author(s):

Xudong Wang ◽

Xiaohui Zhang ◽

Wenling Pan ◽

Yuedong Han ◽

Yanwei Li ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Distal Femur ◽

Proximal Tibia ◽

Left Femur ◽

Tumour Metastasis ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated ◽

Ollier Disease

Abstract Tumour-to-tumour metastasis is very unusual and has been defined as a tumour metastasis into another histologically different tumour. It is extremely rare in bone. We report a case of lung squamous cell carcinoma metastasized to an enchondroma in the femur of a patient with Ollier disease. A 60-year-old female had a history of a poorly differentiated squamous cell carcinoma of the lung. She underwent a video-assisted thoracoscopic lobectomy, and a follow-up MRI scan showed three lesions in the left distal femur and proximal tibia, which were initially interpreted as metastasis on radiology. Resection of the left proximal tibial lesion was performed, and the pathological findings were consistent with enchondroma with no evidence of metastasis. Subsequent curettage of lesions in the distal left femur revealed metastatic poorly differentiated carcinoma with foci of hyaline cartilage, which was most consistent with metastatic carcinoma in a pre-existing enchondroma. The MRI films were re-reviewed. Characteristic MRI features of enchondroma were found in the lesion in the left proximal tibia and one of the lesions in the left distal femur, while the features of the other lesion in the left distal femur included cortical destruction and extensive oedema in surrounding soft tissue, which were consistent with a malignant tumour. In addition, the enchondroma in the lateral condyle showed blurring and irregular inner margin and adjacent bone oedema, which likely represents a co-existing metastatic tumour and enchondroma. The difference in lineage was confirmed by immunohistochemistry. The final diagnosis was metastatic poorly differentiated carcinoma of the lung into a co-existent enchondroma. The diagnosis can be challenging and could be easily overlooked both radiologically and histologically. Thorough clinical and radiological information is critical for the diagnosis, and despite a very unusual event, awareness of the tumour-to-tumour metastasis phenomenon can avoid an inaccurate diagnosis by the pathologist, therefore preventing inappropriate clinical intervention.

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Outcome of locally advanced carcinoma of oesophagus: A single institution experience.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e16507 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e16507-e16507

Author(s):

Thianeshwaran S ◽

Sriniivas Bj ◽

Niyati Prakash Sanghavi ◽

Vinu Sarathy ◽

Bhanu Prakash Lalkota ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Locally Advanced ◽

Disease Free Survival ◽

Pathological Response ◽

Complete Pathological Response ◽

Free Survival ◽

Poorly Differentiated ◽

Disease Free

e16507 Background: Oesophageal cancer is the twelfth most common cancer worldwide and seventh leading cause of cancer related death. Neoadjuvant treatment in addition to surgery has shown improved overall survival compared to surgery alone in resectable oesophageal cancer. We aimed to analyse the survival outcome among locally advanced oesophageal carcinoma patients in neoadjuvant setting. Methods: We analysed 37 patients with locally advanced carcinoma of oesophagus from 2015 to 2019 who underwent neoadjuvant chemoradiotherapy followed by surgical excision of tumour. Descriptive analysis was used for demographic data. overall survival and disease free survival was analysed using Kaplan-Meier survival analysis. Results: Our study includes 20 males (54%) and 17 females (45%). Over all consumption of Tobacco and alcohol consumption was found to be 64% and 18% respectively. The most common tumour site in this study was middle oesophagus (56%) followed by lower (37%) and upper (5%). Histopathologically, moderately differentiated squamous cell carcinoma constituted the highest (62%), followed by well differentiated squamous cell carcinoma (21%) and poorly differentiated carcinoma (16%). The pathological stage post chemoradiotherapy was 80%, 50% and 57% for stage I, II and III respectively. Median over all survival is 60 months and no statistical difference in stage I and stage II. Median over all survival for poorly differentiated squamous cell carcinoma is 16 months and lower one third of squamous cell carcinoma is 37 months. Complete pathological response is 42 %. Conclusions: Our study concluded that patients with tobacco and alcohol consumption have poorer survival. Prognosis was worst for patients with lower end oesophagus and poorly differentiated type. Disease free survival was better for patients who achieved complete pathological response when compared to partial responders.

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