Localized osteosarcoma analysis of very poor responders subgroup (Huvos I).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e22010-e22010
Author(s):  
Alessandra Longhi ◽  
Antonio Carella ◽  
Valquiria Broll ◽  
Emanuela Palmerini ◽  
Marilena Cesari ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Preoperative Chemotherapy ◽  
Poor Prognosis ◽  
New Drugs ◽  
Poor Responders ◽  
Significant Prognostic Factor ◽  
Histologic Response ◽  
The Poor ◽  
Prognostic Group

e22010 Background: Osteosarcoma is a malignant primitive bone tumor whose prognosis is not changed since 4 decades, after the introduction of neoadjuvant chemotherapy with Methotrexate, Cisplatin, Doxorubicine and Ifosfamide. Histologic response to preoperative chemotherapy is a significant prognostic factor. Huvos I (necrosis ≤ 50%) has worst prognosis . Previous studies reported a 3 years EFS of this Huvos I patients around 25% (Tsuda Y,2020). In order to evaluate if survival has changed in recent years in this unfavourable prognostic group we evaluated the outcome of osteosarcoma patients with Huvos I. Methods: from our Pathology archieves we retrieved all cases of localized osteosarcoma treated at Rizzoli with neoadjuvant chemotherapy who reported an histologic necrosis below or equal to 50% (Huvos I grade) after preoperative chemotherapy MAP (Ethical C. Approval 917/2020/Oss/IOR). Results: from 2003 to 2019 we had 70 cases of localized osteosarcoma with Huvos I necrosis after neoadjuvant chemotherapy ( MAP in 66 and MAPI in 4) evaluable. Median age 21,5 (3-70); M:F = 44:26. 10/70 had axial localization vs extremity(60), subhistotype distribution:46 osteoblastic,11 chondroblastic, 7 fibroblastic, 5 teleangectatic, one not classified. In 24 cases PgP was available(14 PgP positive). With a median follow up of 86.7 ms (IQR 41-136) 43/70 had already relapsed. The median EFS was 25 ms (95% CI 15-42) and the 3 yrs EFS was 40.6% (95% CI 29-52). The 3 yrs overall survival was 80% (95%CI 68-88) and median OS was not reached. Axial tumor site was associated with significant inferior EFS (P = .004). Conclusions: these data confirm the poor prognosis of patients with necrosis ≤50% and the need of new drugs to improve their survival in this sub-group.

Long-Term Outcome for Patients With Nonmetastatic Osteosarcoma of the Extremity Treated at the Istituto Ortopedico Rizzoli According to the Istituto Ortopedico Rizzoli/Osteosarcoma-2 Protocol: An Updated Report

2000 ◽  
Vol 18 (24) ◽  
pp. 4016-4027 ◽  
Author(s):  
Gaetano Bacci ◽  
Stefano Ferrari ◽  
Franco Bertoni ◽  
Pietro Ruggieri ◽  
Piero Picci ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Tumor Necrosis ◽  
Poor Responders ◽  
High Dose ◽  
Second Malignancies ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Long Term Follow Up

PURPOSE: To provide an estimate of long-term prognosis for patients with osteosarcoma of the extremity treated in a single institution with neoadjuvant chemotherapy and observed for at least 10 years. PATIENTS AND METHODS: Patients with nonmetastatic osteosarcoma of the extremity were preoperatively treated with high-dose methotrexate, cisplatin, and doxorubicin (ADM). Postoperatively, good responders (90% or more tumor necrosis) received the same three drugs used before surgery, whereas poor responders (less than 90% tumor necrosis) received ifosfamide and etoposide in addition to those three drugs. RESULTS: For the 164 patients who entered the study between September 1986 and December 1989, surgery was a limb salvage in 136 cases (82%) and a good histologic response was observed in 117 patients (71%). At a follow-up ranging from 10 to 13 years (median, 11.5 years), 101 patients (61%) remained continuously free of disease, 61 relapsed, and two died of ADM-induced cardiotoxicity. There were no differences in prognosis between good and poor responding patients. ADM-induced cardiotoxicity (six patients), male infertility (10 of the 12 assessable patients), and second malignancies (seven patients) were the major complications of chemotherapy. Despite the large number of limb salvages performed, only four local recurrences (2.4%) were registered. CONCLUSION: With an aggressive neoadjuvant chemotherapy, it is possible to cure more than 60% of patients with nonmetastatic osteosarcoma of the extremity and amputation may be avoided in more than 80% of them. Because local or systemic relapses, myocardiopathies, and second malignancies are possible even 5 years or more after the beginning of treatment, a long-term follow-up is recommended for these patients.

scholarly journals Increased angiogenic sprouting in poor prognosis FL is associated with elevated numbers of CD163+ macrophages within the immediate sprouting microenvironment

Blood ◽  
2010 ◽  
Vol 115 (24) ◽  
pp. 5053-5056 ◽  
Author(s):  
Andrew J. Clear ◽  
Abigail M. Lee ◽  
Maria Calaminici ◽  
Alan G. Ramsay ◽  
Kelly J. Morris ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Poor Prognosis ◽  
Tissue Microarrays ◽  
Clinical Heterogeneity ◽  
Angiogenic Activity ◽  
The Poor ◽  
Numerical Assessment ◽  
Tumor Neovascularization ◽  
Prognostic Group ◽  
Diagnostic Biopsies

Abstract Follicular lymphoma has considerable clinical heterogeneity, and there is a need for easily quantifiable prognostic biomarkers. Microvessel density has been shown to be a useful prognostic factor based on numerical assessment of vessel numbers within histologic sections in some studies, but assessment of tumor neovascularization through angiogenic sprouting may be more relevant. We therefore examined the smallest vessels, single-staining structures measuring less than 30 μm2 in area, seen within histologic sections, and confirmed that they were neovascular angiogenic sprouts using extended focal imaging. Tissue microarrays composing diagnostic biopsies from patients at the extremes of survival of follicular lymphoma were analyzed with respect to numbers of these sprouts. This analysis revealed higher angiogenic activity in the poor prognostic group and demonstrated an association between increased sprouting and elevated numbers of infiltrating CD163+ macrophages within the immediate microenvironment surrounding the neovascular sprout.

[18F]Fluorodeoxyglucose Positron Emission Tomography Predicts Outcome for Ewing Sarcoma Family of Tumors

2005 ◽  
Vol 23 (34) ◽  
pp. 8828-8834 ◽  
Author(s):  
Douglas S. Hawkins ◽  
Scott M. Schuetze ◽  
James E. Butrynski ◽  
Joseph G. Rajendran ◽  
Cheryl B. Vernon ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Neoadjuvant Chemotherapy ◽  
Ewing Sarcoma ◽  
Fdg Pet ◽  
Emission Tomography ◽  
Disease Stage ◽  
Significant Prognostic Factor ◽  
Histologic Response ◽  
Positron Emission ◽  
Response To Neoadjuvant Chemotherapy

Purpose Response to neoadjuvant chemotherapy is a significant prognostic factor for the Ewing sarcoma family of tumors (ESFTs). [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET) is a noninvasive imaging modality that accurately predicts histopathologic response in several malignancies. To determine the prognostic value of FDG PET response for progression-free survival (PFS) in ESFTs, we reviewed the University of Washington Medical Center experience. Patients and Methods Thirty-six patients with ESFTs were evaluated by FDG PET. All patients received neoadjuvant and adjuvant chemotherapy. FDG PET standard uptake values before (SUV1) and after (SUV2) chemotherapy were analyzed and correlated with chemotherapy response, as assessed by histopathology in surgically excised tumors. Thirty-four patients had both SUV1 and SUV2. Results The mean SUV1, SUV2, and ratio of SUV2 to SUV1 (SUV2:1) were 7.9 (range, 2.3 to 32.8), 2.1 (range, 0 to 4.3), and 0.36 (range, 0.00 to 1.00), respectively. Good FDG PET response was defined as SUV2 less than 2.5 or SUV2:1 ≤ 0.5. FDG PET response by SUV2 or SUV2:1 was concordant with histologic response in 68% and 69% of patients, respectively. SUV2 was associated with outcome (4-year PFS 72% for SUV2 < 2.5 v 27% for SUV2 ≥ 2.5, P = .01 for all patients; 80% for SUV2 < 2.5 v 33% for SUV2 ≥ 2.5, P = .036 for localized at diagnosis patients). SUV2:1 ≤ 0.5 was not predictive of PFS. Conclusion FDG PET imaging of ESFTs correlates with histologic response to neoadjuvant chemotherapy. SUV2 less than 2.5 is predictive of PFS independent of initial disease stage.

scholarly journals Evaluation of breast cancer in women under 50in a Mastology service in the Federal District, Brazil

Mastology ◽  
2021 ◽  
Vol 31 ◽  
Author(s):  
Ana Cláudia Leite Vilela ◽  
Lucimara Priscila Campos Veras ◽  
Sérgio Eduardo Paiva Ramos ◽  
Sádia Martins de Paula Souza
Keyword(s):  
Public Health ◽  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Distant Metastasis ◽  
Poor Prognosis ◽  
Federal District ◽  
The Other ◽  
Public Health Issue ◽  
The Poor ◽  
Advanced Tumors

Introduction: Breast cancer is a relevant public health issue, and its incidence has increased in patients aged less than 50 years. This population usually receives a late diagnosis, which contributes with the poor prognosis of the condition. Objective: To assess the percentage of patients diagnosed with breast cancer before the age of 50 and compare them with the group that was diagnosed after the age of 50. Results: The general mean age was 54 years; 75.68% of the patients were younger than 50 years, aged between 40 and 49 years. Among the ones who were younger than 50, 35.14% were in stage T4; 55.41% underwent neoadjuvant chemotherapy; 16.22% presented distant metastasis; and 10.81%, locoregional metastasis. On the other hand, among those aged more than 50, 22.71% were in stage T4; 30.68% underwent neoadjuvant chemotherapy; 11.36% presented distant metastasis; and 6.82%, locoregional metastasis. Conclusion: Breast cancer in women aged less than 50 years in a Mastology service in the Federal District has been a matter of concern, for presenting more advanced tumors at the time of diagnosis; screening is still debatable.

Childhood osteosarcoma: Evaluation of 94 cases. A single institution study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10040-10040
Author(s):  
I. Ayan ◽  
R. Kebudi ◽  
H. Ozger ◽  
F. Yaman Agaoglu ◽  
O. Gorgun ◽  
...  
Keyword(s):  
Preoperative Chemotherapy ◽  
Myeloid Leukemia ◽  
Progressive Disease ◽  
Single Institution ◽  
Histologic Response ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Histopathologic Diagnosis

10040 Background: Osteosarcoma is the most frequent bone tumor in children and adolescents. The aim of this study is to evaluate the demographic characteristics, therapy, and long term outcome of children with osteosarcoma in a single institution. Methods: Between January 1990 and December 2006, 94 children (53 male, 41 female) with a median age of 13 (5–16) years and a histopathologic diagnosis of osteosarcoma were treated with an institutional chemotherapy regimen comprising of 6 courses (3 pre-, 3 postoperatively) of epirubicin (90 mg/m2), cisplatin(100 mg/m2), and ifosfamide(2 g/m2 × 3 days) every 3 weeks. Results: The median follow-up time was 36 (2–219) months. 68 patients were alive at the time of analysis. 26 patients died; 20 of disease, 5 of toxicity, and 1 of second malignancy (acute myeloid leukemia). 90% of the patients had a limb salvage. 5 and 10 year OS for all patients were 64.7 % ( [95 % CI] 74.8–52.94 %) and 62.2 % (95 % CI 74.6–49.9 %), respectively. 5 and 10 year EFS for all patients was 51.8 % (95% CI 40.2–63.4 %). 5 and 10 year OS for nonmetastatic patients were 78.3 % (95% CI 66.9–89.7 %) and 75.1 %(95% CI 62.6–87.6), vs. 13.5 % 5 year OS for metastatic patients(95% CI 0–30.8 %) (p< 0.001). 5 and 10 year EFS for nonmetastatic patients was superior to those with metastatic disease [62.4 % (95% CI 49.9–79.9 %) vs. 6.9 % (95% CI 0–19.9 %)) (p<0.001). A total of 33 patients experienced relapse and/or progression at a median of 9 months (range 0–40 months). 10 year OS for 18 patients (11 metastatic at diagnosis) who progressed during preoperative chemotherapy was 13 % vs. 75 % for those who didnot have progressive disease (p< 0.001). The rate of histologically good response to preoperative chemotherapy was 64.5 %. Histologic response (<90 percent necrosis vs ≥90 percent) significantly correlated with 5 year EFS (31 % vs 67.6 %, p=0.023) but not with OS (57.7 % vs 76.5 %, p=0.13). Conclusions: The presence of metastases at diagnosis was the most significant characteristic influencing outcome. Our results demonstrate that the combination of epirubicin, cisplatin, and ifosfamide is an active and reasonably well-tolerated regimen for childhood osteosarcoma. No significant financial relationships to disclose.

scholarly journals Histological assessment of the effect of neoadjuvant chemotherapy on conventional high grade osteosarcoma of the long bones

1970 ◽  
Vol 1 (1) ◽  
pp. 60-62
Author(s):  
JB Thapa
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Tumour Response ◽  
Poor Responders ◽  
High Grade ◽  
Medical Oncologist ◽  
Long Term Follow Up ◽  
High Grade Osteosarcoma ◽  
Histological Mapping

A multidisciplinary team of an orthopaedic surgeon, medical oncologist, radiologist and pathologist was involved in the management of osteosarcoma cases. Four cases of osteosarcoma were examined for the effects of neoadjuvant chemotherapy. Total histological mapping was done to study the postchemotherapy biopsies. Two cases were good responders (more than 90% response), and two cases were poor responders (less than 90% response). Good responders had limb sparing surgery performed on them. Long term follow up results are awaited. Keywords: Neoadjuvant chemotherapy; Osteosarcoma; Total histological mapping; Tumour response DOI: 10.3126/jpn.v1i1.4455 Journal of Pathology of Nepal (2011) Vol.1, 60-62

A Follow-up Study of Female Narcotic Addicts: Variables Related to Outcome

1974 ◽  
Vol 125 (584) ◽  
pp. 28-33 ◽  
Author(s):  
P. T. d'Orbán
Keyword(s):  
Poor Prognosis ◽  
Psychological Characteristics ◽  
Prognostic Indicators ◽  
Follow Up Study ◽  
The Poor ◽  
Follow Up Studies ◽  
The Individual ◽  
The Relationship ◽  
Methods Of Treatment

The poor prognosis of narcotic dependence is generally recognized, but this is a field in which it is specially difficult to make predictions about the outcome of treatment in the individual patient. Vaillant (1966a) noted that abstinence appears to depend more on the addict's ability to discover satisfying alternatives to his addiction than on methods of treatment. In an attempt to identify prognostic indicators in narcotic dependence a number of follow-up studies have examined the relationship between outcome and various social and psychological characteristics of the patients studied. While most follow-up studies are of male addicts or of samples containing only a small proportion of women, the present study is concerned with the outcome in a sample of 66 female narcotic addicts.

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