scholarly journals Clinicopathological Features and Treatment Outcomes in Parotid Malignancies at Ocean Road Cancer Institute, Dar-es-Salaam, Tanzania

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 192s-192s
Author(s):  
A. Adatia
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Parotid Gland ◽  
Treatment Outcomes ◽  
Salivary Glands ◽  
Dar Es Salaam ◽  
Treatment Modalities ◽  
Curative Intent ◽  
Geographical Variations ◽  
Pathologic Features

Background: Neoplasms that arise in the salivary glands are relatively rare, yet they represent a wide variety of both benign and malignant histologic subtypes. Tumors of the salivary glands form one of the most heterogeneous groups of oncological pathology. Head and neck tumors represent ∼5% of human neoplasms, and out of these, salivary gland neoplasms constitute 10%. Aim: The challenges faced for parotid gland malignancy are numerous and these factors determine the treatment modality, prognosis and outcome, overall survival, sociodemographic features affecting Tanzanian residents and there is very little knowledge on clinicopathological aspects of parotid gland malignancies diagnosed at a tertiary health center and this study can compare the findings with epidemiologic data from different geographic locations. Methods: A Retrospective study design was used among all patients who had been diagnosed and confirmed histologically with malignant Parotid tumor referred to and treated at Ocean Road Cancer Institute (ORCI) from January 2009-December 2016. Analysis of this retrospective study determined the sociodemographic factors, clinico-pathologic features, treatment outcomes of surgery, radiotherapy, chemotherapy and assessment of 2 years overall survival of parotid malignancies from January 2009 to December 2014. The study was conducted at ORCI in Dar es Salaam. Results: Out of 94 patients with histologically confirmed parotid gland malignancy, more males were affected compared with females with the ratio of 1.18:1 and the mean SD age of patients was 51.9 years. Adenocarcinoma was the most common malignant tumor n = 37 (40%) followed by squamous cell carcinoma n = 18 (19.1%) and the left parotid gland being the most affected site. 44 cases (46.8%) had pathologic grading, grade IV accounting for majority of the grades (27.3%). Stage IV was presented the most n=72 (76.5%) and 8.5% presented with metastasis at diagnosis. 31% of patients were subjected to surgery while 69.1% were deemed to be unfit for surgery due to advanced disease. Radiotherapy was received by n = 82 (95.2%) with 13 patients (14%) subjected to curative intent and 69 patients (86%) subjected to palliative intent. 2 year overall survival for the curative cohort from 2009-2014 is 23% and 11% for the palliative arm. The 2 year overall survival of parotid gland malignancy treated at ORCI is 12%. Conclusion: Clinico-pathologic presentation of parotid gland malignancy seen in this study differs from other studies probably due to geographical variations. More males are affected than women, especially in the middle ages. Adenocarcinoma was the most frequent histology. Two years overall survival from 2009 to 2014 was 12%. Late stage presentation was seen as a problem that needs to addressed to maximize the effectiveness of the treatment, and improve the overall survival. Treatment modalities need to be standardized across health facilities in Tanzania.

Comparative analysis of resected duodenal and ampullary adenocarcinoma.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 362-362
Author(s):  
Angelena Crown ◽  
Alicia M Edwards ◽  
Flavio G. Rocha ◽  
Vincent J. Picozzi ◽  
Scott Helton ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Nodes ◽  
Surgical Complications ◽  
Cox Regression ◽  
Ampullary Adenocarcinoma ◽  
Curative Intent ◽  
T Stage ◽  
Survival Difference ◽  
Pathologic Features ◽  
Positive Lymph Nodes

362 Background: Duodenal and ampullary adenocarcinomas are rare gastrointestinal cancers that share similar anatomic location and treatment strategy. We report a single-institution experience regarding the association between clinicopathologic features, treatment, and survival outcomes. Methods: A retrospective review of all patients resected with curative intent for duodenal adenocarcinoma (DUO) between 2005-2015 and ampullary adenocarcinoma (AMP) between 2011-2015 at VMMC was performed. For AMP, histologic subtyping into intestinal (IT) and pancreatobiliary (PB) phenotypes was determined. Demographic and clinicopathologic parameters were compared between DUO and AMP patients using Chi-square test. Overall survival was calculated using Kaplan-Meier analysis and prognostic factors were identified by univariate Cox regression. Results: Patients with DUO (n = 44) presented at higher T-stage (p = 0.002) and with larger tumors (4.35cm vs 2.33cm, p < 0.001) than AMP patients (n = 46). DUO patients had a higher rate of surgical complications (68% vs 41%, p = 0.01) with a trend for more pancreatic fistulas (36% vs 20%, p = 0.08). There was no difference in median overall survival between groups. Factors positively influencing survival included Caucasian race (p = 0.02) and normal CA19-9 level at diagnosis (p = 0.01). Tumor factors negatively influencing survival included positive lymph nodes (p = 0.04), lymphovascular invasion (p = 0.001), and perineural invasion (p = 0.02). Within AMP, the PB subtype presented at higher T-stage (p = 0.01) and with more positive lymph nodes (p = 0.03) than IT. There was no difference in survival between subtypes. Majority received adjuvant chemotherapy (88.8% in AMP, 76.3% in DUO), fewer received adjuvant radiotherapy (23.3% in AMP, 30% in DUO), but no survival difference was seen. Conclusions: DUO presents with larger tumors and higher T-stage than AMP and is associated with more surgical complications. The PB phenotype has more advanced pathologic features than IT. No survival difference was seen between anatomic locations or subtypes. Better surgical and chemotherapeutic strategies may be needed to overcome high risk features. Longer follow-up with more patients is needed to confirm these findings.

scholarly journals Mcl-1 Expression Is Up-Regulated in Malignancies of the Parotid Gland

2011 ◽  
Vol 30 (5) ◽  
pp. 229-233 ◽  
Author(s):  
Gregor Heiduschka ◽  
Boban M. Erovic ◽  
Johannes Pammer ◽  
Ulana Kotowski ◽  
Alexandra Kaider ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Parotid Gland ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Gland Tumor ◽  
Parotid Gland Tumor ◽  
Apoptotic Protein ◽  
Pleomorphic Adenomas

The anti-apoptotic protein Mcl-1 is highly expressed in various types of malignant tumors. Overexpression is reported to correlate with poor prognosis and disease progression. We report the expression levels of Mcl-1 in tumor samples of the parotid gland. A retrospective study containing 108 patients was performed. A tissue microarray of six malignancies of the parotid gland and pleomorphic adenoma as control was constructed. Parotid gland tumor samples were immunohistochemically stained for Mcl-1 and expression intensities were assessed. Statistical analysis included correlation to patients' clinical data and comparison of malignancies to the adenoma.All malignancies had significantly higher expression of Mcl-1 than the pleomorphic adenomas. The intensity, however, had no significant correlation to overall survival.Our immunohistochemical findings indicate that parotid gland malignancies produce high levels of Mcl-1 protein. Therefore, Mcl-1 might serve as a predictive co-marker in tumors of the parotid gland.

Primary Pulmonary MALT Lymphoma: Clinical Characteristics and Treatment Outcomes – Single Institution Experience

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4168-4168
Author(s):  
Grzegorz S. Nowakowski ◽  
Kay Ristow ◽  
Paul Kurtin ◽  
Mark S Allen ◽  
Ivana N Micallef ◽  
...  
Keyword(s):  
Overall Survival ◽  
Treatment Outcomes ◽  
Malt Lymphoma ◽  
Mayo Clinic ◽  
Pulmonary Lesion ◽  
Treatment Modalities ◽  
Gastric Malt Lymphoma ◽  
Single Institution ◽  
Pulmonary Malt Lymphoma ◽  
The Impact

Abstract Abstract 4168 Background: Primary Pulmonary MALT lymphoma represents 15–20% of Extranodal Marginal Zone Lymphomas of Mucosa Associated Lymphoid Tissue (MALT). In contrast to the more common gastric MALT lymphoma, natural history, prognosis and treatment outcomes for primary pulmonary MALT lymphoma are not well defined. Herein, we report a single institution experience. Methods: Consecutive patients with primary pulmonary MALT lymphoma registered in the Mayo Clinic Lymphoma Database, which includes all consenting patients with lymphoma seen at Mayo Clinic Rochester, were reviewed for clinical features, treatment outcome progression free survival (PFS) and overall survival (OS). The pathology for all patients was centrally reviewed by hematopathologist and the diagnoses were based on WHO lymphoma classification criteria. PFS and OS were assessed using the Kaplan–Meier method and the Cox proportional hazard model was used to assess the impact of variables on PFS and OS. Results: Between December 1986 and June of 2009, ninety-seven patients with primary pulmonary MALT lymphoma were enrolled. The median age at diagnosis was 63 years (range 31–87). There were 43 (44%) males. The initial presentation was a unilateral pulmonary lesion (n=47, 48%), bilateral pulmonary lesions (n=41, 42%), and pulmonary lesion with intrathoracic lymphadenopathy (n= 4, 4%). Bone marrow involvement and presence of B symptoms were 4, 4% and 5, 5%, respectively. International Prognostic Index (IPI) was 0–1, 2–3 and 4–5 in 69, 25 and 1 patient(s) respectively. The median follow-up was 10.4 years. The estimated median OS was 13. 6 years and the median PFS was 5.5 years (Figure). In a multivariate analysis, age >60 (p=0.02) and ECOG PS>2 (p=0.01) were associated with shortened survival. The IPI and age adjusted IPI were not predictive of overall survival. The treatment outcomes for the most common treatment modalities are summarized in the Table below. The median PFS of the 38% of patients who had a complete surgical resection was excellent at 11.2 years; whereas for observed patients with residual disease after biopsy was 3.2 years. Only 8 patients received single agent rituximan with relatively low response rate. Summary: The prognosis of primary pulmonary MALT lymphoma is favorable, with a median survival of over 13 years. In patients with resectable disease, surgery alone is associated with excellent disease control. Further prospective studies are needed to define the optimal treatment of primary pulmonary MALT lymphoma. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Salivary Gland Trauma: A Review of Diagnosis and Treatment

2012 ◽  
Vol 5 (4) ◽  
pp. 189-195 ◽  
Author(s):  
Maria Lazaridou ◽  
Christos Iliopoulos ◽  
Kostas Antoniades ◽  
Ioannis Tilaveridis ◽  
Ioannis Dimitrakopoulos ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Early Diagnosis ◽  
Parotid Gland ◽  
Treatment Outcomes ◽  
Salivary Glands ◽  
Treatment Options ◽  
Diagnosis And Treatment ◽  
Salivary Duct ◽  
Treatment Protocols ◽  
Adequate Evaluation

Salivary gland trauma is uncommon. Parotid gland and duct injuries are far more common than injuries to submandibular and sublingual glands due to anatomic position. Several methods of treating salivary duct injuries and their complications have been advocated. Optimal treatment outcomes can be achieved with early diagnosis, adequate evaluation, and proper management. This article presents current diagnostic and treatment protocols of salivary gland trauma. The anatomy of the salivary glands is briefly described and clinical cases are also presented to illustrate the treatment options described.

scholarly journals Pleural Solitary Fibrous Tumors—A Retrospective Study on 45 Patients

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 185 ◽  
Author(s):  
Cornel Savu ◽  
Alexandru Melinte ◽  
Radu Posea ◽  
Niculae Galie ◽  
Irina Balescu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Ct Scan ◽  
Single Case ◽  
Postoperative Mortality ◽  
Diagnostic Methods ◽  
Chest Wall Resection ◽  
En Bloc ◽  
Curative Intent ◽  
Solitary Fibrous Tumors ◽  
Thoracic Ct

Introduction: The purpose of this paper is to study the type, the clinical presentation, and the best diagnostic methods for pleural solitary fibrous tumors (PSFTs), as well as to evaluate which is the most appropriate treatment, especially as PSFTs represent a rare occurrence in the thoracic pathology. Material and Method: A retrospective study was conducted on a group of 45 patients submitted to surgery between January 2015 and December 2019. In most cases, the diagnosis was established through imaging studies—thoracic computed tomography (CT) scan with or without contrast—but also using magnetic resonance imaging (MRI) or positron emission tomography (PET) scans when data from CT scans were scarce. All patients were submitted to surgery with curative intent. Results: Most patients included in this study were asymptomatic, with this pathology being more common in patients over 60 years of age, and more common in women. The occurrence of malignant PSFT in our study was 17.77% (8 cases). All cases were submitted to surgery with curative intent, with a single case developing further recurrence. In order to achieve complete resection en bloc resection of the tumor with the chest wall, resection was performed in two cases, while lower lobectomy, pneumectomy, and hemidiaphragm resection, respectively, were needed in each case. Postoperative mortality was null. Conclusion: Thoracic CT scan remains the most important imagistic investigation in diagnosing. MRI is superior to thoracic CT, especially in cases that involved the larger blood vessels within the thorax, spinal column, or diaphragm. Complete surgical resection is the gold standard in treatment of PSFT, and the prognosis in benign cases is very good.

scholarly journals Intraductal Carcinoma of the Parotid Gland Presenting as Parapharyngeal Mass

2020 ◽  
Vol 5 (3) ◽  
pp. 1-7
Author(s):  
Yamato Oki ◽  
Hiromitsu Hatakeyama ◽  
Masako Otani ◽  
Hidetaka Ikemiyagi ◽  
Masanori Komatsu ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Parotid Gland ◽  
Salivary Glands ◽  
Parapharyngeal Space ◽  
Malignant Tumors ◽  
Relevant Literature ◽  
Ct Scans ◽  
Intraductal Carcinoma ◽  
First Case

Intraductal carcinomas are rare, malignant tumors that arise from the salivary glands. They commonly grow from the parotid gland and no cases growing from the parapharyngeal space have been reported to date. We report a 76-year-old man who was inadvertently found to have a parapharyngeal lesion by CT scans and MR imaging. The tumor was resected through an upper neck approach and diagnosed histopathologically as intraductal carcinoma. As far as we are aware, this is the first case of intraductal carcinoma arising from the parapharyngeal space. Here, we describe the management of this disease together with a review of the relevant literature.

scholarly journals Interventional Oncology Approach to Hepatic Metastases

2020 ◽  
Vol 37 (05) ◽  
pp. 484-491
Author(s):  
Cathal O'Leary ◽  
Michael C. Soulen ◽  
Susan Shamimi-Noori
Keyword(s):  
Liver Disease ◽  
Liver Function ◽  
Interventional Oncology ◽  
Hepatic Metastases ◽  
Locoregional Therapy ◽  
Treatment Modalities ◽  
Patient Specific ◽  
Curative Intent ◽  
Locoregional Therapies ◽  
Metastatic Liver

AbstractMetastatic liver disease is one of the major causes of cancer-related morbidity and mortality. Locoregional therapies offered by interventional oncologists alleviate cancer-related morbidity and in some cases improve survival. Locoregional therapies are often palliative in nature but occasionally can be used with curative intent. This review will discuss important factors to consider prior to palliative and curative intent treatment of metastatic liver disease with locoregional therapy. These factors include those specific to the tumor, liver function, liver reserve, differences between treatment modalities, and patient-specific considerations.

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