scholarly journals Clinical and Pathological Features of Metastatic Adrenocortical Carcinoma

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A79-A79
Author(s):  
Joana Reis Guiomar ◽  
Diana Festas Silva ◽  
Diana Filipa Catarino ◽  
Carolina Moreno ◽  
Lúcia Fadiga ◽  
...  
Keyword(s):  
Overall Survival ◽  
Metastatic Disease ◽  
Adrenocortical Carcinoma ◽  
Statistical Significance ◽  
Clinical Signs ◽  
Complete Resection ◽  
Hormonal Activity ◽  
Pathological Features ◽  
Endocrine Society ◽  
Clinical And Pathological Features

Abstract Introduction: Adrenocortical carcinoma (AAC) is a rare and aggressive disease, associated with a poor prognosis. Surgery with complete resection (R0) remains the only curative treatment. However, even after complete resection, most patients present with distant metastatic disease. The aim of this study is to determine clinical and pathological features of metastatic disease in AAC. Materials and methods: Retrospective cohort study in 34 patients with AAC followed in our centre since 1991 until 2019. Selected patients with metastatic disease (n=21) and without metastatic disease (=13). Descriptive and comparative data analyses. Statistics: SPSS®v.23, with the variables: age, sex, clinical signs and symptoms, hormonal activity, imaging and pathological characteristics, surgical procedure, postoperative adjuvant treatments and overall survival. Results: 27 (79%) female and 7 (21%) male patients were included in our study, with a median age of 50 ± 13 years at the time of diagnosis. 21 patients (61,2%) presented with metastatic disease (38% of witch at the time of diagnosis) representing the metastatic disease group. 13 (38,8%) patients had no metastases until the collected data (group without metastatic disease). In the comparative analyses between the two groups, patients with metastatic disease had significantly more laparotomy procedures (71,2% n=15 vs 15,4% n=2; p<0,05), bigger tumours (≥ 12cm) (52,4% n=11 vs 23% n=3; p<0,05) and higher Ki67 (34,18% vs 1%, p<0,05). Postoperatively, the metastatic group had higher LDH (LDH at 6 months) (582 ± 502 vs 181 ± 47; p<0,05) and lower overall survival (months) (22,9 ± 4,69 vs 237,16 ± 44,42; p<0,05). Patients with metastatic disease had more constitutional symptoms (weight loss and asthenia) (33,3% n = 7 vs 15,4% n = 2; p = 0.092) and incomplete surgical recessions (R1/R2) (42,8% n = 9 vs 15,4% n = 2; p=0.18), however, without statistical significance. There were no differences regarding: age, sex, hormonal activity, imaging characteristics and post-surgical medical treatment. Conclusion: In this study, the adrenocortical carcinoma metastasis rate was 61,2% with an overall survival of 23 months in the metastatic group. Laparotomy surgeries, tumour size ≥12cm and higher KI67 are features significantly associated with metastatic disease in adrenocortical carcinoma. Constitutional symptoms and incomplete surgical recessions are more common in metastatic patients, however without statistical significance, in this cohort. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. Abstracts presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Survival for patients with resectable lung metastatic colorectal cancer (mCRC).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 708-708
Author(s):  
Timothy Jay Price ◽  
Yoko Tomita ◽  
Carol Beeke ◽  
Robert Padbury ◽  
Amanda Rose Townsend ◽  
...  
Keyword(s):  
Overall Survival ◽  
Liver Resection ◽  
Metastatic Disease ◽  
Statistical Significance ◽  
Lung Resection ◽  
Standard Of Care ◽  
Patient Characteristics ◽  
Term Survival ◽  
Lower Hazard

708 Background: Hepatic resection for CRC metastasis is now considered a standard of care and perioperative chemotherapy may improve outcomes. Resection of metastasis isolated to lung is also considered potentially curable, although there is still some variation in recommendations and no evidence for perioperative or adjuvant chemotherapy. Here, we explore patient characteristics and outcomes for patients undergoing lung resection for mCRC, with the liver resection group as the comparator. Methods: SA mCRC registry data were analysed to assess patient characteristics and survival outcomes between patients suitable for lung or liver resection. K-M survival analysis was used to assess OS. Results: 3,241 patient are registered on the database. 102 (3.1%) patients were able to undergo a lung resection compared to 420 (12.9%) a liver resection. Of the lung resection patients, 21% initially presented with liver only disease, 11% both lung and liver, and 7% brain or pelvic disease. 62 (61%) presented with lung only disease. Of these patients, 79% went straight to surgery and 34% had lung resection as the only intervention. When comparing the groups, they were balanced for age and sex, liver v lung; 67.7 years v 69.5 years, 63.6% v 57.8% male. There was no difference in pathological grade or KRAS MT rate when tested (36% liver v 32% lung). Compared to patients undergoing liver resection, those having lung resection were more likely to be metachronous (75.5% v 44%, p=<0.0001) and have a rectal primary (43.1% v 30.7%, p=0.017). Chemotherapy for metastatic disease was given more often in liver resection patients (76.9% v 53.9%, p=0.17). Median overall survival is not reached for both arms and the lower hazard rate for lung than liver resection does not approach statistical significance (HR 0.82, 95% CI 0.54-1.24, p=0.33). The 3 and 5 year survival liver v lung as follows; 77% v 81% and 62% v 70%. Conclusions: Lung resection occurs less frequently than liver resection for metastatic disease as expected. There was no statistical difference in overall survival in patients suitable for lung or liver resection. These data support the potential for long term survival with resection of both lung and liver metastasis in mCRC.

scholarly journals Clinical and pathological features of aspergillosis due to Aspergillus fumigatus in broilers

2020 ◽  
Vol 13 (12) ◽  
pp. 2787-2792
Author(s):  
Alfarisa Nururrozi ◽  
Yanuartono Yanuartono ◽  
Sitarina Widyarini ◽  
Dhasia Ramandani ◽  
Soedarmanto Indarjulianto
Keyword(s):  
Aspergillus Fumigatus ◽  
Clinical Symptoms ◽  
Histopathological Examination ◽  
Clinical Signs ◽  
Granulomatous Inflammation ◽  
Pathological Features ◽  
Additional Information ◽  
Air Sacs ◽  
Pulmonary Changes ◽  
Clinical And Pathological Features

Background and Aim: Aspergillus fumigatus is a ubiquitous pathogen causing aspergillosis in poultry. This research aimed to evaluate the clinical and pathological features of aspergillosis infection in broilers. Materials and Methods: A. fumigatus infection was induced experimentally by intra-air sac inoculation of a 1.7×108 spore suspension into broilers. Infected and non-infected birds were closely observed for the development of clinical signs of infection twice daily. Pathological samples were collected 5, 14, and 30 days post-infection (dpi) and examined by hematoxylin-eosin staining. Results: A total of 160 birds were included in this study. Clinical signs emerged at 3 dpi and became consistent at 5 dpi. A considerable decrease in severity and number of birds showing infection symptoms followed. The clinical signs of aspergillosis included anorexia (n=40; 50%), lethargy (n=32; 40%), dyspnea (n=38; 48%), and gasping (n=29; 36%). Macroscopic changes in the air sacs at 3 dpi included the development of minor lesions showing cloudiness, slight membrane thickening, and local exudates. Histopathological examination of the air sacs collected at 3 dpi indicated local inflammation surrounded by hyphae and spores. At 5 dpi, infected birds developed nodules, necrosis, and parenchymal consolidation of the lungs. Pulmonary changes, such as bronchopneumonia, spores, septate hyphae, and mild granulomatous inflammation, were also observed. At 14 dpi, multiple caseous nodules and plaques were found in the air sacs; plaque and necrosis in large areas of the lungs and severe multifocal granulomatous inflammation were noted. Conclusion: The clinical symptoms of aspergillosis emerged at 3 dpi and gradually decreased beginning at 7 dpi. Similar pathological changes were observed in the air sacs and lungs. The results of this work provide additional information on the pathogenesis of aspergillosis.

Incidental Prostate Cancer in Radical Cystoprostatectomy Specimens is Associated with Worse Overall Survival

2021 ◽  
pp. 1-7
Author(s):  
Takahiro Kimura ◽  
Hajime Onuma ◽  
Shun Sato ◽  
Hiroyuki Inaba ◽  
Wataru Fukuokaya ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Statistical Significance ◽  
Pathological Features ◽  
Incidental Prostate Cancer ◽  
P Values ◽  
Radical Cystoprostatectomy ◽  
Oncological Outcomes ◽  
The Impact

BACKGROUND: The impact of incidental prostate cancer (IPC) on oncological outcomes after radical cystoprostatectomy (RCP) specimens from patients with bladder cancer (BC) remains controversial. This relationship has not been well elucidated in Asian countries, where the incidence of prostate cancer has recently shown dramatic increases. OBJECTIVES: This study retrospectively compared pathological features and oncological outcomes between BC patients with and without IPC in the RCP specimens. METHODS: This study included 142 men who underwent RCP for BC. Men who were previously diagnosed with prostate cancer were excluded. Each prostate gland and seminal vesicle was processed as whole mounts and 4-mm close-step sectioning was performed. A single genitourinary pathologist diagnosed IPC. The pathological features and oncological outcomes such as overall survival (OS), bladder cancer-specific survival (BCSS), and progression-free survival (PFS) were compared between patients with IPC (IPC+group, n = 45) and without IPC (IPC- group, n = 97). P values less than 0.05 considered to indicate statistical significance for patients’ characteristics. Because of multi-primary endpoint, P values less than 0.0167 was considered statistical significance for oncological outcomes. RESULTS: We detected IPC in 45 RCP specimens (31.6%). Patients in the IPC- group were significantly younger at surgery than those in the IPC+group (P <  0.001). The pathological features of the RCP specimens did not differ significantly. In multivariable analyses, presence of IPC was significantly associated with worse OS (P = 0.005), but not with either BCSS or PFS (P = 0.038 and 0.326, respectively). In Kaplan–Meier analyses, OS tended to be longer in the IPC- group than that in the IPC+group (NR vs 65 months, P = 0.0017). CONCLUSIONS: Our results suggested significantly better OS in patients without IPC than that in those with IPC.

scholarly journals Clinical and pathological features of primary renal angiosarcoma.

2014 ◽  
Vol 8 (3-4) ◽  
pp. 223 ◽  
Author(s):  
Roberto Iacovelli ◽  
Valentina Orlando ◽  
Antonella Palazzo ◽  
Enrico Cortesi
Keyword(s):  
Metastatic Disease ◽  
Case Reports ◽  
Disease Free Survival ◽  
High Recurrence Rate ◽  
Search Term ◽  
Pathological Features ◽  
Free Survival ◽  
Risk Of Death ◽  
Clinical And Pathological Features ◽  
Final Cohort

Introduction: We review all cases of renal angiosarcoma described in the medical literature to describe its clinical and histological features.Methods: The search term was “angiosarcoma of the kidney.” All articles or case reports in English, French, German or Spanish published until March 15, 2013 were considered. When available, data that focused on clinical and pathological features were extracted.Results: In total, the final cohort included 42 cases. The median overall survival (OS) was 5.0 months (95% confidence interval [CI], 2.1-7.9). Patients with metastatic disease had more than a threefold increase in the risk of death compared to patients without metastatic disease (hazard ratio: 3.27, 95% CI, 1.48-7.24; p = 0.004). Non-metastatic patients had dismal disease-free survival (DFS) rates, with a median DFS of 6.0 months (95% CI, 4.3-7.7); despite this, chemotherapy was effective to increase survival in eligible patients (4.0 vs. 1.0 months; p = 0.001). Microscopic examination found epithelioid and spindled cell in 44% and 56% of cases, respectively; there was a statistically insignificant increase in survival in patients with epithelioid patterns compared to spindled ones (9.0 vs. 4.0 months; p = 0.077). The tumour grading was related to OS; the lower the grade, the longer the survival (13 vs.4 months; p = 0.029).Conclusions: Renal angiosarcoma is a rare disease with defined clinical and pathological features. It has a very poor prognosis in patients with metastatic disease and a high recurrence rate in patients with non-metastatic disease.

scholarly journals Survival Trends After Surgery for Spinal Metastatic Tumors: 20-Year Cancer Center Experience

Neurosurgery ◽  
2020 ◽  
Author(s):  
Robert J Rothrock ◽  
Ori Barzilai ◽  
Anne S Reiner ◽  
Eric Lis ◽  
Adam M Schmitt ◽  
...  
Keyword(s):  
Overall Survival ◽  
Metastatic Disease ◽  
Statistical Significance ◽  
Spinal Metastases ◽  
Cox Proportional Hazards ◽  
Postoperative Survival ◽  
Cancer Center ◽  
P Value ◽  
Metastatic Tumors ◽  
Long Term Outcome

ABSTRACT BACKGROUND Over the last 2 decades, advances in systemic therapy have increased the expected overall survival for patients with cancer. It is unclear whether the same survival benefit has been conferred to patients requiring surgery for metastatic spinal disease. OBJECTIVE To examine trends in postoperative survival over a 20-yr period for patients surgically treated for spinal metastatic disease. METHODS Data were obtained for 1515 patients who underwent surgery for metastatic epidural spinal cord compression or tumor-related mechanical instability. Postoperative overall survival was calculated for all included patients using Kaplan-Meier methodology from date of surgery until death or last follow-up for those who were censored. Trends were analyzed using Cox proportional hazards modeling. RESULTS Patients with renal, breast, lung, and colon cancers experienced a statistically significant improvement in survival over time based on the year of surgery (40%-100% improvement over the study period), whereas the overall survival trend for the entire cohort did not reach statistical significance (P = .12, median survival 0.71 yr, 95% CI 0.63-0.78). Patients presenting with synchronous metastatic disease had better survival compared to those presenting with metachronous disease (median overall survival: 0.94 vs 0.63 yr, respectively; log-rank P-value = .00001). CONCLUSION The postoperative survival among patients with spinal metastases has improved over the past 20 yr, particularly in patients with kidney, breast, lung, and colon tumors metastatic to the spine. The observed survival improvement emphasizes the need for long-term outcome consideration in treatment decisions for patients undergoing surgery for spinal metastatic tumors.

Cannabis-associated arteritis

VASA ◽  
2010 ◽  
Vol 39 (1) ◽  
pp. 43-53 ◽  
Author(s):  
Grotenhermen
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Cardiovascular Effects ◽  
Causative Factor ◽  
Cannabis Use ◽  
Thromboangiitis Obliterans ◽  
Pathological Features ◽  
Scientific Support ◽  
Clinical And Pathological Features

Background: To investigate the hypothesis that cases of arteritis similar to thromboangiitis obliterans (TAO) and associated with the use of cannabis were caused by cannabis or THC (dronabinol), or that cannabis use is a co-factor of TAO. Patients and methods: A systematic review on case reports and the literature on so-called cannabis arteritis, TAO, and cardiovascular effects of cannabinoids was conducted. Results: Fifteen reports with 57 cases of an arteritis associated with the use of cannabis and two additional case series of TAO, in which some patients also used cannabis, were identified. Clinical and pathological features of cannabis-associated arteritis do not differ from TAO and the major risk factor of TAO, tobacco use, was present in most, if not in all of these cases. The proposed pathophysiological mechanisms for the development of an arteritis by cannabis use are not substantiated. Conclusions: The hypothesis of cannabis being a causative factor or co-factor of TAO or an arteritis similar to TAO is not supported by the available evidence. The use of the term “cannabis arteritis” should be avoided until or unless more convincing scientific support is forthcoming.

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