Pilocytic Astrocytomas in Children: Prognostic Factors—A Retrospective Study of 80 Cases

Abstract OBJECTIVE Pilocytic astrocytomas (PA) are Grade I brain tumors characterized by an excellent prognosis. In some cases, however, the patient has a bad outcome. The aim of our study was to search for the clinicopathological factors underlying the prognosis for patients with this disease. METHODS We reviewed the clinical, neuroradiological, and histopathological features of 80 PAs (33 cerebellar, 18 optochiasmatic, 16 brainstem, 7 spinal cord, 3 thalamic, 2 optic nerve, and 1 hemispheric) in pediatric patients. RESULTS Pathological examination revealed 58 classic PAs and 20 pilomyxoid astrocytomas, which are a histological variant of PAs. Two cases remained unclassified. The mean overall follow-up period was 58 months, the 5-year progression-free survival rate was 75%, and the 5-year survival rates were 100 and 92% after total and partial removal. Univariate statistical analysis revealed that partial resection, optochiasmatic PA localization, and pilomyxoid variant were associated with a worse prognosis, but the latter two parameters were too closely related to the extent of resection to be independent prognostic factors in multivariate analysis. Among the patients who underwent partial surgical removal, only invasion of the surrounding structures was related to prognosis. CONCLUSION PAs are benign tumors, but some clinicopathological factors, such as partial resection, optochiasmatic location, invasion of surrounding structures, and the pilomyxoid variant, have a worse prognosis.

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Treatment outcomes of endometrial cancer patients with paraaortic lymph node metastasis: a multi-institutional analysis

International Journal of Gynecological Cancer ◽

10.1136/ijgc-2018-000029 ◽

2019 ◽

Vol 29 (1) ◽

pp. 94-101 ◽

Cited By ~ 3

Author(s):

Cem Onal ◽

Berna Akkus Yildirim ◽

Sezin Yuce Sari ◽

Guler Yavas ◽

Melis Gultekin ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Prognostic Factors ◽

Adjuvant Radiotherapy ◽

Survival Rates ◽

Myometrial Invasion ◽

Progression Free Survival ◽

Free Survival ◽

Radiotherapy Alone ◽

Paraaortic Lymph Node Metastasis

ObjectiveTo analyze the prognostic factors and treatment outcomes in endometrial cancer patients with paraaortic lymph node metastasis.MethodsData from four centers were collected retrospectively for 92 patients with endometrial cancer treated with combined radiotherapy and chemotherapy or adjuvant radiotherapy alone postoperatively, delivered by either the sandwich or sequential method. Prognostic factors affecting overall survival and progression-free survival were analyzed.ResultsThe 5-year overall survival and progression-free survival rates were 35 % and 33 %, respectively, after a median follow-up time of 33 months. The 5-year overall survival and progression-free survival rates were significantly higher in patients receiving radiotherapy and chemotherapy postoperatively compared with patients treated with adjuvant radiotherapy alone (P < 0.001 and P < 0.001, respectively). In a subgroup analysis of patients treated with adjuvant combined chemotherapy and radiotherapy, the 5-year overall survival and progression-free survival rates were significantly higher in patients receiving chemotherapy and radiotherapy via the sandwich method compared with patients treated with sequential chemotherapy and radiotherapy (P = 0.02 and P = 0.03, respectively). In the univariate analysis, in addition to treatment strategy, pathology, depth of myometrial invasion, and tumor grade were significant prognostic factors for both overall survival and progression-free survival. In the multivariate analysis, grade III disease, myometrial invasion greater than or equal to 50%, and adjuvant radiotherapy alone were negative predictors for both overall survival and progression-free survival.ConclusionWe demonstrated that adjuvant combined treatment including radiotherapyand chemotherapy significantly increases overall survival and progression-free survival rates compared with postoperative pelvic and paraaortic radiotherapy.

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Multidisciplinary treatment of 99 adult osteosarcoma (OST) patients (pts) with synchronous and metachronous metastases (mets): A retrospective series of the French Sarcoma Group (FSG).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.11030 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 11030-11030

Author(s):

Elise Lavit ◽

Mihaela Aldea ◽

Nicolas Isambert ◽

Jean-Emannuel Kurtz ◽

Corinne Delcambre ◽

...

Keyword(s):

Clinical Trial ◽

Prognostic Factors ◽

Medical Records ◽

Poor Prognosis ◽

Multidisciplinary Treatment ◽

Progression Free Survival ◽

Surgical Removal ◽

Free Survival ◽

Adult Osteosarcoma

11030 Background: Treatment (trt) options for metastatic OST are scarce. Following failure of standard 1st line therapy pts who relapse present a challenging trt dilemma, and have poor prognosis. Surgical removal of all mets is essential. Currently, there are no standardized 2nd line trt options in relapsed OST. Methods: Pts were identified from 2 sarcoma databases; Netsarc and ConticaBase. Clinical data prospectively registered in the databases were supplemented with retrospective review of the medical records. Results: From January 2009 to December 2016, we identified 99 pts, in 12 FSG centers; 30 with synchronous (SC) and 69 with metachronous (MC) mets, with 62 males. Median age was 25 years (18-53). Total number of mets was 1 for 31 pts, 2-5 for 26 and > 5 for 42. Mets sites were lung, bone and other in 77, 14 and 22 pts respectively. Median time to first MC mets was 22 months (mo) (4-97). All pts except 10 with MC mets received a 1st line systemic trt for relapse, 65 a 2d-line, 38 a 3d-line, and 20 a 4th line, with 27 pts included in a clinical trial. Sixty five pts had local trt of distant mets (surgery for 54, irradiation for 5 and radioablation for 6). Eighteen pts had repeated thoracotomies (2 for 13 pts, 3 for 5, 1 for 1 pt). Nine of 10 MC mets pts (with ≤ 5mets) who never received any systemic trt had complete mets resection, 1 had mets radioablation, all were alive at last follow-up (FU). Median FU was 16.5 mo (2-132). Median progression free survival (PFS) and overall survival (OS) were 5.5 (95%CI 4-7) and 16.5 mo (95%CI 10-25) respectively. In multivariate analysis; > 5 mets, time to 1st mets < 24 mo, were negative prognostic factors on OS and PFS (p= 0.03, 0.01 and p=0.013, 0.00 respectively). Bone mets and absence of mets surgery were negative prognostic factors on OS only (with p=0.012, 0.008). Conclusions: Adult OST pts with distant mets are heterogeneous with poor prognosis. Complete surgery of distant mets remains essential. In reference sarcoma center, OST pts at relapse with > 1 mets commonly receive >1st line of systemic trt, and are included in clinical trial. Multidisciplinary trt combining complete mets local trt and systemic therapy seems to be rational.

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Bilateral Brenner tumor of ovary with associated unilateral mucinous cystadenoma: a case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20191981 ◽

2019 ◽

Vol 8 (5) ◽

pp. 2122

Author(s):

Natasha Mittal ◽

Bhaskar Das ◽

Seema Manuja ◽

Renu Gupta

Keyword(s):

Incidental Finding ◽

Transitional Cell ◽

Mucinous Cystadenoma ◽

Pathological Examination ◽

Benign Tumors ◽

Surgical Removal ◽

Brenner Tumor ◽

Brenner Tumors ◽

Mucinous Cystadenomas ◽

Transitional Cell Tumors

Brenner tumors are rare ovarian tumors, which are a subgroup of transitional cell tumors of ovary. Most of these tumors are benign presenting as incidental unilateral masses in postmenopausal age group. Only 5-7% cases are bilateral. These tumors are mostly small, solid and asymptomatic, seen commonly in association with mucinous cystadenomas of ovary. In such cases they may attain a massive size. Specific diagnosis of Brenner tumor is difficult using imaging studies and can be definitely diagnosed only on pathological examination. Surgical removal is usually curative for benign tumors. We present a rare case of bilateral Brenner tumor of ovary with associated unilateral mucinous cystadenoma in which bilateral Brenner tumor was a rare incidental finding on pathological examinatio

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LAPTM4B Overexpression is a Novel Independent Prognostic Marker for Metastatic Ovarian Tumors

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318234f9ac ◽

2012 ◽

Vol 22 (1) ◽

pp. 54-62 ◽

Cited By ~ 13

Author(s):

Mingzhu Yin ◽

Chun Lou ◽

Wang Zhang ◽

Fanling Meng ◽

Haiyu Zhang ◽

...

Keyword(s):

Gastrointestinal Tract ◽

Prognostic Marker ◽

Cox Regression ◽

Survival Rates ◽

Progression Free Survival ◽

Ovarian Tumors ◽

Rank Test ◽

Free Survival ◽

Independent Prognostic Marker ◽

Worse Prognosis

ObjectiveMetastatic ovarian tumors are a series of lethal carcinomas that almost always have bad prognosis. Their prognoses, however, vary depending on the primary tumor malignancies of each. It has been reported that LAPTM4B, a novel tumor-associated gene, might indicate a worse prognosis when it was overexpressed in other carcinomas. Therefore, the authors expected to investigate whether LAPTM4B overexpression is an independent prognostic marker in metastatic ovarian tumors.MethodsImmunohistochemistry was used to assess LAPTM4B expression in metastatic ovarian tumors from 102 patients. Subsequently, univariate and multivariate survival analyses with Cox regression were performed to determine the association between LAPTM4B expression and prognosis. To identify any differences in prognosis between the 2 groups of patients with differing primary malignancies, the log-rank test was used.ResultsThe median overall and progression-free survival rates of patients with tumors of gastrointestinal tract origin were 0.97 and 0.51 years, respectively, and both were statistically significantly lower than those of patients with tumors of breast origin (P < 0.0001), which were 2.68 and 1.96 years, accordingly. Of 102 patients, 77 were classified as having a high expression of LAPTM4B, and LAPTM4B expression had a significant association with the prognosis of metastatic ovarian tumors (P < 0.01); no statistically significant interaction between LAPTM4B expression and primary malignancies was detected (P > 0.1). On the other hand, medians of overall survival and progression-free survival of patients with tumors of gastrointestinal tract origin were significantly lower than those of patients with tumors of breast origin (P < 0.0001).ConclusionsPatients with metastatic ovarian tumors of breast origin had significantly better prognosis than those with the disease from gastrointestinal tract primary malignancies. LAPTM4B overexpression might be an independent prognostic marker of metastatic ovarian tumors.

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Osteosarcoma of the Pelvis: Experience of the Cooperative Osteosarcoma Study Group

Journal of Clinical Oncology ◽

10.1200/jco.2003.01.142 ◽

2003 ◽

Vol 21 (2) ◽

pp. 334-341 ◽

Cited By ~ 209

Author(s):

Toshifumi Ozaki ◽

Silke Flege ◽

Matthias Kevric ◽

Norbert Lindner ◽

Rainer Maas ◽

...

Keyword(s):

Prognostic Factors ◽

Survival Rates ◽

Surgical Margin ◽

Local Therapy ◽

Progression Free Survival ◽

Surgical Excision ◽

Study Group ◽

Large Tumor ◽

Primary Tumor Site ◽

Definitive Surgery

Purpose: To define patients and tumor characteristics as well as therapy results, patients with pelvic osteosarcoma who were registered in the Cooperative Osteosarcoma Study Group (COSS) were analyzed. Patients and Methods: Sixty-seven patients with a high-grade pelvic osteosarcoma were eligible for this analysis. Fifteen patients had primary metastases. All patients received chemotherapy according to COSS protocols. Thirty-eight patients underwent limb-sparing surgery, 12 patients underwent hemipelvectomy, and 17 patients did not undergo definitive surgery. Eleven patients received irradiation to the primary tumor site: four postoperatively and seven as the only form of local therapy. Results: Local failure occurred in 47 of all 67 patients (70%) and in 31 of 50 patients (62%) who underwent definitive surgery. Five-year overall survival (OS) and progression-free survival rates were 27% and 19%, respectively. Large tumor size (P = .0137), primary metastases (P = .0001), and no or intralesional surgery (P < .0001) were poor prognostic factors. In 30 patients with no or intralesional surgery, 11 patients with radiotherapy had better OS than 19 patients without radiotherapy (P = .0033). Among the variables, primary metastasis, large tumor, no or intralesional surgery, no radiotherapy, existence of primary metastasis (relative risk [RR] = 3.456; P = .0009), surgical margin (intralesional or no surgical excision; RR = 5.619; P < .0001), and no radiotherapy (RR = 4.196; P = .0059) were independent poor prognostic factors. Conclusion: An operative approach with wide or marginal margins improves local control and OS. If the surgical margin is intralesional or excision is impossible, additional radiotherapy has a positive influence on prognosis.

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The prolonged use of temozolomide in glioblastoma patients

JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA ◽

10.22290/jbnc.v24i2.1391 ◽

2018 ◽

Vol 24 (2) ◽

pp. 107-112

Author(s):

Maurício Coelho Neto ◽

Luis Fernando Moura Da Silva ◽

Ricardo Ramina ◽

Marcelo Oliveira ◽

Mônica Lima

Keyword(s):

Overall Survival ◽

Survival Rates ◽

Progression Free Survival ◽

Tumor Grade ◽

Karnofsky Performance Scale ◽

Surgical Removal ◽

Strong Positive Correlation ◽

Duration Of Treatment ◽

Free Survival ◽

Logistic Regression Models

The temozolomide protocol established in 2005 increased overall survival rates in patients with glioblastoma. It defined a treatment period of 6 months, but most neuro-oncological centers prescribe more than this, reaching up to 3 years of continuous therapy. The objective of this paper was to compare duration of treatment in groups of patients and analyze the overall survival in each group. Retrospectively, 54 patients were evaluated with glioblastoma operated on from 2004 to 2009. All data were statistically analyzed using Kaplan-Meier curves, ANOVA test, multivariate logistic regression models and Pearson´s correlation. Analyses consisted on age, gender, Karnofsky Performance Scale (KPS) at diagnosis, side and localization of tumor, grade of surgical removal, period of use of temozolomide until recurrence, progression-free survival, KPS after recurrence and overall survival. According to uni and multi-varied analysis there was no statistic significant correlation between survival and age < 45, gender, KPS at diagnosis, and grade of resection. The overall survival in 6, 12, 18 and 24 months were 96.3%, 72.6%, 58.1% and 43.5% respectively. The length of treatment with temozolomide before recurrence showed strong positive correlation (r=0.66) with survival up to 15 months. Also, a correlation (r=0.64) between length of use of temozolomide and progression free-survival was found. Patients receiving treatment with temozolomide presented longer survival when compared with those not treated with it. Longer survival (p=0.04) was observed in those treated more than 12 months. This series could clearly show longer survival in patients treated with 15-cicles over patients treated with 6 or 12-cicles.

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Maximizing the Clinical Benefit of Radiotherapy in Solitary Plasmacytoma: An International Multicenter Analysis

Cancers ◽

10.3390/cancers12030676 ◽

2020 ◽

Vol 12 (3) ◽

pp. 676 ◽

Cited By ~ 1

Author(s):

Khaled Elsayad ◽

Michael Oertel ◽

Laila König ◽

Sebastian Hüske ◽

Emmanuelle Le Ray ◽

...

Keyword(s):

Prognostic Factors ◽

Complete Remission ◽

Local Control ◽

Survival Rates ◽

Progression Free Survival ◽

Patient Characteristics ◽

Local Relapse ◽

Extramedullary Plasmacytoma ◽

Solitary Plasmacytoma ◽

Free Survival

Objective: Although local definitive radiotherapy (RT) is considered the standard of care for solitary plasmacytoma (SP), the optimal RT parameters for SP patients have not been defined. The aim of this retrospective study is to analyze the effectiveness of various RT doses, volumes, and techniques, as well as to define the relevant prognostic factors in SP. Methods: Between 2000 and 2019, 84 patients, including 54 with solitary bone plasmacytoma (SBP) and 30 with extramedullary plasmacytoma (EMP), underwent RT at six institutions. Results: The overall RT median dose was 42 Gy (range, 36.0–59.4). The median follow-up period was 46 months. Overall, the local control (LC) rate was 96%, while the complete remission (CR) rate was 46%. The 5-year local relapse-free survival (LRFS), multiple myeloma-free survival (MMFS), progression-free survival (PFS), and overall survival (OS) rates were 89%, 71%, 55%, and 93%, respectively. Using an RT dose above 40 Gy was associated with a higher complete remission (CR) rate and a lower rate of local relapse. Modern irradiation techniques were associated with a trend toward a higher LC rate (98% vs. 87% for conventional, p = 0.09) and a significantly lower local relapse rate (6% vs. 25% for conventional, p = 0.04). However, RT dose escalation and technique did not lead to a significant effect on MMFS, PFS, and OS. Univariate analyses identified several patient characteristics as potentially relevant prognostic factors. In SBP patients, systemic therapy administration was associated significantly with MMFS and PFS rates. Conclusion: Using an RT dose >40 Gy and modern RT techniques may improve the local control and reduce the rate of relapse, without a significant impact on survival rates. The addition of systemic therapies may improve the MMFS and PFS rates of SBP patients.

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Long-Term Survival Results of a Randomized Trial Comparing Gemcitabine Plus Cisplatin, With Methotrexate, Vinblastine, Doxorubicin, Plus Cisplatin in Patients With Bladder Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2005.07.757 ◽

2005 ◽

Vol 23 (21) ◽

pp. 4602-4608 ◽

Cited By ~ 1004

Author(s):

Hans von der Maase ◽

Lisa Sengelov ◽

James T. Roberts ◽

Sergio Ricci ◽

Luigi Dogliotti ◽

...

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Locally Advanced ◽

Survival Rates ◽

Progression Free Survival ◽

Term Survival ◽

Free Survival ◽

Visceral Metastases ◽

Overall Survival Rates

Purpose To compare long-term survival in patients with locally advanced or metastatic transitional cell carcinoma (TCC) of the urothelium treated with gemcitabine/cisplatin (GC) or methotrexate/vinblastine/doxorubicin/cisplatin (MVAC). Patients and Methods Efficacy data from a large randomized phase III study of GC versus MVAC were updated. Time-to-event analyses were performed on the observed distributions of overall and progression-free survival. Results A total of 405 patients were randomly assigned: 203 to the GC arm and 202 to the MVAC arm. At the time of analysis, 347 patients had died (GC arm, 176 patients; MVAC arm, 171 patients). Overall survival was similar in both arms (hazard ratio [HR], 1.09; 95% CI, 0.88 to 1.34; P = .66) with a median survival of 14.0 months for GC and 15.2 months for MVAC. The 5-year overall survival rates were 13.0% and 15.3%, respectively (P = .53). The median progression-free survival was 7.7 months for GC and 8.3 months for MVAC, with an HR of 1.09. The 5-year progression-free survival rates were 9.8% and 11.3%, respectively (P = .63). Significant prognostic factors favoring overall survival included performance score (> 70), TNM staging (M0 v M1), low/normal alkaline phosphatase level, number of disease sites (≤ three), and the absence of visceral metastases. By adjusting for these prognostic factors, the HR was 0.99 for overall survival and 1.01 for progression-free survival. The 5-year overall survival rates for patients with and without visceral metastases were 6.8% and 20.9%, respectively. Conclusion Long-term overall and progression-free survival after treatment with GC or MVAC are similar. These results strengthen the role of GC as a standard of care in patients with locally advanced or metastatic TCC.

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Factors associated with survival in patients with meningioma

Neurosurgical FOCUS ◽

10.3171/foc.1997.2.4.4 ◽

1997 ◽

Vol 2 (4) ◽

pp. E3 ◽

Cited By ~ 1

Author(s):

Bridget J. McCarthy ◽

Faith Davis ◽

Sally Freels ◽

Tanya S. Surawicz ◽

Denise Damek ◽

...

Keyword(s):

Radiation Therapy ◽

Prognostic Factors ◽

Survival Rate ◽

Program Analysis ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Malignant Tumors ◽

Survival Rates ◽

Age At Diagnosis ◽

Benign Tumors

Factors affecting the survival rate in patients with meningiomas were explored using the National Cancer Database (NCDB), which includes tumors from approximately 1000 hospitals participating in the American College of Surgeons tumor registry program. Analysis included over 9000 cases diagnosed from 1985 to 1988 and 1990 to 1992. Survival estimates were computed and prognostic factors were identified using a proportional hazards model. The overall 5-year survival rate was 69% and it declined with age. This rate was 81% in patients aged 21 to 64 and 56% for patients 65 years of age or older. When patients were grouped by the histological type of their tumors, those with benign tumors had an overall 5-year survival rate of 70%, whereas the overall 5-year survival rates in patients with atypical and malignant meningiomas were 75% and 55%, respectively. Prognostic factors for benign tumors included age at diagnosis, tumor size, whether treated surgically, hospital type, and radiation therapy; for malignant tumors, age at diagnosis, whether treated surgically, and radiation therapy were statistically significant. The 5-year rate for recurrence of symptoms (regardless of the method of treatment) was 18.2% for those with benign tumors and 27.5% for those with malignant tumors. In patients whose benign tumor had been completely removed, the 5-year rate of tumor recurrence was 20.5%. Although not population-based, the NCDB has the potential for providing pertinent information regarding patient characteristics and methods of treatment for benign, as well as malignant, brain tumors.

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Estrogen receptor and progesterone receptor status and their prognostic implications in pelvic high-grade serous carcinomas: A retrospective study

10.21203/rs.2.17522/v1 ◽

2019 ◽

Author(s):

Ting Zhao ◽

Weiyong Gu ◽

Chenyun Zhang ◽

Hongyuan Jiang ◽

Yuan Lu

Keyword(s):

Estrogen Receptor ◽

Prognostic Factors ◽

Prognostic Factor ◽

Progesterone Receptor ◽

Survival Rates ◽

Progression Free Survival ◽

P53 Mutation ◽

Serous Carcinoma ◽

High Grade ◽

Stage Disease

Abstract Background: There is mounting evidence that ovarian, tubal and peritoneal high-grade serous carcinoma (HGSC) share common origin. It was also suggested that extrauterine HGSCs may originate from endometrium. The aim of this study is to compare the estrogen receptor (ER) and progesterone receptor (PR) status among pelvic HGSCs, and to analyze the prognostic role of ER and PR in pelvic HGSCs patients, and the prognostic factors in patients with different ER or PR status Methods: In total, 283 patients diagnosed with ovarian, tubal, peritoneal, and uterine HGSC were retrospectively analyzed. All patients’ diagnosis were reviewed by a panel of gynecologists and pathologists strictly according to criteria based on lesion distribution. Results: Patients in endometrial group were older than ovarian (60.1±8.0 vs. 54.1±8.3, p=0.000) and tubal (60.1±8.0 vs. 55.8±9.5, p=0.008) group. A higher proportion of ovarian group presented with advanced stage disease than fallopian and endometrial group (73.7% vs. 47.2%, p=0.000 and 73.7% vs. 47.4%, p=0.002, respectively). PR positivity rate was much lower in peritoneal compared to ovarian group (25.0% vs. 65.6%, p=0.000). There was no difference in survival rates among four groups. Although ER and PR were not prognostic factors for 5-year overall survival (OS) and progression-free survival (PFS), the prognostic factors were different in patients of distinct ER/PR status. More chemotherapy cycles was a protective prognostic factor in ER(+) or PR(+) patients but not in ER(-) or PR(-) patients. P53 mutation was adverse prognostic factor for OS in PR(-) patients but in PR(+) patients. Conclusions: PR positivity rate were much lower in peritoneal compared to ovarian HGSC. Although ER and PR were not prognostic factors in pelvic HGSCs, prognostic factors for survival were different in patients of different ER/PR status.

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