scholarly journals Treatment Strategies and Prognosis of Patients With Synchronous or Metachronous Colorectal Peritoneal Metastases: A Population-Based Study

2021 ◽  
Author(s):  
C. Bakkers ◽  
R. J. Lurvink ◽  
A. Rijken ◽  
S. W. Nienhuijs ◽  
N. F. Kok ◽  
...  
Keyword(s):  
Treatment Strategies ◽  
Disease Free Survival ◽  
Best Supportive Care ◽  
Population Based ◽  
Peritoneal Metastases ◽  
Primary Colorectal Cancer ◽  
Population Based Study ◽  
Free Survival ◽  
Netherlands Cancer Registry ◽  
Disease Free

Abstract Background This study aimed to compare treatment strategies and survival of patients with synchronous colorectal peritoneal metastases (CPM) and patients with metachronous CPM in a nationwide cohort. Methods All patients from the Netherlands Cancer Registry with synchronous or metachronous CPM whose primary colorectal cancer (CRC) was diagnosed between 1 January and 30 June 2015 were included in the study. Treatments were categorized as (A) cytoreductive surgery and hyperthermic intraperitoneal chemotherapy [CRS-HIPEC]; (B) palliative treatment; or (C) best supportive care. Overall survival (OS) for all the patients and disease-free survival (DFS) for those who underwent CRS-HIPEC were compared between the two groups. Results Of 7233 patients, 743 had a diagnosis of CPM, including 409 patients with synchronous CPM and 334 patients with metachronous CPM. The median OS was 8.1 months for the patients with synchronous CPM versus 12 months for the patients with metachronous CPM (p = 0.003). After multivariable correction, OS no longer differed between the patients with synchronous CPM and those with metachronous CPM (HR 1.03 [0.83–1.27]). The patients with metachronous CPM more often underwent CRS-HIPEC than the patients with synchronous CPM (16 % vs 8 %; p = 0.001). The two groups did not differ statistically in terms of DFS and OS (median DFS, 21.5 vs 14.1 months, respectively; p = 0.094; median OS, 37.8 vs. 35.8 months, respectively; p = 0.553). Conclusion This population-based study showed that survival for the patients with synchronous CPM and patients with metachronous CPM did not significantly differ. This suggests that a similar prognosis may be expected for patients selected for treatment regardless of the onset of CPM.

Disease-free survival after complete mesocolic excision compared with conventional colon cancer surgery: a retrospective, population-based study

2015 ◽  
Vol 16 (2) ◽  
pp. 161-168 ◽  
Author(s):  
Claus Anders Bertelsen ◽  
Anders Ulrich Neuenschwander ◽  
Jens Erik Jansen ◽  
Michael Wilhelmsen ◽  
Anders Kirkegaard-Klitbo ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Disease Free Survival ◽  
Complete Mesocolic Excision ◽  
Population Based ◽  
Cancer Surgery ◽  
Population Based Study ◽  
Free Survival ◽  
Mesocolic Excision ◽  
Colon Cancer Surgery ◽  
Disease Free

Relative and disease-free survival for breast cancer in relation to subtype: a population-based study

2013 ◽  
Vol 139 (9) ◽  
pp. 1569-1577 ◽  
Author(s):  
Pamela Minicozzi ◽  
Francesca Bella ◽  
Angela Toss ◽  
Adriano Giacomin ◽  
Mario Fusco ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Population Based ◽  
Population Based Study ◽  
Free Survival ◽  
Subtype A ◽  
Disease Free

Optimizing Adjuvant Endocrine Therapy in Postmenopausal Women With Early-Stage Breast Cancer: A Decision Analysis

2005 ◽  
Vol 23 (22) ◽  
pp. 5178-5187 ◽  
Author(s):  
Rinaa S. Punglia ◽  
Karen M. Kuntz ◽  
Eric P. Winer ◽  
Jane C. Weeks ◽  
Harold J. Burstein
Keyword(s):  
Breast Cancer ◽  
Aromatase Inhibitor ◽  
Postmenopausal Women ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Sequential Therapy ◽  
Sequential Treatment ◽  
Modest Improvement ◽  
Free Survival ◽  
Disease Free

Purpose The optimal adjuvant endocrine strategy for postmenopausal breast cancer is unknown. Options include the antiestrogen tamoxifen, estrogen deprivation with aromatase inhibitors, and sequential therapy with tamoxifen and then an aromatase inhibitor. Methods We developed Markov models to simulate 10-year disease-free survival among postmenopausal women with hormone receptor–positive breast cancer. The treatment strategies analyzed were 5 years of tamoxifen alone, 5 years of an aromatase inhibitor alone, and sequential treatment consisting of tamoxifen with cross over to an aromatase inhibitor at 2.5 or 5 years. Risk estimates were derived from reported randomized clinical trials. Results Sequential therapy with tamoxifen followed by cross over to an aromatase inhibitor at 2.5 years yielded a modest improvement in disease-free survival compared with planned aromatase inhibitor monotherapy. At 10 years, the cross-over strategy yielded absolute disease-free survival rates of 83.7% and 67.6% for node-negative and node-positive patients, respectively, compared with 82.6% and 65.5%, respectively, for aromatase inhibitor monotherapy, which is a 6% relative risk reduction. Sequential therapy improved disease-free survival estimates by year 6 after treatment initiation. Later cross over from tamoxifen to an aromatase inhibitor at 5 years did not further improve 10-year disease-free survival estimates. Sensitivity analyses suggest that sequential treatment strategies optimized 10-year disease-free and distant disease–free survival independent of the degree of the beneficial carryover effect after aromatase inhibitor therapy or the ratio of local to distant tumor recurrence. Conclusion Modeling estimates suggest that sequential adjuvant therapy with tamoxifen followed by an aromatase inhibitor after 2.5 years yields improved outcomes compared with either drug alone or cross-over treatment after 5 years of tamoxifen.

Abstract A28: DCIS disease-free survival in the population-based Wisconsin In Situ Cohort

2011 ◽  
Author(s):  
Brian Sprague ◽  
Vicki McLaughlin ◽  
John Hampton ◽  
Polly Newcomb ◽  
Amy Trentham-Dietz
Keyword(s):  
Disease Free Survival ◽  
Population Based ◽  
Free Survival ◽  
Disease Free

Survival according to mutations in BRAF, KRAS, or microsatellite instability (MSI-H) after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal metastases from colorectal cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 3565-3565 ◽  
Author(s):  
Stein G Larsen ◽  
Svein Dueland ◽  
M Goscinski ◽  
Sonja Steigen ◽  
Eva Hofsli ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Hyperthermic Intraperitoneal Chemotherapy ◽  
Disease Free Survival ◽  
Peritoneal Metastases ◽  
Wild Type ◽  
Free Survival ◽  
Crs And Hipec ◽  
Disease Free

3565 Background: Patients with metastatic colorectal cancer (mCRC) and mutations in BRAF V600E (mutBRAF) or KRAS (mutKRAS) have a worse prognosis after liver or lung surgery/ablation, whereas the impact of microsatellite instability (MSI-H) has not been well studied. Few patients with mutBRAF receive liver or lung surgery (1-4%), whereas mutBRAF is present in 5-12% of mCRC trial patients and in up to 20% of the general mCRC population. The frequency and prognostic role of mutBRAF, mutKRAS and MSI has not been well studied after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases from colorectal cancer. Methods: The Norwegian Radium Hospital is the only center offering CRS and HIPEC in Norway. From 2004 to 2015 257 patients with histology proven peritoneal metastasis from colorectal cancer, appendiceal cancer excluded, was consecutively enrolled. Molecular analyses of KRAS, BRAF and MSS/MSI in mutBRAF were done. Fourteen patients were excluded due to missing tumour blocks (7), unsuccessful analysis (4) and other malignant disease (1). Results: 180 of 243 patients obtained complete cytoreductive surgery and received HIPEC for 90 minutes with Mitomycin C (45-70mg). Median survival for the 180 patients was 47 months and 5-year survival rate 40.1%. Median disease-free survival was 10 months. mutBRAF was found in 23.4% of cases, mutKRAS 35.1% and double-wild type 41.5%. mutBRAF with MSS was found in 16.4%, mutBRAF with MSI-H in 7.0%. 3-year disease free survival (DFS) and median overall survival (OS) was 38.9% and 59 months with mutBRAF with MSI-H, significantly higher compared to 24.2% and 30 months in patients with double wild type, 13.2 % and 41 months in mutKRAS and 17.9% and 22 months in mutBRAF with MSS. Conclusions: A surprisingly high frequency of mutBRAF was seen in mCRC patients after CRS and HIPEC for peritoneal metastatic disease. Patients with mutBRAF and MSI-H had a significantly better DFS and OS after CRS and HIPEC. DFS for patients with mutBRAF and MSS was numerically lower but not statistically different from patients with mutKRAS or double wild type.

Influence of place of treatment on diagnosis, treatment, and survival in three pediatric solid tumors.

1984 ◽  
Vol 2 (8) ◽  
pp. 917-923 ◽  
Author(s):  
S Kramer ◽  
A T Meadows ◽  
G Pastore ◽  
P Jarrett ◽  
D Bruce
Keyword(s):  
Solid Tumors ◽  
Wilms Tumor ◽  
Disease Free Survival ◽  
Population Based ◽  
Free Survival ◽  
Pediatric Tumor ◽  
Pediatric Solid Tumors ◽  
Management Procedures ◽  
Disease Free

This study examines differences between cancer centers (CC) and noncancer centers (NCC) in terms of management procedures and outcomes for three pediatric solid tumors: Wilms' tumor (N = 147), rhabdomyosarcoma (N = 87), and medulloblastoma (N = 76). Data were derived for the period 1970-1979 from the population-based Greater Delaware Valley Pediatric Tumor Registry maintained at the Children's Cancer Research Center, which routinely collects data on all childhood neoplasms that occur in a 31-county region. Management measures reviewed included the degree to which important pretreatment evaluations were performed, types of therapy used, and extent of follow-up examinations conducted. Outcome variables were three-year disease-free survival and frequency of deaths related to complications of therapy. Differences in three-year disease-free survival between CC and NCC were noted for medulloblastoma (52% v 24%) and rhabdomyosarcoma (48% v 10%), but not for Wilms' tumor (79% v 68%). Among medulloblastoma patients, differences were detected in the frequency of pretreatment evaluations and in the therapy used. The principal management contrast found in rhabdomyosarcoma was that multiagent chemotherapy was used less often in NCC. Wilms' tumor patients were evaluated and treated similarly in the community versus the CC, except for some contrasts in the surgical approach and the frequency of follow-up for the detection of late complications.

scholarly journals Five-Year, Disease-Free Survival after Repeat Palliative Multimodality Therapy in a Patient with Recurrent Metastastic Bladder Cancer

2007 ◽  
Vol 7 ◽  
pp. 1736-1742
Author(s):  
Sebastian Fetscher ◽  
Jan Schmielau ◽  
Wolfgang Schulze-Seemann
Keyword(s):  
Bladder Cancer ◽  
Treatment Strategies ◽  
Disease Free Survival ◽  
Term Treatment ◽  
Short Term ◽  
Course Of Disease ◽  
Free Survival ◽  
Long Term Treatment ◽  
Disease Free

In appropriately selected cases, palliative therapeutic strategies can be adapted to those special features of cancer biographies that indicate an atypical course of disease. Elucidating these features, and adapting multimodal treatment strategies to them, can lead to significantly superior effects when compared to the routine application of conventional treatment algorhythms. A case of regionally metastactic bladder cancer is presented that documents the value of repeat debulking-surgery and repeat radiotherapy leading to unexpected short-term and long-term treatment results.

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