scholarly journals Clinical and ultrasonographic features of choroidal metastases based on primary cancer site: Long-term experience in a single center

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0249210
Author(s):  
Maria Antonietta Blasi ◽  
Martina Maceroni ◽  
Carmela Grazia Caputo ◽  
Maria Grazia Sammarco ◽  
Andrea Scupola ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Primary Tumor ◽  
Survival Rates ◽  
Cancer Site ◽  
Primary Cancer ◽  
Primary Tumor Site ◽  
Diagnostic Biomarkers ◽  
Primary Cancer Site ◽  
Oncology Unit ◽  
Internal Reflectivity

Introduction and purpose Choroidal metastases (CM) are the most common intraocular malignancies. With longer survival rates for cancer patients, CM will be increasingly encountered. We evaluated clinical and ultrasonographic (US) characteristics of CM in order to identify diagnostic biomarkers that correlate with the primary tumor site. Methods The medical records of all patients with CM evaluated at the Ocular Oncology Unit between February 2010 and March 2020 were analyzed. Results 82 eyes of 70 patients were included. The primary cancer site was lung in 26 patients (37%), breast in 23 (33%), kidney in 9 (13%), gastrointestinal in 5 (7%), thyroid in 5 (7%), parathyroids and prostate respectively in 2 (3%). Fifty-five patients (78%) had other systemic metastases at the time of ocular diagnosis. Ten (14%) patients had no history of primary cancer. Bilateral CM were found in 20 patients (29%); fifty-six eyes (68%) had a single CM. The epicenter of CM was predominantly macula (43 eyes, 52%). The mean thickness was 4,1 mm (range 1,8–12,3). US structure was inhomogeneous in 67 eyes (82%). Reflectivity was mainly medium (39%) and medium-low (39%). In particular, CM from lung cancer showed lower reflectivity than those from the breast (p = 0,02). CM deriving from lung cancer were typically dome-shaped, whereas CM originating from breast were characteristically plateau shaped (p = 0,02). Seventy-four (91%) eyes presented fluid on optical coherence tomography. Conclusion We significatively found that CM from lung cancer generally appear dome-shaped with medium-low internal reflectivity, whereas those from breast cancer typically present a plateau appearance and higher internal reflectivity. Though it is hard to identify the site of the primary tumor relying exclusively on clinical and US aspects, morphology and internal reflectivity can be considered as diagnostic biomarkers. Thus, the origin of the primary tumor can be suspected by integrating a constellation of findings.

scholarly journals The impact of treatment facility type on the survival of brain metastases patients regardless of the primary cancer type

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saber Amin ◽  
Michael Baine ◽  
Jane Meza ◽  
Chi Lin
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Small Cell ◽  
Cancer Site ◽  
Primary Cancer ◽  
Small Cell Lung ◽  
Treatment Facility ◽  
Primary Cancer Site ◽  
The Impact

Abstract Background Cancer patients with brain metastases (BMs) require multidisciplinary care, and treatment facility may play a role. This study aimed to investigate the impact of receiving treatment at academic centers on the overall survival (OS) of cancer patients with brain metastases (BMs) regardless of the primary cancer site. Methods This retrospective analysis of the National Cancer Database (NCDB) included patients diagnosed with non-small cell lung cancer, small-cell lung cancer, other types of lung cancer, breast cancer, melanoma, colorectal cancer, and kidney cancer and had brain metastases at the time of diagnosis. The data were extracted from the de-identified file of the NCDB, a joint program of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The Cox proportional hazard model adjusted for age at diagnosis, race, sex, place of living, income, education, primary tumor type, year of diagnosis, chemotherapy, radiation therapy (RT), and surgery of the primary cancer site was used to determine treatment facility-associated hazard ratios (HR) for survival. Overall survival was the primary outcome, which was analyzed with multivariable Cox proportional hazards regression modeling. Results A total of 93,633 patients were analyzed, among whom 31,579/93,633 (34.09%) were treated at academic centers. Based on the log-rank analysis, patients who received treatment at an academic facility had significantly improved OS (median OS: 6.18, CI: 6.05–6.31 vs. 4.57, CI: 4.50–4.63 months; p < 0.001) compared to patients who were treated at non-academic facilities. In the multivariable Cox regression analysis, receiving treatment at an academic facility was associated with significantly improved OS (HR: 0.85, CI: 0.84–0.87; p < 0.001) compared to non-academic facility. Conclusions In this extensive analysis of the NCDB, receiving treatment at academic centers was associated with significantly improved OS compared to treatment at non-academic centers.

scholarly journals The Association of Treatment Facility Type With the Survival of Brain Metastases Patients Regardless of the Primary Site Cancer

2020 ◽  
Author(s):  
SABER Ali AMIN ◽  
Michael Baine ◽  
Jane Meza ◽  
Chi Lin
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Brain Metastases ◽  
Cancer Patients ◽  
Small Cell ◽  
Cancer Site ◽  
Primary Cancer ◽  
Small Cell Lung ◽  
Treatment Facility ◽  
Primary Cancer Site

Abstract Background. Cancer patients with brain metastases (BMs) require multidisciplinary care, and treatment facility may play a role. This study aimed to investigate the impact of receiving treatment at academic centers on the overall survival (OS) of cancer patients with brain metastases (BMs) regardless of the primary cancer site.Methods. This retrospective analysis of the National Cancer Database (NCDB) included patients diagnosed with non-small cell lung cancer, small-cell lung cancer, other types of lung cancer, breast cancer, melanoma, colorectal cancer, and renal cancer and had brain metastases at the time of diagnosis. The data were extracted from the de-identified file of the NCDB, a joint program of the Commission on Cancer of the American College of Surgeons and the American Cancer Society. The Cox proportional hazard model adjusted for age of diagnosis, race, sex, place of living, income, education, primary tumor type, year of diagnosis, chemotherapy, radiation therapy (RT), and surgery of the primary cancer site was used to determine treatment facility-associated hazard ratios (HR) for survival. Overall survival was the primary outcome which was analyzed with multivariable Cox proportional hazards regression modeling. Results. A total of 93,633 patients were analyzed, among whom 31,579/93,633 (34.09%) were treated at academic centers. Based on the log-rank analysis, patients who received treatment at an academic facility had significantly improved median OS (6.18, CI: 6.05-6.31 vs. 4.57, CI: 4.50-4.63; p <0.001) months compared to patients who were treated at non-academic facilities. In the multivariable Cox regression analysis, receiving treatment at an academic facility was associated with significantly improved OS (HR: 0.85, CI: 0.84-0.87; p <0.001) compared to the non-academic facility. Conclusions. In this extensive analysis of the NCDB, receiving treatment at academic centers was associated with significantly improved OS compared to treatment at non-academic centers.

scholarly journals Changes in carnitine levels through induction chemotherapy in head and neck cancer patients as a potential cause of therapy-related malaise

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tatsuya Ito ◽  
Kiyoaki Tsukahara ◽  
Hiroki Sato ◽  
Akira Shimizu ◽  
Isaku Okamoto
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Neck Cancer ◽  
Cancer Site ◽  
Primary Cancer ◽  
Analog Scale ◽  
Before And After ◽  
Primary Cancer Site ◽  
Total Carnitine

Abstract Background Carnitine is related to malaise, and cisplatin is associated with decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on free carnitine (FC). Methods This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS). Results All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7 ± 2.2 μM/mL, 56.7 ± 2.2 μM/mL, and 41.1 ± 1.9 μM/mL, respectively. Compared with the baseline before starting therapy, FC had significantly decreased on Day 21 (p = 0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5 ± 1.2 μM/mL, 13.6 ± 1.4 μM/mL, and 10.7 ± 0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2 ± 2.5 μM/mL, 70.2 ± 3.3 μM/mL, and 51.7 ± 2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise.

RADT-05. PROSPECTIVE LONG-TERM EVALUATION OF MRI- AND CLINICAL CHANGES FOLLOWING STEREOTACTIC RADIOSURGERY FOR BRAIN METASTASES – IS REPEAT SRS A CONSEQUENCE, OR ALSO A CAUSE OF LONG-TERM SURVIVAL?

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi41-vi42
Author(s):  
Bente Skeie ◽  
Per Øyvind Enger ◽  
Geir Olve Skeie ◽  
Jan Ingemann Heggdal
Keyword(s):  
Brain Metastases ◽  
Stereotactic Radiosurgery ◽  
Whole Brain Radiotherapy ◽  
Cancer Site ◽  
Response Patterns ◽  
Primary Cancer ◽  
Term Survival ◽  
Cover Ratio ◽  
Primary Cancer Site

Abstract The use of stereotactic radiosurgery (SRS) for brain metastases are increasing. Response assessment is challenging and the clinical significance of radiological response and retreatments are poorly defined. Ninety-seven patients with a total of 406 brain metastases were followed prospectively for 10 years or until death. Volume changes over time and clinical outcome in response to first time SRS and SRS retreatments were analyzed. Tumors grew significantly before (p = 0.004), but shrunk at 1 and 3 months (p = 0.001) following SRS. Four response-patterns of were observed; tumors either continuously reduced in size (A, 62%), pseudo-progressed (PP, B, 13%), temporarily reduced in size (C, 24%), or grew continuously (D, 2%); corresponding to 75% local control (LC) at initial SRS. Predictors for LC were primary cancer site (p = 0.001), tumor volume (p = 0.002) and target cover ratio (p = 0.005). Subsequent SRS for new lesions resulted in 94% LC (87% A) and repeat-SRS for local failures in 80% LC (57% B), predicted by higher prescribed dose, p = 0.001 and p = 0.042, respectively. Overall survival was only 4.5 months if A-response for all lesions, 13.3 months if at least one B-response, 17.1 months if retreated C- or D-response (p &lt; 0.001), (7.5 and 4.7 months if untreated). Quality of life (p = 0.003), steroid use (p = 0.019) and prior whole brain radiotherapy (p = 0.026) were predictors for survival. There are 4 response patterns to SRS predicted by tumor size, primary cancer site, target cover ratio and prescribed dose. Long-term survivors experienced a higher incidence of PP and were more often retreated for new lesions and local failures. The immune response induced by PP seems beneficial but further studies are needed.

Surgical Treatment of Metastatic Ovarian Tumors From Extragenital Primary Sites

2016 ◽  
Vol 26 (4) ◽  
pp. 688-696 ◽  
Author(s):  
Veysel Sal ◽  
Fuat Demirkiran ◽  
Samet Topuz ◽  
Ilker Kahramanoglu ◽  
Ibrahim Yalcin ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Residual Disease ◽  
Univariate Analysis ◽  
Ovarian Metastasis ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Cancer Site ◽  
Primary Cancer ◽  
Preoperative Serum ◽  
Primary Cancer Site

ObjectiveThe purpose of this study was to investigate the outcomes and prognostic factors of metastasectomy in patients with metastatic ovarian tumors from extragenital primary sites.Materials and MethodsAll patients with pathologically confirmed metastatic ovarian tumors between January 1997 and June 2015 were included in this study. A total of 131 patients were identified. The data were obtained from the patients’ medical records. Clinicopathological features were evaluated by both univariate and multivariate analyses.ResultsThe primary sites were colorectal region (53.4%), stomach (26%), and breast (13%). Preoperative serum CA 125 and CA 19-9 levels were elevated in 29.4% and 39.8% of the patients, respectively. Cytoreductive surgery was performed in 41.2% of the patients. Seventy-three (55.7%) patients had no residual disease after surgery. Sixty-six (49.6%) patients had combined metastases at the time of the surgery to sites including the liver, pancreas, lung, bone, lymph nodes, bladder, or the intestine. With a median follow-up of 33 months, the median survival time was 22 months. The estimated 5-year survival probability is 0.26. On univariate analysis, primary cancer site, combined metastasis outside the ovaries, residual disease, preoperative serum CA 125 and CA 19-9 levels, and histologic type were significant parameters for overall survival. Furthermore, residual disease, preoperative serum CA 19-9 level, and primary cancer site were found to be independent prognostic factors on multivariate analysis.ConclusionsThe most common primary sites for ovarian metastasis are gastrointestinal tract. Metastasectomy may have beneficial effects on survival, especially if the residual disease is less than 5 mm. Prospective studies warranted to evaluate the value of metastasectomy in patients with ovarian metastasis.

Analysis of time from initial imaging study to definitive surgical diagnosis in patients with epithelial ovarian malignancies.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15536-e15536
Author(s):  
Thomas Bickley ◽  
Eericca Clegg ◽  
John Nash ◽  
Xiaowei (Sherry) Yan ◽  
Radhika Gogoi
Keyword(s):  
Ct Scan ◽  
Imaging Study ◽  
Initial Evaluation ◽  
Cancer Site ◽  
Advanced Stage ◽  
Primary Cancer ◽  
Imaging Studies ◽  
Time To Diagnosis ◽  
Primary Cancer Site ◽  
Initial Imaging

e15536 Background: It is well established that women diagnosed with advanced stage ovarian cancer have a significantly lower five-year survival rate. Often multiple imaging modalities are used in the initial evaluation. This is costly, often unnecessary, and may be a contributing factor to a delay in diagnosis. We sought to evaluate the time from initial imaging study to diagnosis. Methods: After IRB approval, a retrospective chart review was performed utilizing data from the electronic medical record at an integrated health care system. All patients who underwent surgery with a diagnosis of primary peritoneal, ovarian, or fallopian tube cancer between 7/2006 and 8/2011 were included. Data collected included age at time of surgery, number and dates of imaging studies performed within 180 days prior to surgery, primary cancer site, stage, and histology. Patients were excluded for recurrent disease, studies without dates, or imaging studies performed greater than 180 days prior to diagnosis. Statistical analysis was performed using the Cox Proportional Model. Results: A total of 146 patients were included in the study. The average number of imaging studies was 1.7 and the average time to diagnosis from initial imaging was 33.5 days. Time to diagnosis was shorter if patients ever had a CT scan (29.3 vs 73.3 days; P<0.001), and longer if patients ever had an ultrasound (40.4 vs 27.8 days; P=0.02). There was no difference in the overall number of imaging studies performed when controlling for stage <3C vs >3C. However, time to diagnosis was significantly less (29.1 vs 45.1 days; P=0.01) for more advanced stage disease. There was no difference in time to diagnosis or overall number of imaging studies performed when controlling for primary cancer site or age. Conclusions: The data suggest that performing a CT scan as the only imaging modality results in a significantly shorter time to diagnosis than when ultrasonography is included in the initial evaluation. Of patients who initially got an ultrasound most ultimately went on to have a CT scan, likely increasing the interval to diagnosis. We suggest that implementing an adnexal mass algorithm may allow patients quicker access to definitive diagnosis and treatment.

Multidisciplinary tumor board for improvement of oncology collaboration in advanced cancer patients.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 175-175
Author(s):  
Sanders Chang ◽  
Amish Doshi ◽  
Cardinale B. Smith ◽  
Bethann Scarborough ◽  
Stelian Serban ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Tumor Board ◽  
Cancer Site ◽  
Primary Cancer ◽  
Advanced Cancer Patients ◽  
Primary Cancer Site ◽  
Supportive Oncology ◽  
The Impact

175 Background: The Palliative and Supportive Oncology Tumor Board was developed in 2015 to provide an interdisciplinary forum for discussion and management of patients with complex or refractory symptoms from advanced cancer. The board meets monthly and consists of medical, surgical, and radiation oncologists, interventional radiologists, pain management, palliative care specialists, residents, and fellows. Here, we assess the impact of the tumor board on the care of these patients. Methods: Electronic records of advanced cancer patients discussed at the tumor board from January 2015 to December 2015 were analyzed. We extracted data regarding sociodemographics, primary cancer site, pain interventions delivered, palliative care services utilized, and readmissions. Results: Thirty-two patients were presented at the tumor board over twelve months. The median age was 60 years (range 26-89); 47% were male. Primary cancer site included multiple myeloma (n = 11), gastrointestinal (n = 9), genitourinary (n = 5), breast (n = 2), lung (n = 2), skin (n = 1), and unknown origin (n = 2). At the time of discussion, 16 patients were hospitalized and 18 were in the ambulatory setting. Recommendations from the tumor board included altering medication regimen (n = 4), discussing eligibility to receive an anesthetic block (n = 7), undergoing vertebroplasty (n = 9), and planning palliative radiation treatment (n = 19). Patients were seen by specialists from pain (n = 21), interventional radiology (n = 14), neurosurgery (n = 9), palliative care (n = 20), radiation oncology (n = 21), or medical oncology (n= 32) within one day of their case presentation at the tumor board. Seven patients were transferred to the inpatient palliative care unit within a day of their tumor board discussion. Five patients were readmitted to the hospital within 30 days due to uncontrolled pain or other symptoms. Conclusions: The palliative and supportive oncology tumor board was well received by clinicians overall. It fostered interdisciplinary collaboration and supported comprehensive management of pain and other symptoms, as evidenced by the mix of cases discussed and the short time within which patients were seen after presentation by the participating specialists.

Sign in / Sign up

Export Citation Format

Share Document