scholarly journals Prognostic factors of choroidal melanoma in Slovenia, 1986–2008

2016 ◽  
Vol 50 (1) ◽  
pp. 104-112
Author(s):  
Boris Jancar ◽  
Marjan Budihna ◽  
Brigita Drnovsek-Olup ◽  
Katrina Novak Andrejcic ◽  
Irena Brovet Zupancic ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Treatment Time ◽  
Choroidal Melanoma ◽  
Distant Metastases ◽  
Treatment Modalities ◽  
Primary Malignancy ◽  
Melanoma Patients ◽  
Malignant Choroidal Melanoma ◽  
Annual Mortality ◽  
Overall Mortality

AbstractIntroductionChoroidal melanoma is the most common primary malignancy of the eye, which frequently metastasizes. The Cancer Registry of Slovenia reported the incidence of choroid melanoma from 1983 to 2009 as stable, at 7.8 cases/million for men and 7.4/million for women. The aim of the retrospective study was to determinate the prognostic factors of survival for choroidal melanoma patients in Slovenia.Patients and methodsFrom January 1986 to December 2008 we treated 288 patients with malignant choroidal melanoma; 127 patients were treated by brachytherapy with beta rays emitting ruthenium-106 applicators; 161 patients were treated by enucleation.ResultsPatients with tumours thickness < 7.2 mm and base diameter < 16 mm were treated by brachytherapy and had 5- and 10-year overall mortality 13% and 32%, respectively. In enucleated patients, 5- and 10-year mortality was higher, 46% and 69%, respectively, because their tumours were larger. Thirty patients treated by brachytherapy developed local recurrence. Twenty five of 127 patients treated by brachytherapy and 86 of 161 enucleated patients developed distant metastases. Patients of age ≥ 60 years had significantly lower survival in both treatment modalities. For patients treated by brachytherapy the diameter of the tumour base and treatment time were independent prognostic factors for overall survival, for patients treated by enucleation age and histological type of tumour were independent prognosticators. In first few years after either of treatments, the melanoma specific annual mortality rate increased, especially in older patients, and then slowly decreased.ConclusionsIt seems that particularly younger patients with early tumours can be cured, whereby preference should be given to eyesight preserving brachytherapy over enucleation.

scholarly journals Clinicopathological Characteristics, Survival Outcomes and Prognostic Factors in Pleomorphic Carcinoma: A SEER Population-based Study

2021 ◽  
Author(s):  
Zhongzhong Chen ◽  
Jiachang Liu ◽  
Lingfeng Min
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Distant Metastases ◽  
Population Based ◽  
Clinicopathological Characteristics ◽  
Outcome Data ◽  
Pleomorphic Carcinoma ◽  
Treatment Modalities ◽  
White People ◽  
Cox Analysis

Abstract Background: Pulmonary pleomorphic carcinoma (PPC) is a rare tumor, and it usually has an aggressive clinical course and poor prognosis. We aim to analyze the clinicopathological features, management and prognostic factors of pulmonary pleomorphic carcinoma. Patients and methods: Using the Surveillance, Epidemiology, and End Results (SEER) database, we identified 310 patients of pulmonary pleomorphic carcinoma from 2004 to 2014 including clinicopathological characteristics, treatment modalities and outcome data.Results: The mean age of all PPC patients was 66 years and 59.4% of the patients were male. Most patients (79.4%) were white people, 51.6% were found in the right lung, and lesions were mostly observed in upper lobe (57.7%). The median overall survival was 12 months and overall 1-, 3- and 5- year survival rate was 42.5%, 28.6%, 24.1%. In Kaplan-Meier analysis, tumor primary site, lymph node metastases, distant metastases, summary stage, chemotherapy and surgery were associated with overall survival. Patients with surgery or chemotherapy have a better OS for patients with PPC. However, we found that radiotherapy did not significantly improve OS Multivariate Cox analysis revealed that SEER summary stage, distant metastases, surgery and chemotherapy were found to be independently associated with the OS.Conclusions: PPC mostly occurred in white people, with a median age of 66 years, and men were more susceptible to this disease. The SEER summary stage, distant metastases, surgery and chemotherapy were independently associated with prognosis.

scholarly journals Real-life use of talimogene laherparepvec (T-VEC) in melanoma patients in centers in Austria, Switzerland and Germany

2021 ◽  
Vol 9 (2) ◽  
pp. e001701
Author(s):  
Julia Maria Ressler ◽  
Matthias Karasek ◽  
Lukas Koch ◽  
Rita Silmbrod ◽  
Joanna Mangana ◽  
...  
Keyword(s):  
Chart Review ◽  
Progressive Disease ◽  
Overall Response Rate ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Distant Metastases ◽  
Complete Response ◽  
Talimogene Laherparepvec ◽  
Metastatic Lesions ◽  
Melanoma Patients

BackgroundTalimogene laherparepvec (T-VEC) is a licensed therapy for use in melanoma patients of stage IIIB-IVM1a with injectable, unresectable metastatic lesions in Europe. Approval was based on the Oncovex Pivotal Trial in Melanoma study, which also included patients with distant metastases and demonstrated an overall response rate (ORR) of 40.5% and a complete response (CR) rate of 16.6%.ObjectivesThe aim of this study was to assess the outcome of melanoma patients treated with T-VEC in a real-life clinical setting.MethodsBased on data from 10 melanoma centers in Austria, Switzerland and southern Germany, we conducted a retrospective chart review, which included 88 patients (44 male, 44 female) with a median age of 72 years (range 36–95 years) treated with T-VEC during the period from May 2016 to January 2020.Results88 patients fulfilled the inclusion criteria for analysis. The ORR was 63.7%. 38 patients (43.2%) showed a CR, 18 (20.5%) had a partial response, 8 (9.1%) had stable disease and 24 (27.3%) patients had a progressive disease. The median treatment period was 19 weeks (range: 1–65), an average of 11 doses (range: 1–36) were applied. 39 (45.3%) patients developed adverse events, mostly mild, grade I (64.1%).ConclusionThis real-life cohort treatment with T-VEC showed a high ORR and a large number of durable CRs.

Stability, Prognostic Factors and Survival of Spinal Bone Metastases in Malignant Melanoma Patients after Palliative Radiotherapy

2016 ◽  
Vol 102 (2) ◽  
pp. 156-161 ◽  
Author(s):  
Tilman Bostel ◽  
Robert Förster ◽  
Ingmar Schlampp ◽  
Robert Wolf ◽  
Andre Franke Serras ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Malignant Melanoma ◽  
Bone Metastases ◽  
Palliative Radiotherapy ◽  
Spinal Bone Metastases ◽  
Melanoma Patients

Isolated same-basin lymph node recurrence after precision lymph node excision for clinically evident melanoma metastasis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9576-9576
Author(s):  
Kevin Lynch ◽  
Yinin Hu ◽  
Norma Farrow ◽  
Yun Song ◽  
Max Meneveau ◽  
...  
Keyword(s):  
Lymph Node ◽  
Disease Control ◽  
Lymph Node Dissection ◽  
Patient Preference ◽  
Distant Metastases ◽  
Node Dissection ◽  
Melanoma Patients ◽  
Regional Disease ◽  
In Transit

9576 Background: While management of the nodal basin for melanoma has largely moved to observation for microscopic sentinel lymph node (SLN) metastasis, complete lymph node dissection (CLND) remains the current standard of care for melanoma patients with macroscopic, clinically detectable lymph node metastases (cLN). As CLND is associated with high surgical morbidity, we sought to study whether cLN may be safely managed by excision of only clinically abnormal nodes (precision lymph node dissection, PLND). Currently, a small subset of patients with cLN do not undergo CLND because of frailty or patient preference. We hypothesized that in these selected patients, PLND would provide acceptable regional control rates. Methods: Retrospective chart review was conducted at four academic tertiary care hospitals to identify melanoma patients who underwent PLND for cLN. cLN were defined as palpable or radiographically abnormal nodes. Recurrences were categorized as local/in-transit, same-basin lymph node, or distal lymph node/visceral. The primary outcome was isolated same-basin recurrence after PLND. Results: Twenty-one patients underwent PLND for cLN without synchronous distant metastases (characteristics of primary lesions summarized in Table). Reasons for forgoing CLND included patient preference (n=8), imaging indeterminate for distant metastases (n=2), comorbidities (n=4), loss to follow up (n=1), partial response to checkpoint blockade (n=1), or not reported (n=5). The inguinal node basin was the most common site (n=10), followed by the axillary (n=8) and cervical basins (n=3). A median of 2 nodes were resected at PLND, and 68% of resected nodes were positive for melanoma (median: 1, range: 1-3 nodes). Median follow-up was 23 months from PLND, and recurrence was observed in 28.6% of patients overall. Only 1 patient (4.8%) developed an isolated same-basin recurrence. The 3-year cumulative incidence of isolated same-basin recurrence was 5.3%, while risk of isolated local/in-transit recurrence or distant basin/visceral metastasis were 19.8% and 33.3%, respectively. Complications from PLND were reported in 1 patient (4.8%) and were limited to post-operative seroma and lymphedema. Conclusions: These pilot data suggest that PLND may offer acceptable regional disease control for cLN. Post-operative morbidity from PLND was also low, raising the possibility that PLND may provide adequate regional disease control without the morbidity associated with CLND. These data justify additional, prospective evaluation of PLND in selected patients.[Table: see text]

Prognostic Factors in Early Glottic Carcinoma Implications for Treatment

2005 ◽  
Vol 91 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Demiral Ayse Nur ◽  
Cetinayak Oguz ◽  
Erdag Taner Kemal ◽  
Eyiler Ferhat ◽  
Sarıoglu Sülen ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Treatment Time ◽  
Salvage Surgery ◽  
Anterior Commissure ◽  
The Other ◽  
Second Primary ◽  
Partial Laryngectomy ◽  
Glottic Carcinoma ◽  
T Classification ◽  
Early Glottic Carcinoma

Aim In this study we aimed to determine the prognostic factors affecting local control (LC) in limited glottic carcinoma treated with definitive radiotherapy (RT). Material and methods Between June 1991 and December 2001, 114 patients with early squamous-cell carcinoma of the glottis were treated with definitive RT at our institution. Only four (3.5%) patients were women. The median age was 60 (27-79). Fifteen percent, 72% and 13% of the patients had Tis, T1 and T2 tumors, respectively. Forty-three (37.7%) patients had anterior commissure invasion. Prior to RT 35 (31%) patients had undergone vocal cord stripping and two (2%) cordectomy. A median dose of 66 Gy (50-70.2) was given over a median period of 46 days (20-60). Univariate and multivariate analyses were performed for LC. The prognostic parameters analyzed for LC were T classification, anterior commissure involvement, total RT dose, and overall treatment time. Results Five-year local and regional control rates were 84.2% and 97.7%. RTOG grade 3-4 late side effects were observed only in one (0.9%) patient. In 15 patients with local failure, salvage treatment consisted of partial laryngectomy in eight patients and total laryngectomy in five. One of the remaining two patients was medically inoperable, and the other refused salvage surgery. In one of the three patients with regional failure, salvage surgery was applied and the other two were given palliative chemotherapy because of unresectable disease. Following salvage treatments, the ultimate five-year LC rate was 96.9% and the five-year larynx preservation rate was 91.1%. Second primary cancer was diagnosed in 17 (14.9%) patients. Only one patient developed distant metastases and two patients died of laryngeal cancer. While T2 disease and anterior commissure involvement were found to be unfavorable prognostic factors significantly influencing LC in univariate analyses, only T2 disease remained independent in multivariate analysis. Conclusion In patients with early glottic carcinoma, T classification proved to be the only independent prognostic factor affecting LC after primary radiotherapy according to the results of this study.

scholarly journals Giant Cell Tumor of Bone, current treatments, and potential therapeutic alternatives

2020 ◽  
pp. 13
Author(s):  
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Research Work ◽  
Cell Tumor ◽  
Treatment Modalities ◽  
Malignant Degeneration ◽  
Primary Malignancy ◽  
Primary Bone Tumor ◽  
Advantages And Disadvantages ◽  
Therapeutic Alternatives

Giant cell tumor of bone (GCTB) is a primary bone tumor, locally aggressive. For many, a GCTB is considered a tumor with an unpredictable behavior, particularly regarding recurrences, pulmonary implants, and the possibility of primary malignancy. In terms of risk of recurrence, it is known that it is associated with the type of treatment used initially for the GCTB. The greater the number or recurrences, the greater the risk of pulmonary implants, and the greater the risk of malignant degeneration. Therefore, much of the prognosis of this tumor could be related to the type of initial treatment. Hence the importance of the treatment theme. This review includes a comparison between the various modalities for treatment in GCTB, considering the advantages and disadvantages of each one. Existing GCTB treatments are not 100% safe and effective at the same time. and this is the reason why the search for other treatment modalities should continue to offer a better oncologic and functional outcome to patients. In the end of this review, based on research work, we also mention other possible therapeutic options that could be explored and used in the future for GCT treatment.

scholarly journals Prognostic factors for mortality in invasive pneumococcal disease: a system review and meta-analysis

2021 ◽  
Author(s):  
Hao Chen ◽  
Hiromi Matsumoto ◽  
Nobuyuki Horita ◽  
Yu Hara ◽  
Nobuaki Kobayashi ◽  
...  
Keyword(s):  
Septic Shock ◽  
Nursing Home ◽  
Prognostic Factors ◽  
Nosocomial Infection ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
Meta Analysis ◽  
Solid Organ ◽  
Factors Associated ◽  
Overall Mortality

Abstract Risk factors associated with mortality in invasive pneumococcal disease remain unclear. The present work is a meta-analysis of studies that enrolled only patients with invasive pneumococcal disease and reported on mortality. Potentially eligible reports were identified from PubMed, CHAHL, and Web of Science, comprising 26 reports in total. Overall mortality for invasive pneumococcal disease was reported as 20.8% (95% confidence interval (CI) 17.5–24%). Factors associated with mortality were age (odds ratio (OR) 3.04, 95%CI 2.5–3.68), nursing home (OR 1.62, 95%CI 1.13–2.32), nosocomial infection (OR 2.10, 95%CI 1.52–2.89), septic shock (OR 13.35, 95%CI 4.54–39.31), underlying chronic diseases (OR 2.34, 95%CI 1.78–3.09), solid organ tumor (OR 5.34, 95%CI 2.07–13.74), immunosuppressed status (OR 1.67, 95%CI 1.31–2.14), and alcohol abuse (OR 3.14, 95%CI 2.13–4.64). Mortality rates with invasive pneumococcal disease remained high, and these findings may help clinicians provide appropriate initial treatment for this disease.Key points: The overall mortality rate from IPD has remained high, at 20.8% and older age, septic shock, immunosuppressed status, underlying chronic diseases, solid organ tumor, alcohol abuse, nursing home, and nosocomial infection were prognostic factors for mortality from IPD.

Abstract 075: Heterogeneity in Treatment Effect in Patients With Peripheral Artery Disease: Insights From the CLEVER Trial

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Yashashwi Pokharel ◽  
Phillip Jones ◽  
Garth Graham ◽  
John Spertus ◽  
Kim Smolderen
Keyword(s):  
Peripheral Artery Disease ◽  
Significant Interaction ◽  
Treatment Time ◽  
Demographic Factors ◽  
Arterial Stenosis ◽  
Treatment Modalities ◽  
Peripheral Artery ◽  
Supervised Exercise ◽  
Maximum Likelihood Methods ◽  
Artery Disease

Background: The CLEVER trial (Claudication: Exercise versus Endoluminal Revascularization) showed significant improvement in peripheral artery disease (PAD)-specific health status (Peripheral Artery Questionnaire, PAQ) at 6 and 18 months for both supervised exercise (SE) and stent therapy (ST) compared with optimal medical care (OMC) in PAD patients. However, it is unknown whether there is variation in treatment by age, gender or race, or if recovery is similar across these groups over time. Methods: A total of 111 patients from 22 sites with hemodynamically significant aortoiliac arterial stenosis were randomized to SE, ST, or OMC. Using maximum likelihood methods for longitudinal analyses, we analyzed change from baseline in PAQ summary scores at 6 and 18 months and tested interactions between demographic factors (≥65 vs. <65 years; women vs. men; non-Caucasians vs. Caucasians) and treatment, time, and treatment by time. When significant, we further examined effects by different treatment modalities (OMC, SE and ST). Results: The mean age of the study population was 64.4 years (53.1% <65 years), 37.8% were women and 32.4% were non-Caucasians (26.1% African Americans and 6.3% other race). There was a significant interaction by race and treatment (p=0.006, overall difference in PAQ summary scores in non-Caucasians minus Caucasians -4.0 [-11.6, 3.6], p=0.30), but there was no significant interaction between other demographic factors and treatment, time, or treatment and time. In Caucasians, PAQ summary scores improved only with ST; in non-Caucasians, improvement was similar with ST or SE (Figure). Estimates of difference in PAQ scores between SE or ST and OMC showed similar results (Table). Conclusion: There was a significant interaction between treatment and race, with only ST showing significant improvement in PAQ scores in Caucasians, whereas both ST and SE showed significant improvements in PAQ among non-Caucasians. Further studies should validate and explore the mechanisms of different racial responses to PAD treatment.

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