scholarly journals Outcomes of extensive surgeries in combination treatment of stage III–IV ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
Kh. I. Mamazhonov ◽  
S. O. Nikogosyan ◽  
A. S. Shevchuk ◽  
V. V. Kuznetsov
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Intraoperative Complications ◽  
Stage Iii ◽  
Control Group ◽  
Node Dissection ◽  
Long Term Outcomes ◽  
Experimental Group

Objective: to evaluate short-term and long-term outcomes of lymph node dissection in patients with stage III–IV ovarian cancer.Materials and methods. This retrospective study included patients with stage III–IV ovarian cancer who have undergone either complete or optimal cytoreduction. Patients in the experimental group additionally had lymph node dissection, whereas patients in the control group had surgery without lymph node dissection. We evaluated 3‑year relapse-free survival (primary outcome measure), 3‑year overall survival, incidence of intraoperative and postoperative complications, and frequency of lymph node lesions.Results. The study included 272 patients: 43 women in the experimental group and 229 women in the control group. Intraoperative complications were significantly more common in patients who had lymph node dissection compared to those who had cytoreductive surgery alone (37.2 % vs 16.6 % respectively; р = 0.0001). The incidence of postoperative complications did not vary significantly between the groups (27.9 % in the experimental group vs 16.2 % in the control group; р = 0.128). Thirty-three patients (76.7 %) were found to have metastasis in the lymph nodes excised. The three-year overall survival rate was 82.6 % among patients who had lymph node dissection and 75.7 % among patients who had no lymph node dissection (р = 0.306). The three-year relapse-free survival rate was 26.2 % in the experimental group and 38.4 % in the control group (р = 0.858).Conclusions. Systemic lymph node dissection does not improve long-term outcomes and increases the incidence of intraoperative complications in patients with stage III–IV ovarian cancer undergoing complete or optimal cytoreduction.

scholarly journals Prophylactic Bilateral Central Neck Dissection Should Be Evaluated Based on Prospective Study of 581 PTC Patients

2021 ◽  
Author(s):  
Shouyi YAN ◽  
Jiafan Yu ◽  
wenxin zhao ◽  
Bo WANG ◽  
Liyong ZHANG
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Test Group ◽  
Control Group ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Abstract Background: Prophylactic central lymph node dissection (PCND) had been a basic consensus for patients with papillary thyroid carcinoma in China. However, unilateral or bilateral central lymph node dissection (CND)was still controversial. This study aimed at investigating the safety and long-term benefit for the patients with bilateral central lymph node dissection (BCCD). Methods: 581 patients were enrolled and divided randomly into the test and control groups according to a different range of CND. 285 patients were prospectively assigned to undergo lobe thyroidectomy plus BCND in the test group, in comparison 296 patients were assigned to undergo lobe thyroidectomy plus ipsilateral central lymph node dissection (ICND) in the control group. Results: We found that the numbers of total LN and N1a in the test group were higher than that of the control group (p=0.002), but there was no difference in the number of metastasized lymph nodes (p=0.857) and tumor recurrence (p=0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P =0.010), and the numbers of transient laryngeal nerve palsy were higher than that(p=0.033). meanwhile we further found that tumors size larger than 1cm and tumor side lymph node metastasis were related to the contralateral lymph node metastasis. Conclusion: BCND resulted in more positive lymph nodes and complications while did not change the patient's long-term prognosis. It may be an alternative for patients with tumor sizes larger than 1cm in large medical centers.

scholarly journals Conformal radiotherapy in combination with cetuximab for stage Т1–2 tongue cancer with N1–2b regional metastases detected after preventive lymphadenectomy

2020 ◽  
Vol 9 (4) ◽  
pp. 32-37
Author(s):  
D. V. Sikorsky ◽  
N. V. Kanishcheva ◽  
S. O. Podvyaznikov ◽  
D. V. Skamnitsky ◽  
S. V. Smetanina ◽  
...  
Keyword(s):  
Lymph Node ◽  
Disease Progression ◽  
Lymph Node Dissection ◽  
Cervical Lymph Node ◽  
Tongue Cancer ◽  
Conformal Radiotherapy ◽  
Control Group ◽  
Node Dissection ◽  
Timely Initiation ◽  
Experimental Group

The study objective is to analyze the experience of conformal radiotherapy in combination with cetuximab for cervical lymph node (LN) metastasis in patients with early-stage tongue cancer who had undergone multicomponent surgeries.Materials and methods. This retrospective study included 48 patients with primary squamous cell carcinoma of the tongue (Т1–2) that were treated in Nizhny Novgorod Regional Clinical Oncology Dispensary between 2012 and 2019. The experimental group comprised 25 patients who underwent hemiglossectomy with simultaneous preventive cervical lymph node dissection. The control group was composed of 23 patients who underwent hemiglossectomy alone due to the presence of concomitant somatic pathology. Before surgery, none of the patients had any signs of metastatic lesions in the cervical LNs according to the results of clinical and instrumental examinations. After surgery, 100 % of patients from the experimental group were found to have N1–2b cervical LN metastases at histological examination. Patients from the control group developed clinical signs of cervical LN metastasis within a year after operation. All patients underwent radiotherapy. The experimental group was divided into two subgroups: patients from subgroup 1 (n = 11) received cetuximab due to disease progression, whereas patients from subgroup 2 (n = 14) received cisplatin. Participants from the control group received no chemotherapy due to their concomitant somatic disorders and because regional metastasis was not confirmed.Results. In the control group, the time between surgery and patient’s death varied between 8 and 14 months. Patients from subgroups 1 and 2 survived for 12–60 months and 8–48 months respectively. So far, 9 patients from subgroup 1 and 6 patients from subgroup 2 are alive. Among them, 8 participants from subgroup 1 and 4 participants from subgroup 2 have no signs of disease progression. Three patients from subgroup 2 died of cardiovascular diseases (they had no cancer progression within 3 months after the completion of chemotherapy).Conclusion. Preventive lymph node dissection in patients with stage Т1–2 tongue cancer enables early detection of subclinical N1–2b metastases and ensures timely initiation of therapy. Our experience confirmed safety of cetuximab plus radiotherapy used to improve disease control and increase patient’s survival.

scholarly journals Neoadjuvant Chemoradiotherapy Followed by Esophagectomy with Three-Field Lymph Node Dissection for Thoracic Esophageal Squamous Cell Carcinoma Patients with Clinical Stage III and with Supraclavicular Lymph Node Metastasis

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 983
Author(s):  
Yusuke Sato ◽  
Satoru Motoyama ◽  
Yuki Wada ◽  
Akiyuki Wakita ◽  
Yuta Kawakita ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Neoadjuvant Chemoradiotherapy ◽  
Stage Iii ◽  
Node Dissection ◽  
Term Survival ◽  
Stage Ivb

Background: Neoadjuvant chemoradiotherapy (NACRT) followed by esophagectomy is now the standard treatment for patients with resectable advanced thoracic esophageal squamous cell carcinoma (ESCC) worldwide. However, the efficacy of NACRT followed by esophagectomy with three-field lymph node dissection for clinical Stage III patients and for clinical Stage IVB patients with supraclavicular LN metastasis has not yet been determined. Methods: Between 2008 and 2018, 94 ESCC patients diagnosed as clinical Stage III and 18 patients diagnosed as clinical Stage IVB with supraclavicular LN metastasis as the only distant metastatic factor were treated with NACRT followed by esophagectomy with extended lymph node dissection at Akita University Hospital. Long-term survival and the patterns of recurrence in these 112 patients were analyzed. Results: The median follow-up period of censored cases was 60 months. The five-year OS and DSS rates among the clinical Stage III patients were 57.6% and 66.6%, respectively. The five-year OS and DSS rates among the clinical Stage IVB patients were 41.3% and 51.6%, respectively. The most frequent recurrence pattern was distant metastasis (69.2%) in the Stage III patients and LN metastasis (75.0%) in the Stage IVB patients. Conclusion: NACRT followed by esophagectomy with three-field LN dissection is feasible and offers the potential for long-term survival of clinical Stage III ESCC patients and even clinical Stage IVB patients with supraclavicular LN metastasis as the only distant metastatic factor. At least in patients with upper and middle thoracic ESCC, treating supraclavicular LNs as regional LNs seems to be appropriate.

scholarly journals Prophylactic Bilateral Central Neck Dissection Should Be Carefully Evaluated Based on Prospective Study of 581 Cases With cN0 Papillary Thyroid Carcinoma

2021 ◽  
Author(s):  
Shouyi Yan ◽  
Wen Xin Zhao ◽  
Bo Wang ◽  
Liyong Zhang
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Test Group ◽  
Control Group ◽  
Node Dissection ◽  
Central Lymph Node ◽  
Central Lymph Node Dissection ◽  
Node Metastasis ◽  
Central Lymph

Abstract Background: prophylactic central lymph node dissection (PCND) had been a basic consensus for patients with papillary thyroid carcinoma (PTC) in China. However, unilateral or bilateral central lymph node dissection (CND)was still controversial. This study aimed at investigating the safety and long-term benefit for the patients with bilateral central lymph node dissection (BCCD). Methods: 581 patients were enrolled and divided randomly into the test and control groups according to a different range of CND. 285 patients were prospectively assigned to undergo lobe thyroidectomy plus BCND in the test group, in comparison 296 patients were assigned to undergo lobe thyroidectomy plus ipsilateral central lymph node dissection (ICND) in the control group. Results: We found that the numbers of total LN and N1a in the test group were higher than that of the control group (p = 0.002), but there was no difference in the number of metastasized lymph nodes (p = 0.857) and tumor recurrence (p = 0.308). Additionally, in the aspect of postoperative complication (1 day after surgery), the serum levels of parathyroid hormone in the BCND group were lower than that in the ICND group (P = 0.010), and the numbers of transient laryngeal nerve palsy were higher than that(p = 0.033). meanwhile we further found that tumors size larger than 1cm and tumor side lymph node metastasis were related to the contralateral lymph node metastasis. Conclusion: BCND resulted in more positive lymph nodes and similar surgical complications compared with ICND but did not change the patient's long-term prognosis. It may be an alternative for patients with tumor sizes larger than 1cm. Meanwhile, and it should be done in large medical centers, with rich experience in PG and RLN protection

scholarly journals Long-Term Outcomes of Laparoscopic Versus Open Gastrectomy With D2 Lymph Node Dissection for Advanced Gastric Cancer

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 225s-225s
Author(s):  
Z. Li
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Propensity Score ◽  
Advanced Gastric Cancer ◽  
Propensity Score Matching ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Long Term Outcomes ◽  
D2 Lymph Node Dissection

Background: Technical safety and short-term surgical outcomes of laparoscopy-assisted gastrectomy (LAG) for advanced gastric cancer (AGC) have been investigated in many clinical trials. However, studies with large sample size and sufficient follow-up comparing LAG and open gastrectomy (OG) for AGC have seldom been reported. Aim: The purpose of this study was to compare the long-term outcomes of LAG vs open OG for AGC using a propensity score matching analysis. Methods: We retrospectively evaluated 459 and 856 patients who underwent LG or OG with D2 lymph node dissection, respectively, for AGC between June 2007 and June 2012. One-to-one propensity score matching was performed to compensate for heterogeneity between groups. We compared long-term outcomes between the 2 groups after propensity score matching. Results: In the propensity score-matched cohort, no significant differences were observed in 5-year overall survival (OS) (52.0% vs 53.4%; P = 0.805) and disease-free survival (DFS) (46.8% vs 47.3%; P = 0.963) between the LAG group and OG group. Stratified analysis showed that the 5-year OS and DFS rates were comparable between the 2 groups in each tumor stage ( P > 0.05). Multivariate analysis revealed that the operation method was not an independent prognostic factor for OS or DFS. Further analysis showed that the recurrence pattern was similar between the LAG group the OG group ( P > 0.05). Conclusion: LAG is a feasible surgical procedure for AGC in comparison with OG in terms of long-term prognosis, although the results should be confirmed by the ongoing randomized controlled trials.

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