scholarly journals Laparoscopic extralevator abdominoperineal extirpation of the rectum: long-term results

2020 ◽  
Vol 10 (3-4) ◽  
pp. 34-42
Author(s):  
M. A. Danilov ◽  
A. V. Leontyev ◽  
A. B. Baychorov ◽  
Z. M. Abdulatipova ◽  
G. G. Saakyan
Keyword(s):  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Main Group ◽  
Long Term Results ◽  
Control Group ◽  
Free Survival ◽  
Significant Difference ◽  
Oncological Results ◽  
Disease Free

Objective: comparative assessment of long-term oncological results of laparoscopic extralevator and traditional abdominal-perineal resection (APR).Materials and methods. The analysis of immediate and long-term oncological results of treatment of 92 patients who underwent traditional laparoscopic and extralevator APR for low rectal cancer. Inclusion criteria were tumors of the lower ampullar rectum, excluding the performance of sphincter-sparing surgical interventions, and patients’ age up to 75 years. Exclusion criteria: distant metastases, histologically confirmed squamous cell carcinoma. Analysis of immediate and long-term results was carried out.Results. The main group included patients who underwent extralevator APR (n = 62), patients in the control group (n = 30) underwent traditional APR. There were no significant differences in the type of neoadjuvant and adjuvant treatment in the comparison groups (p >0.05). In the group of patients operated on in the volume of extralevator APR, 42 received neoadjuvant chemoradiotherapy versus 19 patients in the group of traditional APR, there was no statistically significant difference (p = 0.21). In the extralevator APR group, perineal plastic surgery was performed significantly more often than in the traditional APR group (p = 0.001). When evaluating the immediate results, there was a statistically significant difference in the total number of complications between the study groups, such complications as bladder dysfunction following after surgery, inflammatory pelvic disease in the perineal wound, perineal hernia occurred significantly more often in the traditional APR group than in the extralevator APR group (p >0.05). In terms of overall and disease-free survival, the groups differed statistically significantly: 5-year overall survival in the main group was 90 % versus 62.5 % in the control group (p = 0.03), 5-year disease-free survival in the main group was 98.5 % versus 65 % in the control group, respectively (p = 0.01).Conclusions. Extralevator APR of the rectum is the most radical surgical intervention than with the traditional APR technique due to the lower risk of a positive circumferention resection margin, therefore, reducing the incidence of local recurrence, and as a result, improving overall and disease-free survival rates compared to the traditional technique.

LONG-TERM RESULTS OF BRONCHOPLASTIC SURGICAL INTERVENTIONS IN COMPARISON WITH PNEUMONECTOMIES IN LUNG CANCER

2017 ◽  
Vol 63 (2) ◽  
pp. 234-239
Author(s):  
Yevgeniy Levchenko ◽  
Aleksandr Mikhnin ◽  
Stepan Yergnyan ◽  
Aleksey Barchuk ◽  
Leonid Gorokhov ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Rates ◽  
Group Versus ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Control Group ◽  
Free Survival ◽  
Surgical Interventions ◽  
Disease Free

The analysis of long-term results of surgical treatment of 198 patients with non-small cell lung cancer (NSCLC) I -III stages. Bronchoplasty (BP) interventions were performed in 99 cases, the control group comprised 99 patients after pneumonectomies (PE) corresponding to the main prognostic criteria for patients after BP interventions. A 1-year, 3-year and 5-year observed survival rates of patients were 87.7%, 56.2% and 44.6% after BP versus 82.8%, 54.6% and 35.9% after PE, respectively. A 1-year, 3-year and 5-year disease-free survival in the BP group was 87.9%, 64.2% and 52.3% versus 88.1%, 61.6% and 37.9% in the PE group. The median of overall and disease-free survival was 51.4 and 55.2 months in the BP group versus 46.2 and 41.0 months in the PE group, respectively.

scholarly journals results of neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. Comparative efficiency of hypofractionation and classical fractionation schedules

2020 ◽  
Vol 10 (2) ◽  
pp. 19-27
Author(s):  
A. S. Abdujapparov ◽  
S. I. Tkachev ◽  
V. A. Aliev ◽  
D. S. Romanov ◽  
J. M. Madyarov ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Locally Advanced ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Main Group ◽  
Control Group ◽  
Free Survival ◽  
Disease Free

Objective: comparison of the effectiveness of the results of neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer using classical and hypofractionated schedule of radiation therapy.Materials and methods. This study is based on a retrospective analysis of a database of patients with locally advanced rectal cancer (T3C–D, positive circumferential resection margin or T4) who underwent a prolonged course of neoadjuvant chemoradiotherapy followed by surgery. The patients were divided into two groups: the first (main) group, 71 patients who received a course of chemoradiotherapy in hypofractionation schedule as part of neoadjuvant treatment (4 Gy × 40 Gy, 3 fractions per week) in combination with chemotherapy with capecitabine 1650 mg / m2 in two doses on weekdays. The second group (control group) included 79 patients who treated with long-course chemoradiotherapy in the classic fractionation mode (2 Gy × 50–58 Gy, 5 fractions per week) in combination with chemotherapy with capecitabine 1650 mg / m2 in two doses on weekdays. In the preoperative period, along with chemoradiotherapy, 4–8 courses of the systemic chemotherapy in the CapOx mode was used. The primary endpoint of this study was pathological complete response. Secondary endpoints included the seve rity of early radiation and hematological toxicity, the incidence of local recurrence, distant metastases, overall and disease-free survival. Results. The study included 150 patients. The overall frequency of acute radiation toxicity of grade III–IV was 5.6 % in the main group and 8.9 % in the control group (p = 0.658), from them hematological toxicity – 2.82 % and 7.6 %, respectively (p = 0.350), skin and pelvic organ toxicity – 2.82 % and 1.3 %, respectively (p = 0.926). Complete pathological response of III degree in the groups achieved 22.5 % and 19 %, respectively (p = 0.593), grade IV – 18.3 % and 15.2 %, respectively (p = 0.829). In the main and control groups, 4.2 % and 3.8 % of local recurrence were registered, respectively (p = 0.954; hazard ratio (HR) 1.05; 95 % confidence interval (CI) 0.21–5.22). The median time of disease-free survival was 39.4 months. The three-year disease-free survival in the main group was 73.2 % and in the control group 64.6 %, respectively (p = 0.353; HR 0.79; 95 % CI 0.42–1.35). The three-year overall survival in the main and control groups were 84.5 % and 82.3 %, respectively (p = 0.743; HR 0.87; 95 % CI 0.39–1.92). Conclusions. The hypofractionation schedule can be considered as an alternative and not inferior to the standard dose fractionation regimen in a prolonged course of neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. 

scholarly journals CRITICAL EVALUATION OF LONG-TERM RESULTS OF MALIGNANT HEPATIC TUMORS TREATED BY MEANS CURATIVE LAPAROSCOPIC HEPATECTOMY

2017 ◽  
Vol 30 (3) ◽  
pp. 205-210 ◽  
Author(s):  
Sergio Renato PAIS-COSTA ◽  
Sergio Luiz Melo ARAÚJO ◽  
Olímpia Alves Teixeira LIMA ◽  
Sandro José MARTINS
Keyword(s):  
Overall Survival ◽  
Tumor Recurrence ◽  
Malignant Tumors ◽  
Laparoscopic Hepatectomy ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Colorectal Metastases ◽  
Free Survival ◽  
Disease Free

ABSTRACT Background: Laparoscopic hepatectomy has presented great importance for treating malignant hepatic lesions. Aim: To evaluate its impact in relation to overall survival or disease free of the patients operated due different hepatic malignant tumors. Methods: Thirty-four laparoscopic hepatectomies were performed in 31 patients with malignant neoplasm. Patients were distributed as: Group 1 - colorectal metastases (n=14); Group 2 - hepatocellular carcinoma (n=8); and Group 3 - non-colorectal metastases and intrahepatic cholangiocarcinoma (n=9). The conversion rate, morbidity, mortality and tumor recurrence were also evaluated. Results: Conversion to open surgery was 6%; morbidity 22%; postoperative mortality 3%. There was tumor recurrence in 11 cases. Medians of overall survival and disease free survival were respectively 60 and 46 m; however, there was no difference among studied groups (p>0,05). Conclusion: Long-term outcomes of laparoscopic hepatectomy for treating hepatic malignant tumors are satisfactory. There is no statistical difference in relation of both overall and disease free survival among different groups of hepatic neoplasms.

Surgical Outcomes in Hepatitis C Virus-Related Hepatocellular Carcinoma: Special Reference to Sustained Virological Responses to Interferon Therapy

2017 ◽  
Vol 83 (11) ◽  
pp. 1246-1255 ◽  
Author(s):  
Shogo Tanaka ◽  
Akihiro Tamori ◽  
Shigekazu Takemura ◽  
Genya Hamano ◽  
Tokuji Ito ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Hepatic Resection ◽  
Surgical Outcomes ◽  
Interferon Therapy ◽  
Disease Free Survival ◽  
Control Group ◽  
Free Survival ◽  
Disease Free

Long-term surgical outcomes after hepatic resection for hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) in patients who achieved a sustained virological response (SVR) to interferon (IFN) therapy remain inconclusive. Clinical records of 277 patients who underwent hepatic resection for HCV-related early stage HCC (met the Milan criteria) between 1993 and 2012 were retrospectively reviewed. Thirty-seven patients achieved the SVR during HCC detection (pre-SVR group), whereas 23 achieved SVR using adjuvant interferon therapy after hepatic resection (post-SVR group). The control group included remaining 217 patients. We investigated the SVR effects on surgical outcomes. Disease-free survival (DFS) rates at 5/10/15 years after hepatic resection were significantly greater in the pre and post-SVR groups than in the control group (46/30/30per cent and 61/36/27 per cent vs 23/7/7 per cent, respectively; P < 0.001). Overall survival (OS) rates at 10/15 years after hepatic resection were better in the pre- and post-SVR groups than in the control group (68/68 percent and 78/78 per cent vs 13/11 per cent, respectively; P < 0.001). On multivariate analysis, pre- and post-SVR were independent factors for no recurrence (pre-SVR: hazard ratio (HR), 0.48, P = 0.002; post-SVR: HR, 0.41, P = 0.001) and improved survival (pre-SVR: HR, 0.36, P = 0.002; post-SVR: HR, 0.122, P < 0.001). Achievement of SVR in patients with HCV-related HCC was associated with long-term disease-free survival and OS after hepatic resection.

The Safety and Therapeutic Effect Analysis of Intraoperative Intraperitoneal Chemotherapy with Lobaplatin for Hepato-Biliary-Pancreatic Cancer

2020 ◽  
Author(s):  
Gang Chen ◽  
Hao Chen ◽  
Qifan Zhang ◽  
Siyun Zhang ◽  
Huanyu Li ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Disease Free Survival ◽  
Control Group ◽  
Study Group ◽  
Free Survival ◽  
Significant Difference ◽  
Liver And Kidney ◽  
Intraperitoneal Perfusion ◽  
Disease Free

Abstract Background To examine the safeness and efficacy of intraoperative intraperitoneal perfusion chemotherapy with lobaplatin on hepato-biliary-pancreatic cancer. Methods Clinical data were retrospectively collected from a total of 66 patients with HBP cancer undertaken surgeries. They were divided into two groups: the study (lobaplatin) group (33 patients) and the control group (33 patients). The disease-free survival rate, postoperative complications, and chemotherapy side effects (bone marrow, liver, and kidney toxicity) were analyzed to examine the safeness and efficacy of intraoperative intraperitoneal chemotherapy with lobaplatin. Results In the study group, two patients had a postoperative subphrenic infection and increased peritoneal effusion, one patient had postoperative leukopenia and thrombocytopenia, while the control group had postoperative abnormal coagulation function in 1 patient, and gastrointestinal bleeding in 1 patient, no significant difference in postoperative complication was observed between the two groups. There was no significant difference in the liver and kidney function between the two groups after surgery (p > 0.05). A total of 26 patients in the two groups had recurrence or metastasis within one year after surgery, including eight patients in the study group and 18 patients in the control group. The recurrence rate of hepatocellular cancer in the lobaplatin group and control was 21.14% and 60%, respectively (P = 0.012 < 0.05). But there was no significant difference in the disease-free survival function analysis (P = 0.127 > 0.05). Conclusions Intraperitoneal perfusion chemotherapy with lobaplatin is a safe and effective treatment in the process of radical resection of hepato-biliary-pancreatic tumors, which has therapeutic potential in reducing postoperative tumor recurrence and metastasis.

scholarly journals Influence of Individual Surgeon Volume on Oncological Outcome of Colorectal Cancer Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Marleen Buurma ◽  
Hidde M. Kroon ◽  
Marlies S. Reimers ◽  
Peter A. Neijenhuis
Keyword(s):  
Colorectal Cancer ◽  
Multivariate Analysis ◽  
Disease Free Survival ◽  
High Volume ◽  
Free Survival ◽  
Significant Difference ◽  
Low Volume ◽  
The Impact ◽  
Disease Free

Background. Surgery performed by a high-volume surgeon improves short-term outcomes. However, not much is known about long-term effects. Therefore we performed the current study to evaluate the impact of high-volume colorectal surgeons on survival.Methods. We conducted a retrospective analysis of our prospectively collected colorectal cancer database between 2004 and 2011. Patients were divided into two groups: operated on by a high-volume surgeon (>25 cases/year) or by a low-volume surgeon (<25 cases/year). Perioperative data were collected as well as follow-up, recurrence rates, and survival data.Results. 774 patients underwent resection for colorectal malignancies. Thirteen low-volume surgeons operated on 453 patients and 4 high-volume surgeons operated on 321 patients. Groups showed an equal distribution for preoperative characteristics, except a higher ASA-classification in the low-volume group. A high-volume surgeon proved to be an independent prognostic factor for disease-free survival in the multivariate analysisP=0.04. Although overall survival did show a significant difference in the univariate analysisP<0.001it failed to reach statistical significance in the multivariate analysisP=0.09.Conclusions. In our study, a higher number of colorectal cases performed per surgeon were associated with longer disease-free survival. Implementing high-volume surgery results in improved long-term outcome following colorectal cancer.

Outcomes of transarterial chemoembolization (TACE) of the liver in patients with metastatic triple-negative breast cancer (TNBC).

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e13107-e13107
Author(s):  
Anna E. Storozhakova ◽  
Liubov Yu Vladimirova ◽  
Oleg I. Kit ◽  
Evgeniy N. Kolesnikov ◽  
Aleksandr V. Snezhko ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Liver Metastases ◽  
Disease Free Survival ◽  
Previous Treatment ◽  
Main Group ◽  
Control Group ◽  
Free Survival ◽  
Metastatic Lesions ◽  
Unresectable Liver Metastases ◽  
Disease Free

e13107 Background: TACE is widely used in oncology in patients with metastasis in liver from GI tumors, meanwhile its opportunities in management pts with TNBC are unknown. The purpose of the study was to analyze the results of TACE of the liver metastases from TNBC. Methods: The study included 60 TNBC pts with unresectable liver metastases. 34 pts of the main group underwent chemotherapy including taxanes in standard regimens. After 6-12 chemotherapy cycles, the main group received 1-2 TACE procedures (doxorubicin 30 mg/m², 5-fluorouracil 600 mg/m², 10 ml of lipiodol and 1-2 ml of 300-500 µm HepaSphere microspheres). The control group (n = 32) received only 6-12 cycles of taxane-containing chemotherapy. Pts were aged 32-66 years, mean age in the main group 49.4, in controls 55 years. Primarily advanced breast cancer with unresectable liver metastases was diagnosed in 6 (17.6%) pts of the main group and in 5 (15.6%) controls. Progression after previous treatment was observed in 91.2% (31) main group and 90.6% (29) controls. Sizes of metastatic foci were 2.7-7.3 cm, average number 7.5. Bilobar metastases were most common. Liver metastases were own accompanied by metastases to the bones, intrathoracic lymph nodes, lungs and pleura. Obtained data were processed with software package “Statistica 7.0”. Results: Main group received a total of 46 TACE procedures performed for a maximal number of metastatic lesions, especially for those progressing after systemic therapy and the largest ones, when possible. Post-embolization syndrome after performing TACE, was observed in 60.86% (28) of cases, managed with conservative therapy for 2-7 days. Icterus was not observed. The tumor response rate was 94.1% in the main group vs. 80.6% in controls, with significant differences in PR (44.1% and 15.3% respectively, p < 0.05). Median of duration treatment response was 13.4 months in the main group and 9.3 months in control group (p < 0.05). CR was not achieved. Median follow-up was 17 months. 3-year disease-free survival was 63.2% in the main group and 43.8% in controls (p = 0.039). Conclusions: TACE resulted in better response to the therapy as well as improved disease-free survival in pts with TNBC. TACE is possible to be used to consolidate the achieved effect of the chemotherapy.

Long-term disease-free survival in small-cell carcinoma of the lung: a study of clinical determinants.

1986 ◽  
Vol 4 (9) ◽  
pp. 1307-1313 ◽  
Author(s):  
K Osterlind ◽  
H H Hansen ◽  
M Hansen ◽  
P Dombernowsky ◽  
P K Andersen
Keyword(s):  
Disease Free Survival ◽  
Small Cell ◽  
Long Term Results ◽  
Disease Extent ◽  
Term Survival ◽  
Free Survival ◽  
Long Term Survival ◽  
Stage Disease ◽  
Disease Free

The influence of treatment and of pretreatment patient characteristics on the probability of long-term disease-free survival in small-cell lung cancer (SCLC) was investigated in a consecutive series of 874 patients. The patients were included in six controlled treatment trials from 1973 to 1981, using different combinations of chemotherapy with or without irradiation. All patients underwent pretreatment staging, including bronchoscopy, peritoneoscopy with liver biopsy, and bone marrow examination. The same procedures were repeated in patients without overt signs of disease 18 months from initiation of treatment, and patients without evidence of SCLC were regarded as long-term survivors. Seventy-two patients were disease-free at restaging, corresponding to 13% of 443 patients with limited-stage disease and 3% of 431 patients with extensive-stage disease. The possible relationship between different pretreatment variables and the probability of 18 months' disease-free survival was investigated by multiple regression analysis. Disease extent was the most important determinant of long-term survival. Being a woman was a positive factor and hypouricemia had negative influence on the long-term results, while features such as performance status and serum lactate dehydrogenase (LDH) did not have significant influence in the regression model. Differences between the efficacy of the applied treatment regimens were less in limited disease than they were in extensive disease, in which six-agent regimens of alternating chemotherapy was significantly better than treatment with three- or four-agent regimens. Accordingly, disease extent seems to be the most pivotal determinant of long-term survival in SCLC, but influence of the patient's sex and serum urate concentration should also be considered.

Preoperative hepatic and regional arterial chemotherapy in the prevention of liver metastasis after colorectal cancer surgery

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 4090-4090
Author(s):  
J. Xu ◽  
Y. Zhong ◽  
W. Niu ◽  
X. Qin ◽  
Y. Wei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Liver Metastasis ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Stage Iii ◽  
Control Group ◽  
Free Survival ◽  
Significant Difference ◽  
Disease Free

4090 Background: To investigate whether preoperative hepatic and regional arterial chemotherapy are able to prevent liver metastasis and improve overall survival in patients receiving curative colorectal cancer resection. Methods: Patients with Stage II or Stage III colorectal cancer (CRC) were randomly assigned to receive preoperative hepatic and regional arterial chemotherapy (PHRAC group, n=256) or surgery alone (control group, n=253). The primary endpoint was disease-free survival, whereas the secondary endpoints included liver metastasis-free survival and overall survival. Results: There were no significant differences in overall morbidity between PHRAC and Control groups. During the follow-up period (median, 42 months), the median liver metastasis time for patients with stage III CRC was significantly longer in the PHRAC group (16±3 months v.s. 8±1 months, P=0.01). In stage III patients, there was also significant difference between the two groups with regard to the incidence of liver metastasis (18.9% vs 27.3%, P=0.01), 5-year disease-free survival (70.2% vs 52.0%, P=0.0076), 5-year overall survival (80.3% vs 69.5%, P=0.020) and the median survival time (40.1± 4.6 months vs 36.3 ± 3.2 months, P=0.03). In the PHRAC arm, the risk ratio of recurrence was 0.63 (95% CI, 0.51–0.79, P=0.0001), of death was 0.50(95% CI, 0.32–0.67; P=0.005), and of liver metastasis was 0.70 (95% CI, 0.52–0.86; p=0.01). In contrast, PHRAC seemed to be no benefit for stage II patients. Toxicities, such as hepatic toxicity and leucocyte decreasing, were mild and could be cured with medicine. Conclusions: Preoperative hepatic and regional arterial chemotherapy, in combination with surgical resection, could be able to reduce and delay the occurrence of liver metastasis and therefore improve survival rate in patients with stage III colorectal cancer. No significant financial relationships to disclose.

Long-term results and competing risk analysis of the H89 trial in patients with advanced-stage Hodgkin lymphoma: a study by the Groupe d'Etude des Lymphomes de l'Adulte (GELA)

Blood ◽  
2006 ◽  
Vol 107 (12) ◽  
pp. 4636-4642 ◽  
Author(s):  
Christophe Fermé ◽  
Nicolas Mounier ◽  
Olivier Casasnovas ◽  
Pauline Brice ◽  
Marine Divine ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Significant Risk ◽  
Disease Free Survival ◽  
Significant Risk Factor ◽  
Long Term Results ◽  
Consolidation Chemotherapy ◽  
Free Survival ◽  
To Receive ◽  
Disease Free

AbstractFrom 1989 to 1996, 533 eligible patients with stage IIIB/IV Hodgkin lymphoma (HL) were randomly assigned to receive 6 cycles of hybrid MOPP/ABV (mechlorethamine, vincristine, procarbazine, prednisone/Adriamycin [doxorubicin], bleomycin, vinblastine; n = 266) or ABVPP (doxorubicin, bleomycin, vinblastine, procarbazine, prednisone; n = 267). Patients in complete remission (CR) or partial response of at least 75% after 6 cycles received 2 cycles of consolidation chemotherapy (CT) (n = 208) or subtotal nodal irradiation (RT) (n = 210). A better survival probability was observed after ABVPP alone: the 10-year overall survival (OS) estimates were 90% for ABVPP×8, 78% for MOPP/ABV×8, 82% for MOPP/ABV with RT, and 77% for ABVPP×6 with RT (P = .03); and the 10-year disease-free survival (DFS) estimates were 70%, 76%, 79%, and 76%, respectively (P = .09). The 10-year DFS estimates for patients treated with consolidation CT or RT were 73% and 78% (P = .07), and OS estimates were 84% and 79%, respectively (P = .29). These results showed that RT was not superior to consolidation CT after a doxorubicin-induced CR in patients with advanced HL. An analysis of competing risks identified age more than 45 years as a significant risk factor for death, relapse, and second cancers. Prospective evaluation of late adverse events may improve the management of patients with HL.

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