scholarly journals Patterns of recurrence in adenocarcinoma of the esophagogastric junction: a retrospective study

2020 ◽  
Author(s):  
haitao xu ◽  
Lianguo Zhang ◽  
Jing Miao ◽  
Shuai Liu ◽  
Hongjian Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Distant Metastasis ◽  
Esophagogastric Junction ◽  
Postoperative Recurrence ◽  
Subsequent Treatment ◽  
Postoperative Treatment ◽  
Recurrence Rates ◽  
Hematogenous Dissemination ◽  
Pn Stage ◽  
Cox Analysis

Abstract Background: The prognosis of adenocarcinoma of the esophagogastric junction (AEG) is poor. Understanding the postoperative recurrence pattern of AEG is helpful to verify the effectiveness of treatment and optimize subsequent treatment, so as to improve prognosis.Methods: This single centre,retrospective study included patients with stage III AEG who underwent surgical treatment between January 2009 and December 2016. According to the different postoperative treatment arm, patients were divided into surgery and surgery plus chemotherapy groups. Recurrence-free survival was used as the outcome to compare the recurrence site and pattern between the groups. Results: In total, enrolled 306 patients, 123 in the surgery group and 183 in the surgery plus chemotherapy group.During follow-up (median 17.1 months) of 24 months after surgery, 62.0% of patients had tumor recurrence. The overall recurrence rates in the surgery and surgery plus chemotherapy group were 86.9% and 77.0%, respectively. The recurrence patterns of both groups were mainly distant metastasis. Postoperative chemotherapy reduced the incidence of hematogenous dissemination from 51.2% to 42.0%. Multivariate Cox analysis showed that pN stage increased the risk of recurrence,while surgery plus chemotherapy reduced the risk. Conclusions: Patients with AEG have a risk of hematogenous dissemination after surgery. Postoperative treatment arm and pN stage were independent risk factors in patients with AEG.Surgery plus chemotherapy can improve RFS and reduce distant metastasis, but they do not have a beneficial role in controlling local recurrence.

scholarly journals Patterns of recurrence in adenocarcinoma of the esophagogastric junction: a retrospective study

2020 ◽  
Author(s):  
haitao xu ◽  
Lianguo Zhang ◽  
Jing Miao ◽  
Shuai Liu ◽  
Hongjian Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Distant Metastasis ◽  
Esophagogastric Junction ◽  
Postoperative Recurrence ◽  
Subsequent Treatment ◽  
Postoperative Treatment ◽  
Recurrence Rates ◽  
Hematogenous Dissemination ◽  
Pn Stage ◽  
Cox Analysis

Abstract Background: The prognosis of adenocarcinoma of the esophagogastric junction (AEG) is poor. Understanding the postoperative recurrence pattern of AEG is helpful to verify the effectiveness of treatment and optimize subsequent treatment, so as to improve prognosis.Methods: This single centre,retrospective study included patients with stage III AEG who underwent surgical treatment between January 2009 and December 2016. According to the different postoperative treatment arm, patients were divided into surgery and surgery plus chemotherapy groups. Recurrence-free survival was used as the outcome to compare the recurrence site and pattern between the groups. Results: In total, enrolled 306 patients, 123 in the surgery group and 183 in the surgery plus chemotherapy group.During follow-up (median 522 days) of 730 days after surgery, 62.0% of patients had tumor recurrence. The overall recurrence rates in the surgery and surgery plus chemotherapy group were 86.9% and 77.0%, respectively. The recurrence patterns of both groups were mainly distant metastasis. Postoperative chemotherapy reduced the incidence of hematogenous dissemination from 51.2% to 42.0%. Multivariate Cox analysis showed that pN stage increased the risk of recurrence,while surgery plus chemotherapy reduced the risk. Conclusions: Patients with AEG have a risk of hematogenous dissemination after surgery. Postoperative treatment arm and pN stage were independent risk factors in patients with AEG.Surgery plus chemotherapy can improve RFS and reduce distant metastasis, but they do not have a beneficial role in controlling local recurrence.

scholarly journals Patterns of recurrence in adenocarcinoma of the esophagogastric junction: a retrospective study

2020 ◽  
Author(s):  
Haitao Xu ◽  
Lianguo Zhang ◽  
Jing Miao ◽  
Shuai Liu ◽  
Hongjian Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Distant Metastasis ◽  
Esophagogastric Junction ◽  
Postoperative Recurrence ◽  
Subsequent Treatment ◽  
Postoperative Treatment ◽  
Recurrence Rates ◽  
Hematogenous Dissemination ◽  
Pn Stage ◽  
Cox Analysis

Abstract Background The prognosis of adenocarcinoma of the esophagogastric junction (AEG) is poor. Understanding the postoperative recurrence pattern of AEG is helpful to verify the effectiveness of treatment and optimize subsequent treatment, so as to improve prognosis. Methods This single centre,retrospective study included patients with stage III AEG who underwent surgical treatment between January 2009 and December 2016. According to the different postoperative treatment arm, patients were divided into surgery and surgery plus chemotherapy groups. Recurrence-free survival was used as the outcome to compare the recurrence site and pattern between the groups. Results In total, enrolled 306 patients, 123 in the surgery group and 183 in the surgery plus chemotherapy group.During follow-up (median 522 days) of 730 days after surgery, 62.0% of patients had tumor recurrence. The overall recurrence rates in the surgery and surgery plus chemotherapy group were 86.9% and 77.0%, respectively. The recurrence patterns of both groups were mainly distant metastasis. Postoperative chemotherapy reduced the incidence of hematogenous dissemination from 51.2–42.0%. Multivariate Cox analysis showed that pN stage increased the risk of recurrence,while surgery plus chemotherapy reduced the risk. Conclusions Patients with AEG have a risk of hematogenous dissemination after surgery. Postoperative treatment arm and pN stage were independent risk factors in patients with AEG.Surgery plus chemotherapy can improve RFS and reduce distant metastasis, but they do not have a beneficial role in controlling local recurrence.

scholarly journals Efficacy and Prognosis of Chemoradiotherapy for 501 Patients With Postoperative Recurrence of Esophageal Cancer

2020 ◽  
Author(s):  
Yan Kong ◽  
Hongmei Gao ◽  
Youmei Li ◽  
Shuguang Li ◽  
Ke Yan ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Multivariate Analysis ◽  
Distant Metastasis ◽  
Survival Rates ◽  
Postoperative Recurrence ◽  
Chemotherapy Cycle ◽  
Recurrence Time ◽  
Factors Affecting ◽  
Pn Stage ◽  
Local Regional Recurrence

Abstract Background: To analyze the efficacy and prognosis of chemoradiotherapy for patients with recurrence of esophageal cancer. Method: A single center study was conducted in 501 patients with recurrent esophageal cancer who received chemotherapy and radiotherapy. Univariate or multivariate analysis was performed to assess the survival, recurrence pattern, prognosis of retreatment and influencing factors. Result: The median time to recurrence of esophageal cancer was 11.6 months (range: 0.3-87.4 months), while the median survival time of chemoradiotherapy after recurrence was 12.1 months. Multivariate analysis identified gender, pN stage, log odds of positive lymph nodes (lodds) value, chemotherapy cycle, recurrence time, and combined distant metastasis as independent prognostic factors (P=0.002, 0.035, 0.000, 0.000, 0.000, 0.001). In this study, 157 patients had combined combined distant metastasis, and the 1-, 3-, and 5-year survival rates of these patients after radiotherapy were 43.3%, 9.1%, and 5.5%, respectively. On the contrary, the 1-, 3-, and 5-year survival rates of patients with local regional recurrence (LRR) only were 53.6, 22.6%, and 16.4%, respectively. Statistically, the differences in the survival rates were significant between the above two groups of patients (B=10.786, P=0.001). Meanwhile, we identified recurrence time, chemotherapy cycle, and prescribed dose as the significant factors affecting the prognosis among 344 patients with postoperative LRR only (a=22.605, 13.957, 10.446; P=0.000, 0.000, 0.005). Conclusion: This study showed that chemoradiotherapy is safe and effective in patients with recurrent esophageal cancer, while male patients with late pN stage, high lodds, chemotherapy of ≤ 2 cycles, recurrence time of ≤ 24 months, or combined distant metastasis had a poor prognosis.

The Correlation between Vitamin D Levels and the Risk of Postoperative Recurrence in Crohn’s Disease

Digestion ◽  
2021 ◽  
pp. 1-9
Author(s):  
Akihiro Yamada ◽  
Yuga Komaki ◽  
Fukiko Komaki ◽  
Haider Haider ◽  
Dejan Micic ◽  
...  
Keyword(s):  
Vitamin D ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Postoperative Recurrence ◽  
Recurrence Rates ◽  
Reactive Protein ◽  
Endoscopic Recurrence ◽  
Vitamin D Levels ◽  
Endoscopic Remission ◽  
The University

<b><i>Background and Aims:</i></b> Vitamin D deficiency has been associated with disease activity in Crohn’s disease (CD). We assessed whether there is a correlation between vitamin D levels and the risk of postoperative recurrence in CD. <b><i>Methods:</i></b> CD patients who underwent surgery were identified from a prospectively maintained database at the University of Chicago. The primary endpoint was the correlation of serum 25-hydroxy vitamin D levels measured at 6–12 months after surgery and the proportion of patients in endoscopic remission, defined as a simple endoscopic score for CD of 0. Clinical, biological (C-reactive protein), and histologic recurrences were also studied. <b><i>Results:</i></b> Among a total of 89 patients, 17, 46, and 26 patients had vitamin D levels of &#x3c;15, 15–30, and &#x3e;30 ng/mL, respectively. Patients with higher vitamin D levels were significantly more likely to be in endoscopic remission compared to those with lower levels (23, 42, and 67% in ascending tertile order; <i>p</i> = 0.028). On multivariate analysis, vitamin D &#x3e;30 ng/mL (odds ratio [OR] 0.22, 95% confidence interval [CI] 0.07–0.66, <i>p</i> = 0.006) and anti-tumor necrosis factor agent treatment (OR 0.25, 95% CI 0.08–0.83, <i>p</i> = 0.01) were associated with reduced risk of endoscopic recurrence. Rates of clinical, biological, and histologic remission trended to be higher in patients with higher vitamin D levels (<i>p</i> = 0.17, 0.55, 0.062, respectively). <b><i>Conclusion:</i></b> In the present study, higher vitamin D level was associated with lower risk of postoperative endoscopic CD recurrence. Further, studies are warranted to assess the role of vitamin D in postoperative CD recurrence.

scholarly journals Surgical choice of non-small cell lung cancer with unexpected pleural dissemination intraoperatively

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junjie Hu ◽  
Yan Chen ◽  
Xinsheng Zhu ◽  
Qiang Ma ◽  
Jing Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Targeted Therapy ◽  
Small Cell Lung Cancer ◽  
Distant Metastasis ◽  
Survival Benefit ◽  
Tumor Resection ◽  
Small Cell ◽  
Small Cell Lung ◽  
Systematic Lymphadenectomy ◽  
Cox Analysis

Abstract Background Whether patients with non-small cell lung cancer (NSCLC) with unexpected pleural dissemination (UPD) could get survival benefit from tumor resection remained controversial. Methods Totally, 169 patients with NSCLC with UPD were included between 2012 and 2016. Patients were divided into the tumor resection and open-close group. Progression-free survival (PFS) and overall survival (OS) were compared with a log-rank test. The multivariable Cox analysis was applied to identify prognostic factors. Results Sixty-five patients received open-close surgery and 104 patients underwent main tumor and visible pleural nodule resection. Tumor resection significantly prolonged OS (hazard ratio [HR]: 0.408, P < 0.001), local PFS (HR: 0.283, P < 0.001), regional PFS (HR: 0.506, P = 0.005), and distant metastasis (HR: 0.595, P = 0.032). Multivariable Cox analysis confirmed that surgical method was an independent prognostic factor for OS, local PFS and regional PFS, except distant metastasis. Subgroup analyses indicated that tumor resection could not improve OS in the patients who received targeted therapy (HR: 0.649, P = 0.382), however, tumor resection was beneficial for the patients who received adjuvant chemotherapy alone (HR: 0.322, P < 0.001). In the tumor resection group, lobectomy (HR: 0.960, P = 0.917) and systematic lymphadenectomy (HR: 1.512, P = 0.259) did not show survival benefit for OS. Conclusions Main tumor and visible pleural nodule resection could improve prognosis in patients with UPD who could not receive adjuvant targeted therapy. Sublobar resection without systematic lymphadenectomy may be the optimal procedure.

Adjuvant radiotherapy plus systemic chemotherapy in resected head and neck mucosal melanoma.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18042-e18042
Author(s):  
Rong Duan ◽  
Bixia Tang ◽  
Zhihong Chi ◽  
Chuanliang Cui ◽  
Bin Lian ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Head And Neck ◽  
Distant Metastasis ◽  
Adjuvant Radiotherapy ◽  
Postoperative Radiotherapy ◽  
Local Relapse ◽  
Mucosal Melanoma ◽  
Uicc Stage ◽  
Free Survival ◽  
Cox Analysis

e18042 Background: The median over survival (OS) of resected head and neck mucosal melanoma (HNMM) is 49.0 months. About 65% of patients experience local recurrence or distant metastasis after surgery. Therefore, adjuvant therapy is critical to improve the poor prognosis. Methods: Data regarding HNMMs with radical surgery (stage III-IVa, AJCC HNMM 8th version) between September 1, 2006 and February 28, 2020 at Peking University Cancer Hospital was collected retrospectively. Postoperative radiotherapy was usually prescribed as GTV 60-70Gy/CTV 60Gy/30f. Patients were divided into four groups by the adjuvant regimens: radiotherapy+chemotherapy (RC), chemotherapy (C), radiotherapy (R) and observation (O). Results: In total, 368 patients were enrolled, including 104 RC,114 C, 53 R, 97 O, respectively. After median follow-up of 63.9 mo (range: 0.9-146.7), the median local relapse-free survival (LRFS) was 10.1 mo (95%CI: 6.7-13.6) in the O group, as compared with 65.9 mo (95%CI: 31.7-100.1, P＜0.001) in the R group, 75.6 mo (95%CI: 50.1-101.0, P＜0.001) in the C group, and 84.6 mo (95%CI: 48.5-120.8, P＜0.001) in the RC group. The median distant metastasis-free survival (DMFS) was 13.7 mo (95%CI: 8.0-19.5) in the O group, 15.3 mo (95%CI: 8.7-21.9, P = 0.898) in the R group, as compared with 25.7 mo (95%CI: 14.6-36.8, P = 0.001) in the C group, 49.3 mo (95%CI: 32.6-66.0, P＜0.001) in the RC group. Estimated OS was 36.4 mo (95%CI: 24.0-48.8) in the O group, as compared with 30.8 mo (95%CI: 23.0-38.6, P = 0.733) in the R group, 40.8 mo (95%CI: 34.8-46.8, P = 0.289) in the C group, 58.2 mp (95%CI: 36.4-79.9, P = 0.002) in the RC group. Primary location, age, gender, UICC staging and adjuvant regimens were included for multivariate Cox analysis. With regard to OS, UICC stage and RC were the prognostic factors. With regard to DMFS, UICC stage, RC and C were the prognostic factors. With regard to LRFS, UICC stage, RC, R, C were the prognostic factors. Conclusions: It is the largest study on the role of adjuvant radiotherapy and chemotherapy on HNMM till now. The results demonstrate that postoperative radiotherapy improves LRFS but has no impact on DMFS, while adjuvant radiotherapy plus chemotherapy prolongs OS. It further validates the clinical practice of UICC stage of HNMM, which might shed lights on the study of the whole mucosal melanoma.

scholarly journals Treatment of epistaxis without the use of nasal packing, a patient study

2011 ◽  
Vol 49 (5) ◽  
pp. 600-604
Author(s):  
Esther Vis ◽  
Herbert van den Berge
Keyword(s):  
Retrospective Study ◽  
The Netherlands ◽  
Treatment Modality ◽  
Training Programs ◽  
Cost Effective ◽  
Nasal Packing ◽  
Recurrent Bleeding ◽  
Bleeding Site ◽  
Recurrence Rates ◽  
Patient Study

We questioned how many patients with epistaxis can be treated by cautery without the use of nasal packing, as cautery is more effective and efficient. To investigate this, we performed a retrospective study of a cohort of 418 patients with epistaxis who presented to one ENT consultant at the ENT department of Medisch Centrum Leeuwarden (the Netherlands) between 1997 and 2007. Main outcomes were the treatment modality (cautery and/or nasal packing), recurrence of epistaxis and need for hospitalization. In 98% of all patients the bleeding site could be found and treated by cautery. The incidence of recurrent bleeding was 6%. Two percent of all patients had to be admitted to the hospital. This is considerably lower compared with recurrence rates and hospitalization after treatment by nasal packing known from the literature. Therefore we concluded that nearly all patients can be effectively treated by cautery with a low recurrence rate. In addition, this method of treatment is very cost effective. Because cautery requires skill and appropriate facilities, we recommend special attention for this in ENT training programs.

Zero Postoperative Recurrence Rates in Chronic Subdural Hematoma

1993 ◽  
pp. 157-160
Author(s):  
Masaaki Yamamoto ◽  
Minoru Jimbo ◽  
Mitsunobu Ide ◽  
Noriko Tanaka ◽  
Yutaka Umebara ◽  
...  
Keyword(s):  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Postoperative Recurrence ◽  
Recurrence Rates

scholarly journals Results of a nation-wide retrospective study of lymphadenectomy for esophagogastric junction carcinoma

2016 ◽  
Vol 20 (S1) ◽  
pp. 69-83 ◽  
Author(s):  
Hiroharu Yamashita ◽  
◽  
Yasuyuki Seto ◽  
Takeshi Sano ◽  
Hiroyasu Makuuchi ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Esophagogastric Junction ◽  
Esophagogastric Junction Carcinoma

scholarly journals Prognostic impact of Claudin 18.2 in gastric and esophageal adenocarcinomas

2020 ◽  
Vol 22 (12) ◽  
pp. 2357-2363
Author(s):  
A. Arnold ◽  
S. Daum ◽  
M. von Winterfeld ◽  
E. Berg ◽  
M. Hummel ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Distant Metastasis ◽  
Esophagogastric Junction ◽  
Epithelial Tissue ◽  
Prognostic Impact ◽  
Tumor Subtype ◽  
Primary Tumors ◽  
Node Metastasis ◽  
Therapy Target

Abstract Introduction The tight junction molecule Claudin 18.2 is selectively expressed in healthy and malignant gastric epithelial tissue and is a promising therapy target for high Claudin 18.2 expressing adenocarcinomas of the esophagogastric junction and stomach (AEG/S). Methods This study analyzed the prevalence, characteristics and prognostic impact of Claudin 18.2 expression in primary tumor, lymph node and distant metastasis in a large Caucasian AGE/S cohort with 414 patients. Results Claudin 18.2 was highly expressed in 17.1% of primary tumors, 26.7% of lymph node metastasis and 16.7% of distant metastasis. High Claudin 18.2 expression in lymph node metastasis and primary tumors correlated significantly (p < 0.001). High expression of Claudin 18.2 was neither associated with histomorphogical subtype, or tumor state, nor with overall survival. Conclusion In Caucasian AEG/S patients, 17.1% appeared to be eligible for an anti-Claudin 18.2 therapy. Claudin 18.2 expression itself has no impact on prognosis and is not related to any tumor subtype.

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