scholarly journals Prognosis classification of breast cancer with distant lymph node metastasis IIIc or M1 category

2021 ◽  
Author(s):  
Shu Wang ◽  
Jinbo Wu ◽  
Taobo Hu
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
Median Survival ◽  
Seer Database ◽  
Term Survival ◽  
Distant Organ Metastasis ◽  
Organ Metastasis ◽  
Distant Organ

Abstract Background: In the American Joint Commission on Cancer (AJCC) staging manual, ipsilateral supraclavicular lymph node metastases (ISLM) were defined as N3c, while contralateral supraclavicular and subclavian lymph node, contralateral internal mammary lymph node, contralateral axillary lymph node, and cervical lymph node as distant lymph nodes metastasis (DLM) were classified as M1, stage IV. Herein, we used the information recorded in the Surveillance, Epidemiology, and End Results (SEER) database to compare patients' overall survival with DLM, ISLM, and distant organ metastasis. Methods: A total of 376 patients with ISLM, 562 patients with DLM, 5,069 patients with IIIc stage breast cancer, and 7,540 patients with distant organ metastasis from the SEER database (2004-2016) were included in the present study. R package was used to perform the Kaplan–Meier survival analysis among these four groups, and propensity score weighting (PSW) was used to minimize the differences in clinicopathological characteristics among groupsResults: After PSW, the median survival of ISLM, DLM, IIIc stage, and distant organ metastasis was 42 months, 50 months, 55 months, and 31months, respectively. DLM achieved significantly better overall survival than distant organ metastasis (p<0.001, HR=0.646, 95%CI:0.561-0.737), while there was no significant difference in long-term survival between DLM and ISLM (p=0.467, HR=0.915, 95%CI:0.719-1.163) or DLM and IIIc stage (p=0.959, HR=0.995, 95%CI:0.837-1.183). Surgery (p<0.001, HR=0.502, 95%CI:0.375-0.674) and chemotherapy (p=0.007, HR=0.701, 95%CI:0.527-0.932) could significantly improve the OS for patients with DLM. When compared with chemotherapy alone, a combination of chemotherapy, surgery, and radiotherapy could achieve better survival, with the increased median survival from 26 months to 82 months (p<0.001, HR=0.366, 95%CI:0.253-0.529).Conclusion: The prognosis of breast cancer patients with DLM was similar to ISLM and IIIc stage, but much better than that of patients with distant organ metastasis. Also, combined-modality therapy significantly improved long-term survival. Consequently, it seems more reasonable to classify DLM as IIIc category instead of M1.

Long-Term Survival in Patients With Para-Aortic Lymph Node Metastasis With Systematic Retroperitoneal Lymphadenectomy Followed by Adjuvant Chemotherapy in Endometrial Carcinoma

2010 ◽  
Vol 20 (6) ◽  
pp. 1000-1005 ◽  
Author(s):  
Masamichi Hiura ◽  
Takayoshi Nogawa ◽  
Takashi Matsumoto ◽  
Takashi Yokoyama ◽  
Yuko Shiroyama ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Node Metastasis ◽  
Endometrial Carcinoma ◽  
Peritoneal Cytology ◽  
Term Survival ◽  
Long Term Survival ◽  
Node Metastasis

Objective:The purposes of this study were to assess modified radical hysterectomy including systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy in patients with para-aortic lymph node (PAN) metastasis in endometrial carcinoma and to identify the multivariate independent prognostic factors for long-term survival during the past 10 years.Methods:Between December 1987 and December 2002, we performed modified radical hysterectomy with bilateral salpingo-oophorectomy including systematic pelvic and para-aortic lymphadenectomy and peritoneal cytology in 284 endometrial carcinoma patients according to the classification of the International Federation of Gynecology and Obstetrics (stage IA, n = 66; stage IB, n = 96; stage IC, n = 33; stage IIA, n = 5; stage IIB, n = 20; stage IIIA, n = 28; stage IIIC, n = 28; and stage IV, n = 8) who gave informed consents at our institute. Patients with tumor confined to the uterus (stages IC and II) were treated by 3 courses of cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, and cisplatin 75 mg/m2 regimen 3 to 4 weeks apart, and patients with extrauterine lesions involving adnexa and/or pelvic lymph node (PLN) were treated by 5 courses. In addition, 10 courses were given to patients with PAN metastasis. Patients with PLN metastasis received adjuvant chemotherapy, and adjuvant radiation was not part of our institutional protocol. For multivariate regression modeling with proportional hazards, the regression model of Cox was used. Survival curves were analyzed by the Kaplan-Meier method, and analysis of the differences was performed by the log-rank test.Results:The overall incidence of retroperitoneal lymph node metastasis assessed by systematic pelvic and para-aortic lymphadenectomy was 12.0% (34/284) in stages I to IV endometrial carcinoma, and incidences of PLN and PAN metastases were 9.2% (26/284) and 7.4% (21/284), respectively. However, PAN metastasis rate is 50% (13/26) in patients with PLN metastasis. Univariate analysis of prognostic factors revealed that International Federation of Gynecology and Obstetrics clinical stage (P < 0.0001), histological finding (P = 0.0292), myometrial invasion (P < 0.0001), adnexal metastasis (P < 0.0001), lymphovascular space invasion (P < 0.0001), tumor diameter (P = 0.0108), peritoneal cytology (P = 0.0001), and retroperitoneal lymph node metastasis (P < 0.0001) were significantly associated with 10-year overall survival. Survival was not associated with age (P = 0.1558) or cervical involvement (P = 0.1828). A multivariate analysis showed that adnexal metastasis (P = 0.0418) and lymphovascular space invasion (P = 0.0214) were significantly associated with 10-year overall survival. The 5- and 10-year overall survival rates in patients with negative PAN were 96% and 93% versus 72% and 62% in patients with positive PAN (P = 0.006).Conclusions:It is suggested that surgery with systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy could improve long-term survival in patients with PAN metastasis, although there are only 21 patients with PAN metastasis.

Postoperative Morbidity in Curative Resection of Gastroesophageal Carcinoma Does Not Impact Long-term Survival

2015 ◽  
Vol 81 (12) ◽  
pp. 1228-1231
Author(s):  
Jennifer E. Samples ◽  
Anna C. Snavely ◽  
Michael O. Meyers
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Neoadjuvant Therapy ◽  
Postoperative Morbidity ◽  
Gastroesophageal Junction ◽  
Morbidity And Mortality ◽  
Term Survival ◽  
Long Term Survival ◽  
Nodal Dissection

Significant morbidity and mortality have historically been reported for surgical resection of gastric and gastroesophageal junction tumors. We evaluated our experience to determine morbidity and mortality and evaluated demographic and pathologic risk factors associated with postoperative outcome and long-term survival. A retrospective, Institutional Review Board-approved, single-institution database identified 102 patients who underwent resection with curative intent for gastroesophageal junction or gastric carcinoma from 2004 to 2012. The method of Kaplan and Meier was used to describe overall survival and estimate median survival. Of 102 patients, 74 were male and 28 were female. Of these, 24 patients were > 70 years of age at surgery (median = 62.9). Forty esophagectomies, 25 total gastrectomies, and 37 subtotal gastrectomies were performed. Two patients died (one esophagectomy and one gastrectomy). Forty-one developed a complication: 17 minor and 35 major, including six anastomotic leaks. Patients with low preoperative albumin ( P = 0.01) and increased age ( P = 0.05) were associated with having a postoperative complication; extent of nodal dissection ( P = 0.48), jejunostomy (0.24), performance status ( P = 0.77), type of surgery ( P = 0.74), and neoadjuvant therapy ( P = 0.24) were not associated. More extensive nodal dissection was associated with a decreased risk of death ( P = 0.007). Having any complication ( P = 0.20), an anastomotic leak ( P = 0.17), worse grade of complication ( P = 0.15), presence of feeding jejunostomy tube ( P = 0.17), and neoadjuvant therapy ( P = 0.30) were not associated with changes in overall survival. Thorough lymph node dissection improves survival without increasing postoperative morbidity. The data advocate for increased lymph node yield and close attention to nutritional support in gastroesophageal carcinoma patients.

Predictive factors for achieving a pathologic complete remission (pCR) rate after neoadjuvant radiochemotherapy in locally advanced noninflammatory breast cancer: Results of a multivariant analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11556-e11556
Author(s):  
Edwin Boelke ◽  
Christiane Matuschek ◽  
Stephan L. Roth ◽  
Hans Bojar ◽  
Johann Wolfgang Janni ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Complete Remission ◽  
Predictive Factors ◽  
Locally Advanced ◽  
Time Interval ◽  
Term Survival ◽  
Long Term Survival ◽  
Pathologic Complete Remission

e11556 Background: In contrast to neoadjuvant chemotherapy they are no predictive factors to estimate the pathologic complete remission (pCR) rate after preoperative chemotherapy (NRT-CHX) in locally advanced breast cancer (LABC). Methods: 315 LABC patients were included in this trial. They were treated during 1991-1998. The last follow up was in November 2011. Radiotherapy was applied with 50 Gy (5x2 Gy / week) to the breast and the supra-/infraclavicular lymph nodes. 101 patients received a 10 Gy interstitial boost (breast conservation). Chemotherapy (CMF, EC or Mitoxantron was applied in 192 patients prior to radiotherapy and in 113 patients simultaneously. Ten patients had no chemotherapy. Age, tumor grade, nodal status, hormone receptor status, simultaneous vs. sequential CHX and the time period up to surgery were examined in multivariate terms for pCR and overall survival. Results: The pCR rate for NRT-CHX after surgery was 29.2%. In multivariante analysis a longer time interval to surgery increased the probability of a pCR (HR 1,17 [95% CI 1,05-1,31], p<0,01). In term of overall survival, the achievement of a pCR is the strongest predictor for long term survival (HR 0,28 [95% CI 0,19-0,56], p<0,001). Conclusions: A long time interval to surgery (> 2 months) increases the probability of a pCR after NRT-CHX. Like in neoadjuvant CHX the achievement of a pCR is an important prognostic factor for long term survival.

MR-guided laser-induced thermotherapy (LITT) in liver metastases of colorectal cancer: Long-term survival data.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14131-e14131
Author(s):  
Thomas J. Vogl ◽  
Alena Dommermuth ◽  
Katrin Eichler ◽  
Stephan Zangos
Keyword(s):  
Overall Survival ◽  
Survival Analysis ◽  
Survival Rate ◽  
Lymph Nodes ◽  
Liver Metastases ◽  
Median Survival ◽  
Cox Regression ◽  
Term Survival ◽  
Median Survival Rate

e14131 Background: To evaluate retrospectively long-term survival of 594 patients with colorectal liver metastases treated with MR-guided laser-induced thermotherapy (LITT) depending on different factors. Methods: 594 patients with liver metastases from colorectal carcinoma treated with MR-guided LITT between 01/99 and 12/10 were included. For survival analysis tumor localization, TNM classification, number of metastases, diameter and volume of metastases and necrosis, lobular spread, number of treatment sessions, performance of adjuvant chemotherapy and transarterial chemoembolisation were considered. The Kaplan-Meier method was used to conduct this survival analysis. Results: Log-rank test showed statistically significant differences between survival curves, multivariate Cox-regression-analysis (p<0.05) showed prognostic factors regarding overall survival like number of metastases pre intervention, adjuvant chemotherapy, diameter of metastases, ratio of volumes of necrosis and metastases, and affected lymph nodes. Median overall survival rate at the time of first LITT was 25 months, 1-year survival: 78%, 2-year survival: 50.1%, 3-year survival: 28%; 4-year survival: 16.4%; 5-year survival: 7.8%. Numbers of metastases pre intervention: 1-2 metastases with a median survival rate of 60 months; 3-4 metastases: 45 months; ≥5 metastases: 42 months. Median survival rate for metastases <20mm in diameter 36 months; 20-30mm 27 months, 30-40mm 24 months and >40mm 21 months. Affected lymph nodes: median survival rate for patients with N0-classification 30 months, N1-classification 24 months; N2/N3/N4-classification 22 months. Conclusions: Multivariate Cox regression model provided the minimal number of significant variables with the maximal prognostic value concerning overall survival for MR-guided LITT, i.e., diameter and number of metastases and primary classification of lymph nodes.

Long-term survival in patients with peritoneal metastasized gastric cancer treated with cytoreductive surgery and HIPEC: A multi-institutional cohort from PSOGI.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 390-390
Author(s):  
Andreas Brandl ◽  
Yutaka Yonemura ◽  
Olivier Glehen ◽  
Paul H. Sugarbaker ◽  
Beate Rau
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Median Survival ◽  
Cytoreductive Surgery ◽  
Peritoneal Metastasis ◽  
Tumor Recurrence ◽  
Term Survival ◽  
Long Term Survival ◽  
Crs And Hipec

390 Background: Peritoneal metastasis of gastric cancer is relatively common (17%) and is associated with poor survival. Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is still controversially discussed, as it has proven an increase in median survival in selected patients, but only a small subgroup reached long-term survival. The aim of this study was to collect and analyze a worldwide cohort of patients treated with CRS and HIPEC with long-term survival in order to explore relevant patient characteristics. Methods: We conducted a questionnaire, which was distributed to all collaborators of the Peritoneal Surface Oncology Group International (PSOGI). Inclusion criteria were: histopathologic proven peritoneal metastasis of gastric cancer, treated with CRS and HIPEC, and overall survival > 5 years. Patient, tumor, and therapeutic details were collected and analyzed. Results: A total of 29 patients with a mean age of 52.5 years and a mean PCI of 3.2 were included. The overall median survival was 11.0 years (min 5.0; max 27.9). The predictors completeness of cytoreduction (CC-0) and low PCI (PCI < 6) were present in 23/29 patients. 13/29 patients developed at a median of 82.2 months tumor recurrence. Tumor recurrence was associated with inferior median overall survival compared to patients without tumor recurrence (8.8 years vs. not reached; p = 0.002). Conclusions: Long-term survival and even cure are possible in patients with peritoneal metastasis of gastric cancer treated with CRS and HIPEC. Completeness of cytoreduction (CC-0) and low PCI seemed to be crucial. Further studies are needed in order to improve existing selection criteria.

Recurrence rates and long-term survival in women diagnosed with breast cancer at age 40 and younger.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 70-70 ◽  
Author(s):  
J. M. Buckley ◽  
S. Coopey ◽  
S. Samphao ◽  
M. C. Specht ◽  
K. S. Hughes ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Breast Conservation ◽  
Disease Recurrence ◽  
Distant Recurrence ◽  
Recurrence Rates ◽  
Term Survival ◽  
Long Term Survival

70 Background: Young age at diagnosis of breast cancer has been reported to be an independent risk factor for disease recurrence. However, there is little data on long term survival of young patients. We present long term follow up of a large cohort of women diagnosed with breast cancer at age 40 and younger. We determined rates of loco-regional recurrence (LRR), distant recurrence, and overall survival and adjusted for the patient and tumor characteristics which potentially predict outcomes. Methods: Following Institutional Review Board approval, data from the medical records of 628 women diagnosed with breast cancer at age 40 or younger between 1996 and 2008 were collected. Survival curves were estimated using the Kaplan Meier method. Results: Median age was 37 years (range: 21-40) and median follow-up was 72 months (range: 5-177). The rates of LRR as a first site of recurrence were 5.56% at 5 years and 12.11% at 10 years. In the entire population, with median follow-up of 72 months, there was no difference in the rates of loco-regional failure between patients who underwent breast conserving therapy (7.34%) compared to mastectomy (7.40%) (p=0.980). The rates of distant recurrence as a first event were 10.65% at 5 years and 14.58% at 10 years. Overall survival was 93.1% at 5 years and 87.26% at 10 years. 79.1% of patients received systemic therapy. For patients who developed disease recurrence, either LRR or distant, median time to first recurrence was 35 months (range: 3-167). Conclusions: Women aged 40 and younger at diagnosis of breast cancer have a good prognosis, with low overall recurrence rates at 5 and 10 years. Local recurrence in our cohort is lower than in prior studies, suggesting advances in therapy have made breast conservation a safe option in young breast cancer patients.

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