scholarly journals ANGKA BANDING NEUTROFIL/LIMFOSIT DI KARSINOMA PAYUDARA

Author(s):  
Yuly Eko Prasetyo ◽  
Uleng Bahrun ◽  
Ruland DN. Pakasi

Carcinoma Mammae (CM) is a malignancy of epithelial cells restricting at the breast ducts or lobes which causes very high mortalityrate. The Neutrophil/Lymphocyte ratio (NLR) is reflecting the inflamatory status, has been reported to be a prognostic indicator in somemalignant tumors. The purpose of this study is to know the NLR as an indicator of the progressivity of CM by analyzing it. A retrospectiveobservational study performed using data from the medical record of CM patients at Wahidin Sudirohusodo Hospital from January 2010up to December 2012. The diagnosis were established by the clinicians based on the result of histopathological exsamination, chest X-ray,abdominal ultrasound, bone scan and CT scan. The patients with surgical history, chemotherapy, radiotherapy, leukocytes >12.000/mm3and incomplete data were excluded from the analysis. The data distribution was analyzed using Kolmogorov-Smirnov test. The relationbetween NLR in CM was analized by One way ANOVA test and post hoc analysis. The result were 130 samples, consisting of 17 patientsin early stage, 71 in stage III and 42 in stage IV CM. In the early stage the mean of NLR were 1.69, 2.04 in stage III and 2.89 in stage IVand their differences were statistically significant (p<0.001). Post hoc analysis showed that the significant differences occurred betweenthe early stage and IV, as well as between stage III and IV. The mean of NLR were 2.28±1.02 in the non metastatic and 3.36±1.5 in themetastatic they were statistically significant (p<0.001). Based on the study results can be concluded that the neutrophil/lymphocyteratio can be used to assess the progressivity of CM. Further studies with larger samples were needed for the determination of the cut offpoint of NLR.

2018 ◽  
Vol 28 (5) ◽  
pp. 915-924 ◽  
Author(s):  
Jennifer J. Mueller ◽  
Henrik Lajer ◽  
Berit Jul Mosgaard ◽  
Slim Bach Hamba ◽  
Philippe Morice ◽  
...  

ObjectiveWe sought to describe a large, international cohort of patients diagnosed with primary mucinous ovarian carcinoma (PMOC) across 3 tertiary medical centers to evaluate differences in patient characteristics, surgical/adjuvant treatment strategies, and oncologic outcomes.MethodsThis was a retrospective review spanning 1976–2014. All tumors were centrally reviewed by an expert gynecologic pathologist. Each center used a combination of clinical and histologic criteria to confirm a PMOC diagnosis. Data were abstracted from medical records, and a deidentified dataset was compiled and processed at a single institution. Appropriate statistical tests were performed.ResultsTwo hundred twenty-two patients with PMOC were identified; all had undergone primary surgery. Disease stage distribution was as follows: stage I, 163 patients (74%); stage II, 8 (4%); stage III, 40 (18%); and stage IV, 10 (5%). Ninety-nine (45%) of 219 patients underwent lymphadenectomy; 41 (19%) of 215 underwent fertility-preserving surgery. Of the 145 patients (65%) with available treatment data, 68 (47%) had received chemotherapy—55 (81%) a gynecologic regimen and 13 (19%) a gastrointestinal regimen. The 5-year progression-free survival (PFS) rates were 80% (95% confidence interval [CI], 73%–85%) for patients with stage I to II disease and 17% (95% CI, 8%–29%) for those with stage III to IV disease. The 5-year PFS rate was 73% (95% CI, 50%–86%) for patients who underwent fertility-preserving surgery.ConclusionsMost patients (74%) presented with stage I disease. Nearly 50% were treated with adjuvant chemotherapy using various regimens across institutions. The PFS outcomes were favorable for those with early-stage disease and lower but acceptable for those who underwent fertility preservation.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 15056-15056
Author(s):  
S. Kilickap ◽  
O. Dizdar ◽  
H. Harputluoglu ◽  
S. Aksoy ◽  
S. Yalcin

15056 Background: Determination of patients (pts) with early stage disease who have a high risk for developing metastatic disease is crucial. We investigated the risk factors associated with metastases development in pts with operable gastric cancer. Patients and Methods: In this retrospective study, pts with stage I-III and non-metastatic stage IV gastric cancer diagnosed between 1990 and 2006 were evaluated. The medical records of all pts including patient characteristics, laboratory results, histopathological examinations, were reviewed. Logistic regression methods were used to determine the risk factors for developing metastasis and to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: 184 pts (70% male, 30% female) were analyzed. The mean age ± standard deviation was 56.5±11.9. The mean age of female were higher than male (p=0.014). At the time of diagnosis, 13.6% of the pts had stage I, 19.0% had stage II, 53.3% had stage III, and 14.1% had non-metastatic stage IV disease. The tumors were distally localized in 80% of the cases. Median follow-up period was 35 months. During follow up, 51 pts developed metastases. Median time to metastases development was 14 months. Overall survival was shorter in pts who developed metastasis than those who did not. (20 months vs. not reached, respectively, p=0.002). In univariate analyses, stage (p=0.020), tumor localization (p=0.006), extracapsular lymphatic extension (ELE) (p<0.001), the number of metastatic lymph nodes (p=0.001), CEA level (p<0.001), lymphovascular invasion (LVI) (p=0.001), and perineural invasion (p=0.007) were associated with metastasis development. In multivariate analysis, elevated CEA levels (p=0.009; OR: 2.8; CI 95%: 1.29–6.19), LVI (p=0.041; OR: 2.2; CI 95%: 1.03–4.64) and ELE (p=0.029; OR: 2.3; CI 95%: 1.09–4.78) were associated with increased risk of metastasis development while distal localization (p=0.038; OR: 0.42; CI%: 0.18–0.95) was associated with decreased risk in pts with gastric cancer. Discussion: In pts with early stage or locally advanced gastric cancer, elevated CEA levels, LVI, proximal localization and ELE were associated with increased risk of developing metastasis. Aggressive treatment options and closer follow up should be considered for pts with these risk factors. No significant financial relationships to disclose.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17062-e17062
Author(s):  
Hee Yeon Lee ◽  
Ji Hyung Hong ◽  
Jae Ho Byun ◽  
Hee Jun Kim ◽  
Sun Kyung Baek ◽  
...  

e17062 Background: Clear cell ovarian cancer is rare, accounts for about 3-10% of epithelial ovarian carcinoma, and is known to be associated with endometriosis. This tumor type has poor prognosis due to inherent chemoresistance. We investigated clinical characteristics and prognostic factors of clear cell ovarian cancer in South Korea. Methods: We reviewed the medical records of 308 patients with clear cell histology ovarian cancer who underwent debulking surgery from 21 institutions in South Korea between 1995 and 2015. Results: Mean age was 51 years (range, 25-81) and 194 patients (63.7%) had stage I disease, 34 (11.1%) had stage II, 66 (21.6%) had stage III, and 11 (3.6%) had stage IV. 107 patients (34.9%) had endometriosis. 9 patients (2.9%) received neoadjuvant chemotherapy, 248 (80.5%) received postoperative chemotherapy, and among them, 238 (96%) received taxane-platinum chemotherapy. 275 patients (89.3%) achieved optimal debulking. 112 patients (37%) had recurrence, 182 (59.1%) was disease-free, and 12 (3.9%) lost follow up. Median value of CA-125 was 72.34 U/ml (range, 1.9-8930), 45.7 in stage I, 98.9 in stage II, 192.1 in stage III, and 634.8 in stage IV. 1-year, and 3-year rate of disease-free survival (DFS) was 70%, and 63%, respectively. 1-yr DFS rate was 90% in stage Ia and Ib, 88% in stage Ic and II, and 60% in stage III and IV. According to the same stage grouping, 3-year DFS rate was 82%, 70%, and 40%, respectively. Overall survival (OS) rate at 1 year was 97%, 99%, and 90%, and 97%, 96%, and 88% at 3 year. Multivariate analysis revealed optimal debulking (HR 6.62, p < 0.001) as a significant prognostic factor for DFS. Among the 94 patients with early stage (Ia and Ib), 17 patients (18.1%) received adjuvant chemotherapy, and there was no significant difference in DFS according to adjuvant chemotherapy (log rank p = 0.57). Conclusions: In patients with clear cell ovarian cancer, optimal debulking surgery was associated with improved DFS. And the role of adjuvant chemotherapy in early stage clear cell ovarian cancer is elusive and needs further study.


2018 ◽  
Vol 48 (4) ◽  
Author(s):  
Simone Carvalho dos Santos Cunha ◽  
Katia Barão Corgozinho ◽  
Franciele Basso Fernandes Silva ◽  
Kassia Valéria Gomes Coelho da Silva ◽  
Ana Maria Reis Ferreira

ABSTRACT: Our retrospective study evaluated the survival of 24 dogs with unresectable malignant melanoma treated with radiation therapy. Fifteen dogs were treated with radiation therapy (RT) and chemotherapy (CT), five with surgery followed by RT and CT, three with palliative RT, and one with electrochemotherapy associated with RT. All dogs were treated with an orthovoltage Stabilipan I. The protocol used was three or four weekly fractions of 8 Gy. Carboplatin was administered every 21 days, a total of four times. Five percent of dogs were classified as having stage I melanoma, 17% as stage II, 50% as stage III, and 17% as stage IV. Sixty-four percent had a partial response to treatment, 29% achieved complete remission, and 7% remained in a stable disease state. The mean survival time was 390 days for stage I, 286 days for stage II, 159 days for stage III, and 90 days for stage IV. We concluded that radiation therapy can be considered a viable alternative for the palliative treatment of canine oral melanoma.


2020 ◽  
Vol 25 (1) ◽  
pp. 10-18
Author(s):  
Mohammad Ashequr Rahman Bhuiyan ◽  
Md Zakaria Sarker ◽  
Md Nazmul Haque ◽  
Saif Rahman Khan ◽  
Towsif Bin Mamoon ◽  
...  

Objective: To observe Post-operative complications of Total Laryngectomy in advanced Laryngeal Carcinoma Patients. Methods: This prospective observational study was conducted in National Institute of ENT, Tejgaon, Dhaka. Study duration 3 years, from January 2015 to December 2017. 17 patients were selected who underwent total laryngectomy for histologically proven advanced carcinoma larynx. Patients were followed up monthly for 3 months & then after 6 months for life long. Results: The age of the patients ranged from 39 to 66 years. The mean age was 47 years. Most of the cases are supraglottic carcinoma 12 (70.59%), Glottic carcinoma in 5 (29.41%) & no subglottic carcinoma. In this study, out of 12 supraglottic cases, 4 patients were presented in stage III & 8 in stage IV. Among the glottic cases 1 patient presented in stage I, 2 in stage III & 2 patients presented in stage IV. Patients were followed up monthly for 3 months & then after 6 months for life long. 2 patients (11.76%) developed pharyngocutaneous fistula within 7th to 15th post-operative day & these patients were managed conservatively which involved adequate drainage, frequent dressing & fresh blood transfusion. With these conservative management fistula healed completely within 3 to 4 weeks. 3 patients (17.65%) developed wound infection. Wound swab was sent for culture & sensitivity and antibiotics changed accordingly. Wound healed within 2-3 weeks with conservative treatment & adequate aseptic dressing. 1 patient (5.88%) developed postoperative hematoma which was drained immediately. This patient developed wound infection later on & was managed conservatively. 2 patients (11.76%) developed stomal recurrence 4 months after surgery, which was confirmed by biopsy. The cases were inoperable & were sent for radiotherapy. 2 patients (11.76%) developed dysphagia due to pharyngeal stenosis 4 months after surgery. Conclusion: The most frequent troublesome immediate complication is pharyngocutaneous fistula all of which have been treated conservatively with satisfactory result. Preoperative radiotherapy is an important risk factor for the development of pharyngocutaneous fistula in total laryngectomy. Bangladesh J Otorhinolaryngol; April 2019; 25(1): 10-18


2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18614-18614
Author(s):  
N. J. Tirgan ◽  
A. H. Hamrahian

18614 Background: Primary adrenocortical carcinoma (PAC) is a rare disease with a incidence of 1 per million. PAC’s are highly malignant tumors with guarded prognosis. Radical surgery is the treatment of choice. Methods: The pathology database and medical charts of these patients were retrospectively reviewed. Results: There were 14 females, 8 males, and 95% were caucasion. The mean age was 49.2 ± 11.8 years (females 51.6 years, males 45 years). The mean size of the tumor was 12.6 ± 5.1 cm (range of 3.6 to 25 cm). Thirteen patients (59.1%) presented with left and nine (40.9%) with right sided PAC. Seventy- two percent of the patients had abdominal, back, and/or flank pain. Forty five percent of patients had symptoms related to hypercortisolism and/or hyperandrogenism. Twelve patients (55%) had functional tumors (hypercortisolism 67%, hyperandrogenism 42%, and DHEA-S hypersecretion 42%) and ten were non-functional. Five percent of the tumors were classified as stage I, 33% were stage II, 38% were stage III, and 24% were stage IV. Twelve patients (55%) had distant metastases (liver 75%, lung 67%, retroperitoneum 33%, kidney 17%, contra-lateral adrenal gland 17%). All 22 patients had adrenalectomies (open 91%; laparoscopic 9%). The microscopic margin of resection were negative in 14 and positive in 6 patients. The information for 18 patients were evaluable for treatment. Eight patients received post-op therapy. Four patients received Mitotane (o,p’-DDD) alone (three died at 2, 29, and 213 months; and one is alive at 38 months after diagnosis). Three patients received both Mitotane and chemotherapy (two died at 3 and 43 months, one is alive at 140 months). One patient received only chemotherapy and died at 8 months. Ten patients received no post-op therapy. The estimated 5-year survival for the entire group was 48% (Kaplan-Meier survival estimate, 95% confidence interval). The estimated 5-year survival for stage III was 33%, and for stage IV was 30%. There were no deaths in patients with stage II group. The estimated 5-year survival for the treated group (8 patients) was 33% and 58% for the untreated group (10 patients). Conclusions: In PACs, surgery remains the main method of therapy. In our experience, Mitotane with or without chemotherapy did not improve survival. No significant financial relationships to disclose.


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