AN UNUSUAL CASE OF DUAL SITE LATE RECURRENCE FOLLOWING SURGERY FOR LOW-RISK ENDOMETROID CARCINOMA: A REPORT OF A CASE

2017 ◽  
Author(s):  
SAURABH PHADNIS
Keyword(s):  
Unusual Case ◽  
Late Recurrence ◽  
Low Risk ◽  
Dual Site

Late Recurrence of Low-Risk Stage II Colorectal Cancer Shortly After Etanercept

2015 ◽  
Vol 47 (4) ◽  
pp. 506-508 ◽  
Author(s):  
Tony Ibrahim ◽  
Khalil Saleh ◽  
Viviane Track-smayra ◽  
Nelly Ziade ◽  
Dalia Sarraf ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Late Recurrence ◽  
Low Risk ◽  
Stage Ii ◽  
Stage Ii Colorectal Cancer

Utility of the Breast Cancer Index (BCI) in the clinical practice.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14723-e14723
Author(s):  
Saranya Kodali ◽  
Eswar Tipirneni ◽  
Kim Dittus
Keyword(s):  
Breast Cancer ◽  
Side Effects ◽  
High Risk ◽  
Endocrine Therapy ◽  
Early Stage ◽  
Late Recurrence ◽  
Low Risk ◽  
Breast Cancer Index ◽  
Pathologic Features ◽  
Poor Tolerance

e14723 Background: Extended endocrine therapy (EET) greater than 5 years in early stage hormone receptor positive (HR+) breast cancer (BC) patients has shown benefit. However, EET is associated with side effects and there is no validated assay to determine which group of patients would derive benefit. Breast Cancer Index (BCI) is a validated bio-marker test that incorporates 2 distinct genomic assays and is prognostic/predictive. The objective of this study is to assess patient characteristics, pathologic features and patient preferences with regards to extending endocrine therapy after reviewing the BCI results. Methods: We performed a retrospective chart review on early stage HR+ BC patients from Jan, 2016 to Jan, 2017 at the University of Vermont Medical Center. We identified 25 cases on whom BCI was submitted. Results: Median age was 68 years. Majority of the patients were stage IA (64%). 56% of the tumors were moderately differentiated. All patients were ER +ve and 12% were HER2+. Median tumor size was 1.4 cm (0.3-4). 76% had poor tolerance to the ET and preferred the test to be sent. In LN-patients, BCI identified 42% as high risk and 52% as low risk for late recurrence and 32% who derive high benefit from EET. In LN+ patients, BCI identified 75% as high risk for late recurrence and 25% as low risk for late recurrence. 40% of the entire group were identified to highly benefit from EET (70% agreed to continue ET and 30% denied due to side effects). Conclusions: BCI is a reasonable test to consider in early stage HR+ BC, especially in patients with poor tolerance to ET. This test might aid in decision making with tolerability/compliance challenges to EET. [Table: see text]

scholarly journals Rare brain metastasis with unusual characteristics in a late recurrence of stage IIIA uterine papillary serous carcinoma

2021 ◽  
pp. 20200157
Author(s):  
Charles Nicolas Crain ◽  
Remy Ngwanyam ◽  
Gregory Punch
Keyword(s):  
Brain Metastasis ◽  
Unusual Case ◽  
Late Recurrence ◽  
Brain Lesions ◽  
Serous Carcinoma ◽  
Stage Iiia ◽  
Uterine Papillary Serous Carcinoma ◽  
Imaging Characteristics ◽  
Papillary Serous Carcinoma ◽  
Disseminated Disease

Uterine papillary serous carcinoma (UPSC) is a rare endometrial neoplasm with high mortality rates. While the malignancy has often metastasized to distant organs by the time of diagnosis, brain lesions are extremely rare and most commonly only observed in widely disseminated disease. Here, we present an unusual case of UPSC with brain metastasis discovered six years after undergoing treatment for stage IIIA disease. Compared to the few previous cases of brain metastasis from UPSC, this lesion exhibited unusual imaging characteristics. We also highlight a potential imaging interpretation pitfall which was associated with this case.

Necessity of long follow-up schedule after surgery and partial nephrectomy for patients with T1 renal cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15521-e15521
Author(s):  
Yukio Naya ◽  
Kazuhiro Araki ◽  
Masahiro Sugiura ◽  
Satoko Kojima ◽  
Shinichi Sakamoto ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Partial Nephrectomy ◽  
Renal Carcinoma ◽  
Disease Free Survival ◽  
Surgical Excision ◽  
Late Recurrence ◽  
Low Risk ◽  
Short Term Treatment

e15521 Background: Almost renal cancers are renal cell carcinoma (RCC). Short term treatment results are excellent with 90% or more disease specific and overall survival at 5year. Follow up schedule of NCCN guideline for low risk group was up to 5 years after surgery. Although, we have experienced late recurrence in such a low risk cases. Therefore, we examined the recurrence of T1 and T2 renal carcinoma in our institute, retrospectively. Methods: Between March 1997 and September 2009, 580 patients with renal carcinoma were undergone surgical excision of renal tumor at Chiba University Hospital. In these cases,349 patients were T1 without metastasis. We analyzed the clinopathological deta of these 349 patents. Univariate and multivariate analysis were conducted to identify the prognostic factor of T1a or T1b patients with surgical excision. Results: During follow up, 5, 10, 15 and 20 years overall survival rate(OS) of T1a were 98.1%, 98.1%, 90.6% and 90.6%, respectively. Those of T1b were 95.8%, 92.7%, 90.2% and 90.2%, respectively. 5, 10, 15 and 20 years disease free survival rate (DFS) of T1a was 93.1%, 86.6%, 76.8%, 38.4%, respectively. 5, 10, 15 and 20 years DFS of T1b was 82.9 %, 66.5%, 58%, 50.8% ,respectively. 33% of metastasis was lung 10% of metastasis was contralateral kidney. Conclusions: 20 years OS of T1a was an excellent, however, 20 years DFS was 38.4%. Life expectancy of Japanese men and women in 2009 were 79.59 years old and 86.44 years old. Almost patients with T1a renal carcinoma might have a late recurrence. We think it is necessary to long follow p schedule for T1 cancer and partial nephrectomy is recommended.

Clinical utilization of Breast Cancer Index (BCI) for late recurrence risk assessment and prediction of extended endocrine therapy (EET) benefit in early stage HR+ breast cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 551-551
Author(s):  
Reshma L. Mahtani ◽  
Vijayakrishna K. Gadi ◽  
Theresa N. Operana ◽  
Harris S Soifer ◽  
Brock Schroeder ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
High Risk ◽  
Early Stage ◽  
Patient Characteristics ◽  
Recurrence Risk ◽  
Late Recurrence ◽  
Distant Recurrence ◽  
Low Risk ◽  
Extended Endocrine Therapy

551 Background: Randomized trials demonstrated a modest (3-5%) absolute benefit from EET in patients (pts) with early stage HR+ breast cancer (BC), but also a risk of toxicities. BCI is a validated gene expression-based assay that provides 2 results: BCI Prognostic, based on the algorithmic combination of HoxB13/IL17BR (H/I ratio) and a set of proliferation-based genes, reports individualized risk of late distant recurrence (DR); BCI Predictive, based on H/I alone, reports a prediction of high vs low likelihood of benefit from EET. The objective of this study was to assess clinical and pathologic patient characteristics, prognostic and predictive assay results, and physician testing patterns in >14,000 clinical cases. Methods: The BCI Clinical Database for Correlative Studies is a de-identified database developed under an IRB approved protocol that contains >50 clinicopathologic and molecular variables from cases submitted for BCI in clinical practice. Clinicopathologic variables were abstracted from pathology reports, and were available for a subset of cases. Results: Across all pts (N=14,463), median age was 58.2y (range: 23-92y; 73.9% ≥50y). The majority were Stage I (47.3% IA, 3.5% IB, 29.1% IIA, 14.1% IIB, 6% III). Cases were 29%, 51%, and 20% Grade 1, 2, and 3, respectively. Most pts were ER+/PR+ (87.7%) or ER+/PR- (11.3%); 11.3% were HER2+. The majority of cases (55.7%) were ordered 4-6y postdiagnosis, with 23.1% >6y, 14.4% between 1-4y, and 6.8% <1y postdiagnosis. In LN- pts (n=3395), BCI Prognostic identified 50.6% as low risk for late DR vs 49.4% as high risk, while BCI Predictive (H/I) classified 41.0% as high vs 59.0% as low likelihood of benefit. In LN+ pts tested with the BCIN+ Prognostic algorithm (BCI + size/grade, n=818), 77.3% were classified as high risk vs 22.7% as low risk, while BCI Predictive (H/I) classified 44.6% and 55.4% as high vs low likelihood of benefit. Conclusions: Findings from this large cohort characterize utilization of BCI in clinical practice for pts with early-stage, HR+ BC. BCI stratification of pts with high risk and high likelihood of benefit from EET may facilitate selection of pts for prolonged regimens.

scholarly journals An Unusual Case of Complete Aortic Dissection in a Low-Risk Female

CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 60A
Author(s):  
Adnan Raza ◽  
Mouzam Faroqui ◽  
Salman Haq
Keyword(s):  
Aortic Dissection ◽  
Unusual Case ◽  
Low Risk

Clinical validity of CTS5 for estimating risk of late recurrence in unselected, non-trial patients with early ER+ breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 514-514 ◽  
Author(s):  
Juliet Richman ◽  
Alistair E. Ring ◽  
Mitchell Dowsett ◽  
Ivana Sestak
Keyword(s):  
Breast Cancer ◽  
Postmenopausal Women ◽  
Endocrine Therapy ◽  
Cox Regression ◽  
Premenopausal Women ◽  
Risk Groups ◽  
Late Recurrence ◽  
Distant Recurrence ◽  
Low Risk ◽  
Clinical Validity

514 Background: The Clinical Treatment Score at 5 years (CTS5) is a prognostic tool using clinicopathological data to estimate distant recurrence (DR) risk after 5 years of endocrine therapy for postmenopausal women with estrogen receptor positive (ER+) breast cancer. It was developed and validated in the ATAC and BIG 1-98 trials. Methods: The validity of CTS5 was tested in a retrospective cohort of unselected, non-trial patients diagnosed with early ER+ breast cancer at the Royal Marsden Hospital from 2000-2007 who were alive and distant recurrence-free at 5 years. The primary endpoint was time to late DR (5-10 years). Cox regression models were used to determine the prognostic value of CTS5 and to produce Kaplan-Meier curves with associated 10-year DR risks (%). Results: A total of 2428 women were included with a median follow-up of 9.34 years from diagnosis. The CTS5 was significantly prognostic for late DR in post- and premenopausal women (Table). Risk stratification by CTS5 of the postmenopausal cohort was comparable with the development cohort. 42.1% of postmenopausal women were categorised into the low risk group with a late DR risk of 4.9% and these women had significantly lower risk of late DR compared to those in the intermediate or high-risk groups (Table). Amongst the premenopausal cohort, 41% were categorised as low risk with a late DR risk of 4.9%. The prognostic effect of CTS5 was seen for chemotherapy treated (HR=2.26, 95% CI (1.68-3.03)) and untreated patients (HR=1.93, 95% (1.32-2.82)). Conclusions: CTS5 demonstrated clinical validity for predicting late DR within a large cohort of unselected, non-trial patients that included premenopausal women. The low risk cohort identified by the CTS5 represents a group of women whose risk of late DR is so low as to not warrant extended endocrine therapy to ten years. [Table: see text]

Exploring the Validity and Operational Impact of Using Allied Health Assistants to Conduct Dysphagia Screening for Low-Risk Patients Within the Acute Hospital Setting

2020 ◽  
Vol 29 (4) ◽  
pp. 1944-1955 ◽  
Author(s):  
Maria Schwarz ◽  
Elizabeth C. Ward ◽  
Petrea Cornwell ◽  
Anne Coccetti ◽  
Pamela D'Netto ◽  
...  
Keyword(s):  
At Risk ◽  
Allied Health ◽  
Assessment Tool ◽  
Hospital Setting ◽  
Low Risk ◽  
False Negatives ◽  
Exact Agreement ◽  
Risk Patients ◽  
Impact Phase ◽  
Operational Impact

Purpose The purpose of this study was to examine (a) the agreement between allied health assistants (AHAs) and speech-language pathologists (SLPs) when completing dysphagia screening for low-risk referrals and at-risk patients under a delegation model and (b) the operational impact of this delegation model. Method All AHAs worked in the adult acute inpatient settings across three hospitals and completed training and competency evaluation prior to conducting independent screening. Screening (pass/fail) was based on results from pre-screening exclusionary questions in combination with a water swallow test and the Eating Assessment Tool. To examine the agreement of AHAs' decision making with SLPs, AHAs ( n = 7) and SLPs ( n = 8) conducted an independent, simultaneous dysphagia screening on 51 adult inpatients classified as low-risk/at-risk referrals. To examine operational impact, AHAs independently completed screening on 48 low-risk/at-risk patients, with subsequent clinical swallow evaluation conducted by an SLP with patients who failed screening. Results Exact agreement between AHAs and SLPs on overall pass/fail screening criteria for the first 51 patients was 100%. Exact agreement for the two tools was 100% for the Eating Assessment Tool and 96% for the water swallow test. In the operational impact phase ( n = 48), 58% of patients failed AHA screening, with only 10% false positives on subjective SLP assessment and nil identified false negatives. Conclusion AHAs demonstrated the ability to reliably conduct dysphagia screening on a cohort of low-risk patients, with a low rate of false negatives. Data support high level of agreement and positive operational impact of using trained AHAs to perform dysphagia screening in low-risk patients.

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