Electrochemotherapy of Posterior Resection Surface for Lowering Disease Recurrence Rate in Pancreatic Cancer (PanECT Study)

2020 ◽  
Author(s):  
Keyword(s):  
Pancreatic Cancer ◽  
Recurrence Rate ◽  
Disease Recurrence

scholarly journals The plasticity of pancreatic cancer stem cells: implications in therapeutic resistance

2021 ◽  
Author(s):  
Kalyani Patil ◽  
Farheen B. Khan ◽  
Sabah Akhtar ◽  
Aamir Ahmad ◽  
Shahab Uddin
Keyword(s):  
Pancreatic Cancer ◽  
Stem Cells ◽  
Cancer Stem Cells ◽  
Disease Recurrence ◽  
Resistance Mechanisms ◽  
Cytotoxic Agents ◽  
Plastic State ◽  
Metastatic Progression ◽  
Acquired Drug Resistance ◽  
Natural Agents

AbstractThe ever-growing perception of cancer stem cells (CSCs) as a plastic state rather than a hardwired defined entity has evolved our understanding of the functional and biological plasticity of these elusive components in malignancies. Pancreatic cancer (PC), based on its biological features and clinical evolution, is a prototypical example of a CSC-driven disease. Since the discovery of pancreatic CSCs (PCSCs) in 2007, evidence has unraveled their control over many facets of the natural history of PC, including primary tumor growth, metastatic progression, disease recurrence, and acquired drug resistance. Consequently, the current near-ubiquitous treatment regimens for PC using aggressive cytotoxic agents, aimed at ‘‘tumor debulking’’ rather than eradication of CSCs, have proven ineffective in providing clinically convincing improvements in patients with this dreadful disease. Herein, we review the key hallmarks as well as the intrinsic and extrinsic resistance mechanisms of CSCs that mediate treatment failure in PC and enlist the potential CSC-targeting ‘natural agents’ that are gaining popularity in recent years. A better understanding of the molecular and functional landscape of PCSC-intrinsic evasion of chemotherapeutic drugs offers a facile opportunity for treating PC, an intractable cancer with a grim prognosis and in dire need of effective therapeutic advances.

scholarly journals Evaluation of Cases of Abdominal Wall Endometriosis at Universidade Estadual de Campinas in a period of 10 Years

2017 ◽  
Vol 39 (08) ◽  
pp. 403-407 ◽  
Author(s):  
Daniela Yela ◽  
Lucas Trigo ◽  
Cristina Benetti-Pinto
Keyword(s):  
Cesarean Section ◽  
Abdominal Wall ◽  
Recurrence Rate ◽  
Clinical Manifestations ◽  
Disease Recurrence ◽  
Surgical Margins ◽  
Abdominal Wall Endometriosis ◽  
Postoperative Control ◽  
Epidemiological Characteristics ◽  
Previous Cesarean

Purpose To determine the clinical and epidemiological characteristics of abdominal wall endometriosis (AWE), as well as the rate and recurrence factors for the disease. Methods A retrospective study of 52 women with AWE was performed at Universidade Estadual de Campinas from 2004 to 2014. Of the 231 surgeries performed for the diagnosis of endometriosis, 52 women were found to have abdominal wall endometriosis (AWE). The frequencies, means and standard deviations of the clinical characteristics of these women were calculated, as well as the recurrence rate of AWE. To determine the risk factors for disease recurrence, Fisher's exact test was used. Results The mean age of the patients was 30.71 ± 5.91 years. The main clinical manifestations were pain (98%) and sensation of a mass (36.5%). We observed that 94% of these women had undergone at least 1 cesarean section, and 73% had used medication for the postoperative control of endometriosis. The lesion was most commonly located in the cesarean section scar (65%). The recurrence rate of the disease was of 26.9%. All 14 women who had relapsed had surgical margins compromised in the previous surgery. There was no correlation between recurrent AWE and a previous cesarean section (p = 0.18), previous laparotomy (p = 0.11), previous laparoscopy (p = 0.12) and postoperative hormone therapy (p = 0.51). Conclusion Women with previous cesarean sections with local pain or lumps should be investigated for AWE. The recurrence of AWE is high, especially when the first surgery is not appropriate and leaves compromised surgical margins.

Randomized Double-Blind Trial of Estrogen Replacement Therapy Versus Placebo in Stage I or II Endometrial Cancer: A Gynecologic Oncology Group Study

2006 ◽  
Vol 24 (4) ◽  
pp. 587-592 ◽  
Author(s):  
Richard R. Barakat ◽  
Brian N. Bundy ◽  
Nick M. Spirtos ◽  
Jeffrey Bell ◽  
Robert S. Mannel
Keyword(s):  
Endometrial Cancer ◽  
Placebo Group ◽  
Replacement Therapy ◽  
Recurrence Rate ◽  
Estrogen Replacement Therapy ◽  
Disease Recurrence ◽  
Stage I ◽  
Age At Diagnosis ◽  
Estrogen Replacement

Purpose To determine the effect of estrogen replacement therapy (ERT) on recurrence rate and survival in women who have undergone surgery for stage I or II endometrial cancer. Patients and Methods After surgery, eligible patients were allocated to therapy with ERT or placebo after undergoing hysterectomy with or without pelvic and aortic nodal sampling. Planned duration of hormonal versus placebo treatment was 3 years, with an additional 2 years of follow-up. Results The median follow-up time for all 1,236 eligible and assessable patients was 35.7 months. Stage, grade, histologic subtype, and percentage of patients receiving adjuvant therapy were similarly distributed between the groups. The median age at diagnosis for the 618 patients randomly assigned to ERT was 57 years (range, 26 to 91 years). Two hundred fifty-one patients (41.1%) were compliant with ERT for the entire treatment period. Disease recurrence was experienced in 14 patients (2.3%). Eight patients (1.3%) developed a new malignancy. There were 26 deaths (4.2%), and five deaths (0.8%) were a result of endometrial cancer. The median age at diagnosis for the 618 patients in the placebo group was 57 years (range, 30 to 88 years). Twelve patients (1.9%) experienced disease recurrence. Ten patients (1.6%) developed a new malignancy. There were 9 deaths (3.1%) in the placebo group, and four deaths (0.6%) were a result of endometrial cancer. Conclusion Although this incomplete study cannot conclusively refute or support the safety of exogenous estrogen with regard to risk of endometrial recurrence, it is noteworthy that the absolute recurrence rate (2.1%) and the incidence of new malignancy were low.

scholarly journals Survival and Disease Recurrence in Patients with Duodenal Neuroendocrine Tumours—A Single Centre Cohort

Cancers ◽  
2021 ◽  
Vol 13 (16) ◽  
pp. 3985
Author(s):  
Oddry Folkestad ◽  
Hans H. Wasmuth ◽  
Patricia Mjønes ◽  
Reidun Fougner ◽  
Øyvind Hauso ◽  
...  
Keyword(s):  
Overall Survival ◽  
Recurrence Rate ◽  
Surgical Resection ◽  
Endoscopic Treatment ◽  
Neuroendocrine Tumours ◽  
Disease Recurrence ◽  
Tumour Grade ◽  
Single Centre ◽  
Duodenal Neuroendocrine Tumours

Background: Duodenal neuroendocrine tumours (D-NETs) are rare but increasingly diagnosed. This study aimed to assess the overall survival and recurrence rate among patients treated for D-NETs. Methods: Patients with D-NETs were retrospectively reviewed with a median follow-up time of 4.8 years (range 0.0–17.2 years). Results: A total of 32 patients with median age 68.0 years were identified. Fifteen patients underwent surgery while ten patients underwent endoscopic treatment. Mean estimated overall survival for the entire population was 12.1 years (95% CI 9.5–14.7 years), while 5-year overall survival was 81.3%. Tumour grade G1 was associated with longer mean estimated survival compared to G2 tumours (13.2 years versus 4.4 years, p = 0.010). None of the 23 patients who underwent presumed radical endoscopic or surgical resection had disease recurrence during follow-up. Tumours <10 mm could be treated endoscopically whereas a high proportion of patients with tumours 10–20 mm should be considered for surgery. Conclusion: Patients with D-NETs had long overall survival, and mortality was more influenced by other diseases. Both endoscopic and surgical resections were effective as no recurrences were diagnosed during follow-up.

Impact of postoperative complications on pancreatic cancer survival and recurrence.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 446-446
Author(s):  
Masahiro Asari ◽  
Toru Aoyama ◽  
Yusuke Katayama ◽  
Masaaki Murakawa ◽  
Koichiro Yamaoku ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pancreatic Cancer ◽  
Overall Survival ◽  
Postoperative Complications ◽  
Cancer Survival ◽  
Disease Recurrence ◽  
Lymphatic Invasion ◽  
Curative Surgery ◽  
Independent Risk Factors ◽  
The Impact

446 Background: We investigated the impact of postoperative complications on pancreatic cancer survival and recurrence after curative surgery. Methods: This study included 164 patients who underwent curative surgery for pancreatic cancer between 2005 and 2014. The patients were classified into those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for overall survival (OS) and recurrence-free survival (RFS) were identified. Results: Postoperative complications were found in 61 of the 164 patients (37.2%). The RFS rate at five years after surgery was 10.6% in the C group patients and was 21.0% in the NC group patients. The RFS tended to be worse in the C group than in the NC group (p=0.1756). The OS rate at five years after surgery was 7.4% in the C group and 22.8% in the NC group, which was significantly different (p=0.0189). The multivariate analysis demonstrated that postoperative complications and lymphatic invasion were significant independent risk factors for the RFS and OS. Conclusions: The development of postoperative complications was a risk factor for a decreased overall survival and for disease recurrence in patients who underwent curative surgery for pancreatic cancer. The surgical procedure, perioperative care and the surgical strategy should be carefully planned to avoid complications.

Phase III, international, randomized trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P + G) versus gemcitabine (G) for resected pancreatic cancer (APACT): Recurrence patterns.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 704-704
Author(s):  
Vaibhav Sahai ◽  
Josep Tabernero ◽  
Eric Van Cutsem ◽  
Michele Reni ◽  
Margaret A. Tempero ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Local Recurrence ◽  
Disease Free Survival ◽  
Disease Recurrence ◽  
Geographic Region ◽  
Phase Iii ◽  
Lymph Node Status ◽  
Liver Recurrence ◽  
R1 Resection ◽  
Recurrence Patterns

704 Background: APACT did not meet the primary endpoint of independently assessed disease-free survival (DFS) with nab-P + G vs G; overall survival showed a nominal improvement. Here, we report recurrence patterns by resection status. Methods: A total of 866 treatment-naive patients (pts) with histologically confirmed pancreatic cancer, R0/R1 resection, CA19-9 < 100 U/mL, and ECOG PS ≤ 1 received 6 cycles of nab-P + G or G on days 1, 8, and 15 Q28 days. Stratification: resection (R0/R1); lymph node status (LN+/−); geographic region. Disease recurrence was per investigator review of CT/MRI scans. Results: Of 571 (66%) pts with investigator-assessed DFS events (median follow up, 35.4 mo), 543 had radiographic progression with 764 recurrent lesions (≥ 20 events: liver, 271; unspecified abdominal organ, 152; lung, 130; surgical bed, 70; mesenteric nodes, 54). Most pts (73%) had only abdominal, 61% had only distant, and 10% had only local recurrence (Table). Although more pts with R1 vs R0 status had recurrence (72% vs 60%), patterns were generally similar, and local recurrence was similarly low. Conclusions: Most recurrences in APACT were distant and in abdomen (liver). Recurrence patterns were generally similar in pts with R0 and R1 status, with low rates of local recurrence. These data may help make more informed pt management decisions. Additional data on patterns by baseline characteristics will be presented. Clinical trial information: NCT01964430 . [Table: see text]

Improved Survival in Patients with Stage II Adrenocortical Carcinoma Followed Up Prospectively by Specialized Centers

2010 ◽  
Vol 95 (11) ◽  
pp. 4925-4932 ◽  
Author(s):  
Martin Fassnacht ◽  
Sarah Johanssen ◽  
Wiebke Fenske ◽  
Dirk Weismann ◽  
Ayman Agha ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Adrenocortical Carcinoma ◽  
Cohort Analysis ◽  
Disease Recurrence ◽  
Stage Ii ◽  
Newly Diagnosed ◽  
Prospective Group ◽  
Specialized Center ◽  
Specialized Care ◽  
Referral Bias

Context: Median survival in stage II adrenocortical carcinoma (ACC) differs widely in published series ranging between 23 and more than 60 months. We hypothesized that these results may have been affected by a referral bias because many patients may contact specialized centers only after recurrence. Objective: The objective of the study was a comparison of outcome in patients with stage II ACC who were followed up prospectively early after surgery and were counseled by a specialized center (prospective group) with patients who registered with the German ACC registry later than 4 months after diagnosis (retrospective group). Patients/Methods: The study was a cohort analysis in 149 adult patients with stage II ACC. Results: Patients who were followed up prospectively (n = 30) had a lower recurrence rate and a superior 5-yr survival compared with the 119 patients in the retrospective group (30 vs. 74%, P &lt; 0.01 and 96 vs. 55%, P &lt; 0.05, respectively). In the retrospective group, 67% of the patients had registered only after disease recurrence. In the remaining patients, the recurrence rate was low (21%), and the 5-yr survival was greater than 95%. More patients in the prospective group received adjuvant mitotane (53 vs. 16%, P &lt; 0.001), and adjuvant mitotane was associated with improved survival [hazard risk 0.35 (95% confidence interval 0.13–0.97); P = 0.04]. However, the survival advantage was maintained when only patients without mitotane therapy were analyzed. Conclusions: Patients who are followed up prospectively after surgery for stage II ACC and receive early specialized care have a much better prognosis than previously reported due to a major referral bias in previous series and use of adjuvant mitotane. These findings will impact on the perception of prognosis in newly diagnosed stage II ACC.

scholarly journals Laparoscopic Radical Antegrade Modular Pancreatosplenectomy: Preliminary Experience with 10 Cases

2021 ◽  
Author(s):  
Renchao Zhang ◽  
Xin-Jun Gan ◽  
Wei Song ◽  
Song-Tao Shi ◽  
Hui-Fang Yu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Nodes ◽  
Hospital Stay ◽  
Disease Recurrence ◽  
Postoperative Hospital Stay ◽  
Regional Lymph Nodes ◽  
Patient Demographics ◽  
Radical Antegrade Modular Pancreatosplenectomy ◽  
Distal Pancreas

Abstract BackgroundThe radical antegrade modular pancreatosplenectomy (RAMPS) which is a reasonable surgical approach for left-sided pancreatic cancer is emphasis on the complete resection of regional lymph nodes and tumor-free margin resection. Laparoscopic radical antegrade modular pancreatosplenectomy(LRAMPS) has been rarely performed, with only 49 cases indexed on PubMed. In this study, we present our experience of LRAMPS.Methods: From December 2018 to February 2020, 10 patients underwent LRAMPS for pancreatic cancer at our department. The data of the patient demographics, intraoperative variables , postoperative hospital stay, morbidity, mortality, pathologic findings and follow-up were collected.Results：LRAMPS was performed successfully in all the patients. The median operative time was 235 minutes (range, 212-270min), with an EBL of 120ml(range,100-200ml) . Postoperative complications occurred in 5 (50.0%) patients. Three patients developed a grade B pancreatic fistula. There was no postoperative 30-day mortality and reoperation. The median postoperative hospital stay was 14 days(range,9- 24d).The median count of retrieved lymph nodes was 15 (range, 13–21), and four patients (40%) had malignant-positive lymph nodes. All cases achieved a negative tangential margin and R0 resection.Median follow-up time was 11 months (range, 3–14m). Two patients developed disease recurrence(pancreatic bed recurrence and liver metastasis) 9 months,10 months after surgery,respectively. Others survived without tumor recurrence or metastasis．ConclusionsLRAMPS is technically safe and feasible procedure in well-selected patients with pancreatic cancer in the distal pancreas. The oncologically outcomes need to be further validated based on additional large-volume studies.

scholarly journals Recurrence Pattern and Complication Rate of Allergic Fungal Sinusitis: A 10-Year Tertiary Center Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yazeed Alghonaim ◽  
Abdulrhman Alfayez ◽  
Riyadh Alhedaithy ◽  
Abdullah Alsheikh ◽  
Malak Almalki
Keyword(s):  
Chronic Rhinosinusitis ◽  
Recurrence Rate ◽  
Nasal Obstruction ◽  
Recurrent Disease ◽  
Disease Recurrence ◽  
Fungal Sinusitis ◽  
Allergic Fungal Sinusitis ◽  
Bilateral Disease ◽  
Fungal Rhinosinusitis ◽  
Allergic Fungal Rhinosinusitis

Background. Allergic fungal rhinosinusitis is a noninvasive form of highly recurrent chronic rhinosinusitis. Despite the advancement in medical and surgical strategies, recurrence in AFRS in general poses another challenging problem with reported incidence that eventually can reach more than 60%. Recognition and understanding the pattern of disease recurrence will lead to greater understanding of the disease response in our population. Method. A retrospective cohort study was performed in King Abdulaziz Medical City in Riyadh, Saudi Arabia. All patients diagnosed with chronic rhinosinusitis and underwent functional endoscopic sinus surgery from the period of January 2006 to December 2016 were reviewed. Results. 28 patients were found to have AFRS based on clinical, radiological, and microscopic examination suggestive of allergic fungal rhinosinusitis. Among these patients, 53% of them were female and 46% were male. The age ranged from 13 to 55 years, with a mean age of 31.57 years. 28.57% of the patients presented with recurrent allergic fungal sinusitis. The duration between the surgery and symptoms recurrence was around one year. Male and female patients had similar recurrence rate (50%). At first visit, 95% of the patients with nonrecurrent disease presented with nasal obstruction compared to 87.5% of the patients with recurrent disease. On the other hand, patients with recurrent disease had more nasal discharge (87.5%), postnasal drip (37.5%), facial pressure/pain (50%), headache (50%), nasal polyposis (87.5%), hypertrophy of inferior turbinate (37.5%), and proptosis (12.5%). Nasal obstruction (87.5%) and nasal polyps (87.5%) were the most common presenting symptoms for the disease recurrence. The pattern of disease recurrence in the previously unilateral disease was 18% ipsilateral and 27% bilateral. For the patients who had bilateral disease formerly, 17% (n = 3) of them had recurrent bilateral disease. Conclusion. Allergic fungal rhinosinusitis is a distinct clinical entity. A high recurrence rate is a pathognomonic feature of the disease, despite all the development in medical and surgical trials. This study demonstrated that recurrence rate is lower in our population. However, more studies with a greater number of patients are needed in the future to clearly recognize the pattern of recurrence in patients with AFRS.

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