scholarly journals METASTASIS AND LOCAL INVASION PATTERN OF BLADDER CANCER IN HASAN SADIKIN HOSPITAL

2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Akhmad Mustafa ◽  
Ferry Safriadi

Objective: The aim of this study is to provide database about local invasion and metastasis pattern, as well as the disease characteristics of bladder cancer in Hasan Sadikin Hospital, Bandung. Material & Methods: Between January 2011 and December 2016 there were 321 cases of bladder cancer recorded in our hospital. Of all cases, 106 patients included in this study, with evident of local invasion or distant metastasis either radiologically (contrast abdominal pelvic CT scan) or pathologically. Results: The study group consist of 106 patients (86 men [81.7%], 20 women [28.3%]); with mean age of 56.78 ± 13.19 (4-76) years old. Histopathology findings of transitional cell carcinoma (TCC) consist of 82 (77.3%) patients and the atypical histology features group of 24 (22.7%) patients. Local invasion was found in 99 patients of 321 (30.8%), with the most common organ invasion to the prostate in male (n=38 [35.8%]). Lymph node metastasis were found in 47 patients (44.3%), with the most common nodal metastasis to obturator lymph nodes (n=21 [19.8%]). Distant metastasis was found in 24 patients (22.6%) with the most common site for distant metastasis was the liver (n=12 [11.3%]). In TCC group, 12 patients (63.1%) had a distant organ metastasis with nodal metastasis, whereas in atypical group, majority of the patients with distant organ metastasis (n=5 [83.3%]) had no lymph node involvement. Moreover, in transitional cell group, not all patient (n=17 [73.1%]) had local invasion of the tumor, while all patients with distant organ metastasis in atypical group (n=6 [100%]) had abdominal or pelvic wall invasion (cT4b). Conclusion: TCC is the most common pathology findings and with Prostate is the most common site for local tumor invasion. Obturator lymph nodes is the most common nodal metastasis and liver is the most common site for distant metastasis in bladder cancer. 

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Megumi Nishioka ◽  
Atsushi Tanemura ◽  
Takashi Yamanaka ◽  
Noriko Umegaki ◽  
Mamori Tani ◽  
...  

We report a rare case of giant squamous cell carcinoma of the buttock infiltrated to the rectum. The tumor may have arisen from syringocystadenoma papilliferum. Since there was no sign of metastasis, radical operation including rectal amputation was performed after successful neoadjuvant therapies. Afterwards, the patient has been alive free from disease for 15 months with no lymph node and distant organ metastasis.


2021 ◽  
Author(s):  
Shu Wang ◽  
Jinbo Wu ◽  
Taobo Hu

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.


2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5575-5575
Author(s):  
J. Brown ◽  
M. T. Deavers ◽  
A. M. Nick ◽  
L. Milojevic ◽  
D. M. Gershenson ◽  
...  

5575 Background: Distant metastasis is common in patients with sex cord-stromal ovarian tumors (SCSTs), but lymph node involvement is extremely rare. Given the lack of lymphatics in the normal granulosa layer, we examined the clinical relevance of angiogenesis and lymphangiogenesis in patients with SCSTs. Methods: After Institutional Review Board approval, 80 tumor samples (46 primary, 34 recurrent) were obtained from 65 patients and stained for CD31 (microvessel density; MVD), D2–40 (lymphvascular density; LVD), and VEGF. Clinical data were extracted by chart review and correlated with the angiogenesis and lymphatic markers. Results: The median age of the patients was 42.1 years (range, 8.6–78.6 years). At presentation, 53% of patients had stage I disease, 8% had stage II, 16% had stage III, and 23% were unstaged. Although VEGF expression was noted at some level in 99% of samples, VEGF overexpression (upper tertile of overall score) was noted in 35% of samples. On the basis of ROC analysis, vessel density was stratified into high versus low at a mean MVD cutoff of 12.3. High MVD was present in 41% of all tumors. High MVD was significantly associated with shorter disease-specific survival (mean 16.7 versus 32.3 months; p = 0.024), increased risk of recurrence (p < 0.04), and shorter overall survival (median 108.6 versus 388.5 months; p < 0.001). High MVD was strongly related to VEGF overexpression (p = 0.009). While VEGF expression was not related to the pattern of recurrence, high MVD was strongly associated with distant metastasis (abdomen, liver, lung, bone) compared with local recurrence (p < 0.001). Lymph node metastasis was clinically evident in only 3 of the 65 patients. Most tumors had either absent or low LVD. Interestingly, all 3 tumors with nodal metastasis had significantly greater LVD (LVD = 35.8 vessels/hpf) compared to those without nodal metastasis (LVD = 2.7 vessels/hpf; p < 0.001). Conclusions: Increased angiogenesis is a significant predictor of poor clinical outcome in patients with sex-cord stromal tumors. Most of these tumors have poor lymphatic development that might explain the low likelihood of nodal metastasis. These data provide support for further investigation of antiangiogenic biological agents in these patients. No significant financial relationships to disclose.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5583-5583
Author(s):  
Yuefeng Wang ◽  
Todd D. Tillmanns ◽  
Michael Farmer ◽  
Lillian Rinker ◽  
Bradley G. Somer ◽  
...  

5583 Background: There is growing evidence that definitive local therapies (surgery or radiotherapy) may increase patient’s survival for some types of metastatic cancers. However, the role of total abdominal hysterectomy (TAH) for newly diagnosed uterine cancer with distant organ metastasis has not been established. The objective of this study is to determine the potential overall survival (OS) benefit associated with TAH for distant metastatic uterine cancer. Methods: The National Cancer Database was analyzed to evaluate OS for newly diagnosed uterine cancer patients with metastasis to brain, lung, liver, bone or distant lymph node, treated with chemotherapy with or without TAH. Those without treatment, treated with definitive pelvic radiotherapy, or without baseline variables were excluded. OS was analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses. In order to control the selection biases, we performed Landmark analysis, and survival analysis by the sequence of chemotherapy and TAH. Separate survival analysis was performed for patients who received chemotherapy plus definitive pelvic radiotherapy (RT) or chemotherapy plus TAH and definitive pelvic RT. Results: From 2010 to 2014, 1,809 uterine cancer patients with distant organ metastasis received chemotherapy alone and 1,388 patients received chemotherapy plus TAH. At a median follow-up of 13.4 months, addition of TAH to chemotherapy was associated with improved survival on univariate (HR 0.57; P < 0.001) and multivariate analysis (HR 0.59; P < 0.001) compared to chemotherapy alone. Propensity score-matched analysis demonstrated superior median survival (19.8 vs 11.0 months) and 2-year OS (44% vs 28%) with TAH (multivariate HR 0.59; P < 0.001). Landmark analyses limited to long-term survivors of ≥0.5, ≥1, and ≥2 years showed improved OS with TAH in all subsets (all P < 0.05). The benefit of TAH was present among not only those involving one metastatic site (HR 0.59; P < 0.001), but also those involving multiple metastatic sites (HR 0.60; P < 0.001). Separate survival analyses showed chemotherapy plus definitive pelvic RT or chemotherapy plus TAH and RT were both superior to chemotherapy alone. Conclusions: In this large contemporary analysis, uterine cancer patients with distant organ metastasis receiving TAH and chemotherapy had substantial longer survival than patients treated with chemotherapy alone. Prospective trials evaluating TAH for metastatic uterine cancer are warranted.


2018 ◽  
Vol 104 (6) ◽  
pp. 434-437
Author(s):  
Hakan Türk ◽  
Sıtkı Ün ◽  
Ahmet Cinkaya ◽  
Hilmi Kodaz ◽  
Murtaza Parvizi ◽  
...  

Introduction: Radical cystectomy (RC) is the main treatment option for patients with muscle-invasive bladder cancer (MIBC) and non-muscle-invasive bladder cancer (NMIBC), which carry the highest risk of progression. In this study, we investigated the effect of time from transurethral resection of the bladder (TUR-B) to cystectomy on lymph node positivity, cancer-specific survival and overall survival in patients with MIBC. Methods: The records were reviewed of 530 consecutive patients who had RC and pelvic lymphadenectomy procedures with curative intent performed by selected surgeons between May 2005 and April 2016. Our analysis included only patients with transitional cell carcinoma of the bladder; we excluded 23 patients with other types of tumor histology. Results: Patients who underwent delayed RC were compared with patients who were treated with early RC; both groups were similar in terms of age, gender, T stage, tumor grade, tumor differentiation, lymph node status and metastasis status. However, when both groups were compared for disease-free survival and overall survival, patients of the early-RC group had a greater advantage. Conclusions: The optimal time between the last TUR-B and RC is still controversial. A reasonable time for preoperative preparation can be allowed, but long delays, especially those exceeding 3 months, can lead to unfavorable outcomes in cancer control.


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