scholarly journals Oncological Outcomes of Patients With Different Pathological Features of pT3a Renal Tumor: A Systematic Review and Quantitative Synthesis

2021 ◽  
Vol 11 ◽  
Author(s):  
Pengju Guo ◽  
Yongxing Wang ◽  
Yili Han ◽  
Dechao Wei ◽  
Jiahui Zhao ◽  
...  
Keyword(s):  
Positive Margin ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Fuhrman Grade ◽  
Oncological Outcomes ◽  
Quantitative Synthesis ◽  
Node Involvement ◽  
Cancer Specific Mortality ◽  
Risk Of Cancer ◽  
Invasion Patterns

PurposeTo identify the differences in oncological outcomes for patients with different pT3a renal tumor invasion patterns and pathological features.MethodsThe protocol of this study was registered on PROSPERO (CRD42021234475). Relevant studies were identified by searching the PubMed, Cochrane library, Embase, and Web of Science databases. Cancer-specific survival (CSS) was selected as the endpoint. Pooled hazard ratio (HR) and 95% confidence interval (CI) extracted from multivariate Cox models were evaluated to identify the hazard association.ResultsA total of 22 studies, which enrolled 12384 patients were included for quantitative synthesis. Sinus fat invasion (SFI) + perinephric fat invasion (PFI) was associated with inferior CSS compared to SFI only (p = 0.02). Comparable CSS was observed between SFI and PFI (p = 0.57). SFI ± PFI showed inferior CSS compared to PFI only (p = 0.0002). The presence of pelvicalyceal system invasion significantly increased the risk of cancer-specific mortality (p = 0.0005). Renal vein invasion (RVI) indicated poor oncological outcomes in terms of CSS (p = 0.002). The concomitant RVI and fat invasion (FI) significantly increased the risk of deterioration of CSS compared to RVI or FI (p < 0.0001). Multiple invasion patterns translated into a significantly decreased CSS (p < 0.0001). Aggressive tumor behavior, including lymph node involvement (p = 0.006), distant metastases (p < 0.00001), sarcomatoid differentiation (p < 0.0001), necrosis (p < 0.0001), Fuhrman grade III or IV (p < 0.0001), positive margin (p < 0.0001), and tumor size >7cm (p < 0.0001) were the predictors of inferior CSS. The lymphovascular invasion (p = 0.67) was indolent in terms of CSS.ConclusionThis study confirmed the heterogenicity of pT3a renal tumors. Multiple invasion patterns could translate into a significantly decreased CSS, and SFI should not be merged in the SFI + PFI group. The presence of PSI or RVI could significantly increase the risk of cancer-specific mortality. Lymph node involvement, distant metastases, sarcomatoid differentiation, necrosis, high Fuhrman grade, positive margin, and size >7cm were the predictors of inferior CSS. A precise-risk grade of CSS for different invasion patterns including comprehensive combinations may be useful for the further refinements of the TNM system.Systematic Review RegistrationThe current study was registered on PROSPERO, and the registration numbers is CRD42021234475.

scholarly journals PD-L1 Expression in Muscle Invasive Urothelial Carcinomas as Assessed via Immunohistochemistry: Correlations with Specific Clinical and Pathological Features, with Emphasis on Prognosis after Radical Cystectomy

Life ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 404
Author(s):  
Ioan Alin Nechifor-Boilă ◽  
Andrada Loghin ◽  
Adela Nechifor-Boilă ◽  
Myriam Decaussin-Petrucci ◽  
Septimiu Voidăzan ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Histological Variant ◽  
Node Involvement ◽  
Positive Score ◽  
Checkpoint Inhibitor Therapy ◽  
N Stage ◽  
Combined Positive Score ◽  
Muscle Invasive

In the present study, we analyzed Programmed Death Ligand-1 (PD-L1) expression in radical cystectomy (RC) specimens from patients with muscle-invasive urothelial carcinoma (UC), in order to assess any correlations with specific clinicopathological features and its potential prognostic value. A multi-institutional study was performed within the departments of urology and pathology at the Mureș County Hospital, Romania, and Centre Hospitalier Lyon Sud, France. Sixty-nine patients with MIBC were included, for whom tumor histology (conventional versus histological variant/differentiation), tumor extension (T), lymph node involvement (N), and distant metastases (M) were recorded. PD-L1 immunostaining was performed using the 22C3 clone and was interpreted using the combined positive score (CPS) as recommended (Dako Agilent, Santa Clara, CA, USA). Positive PD-L1 immunostaining was more prevalent among UCs with squamous differentiation compared to conventional UCs and trended towards an improved OS (p = 0.366). We found the T stage to be a risk factor for poor survival in PD-L1-positive patients (HR 2.9, p = 0.021), along with the N stage in PD-L1-negative patients (HR 1.98, p = 0.007). No other clinicopathological factor was found to be significantly associated with PD-L1 positivity. Thus, we confirm the need for PD-L1 immunostaining prior to initiating immune checkpoint inhibitor therapy for a more accurate assessment of the patients’ chances of responding to treatment.

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

scholarly journals Impact of 18F-FDG PET/CT on the staging of patients with non-small cell lung cancer

2020 ◽  
Vol 8 (6) ◽  
pp. 2023
Author(s):  
Ngo Minh Xuan ◽  
Huynh Quang Huy
Keyword(s):  
Lymph Node ◽  
Tumor Size ◽  
Distant Metastases ◽  
Large Cell ◽  
Lymph Node Involvement ◽  
Emission Tomography ◽  
Small Cell Lung ◽  
Positron Emission ◽  
Node Involvement ◽  
Group 3

Background: Non-small cell lung cancer (NSCLC) accounts for approximately 80% of new diagnoses of pulmonary carcinoma. This study investigated the correlation between 18 F-fluorodeoxyglucose uptake in computerized tomography integrated positron emission tomography and tumor size, lymph node metastasis, and distant metastasis in patients with NSCLC.Methods: The records of 318 NSCLC patients (220 male, 98 females; mean age 60.94 years) were evaluated retrospectively.Results: 278 cases were adenocarcinomas; 28 squamous cell carcinomas; and 12 large cell carcinoma. When the cases were categorized according to tumor size (group 1, ≤3 cm; group 2, >3 and ≤5 cm; group 3, >5 cm), the maximum standardized uptake value (SUVmax) was significantly lower in groups 1 and 2 compared with group 3 (p<0,001 for each). Considering all cases, tumor SUVmax was not correlated with age, gender or histopathological type. Lymph node metastases were seen in 250 cases: 80.2% of these were adenocarcinomas, 71.4% squamous cell carcinomas, and 58.3% large cell carcinomas. Neither lymph node involvement nor distant metastases were correlated with tumor SUVmax, although lymph node size was positively correlated with lymph node SUVmax (r=0.758; p<0.001).Conclusions: SUVmax was significantly associated with tumor size, but not with distant metastases or lymph node involvement. Therefore, SUVmax on positron emission tomography is not predictive of the presence of metastases. 

scholarly journals Retropharyngeal Lymph Node Involvement in Oropharyngeal Carcinoma: Impact upon Risk of Distant Metastases and Survival Outcomes

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 83
Author(s):  
Zsuzsanna Iyizoba-Ebozue ◽  
Louise J. Murray ◽  
Moses Arunsingh ◽  
Karen E. Dyker ◽  
Sriram Vaidyanathan ◽  
...  
Keyword(s):  
Lymph Node ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Concurrent Chemotherapy ◽  
Oropharyngeal Carcinoma ◽  
Retropharyngeal Lymph Node ◽  
Significant Difference ◽  
Node Involvement ◽  
Fdg Pet Ct ◽  
The Impact

The influence of retropharyngeal lymph node (RPLN) involvement on prognosis in oropharyngeal carcinoma remains poorly defined. The aim of this study was to assess the impact of RPLN involvement upon outcomes. A single-centre retrospective analysis of 402 patients with oropharyngeal carcinoma treated nonsurgically between 2010 and 2017 was performed. All had a baseline 2-[fluorine-18]-fluoro-2-deoxy-d-glucose (FDG) PET-CT and contrast-enhanced MRI and/or CT. RPLN status was determined by radiology review of cases with reported abnormal RPLN. Multivariate backwards logistic regression was used to examine impact on outcomes of factors. Abnormal RPLNs were identified in 40/402 (10%) of patients. Median follow up was 42.9 months. RPLN involvement was associated with inferior 3 year outcomes for overall survival (OS) (67.1% vs. 79.1%, p = 0.006) and distant metastases-free survival (DMFS) (73.9% versus 88.0%, p = 0.011), with no significant difference in local control (81.6% vs. 87.7%, p = 0.154) or regional control (80.7% vs. 85.4%, p = 0.252). On multivariate analysis abnormal RPLN, no concurrent chemotherapy and ongoing smoking were associated with inferior DMFS and OS, while advanced T stage was also associated with inferior OS. In summary, RPLN involvement, present in 10% of patients, was an independent prognostic factor for the development of distant disease failure translating into inferior OS. These findings need confirmation in future studies.

scholarly journals Oral carcinoma epidemiology in Paraná State, Southern Brazil

2009 ◽  
Vol 25 (2) ◽  
pp. 393-400 ◽  
Author(s):  
Roberta Losi-Guembarovski ◽  
Rodrigo Paes de Menezes ◽  
Fernando Poliseli ◽  
Vivian Nappi Chaves ◽  
Hellen Kuasne ◽  
...  
Keyword(s):  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Oral Carcinoma ◽  
Female Ratio ◽  
Anatomical Distribution ◽  
Floor Of Mouth ◽  
Male Female Ratio ◽  
Node Involvement ◽  
Histological Characteristics ◽  
Male To Female

Oral carcinoma is the sixth most frequent type of cancer in the world and the seventh most common in Brazil (the country with the highest incidence in Latin America). Mean five-year survival remains one of the lowest among the main cancers, thus justifying studies that contribute to the development of preventive strategies. The aim of this study was to compare the epidemiological, clinical, and histological characteristics of 91 patients with oral carcinoma. Mean age was 58.62 ± 10.46 years, and male-to-female ratio was 6.6:1.0 (79 men and 12 women). European descendants predominated with 79 patients (86.8%). Eighty-five individuals (93.4%) smoked and 70 (76.9%) consumed alcohol regularly. Anatomical distribution of tumors was: 27 (29.7%) tongue; 18 (19.8%) floor of mouth; 11 (12.1%) oropharynx; and 11 (12.1%) oral mucosa. Fifty-seven patients (62.6%) presented lymph node involvement and three (3.3%) had distant metastases. Surgery and radiotherapy were used in 43.2% of patients. With the exception of the male/female ratio (which was higher), our data are consistent with previous studies on oral carcinoma patients.

Changing trends of incidence and prognosis of thyroid carcinoma

2019 ◽  
Vol 58 (02) ◽  
pp. 86-92 ◽  
Author(s):  
Jamshid Farahati ◽  
Uwe Mäder ◽  
Elena Gilman ◽  
Rainer Görges ◽  
Ines Maric ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Lymph Node ◽  
Distant Metastases ◽  
Tumor Stage ◽  
Lymph Node Involvement ◽  
Population Based ◽  
Management Algorithm ◽  
Node Involvement ◽  
T1 And T2 ◽  
Lower Franconia

Abstract Aim to evaluate the time trend of epidemiology of follicular cell derived thyroid cancer (TC) based on data from a well documented cancer registry. Methods Population based data on TC from Lower Franconia (LF), Germany, within 1981 and 2015 were analysed to estimate the regional epidemiology of TC. The incidence was assessed in 5-year-intervals for gender, histology, and tumor stage. Results Incidence of TC solely attributable to papillary TC (PTC) doubled mainly in T1- and T2-stages within the evaluation period from 4.5 to 8.7/100.000/y in females and 1.7 to 4.1/100.000/y in males. There was no significant change of follicular TC (FTC), whereas anaplastic TC (ATC) decreased in the same interval. The number of lymph-node metastases and T3-cases increased, while the frequency of T4-stage and distant metastases decreased. Increased incidences of T1- and T2-stages suggest an over-diagnosis. In contrast, increasing number of tumors at T3-stage and with lymph node involvement contradict the over-diagnosis as the only reason for rising incidence. Declining of T4-stages in spite of increasing of T3-stages and N1-cases indicates the value of timely detection and treatment of TC. In accordance, reduced incidence of advanced cancers with M1-stage and ATC cases promote our current management of TC. Conclusion Timely diagnosis and adequate risk-adopted treatment of thyroid cancer reduce the frequency of high-risk cases with distant metastases and the possible protracted dedifferentiation of TC to anaplastic features. Our analyses support the management algorithm in thyroid cancer according to the recent guidelines of German Nuclear Medicine Society.

scholarly journals Diagnostic Performance of F18-FDG PET/CT in Male Breast Cancers Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 119
Author(s):  
Andra Piciu ◽  
Doina Piciu ◽  
Narcis Polocoser ◽  
Anita A. Kovendi ◽  
Iulia Almasan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Fdg Pet ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Male Breast ◽  
Axillary Lymph ◽  
Pet Ct ◽  
Node Involvement ◽  
Male Patients ◽  
Fdg Pet Ct

Introduction: F18-FDG PET/CT is the most important hybrid imaging used in the diagnostic, staging, follow-up, and treatment evaluation response in cancer patients. However, it is well-known that in breast cancer the use of F18-FDG is not included in the first line protocol of initial diagnostic, both in female and male breast cancer patients. F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. This study assesses F18-FDG PET/CT systemic staging in male patients with diagnosed breast cancer and determines detection rates for unsuspected distant metastases and synchronous malignancies. Methods: We analyzed a number of 170 male patients with breast cancer, seen between 2000–2020, in a tertiary center. From this group, between 2013–2020 a number of 23 patients underwent F18-FDG PET/CT. Rates of upstaging were determined for each case and the detection of other primary malignancies was analyzed. Results: Median age of male breast cancer group was 61.3 y (range, 34–85 y), most had intraductal carcinoma (82.4%) and unsuspected distant metastases, which increased patient stage to IV, observed in 27%. In 4 out 23 patients (17.4%), F18-FDG PET/CT identified synchronous cancers (2 prostate cancers, 1 thyroid and 1 colon cancer). Conclusion: F18-FDG PET/CT is a valuable tool to provide information on extra-axillary lymph node involvement, distant metastases, and other occult primary cancers. Baseline F18-FDG PET/CT has a substantial impact on the initial staging and on clinical management in male breast patients and should be considered for use in newly diagnosed patients.

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