scholarly journals Reirradiation for Nasal Cavity or Paranasal Sinus Tumor—A Multi-Institutional Study

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6315
Author(s):  
Hideya Yamazaki ◽  
Gen Suzuki ◽  
Norihiro Aibe ◽  
Makoto Yasuda ◽  
Hiroya Shiomi ◽  
...  
Keyword(s):  
Adverse Events ◽  
Nasal Cavity ◽  
Paranasal Sinus ◽  
Survival Rates ◽  
Tumor Location ◽  
Lymph Node Involvement ◽  
Predisposing Factor ◽  
Node Involvement ◽  
Grade 3 ◽  
Paranasal Sinus Tumor

We evaluated the efficacy and toxicity of reirradiation of nasal cavity or paranasal sinus tumors. We collected and analyzed multi-institutional data of reirradiation cases. Seventy-eight patients with nasal or paranasal sinus tumors underwent reirradiation. The median survival time was 20 months with a medial follow-up of 10.7 months. The 2-year local control and overall survival rates were 43% and 44%, respectively. Tumor volume (≤25 cm3), duration between previous radiotherapy and reirradiation (≤12 months), histology (squamous cell carcinoma), male sex, and lymph node involvement were predisposing factors for poor survival. Distant metastasis was observed in 20 patients (25.6%). Grade ≥ 3 adverse events were observed in 22% of the patients, including five grade 4 (8.6%) cases and one grade 5 (1.2%) case. Tumor location adjacent to the optic pathway was a significant predisposing factor for grade ≥3 visual toxicity. Reirradiation of nasal and paranasal sinus tumors is feasible and effective. However, adverse events, including disease-related toxicities, were significant. Prognostic factors emerge from this study to guide multidisciplinary approaches and clinical trial designs.

scholarly journals Gastrocolic Fistula: A Rare Presentation of Colon Cancer

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Chukwunonso Chime ◽  
Madhavi Ravi ◽  
Myrta Daniel ◽  
Harish Patel ◽  
Bhavna Balar
Keyword(s):  
Colon Cancer ◽  
Late Complication ◽  
Survival Rates ◽  
Standard Of Care ◽  
Lymph Node Involvement ◽  
En Bloc ◽  
Rare Presentation ◽  
Additional Advantage ◽  
Node Involvement

Gastrocolic fistulae have been described for benign conditions including penetrating peptic ulcer and complicated pancreatitis. Malignant etiology can arise from gastric or colon cancer and is a rare and late complication with an incidence of 0.3-0.4%. Usual presentation is the classic triad of weight loss, diarrhea, and feculent vomiting. Barium enema has been shown to have the highest diagnostic accuracy but endoscopy offers additional advantage of biopsy to aid in diagnosis of malignant etiology; the role of computed tomography (CT) scan is controversial. Treatment by one-stage en bloc surgical approach is the current acceptable standard of care with variable recurrence and survival rates. Adjuvant chemotherapy would be based on lymph node involvement and patient discussion.

scholarly journals Comparison between 5-day decitabine and 7-day azacitidine for lower-risk myelodysplastic syndromes with poor prognostic features: a retrospective multicentre cohort study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Byung-Hyun Lee ◽  
Ka-Won Kang ◽  
Min Ji Jeon ◽  
Eun Sang Yu ◽  
Dae Sik Kim ◽  
...  
Keyword(s):  
Adverse Events ◽  
Myelodysplastic Syndromes ◽  
Lower Risk ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Free Survival ◽  
Prognostic Features ◽  
Multicentre Cohort Study ◽  
Treatment Responses ◽  
Grade 3

AbstractNumerous studies have analysed the clinical efficacies of hypomethylating agents (HMAs) in patients with myelodysplastic syndromes (MDS). However, reports that compare the two HMAs, decitabine and azacitidine, in patients with lower-risk (low and intermediate-1) MDS are limited. We compared 5-day decitabine and 7-day azacitidine regimens in terms of treatment responses, survival outcomes, and adverse events in patients with lower-risk MDS with poor prognostic features. The overall response rates (ORRs) were 67.2% and 44.0% in the patients treated with decitabine and azacitidine, respectively (P = 0.014). While the median progression-free survival (PFS) was significantly better in the patients treated with decitabine than in those treated with azacitidine (P = 0.019), no significant differences in event-free and overall survival rates were observed between the two groups. Multivariate analysis revealed that compared with azacitidine treatment, decitabine treatment is significantly associated with a higher ORR (P = 0.026) and longer PFS (P = 0.037). No significant differences were observed in the incidence of grade 3 or higher haematologic adverse events in response to the two HMAs. In conclusion, in lower-risk MDS, especially with poor prognostic features, ORR and PFS were significantly better with 5-day decitabine treatment than with 7-day azacitidine treatment, with comparable safety.

Clinicopathologic characteristics of pure papillary breast carcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12521-e12521
Author(s):  
Fatma P. Turkoz ◽  
Mustafa Solak ◽  
Özge Keskin ◽  
Zafer Arik ◽  
Cagatay Arslan ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Menopausal Status ◽  
Survival Rates ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Low Grade ◽  
Breast Cancer Patients ◽  
Clinicopathologic Characteristics ◽  
Node Involvement

e12521 Background: Pure papillary breast carcinoma (PPBC) is a very rare entity which usually occurs in older women with a favorable prognosis. The aim of this cohort study was to evaluate the demographic, clinicopathologic characteristics and survival rates of PPBC compared to invasive ductal carcinoma (IDC). Methods: A total of 2451 invasive breast cancer patients from a single center were analyzed retrospectively. Of these, 24 patients were PPBC (1%) and 1785 (73%) patients were pure IDC. Results: PPBC were significantly different from IDC with respect to the age at diagnosis, menopausal status, tumor size, grade and lymph node involvement (p<0.05) (Table 1). The median follow-up period was 26,5 months (4-400 months). Only one patient with PPBC had lung and bone metastasis, others were alive with no evidence of disease. PPBC was associated with a better 5-year overall survival (100 vs. 84%) and disease-free survival (75 vs. 54%) compared to IDC. Conclusions: Compared to IDC, PPBC is a small, low-grade tumor and less likely to involve the lymph nodes. Cases are usually older, postmenopausal women and have a better prognosis. [Table: see text]

Apatinib combined with Raltitrexed in patients with metastatic colorectal cancer after failure of standard therapy (AHEAD-311): A single-arm phrase II pilot trial.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15008-e15008
Author(s):  
Haiyan Si ◽  
Miaomiao Gou ◽  
Yong Zhang ◽  
Huan Yan ◽  
Niansong Qian ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Adverse Events ◽  
Metastatic Colorectal Cancer ◽  
Objective Response ◽  
Pilot Trial ◽  
Growth Factor Receptor ◽  
Progression Free Survival ◽  
Tumor Location ◽  
Nausea And Vomiting ◽  
Grade 3

e15008 Background: To assess the safety and efficacy of apatinib, an oral vascular endothelial growth factor receptor-2 inhibitor, combined with thymidylate synthase inhibitor raltitrexed in patients with metastatic colorectal cancer (mCRC) as a third- or later-line therapy. Methods: Patients with mCRC after at least 2 lines of chemotherapy were enrolled whenever they previously treated with bevacizumab or not. Apatinib was given orally at 250mg or 500mg daily. Raltitrexed was administered intravenously at 3 mg/m2 on day 1 every 3 weeks. The primary endpoints were progression-free survival (PFS). The second endpoints were objective response rate (ORR), overall survival (OS) and safety. Results: From August 2017 to November 2018, thirty-one patients were enrolled in Chinese PLA General Hospital. After a median follow-up of 6.4 months, the median treatment cycle was 4. four patient achieved partial response(PR), and 11 patients achieved stable disease (SD) and 16 achieved progression disease (PD) in accordance with RECIST version 1.0, illustrating a DCR of 48.4% and an ORR of 12.9% .The Median PFS was 2.4 months and the median OS was 6.4 months. The most common adverse events were hypertension (n=12, 38.7%), nausea and vomiting (n=11, 33.8%), myelosuppression (n=9, 29.0%). The most common grade 3 to 4 adverse events were hypertension (n=2, 6.4%) and hand-foot syndrome (n=2, 6.4%). Grade 3 to 4 hematologic toxicities were rare. One patient died from cardiac arrest after three days treatment. There was no significantly association between PFS or OS, and clinical features including tumor location, KRAS status, and prior surgery or not, and number of metastatic organs. There was no trend showing patients who experienced had hypertension or myelosuppression had longer PFS and OS. Compared to the patients never received bevacizumab, the patients who had previously bevacizumab had the similar PFS and OS (3.9 versus 2.3months, P=0.787; 6.1 versus 6.4months, P=0.287). Grade1-2 nausea and vomiting and age <57 were independent predictors for longer PFS and OS. Conclusions: Apatinib combined with raltitrexed had efficacy but had limited survival benefit in mCRC refractory to standard chemotherapy. This regime showed us a higher risk of adverse event incidence and warrant further exploring of benefit population. Clinical trial information: NCT03344614 .

Benefits and Adverse Events in Younger Versus Older Patients Receiving Neoadjuvant Chemotherapy for Osteosarcoma: Findings From a Meta-Analysis

2013 ◽  
Vol 31 (18) ◽  
pp. 2303-2312 ◽  
Author(s):  
Marnie Collins ◽  
Miriam Wilhelm ◽  
Rachel Conyers ◽  
Alan Herschtal ◽  
Jeremy Whelan ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Tumor Necrosis ◽  
Meta Analysis ◽  
Survival Rates ◽  
Tumor Location ◽  
Published Data ◽  
Cooperative Groups ◽  
Data Set ◽  
Landmark Analysis ◽  
Grade 3

Purpose The LIVESTRONG Young Adult Alliance has conducted a meta-analysis of individual patient data from prospective neoadjuvant chemotherapy osteosarcoma studies and registries to examine the relationships of sex, age, and toxicity on survival. Patients and Methods Suitable data sets were identified by a survey of published data reported in PubMed. The final pooled data set comprised 4,838 patients from five international cooperative groups. Results After accounting for important variables known at study entry such as tumor location and histology, females experienced higher overall survival rates than males (P = .005) and children fared better than adolescents and adults (P = .002). Multivariate landmark analysis following surgery indicated that a higher rate of chemotherapy-induced tumor necrosis was associated with longer survival (P < .001), as was female sex (P = .004) and the incidence of grade 3 or 4 mucositis (P = .03). Age group was not statistically significant in this landmark analysis (P = .12). Females reported higher rates of grade 3 or 4 thrombocytopenia relative to males (P < .001). Children reported the highest rates of grade 3 or 4 neutropenia (P < .001) and thrombocytopenia (P < .001). The achievement of good tumor necrosis was higher for females than for males (P = .002) and for children than for adults (P < .001). Conclusion These results suggest fundamental differences in the way chemotherapy is handled by females compared with males and by children compared with older populations. These differences may influence survival in a disease in which chemotherapy is critical to overall outcomes.

scholarly journals Metastatic Merkel Cell Carcinoma Masquerading as Multiple Immune-Related Adverse Events

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Farees Saqlain ◽  
Sophia Z. Shalhout ◽  
Kevin S. Emerick ◽  
Tomas G. Neilan ◽  
Tatyana Sharova ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cell Carcinoma ◽  
Merkel Cell Carcinoma ◽  
Regional Lymph Node ◽  
Lymph Node Involvement ◽  
High Rate ◽  
Merkel Cell ◽  
Node Involvement ◽  
Cutaneous Neuroendocrine Carcinoma ◽  
Cutaneous Adverse Event

Merkel cell carcinoma is a rare cutaneous neuroendocrine carcinoma with a high rate of regional and distant metastasis and mortality. Here, we report a novel case of Merkel cell carcinoma which presented as a primary lesion to the left cheek with regional lymph node involvement and was treated with pembrolizumab and radiation. Widely metastatic disease eventually revealed on autopsy clinically mimicked immune-related organ insult leading to management with immunosuppressants. The patient also had a biopsy-confirmed immune-related cutaneous adverse event during admission. The case highlights a rare circumstance in which disease progression masqueraded as multiple immune-related end-organ adverse events. Contribution of on-target anti-PD-1 toxicity remains a possibility.

Clinical and biologic factors associated with time to progression in patients treated by first-line palliative FOLFOX chemotherapy in metastatic colorectal cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14159-e14159
Author(s):  
Wieslaw Bal ◽  
Michal Jarzab ◽  
Ewa Stobiecka ◽  
Jadwiga Zebracka ◽  
Marta Mianowska ◽  
...  
Keyword(s):  
Gene Expression ◽  
Colorectal Cancer ◽  
Lymph Node ◽  
Tumor Grade ◽  
Lymph Node Involvement ◽  
Time To Progression ◽  
First Line ◽  
Node Involvement ◽  
Grade 3 ◽  
Folfox Chemotherapy

e14159 Background: Chemotherapy is the mainstay of treatment patients with metastatic colorectal cancer. The choice of first-line treatment is difficult, especially when cost-effectiveness is the primary constraint. Thus, the optimal use of the clinical and biological factors influencing prognosis would be beneficial. The aim of our study was to identify factors affecting the time to progression (TTP) after first-line FOLFOX chemotherapy in palliative setting. Methods: The study is a retrospective analysis of the series of consecutive patients from large cancer center in south of Poland. The analysis was carried out in the group of 180 patients (37.2% of women), treated between 2007-2010 by FOLFOX-4 regimen and followed-up with the median time of observation 16.3 month. Patients received chemotherapy with median time of 5.0 months, median 10 cycles. Progression was defined as PD by RECIST criteria, death due to disease or sympomatic deterioration. 94 paraffin blocks were available for KRAS testing and gene expression analysis by real-time PCR. Results: The median TTP (counted from beginning of chemotherapy) was 8.6 month, the median TTP from the end of treatment was 3.4 month. We tested the wide range of clinical variables associated with both disease and and patient status by multivariate Cox regression analysis. Two most potent independent negative predictors were identified: the presence of massive lymph node involvement as assessed in CT scan before palliative treatment (>10 nodes enlarged) – hazard ratio 2.82, p<0.001; and tumor grade in histopathological assessment (grade 3 vs. grade 1-2) – hazard ratio 2.76, p=0.003. KRAS status was not prognostic for the TTP; Ki67 gene expression measurement by quantitative RT-PCR did not predict better that the routine assessment of grade. Patients with either grade 3 or lymph node involvement showed significantly shorter TTP (median 5.7 months vs 9.7 months in patients with none of these factors). Conclusions: High tumor grade and the massive involvement of lymph nodes worsen prognosis and shorten time to progression in patients treated with first line palliative FOLFOX chemotherapy.

Nomogram to predict sentinel lymph node involvement in patients with clinically node-negative breast cancer receiving neoadjuvant chemotherapy.

2012 ◽  
Vol 30 (27_suppl) ◽  
pp. 150-150 ◽  
Author(s):  
Lisa R. Allen ◽  
Pranjali V. Gadgil ◽  
Roland Bassett ◽  
Kelly Hunt ◽  
Elizabeth Ann Mittendorf ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Multidisciplinary Treatment ◽  
Tumor Location ◽  
Lymph Node Involvement ◽  
Breast Cancer Patients ◽  
Node Negative ◽  
Node Involvement

150 Background: Sentinel lymph node biopsy (SLNB) has been shown to be an accurate predictor of axillary lymph node involvement in breast cancer patients treated with neoadjuvant chemotherapy (NAC). A predictive model of SLN positivity in clinically node negative patients who completed NAC can assist in preoperative multidisciplinary treatment decision making, such as planning for postmastectomy radiation therapy and breast reconstruction. Methods: We reviewed our prospective database to identifyclinically node negative patients with invasive breast cancer who underwent NAC and SLNB from 1998-2011. Clincopathologic factors including age, tumor location, histology, nuclear grade, tumor size, decrease in tumor size with therapy, multifocality, nodal appearance on preoperative ultrasound, hormone receptor status, and lymphovascular invasion (LVI) were analyzed. A nomogram to predict SLN metastasis was developed using multivariate logistic regression analysis. Results: A total of 836 patients were treated with NAC followed by SLNB. Of these, 160 patients (19.1%) had a positive SLN. All factors were significant predictors of SLN positivity on univariate analysis except tumor location and nodal appearance on preoperative ultrasound. Multivariate analysis showed that young age, invasive lobular histology, tumor size, multifocality, and LVI were independent positive predictors of SLN positivity whereas high grade, response to chemotherapy, and triple negative hormone receptor status were negative predictors. Favorable histologies were strongly associated with a lower rate of SLN positivity but were excluded from the nomogram due to small numbers of patients (N=14). Discrimination of the nomogram to correctly predict SLN positivity was measured using the area under the receiver operating characteristic curve (AUC). The unadjusted AUC was 75.9, while the internally validated 2000 bootstrap sample-adjusted AUC was 74.2. Conclusions: Neoadjuvant chemotherapy is known to decrease the incidence of positive nodes in breast cancer patients. Use of our nomogram preoperatively can assist in decisions regarding multidisciplinary treatment planning.

scholarly journals The role of hilar lymphadenectomy in patients subjected to hepatectomy due to colorectal metastasis

2011 ◽  
Vol 48 (3) ◽  
pp. 217-219 ◽  
Author(s):  
Eduardo Freitas Viana ◽  
Paulo Herman ◽  
Fabrício Ferreira Coelho ◽  
Thomas Augusto Taka ◽  
Luiz A. Carneiro D'Albuquerque ◽  
...  
Keyword(s):  
Lymph Node ◽  
Liver Resection ◽  
Survival Rates ◽  
Lymph Node Involvement ◽  
Hilar Lymph Node ◽  
Disease Staging ◽  
Impact On Survival ◽  
Node Involvement ◽  
Long Term Prognosis ◽  
Improvement In Survival

CONTEXT: Hepatectomy is the treatment of choice for colorectal liver metastases, and several studies have shown good results, with 5-year survival rates ranging from 40% to 57%. Several clinical and pathological predictive factors for survival after liver resection have been studied. Involvement of the hepatic hilum lymph nodes, the incidence of which varies from 2% to 10%, indicates a poor long-term prognosis. RESULTS: Despite variable results, some authors have reported a not-insignificant improvement in survival rate in liver-metastasis patients with hilar lymph node involvement who undergo combined liver resection and lymphadenectomy. Due to the low rates of morbidity and mortality for liver-resection surgery, several specialized centers perform liver resections combined with lymphadenectomies in selected cases. It should be noted that the therapeutic value of systemic lymphadenectomy is not yet entirely understood, and only controlled studies comparing groups with and without lymphadenectomy can fully resolve the issue. CONCLUSION: In any case, hilar lymph node dissection has been shown to be a useful tool for improving the accuracy of extra hepatic disease staging, regardless of its impact on survival.

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