Three Thousand Consecutive Pancreaticoduodenectomies in a Tertiary Cancer Center: A Retrospective Observational Study

(1) Aim: To evaluate clinicopathological features and postoperative outcomes including survival in patients who underwent pancreaticoduodenectomy (PD) for periampullary diseases. (2) Methods: We retrospectively reviewed 3078 cases of PD performed in our center for 25 years. Periampullary diseases were divided into benign and malignancy groups. All cases were also classified by location. The time of 25 years was divided to different periods (5 years per period) to compare outcomes. Overall survival was compared between subdivided periods. (3) Results: Hospitalization became significantly shorter from 28.0 days in the 1st period to 13.8 days in the 5th period. Overall complication rate was significantly increased since the 3rd period. The rate without postoperative pancreatic fistula (POPF) was high at 98.7% in the 1st period. This might be because drain amylase on the 3rd day after PD was not routinely checked in the past. Thus, POPF was not detected. In survival analysis of adenocarcinoma of pancreas, bile duct, and ampulla, overall survival was found to be improved significantly in recent years. (4) Conclusions: Our study revealed that outcomes were improved with increasing number of PDs performed. Although POPF and overall complications showed increases more recently, those were detected and managed, resulting in shorter hospitalization and improved outcomes.

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Real-World Outcome of Platinum-Based Chemotherapy in Advanced Breast Cancer (ABC): A Retrospective Study from a Tertiary Cancer Center in India

Indian Journal of Medical and Paediatric Oncology ◽

10.1055/s-0041-1735597 ◽

2021 ◽

Author(s):

Indhuja Muthiah Vaikundaraja ◽

Manikandan Dhanushkodi ◽

Venkatraman Radhakrishnan ◽

Jayachandran Perumal Kalaiarasi ◽

Nikita Mehra ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Retrospective Study ◽

Progressive Disease ◽

Progression Free Survival ◽

Median Number ◽

Cancer Center ◽

Free Survival ◽

Platinum Based Chemotherapy ◽

Tertiary Cancer Center

Abstract Introduction There is a paucity of data on platinum-based chemotherapy in advanced breast cancer (ABC) from developing countries like India. Objectives The objectives were to analyze the efficacy and safety of platinum-based chemotherapy in patients with ABC. Materials and Methods This was a retrospective study of 35 patients with ABC who were treated with platinum-based chemotherapy (gemcitabine and carboplatin, [GC]) in a tertiary cancer center in India from August 2015 to November 2019. The inclusion criteria were patients with ABC, who had received palliative chemotherapy with GC. The exclusion criteria were patients who had received less than two cycles of GC and patients who received platinum-based chemotherapy for neuroendocrine carcinoma of the breast. Results The median age was 45 years (range: 28–68 years). All patients were female (97%) except one male (3%). The histology was ductal carcinoma (77%), mixed (17%), and others (6%). Out of the 12 patients tested for breast cancer (BRCA) gene mutation, six patients had a BRCA mutation. Patients with metastatic and locally progressive disease were 91 and 9%, respectively. The median number of prior lines of systemic therapy for metastatic disease was 1 (range: 0–5). The median number of sites of metastasis was 2 (range: 0–5). Patients with visceral crises were 23%. The median number of cycles of GC chemotherapy received was 6 (range: 2–6). A dose reduction in chemotherapy was done in 74%. The responses among 34 evaluable patients were complete response (11%), partial response (24%), stable disease (41%), and progressive disease (24%). Grade 3 or more hematological and nonhematological toxicities were observed in 69 and 9%, respectively. The median progression-free survival and overall survival were 6 and 8 months, respectively. The 1-year progression-free survival and overall survival were 19 and 34%, respectively. Multivariate analysis showed that patients who had received more than 3 cycles had a better outcome. Conclusion GC was an active and well-tolerated regimen in ABC regardless of the receptor status. Further prospective randomized studies are warranted to assess the optimal regimen in patients with triple-negative breast cancer.

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Changing trends in the management of early stage endometrial cancer over the past decade: Experience from a tertiary cancer center

Gynecologic Oncology ◽

10.1016/j.ygyno.2015.01.238 ◽

2015 ◽

Vol 137 ◽

pp. 96

Author(s):

J.A. Thomes Pepin ◽

J.G. Ross ◽

F. He ◽

E.C. Rossi

Keyword(s):

Endometrial Cancer ◽

Early Stage ◽

Cancer Center ◽

The Past ◽

Changing Trends ◽

Tertiary Cancer Center ◽

Early Stage Endometrial Cancer

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Use of disseminated tumor cells to predict outcome in patients with stage I-III breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.27_suppl.119 ◽

2012 ◽

Vol 30 (27_suppl) ◽

pp. 119-119

Author(s):

Sarah Marie Gainer ◽

Savitri Krishnamurthy ◽

Anirban Bhattacharyya ◽

Ashutosh Lodhi ◽

Carolyn S. Hall ◽

...

Keyword(s):

Breast Cancer ◽

Bone Marrow ◽

Overall Survival ◽

Tumor Cells ◽

Independent Predictor ◽

Metastatic Breast ◽

Disseminated Tumor Cells ◽

Stage I ◽

Cancer Center ◽

Tertiary Cancer Center

119 Background: Published studies from Europe have shown the presence of disseminated tumor cells (DTCs) to independently predict outcomes in patients with non-metastatic breast cancer. The purpose of this study was to assess the experience with DTCs at a tertiary cancer center and to see if these cells indeed predict outcomes in patients with stage I-III breast cancer. Methods: Clinical stage I-III breast cancer patients seen at a single tertiary cancer center provided consent to participate in an IRB-approved study involving collection of bone marrow (5 ml x 2 tubes) at the time of surgery for their primary breast cancer. DTCs were assessed by anti-CK antibody cocktail (AE1/AE3, CAM5.2, MNF 116, CK 8 and 18) following cytospin. A positive result was defined as the presence of one or more cells per 5 ml of bone marrow. Statistical analyses used chi-square and Fischer’s exact tests. Results: Three hundred and sixty-six patients were prospectively enrolled. Mean age was 53 years. Median follow-up was 32 months. DTCs were identified in 109 patients (30%). Ten percent of patients with DTCs (11/109) and 3% of patients without DTCs (8/257) died (p = 0.009). Overall survival (OS) in patients with DTCs was 30 months vs. 31 months in those without DTCs. DTCs did not predict relapse free survival (P=NS). On multivariate analysis the presence of DTCs was an independent predictor of worse overall survival (p < 0.0001). No correlation was observed between the presence of DTCs and lymph node metastases and/or other clinicopathologic variables. Conclusions: The presence of DTCs was an independent predictor of worse OS in patients with stage I-III breast cancer. Consideration should be given to the utilization of DTCs as predictors of outcome in clinical practice.

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Clinical features and overall survival among elderly cancer patients in a tertiary cancer center in Sao Paulo- Brazil

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2013.09.100 ◽

2013 ◽

Vol 4 ◽

pp. S66-S67

Author(s):

L.B. Pontes ◽

Y.P.P.V. Antunes ◽

D.D.G. Bugano ◽

T. Karnakis ◽

A. Del Giglio ◽

...

Keyword(s):

Overall Survival ◽

Cancer Patients ◽

Clinical Features ◽

Sao Paulo ◽

Cancer Center ◽

São Paulo ◽

Elderly Cancer Patients ◽

Tertiary Cancer Center

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Survival analysis of osteosarcoma patients: A 15-year experience

Journal of Orthopaedic Surgery ◽

10.1177/2309499019896662 ◽

2020 ◽

Vol 28 (1) ◽

pp. 230949901989666

Author(s):

Nor Faissal Yasin ◽

Muhammad Lutfi Abdul Rashid ◽

Vivek Ajit Singh

Keyword(s):

Overall Survival ◽

Multivariate Analysis ◽

Survival Analysis ◽

Survival Rates ◽

Limb Salvage Surgery ◽

Term Survival ◽

The Past ◽

Chemotherapy Regime ◽

Independent Risk Factors

Introduction: Management of osteosarcoma has evolved considerably for the past two decades and there have been changes of practices especially pertaining to chemotherapy regime. This is a review of our cases in the past 15 years. Method: This is a retrospective survival analysis study of 128 patients treated at University Malaya Medical Centre (UMMC) from 1997 to 2011. Results: There were 80 (62.5%) male and 48 (37.5%) female patients with the median age being 15 (5–59). Majority had osteosarcoma of extremities (94.5%). More than 60% patients developed metastasis throughout the course of treatment with 39% presenting with lung metastasis. Osteoblastic osteosarcoma was the commonest subtype (65.6%). Of the 109 patients treated surgically, 84 patients (65.6%) underwent limb salvage surgery while the rest underwent amputation. Seventy-one per cent of patients completed treatment with local recurrence rate of 22.7%. The 5-year and 10-year survival rates were 56.31% (95% CI: 46.20, 65.24) and 22.33% (95% CI: 14.86, 30.76), respectively. The 5-year event-free survival was 52.94% (95% CI: 41.83, 62.87). In multivariate analysis, the independent prognostic factors were presence of metastasis and completion of treatment for both 5-year and 10-year overall survival. Good histological response was only significant for multivariate analysis at 5 years. Patients with metastasis had a hazard ratio of 20.4 at 5 years and 3.26 at 10 years. Conclusion: Overall survival rate for osteosarcoma patients at our centre was comparably higher than other centres in the region. Two independent risk factors for survival are metastatic status and completion of treatment. A standardized chemotherapy regime is essential for long-term survival.

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Retrospective review of treatment for angiosarcoma at Fox Chase Cancer Center over the past 15 years

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.10034 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 10034-10034 ◽

Cited By ~ 5

Author(s):

S. Saroha ◽

S. Litwin ◽

M. von Mehren

Keyword(s):

Overall Survival ◽

Chemotherapeutic Agents ◽

Weekly Paclitaxel ◽

Cancer Center ◽

Exact Test ◽

Fisher's Exact Test ◽

The Past ◽

Response To Chemotherapy ◽

Fisher’S Exact Test ◽

Anatomic Locations

10034 Background: Angiosarcoma is a rare vascular neoplasm that may arise in a variety of anatomic locations. There is limited published data on chemotherapy treatment in angiosarcoma and data on taxane therapy does not utilize contemporary schedules. We present a retrospective analysis of our institution's experience with angiosarcoma over the past 15 years. We reviewed patient characteristics, overall survival and response to various chemotherapeutic agents. We specifically compared the response to weekly paclitaxel with all other chemotherapeutic agents used over the study period. Methods: Medical records of all the patients treated with the diagnosis of angiosarcoma at Fox Chase Cancer Center between January 1990 and June 2005 were reviewed. Overall survival was determined by the Kaplan-Meier method. Response to chemotherapy was determined at two-month follow-up after starting treatment. Clinician judgment was used to define response for superficial lesions. We compared the response to weekly paclitaxel with all other chemotherapy regimens using Fisher's exact test. p <0.10 was considered significant. Results: A total of 39 patients were identified. Most common sites for angiosarcoma were head and neck (including scalp) and breast. Median overall survival was 21 months. Since many patients received several lines of chemotherapy, 40 chemotherapy administrations were identified for analysis. 10 of 13 patients showed response to weekly paclitaxel versus 14 of 27 for non-paclitaxel regimens, which was not statistically significant by Fisher's exact test (2-tail, p=0.18). We also analyzed the response with respect to different anatomic locations of angiosarcoma and individual chemotherapy regimens used, however the numbers were too small for statistical comparisons. Conclusions: Angiosarcoma is an aggressive malignancy with poor survival rates. Our study demonstrated that paclitaxel has efficacy in angiosarcoma, although not statistically superior to non-taxane containing regimens. No significant financial relationships to disclose.

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Primary extranodal non-Hodgkin′s lymphoma: A retrospective analysis of its clinicopathological features and treatment outcomes in a tertiary cancer center of eastern India

Clinical Cancer Investigation Journal ◽

10.4103/2278-0513.119269 ◽

2013 ◽

Vol 2 (3) ◽

pp. 218 ◽

Cited By ~ 1

Author(s):

Bitoti Chattopadhyay ◽

Kakali Choudhury ◽

Debabrata Mitra ◽

Biswamit Bhattacharya

Keyword(s):

Treatment Outcomes ◽

Retrospective Analysis ◽

Clinicopathological Features ◽

Cancer Center ◽

Eastern India ◽

Tertiary Cancer Center

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Surgical treatment of sacral metastases: indications and results

Journal of Neurosurgery Spine ◽

10.3171/2012.7.spine09351 ◽

2012 ◽

Vol 17 (4) ◽

pp. 285-291 ◽

Cited By ~ 11

Author(s):

Iman Feiz-Erfan ◽

Benjamin D. Fox ◽

Remi Nader ◽

Dima Suki ◽

Indro Chakrabarti ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Overall Survival ◽

Cell Carcinoma ◽

Metastatic Disease ◽

Renal Cell ◽

Median Overall Survival ◽

Cancer Center ◽

Spinal Instability ◽

Pain Scores ◽

Tertiary Cancer Center

Object Hematogenous metastases to the sacrum can produce significant pain and lead to spinal instability. The object of this study was to evaluate the palliative benefit of surgery in patients with these metastases. Methods The authors retrospectively reviewed all cases involving patients undergoing surgery for metastatic disease to the sacrum at a single tertiary cancer center between 1993 and 2005. Results Twenty-five patients (21 men, 4 women) were identified as having undergone sacral surgery for hematogenous metastatic disease during the study period. Their median age was 57 years (range 25–71 years). The indications for surgery included palliation of pain (in 24 cases), need for diagnosis (in 1 case), and spinal instability (in 3 cases). The most common primary disease was renal cell carcinoma. Complications occurred in 10 patients (40%). The median overall survival was 11 months (95% CI 5.4–16.6 months). The median time from the initial diagnosis to the diagnosis of metastatic disease in the sacrum was 14 months (95% CI 0.0–29.3 months). The numerical pain scores (scale 0–10) were improved from a median of 8 preoperatively to a median of 3 postoperatively at 90 days, 6 months, and 1 year (p < 0.01). Postoperative modified Frankel grades improved in 8 cases, worsened in 3 (due to disease progression), and remained unchanged in 14 (p = 0.19). Among patients with renal cell carcinoma, the median overall survival was better in those in whom the sacrum was the sole site of metastatic disease than in those with multiple sites of metastatic disease (16 vs 9 months, respectively; p = 0.053). Conclusions Surgery is effective to palliate pain with acceptable morbidity in patients with metastatic disease to the sacrum. In the subgroup of patients with renal cell carcinoma, those with the sacrum as their solitary site of metastatic disease demonstrated improved survival.

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