Insular Glioma Esoteric Precinct

Background and Objective: The complex insular anatomy and its proximity to eloquent areas make this area almost inaccessible for safe surgical resection of Glioma. Aim of our study is to determine outcome assessment after surgical resection. Materials & Methods: This was a retrospective analysis of 59 patients over a period of 5 years from July 2013 till June 2018. All patients of insular Glioma were included in our study irrespective of age and sex. Degree of surgical resection, Post-operative neurological deficits and complications were assessed. They were followed in the outpatient department at 3, 6 and 12 months. Results: Total 59 patients were included 38 (64.40%) male and 21 (35.59%) females. 36 (61%) patients had right sided insular Glioma and 23 (38.98%) have left sided. Seizures were main presentation in 46(77.96%) patients. Trans-sylvian route adopted in 34 (57.6%) patients followed by transcortical route. Near total Resection was Possible in 30 (50.84%) patients and partial in 29 (49.15%) patients. Focal neurological deficits the motor weakness & dysphasia were main post-operative complications in 18 (30.5%) patients. Three (5.08%) patients died. In all grade II and grade III Gliomas no increase in size was discovered on MRI Brain at 6 and 12 months. Conclusion: Maximum safe resection of insular Glioma with acceptable morbidity is possible with improved overall survival and disease free interval.

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Outcomes after resection of synchronous or metachronous hepatic and pulmonary colorectal metastases

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.4059 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 4059-4059

Author(s):

G. Miller ◽

P. Biernacki ◽

N. Kemeny ◽

M. Gonen ◽

R. Downey ◽

...

Keyword(s):

Surgical Resection ◽

Cox Regression ◽

Pulmonary Metastases ◽

Hepatic Metastases ◽

Colorectal Metastases ◽

Patient Treatment ◽

Disease Free Interval ◽

Free Interval ◽

Disease Free ◽

Pulmonary Colorectal Metastases

4059 Background: Surgical resection of isolated hepatic or pulmonary colorectal metastases prolongs survival in selected patients. However, the benefits of resection and appropriate selection criteria in patients who develop both hepatic and pulmonary metastases are ill-defined. Methods: Data were prospectively collected from 131 patients with colorectal cancer who underwent resection of both hepatic and pulmonary metastases over a 20-year period. Median follow-up was 6.6 years from the time of resection of the primary tumor. Patient, treatment, and outcome variables were analyzed using log-rank, Cox regression, and Kaplan-Meier methods. Results: The site of first metastasis was the liver in 65% of patients, lung in 11%, and both simultaneously in 24%. Multiple hepatic metastases were present in 51% of patients and multiple pulmonary metastases were found in 48%. Hepatic lobectomy or trisegmentectomy was required in 61% of patients while most lung metastases (80%) were treated with wedge excisions. Median survival from resection of the primary disease, first site of metastasis, and second site of metastasis was 6.9, 5.0, and 3.3 years, respectively. After resection of disease at the second site of metastasis, the 1, 3, 5, and 10 year disease-specific survival rates were 91, 55, 31 and 19%, respectively. An analysis of prognostic factors revealed that survival was significantly longer when the disease-free interval between the development of the first and second sites of metastases exceeded one year, in patients with a single liver metastasis, and in patients younger than 55 years. Conclusions: Surgical resection of both hepatic and pulmonary colorectal metastases is associated with prolonged survival in selected patients. Patients with a longer disease free interval between metastases and those with single liver lesions had the best outcomes. [Table: see text] No significant financial relationships to disclose.

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Chondrosarcoma of the spine: 1954 to 1997

Journal of Neurosurgery Spine ◽

10.3171/spi.1999.90.1.0073 ◽

1999 ◽

Vol 90 (1) ◽

pp. 73-78 ◽

Cited By ~ 20

Author(s):

Julie E. York ◽

Rasim H. Berk ◽

Gregory N. Fuller ◽

Jasti S. Rao ◽

Dima Abi-Said ◽

...

Keyword(s):

Radiation Therapy ◽

Surgical Procedures ◽

Gross Total Resection ◽

Total Resection ◽

Disease Free Interval ◽

Content Type ◽

Free Interval ◽

Kaplan Meier ◽

Disease Free ◽

Fine Print

Object. Primary chondrosarcoma of the spine is extremely rare. During the last 43 years only 21 patients with this disease were registered at The University of Texas M. D. Anderson Cancer Center. The purpose of this study was to examine the demographic characteristics, treatments, and outcomes of this set of patients. Methods. Medical records for 21 patients were reviewed. Age, sex, race, clinical presentation, tumor histology, tumor location in the spinal column, treatments, surgical details, and response to treatment were recorded. Surgical procedures were categorized as either gross-total resection or subtotal excision of tumor. Neurological function was assessed using Frankel's functional classification. Time to recurrence and survival analyses were performed using the Kaplan—Meier method. The median age of patients was 51 years, with fairly equal gender representation. Eighteen patients underwent at least one surgical procedure for a total of 28 surgical procedures: seven radical resections and 21 subtotal excisions. Radiation therapy was used in conjunction with 10 of the 28 surgical procedures. The median Kaplan—Meier estimate of overall survival for the entire group was 6 years (range 6 months–17 years). Tumors recurred after 18 of the 28 procedures. Kaplan—Meier analysis revealed a statistically significant difference in the per-procedure disease-free interval after gross-total resection relative to subtotal excision (exact log rank 3.39; p = 0.04). The addition of radiation therapy prolonged the median disease-free interval from 16 to 44 months, although this was not statistically significant (exact log rank 2.63; p = 0.16). Conclusions. Our results suggest that gross-total resection of the chondrosarcoma provides the best chance for prolonging the disease-free interval in patients. Subtotal excision should be avoided whenever possible. Addition of radiation therapy does not appear to lengthen significantly the disease-free interval in this patient population.

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Survival and Disease-free Interval of Cats with Mammary Carcinoma Treated with Chain Mastectomy

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.80900 ◽

2018 ◽

Vol 44 (1) ◽

pp. 8

Author(s):

Simone Cunha ◽

Katia Corgozinho ◽

Heloisa Justen ◽

Kassia Silva ◽

Juliana Leite ◽

...

Keyword(s):

Lymph Node ◽

Local Recurrence ◽

Regional Lymph Node ◽

Radical Mastectomy ◽

Mammary Tumors ◽

Disease Free Interval ◽

Free Interval ◽

Mixed Breed ◽

Grade Ii ◽

Disease Free

Background: Mammary tumors are extremely common in cats and have high metastatic rates with poor prognosis. The main objective of the present study was to evaluate the disease free interval and survival in cats undergoing radical mastectomy as sole therapy.Materials, Methods & Results: Twenty cats with mammary tumors and no evidence of distant metastasis were studied. General health and concomitant diseases were assessed by clinical and hematological examination. Thoracic radiographs and abdominal ultrasonography were performed to evaluate thoracic and abdominal metastases. All cats underwent chain mastectomy, which was unilateral when tumor was present in one mammary chain, and bilateral in steps if tumors were present in both mammary chains. Intact cats were spayed. An elliptical incision was made around the mammary chain with a three centimeter margin around tumor. Regional lymph node was removed. Mean age was ten years, and 14 cats were mixed breed, three were Persian and two were Siamese. Fifteen cats were spayed at tumor diagnosis, but only three had been spayed before one year old. The inguinal mammary glands were the most affected, followed by abdominal and thoracic glands. Histopathology diagnosed well-differentiated adenocarcinoma in eight cases, moderately differentiated adenocarcinoma in nine cases, poorly differentiated adenocarcinoma in two cases and carcinoma in situ in one case. Most tumors were grade II, and regional lymph node metastasis was present in two cases. Disease free interval ranged from 120 to 1800 days, with an average of 678 days. Four cats had tumor local recurrence and six developed lung metastasis. The survival time ranged from seven to 1800 days, with an average of 768 days. Twelve cats are still alive with no tumor recurrence.Discussion: The average age of onset of mammary carcinomas in cats was ten years old, similar to previous studies. Siamese cats have more risk of developing this disease, but mixed breed cats were frequent in this study. Intact or late spayed cats are predisposed to mammary tumors because of hormonal stimulation, the same was observed in this study. Inguinal and abdominal glands were most affected, similar to other reports. The histopathologic diagnosis was adenocarcinoma in most cases of this study, mostly grade II tumors, which was also observed in previous papers. Regional lymph nodes (axillary or inguinal) should always be removed during mastectomy in cats, as regional metastasis at diagnosis is common, even when not clinically palpable, as was observed in two cases. Distant metastasis occurs most often to the lungs, leading to severe dyspnea. In this study, four cats had local tumor recurrence and six developed lung metastasis. Aggressive and early surgical intervention is the treatment of choice for feline mammary tumors. Unlike dogs (where conservative mammary resections are appropriate in some cases), radical chain mastectomy is recommended for feline mammary tumors, as significantly reduces the risk of local recurrence. In this study, all animals underwent radical mastectomy, without previous cytology or biopsy. Survival is variable between studies, ranging from 220 to 1408 days. Several factors may be involved in disease free intervals and survival times, as tumor size, tumor histological grade, presence of metastasis at diagnosis, type of surgery performed, presence of concomitant diseases and adjuvant chemotherapy. In this study, mean survival time was 768 days and 12 cats are still alive and in follow-up, which may increase this number. This study supports that, if treated early and agressively, cats with malignant mammary tumors can have long survival after chain mastectomy.

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Survival outcomes after surgical resection of pulmonary metastases of head and neck tumours

The Journal of Laryngology & Otology ◽

10.1017/s0022215116000050 ◽

2016 ◽

Vol 130 (3) ◽

pp. 291-295 ◽

Cited By ~ 2

Author(s):

S Hosokawa ◽

K Funai ◽

K Sugiyama ◽

G Takahashi ◽

J Okamura ◽

...

Keyword(s):

Overall Survival ◽

Head And Neck ◽

Surgical Resection ◽

Pulmonary Metastases ◽

Clinical Staging ◽

Disease Free Interval ◽

Head And Neck Malignancies ◽

Free Interval ◽

Pathological Subtype ◽

Disease Free

AbstractBackground:There is limited information available regarding the benefits and outcomes of resection of pulmonary metastases arising from head and neck cancers.Methods:A retrospective review was performed of 21 patients who underwent resection of pulmonary metastases of primary head and neck malignancies at Hamamatsu University Hospital. Clinical staging, treatment methods, pathological subtype (particularly squamous cell carcinoma), disease-free interval and overall survival were evaluated.Results:The 5- and 10-year overall survival rates of the study participants were 67.0 per cent and 55.0 per cent, respectively, as determined by the Kaplan–Meier method. The prognosis for patients with a disease-free interval of less than 24 months was poor compared to those with a disease-free interval of greater than 24 months (p = 0.0234).Conclusion:Patients with short disease-free intervals, and possibly those who are older than 60 years, should be categorised as having severe disease. However, pulmonary metastases from head and neck malignancies are potentially curable by surgical resection.

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Non-surgical Treatments for Lung Metastases in Patients with soft Tissue Sarcoma: Stereotactic Body Radiation Therapy (SBRT) and Radiofrequency Ablation (RFA)

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200819165709 ◽

2020 ◽

Vol 16 ◽

Author(s):

Cecilia Tetta ◽

Maria Carpenzano ◽

Areej Tawfiq J Algargoush ◽

Marwah Algargoosh ◽

Francesco Londero ◽

...

Keyword(s):

Overall Survival ◽

Radiation Therapy ◽

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Stereotactic Body Radiation Therapy ◽

Lung Metastases ◽

Disease Free Interval ◽

Stereotactic Body Radiation ◽

Free Interval ◽

Disease Free

Background: Radio-frequency ablation (RFA) and Stereotactic Body Radiation Therapy (SBRT) are two emerging therapies for lung metastases. Introduction: We performed a literature review to evaluate outcomes and complications of these procedures in patients with lung metastases from soft tissue sarcoma (STS). Method: After selection, seven studies were included for each treatment encompassing a total of 424 patients: 218 in the SBRT group and 206 in the RFA group. Results: The mean age ranged from 47.9 to 64 years in the SBRT group and from 48 to 62.7 years in the RFA group. The most common histologic subtype was, in both groups, leiomyosarcoma. : In the SBRT group, median overall survival ranged from 25.2 to 69 months and median disease-free interval from 8.4 to 45 months. Two out of seven studies reported G3 and one G3 toxicity, respectively. In RFA patients, overall survival ranged from 15 to 50 months. The most frequent complication was pneumothorax. : Local control showed high percentage for both procedures. Conclusion: SBRT is recommended in patients unsuitable to surgery, in synchronous bilateral pulmonary metastases, in case of deep lesions and in patients receiving high-risk systemic therapies. RFA is indicated in case of a long disease-free interval, in oligometastatic disease, when only the lung is involved, in small size lesions far from large vessels. : Further large randomized studies are necessary to establish whether these treatments may also represent a reliable alternative to surgery.

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Prognostic Value of Ki67 and Other Clinical and Histopathological Factors in Canine Apocrine Gland Anal Sac Adenocarcinoma

Animals ◽

10.3390/ani11061649 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1649

Author(s):

Emanuela Maria Morello ◽

Marzia Cino ◽

Davide Giacobino ◽

Arturo Nicoletti ◽

Selina Iussich ◽

...

Keyword(s):

Lymph Nodes ◽

Vascular Invasion ◽

Apocrine Gland ◽

Regional Lymph Nodes ◽

Disease Free Interval ◽

Lymph Nodes Metastasis ◽

Free Interval ◽

Histologic Pattern ◽

Anal Sac ◽

Disease Free

Apocrine gland anal sac adenocarcinoma (AGASACA) is locally aggressive and highly metastatic to regional lymph nodes. The aim of this study was to evaluate the prognostic significance of Ki67 in surgically excised AGASACA. Prognostic impact of size, regional lymph nodes metastasis, hypercalcemia, histologic pattern, mitotic count, necrosis, inflammatory and lympho-vascular invasion, anisokaryosis and anisocytosis was also evaluated. Thirty-five dogs were included, twenty-four of which also had metastatic lymph nodes. When the entire population was evaluated, only metastatic disease spread to regional lymph nodes, and necrosis and inflammatory infiltration were correlated to prognosis. When only dogs with metastatic disease were evaluated, size, solid histologic pattern, presence of lymphatic and vascular invasion showed influence on prognosis. Ki67 index was not associated with survival time and disease free interval in any case. The results of this study showed that lymph nodes metastasis at diagnosis reduced disease free interval. Moreover, tumor size greater than 5.25 cm, presence of lymphatic and vascular invasion and a solid histologic pattern were associated with a shorter survival time in dogs with metastasis to regional lymph nodes. Ki67 expression was not significantly associated with prognosis, therefore it could not be considered as a prognostic factor in this tumor type, while the role of hypercalcemia remained unclear.

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AB0563 DISCONTINUATION OF ANTI-TNFα IN PATIENTS WITH PSORIATIC ARTHRITIS: A SINGLE-CENTER EXPERIENCE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3002 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1318.1-1318

Author(s):

D. Graceffa ◽

V. Lora ◽

A. Cristaudo ◽

F. Elia ◽

A. Morrone ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Disease Activity ◽

Power Doppler ◽

Disease Recurrence ◽

Treat To Target ◽

Disease Free Interval ◽

Free Interval ◽

Contrast Enhanced ◽

Factor Inhibitor ◽

Disease Free

Background:TNF inhibitors have been largely demonstrated to be effective and reasonably safe for the treatment of psoriatic arthritis (PsA). Current EULAR guidelines recommend the use of an anti-TNF as first choice treatment in patients with PsA for whom a synthetic DMARD (usually methotrexate or leflunomide) is not efficacious or not well tolerated [1]. In a scenario where biologic treatments are easily available, and the treat to target strategy is widely accepted, a complete disease remission or at least a minimal disease activity are considered realistic goals to be achieved in a growing proportion of patients [2]. However, there remains very little research regarding anti-TNF discontinuation in patients who achieved a complete remission [3-5].Objectives:The primary aim of this study was to measure the disease-free interval after anti-TNF discontinuation, secondary it was investigated whether the use of Power Doppler Ultrasound (PDUS) and Contrast Enhanced Ultrasound (CEUS) could improve the diagnostic accuracy in the recognition of the relapse. Finally, we wanted to characterize the clinical features of the disease recurrence.Methods:From June 2018, 35 patients with PsA (27 males and 8 female) treated with anti-TNF, in stable remission were prospectively monitored for 1 year after treatment discontinuation. Remission was defined as documented absence of clinical and ultrasonographic signs of arthritis or enthesitis. Complete rheumatological and dermatological examinations were performed in all participants, at baseline and every 8-12 weeks: American College of Rheumatology (ACR) 66-68 joint count; Psoriasis Area Severity Index (PASI); patient pain visual analog score (VAS); patient global disease activity VAS; Health Assessment Questionnaire (HAQ); Leeds Enthesitis Index (LEI); Bath Ankylosing Spondylitis Disease Activity Index (BASDAI); Bath Ankylosing Spondylitis Functional Index (BASFI); Power Doppler Ultrasound (PDUS) of the involved joints and entheses, Contrast Enhanced Ultrasound (CEUS) of a selected joint or enthesis and laboratory inflammation tests.Results:31 out of the 35 enrolled patients, experienced a disease recurrence with an average disease-free interval of 27.9±21.1 weeks (Figure 1). In 3 patients the treatment was restored for a relapse of the skin psoriasis, 8 patients reported only axial symptoms of disease relapse and 20 patients had both axial and peripheral joints involvement (average DAPSA score of 23.6±11.1; average BASDAI score of 4.7±2.6; average BASFI score 4.5±2.9). In all cases the disease flare was moderate and all patients promptly regained remission after restarting the treatment. Both PDUS and CEUS were safe and reliable showing a good percentage of accordance (95,4%) in detecting synovitis and enthesitis.Conclusion:The rate of disease relapse of PsA after anti-TNF discontinuation is relevant. However the disease-free interval was not short. Retreatment with the same anti-TNF was effective and safe.References:[1]Gossec L, Baraliakos X, Kerschbaumer A, et al. EULAR recommendations for the management of psoriatic arthritis with pharmacological therapies: 2019 update. Ann Rheum Dis. 2020 Jun;79(6):700-712.[2]Dures E, Shepperd S, Mukherjee S, et al. Treat-to-target in PsA: methods and necessity. RMD Open. 2020 Feb;6(1):e001083.[3]Stober C, Ye W, Guruparan T, et al. Prevalence and predictors of tumour necrosis factor inhibitor persistence in psoriatic arthritis. Rheumatology (Oxford). 2018 Jan 1;57(1):158-163.[4]Huynh DH, Boyd TA, Etzel CJ, et al. Persistence of low disease activity after tumour necrosis factor inhibitor (TNFi) discontinuation in patients with psoriatic arthritis. RMD Open. 2017 Jan 16;3(1):e000395.[5]Ye W, Tucker LJ, Coates LC. Tapering and Discontinuation of Biologics in Patients with Psoriatic Arthritis with Low Disease Activity. Drugs. 2018 Nov;78(16):1705-1715.Disclosure of Interests:None declared.

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Analysis of the immunohistochemical expressions of p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and their correlations with the prognostic factors

Arquivos de Gastroenterologia ◽

10.1590/s0004-28032010000200005 ◽

2010 ◽

Vol 47 (2) ◽

pp. 141-147 ◽

Cited By ~ 19

Author(s):

Hunaldo Lima de Menezes ◽

Mário Jorge Jucá ◽

Edmundo Guilherme de A. Gomes ◽

Benício L. Bulhões B. P. Nunes ◽

Henrique Oliveira Costa ◽

...

Keyword(s):

Prognostic Factors ◽

Cell Differentiation ◽

Colorectal Adenocarcinoma ◽

Sao Paulo ◽

Immunohistochemical Expression ◽

Ki 67 ◽

Disease Free Interval ◽

Free Interval ◽

Specific Mortality ◽

Disease Free

CONTEXT: Search of tumors markers that allow treatment with higher survival rates, and indicate the response to treatment and recurrence of cancer OBJECTIVE: To analyze the immunoexpression of the proteins p53, bcl-2 and Ki-67 in colorectal adenocarcinoma and correlate them with the clinical-pathological prognostic factors. METHOD: Tissue microarray paraffin blocks were made from colorectal adenocarcinoma tissue resected from 82 patients who had undergone surgery but not chemotherapy or radiotherapy, at "Hospital São Paulo", São Paulo, SP, Brazil, between 2002 and 2005. Thin sections (4 µm) were subjected to immunohistochemical reactions, and immunoexpression staining scores were obtained. The scores were correlated with the degree of cell differentiation, staging, disease-free interval, recurrence, survival and specific mortality. The study variables were analyzed using the chi-square and Kaplan-Meier tests to investigate associations with the markers. The significance of the differences between the curves of the disease-free interval and survival was analyzed using the Logrank and Wilcoxon tests. RESULTS: The immunohistochemical expression of p53 was positive in 70 tumors (85.4%) and negative in 12 (14.6%). The expression of bcl-2 was positive in 26 (31.7%) and negative in 56 (68.3%). The expression of Ki-67 was positive in 62 (75.6%) and negative in 20 (24.4%). There was no statistically significant correlation between the expressions of these markers separately or in conjunction, in relation to the degree of cell differentiation, staging, disease-free interval, survival and specific mortality. In relation to recurrence, there was a statistically significant correlation with positive expression of Ki-67 (P = 0.035). CONCLUSION: The immunohistochemical expression of Ki-67 in colorectal cancer is associated with recurrence of this disease.

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Expression of A9 Antigen and Loss of Blood Group Antigens as Determinants of Survival in Patients with Head and Neck Squamous Carcinoma

Otolaryngology ◽

10.1177/019459988709600301 ◽

1987 ◽

Vol 96 (3) ◽

pp. 221-230 ◽

Cited By ~ 20

Author(s):

Thomas E. Carey ◽

Gregory T. Wolf ◽

S. Hsu ◽

J. Poore ◽

K. Peterson ◽

...

Keyword(s):

Head And Neck ◽

Blood Group ◽

Squamous Cell ◽

Primary Tumor ◽

Primary Tumor Site ◽

Disease Free Interval ◽

Free Interval ◽

Disease Free

The murine monoclonal antibody (A9), raised to the human squamous cell carcinoma (SCC) cell-line UM-SCC-1, defines a squamous cell antigen associated with aggressive biologic behavior of SCC cell lines in vivo and in vitro. In the present investigation, A9 antigen was detected in tissue sections from 37 consecutive, previously untreated patients with SCC of the head and nack. All tumors were positive for A9 binding, although three distinct patterns (reflecting different intensities of A9 expression) were identified. The intensity of A9 expression was independent of primary tumor site, tumor differentiation, keratinization, or growth pattern. The frequency of high expression (Pattern 1) grew with increasing T class, N class, and tumor stage, and was associated with loss of blood group expression in the tumor and with low levels of lymphocyte infiltration In the tumor. Strong A9 expression had a statistically signification association with low nuclear grade (i.e., tumors with more mature and fewer enlarged nuclei, P = 0.019), low vascular/stromal response (i.e., patchy response rather than continuous, P = 0.014), and impaired in vitro lymphokine production by peripheral blood leukocytes ( P = 0.0011). Of greatest interest, however, was the strong association of high A9 expression with shortened disease-free interval (DFI) ( P = 0.085) and survival ( P = 0.081) relative to patients with weak A9 tumor staining (Patterns 2 and 3). Similarly, the loss of blood group antigen expression was strongly associated with decreased DFI ( P = 0.038) and survival ( P = 0.062). While neither Pattern 1 A 9 expression nor loss of blood group reach statistical significance in prediction of survival, the combination of Pattern 1 A 9 expression and loss of blood group expression in primary tumors was significantly associated, both with decreased disease-free interval ( P = 0.017) and with decreased overall survival ( P = 0.011) (median length of follow-up = 22 months). The length of follow-up (LFU) ranged from 2 to 38 months, with a median LFU of 22 months. While the number of patients (37) is small, the significant association between the expression of these cell-surface markers with relapse and survival indicates that immunohistologic staining of the primary tumor will be an important prognostic indicator useful in identification of individual patients at greatest risk of recurrence or early death from head and neck cancer, independent of tumor size, site, or stage at presentation. These markers may thus provide means of selecting patients who should receive adjuvant therapy and more intensive monitoring for the early detection of recurrent disease.

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