Bladder-sparing trimodal therapy versus radical cystectomy for muscleinvasive bladder cancer: A systematic review and meta-analysis of comparative studies

Objective: To compare oncologic outcomes between patients with muscle-invasive bladder cancer who were treated with radical cystectomy (RC) or trimodal therapy (TMT). Materials and Methods: The primary sources were the PubMed, Embase, and Cochrane Library electronic databases. Studies published between June 1990 and July 2017 that evaluated combination bladder-sparing surgery for a bladder tumour with radiotherapy (RT) and chemotherapy compared with RC surgery alone for MIBC were included. Published data were extracted and used to calculate the 5-year overall survival rates. The secondary efficacy endpoints were disease-free survival and local and distant recurrence. Results: Nine studies incorporating 15,160 cases were included in the final analysis. Pooled data from 8 studies that assessed overall survival rates for 15,089 patients showed no significant differences in this metric between the TMT and RC groups (HR: 1.27; 95% CI, 0.98-1.63; P=0.066). No significant differences were found between TMT and RC in the subgroup analyses according to the lymph node stage (Nx), age and physiclal status (PS) stage, but differences were found for patients with node-negative disease (HR: 1.36; 95% CI, 1.02-1.81; P=0.036). Disease-free survival and local and distant recurrence did not differ significantly between the techniques. Conclusion: RC seems to be suitable for node-negative disease patients. TMT yielded survival outcomes similar to those of patients who underwent RC. Given the inherent limitations of the included studies, future well-designed RCTs are needed to confirm and update the findings of this analysis.

Ovarian stimulation for oocyte vitrification does not modify disease-free survival and overall survival rates in patients with early breast cancer

Reproductive BioMedicine Online ◽

10.1016/j.rbmo.2019.07.003 ◽

2019 ◽

Vol 39 (5) ◽

pp. 860-867 ◽

Cited By ~ 1

Author(s):

Elkin Muñoz ◽

Javier Domingo ◽

Gonzalo De Castro ◽

Isabel Lorenzo ◽

Juan A. García-Velasco ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Early Breast Cancer ◽

Ovarian Stimulation ◽

Survival Rates ◽

Disease Free Survival ◽

Oocyte Vitrification ◽

Free Survival ◽

Disease Free ◽

Anaplastic ependymoma: treatment of pediatric patients with or without craniospinal radiation therapy

Journal of Neurosurgery ◽

10.3171/jns.1997.86.6.0943 ◽

1997 ◽

Vol 86 (6) ◽

pp. 943-949 ◽

Cited By ~ 95

Author(s):

Thomas E. Merchant ◽

Toni Haida ◽

Ming-Hsien Wang ◽

Jonathan L. Finlay ◽

Steven A. Leibel

Keyword(s):

Overall Survival ◽

Radiation Therapy ◽

Pediatric Patients ◽

Survival Rates ◽

Disease Free Survival ◽

Primary Site ◽

Anaplastic Ependymoma ◽

Free Survival ◽

Disease Free ◽

✓ The authors conducted a retrospective review of the clinical and treatment characteristics and outcomes in 28 pediatric patients with anaplastic ependymoma treated with radiation therapy since the advent of computerized tomography (CT) (1978–1994). Twelve patients received craniospinal irradiation followed by a boost to the primary site, two received whole-brain radiation therapy followed by a boost to the primary site, and the remaining 14 were treated with focal radiation therapy. The mean dose to the primary site was 5486 cGy. With a median follow-up period of 86 months for the 14 surviving patients (range 31–201 months), the median disease-free survival, measured from the date of diagnosis to the time of recurrence after radiation therapy, was 40 months. The median disease-free survival measured from the start of radiation therapy was 32 months. The median overall survival rate has not been reached and the actuarial estimates of overall survival rates at 5 and 10 years were 56% and 38%, respectively. According to univariate analysis, the disease-free survival rate was significantly improved (p < 0.01) in patients who underwent a gross-total resection at diagnosis. Overall survival rates were negatively influenced by treatment with craniospinal and whole-brain irradiation. As calculated by multivariate analysis, increasing dosage to the primary site (p < 0.05), infratentorial location (p < 0.01), and gross-total resections (p < 0.02) resulted in the longest disease-free survival times. All 19 patients in whom treatment failed after radiation therapy suffered a recurrence at the primary site. In addition, one of these patients experienced subarachnoid dissemination. Radiation treatment recommendations for patients with ependymoma have been based on the tumor's location, perceived risk for dissemination, and malignant propensity. The significance of anaplastic histological classification is controversial. Differences in the disease-free and overall survival rates have been demonstrated between ependymomas and anaplastic ependymomas treated in the pre—CT era. The results of this study show that there is no benefit from craniospinal irradiation in this group of patients.

Adjuvant Treatment of High-risk Adult Soft Tissue Sarcomas: A Survey by the Italian Sarcoma Group

Tumori Journal ◽

10.1177/030089160609200202 ◽

2006 ◽

Vol 92 (2) ◽

pp. 92-97 ◽

Cited By ~ 5

Author(s):

Sergio Frustaci ◽

Massimiliano Berretta ◽

Alessandro Comandone ◽

Ettore Bidoli ◽

Antonino De Paoli ◽

...

Keyword(s):

Overall Survival ◽

High Risk ◽

Soft Tissue ◽

Survival Rates ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Free Survival ◽

Disease Free ◽

Aims and Background After the first adjuvant study on adult soft tissue sarcomas was concluded, the participating institutions continued to select and treat patients according to that protocol. The aim of this study was to test the protocol reproducibility when applied as a standard practice. Methods A call for retrospective data was launched in June 1999 (self-referral of consecutive unregistered patients); thereafter, a prospective follow-up was performed. The treatment regimen consisted of epirubicin (60 mg/m2 days 1 and 2), ifosfamide (3 g/m2/die for 3 days) and equimolar doses of 6-mercapto-ethansulfonate (MESNA), with 300 μg G-CSF administered subcutaneously from day +8 until recovery, every 3 weeks for a total of 5 cycles. Results From November 1996 to June 1999, 55 high-risk, adult patients were treated. The average median dose intensity was 89% of the planned program. Grade 3-4 toxicities were leukopenia (49%), thrombocytopenia (14%), transfusion requiring anemia in 7 patients (16%), and alopecia in all patients (100%). After a median follow-up of 70 months, 23 patients (41.8%) relapsed and 19 died. Median disease-free, local disease-free and overall survival rates have not yet been reached. The disease-free survival rates at 2 and 4 years were 73% and 57%, respectively; the corresponding overall survival rates were 91% and 70%, respectively. Conclusions The feasibility and reproducibility of the original protocol were confirmed, since disease-specific overall survival and disease-free survival rates at the same period of observation and with the same prolonged follow-up did not differ.

The Prognostic Value of the Tumor Marker CA 15–3 at Initial Diagnosis of Patients with Breast Cancer

The International Journal of Biological Markers ◽

10.1177/172460080001500412 ◽

2000 ◽

Vol 15 (4) ◽

pp. 340-342 ◽

Cited By ~ 21

Author(s):

R. McLaughlin ◽

J. McGrath ◽

H. Grimes ◽

H.F. Given

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Tumor Marker ◽

Survival Rates ◽

Disease Free Survival ◽

Serum Tumor Marker ◽

Free Survival ◽

Disease Free ◽

CA 15–3 has been most widely used as a serum tumor marker in follow-up and detection of breast cancer recurrence. In this study we have specifically focused upon the prognostic implications and utility of preoperative CA 15–3 levels. We have identified on our database 414 patients with breast cancer in whom serial levels of the serum tumor marker CA 15–3 had been determined at diagnosis and follow-up. We have analyzed the follow-up and clinical outcomes in these patients and from this data we have assessed the potential of CA 15–3 as a predictor of five-year overall and disease-free survival. Our results show that an initially elevated CA 15–3 level is associated with a very poor prognosis in both early and late stage disease. Elevated pre-biopsy CA 15–3 levels are associated with 14% five-year disease-free survival rates and 17% overall survival rates at five years. In contrast, normal CA 15–3 levels are associated with 47% five-year disease-free survival rates and 54% overall survival rates at five years (p<0.01). Comparison of five-year survival rates between patients with elevated and normal CA 15–3 levels in early breast cancer (stage I and II) also showed significant differences, with survival being 41% and 75%, respectively (p<0.01).

15-year Follow-up of Comparing Mastoscopic and Conventional Axillary Dissection in Breast Cancer: A Multicentres, Randomized Controlled Trial

10.21203/rs.3.rs-35580/v1 ◽

2020 ◽

Author(s):

Chengyu Luo ◽

Guang Cao ◽

wenbin Guo ◽

Jie Yang ◽

Qiuru Sun ◽

...

Keyword(s):

Breast Cancer ◽

Overall Survival ◽

Survival Rates ◽

Disease Free Survival ◽

Axillary Lymph ◽

Term Survival ◽

Free Survival ◽

Significant Difference ◽

Abstract Backgroud: Longer follow-up was necessary to testify the exact value of mastoscopic axillary lymph node dissection (MALND).Methods：From January 1, 2003 to December 31, 2005,1027 patients with operable breast cancer were randomly assigned to two groups: MALND and CALND. 996 eligible patients were enrolled. The end points are disease free survival and overall survival.Results：The final cohort of 996 patients was followed for an average of 184 months. The distribution of all events was fairly similar between two groups of patients. The incidence of local in-breast events did not differ in a significant manner between two cohorts. Similarly, the rate of distant metastases was not significantly different with 30.0% in MLND and 32.6% in CALND. And no significant difference was observed in other primary tumor between two groups (p=0.46). Patients who remain alive with no event comprise a total of 37.2% in MALND and 35.4% in CALND. Other primary cancers and deaths from other causes were distributed equally between two groups. The 15-year disease-free survival rates were41.1 percent for the MALND group and 39.6 percent for the CALND group (p=0.79). MALND was found to be not inferior for overall survival (P =0.54). The 15-year overall survival rates were 49.5 percentafter MALND and 51.2 percentafter CALND (p=0.86). Probability of overall survival was not significantly different between two groups.Conclusions：MALND does not increase unfavorable events, and also does not affect the long-term survival of patients. Therefore, MALND should be one of the preferred approaches for breast cancer surgery.

Neck Dissections Based on Sentinel Lymph Node Navigation Versus Elective Neck Dissections in Early Oral Cancers: A Randomized, Multicenter, and Noninferiority Trial

Journal of Clinical Oncology ◽

10.1200/jco.20.03637 ◽

2021 ◽

pp. JCO.20.03637

Author(s):

Yasuhisa Hasegawa ◽

Kiyoaki Tsukahara ◽

Seiichi Yoshimoto ◽

Kouki Miura ◽

Junkichi Yokoyama ◽

...

Keyword(s):

Overall Survival ◽

Lymph Node ◽

Survival Rate ◽

Sentinel Lymph Node ◽

Lower Limit ◽

Disease Free Survival ◽

Sentinel Lymph Nodes ◽

Free Survival ◽

Node Negative ◽

PURPOSE This study aimed to compare patients with early oral cavity squamous cell carcinoma (OCSCC) (tumor category [T] 1-2, node-negative, and no distant metastasis) treated with traditional elective neck dissection (ND) with those managed by sentinel lymph node biopsy (SLNB) using survival and neck function and complications as end points. METHODS Sixteen institutions in Japan participated in the study (trial registration number: UMIN000006510). Patients of age ≥ 18 years with histologically confirmed, previously untreated OCSCC (Union for International Cancer Control TNM Classification of Malignant Tumors 7th edition T1-2, node-negative no distant metastasis), with ≥ 4 mm (T1) depth of invasion, were randomly assigned to undergo standard selective ND (ND group; n = 137) or SLNB-navigated ND (SLNB group; n = 134). The primary end point was the 3-year overall survival rate, with a 12% noninferiority margin; secondary end points included postoperative neck functionality and complications and 3-year disease-free survival. Sentinel lymph nodes underwent intraoperative multislice frozen section analyses for the diagnosis. Patients with positive sentinel lymph nodes underwent either one-stage or second-look ND. RESULTS Pathologic metastasis-positive nodes were observed in 24.8% (34 of 137) and 33.6% (46 of 134) of patients in the ND and SLNB groups, respectively ( P = .190). The 3-year overall survival in the SLNB group (87.9%; lower limit of one-sided 95% CI, 82.4) was noninferior to that in the ND group (86.6%; lower limit 95% CI, 80.9; P for noninferiority < .001). The 3-year disease-free survival rate was 78.7% (lower limit 95% CI, 72.1) and 81.3% (75.0) in the SLNB and ND groups, respectively ( P for noninferiority < .001). The scores of neck functionality in the SLNB group were significantly better than those in the ND group. CONCLUSION SLNB-navigated ND may replace elective ND without a survival disadvantage and reduce postoperative neck disability in patients with early-stage OCSCC.

Perineural Invasion Is an Independent Predictor of Outcome in Colorectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.22.4949 ◽

2009 ◽

Vol 27 (31) ◽

pp. 5131-5137 ◽

Cited By ~ 233

Author(s):

Catherine Liebig ◽

Gustavo Ayala ◽

Jonathan Wilks ◽

Gordana Verstovsek ◽

Hao Liu ◽

...

Keyword(s):

Colorectal Cancer ◽

Overall Survival ◽

Multivariate Analysis ◽

Survival Rate ◽

Perineural Invasion ◽

Disease Free Survival ◽

Free Survival ◽

Node Negative ◽

Disease Free Survival Rate ◽

Purpose Perineural invasion (PNI) is associated with decreased survival in several malignancies, but its significance in colorectal cancer (CRC) remains to be clearly defined. We evaluated PNI as a potential prognostic indicator in CRC, focusing on its significance in node-negative patients. Patients and Methods We identified 269 consecutive patients who had CRC resected at our institution. Tumors were rereviewed for PNI by a pathologist blinded to the patients' outcomes. Overall and disease-free survivals were determined using the Kaplan-Meier method, with differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using the log-rank test. Results PNI was identified in less than 0.5% of the initial pathology reports. On rereview, 22% of tumors in our series were found to be PNI positive. The 5-year disease-free survival rate was four-fold greater for patients with PNI-negative tumors versus those with PNI-positive tumors (65% v 16%, respectively; P < .0001). The 5-year overall survival rate was 72% for PNI-negative tumors versus 25% for PNI-positive tumors. On multivariate analysis, PNI was an independent prognostic factor for both cancer-specific overall and disease-free survival. In a subset analysis comparing patients with node-negative disease with patients with stage III disease, the 5-year disease-free survival rate was 56% for stage III patients versus 29% for patients with node-negative, PNI-positive tumors (P = .0002). Similar results were seen for overall survival. Conclusion PNI is grossly underreported in CRC and could serve as an independent prognostic factor of outcomes in these patients. PNI should be considered when stratifying CRC patients for adjuvant treatment.

VEGF overexpression predicts poor survival in hepatocellular carcinoma

Open Medicine ◽

10.1515/med-2017-0061 ◽

2017 ◽

Vol 12 (1) ◽

pp. 430-439 ◽

Cited By ~ 3

Author(s):

Sae Byeol Choi ◽

Hyung Joon Han ◽

Wan Bae Kim ◽

Tae Jin Song ◽

Sang Yong Choi

Keyword(s):

Overall Survival ◽

Survival Rate ◽

Surgical Resection ◽

Immunohistochemical Staining ◽

Survival Rates ◽

Disease Free Survival ◽

Overall Survival Rate ◽

Free Survival ◽

Disease Free ◽

Capsule Invasion

AbstractObjectiveThe aim of this study was to investigate the clinicopathological and immunohistochemical (including VEGF, Akt, HSP70, and HSP20 expression) factors that affect the overall and disease-free survival of HCC patients following surgical resection.Methods234 patients with HCC following surgical resection were enrolled. Clinicopathological and survival data were analyzed, and immunohistochemical staining was performed on tissue microarray sections using the anti-VEGF, anti-Akt, anti-HSP70, and anti-HSP27 antibodies.ResultsThe 3- and 5-year overall survival rates were 86.5 and 81.54%, respectively. Multivariate analysis revealed that VEGF expression (P = 0.017, HR = 2.573) and T stage (P < 0.001, HR = 4.953) were independent prognostic factors for overall survival. Immunohistochemical staining showed that the expression of Akt, HSP70, and HSP27 did not affect the overall survival rate. The 3- and 5-year disease-free survival rates were 58.2 and 49.4%, respectively. Compared to the VEGF(−)/(+) group, the VEGF(++)/(+++) group demonstrated significantly higher proportion of patients with AFP levels > 400 ng/mL, capsule invasion, and microvascular invasion.ConclusionVEGF overexpression was associated with capsule invasion, microvascular invasion, and a poor overall survival rate.

Hand-assisted laparoscopic versus open surgery for radical gastrectomy in the treatment of advanced distal gastric cancer: long-term overall and disease-free survival (final results of a single-center study)

Journal of International Medical Research ◽

10.1177/03000605211047700 ◽

2021 ◽

Vol 49 (9) ◽

pp. 030006052110477

Author(s):

Guode Luo ◽

Xiaohua Wang ◽

Yajiao Li ◽

Guangyu Chen ◽

Yongkuan Cao ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Open Surgery ◽

Survival Rates ◽

Disease Free Survival ◽

Radical Gastrectomy ◽

Free Survival ◽

Distal Gastric Cancer ◽

Objective To compare the surgical effects and long-term efficacy of hand-assisted laparoscopic surgery (HALS) and open surgery (OS) in radical gastrectomy for advanced distal gastric cancer. Methods One hundred twenty-four patients who were admitted to the Department of Gastrointestinal Surgery of the West War Zone General Hospital from May 2008 to April 2012 were randomly divided into a HALS group (n = 62) and an OS group (n = 62). After surgery, 113 patients were followed up for 5 and 8 years, and 11 patients were lost to follow-up. The 5- and 8-year overall survival and disease-free survival rates of the two groups were compared and analyzed. Results The 5- and 8-year overall survival rates were 31.90% and 18.40% in the HALS group and 32.50% and 18.60% in the OS group, respectively. The 5- and 8-year disease-free survival rates were 21.50% and 13.00% in the HALS group and 21.90% and 13.10% in the OS group, respectively. No significant differences were found. Conclusion Hand-assisted laparoscopic radical gastrectomy for advanced distal gastric cancer has the advantages of less severe trauma, less intraoperative blood loss, more rapid postoperative recovery, and equivalent long-term efficacy compared with OS.

Stage IB Endometrioid Type Endometrial Cancer: The Role of Lymphadenectomy and Adjuvant Radiation Therapy

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2017.704 ◽

2018 ◽

Vol 24 (3) ◽

pp. 156

Author(s):

Osman Turkmen ◽

Tolga Tasci ◽

Derman Basaran ◽

Gunsu Comert Kimyon ◽

Alper Karalök ◽

...

Keyword(s):

Overall Survival ◽

Endometrial Cancer ◽

Adjuvant Radiotherapy ◽

Survival Rates ◽

Disease Free Survival ◽

Adjuvant Radiation ◽

Free Survival ◽

Stage Ib ◽

Gynecology And Obstetrics ◽

Objective: Both performances of lymphadenectomy and benefit of adding adjuvant radiotherapy are controversial for patients with International Federation of Gynecology and Obstetrics stage IB endometrioid type endometrial cancer. We aimed to identify the role of lymphadenectomy and adjuvant radiation therapy as well as clinicopathological prognostic factors for this group of patients. Study Design: Records of all patients (n=132) with stage IB endometrioid endometrial cancer who were referred to or treated in our institution between Jan 1992 and Dec 2013 were retrospectively reviewed. Cox Proportional Hazard Regression Analysis was used to determine the effects of lymphadenectomy and adjuvant radiation as well as other clinicopathological factors on disease free survival and overall survival.Results: Mean age was 59.9 years (range, 45-82). Lymphadenectomy didn't perform in 36 (27.3%) patients and 23 (17.4%) patients did not have any kind of adjuvant treatment. Mean lymph node count was 18.8 (range, 3-67). Federation of Gynecology and Obstetrics grade, lymphovascular space invasion, lymphadenectomy, receiving adjuvant treatment and type of received adjuvant therapy were not associated with disease free survival and overall survival for the entire cohort. In a subgroup of patients with grade1&2 tumor, 5-year disease free survival rates were 80% and 50% (p=0.4), respectively and overall survival rates were 94.8% and 93.8% (p=0.2), respectively for patients who had or didn't have adjuvant radiotherapy. While performance of lymphadenectomy was not significantly associated with disease free survival in this subgroup (p=0.56), this association was statistically significant for overall survival (97.9% vs. 86.4%, p=0.04) Conclusion: Benefit of adjuvant radiotherapy in regard to prevention of recurrence needs to be confirmed by further studies. Lymphadenectomy had a survival benefit for patients with myometrial invasion greater than a half of myometrial thickness.