Pilot Therapeutic Protocol for the Treatment of Local Advanced Disease, such as the Generalized Peritoneal Carcinomatosis and for the Treatment of Distant Metastases in Human Malignant Neoplastic Disease-Targeting the Medium

ContextPeritoneal carcinomatosis (PC) is a rare site of distant metastases in patients with adrenocortical cancer (ACC). One preliminary study suggests an increased risk of PC after laparoscopic adrenalectomy (LA) for ACC.ObjectiveThe objective of the study was to search for risk factors of PC including surgical approach.DesignThis was a retrospective cohort study conducted in an institutional practice.PatientsSixty-four consecutive patients with ACC seen at our institution between 2003 and 2009 were included. Mean tumor size was 132 mm. Patients had stage I disease in 2 cases, stage II disease in 32 cases, stage III disease in 7 cases, stage IV disease in 21 cases, and unknown stage disease in 2 cases. Surgery was open in 58 cases and laparoscopic in 6 cases.Main outcomeThe main outcome was the risk factors of PC.ResultsPC occurred in 18 (28%) patients. It was present at initial diagnosis in three cases and occurred during follow-up in 15 cases. The only risk factor of PC occurring during follow-up was the surgical approach with a 4-year rate of PC of 67% (95% confidence interval (CI), 30–90%) for LA and 27% (95% CI, 15–44%) for open adrenalectomy (P=0.016). Neither tumor size, stage, functional status, completeness of surgery, nor plasma level of op'DDD was associated with the occurrence of PC.ConclusionWe found an increased risk of PC after LA for ACC. Whether this is related to an inappropriate surgical approach or to insufficient experience in ACC surgery should be clarified by a prospective program.

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Alternatives for the treatment of local advanced disease: electrochemotherapy, limb perfusion, limb infusion, intralesional IL2. What is the role?

Dermatologic Therapy ◽

10.1111/j.1529-8019.2012.01486.x ◽

2012 ◽

Vol 25 (5) ◽

pp. 443-451 ◽

Cited By ~ 9

Author(s):

Alessandro Testori ◽

Antonio Intelisano ◽

Francesco Verrecchia ◽

Claudia Menicanti ◽

Giulio Tosti ◽

...

Keyword(s):

Advanced Disease ◽

Limb Perfusion ◽

Local Advanced

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Controversies in Rectal Cancer Treatment and Management

American Society of Clinical Oncology Educational Book ◽

10.1200/edbk_279871 ◽

2020 ◽

pp. 136-146

Author(s):

Weijing Sun ◽

Raed Al-Rajabi ◽

Rodrigo O. Perez ◽

Saquib Abbasi ◽

Ryan Ash ◽

...

Keyword(s):

Rectal Cancer ◽

Cancer Treatment ◽

Organ Preservation ◽

Advanced Disease ◽

Treatment Modalities ◽

Preoperative Treatment ◽

Perioperative Therapy ◽

Rectal Cancer Treatment ◽

New Treatment ◽

Local Advanced

Incorporation of new treatment modalities has significantly increased the complexity of the treatment and management of rectal cancer, including perioperative therapy for local advanced disease and organ preservation for those with response to the preoperative treatment. This review may help practitioners better understand the rationale and selection.

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Multiple organ resection for large paraganglioma − a case report

10.33699/pis.2021.100.3.138-142 ◽

2021 ◽

Vol 100 (3) ◽

Keyword(s):

Neuroendocrine Tumours ◽

Advanced Disease ◽

Radical Surgery ◽

Treatment Options ◽

Distant Metastases ◽

Radical Resection ◽

Early Recurrence ◽

Multiple Organ ◽

Multiple Treatment ◽

Symptoms And Signs

Paragangliomas represent a group of neuroendocrine tumours which occur in various localizations. Most of them produce catecholamines, and in advanced cases present with typical symptoms and signs such as palpitations, headache and hypertension. The only curative treatment is radical resection. About one-quarter of paragangliomas are malignant, defined by the presence of distant metastases. There are multiple treatment options for unresectable metastatic tumours. They include radionuclid therapy, chemotherapy, and radiotherapy, although none of them are curative. Cytoreductive surgery can also be considered, especially when the goal is to decrease symptoms related to advanced disease. We present a rare case of a large paraganglioma of the left retroperitoneum. Despite radical surgery, early recurrence of the disease was observed.

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Isolated Contralateral Axillary Lymph Node Involvement in Breast Cancer Represents a Locally Advanced Disease Not Distant Metastases

Clinical Breast Cancer ◽

10.1016/j.clbc.2017.10.019 ◽

2018 ◽

Vol 18 (4) ◽

pp. 298-304 ◽

Cited By ~ 5

Author(s):

Rati Chkheidze ◽

Mary Ann G. Sanders ◽

Barbara Haley ◽

A. Marilyn Leitch ◽

Sunati Sahoo

Keyword(s):

Breast Cancer ◽

Lymph Node ◽

Axillary Lymph Node ◽

Advanced Disease ◽

Locally Advanced ◽

Distant Metastases ◽

Lymph Node Involvement ◽

Axillary Lymph ◽

Node Involvement ◽

Axillary Lymph Node Involvement

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Dilemmas in Metastatic Differentiated Thyroid Cancer: To irradiate, medicate, or palliate?

World Journal of Endocrine Surgery ◽

10.5005/jp-journals-10002-1184 ◽

2016 ◽

Vol 8 (2) ◽

pp. 168-171

Author(s):

Melissa H Lee ◽

Jayne E Moxey ◽

Sue-Anne McLachlan ◽

Richard J MacIsaac ◽

Nirupa Sachithanandan

Keyword(s):

Thyroid Cancer ◽

Thyroid Carcinoma ◽

Differentiated Thyroid Cancer ◽

Kinase Inhibitors ◽

Advanced Disease ◽

Clinical Success ◽

Initial Diagnosis ◽

Neoplastic Disease ◽

Cell Adenoma

ABSTRACT Aims To explore the challenges in the management of metastatic differentiated thyroid cancer. Introduction Differentiated thyroid cancer (DTC) is the most common form of thyroid cancer. The initial diagnosis of thyroid carcinoma and the distinction between benign and neoplastic disease can be challenging. Radioiodine-refractory metastatic DTC also presents a therapeutic dilemma. Novel targeted agents for advanced radioiodine-refractory metastatic thyroid cancer, such as tyrosine kinase inhibitors (TKIs), are being increasingly used with clinical success, broadening current available therapeutic options. Case report We present the case of a 61-year-old woman with radioiodine-refractory metastatic follicular thyroid carcinoma, which was initially misdiagnosed as benign Hurthle cell adenoma. We focus on the challenges in both the initial diagnosis and the subsequent management of her advanced disease with skeletal dominant metastases. Conclusion The advent of targeted systemic therapies as emerging frontline and salvage therapy is a novel addition to the management of radioiodine-refractory advanced DTC. Further studies to expand the role of sequential and redifferentiation therapy for advanced disease and strategies to reduce skeletalrelated events are still required. How to cite this article Lee MH, Moxey JE, McLachlan S-A, MacIsaac RJ, Sachithanandan N. Dilemmas in Metastatic Differentiated Thyroid Cancer: To irradiate, medicate, or palliate? World J Endoc Surg 2016;8(2):168-171.

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Imaging of Rectal Carcinoma at Surveillance

KYAMC Journal ◽

10.3329/kyamcj.v9i3.38780 ◽

2018 ◽

Vol 9 (3) ◽

pp. 104-109

Author(s):

Md Mofazzal Sharif ◽

Islam U Chowdhury ◽

Deepak Shankar Ray ◽

Mst Monira Khatun ◽

Samia Ahmed ◽

...

Keyword(s):

Rectal Carcinoma ◽

Residual Disease ◽

Distant Metastases ◽

Cancer Registries ◽

Post Treatment ◽

Neoplastic Disease ◽

Imaging Findings ◽

Surveillance Imaging ◽

Rectovesical Fistula ◽

One Year

Background: Among communicable and non-communicable diseases, neoplastic diseases are the 6th leading cause of death in Bangladesh. Hospital-based cancer registries in Bangladesh reveal more than 50% of subjects with neoplastic disease (cancer) are estimated to be within 30 to 65 years of age.Objective: To observe imaging findings in patient with rectal carcinoma in terms of no residual disease, post treatment fibrosis, residual disease, loco-regional recurrence and metastasis at surveillance by CT, MR scan.Methodology: CT and MRI scan was performed with standard protocol among 64 subjects (both males, females) over a period of one year at department of Radiology and Imaging, KYAMCH who came for follow up. The study subjects were referred from Department of Oncology of same institution.Result: Among total 64 patients majority were female (54.68%) and rest were male (45.32%) and mean age was 51.38 (± 22.86) years. Most (26.56%) of the patients were in 31-40 years age group. CT scan was performed in 81.25% and MRI in 31.25% patients. No recurrence was observed to surveillance imaging in 18.75% patients. Post treatment fibrosis were seen in 23.43% and locoregional recurrence in 20.31% subjects. Local extension (35.93%), lymphadenopathy (43.75%) and distant metastases (26.56%) were observed. Associated imaging findings other than tumour recurrence or extension were ischaemic colitis (10.93%), perforation (4.68%), rectovesical fistula (3.12%), rectouterine fistula (1.56%) and rectovaginal fistula (6.25%). Other than loco regional extension, distant metastases were observed in liver (14.06%), lung (10.94%), bone (6.25%) and brain (4.68%).Conclusion: This study reveals that during image analysis of patients with rectal carcinoma, radiologists should carefully distinguish post treatment fibrosis from local recurrence, check the locoregional areas, possible sites for metastasis and oncologist should request for screening of chest including lower part of neck at the time imaging of abdomen at follow up.KYAMC Journal Vol. 9, No.-3, October 2018, Page 104-109

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Nasopharyngeal Carcinoma: Evidence for Improved Survival with Combined Chemoradiation

Ear Nose & Throat Journal ◽

10.1177/014556139807700611 ◽

1998 ◽

Vol 77 (6) ◽

pp. 484-489

Author(s):

Timothy L. Smith ◽

Douglas C. DiRugguero ◽

Mark C. Weissler

Keyword(s):

Squamous Cell Carcinoma ◽

Radiation Therapy ◽

Nasopharyngeal Carcinoma ◽

Advanced Disease ◽

Nasopharyngeal Cancer ◽

Distant Metastases ◽

Concurrent Chemoradiation ◽

Traditional Treatment ◽

Kaplan Meier ◽

Radiotherapy Alone

Radiation therapy has been the traditional treatment for nasopharyngeal carcinoma. Patients with advanced disease have a higher rate of locoregional as well as distant metastases, which has warranted the addition of chemotherapy in an attempt to improve survival. This retrospective study was designed to determine the absolute survival of patients with nasopharyngeal cancer treated with radiation alone, compared to that of patients receiving concurrent chemoradiation. Between December 1975 and December 1993 eight patients were treated with radiotherapy alone and 14 patients were treated with concurrent chemoradiation using 5-fluorouracil and cisplatin. Analysis of Kaplan-Meier cumulative absolute survival plots revealed that patients receiving chemoradiation survived longer than those receiving radiation alone (p=0.0321). Patients with lymphoepithelioma, as opposed to squamous cell carcinoma, and patients younger than 30 years were also found to have longer survival, although these differences were not statistically significant (p=0.0913 and p=0.04044, respectively).

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