scholarly journals Management of Medulloblastoma Metastases: Algerian Experience

2021 ◽  
pp. 1-3
Author(s):  
K Badache ◽  
Keyword(s):  
Surgical Excision ◽  
Clinical Results ◽  
Pathological Study ◽  
Average Delay ◽  
Term Survival ◽  
Imaging Results ◽  
Standard Risk ◽  
Symptoms And Signs ◽  
Health Hospital

This work is based on the study of patients treated for medulloblastoma metastasis at diagnosis between January 2006 and December 2015 in the neurosurgery department of the Ait IDDIR Health Hospital Establishment. Our series consisted of 16 patients, 11 men and 5 women; the median age was 16.9 years. The baseline, presentation of symptoms and signs, imaging results (MRI), surgical results and clinical results were recorded. The clinical manifestation was revealed by intracranial hypertension syndrome (100%), associated with cerebellar syndrome (80%). The localization was in Intra-nevraxics: (81.25%) and in Extra-nevraxics (18.75%). 68.75% of patients underwent total surgical excision and 31.25% underwent subtotal surgical excision. The presence of malignant cells in the CSF is marked in 56.25%. The pathological study revealed that 62.5% of cases had a classic variant and 37.5% a desmoplastic variant. 30% of the cases were classified as “standard risk” and 70% as “high risk”. The surgery was supplemented by radiotherapy of the entire neuraxis using the “movable junctions” technique in all cases. The average delay was 70 days. Adjuvant chemotherapy was performed in 9 cases. The long-term survival rate after metastasis varies between 06 months to 24 months, only 04 cases (25%) are still alive. The management of medulloblastoma must be multidisciplinary involving neurosurgeons and radiotherapist oncologists. This collaboration is the only guarantee of an improvement in his prognosis

Clinical, functional and radiographic outcomes after revision total hip arthroplasty with tapered fluted modular or non-modular stems: a systematic review

2021 ◽  
pp. 112070002110043
Author(s):  
Antonios A Koutalos ◽  
Sokratis Varitimidis ◽  
Konstantinos N Malizos ◽  
Theofilos Karachalios
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Revision Rate ◽  
Clinical Results ◽  
Fracture Rate ◽  
Revision Total Hip Arthroplasty ◽  
Term Survival ◽  
Total Hip ◽  
Radiographic Outcomes

Purpose: The aim of the study was to systematically evaluate clinical outcomes of tapered fluted stems, either monoblock or modular, in revision total hip arthroplasty. Methods: PubMed, EMBASE and Web of Science and Cochrane databases were systematically searched by 2 researchers. Clinical studies reporting primarily on survival and re-revision rates, and secondarily on subsidence, dislocation, intraoperative fractures, periprosthetic fractures and infection were included. 2 investigators assessed the quality of the studies. Results: 46 studies were included in this review, reporting on 4601 stem revisions. The pooled re-revision rate was 5.1% and long-term survival ranged from 75% to 98.5%. No differences were observed between monoblock and modular stems regarding re-revision rate, dislocation rate, periprosthetic fracture rate or infection rates. Monoblock stems exhibited more subsidence and modular stems displayed more intraoperative fractures. Conclusions: Satisfactory results can be obtained with the use of tapered fluted end-bearing stems. Monoblock stems offer the same clinical results as modular stems.

scholarly journals Clinical Results of Oxidized Zirconium Femoral Component in TKA. A Review of Long-Term Survival

2016 ◽  
Vol 13 (1) ◽  
pp. 32-34 ◽  
Author(s):  
Roberto Civinini ◽  
Fabrizio Matassi ◽  
Christian Carulli ◽  
Luigi Sirleo ◽  
Andrea Cozzi Lepri ◽  
...  
Keyword(s):  
Femoral Component ◽  
Clinical Results ◽  
Term Survival ◽  
Long Term Survival ◽  
Oxidized Zirconium

EXTH-13. LOCAL DELIVERY OF AN IL-15 SUPERAGONIST USING A REPLICATING RETROVIRUS SIGNIFICANTLY IMPROVES SURVIVAL AND LYMPHOCYTE INFILTRATION IN POORLY IMMUNOGENIC MURINE GLIOBLASTOMA MODELS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi166-vi166
Author(s):  
Alexander Haddad ◽  
Jordan Spatz ◽  
Megan Montoya ◽  
Sara Collins ◽  
Sabraj Gill ◽  
...  
Keyword(s):  
T Cell ◽  
Median Survival ◽  
T Cell Activation ◽  
Term Survival ◽  
Long Term Survival ◽  
Immunosuppressive Cell ◽  
Imaging Results ◽  
Local Immunosuppression ◽  
Inflammatory Changes

Abstract Glioblastoma (GBM) leads to severe systemic and local immunosuppression, and immunotherapies have had limited clinical success. Here, we evaluated the treatment efficacy of RLI, a superagonist of T-cell activator IL-15, delivered to tumor cells using a tumor-selective retroviral replicating vector (RRV) in the syngeneic murine SB28 and Tu2449 GBM models, which are both engineered to be poorly immunogenic with low-mutational burden and known resistance to immunotherapy, and hence more accurate biomimetic models of human GBM. RRV-RLI replicated and spread effectively in cultured murine GBM cells with robust production of functional RLI (165.4 ± 5.3 ng/mL). Stereotactic injection of RRV-RLI into pre-established intracerebral SB28 tumors significantly reduced tumor growth on bioluminescent imaging, and increased median survival compared to control mice (55 vs. 19 days, p=0.002), leading to long-term survival in 12% of treated mice. In the Tu2449 model, imaging results showed complete eradication of intracerebral tumors after RRV-RLI treatment, with long-term survival (median not reached) in > 85% of treated mice, compared to a median survival of 12.5 days in control mice (p=0.001). RRV-RLI treated tumors showed significantly increased CD8 T-cell infiltration, without altering immunosuppressive cell populations. Similarly, broad anti-tumor inflammatory changes, including increased expression of genes involved in T-cell activation and killing, were observed in the NanoString nCounter platform using a 770-gene panel representing various immune cell types. Notably, RLI was not detected in the blood of treated mice, and tumor-localized RRV-RLI gene delivery showed no adverse systemic immune effects in either model. In summary, RRV-mediated RLI immunotherapy results in immunostimulatory and pro-inflammatory changes to the tumor microenvironment and achieves a significant survival benefit in two poorly immunogenic syngeneic murine models of GBM. This tumor-localized immunomodulatory gene therapy has the potential to safely reverse the T-cell depleted immunophenotype of GBM.

scholarly journals Cardiac Metastasis from Medullary Thyroid Cancers with Long-Term Survival under Vandetanib

2021 ◽  
pp. 1-6
Author(s):  
Camille Buffet ◽  
Sophie Leboulleux ◽  
Françoise Kraeber-Bodéré ◽  
Caroline Bodet-Milin ◽  
Laure Cabanes ◽  
...  
Keyword(s):  
Kinase Inhibitor ◽  
Surgical Excision ◽  
Cardiac Metastasis ◽  
Term Survival ◽  
Long Term Survival ◽  
Thyroid Cancers ◽  
Medullary Thyroid ◽  
Cardiac Metastases

<b><i>Background:</i></b> Cardiac metastases from thyroid cancers are uncommon with a poor prognosis. There is a lack of long-term follow-up studies. <b><i>Cases:</i></b> We report 2 cases of cardiac metastasis from medullary thyroid cancer (MTC). Both patients presented limited metastatic disease apart from a cardiac metastasis. The initial diagnosis was challenging and was facilitated by functional imaging with an immuno-PET-CT using an anti-CEA bispecific antibody and a <sup>68</sup>Ga-labeled peptide. Both patients were treated with the multitarget kinase inhibitor vandetanib with prolonged stability. The first patient was alive at the last follow-up, 14 years after the diagnosis of cardiac metastasis. The second patient required surgical excision of the cardiac mass because of disease progression under vandetanib. <b><i>Conclusion:</i></b> These cases illustrate long-term survival and effectiveness of clinical management of 2 patients who developed cardiac metastases from MTC, in the current era of personalized medicine with targeted therapy.

Sclerosing Hemangioma of the Lung

2009 ◽  
Vol 133 (5) ◽  
pp. 820-825 ◽  
Author(s):  
C. P. T. Joren B. Keylock ◽  
Jeffrey R. Galvin ◽  
Teri J. Franks
Keyword(s):  
Regional Lymph Node ◽  
Benign Lesion ◽  
Surgical Excision ◽  
Cell Types ◽  
Additional Treatment ◽  
Term Survival ◽  
Sclerosing Hemangioma ◽  
Architectural Patterns ◽  
Node Metastases

Abstract We present a brief review of sclerosing hemangioma, an uncommon but histologically distinctive neoplasm of the lung. Based on immunohistochemical and molecular findings, sclerosing hemangioma is thought to be derived from incompletely differentiated respiratory epithelium. Sclerosing hemangiomas typically present as asymptomatic, peripheral, solitary, well-circumscribed lesions in women with a mean age at diagnosis in the fifth decade. Rare cases are reported to have regional lymph node metastases; however, metastases do not appear to affect long-term survival. Histologically, sclerosing hemangioma is characterized by a distinct constellation of findings including 2 epithelial cell types, surface cells and round cells, which form 4 architectural patterns, papillary, sclerotic, solid, and hemorrhagic. Sclerosing hemangioma of the lung is generally considered to be a benign lesion, and surgical excision is curative without the need for additional treatment.

Autologous Peripheral Blood Stem Cell Transplantation (PBSCT) Combined with Haploidentical Lymphocytes Infusion Increases the Long Term Survival of Adult Acute Myeloid Leukemia with Standard Risk.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2879-2879
Author(s):  
Bingyi Wu ◽  
Guo Kunyuan ◽  
Haiyan Hu ◽  
Yuliang Yang ◽  
Lan Deng ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Stem Cell ◽  
Peripheral Blood ◽  
Myeloid Leukemia ◽  
Peripheral Blood Stem Cell ◽  
Term Survival ◽  
Standard Risk ◽  
Blood Stem Cell Transplantation ◽  
Acute Myeloid

Abstract OBJECTIVES: The long term survival of adult patients with acute myeloid leukemia with standard risk factor which treated by autologous peripheral blood stem cell transplantation is about 30–50%. We designed a new therapy to improve the long term survival of adult patients with acute myeloid leukemia with standard risk factor. After completely remission, patients underwent 2–3 courses of consolidation chemotherapy. Autologous peripheral blood stem cell transplantation (PBSCT) was performed. After hematology recovery, haploidentical lymphocytes irradiated with 7.5 Gy were infused into patients. Here we evaluate the outcome of this approach in adult patients with acute myeloid leukemia with standard risk. METHODS: From July 1998 to July 2007, twenty-four patients including 17 males and 7 females, median age 36 year old (range 14–58) with acute myeloid leukemia with morphology M2 subtype and normal karotype received this approach therapy. Autologous peripheral blood stem cells were collected by aphereses and froze in −198° and storied after 2–3 courses of median dose cytarabine consolidation chemotherapy The autologous stem cells were grafted to patients following the conditioning with the BuCy regimen (Bu16mg/kg and CTX 120mg/kg). Haploidentical lymphocytes obtained by leukapheresis from sibling donors or other relatives were irradiated with 7.5 Gy and were infused into patients after hematopoietic reconstitution. RESULTS: A median dose of 2.5×108/kg, nucleated cells/kg (range, 2.97×107/kg-6.0×108/kg)containing 5 × 106 CD34+ cells/kg (range,1.5– 4.8) were autografted. All patients were got hematopoietic reconstitution. The median time for granulocyte recovery >0.5 × 109 /L was 11 days and for platelets >20 × 109/L was 14 days following transplantation. All patients were administrated a median dose of 2.0×108/kg haploidentical lymphocytes irradiated with 7.5 Gy. Severe acute GVHD occurred in two patients. One died with severe acute GVHD. Hematopoietic reconstitution delayed in four patients. No other side effects were observed. For the whole group of 24 patients, the median overall survival rate (OSR) was 83.7%. The median disease-free survival (DFS) time was 28.3 moths (range 2–120 m) and the 5-year DFS rate was 50%. The 2-year OS rate was 71%. After a median follow-up of 5.0 years from transplantation, the median DFS and OS were 28.3 years respectively, and the 3-year rates were 50%. Nineteen patients were still in continuous complete remission, 4 patients had relapsed and 3 had died. CONCLUSIONS: Autologous peripheral blood stem cell transplantation (PBSCT) combined with haploidentical lymphocytes infusion may prolong the long term survival of adult acute myeloid leukemia with standard risk.

Neurological morbidity in survivors of childhood acute lymphoblastic leukemia (ALL)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 9529-9529
Author(s):  
B. Morris ◽  
R. Khan ◽  
D. Ledet ◽  
C. Howell ◽  
C. Pui ◽  
...  
Keyword(s):  
Back Pain ◽  
Lymphoblastic Leukemia ◽  
Sensory Neuropathy ◽  
Neurological Symptoms ◽  
Term Survival ◽  
Childhood All ◽  
Number Of Patients ◽  
Neurological Morbidity ◽  
Symptoms And Signs

9529 Background: The majority of children diagnosed with ALL over the past two decades have achieved long-term survival. This remarkable success is attributed in part to intensive central nervous system (CNS)-directed therapy that effectively prevents CNS relapse. Because treatment-related neurological morbidity is recognized but poorly characterized, the objective of this cross-sectional study was to estimate the prevalence of neurological symptoms and signs in long-term survivors of childhood ALL. Methods: After obtaining IRB approval, all long-term ALL survivors (≥ 5 years since diagnosis) aged 6–28 years who remained active patients at our institution were identified. All participants completed a questionnaire consisting of independent (and when possible validated) instruments designed to identify various neurological symptoms, as well as, a comprehensive and standardized neurologic examination by a board-certified neurologist. Results: Of the 433 potentially eligible subjects, 162 (37.4%) were enrolled. Participant demographic information and previous treatment exposure were similar to those not enrolled in the study. The rates of endorsed neurological symptoms were: neuropathy (40.1%), dizziness (33%), back pain (22.8%), fatigue (19.1%), falls (15.4%), headache (14.8%), seizures (10.5%), urinary incontinence (8.6%), and stroke (1.2%). Neurological examination confirmed an underlying sensory neuropathy in 44 patients (27.3%). Otherwise, signs of chronic cranial nerve dysfunction (1.9%) and motor weakness (5.6%) were rare. Conclusions: Symptoms and signs of a chronic sensory neuropathy, presumably from previous vincristine exposure, were evident in many patients. Complaints of fatigue, dizziness, and chronic back pain were also relatively common. The number of patients who routinely fall is of concern. Whether these falls are associated with symptoms/signs of neuropathy, weakness, and/or dizziness will require further analysis. Although headache was a common complaint, its prevalence may not differ significantly from a normal age-matched population. No significant financial relationships to disclose.

Long-Term Survival in a Rare Case of Malignant Esophageal Schwannoma Cured by Surgical Excision

2011 ◽  
Vol 92 (1) ◽  
pp. 357-358 ◽  
Author(s):  
Shaohua Wang ◽  
Jian Zheng ◽  
Zheng Ruan ◽  
Hailong Huang ◽  
Zhaorui Yang ◽  
...  
Keyword(s):  
Rare Case ◽  
Surgical Excision ◽  
Term Survival ◽  
Long Term Survival ◽  
Esophageal Schwannoma

scholarly journals Surgical Management of Large Gastrinomas in a Young Patient With MEN1

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A1006-A1007
Author(s):  
Nydia Burgos ◽  
Janet Marie Colon Castellano ◽  
Yadiel Rivera Nieves ◽  
Nicolle Canales Ramos ◽  
Alberto Javier Grana Santini ◽  
...  
Keyword(s):  
Young Patient ◽  
Surgical Management ◽  
Neuroendocrine Tumors ◽  
Surgical Approach ◽  
Pancreatic Head ◽  
Surgical Excision ◽  
High Morbidity ◽  
Term Survival ◽  
Acid Suppression Therapy

Abstract Multiple Endocrine Neoplasia 1 (MEN1) is a well-described hereditary disorder that requires a multidisciplinary approach. Gastrinomas are the most common enteropancreatic tumors found in MEN1. They often appear as small (&lt; 0.5 cm) multifocal lesions and are rarely found as large masses in the pancreas. The crossroads of deciding between medical versus surgical management when treating these tumors requires an evidenced-based- and patient-centered approach. We describe a rare case of a young patient with MEN1 and large pancreatic gastrinomas. A 23-year-old female patient with MEN1 (prolactinoma, primary hyperparathyroidism) was evaluated for the development of hypocalcemia after surgical excision of 3 parathyroid glands. A prior history of a perforated peptic ulcer prompted further evaluation that revealed gastrin levels of 481 pg/ml (13 - 115 pg/ml) off any acid suppression therapy, and an abdominopelvic MRI that revealed two T1 hypointense lesions measuring 2.4 cm and 1.4 cm at pancreatic head and tail, respectively. Both lesions resulted to be grade 2/3 neuroendocrine tumors consistent with gastrinoma. Abdominopelvic CT scan for staging showed 6 isodense lesions distributed within the pancreas measuring up to 3.2 cm without lymphadenopathy nor metastatic liver lesions. After extensive discussion regarding management, the patient opted for a surgical approach. A total pancreaticoduodenectomy was performed. The pathology revealed 7 grade 2 well-differentiated neuroendocrine tumors (6 in pancreas and 1 in duodenum) and 18 of 22 positive lymph nodes. Post-surgically she experienced multiple admissions due to surgical complications and the expected endocrine and exocrine dysfunction. Eight weeks after surgery gastrin remained elevated [652 pg/ml (13 - 115 pg/ml)]. The surgical management of gastrinomas in MEN1 remains without consensus. Due to the multifocality of gastrinomas associated with MEN1 and the high probability of persistent hypergastrinemia, surgery is not usually recommended. However, most guidelines are in favor of surgical excision for tumors &gt; 2 cm to decrease their associated risk for liver metastasis and improve long-term survival. In this young patient with a 3.2 cm tumor, a surgical approach was favored to improve prognosis. Persistent hypersecretion may occur, as in our patient, due to residual hypertrophy of gastric parietal cells, although the possibility of remaining tumors still exists, especially in view of high lymph node positivity. The best available evidence-based treatment alternatives were offered to our patient; unfortunately, both the disease itself and surgical treatment options impose high morbidity and decreased quality of life. More studies reporting on the long-term outcomes after surgical resection of gastrinomas in MEN1 are needed to identify predictors to help recognize patients which benefit from a surgical approach.

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