scholarly journals Impact of targeted treatment in non-Hodgkin’s lymphoma with primary lymph node involvement

2021 ◽  
Vol 64 (5) ◽  
pp. 56-61
Author(s):  
Victor Tomacinschii ◽  
◽  
Maria Robu ◽  
Sanda Buruiana ◽  
Veronica Finciuc ◽  
...  
Keyword(s):  
Lymph Node ◽  
Malignant Tumors ◽  
Progression Free Survival ◽  
Lymph Node Involvement ◽  
Free Survival ◽  
Node Involvement ◽  
The Mean ◽  
Group 2 ◽  
Primary Lymph Node ◽  
Hodgkin's Lymphomas

Background: Non-Hodgkin’s lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. Primary lymph node (LN) involvement is the most common localization (52-70%). The integration of Rituximab (R) in the NHL treatment represented a turning point. The aim of this study was to evaluate the therapeutic impact of the use of R in combination with conventional polychemotherapeutic (PChT) in the treatment of nodal onset NHL. Material and methods: A descriptive cohort study was performed on 80 patients diagnosed with NHL. Results: In the study participated: men – 39(48.8%), women – 41(51.2%). The mean age of the patients was 56.09 ± 13.6 years. The onset of NHL occurred in peripheral l/n in 85.0% of cases, in mediastinal LN – 7.5%, and abdominals in 7.5%. Stages I-II were identified in 21(26.2%) patients, stages III-IV in 59(73.8%) cases. Aggressive NHLs were diagnosed in 54(67.5%) patients, indolent NHLs in 26(32.5%) cases. In 61(76.3%) patients, first-line R+PChT treatment was applied – group 1(G1), and in 19(23.8%) cases conventional PChT was applied – group 2(G2). The overall response rate (ORR) in G1 was 86.8%, in G2 – 63.1%. Complete remissions (CR) were obtained in G1 in 63.9% of patients, in G2 – 47.3% of cases. Progression-free survival (PFS) in G1 had a median of 20 months, and in G2 the median was 12 months (p <0.05). Conclusions: The use of Rituximab increased the ORR rate (86.8% vs 63.1%), the frequency of CR (63.9% vs 47.3%) and PFS (20 months vs 12 months (p <0.05).

Is Adjuvant Radiochemotherapy Always Mandatory in Patients with Resected N2 Non-Small Cell Lung Cancer?

2021 ◽  
Author(s):  
Samantha Taber ◽  
Joachim Pfannschmidt ◽  
Torsten T. Bauer ◽  
Torsten G. Blum ◽  
Christian Grah ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lymph Node ◽  
Adjuvant Treatment ◽  
Lymph Node Involvement ◽  
Small Cell ◽  
Small Cell Lung ◽  
Term Survival ◽  
Node Involvement ◽  
The Mean

Abstract Background In patients with non-small cell lung cancer (NSCLC), the pathologic union for international cancer control (UICC) stage IIIA is a heterogeneous entity, with different forms of N2-lymph node involvement representing different prognoses. Although a multimodality treatment approach, including surgery, systemic therapy, and/or radiotherapy, is almost always recommended, in this retrospective observational study, we sought to determine whether long-term survival might be possible in selected patients who are treated with complete surgical resection alone. Methods Between 2013 and 2018, we retrospectively identified 24 patients with NSCLC (16 men and 8 women), who were found to have pathologic N2-lymph node involvement, and were treated with complete surgical lung resection and systematic mediastinal and hilar lymph node dissection but no neoadjuvant or adjuvant treatment. Results The most frequent reason (n = 14) for forgoing adjuvant treatment was patient refusal. The mean overall survival (OS) was 34.5 months (interquartile range [IQR]: 15.5–53.5 months). The mean disease-free survival (DFS) was 18 months (IQR: 4.75–46.75 months). We identified five patients who survived at least 5 years without recurrence (21%). In each of these cases, the nodal metastases were restricted to a single level and no extracapsular lymph node involvement were detected. Additionally, worse DFS was associated with pT3/4 (vs. a lower T-stage), as well as microscopic lymphovascular invasion. Conclusion Although the small sample size precludes any definitive conclusions, it was possible to demonstrate that long-term survival without neoadjuvant and adjuvant treatment is possible in some patients if complete tumor and nodal resection is performed.

scholarly journals Serum cyfra21-1 associated with biological aggressiveness and poor prognosis in male patients with urothelial carcinoma of bladder.

2020 ◽  
Author(s):  
Haitao Liang ◽  
Yunlin Ye ◽  
Zhu Lin ◽  
Zikun Ma ◽  
Lei Tan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Lymph Node ◽  
Lymphovascular Invasion ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Free Survival ◽  
Node Involvement ◽  
Male Patients ◽  
Disease Free ◽  
Urothelial Carcinoma Of Bladder

Abstract Background : To assess the prognostic value of preoperative serum cyfra21-1 in male patients with urothelial carcinoma of bladder treated with radical cystectomy.Methods: Patients underwent radical cystectomy from 2009-2018 at our center were retrospectively analyzed and 267 male patients met our criterions. The median follow-up was 34 months. The serum level of cyfra21-1 was measured using enzyme linked immunosorbent assay. Patients were divided into two groups (cyfra21-1≤3.30ng/ml and cyfra21-1>3.30 ng/ml). Clinical significance of cyfra21-1 level was assessed.Results: Of the 267 patients, 110 (41.2%) had normal cyfra21-1, while 157 (58.8%) had elevated serum cyfra21-1. The prevalence of lymph node involvement, locally advanced stage (≥ pT3), tumor stages, tumor size and papillary were significantly higher in patients with elevated cyfra21-1 than in those with normal cyfra21-1. Patients with high cyfra21-1 showed worse Disease free survival and Overall survival than those with low cyfra21-1 ( P = 0.001 and 0.007, respectively). In multivariate analysis, High cyfra21-1, lymph node involvement, lymphovascular invasion and papillary were independent predictors of worse Disease free survival ( P = 0.036, <0.001, 0.002, 0.014 respectively). High cyfra21-1, lymph node involvement and lymphovascular invasion were also confirmed as independent predictors of worse Overall survival ( P = 0.038, 0.010, 0.005, respectively.)Conclusions: Elevated cyfra21-1 was associated with greater biological aggressiveness and worse prognosis than normal cyfra21-1.

Primary and secondary cutaneous CD30+lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3653-3661 ◽  
Author(s):  
Marcel W. Bekkenk ◽  
Françoise A. M. J. Geelen ◽  
Pieter C. van Voorst Vader ◽  
F. Heule ◽  
Marie-Louise Geerts ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Lymphoproliferative Disorders ◽  
Group 4 ◽  
Long Term Follow Up ◽  
Node Involvement ◽  
Group 3 ◽  
Group 2 ◽  
Multiagent Chemotherapy ◽  
Group 1

Abstract To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30+ lymphoproliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with primary cutaneous CD30+ large T-cell lymphoma (LTCL; group 2), 11 patients with CD30+ LTCL and skin and regional lymph node involvement (group 3), and 11 patients with secondary cutaneous CD30+ LTCL (group 4). Patients with LyP often did not receive any specific treatment, whereas most patients with primary cutaneous CD30+ LTCL were treated with radiotherapy or excision. All patients with skin-limited disease from groups 1 and 2 who were treated with multiagent chemotherapy had 1 or more skin relapses. The calculated risk for systemic disease within 10 years of diagnosis was 4% for group 1, 16% for group 2, and 20% for group 3 (after initial therapy). Disease-related 5-year-survival rates were 100% (group 1), 96% (group 2), 91% (group 3), and 24% (group 4), respectively. The results confirm the favorable prognoses of these primary cutaneous CD30+ lymphoproliferative disorders and underscore that LyP and primary cutaneous CD30+ lymphomas are closely related conditions. They also indicate that CD30+ LTCL on the skin and in 1 draining lymph node station has a good prognosis similar to that for primary cutaneous CD30+ LTCL without concurrent lymph node involvement. Multiagent chemotherapy is only indicated for patients with full-blown or developing extracutaneous disease; it is never or rarely indicated for patients with skin-limited CD30+ lymphomas.

Primary and secondary cutaneous CD30+lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment

Blood ◽  
2000 ◽  
Vol 95 (12) ◽  
pp. 3653-3661 ◽  
Author(s):  
Marcel W. Bekkenk ◽  
Françoise A. M. J. Geelen ◽  
Pieter C. van Voorst Vader ◽  
F. Heule ◽  
Marie-Louise Geerts ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Lymphoproliferative Disorders ◽  
Group 4 ◽  
Long Term Follow Up ◽  
Node Involvement ◽  
Group 3 ◽  
Group 2 ◽  
Multiagent Chemotherapy ◽  
Group 1

To evaluate our diagnostic and therapeutic guidelines, clinical and long-term follow-up data of 219 patients with primary or secondary cutaneous CD30+ lymphoproliferative disorders were evaluated. The study group included 118 patients with lymphomatoid papulosis (LyP; group 1), 79 patients with primary cutaneous CD30+ large T-cell lymphoma (LTCL; group 2), 11 patients with CD30+ LTCL and skin and regional lymph node involvement (group 3), and 11 patients with secondary cutaneous CD30+ LTCL (group 4). Patients with LyP often did not receive any specific treatment, whereas most patients with primary cutaneous CD30+ LTCL were treated with radiotherapy or excision. All patients with skin-limited disease from groups 1 and 2 who were treated with multiagent chemotherapy had 1 or more skin relapses. The calculated risk for systemic disease within 10 years of diagnosis was 4% for group 1, 16% for group 2, and 20% for group 3 (after initial therapy). Disease-related 5-year-survival rates were 100% (group 1), 96% (group 2), 91% (group 3), and 24% (group 4), respectively. The results confirm the favorable prognoses of these primary cutaneous CD30+ lymphoproliferative disorders and underscore that LyP and primary cutaneous CD30+ lymphomas are closely related conditions. They also indicate that CD30+ LTCL on the skin and in 1 draining lymph node station has a good prognosis similar to that for primary cutaneous CD30+ LTCL without concurrent lymph node involvement. Multiagent chemotherapy is only indicated for patients with full-blown or developing extracutaneous disease; it is never or rarely indicated for patients with skin-limited CD30+ lymphomas.

Postoperative chemoradiotherapy in patients with rectal cancer, prognostic factors for disease control and survival

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 13575-13575 ◽  
Author(s):  
M. Hetnal ◽  
K. Malecki ◽  
S. Korzeniowski ◽  
T. Zemelka
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factors ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Lymph Node Metastases ◽  
Lymph Node Involvement ◽  
Fatty Tissue ◽  
Free Survival ◽  
Node Involvement ◽  
Node Metastases

13575 Background: The aim of this paper is an assessment of results of adjuvant chemoradiotherapy in patients with rectal cancer with respect to prognostic factors, causes of treatment failures and treatment tolerance. Methods: 178 pts with Dukes’ stage B or C rectal cancer received postoperative chemoradiotherapy between 1993 and 2002. Median age was 62; 110 patients were males, 68 were females. Median follow-up time was 45 months. Main endpoints of the analysis were locoregional recurrence-free survival (LRRFS), distant relapse free survival (DRFS), disease free survival (DFS) and overall survival (OS). Kaplan-Meier method was used to calculate survival rates. Univariate and multivariate analyses of prognostic factors were performed using log rank and Cox’s proportional hazard method. Results: The 5-year LRRFS was 73%, DRFS was 80%, DFS was 61% and OS was 65%. Lymph node involvement and method of resection (AR favoured) were the only independent prognostic factors for LRRFS. Lymph node involvement, in particular when four or more are involved, was independent prognostic factors for DFS. For DRFS are histological grade, lymph node involvement and extracapsular extension of the lymph node metastases. For OS, the independent prognostic factors were infiltration of the pararectal fatty tissue, lymph node involvement in particular when four or more are involved, total number of chemotherapy cycles (at least six favoured). The 5-year LRRFS was 73%, DRFS was 80%, DFS was 61% and OS was 65%. Radiation therapy was well tolerated in 45% of patients. Most common early reactions were diarrhoea, nausea/vomiting and leucopoenia. Conclusions: Involvement of lymph nodes and method of resection were the only independent prognostic factors for LRRFS. Prognostic factors for OS were infiltration of the pararectal fatty tissue, lymph node metastases, four or more involved lymph nodes, total number of chemotherapy cycles. No significant financial relationships to disclose.

scholarly journals Survival Study of Triple-Negative and Non–Triple-Negative Breast Cancer in a Brazilian Cohort

2018 ◽  
Vol 12 ◽  
pp. 117955491879056 ◽  
Author(s):  
Homero Gonçalves ◽  
Maximiliano Ribeiro Guerra ◽  
Jane Rocha Duarte Cintra ◽  
Vívian Assis Fayer ◽  
Igor Vilela Brum ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Disease Free Survival ◽  
Lymph Node Involvement ◽  
Free Survival ◽  
Node Involvement ◽  
Brazilian Cohort ◽  
Disease Free

Objective: To analyze the clinical, pathological, and sociodemographic aspects between triple-negative breast cancer (TNBC) and non-TNBC in a Brazilian cohort and identify potential prognostic factors. Methods: This hospital-based retrospective cohort study included 447 women with breast cancer treated at referral centers in Southeastern Brazil. Overall and disease-free survival were compared; prognostic factors were evaluated. Results: Triple-negative breast cancer corresponded to 19.5% of breast cancer diagnosis and was more prevalent among nonwhite and less educated women. The patients with TNBC tended to present with stage III cancer, high p53 expression, lymphocytic infiltration, and multifocality and treated with radical surgery and chemotherapy. The 5-year overall and disease-free survival were 62.1% and 57.5% for TNBC and 80.8% and 75.3% for non-TNBC, respectively ( P < .001). The TNBC recurrence was associated with multicentricity, whereas lymph node involvement increased the risk of both recurrence and death. Non-TNBC worse clinical course was associated with nonwhite ethnicity, lower education level, lymph node involvement, and advanced stage. Conclusions: Triple-negative breast cancer exhibited a more aggressive behavior, earlier and more frequent recurrence, and worse survival compared with non-TNBC. While biological and social variables were associated with poorer prognosis in non-TNBC, only lymph node involvement and multicentricity were correlated with worse clinical outcomes in TNBC.

scholarly journals Stereotactic Body Radiotherapy for Lymph Node Oligometastases: Real-World Evidence From 90 Consecutive Patients

2021 ◽  
Vol 10 ◽  
Author(s):  
Petr Burkon ◽  
Iveta Selingerova ◽  
Marek Slavik ◽  
Petr Pospisil ◽  
Lukas Bobek ◽  
...  
Keyword(s):  
Lymph Node ◽  
Stereotactic Body Radiotherapy ◽  
Systemic Treatment ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Lymph Node Involvement ◽  
Primary Tumors ◽  
Real World Evidence ◽  
Node Involvement ◽  
Time To Relapse

AimsTo evaluate the efficacy and toxicity of extracranial stereotactic body radiotherapy (SBRT) in the treatment of oligometastatic lymph node involvement in the mediastinum, retroperitoneum, or pelvis, in a consecutive group of patients from real clinical practice outside clinical trials.MethodsA retrospective analysis of 90 patients with a maximum of four oligometastases and various primary tumors (the most common being colorectal cancers). The endpoints were local control of treated metastases (LC), freedom from widespread dissemination (FFWD), progression-free survival (PFS), overall survival (OS), and freedom from systemic treatment (FFST). Acute and delayed toxicities were also evaluated.ResultsThe median follow-up after SBRT was 34.9 months. The LC rate at three and five years was 68.4 and 56.3%, respectively. The observed median FFWD was 14.6 months, with a five-year FFWD rate of 33.7%. The median PFS was 9.4 months; the three-year PFS rate was 19.8%. The median FFST was 14.0 months; the five-year FFST rate was 23.5%. The OS rate at three and five years was 61.8 and 39.3%, respectively. Median OS was 53.1 months. The initial dissemination significantly shortened the time to relapse, death, or activation of systemic treatment—LC (HR 4.8, p &lt; 0.001), FFWD (HR 2.8, p = 0.001), PFS (HR 2.1, p = 0.011), FFST (HR 2.4, p = 0.005), OS (HR 2.2, p = 0.034). Patients classified as having radioresistant tumors noticed significantly higher risk in terms of LC (HR 13.8, p = 0.010), FFWD (HR 3.1, p = 0.006), PFS (HR 3.5, p &lt; 0.001), FFST (HR 3.2, p = 0.003). The multivariable analysis detected statistically significantly worse survival outcomes for initially disseminated patients as well as separately in groups divided according to radiosensitivity. No grade III or IV toxicity was reported.ConclusionOur study shows that targeted SBRT is a very effective and low toxic treatment for oligometastatic lymph node involvement. It can delay the indication of cytotoxic chemotherapy and thus improve and maintain patient quality of life. The aim of further studies should focus on identifying patients who benefit most from SBRT, as well as the correct timing and dosage of SBRT in treatment strategy.

Prognostic value of Serum and Tumor Tissue CA 72-4 Content in Gastric Cancer

2003 ◽  
Vol 18 (1) ◽  
pp. 21-27 ◽  
Author(s):  
S. Aloe ◽  
R. D'alessandro ◽  
A. Spila ◽  
P. Ferroni ◽  
S. Basili ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Prognostic Value ◽  
Tumor Tissue ◽  
Prognostic Significance ◽  
Lymph Node Involvement ◽  
Depth Of Invasion ◽  
Free Survival ◽  
Tissue Content ◽  
Node Involvement

To date no general agreement has been reached regarding the prognostic significance of CEA, CA 19-9 and CA 72-4 as serum markers in gastric cancer, and only scattered information is available on the predictive value of marker expression in tumor tissue. Therefore, a longitudinal study was designed to analyze the presurgical serum and tumor tissue content of CA 72-4, CEA and CA 19-9 in 166 patients at different stages of gastric cancer, and to evaluate the possible correlation with clinicopathological features in respect to prognostic information on relapse-free survival. The results obtained showed that 48.4% of patients with tumor recurrence had positive presurgical CA 72-4 levels compared to approximately 24% of patients who remained free of disease. Furthermore, the median presurgical serum CA 72-4 levels were significantly elevated in relapsing patients. Serosa and lymph node involvement as well as positive presurgical serum CA 72-4 levels had independent prognostic value in predicting recurrence. A significant association between disease-free survival and lymph node involvement, depth of invasion and tumor tissue content of CA 72-4 was also demonstrated. We may therefore conclude that CA 72-4 antigen can be considered the marker of choice in the follow-up of gastric cancer patients and may be used as a prognostic indicator of relapse.

Surgical staging for epithelial ovarian tumors of low malignant potential

1994 ◽  
Vol 4 (5) ◽  
pp. 310-314 ◽  
Author(s):  
F. Di Re ◽  
R. Fontanelli ◽  
F. Raspagliesi ◽  
D. Paladini ◽  
E. A.A. Feudale
Keyword(s):  
Lymph Node ◽  
Lymph Node Involvement ◽  
Pelvic Lymphadenectomy ◽  
Malignant Potential ◽  
Ovarian Tumors ◽  
Low Malignant Potential ◽  
Node Involvement ◽  
Node Metastases ◽  
Group 2 ◽  
Group 1

From January 1975 to December 1991, 34 patients with a diagnosis of epithelial ovarian tumors of low malignant potential (LMP) were admitted to the Istituto Nazionale Tumori of Milan. Eighteen of them (group 1) underwent complete staging laparotomy and retroperitoneal para-aortic and pelvic lymphadenectomy, as for ovarian cancer. In the remaining 16 cases (group 2), the surgical treatment ranged from unilateral oophorectomy to incomplete staging procedure. In group 1, nine patients (50%) were found to have retroperitoneal nodal involvement. In group 2, all patients had stage I disease. Patients were followed up for 20–222 months (mean 108, median 86). There were two recurrences in group 2 (after 5 years) and none in group 1 (NS). Currently all patients are alive and disease free. Nine of 18 group 1 patients were upstaged to stage III on the basis of lymph node involvement only. However, at least in this retrospective series, lymph node metastases did not affect prognosis or survival.

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