scholarly journals Histologic Evaluation of Malignant Polyps and Low-Stage Colorectal Carcinoma

2019 ◽  
Vol 143 (12) ◽  
pp. 1450-1454 ◽  
Author(s):  
Catherine E. Hagen ◽  
Ayesha Farooq
Keyword(s):  
Prognostic Factors ◽  
Lymphovascular Invasion ◽  
Resection Margin ◽  
Adverse Outcome ◽  
Early Stage ◽  
Prognostic Significance ◽  
Tumor Grade ◽  
Histologic Evaluation ◽  
Node Metastases ◽  
Malignant Polyps

Context.— With widespread screening for colorectal cancer, the number of early-stage colorectal cancers is increasing. Local excision of pT1 tumors is associated with considerably less morbidity and mortality, but this must be weighed against risk of lymph node metastases. Objective.— To understand histologic prognostic factors associated with adverse outcome in malignant polyps. Data Sources.— Pertinent literature regarding histologic features of prognostic significance in malignant polyps and low-stage colorectal carcinomas is summarized and our institute's cases are used to highlight these histologic features. Conclusions.— Poor prognostic factors for malignant polyps include high tumor grade, presence of lymphovascular invasion, tumor less than 1 mm from resection margin, submucosal invasion deeper than 1 mm, and high tumor budding. These features should be assessed by the pathologist and communicated to the clinical team in order to allow proper management.

scholarly journals Management of colorectal polyp cancers

2012 ◽  
Vol 94 (8) ◽  
pp. 574-578 ◽  
Author(s):  
S Naqvi ◽  
S Burroughs ◽  
HS Chave ◽  
G Branagan
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastases ◽  
Resection Margin ◽  
Adverse Outcome ◽  
Colorectal Polyps ◽  
Adverse Outcomes ◽  
Resection Margins ◽  
Residual Tumour ◽  
Clear Resection Margin ◽  
Node Metastases

INTRODUCTION Management of malignant colorectal polyps is controversial. The options are resection or surveillance. Resection margin status is accepted as an independent predictor of adverse outcome. However, the rate of adverse outcome in polyps with a resection margin of <1mm has not been investigated. METHODS A retrospective search of the pathology database was undertaken. All polyp cancers were included. A single histopathologist reviewed all of the included polyp cancers. Polyps were divided into three groups: clear resection margin, involved resection margin and unknown resection margin. Polyps were also analysed for tumour grade, morphology, Haggitt/Kikuchi level and lymphovascular invasion. Adverse outcome was defined as residual tumour at the polypectomy site and/or lymph node metastases in the surgical group and local or distant recurrence in the surveillance group. RESULTS Sixty-five polyps (34 male patients, mean age: 73 years, range: 50–94 years) were included. Forty-six had clear polyp resection margins; none had any adverse outcomes. Sixteen patients had involved polyp resection margins and twelve of these underwent surgery: seven had residual tumour and two of these patients had lymph node metastases. Four underwent surveillance, of whom two developed local recurrence. Three patients had resection margins on which the histopathologist was unable to comment. All patients with a clear resection margin had no adverse outcome regardless of other predictive factors. CONCLUSIONS Polyp cancers with clear resection margins, even those with <1mm clearance, can be treated safely with surveillance in our experience. Polyp cancers with unknown or involved resection margins should be treated surgically.

Prognostic Factors in Early-Stage Leiomyosarcoma of the Uterus

2009 ◽  
Vol 19 (3) ◽  
pp. 385-390 ◽  
Author(s):  
Manuela Pelmus ◽  
Frédérique Penault-Llorca ◽  
Louis Guillou ◽  
Françoise Collin ◽  
Gérard Bertrand ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Vascular Invasion ◽  
Early Stage ◽  
Prognostic Significance ◽  
Figo Stage ◽  
Stage I ◽  
Free Interval ◽  
Important Prognostic Factor ◽  
Pathologic Features

Uterine leiomyosarcomas (LMSs) are rare cancers representing less than 1% of all uterine malignancies. Clinical International Federation of Gynecology and Obstetrics (FIGO) stage is the most important prognostic factor. Other significant prognostic factors, especially for early stages, are difficult to establish because most of the published studies have included localized and extra-pelvian sarcomas. The aim of our study was to search for significant prognostic factors in clinical stage I and II uterine LMS. The pathologic features of 108 uterine LMS including 72 stage I and II lesions were reviewed using standardized criteria. The prognostic significance of different pathologic features was assessed. The median follow-up in the whole group was 64 months (range, 6-223 months). The 5-year overall survival (OS) and metastasis-free interval and local relapse-free interval rates in the whole group and early-stage group (FIGO stages I and II) were 40% and 57%, 42% and 50%, 56% and 62%, respectively. Clinical FIGO stage was the most important prognostic factor for OS in the whole group (P = 4 × 10−15). In the stage I and II group, macroscopic circumscription was the most significant factor predicting OS (P = 0.001). In the same group, mitotic score and vascular invasion were associated with metastasis-free interval (P = 0.03 and P = 0.04, respectively). Uterine LMSs diagnosed using standardized criteria have a poor prognosis, and clinical FIGO stage is an ominous prognostic factor. In early-stage LMS, pathologic features such as mitotic score, vascular invasion, and tumor circumscription significantly impact patient outcome.

scholarly journals Prognostic Factors of Early Stage Epithelial Ovarian Carcinoma

2019 ◽  
Vol 16 (4) ◽  
pp. 637 ◽  
Author(s):  
Shu-Feng Hsieh ◽  
Hei-Yu Lau ◽  
Hua-Hsi Wu ◽  
Heng-Cheng Hsu ◽  
Nae-Fang Twu ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Chemotherapy ◽  
Ovarian Carcinoma ◽  
Cox Regression ◽  
Clear Cell ◽  
Early Stage ◽  
Disease Free Survival ◽  
Tumor Grade ◽  
Epithelial Ovarian Carcinoma ◽  
Gynecology And Obstetrics

We aimed to determine prognostic factors of early stage (I/II) epithelial ovarian carcinoma (EOC) including clinicopathologic and chemotherapeutic regimens. Four hundred and thirty-seven women who underwent primary staging surgery with adjuvant chemotherapy between January 1, 2000 and December 31, 2010 were retrospectively reviewed and analyzed from two medical centers. The prognostic factors were determined from multivariate survival analyses using Cox regression models. The majority of women were diagnosed with stage Ic (244/437, 55.8%). The histopathologic types were clear cell (37.5%), endometrioid (27.2%), serous (14.0%), and mucinous (13.3%). Fifty-seven percent (249/437) of the women received taxane-based (platinum plus paclitaxel) regimens and 43.0% received non-taxane (platinum plus cyclophosphamide) regimens as frontline adjuvant chemotherapy. Clear cell tumors (adjusted Hazard ratio (aHR) 0.37, 95% confidence interval (CI) 0.21–0.73, p = 0.001) showed better 5-year disease-free survival (DFS) than serous tumors. Women diagnosed at FIGO (International Federation of Gynecology and Obstetrics) stage II (aHR 5.97, 95% CI = 2.47–14.39, p < 0.001), grade 3 tumor without clear cell (aHR 2.28, 95% CI = 1.02–5.07, p = 0.004) and who received 3–5 cycles of non-taxane regimens (aHR 3.29, 95% CI = 1.47–7.34, p = 0.004) had worse 5-year overall survival (OS). Clear cell histology treated with taxane-based regimens showed significantly higher 5-year DFS (91.2% vs. 82.0%, aHR = 0.45, 95% CI = 0.21–0.93, p = 0.043) and 5-year OS (93.5% vs. 79.0%, aHR = 0.30, 95% CI = 0.13–0.70, p = 0.005) than those treated with non-taxane-based regimens. We conclude that stage, tumor grade, and chemotherapeutic regimens/cycles are independent prognostic factors for early stage ovarian cancer.

Occult axillary lymph node metastases do not have prognostic significance in early stage breast cancer

Cancer ◽  
2011 ◽  
Vol 118 (6) ◽  
pp. 1507-1514 ◽  
Author(s):  
Yun Wu ◽  
Elizabeth A. Mittendorf ◽  
Canan Kelten ◽  
Susan L. Tucker ◽  
Wei Wei ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Node Metastases ◽  
Axillary Lymph Node ◽  
Early Stage ◽  
Prognostic Significance ◽  
Early Stage Breast Cancer ◽  
Axillary Lymph ◽  
Axillary Lymph Node Metastases ◽  
Node Metastases

scholarly journals Prognostic Significance of Signet-Ring Cell Components in Patients With Gastric Carcinoma of Different Stages

2021 ◽  
Vol 8 ◽  
Author(s):  
Xiaoyuan Dong ◽  
Guorui Sun ◽  
Hui Qu ◽  
Qingsi He ◽  
Zhaofan Hao
Keyword(s):  
Survival Analysis ◽  
Prognostic Factors ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Signet Ring Cell ◽  
Multivariate Survival Analysis ◽  
Multivariate Survival ◽  
Signet Ring ◽  
Ring Cell ◽  
Pn Stage

Background: Gastric carcinoma (GC), which contains signet ring cell (SRC) components are frequently observed in postoperative pathological assessment. This study aims to study the prognostic significance of SRC components in GC patients.Methods: From 2003 to 2017, surgically resected primary GC patients were retrospectively reviewed. All enrolled patients were divided into three groups according to the proportion of SRC. The overall survival (OS) and disease-free survival (DFS) of GC patients with different tumor stages were analyzed.Results: Patients with SRC or mixed-SRC were more associated with female, younger age, middle or lower third of the stomach, larger tumor, higher pN stage, and more lymphovascular invasion. For GC patients in stage I, multivariate survival analysis showed that age &gt;60, SRC components &gt;50%, and pT stage were independent prognostic factors for OS (all p &lt; 0.05). The 5-year OS of patients with SRC were higher than that of patients with pure adenocarcinoma (p = 0.021). For GC patients in stage II/III, multivariate survival analysis showed that age &gt;60, SRC proportion, surgical types, Borrmann's type, pT stage, pN stage, and lymphovascular invasion were independent prognostic factors for OS (all p &lt; 0.05). The 5-year OS/DFS of patients with SRC were lower than that of patients with pure adenocarcinoma (p &lt; 0.001).Conclusions: SRC seemed to be a favorable prognostic factor in GC patients in stage I. However, for GC patients in stage II/III, the SRC components were associated with poor prognosis, independent of other clinicopathological factors.

The prognostic importance of p53, bcl-2, and bax in early stage epithelial ovarian carcinoma treated with adjuvant chemotherapy

2002 ◽  
Vol 12 (3) ◽  
pp. 265-276 ◽  
Author(s):  
I Skirnisdóttir ◽  
T Seidal ◽  
E Gerdin ◽  
B Sorbe
Keyword(s):  
Prognostic Factors ◽  
Survival Rate ◽  
Adjuvant Chemotherapy ◽  
Early Stage ◽  
Tumor Grade ◽  
Figo Stage ◽  
Epithelial Ovarian Carcinoma ◽  
Cancer Specific Survival ◽  
Persistent Disease ◽  
Prognostic Importance

Abstract.Skirnisdóttir I, Seidal T, Gerdin E, Sorbe B. The prognostic importance of p53, bcl-2, and bax in early stage epithelial ovarian carcinoma treated with adjuvant chemotherapy.Epithelial ovarian cancer is one of the major causes of death among women. The increasing knowledge about molecular events involved in the early stages of ovarian tumorigenesis may provide the basis for management in the future. In a series of 109 patients with epithelial carcinomas in FIGO stages IA-IIC, a number of clinicopathologic prognostic factors (age, FIGO stage, histopathologic type, and tumor grade) were studied in relation to the biologic factors p53, bcl-2, and bax, which are important regulators of apoptosis. Immunohistochemical techniques were used. All the patients received adjuvant chemotherapy after the primary surgery. Univariate analysis showed that expression of p53 was significantly associated with tumor grade (P = 0.014), probability of persistent disease (P = 0.016), and cancer-specific survival rate (P = 0.007). Positive bcl-2 staining was associated with endometrioid tumor subtype (P = 0.029) and a favorable tumor grade distribution (P = 0.034), but not with the survival status. The combined p53-bcl-2 expression was related to histopathologic subtype (P = 0.032), tumor grade (P = 0.011), persistent disease (P = 0.014), and risk of dying due to the disease (P = 0.039). The bax status was not a prognostic factor, but the combined p53-bax expression showed an association with FIGO stage (P = 0.014), tumor grade (P = 0.034), persistent disease (P = 0.006), and risk of dying due to the disease (P = 0.039). The combined bcl-2-bax expression was related to histopathologic subtype (P = 0.045) and tumor grade (P = 0.022). In a multivariate Cox analysis, tumor grade (P = 0.014), and p53 status (P = 0.020) were independent and significant prognostic factors with regard to the cancer-specific survival rate.

Galectin-1 (Gal-1) expression as a prognostic factor in patients with newly diagnosed glioblastoma (GB) treated with Stupp regimen (GLIOCAT study).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e13526-e13526
Author(s):  
Noelia Vilarino ◽  
Neus Martinez-Bosch ◽  
Carmen Balana ◽  
Francesc Alameda ◽  
Anna Estival ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Factor ◽  
Clinical Outcome ◽  
Methylation Status ◽  
Prognostic Significance ◽  
Tumor Grade ◽  
Extent Of Resection ◽  
Newly Diagnosed ◽  
Initial Surgery ◽  
Newly Diagnosed Glioblastoma

e13526 Background: Gal-1 is a β-galactoside binding protein that plays an important role in cancer, promoting cell invasion, proliferation, migration, angiogenesis and evasion of the immune response. Gal-1 is involved in glioma progression and is related to tumor grade and poor clinical outcome. Gal-1 has been implicated in resistance to chemotherapy and as a potential mediator of resistance to anti-VEGF therapy. The aim of our study was to evaluate the prognostic significance of Gal-1 in a homogenous cohort of GB patients and to analyze its potential predictive value of response to bevacizumab at recurrence. Methods: A substudy of GLIOCAT, a multicenter study of newly diagnosed GB patients treated with standard Stupp regimen (previously reported). GLIOCAT enrolled 432 patients between 2005-2014. Tissue was available from 243 cases, from which a tissue microarray (TMA) was constructed. Gal-1 expression in tissue from initial surgery was analyzed by immunohistochemistry. Results were evaluated by three reviewers and quantified by H-score. Expression levels were correlated with clinical outcome, known GB prognostic factors and response to bevacizumab. Results: We defined a cut off for Gal-1 H-Score of >60 (cytoplasm) and >25 (nucleus). HighcytoplasmicGal-1 expression significantly correlated with worse OS and with a trend for shorter PFS. In the multivariate analysis KPS, age, MGMT methylation status and, extent of resection but not Gal-1 expression were independent prognostic factors for survival. Of 92 patients who received bevacizumab at recurrence, only 54 were included in the TMA, and only 1 had low Gal-1 expression. We couldn’t find any relationship with OS or PFS in this population. Conclusions: Gal-1 expression may represent a prognostic factor for GB patients treated with standard therapy. [Table: see text]

Patterns of Adjuvant Therapy for Endometrial Cancer: Single Institutional Experience in Thailand

2015 ◽  
Vol 25 (4) ◽  
pp. 665-672 ◽  
Author(s):  
Siriwan Tangjitgamol ◽  
Jakkapan Khunnarong ◽  
Kanyarat Katanyoo ◽  
Sunamchok Srijaipracharoen ◽  
Thaovalai Thavaramara ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Early Stage ◽  
Performance Status ◽  
Progression Free Survival ◽  
Poor Performance ◽  
Tumor Grade ◽  
Poor Performance Status

AimThe aim of this study was to evaluate the use of adjuvant therapy and treatment outcomes in patients with endometrial cancer (EMC).MethodsPatients with EMC treated in the institution were identified. Data collected were age, stage of disease, histopathology, and adjuvant therapy. Progression-free survival (PFS) and overall survival (OS) were studied.ResultsThe median age of 383 patients was 57 years (30–86 years). Majority had early-stage diseases (76.5%), endometrioid histopathology (87.2%), and high-grade tumors (74.9%). Less than half (44.4%) had adjuvant therapy. Pelvic radiation was the most common type of adjuvant treatment. We found that 25.7% of stages III to IV patients did not have adjuvant therapy (mainly from old age or poor performance status). On the other hand, 21.5% of patients with stage IA had adjuvant treatment (owing to risk factors or other synchronous cancers). The 5-year PFS and 5-year OS (95% confidence interval) were 84.3% (80.5%–88.1%) and 81.2% (77.1%–85.4%), respectively. Significant prognostic factors for survival by univariable analyses were stage, tumor grade, and histopathology. By multivariable analyses, significant prognostic factors were stage, tumor grade (only for OS), histopathology, and adjuvant therapy. Focusing on stage and adjuvant therapy, we found that the PFS and OS of early-stage patients who had or did not have adjuvant therapy were not significantly different, whereas the PFS and OS of advanced-stage patients who had adjuvant treatment were significantly higher than the PFS and OS of those who did not have adjuvant treatment.ConclusionsThe use of adjuvant therapy for patients with EMC was not according to the standard recommendation in all patients for many reasons. The benefit of adjuvant therapy was demonstrated in advanced- but not in early-stage cancer.

scholarly journals Prognostic significance of solitary lymph node metastasis in patients with stages IA2 to IIA cervical carcinoma

2018 ◽  
Vol 46 (10) ◽  
pp. 4082-4091 ◽  
Author(s):  
Yi-Fang Dai ◽  
Mu Xu ◽  
Li-Ying Zhong ◽  
Xiao-Yan Xie ◽  
Zhao-Dong Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cervical Carcinoma ◽  
Lymphovascular Invasion ◽  
Prognostic Significance ◽  
Figo Stage ◽  
Tumour Invasion ◽  
Node Metastasis ◽  
Solitary Lymph Node ◽  
Node Metastases

Objective To investigate the prognostic significance of and risk factors for solitary lymph node metastasis (SLNM) of patients with cervical carcinoma. Methods Clinical data from patients with International Federation of Gynecology and Obstetrics (FIGO) stages IA2 to IIA cervical carcinoma who underwent radical hysterectomy and pelvic lymphadenectomy between January 2003 and December 2010 were analysed retrospectively. Histopathological analysis was used to identify SLNM. Long-term survival and risk factors associated with SLNM were analysed. Results The study enrolled 302 patients with cervical cancer: 48 with SLNM (SLNM group) and 254 patients with no lymph node metastases (nLNM group). FIGO stage, tumour grade, depth of tumour invasion, uterine body involvement, parametrial involvement and lymphovascular invasion differed significantly between the two groups. Logistic regression analysis revealed that FIGO stage, depth of tumour invasion and lymphovascular invasion were independent factors associated with SLNM. The 5-year survival rates of the SLNM and nLNM groups were 54.2% and 87.8%, respectively. Multivariate analysis identified SLNM as an independent factor affecting survival. Conclusions The occurrence of just one solitary lymph node metastasis significantly worsened the prognosis in patients with cervical carcinoma compared with patients without lymph node metastases.

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