101
|
Scala L, Chi D, Bochner B, Andikyan V, Gerst S, Sandhu J, Boland P, Sonoda Y, Alektiar K. OC-46 HIGH DOSE RATE (HDR) INTRAOPERATIVE BRACHYTHERAPY IN THE MANAGEMENT OF RECURRENT GYNECOLOGIC MALIGNANCIES. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72013-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
102
|
Barlin J, Khoury Collado F, Kim C, Cassella D, Chi D, Sonoda Y, Alektiar K, DeLair D, Barakat R, Abu-Rustum N. The importance of applying a sentinel lymph node mapping algorithm in endometrial cancer staging: Beyond removal of blue nodes. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
103
|
Tanner E, Diaz J, Kostolias A, Zhou Q, Iasonos A, Park K, Alektiar K, Sonoda Y, Barakat R, Abu-Rustum N. The changing clinical features of cervical adenocarcinoma: Increasing proportion but favorable oncologic outcome. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
104
|
Leitao M, Calderon B, Gardner G, Chi D, Sonoda Y, Barakat R. Feasibility and safety of same-day discharge after minimally invasive hysterectomy alone or with other procedures for benign and malignant indications. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
105
|
Shih K, Frey M, Chi D, Sonoda Y, Abu-Rustum N, Barakat R, Alektiar K. Impact of postoperative intensity-modulated radiation therapy on the rate of bowel obstruction in gynecologic malignancy. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
106
|
Khoury Collado F, Alchyib O, Kim C, Barlin J, Cassella D, Sonoda Y, Leitao M, Chi D, Barakat R, Abu-Rustum N. Incidence of sentinel lymph node metastasis in endometrial carcinoma: Correlation with tumor grade and myometrial invasion. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
107
|
Long K, Tanner E, Frey M, Cormier B, Gardner G, Sonoda Y, Levine D, Brown C, Barakat R, Chi D. Does intraoperative hypothermia contribute to postoperative morbidity in patients undergoing optimal primary surgical cytoreduction for advanced ovarian cancer? Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
108
|
Wethington S, Park K, Soslow R, Kauff N, Brown C, Sonoda Y, Abu-Rustum N, Barakat R, Levine D, Gardner G. Clinical outcome of Serous Tubal Intraepithelial Carcinomas (STIC). Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
109
|
Wethington S, Cibula D, Duska L, Garrett L, Kim C, Sonoda Y, Abu-Rustum N. An international series on abdominal trachelectomy: 101 patients and 28 pregnancies. Gynecol Oncol 2012. [DOI: 10.1016/j.ygyno.2011.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
110
|
Snyder LA, Honea N, Coons SW, Eschbacher J, Smith KA, Spetzler RF, Sanai N, Groves MD, DeGroot J, Tremont I, Forman A, Kang S, Pei BL, Julie W, Schultz D, Yuan Y, Guha N, Hwu WJ, Papadopoulos N, Camphausen K, Yung WA, Ryken T, Johnston SK, Graham C, Grimm S, Colman H, Raizer J, Chamberlain MC, Mrugala MM, Adair JE, Beard BC, Silbergeld DL, Rockhill JK, Kiem HP, Lee EQ, Batchelor TT, Lassman AB, Schiff DS, Kaley TJ, Wong ET, Mikkelsen T, Purow BW, Drappatz J, Norden AD, Beroukhim R, Weiss S, Alexander BM, Sceppa C, Gerard M, Hallisey SD, Bochacki CA, Smith KH, Muzikansky AM, Wen PY, Peereboom DM, Mikkelson T, Sloan AE, Rich JN, Supko JG, Ye X, Brewer C, Lamborn K, Prados M, Grossman SA, Zhu JJ, Recht LD, Colman H, Kesari S, Kim LJ, Balch AH, Pope CC, Brulotte M, Beelen AP, Chamberlain MC, Wong ET, Ram Z, Gutin PH, Stupp R, Marsh J, McDonald K, Wheeler H, Teo C, Martin L, Palmer L, Rodriguez M, Buckland M, Koh ES, Back M, Robinson B, Joseph D, Nowak AK, Saito R, Sonoda Y, Yamashita Y, Kanamori M, Kumabe T, Tominaga T, Rodon J, Tawbi HA, Thomas AL, Amakye DD, Granvil C, Shou Y, Dey J, Buonamici S, Dienstmann R, Mita AC, Dummer R, Hutterer M, Martha N, Sabine E, Thaddaus G, Florian S, Christine M, Stefan O, Richard G, Martin M, Johanna B, Jochen T, Ullrich H, Wolfgang W, Peter V, Gunther S, Field KM, Cher L, Wheeler H, Hovey E, Nowak AK, Simes J, Sawkins K, France T, Brown C, Nicholas MK, Chmura S, Paleologos N, Krouwer H, Malkin M, Junck L, Vick NA, Lukas RV, Jaeckle KA, Anderson SK, Kosel M, Sarkaria J, Brown P, Flynn PJ, Buckner JC, Galanis E, Batchelor T, Grossman S, Brem S, Lesser G, Voloschin A, Nabors LB, Mikkelsen T, Desideri S, Supko J, Peereboom D, Westphal M, Pietsch T, Bach F, Heese O, Vredenburgh JJ, Desjardins A, Reardon DA, Peters KB, Kirkpatrick JP, Herndon JE, Coan AD, Bailey L, Janney D, Lu C, Friedman HS, Desjardins A, Reardon DA, Peters KB, Herndon JE, Gururangan S, Norfleet J, Friedman HS, Vredenburgh JJ, Lassman AB, Kaley TJ, DeAngelis LM, Hormigo A, Mellinghoff IK, Otap DD, Seger J, Doyle LA, Ludwig E, Lacouture ME, Panageas KS, Rezazadeh A, LaRocca RV, Vitaz TW, Villanueva WG, Hodes J, Haysley L, Pertschuk D, Cloughesy TF, Chang SM, Aghi MK, Vogelbaum MA, Liau LM, Shafa B, Jolly DJ, Ibanez CE, Perez OD, Robbins JM, Gruber HE, Maher EA, Stewart C, Hatanpaa K, Raisanen J, Mashimo T, Yang XL, Muralidhara C, Madden C, Ramachandran A, Mickey B, Bachoo R. ONGOING CLINICAL TRIALS. Neuro Oncol 2011; 13:iii85-iii91. [PMCID: PMC3199166 DOI: 10.1093/neuonc/nor154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023] Open
|
111
|
Prithviraj GK, Sommers SR, Jump RL, Halmos B, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC, Hunter K, Chamberlain MC, Le EM, Lee ELT, Chamberlain MC, Sadighi ZS, Pearlman ML, Slopis JM, Vats TS, Khatua S, DeVito NC, Yu M, Chen R, Pan E, Cloughesy T, Raizer J, Drappatz J, Gerena-Lewis M, Rogerio J, Yacoub S, Desjardin A, Groves MD, DeGroot J, Loghin M, Conrad CA, Hess K, Ni J, Ictech S, Hunter K, Yung WA, Porter AB, Dueck AC, Karlin NJ, Chamberlain MC, Olson J, Silber J, Reiner AS, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Shiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Cachia D, Alderson L, Moser R, Smith T, Yunus S, Saito K, Mukasa A, Narita Y, Tabei Y, Shinoura N, Shibui S, Saito N, Flechl B, Ackerl M, Sax C, Dieckmann K, Crevenna R, Widhalm G, Preusser M, Marosi C, Marosi C, Ay C, Preusser M, Dunkler D, Widhalm G, Pabinger I, Dieckmann K, Zielinski C, Belongia M, Jogal S, Schlingensiepen KH, Bogdahn U, Stockhammer G, Mahapatra AK, Venkataramana NK, Oliushine V, Parfenov V, Poverennova I, Hau P, Jachimczak P, Heinrichs H, Mammoser AG, Shonka NA, de Groot JF, Shibahara I, Sonoda Y, Kumabe T, Saito R, Kanamori M, Yamashita Y, Watanabe M, Ishioka C, Tominaga T, Silvani A, Gaviani P, Lamperti E, Botturi A, DiMeco F, Broggi G, Fariselli L, Solero CL, Salmaggi A, Green RM, Woyshner EA, Cloughesy TF, Shu F, Oh YS, Iganej S, Singh G, Vemuri SL, Theeler BJ, Ellezam B, Gilbert MR, Aoki T, Kobayashi H, Takano S, Nishikawa R, Shinoura N, Nagane M, Narita Y, Muragaki Y, Sugiyama K, Kuratsu J, Matsutani M, Sadighi ZS, Khatua S, Langford LA, Puduvalli VK, Shen D, Chen ZP, Zhang JP, Chen ZP, Bedekar D, Rand S, Connelly J, Malkin M, Paulson E, Mueller W, Schmainda K, Gallego O, Benavides M, Segura PP, Balana C, Gil M, Berrocal A, Reynes G, Garcia JL, Murata P, Bague S, Quintana MJ, Vasishta VG, Nagane M, Kobayashi K, Tanaka M, Tsuchiya K, Shiokawa Y, Bavle AA, Ayyanar K, Puduvalli VK, Prado MP, Hess KR, Hunter K, Ictech S, Groves MD, Gilbert MR, Liu V, Conrad CA, de Groot J, Loghin ME, Colman H, Levin VA, Alfred Yung WK, Hackney JR, Palmer CA, Markert JM, Cure J, Riley KO, Fathallah-Shaykh H, Nabors LB, Saria MG, Corle C, Hu J, Rudnick J, Phuphanich S, Mrugala MM, Lee LK, Fu BD, Bota DA, Kim RY, Brown T, Feely H, Hu A, Drappatz J, Wen PY, Lee JW, Carter B, Kesari S, Fu BD, Kong XT, Bota DA, Fu BD, Bota DA, Sparagana S, Belousova E, Jozwiak S, Korf B, Frost M, Kuperman R, Kohrman M, Witt O, Wu J, Flamini R, Jansen A, Curtalolo P, Thiele E, Whittemore V, De Vries P, Ford J, Shah G, Cauwel H, Edrich P, Sahmoud T, Franz D, Khasraw M, Brown C, Ashley DM, Rosenthal MA, Jiang X, Mou YG, Chen ZP, Oh M, kim E, Chang J, Juratli TA, Kirsch M, Schackert G, Krex D, Gilbert MR, Wang M, Aldape KD, Stupp R, Hegi M, Jaeckle KA, Armstrong TS, Wefel JS, Won M, Blumenthal DT, Mahajan A, Schultz CJ, Erridge SC, Brown PD, Chakravarti A, Curran WJ, Mehta MP, Hofland KF, Hansen S, Sorensen M, Schultz H, Muhic A, Engelholm S, Ask A, Kristiansen C, Thomsen C, Poulsen HS, Lassen UN, Zalatimo O, Weston C, Zoccoli C, Glantz M, Rahmanuddin S, Shiroishi MS, Cen SY, Jones J, Chen T, Pagnini P, Go J, Lerner A, Gomez J, Law M, Ram Z, Wong ET, Gutin PH, Bobola MS, Alnoor M, Silbergeld DL, Rostomily RC, Chamberlain MC, Silber JR, Martha N, Jacqueline S, Thaddaus G, Daniel P, Hans M, Armin M, Eugen T, Gunther S, Hutterer M, Tseng HM, Zoccoli CM, Glantz M, Zalatimo O, Patel A, Rizzo K, Sheehan JM, Sumrall AL, Vredenburgh JJ, Desjardins A, Reardon DA, Friiedman HS, Peters KB, Taylor LP, Stewart M, Blondin NA, Baehring JM, Foote T, Laack N, Call J, Hamilton MG, Walling S, Eliasziw M, Easaw J, Shirsat NV, Kundar R, Gokhale A, Goel A, Moiyadi AA, Wang J, Mutlu E, Oyan A, Yan T, Tsinkalovsky O, Jacobsen HK, Talasila KM, Sleire L, Pettersen K, Miletic H, Andersen S, Mitra S, Weissman I, Li X, Kalland KH, Enger PO, Sepulveda J, Belda C, Balana C, Segura PP, Reynes G, Gil M, Gallego O, Berrocal A, Blumenthal DT, Sitt R, Phishniak L, Bokstein F, Philippe M, Carole C, Andre MDP, Marylin B, Olivier C, L'Houcine O, Dominique FB, Philippe M, Isabelle NM, Olivier C, Frederic F, Stephane F, Henry D, Marylin B, L'Houcine O, Dominique FB, Errico MA, Kunschner LJ, Errico MA, Kunschner LJ, Soffietti R, Trevisan E, Ruda R, Bertero L, Bosa C, Fabrini MG, Lolli I, Jalali R, Julka PK, Anand AK, Bhavsar D, Singhal N, Naik R, John S, Mathew BS, Thaipisuttikul I, Graber J, DeAngelis LM, Shirinian M, Fontebasso AM, Jacob K, Gerges N, Montpetit A, Nantel A, Albrecht S, Jabado N, Mammoser AG, Shah K, Conrad CA, Di K, Linskey M, Bota DA, Thon N, Eigenbrod S, Kreth S, Lutz J, Tonn JC, Kretzschmar H, Peraud A, Kreth FW, Muggeri AD, Alderuccio JP, Diez BD, Jiang P, Chao Y, Gallagher M, Kim R, Pastorino S, Fogal V, Kesari S, Rudnick JD, Bresee C, Rogatko A, Sakowsky S, Franco M, Hu J, Lim S, Lopez A, Yu L, Ryback K, Tsang V, Lill M, Steinberg A, Sheth R, Grimm S, Helenowski I, Rademaker A, Raizer J, Nunes FP, Merker V, Jennings D, Caruso P, Muzikansky A, Stemmer-Rachamimov A, Plotkin S, Spalding AC, Vitaz TW, Sun DA, Parsons S, Welch MR, Omuro A, DeAngelis LM, Omuro A, Beal K, Correa D, Chan T, DeAngelis L, Gavrilovic I, Nolan C, Hormigo A, Lassman AB, Kaley T, Mellinghoff I, Grommes C, Panageas K, Reiner A, Barradas R, Abrey L, Gutin P, Lee SY, Slagle-Webb B, Glantz MJ, Sheehan JM, Connor JR, Schlimper CA, Schlag H, Stoffels G, Weber F, Krueger DA, Care MM, Holland K, Agricola K, Tudor C, Byars A, Sahmoud T, Franz DN, Raizer J, Rice L, Rademaker A, Chandler J, Levy R, Muro K, Grimm S, Nayak L, Iwamoto FM, Rudnick JD, Norden AD, Omuro A, Kaley TJ, Thomas AA, Fadul CE, Meyer LP, Lallana EC, Colman H, Gilbert M, Alfred Yung WK, Aldape K, De Groot J, Conrad C, Levin V, Groves M, Loghin M, Chris P, Puduvalli V, Nagpal S, Feroze A, Recht L, Rangarajan HG, Kieran MW, Scott RM, Lew SM, Firat SY, Segura AD, Jogal SA, Kumthekar PU, Grimm SA, Avram M, Patel J, Kaklamani V, McCarthy K, Cianfrocca M, Gradishar W, Mulcahy M, Von Roenn J, Helenowski I, Rademaker A, Raizer J, Galanis E, Anderson SK, Lafky JM, Kaufmann TJ, Uhm JH, Giannini C, Kumar SK, Northfelt DW, Flynn PJ, Jaeckle KA, Buckner JC, Omar AI, Panageas KS, Iwamoto FM, Cloughesy TF, Aldape KD, Rivera AL, Eichler AF, Louis DN, Paleologos NA, Fisher BJ, Ashby LS, Cairncross JG, Roldan GB, Wen PY, Ligon KL, Schiff D, Robins HI, Rocque BG, Chamberlain MC, Mason WP, Weaver SA, Green RM, Kamar FG, Abrey LE, DeAngelis LM, Jhanwar SC, Rosenblum MK, Lassman AB, Delios A, Jakubowski A, DeAngelis L, Grommes C, Lassman AB, Theeler BJ, Melguizo-Gavilanes I, Shonka NA, Qiao W, Wang X, Mahajan A, Puduvalli V, Hashemi-Sadraei N, Bawa H, Rahmathulla G, Patel M, Elson P, Stevens G, Peereboom D, Vogelbaum M, Weil R, Barnett G, Ahluwalia MS, Alvord EC, Rockne RC, Rockhill JK, Mrugala MM, Rostomily R, Lai A, Cloughesy T, Wardlaw J, Spence AM, Swanson KR, Zadeh G, Alahmadi H, Wilson J, Gentili F, Lassman AB, Wang M, Gilbert MR, Aldape KD, Beumer JJ, Wright J, Takebe N, Puduvalli VK, Hormigo A, Gaur R, Werner-Wasik M, Mehta MP, Gupta AJ, Campos-Gines A, Le K, Arango C, Richards M, Landeros M, Juan H, Chang JH, Kim JS, Cho JH, Seo CO, Baldock AL, Rockne R, Canoll P, Born D, Yagle K, Swanson KR, Alexandru D, Bota D, Linskey ME, Nabeel S, Raval SN, Raizer J, Grimm S, Rice L, Rosenow J, Levy R, Bredel M, Chandler J, New PZ, Plotkin SR, Supko JG, Curry WT, Chi AS, Gerstner ER, Stemmer-Rachamimov A, Batchelor TT, Ahluwalia MS, Hashemi N, Rahmathulla G, Patel M, Chao ST, Peereboom D, Weil RJ, Suh JH, Vogelbaum MA, Stevens GH, Barnett GH, Corwin D, Holdsworth C, Stewart R, Rockne R, Swanson K, Graber JJ, Kaley T, Rockne RC, Anderson AR, Swanson KR, Jeyapalan S, Goldman M, Boxerman J, Donahue J, Elinzano H, Evans D, O'Connor B, Puthawala MY, Oyelese A, Cielo D, Blitstein M, Dargush M, Santaniello A, Constantinou M, DiPetrillo T, Safran H, Plotkin SR, Halpin C, Merker V, Barker FG, Maher EA, Ganji S, DeBerardinis R, Hatanpaa K, Rakheja D, Yang XL, Mashimo T, Raisanen J, Madden C, Mickey B, Malloy C, Bachoo R, Choi C, Ranjan T, Yono N, Zalatimo O, Zoccoli C, Glantz M, Han SJ, Sun M, Berger MS, Aghi M, Gupta N, Parsa AT. MEDICAL AND NEURO-ONCOLOGY. Neuro Oncol 2011. [DOI: 10.1093/neuonc/nor152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
112
|
Nii T, Sonoda Y, Isobe N, Yoshimura Y. Effects of lipopolysaccharide on the expression of proinflammatory cytokines and chemokines and the subsequent recruitment of immunocompetent cells in the oviduct of laying and molting hens. Poult Sci 2011; 90:2332-41. [DOI: 10.3382/ps.2011-01596] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
113
|
Saito R, Kumabe T, Kanamori M, Yamashita Y, Sonoda Y, Higano S, Takahashi S, Tominaga T. Preoperative evaluation of the deep cerebral veins using 3-tesla magnetic resonance imaging. MINIMALLY INVASIVE NEUROSURGERY : MIN 2011; 54:105-9. [PMID: 21863516 DOI: 10.1055/s-0031-1279715] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Surgical treatment of deep-seated tumors such as supratentorial intraventricular and thalamic-pineal-tectal region tumors carries a risk of postoperative deficits due to possible damage to deep cerebral veins including the internal cerebral vein. It is often difficult to identify whether the vessel encountered during surgery needs to be preserved or not through the small operative field. Therefore, preoperative evaluation of deep venous structures is important. We evaluated the usefulness of 3-Tesla magnetic resonance imaging (3 T MRI) for this purpose. METHODS First, the ability to detect deep venous structures was compared with both 3-dimensional computed tomographical angiography (3D-CTA) and 3 T MRI in patients without any damage to deep venous structures. Images of 7 consecutive patients suffering from insulo-opercular gliomas who underwent both imaging modes for the identification of lateral striate arteries were reconstructed for evaluation of the deep cerebral veins. Subsequently, surgery for tumors at the supratentorial intraventricular and thalamic-pineal-tectal regions was prospectively performed with preoperative evaluation of deep venous system only using 3 T MRI. RESULTS Information on the deep venous systems acquired by 3 T MRI was as useful as that acquired by 3D-CTA. Until today, we have treated 8 cases of supratentorial intraventricular and thalamic-pineal-tectal region tumors with preoperative evaluation of the deep venous system using 3 T MRI without any morbidity. CONCLUSION Information on the deep venous system obtained with 3 T MRI aids the surgery of supratentorial intraventricular and thalamic-pineal-tectal region tumors. As the required sequences of 3 T MRI are same as those necessary for the neuronavigation system, and 3 T MRI can be achieved without the use of iodine-based contrast agents, 3 T MRI can be an alternative for preoperative evaluation of the deep venous systems.
Collapse
|
114
|
Khoury-Collado F, Murray MP, Hensley ML, Sonoda Y, Alektiar KM, Levine DA, Leitao MM, Chi DS, Barakat RR, Abu-Rustum NR. Sentinel lymph node mapping for endometrial cancer improves the detection of metastatic disease to regional lymph nodes. Gynecol Oncol 2011; 122:251-4. [PMID: 21570109 DOI: 10.1016/j.ygyno.2011.04.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 03/17/2011] [Accepted: 04/19/2011] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare the incidence of metastatic cancer cells in sentinel lymph nodes (SLN) vs. non-sentinel nodes in patients who had lymphatic mapping for endometrial cancer and to determine the contribution of metastases detected on ultrastaging to the overall nodal metastasis rate. METHODS All patients who underwent lymphatic mapping for endometrial cancer were reviewed. Cervical injection of blue dye was used in all cases. Sentinel nodes were examined by routine hematoxylin and eosin (H&E), and if negative, by standardized institutional pathology protocol that included additional sections and immunohistochemistry (IHC). RESULTS Between 09/2005 and 03/2010, 266 patients with endometrial cancer underwent lymphatic mapping. Sentinel node identification was successful in 223 (84%) cases. Positive nodes were diagnosed in 32/266 (12%) patients. Of those, 8/266 patients (3%) had the metastasis detected only by additional section or IHC as part of SLN ultrastaging. Excluding the 8 cases with positive SLN on ultrastaging only, 24/801 (2.99%) SLN and 30/2698 (1.11%) non-SLN were positive for metastatic disease (p=0.0003). CONCLUSION Using a cervical injection for mapping, metastatic cells from endometrial cancer are three times as likely to be detected in SLN than in the non-sentinel nodes. This finding strongly supports the concept of lymphatic mapping in endometrial cancer to fine tune the nodal dissection topography. By adding SLN mapping to our current surgical staging procedures we may increase the likelihood of detecting metastatic cancer cells in regional lymph nodes. An additional benefit of incorporating pathologic ultrastaging of SLN is the detection of micrometastasis, which may be the only evidence of extrauterine spread.
Collapse
|
115
|
Tanner E, Long K, Zhou Q, Brightwell R, Gardner G, Abu-Rustum N, Leitao M, Sonoda Y, Barakat R, Iasonos A, Chi D. Does operative start time impact the frequency of complete gross resection in patients undergoing primary cytoreduction for advanced serous ovarian carcinoma? Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2011.02.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
116
|
Long K, Tanner E, Guy M, Leitao M, Gardner G, Sonoda Y, Brown C, Barakat R, Chi D. Cytoreductive surgery for serous ovarian cancer in patients 75years and older. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
117
|
Leitao M, Khoury Collado F, Gardner G, Jewell E, Brown C, Sonoda Y, Levine D, Barakat R, Abu-Rustum N. Sentinel lymph node mapping in patients with endometrial cancer undergoing robot-assisted or standard laparoscopic procedures. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
118
|
Leitao M, Gardner G, Briscoe G, Dholakiya P, Santos K, Jewell E, Abu-Rustum N, Sonoda Y, Barakat R, Malhotra V. Postoperative pain medication requirements in patients undergoing robotically assisted and standard laparoscopic procedures for newly diagnosed endometrial cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
119
|
Diaz J, Park B, Sonoda Y, Chi D. Intrathoracic cytoreductive surgery by video-assisted thoracic surgery in advanced ovarian carcinoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
120
|
Collado FK, Murray M, Hensley M, Sonoda Y, Gomez J, Levine D, Leitao M, Chi D, Barakat R, Abu-Rustum N. Sentinel lymph node mapping for grade 1/2 endometrial cancer with superficial myoinvasion: Less is more. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
121
|
Cormier B, Diaz J, Shih K, Sampson R, Sonoda Y, Park K, Chi D, Barakat R, Alektiar K, Abu-Rustum N. Establishing an optimal sentinel lymph node mapping algorithm for the treatment of early cervical cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
122
|
Khoury Collado F, Murray M, Sonoda Y, Levine D, Leitao M, Chi D, Barakat R, Abu-Rustum N. Sentinel lymph node mapping for endometrial cancer improves the detection of metastatic disease to regional lymph nodes. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
123
|
Long K, Tanner E, Brightwell R, Shih K, Sonoda Y, Leitao M, Abu-Rustum N, Barakat R, Chi D. Utilization of specialized postoperative services in a comprehensive surgical cytoreduction program. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
124
|
Leitao M, Gardner G, Briscoe G, Santos K, Jewell E, Abu-Rustum N, Brown C, Chi D, Sonoda Y, Barakat R. Comparison of robot-assisted and standard laparoscopic procedures in patients with endometrial cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
125
|
Khoury Collado F, Sonoda Y, Bochner B. Urinary reconstruction after pelvic exenteration: Modified Indiana pouch. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
126
|
Kim C, Abu-Rustum N, Chi D, Gardner G, Leitao M, Barakat R, Sonoda Y. Oncologic outcomes of radical trachelectomy at a single institution. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
127
|
Kim C, Abu-Rustum N, Chi D, Gardner G, Leitao M, Carter J, Barakat R, Sonoda Y. Reproductive outcomes of patients undergoing radical trachelectomy for early-stage cervical cancer. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
128
|
Gardner G, Leitao M, Carreras M, Jewell E, Sonoda Y, Levine D, Abu-Rustum N, Brown C, Chi D, Barakat R. Robotic radical hysterectomy: Extent of tumor resection and operative outcomes compared with laparoscopy and exploratory laparotomy. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
129
|
Diaz J, Park B, Stine J, Flores R, Sonoda Y, Abu-Rustum N, Barakat R, Chi D. The feasibility of mediastinal lymphadenectomy in the management of advanced and recurrent ovarian carcinoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
130
|
Tanner E, Gardner G, Sonoda Y, Garg K, Chi D, Leitao M, Jewell E. Complete gross resection is associated with improved survival in advanced-stage uterine carcinosarcoma. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
131
|
Jensen RL, Gilliespie D, Ajewung N, Faure R, Kamnasaran D, Ajewung N, Poirier D, Kamnasaran D, Tamura K, Wakimoto H, Rabkin SD, Martuza RL, Shah K, Hashizume R, Aoki Y, Serwer LP, Drummond D, Noble C, Park J, Bankiewicz K, James DC, Gupta N, Agerholm-Larsen B, Iversen HK, Jensen KS, Moller J, Ibsen P, Mahmood F, Gehl J, Corem E, Ram Z, Daniels D, Last D, Shneor R, Salomon S, Perlstein B, Margel S, Mardor Y, Charest G, Fortin D, Mathieu D, Sanche L, Paquette B, Li HF, Hashizume R, Aoki Y, Hariono S, Dasgupta T, Kim JS, Haas-Kogan D, Weiss WA, Gupta N, James CD, Waldman T, Nicolaides T, Ozawa T, Rao S, Sun H, Ng C, De La Torre J, Santos R, Prados M, James CD, Butowski N, Michaud K, Solomon DA, Li HF, Kim JS, Prados MD, Ozawa T, Waldman T, James CD, Pandya H, Gibo D, Debinski W, Vinchon-Petit S, Jarnet D, Jadaud E, Feuvret L, Garcion E, Menei P, Chen R, Yu JC, Liu C, Jaffer ZM, Chabala JC, Winssinger N, Rubenstein AE, Emdad L, Kothari H, Qadeer Z, Binello E, Germano I, Hirschberg H, Baek SK, Kwon YJ, Sun CH, Li SC, Madsen S, Debinski W, Liu T, Wang SW, Gibo DM, Fan QW, Cheng C, Hackett C, Feldman M, Houseman BT, Houseman BT, Nicolaides T, James CD, Haas-Kogan D, Oakes SA, Debnath J, Shokat KM, Weiss WA, Sai K, Chen F, Qiu Z, Mou Y, Zhang X, Yang Q, Chen Z, Patel TR, Zhou J, Piepmeier JM, Saltzman WM, Banerjee S, Kaul A, Gianino SM, Christians U, Gutmann DH, Wu J, Shen R, Puduvalli V, Koul D, Alfred Yung WK, Yun J, Sonabend A, Stuart M, Yanagihara T, Dashnaw S, Brown T, McCormick P, Romanov A, Sebastian M, Canoll P, Bruce JN, Piao L, Joshi K, Lee RJ, Nakano I, Madsen SJ, Chou CC, Blickenstaff JW, Sun CH, Zhou YH, Hirschberg H, Tome CML, Wykosky J, Palma E, Debinski W, Nduom E, Machaidze R, Kaluzova M, Wang Y, Nie S, Hadjipanayis C, Saito R, Nakamura T, Sonoda Y, Kumabe T, Tominaga T, Lun X, Zemp F, Zhou H, Stechishin O, Kelly JJ, Weiss S, Hamilton MG, Cairncross G, Rabinovich BA, Bell J, McFadden G, Senger DL, Forsyth PA, Kang P, Jane EP, Premkumar DR, Pollack IF, Yoo JY, Haseley A, Bratasz A, Powell K, Chiocca EA, Kaur B, Johns TG, Ferruzzi P, Mennillo F, De Rosa A, Rossi M, Giordano C, Magrini R, Benedetti G, Pericot GL, Magnoni L, Mori E, Thomas R, Tunici P, Bakker A, Yoo JY, Pradarelli J, Kaka A, Alvarez-Breckenridge C, Pan Q, Teknos T, Chiocca EA, Kaur B, Cen L, Ostrem JL, Schroeder MA, Mladek AC, Fink SR, Jenkins RB, Sarkaria JN, Madhankumar AB, Slagle-Webb B, Park A, Pang M, Klinger M, Harbaugh KS, Sheehan JM, Connor JR, Chen TC, Wang W, Hofman FM, Serwer LP, Michaud K, Drummond DC, Noble CO, Park JW, Ozawa T, James CD, Serwer LP, Noble CO, Michaud K, Drummond DC, Ozawa T, Zhou Y, Marks JD, Bankiewicz K, Park JW, James CD, Alonso MM, Gomez-Manzano C, Cortes-Santiago N, Roche FP, Fueyo J, Johannessen TCA, Grudic A, Tysnes BB, Nigro J, Bjerkvig R, Joshi AD, Parsons W, Velculescu VE, Riggins GJ, Bindra RS, Jasin M, Powell SN, Fu J, Koul D, Shen RJ, Colman H, Lang FF, Jensen MR, Alfred Yung WK, Friedman GK, Haas M, Cassady KA, Gillespie GY, Nguyen V, Murphy LT, Beauchamp AS, Hollingsworth CK, Debinski W, Mintz A, Pandya H, Garg S, Gibo D, Kridel S, Debinski W, Conrad CA, Madden T, Ji Y, Colman H, Priebe W, Seleverstov O, Purow BW, Grant GA, Wilson C, Campbell M, Humphries P, Li S, Li J, Johnson A, Bigner D, Dewhirst M, Sarkaria JN, Cen L, Pokorny JL, Mladek AC, Kitange GJ, Schroeder MA, Carlson BL, Suphangul M, Petro B, Mukhtar L, Baig MS, Villano J, Mahmud N, Keir ST, Reardon DA, Watson M, Shore GC, Bigner DD, Friedman HS, Keir ST, Gururangan S, Reardon DA, Bigner DD, Friedman HS. Pre-clinical Experimental Therapeutics and Pharmacology. Neuro Oncol 2010. [DOI: 10.1093/neuonc/noq116.s13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
132
|
Sonoda Y, Mukai H, Matsuo K, Takahashi M, Ono Y, Maeda K, Akiyama H, Kawamata T. Accumulation of tumor-suppressor PTEN in Alzheimer neurofibrillary tangles. Neurosci Lett 2010; 471:20-4. [PMID: 20056128 DOI: 10.1016/j.neulet.2009.12.078] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Revised: 12/28/2009] [Accepted: 12/31/2009] [Indexed: 01/15/2023]
Abstract
The phosphatase and tensin homologue deleted on chromosome 10 (PTEN) negatively regulates intracellular levels of PIP3 and antagonizes the PI3K signaling pathway important for cell survival. The present study determined whether altered distribution of PTEN occurs in Alzheimer's disease (AD) brains. We investigated a possible role for PTEN in postmortem brain tissues from elderly controls and patients with AD using immunoblotting and microscopic analyses. Intense immunolabeling was found in the large neurons such as pyramidal cells. In normal neurons, PTEN was located in the nucleus, the cytoplasm of cell bodies and the proximal portion of apical dendrites. Reduced expression and redistribution of PTEN was seen in the remaining neurons in AD. In addition, PTEN was redistributed in damaged neurons from the nucleus and cytoplasm to neuritic pathology such as intracellular neurofibrillary tangles (NFTs), neuropil threads and dystrophic neurites within senile plaques in AD hippocampus, subiculum, entorhinal cortex and angular gyrus. Furthermore, double immunofluorescence staining showed dual labeling of intracellular NFTs for PTEN and tau, labeling of some axons for PTEN and phosphorylated neurofilament, and weak labeling of a few reactive astrocytes around senile plaques for PTEN and GFAP. Double labeling of NFTs was observed in a subset of tangle-bearing neurons either for PTEN and GSK3beta or for PTEN and MEK. Thus our results suggest that PTEN delocalized from the nucleus to the cytoplasm and to intracellular NFTs may cause a deregulation of PI3K pathway in the cytoplasm and may induce the nuclear dysfunction of PTEN in AD degenerating neurons.
Collapse
|
133
|
Chi D, Zivanovic O, Kolev V, Yu C, Levine DA, Sonoda Y, Abu-Rustum NR, Huh J, Barakat RR, Kattan MW. Nomogram for predicting 5-year survival after primary surgery for epithelial ovarian cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5523 Background: Nomograms have been shown to be superior to traditional staging systems for predicting an individual's probability of long-term survival. Our objective was to develop a nomogram based on established prognostic factors to predict the probability of 5-year disease-specific survival (DSS) after primary surgery for patients with epithelial ovarian cancer (EOC) and to compare its predictive accuracy with the currently used FIGO staging system. Methods: We identified all pts with EOC who had their primary staging/cytoreductive surgery at our institution from January 1996-December 2004. DSS was estimated using the Kaplan-Meier method. We analyzed 28 clinical and pathologic factors for prognostic significance. Significant factors on univariate analysis were then included in the Cox proportional hazards regression model, which identified the factors to be used to construct the nomogram. The concordance index (CI) was used as an accuracy measure, with bootstrapping to correct for optimistic bias. Calibration plots were constructed. Results: There were 478 evaluable pts on the study. The median age was 58 years (range 25–96). The primary surgeon in all cases was an attending gynecologic oncologist. All patients received platinum-based systemic chemotherapy postop. DSS at 5 years was 52%. The most predictive nomogram was constructed using the following 7 predictor variables: age, ASA status, family history suggestive of hereditary breast/ovarian cancer syndrome, preoperative serum albumin level, FIGO stage, tumor histology, and residual disease status after primary surgery. This nomogram was internally validated using bootstrapping and shown to have excellent calibration with a bootstrap-corrected CI of 0.721. The CI for FIGO staging alone was significantly less at 0.62 (p = 0.002). Conclusions: We developed a nomogram to predict 5-year DSS after primary surgery for EOC. The nomogram uses 7 variables that are readily accessible, assigns a point value to each variable, and then predicts the probability of 5-year survival based on the total point value for an individual patient. This tool is more accurate than FIGO staging and should be useful for patient counseling, clinical trial eligibility determination, postop management, and follow-up. No significant financial relationships to disclose.
Collapse
|
134
|
Einstein MH, Barakat RR, Chi DS, Sonoda Y, Alektiar KM, Hensley ML, Abu-Rustum NR. Management of uterine malignancy found incidentally after supracervical hysterectomy or uterine morcellation for presumed benign disease. Int J Gynecol Cancer 2008; 18:1065-70. [PMID: 17986239 DOI: 10.1111/j.1525-1438.2007.01126.x] [Citation(s) in RCA: 150] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Patients who have undergone supracervical hysterectomy or uterine morcellation for presumed benign uterine disease and are found to have malignancy on final pathology represent a management dilemma. Our goal was to analyze our experience and make observations regarding staging, treatment, and outcomes. We performed a retrospective case series of patients referred to our institution with uterine malignancy who previously underwent supracervical hysterectomy or uterine morcellation at the time of original surgery for presumed benign uterine disease. Between January 2000 and March 2006, 17 patients with uterine malignancy were identified. Following initial surgery, 15 (88%) patients had presumed stage I disease and 2 (12%) patients had stage III disease. Two (15%) of 13 patients who underwent completion surgery were upstaged; both had leiomyosarcoma (LMS) originally resected with morcellation. Ten of 11 patients whose stage was confirmed with secondary surgery remain disease free. None of the patients who initially underwent supracervical hysterectomy without morcellation were upstaged by secondary surgery. The median follow-up interval was 30 months (range, 2-90 months). Reoperation for completion surgery and staging is important when uterine malignancy is found incidentally after morcellation or supracervical hysterectomy for presumed benign uterine disease. Approximately 15% of patients will be upstaged by reexploration, particularly those with LMS who underwent morcellation. Patients who undergo completion surgery with restaging and are not upstaged appear to have a good prognosis. Surgical staging is valuable for prognosis and may alter postoperative treatments.
Collapse
|
135
|
Chi DS, Barakat RR, Palayekar MJ, Levine DA, Sonoda Y, Alektiar K, Brown CL, Abu-Rustum NR. The incidence of pelvic lymph node metastasis by FIGO staging for patients with adequately surgically staged endometrial adenocarcinoma of endometrioid histology. Int J Gynecol Cancer 2008; 18:269-73. [PMID: 18334008 DOI: 10.1111/j.1525-1438.2007.00996.x] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The seminal Gynecologic Oncology Group study on surgical pathologic spread patterns of endometrial cancer demonstrated the risk of pelvic lymph node metastasis for clinical stage I endometrial cancer based on tumor grade and thirds of myometrial invasion. However, the FIGO staging system assigns surgical stage by categorizing depth of myometrial invasion in halves. The objective of this study was to determine the incidence of pelvic lymph node metastasis in endometrial cancer based on tumor grade and myometrial invasion as per the current FIGO staging system. We reviewed the records of all patients who underwent primary surgical staging for clinical stage I endometrial cancer at our institution between May 1993 and November 2005. To make the study cohort as homogeneous as possible, we included only cases of endometrioid histology. We also included only patients who had adequate staging, which was defined as a total hysterectomy with removal of at least eight pelvic lymph nodes. During the study period, 1036 patients underwent primary surgery for endometrial cancer. The study cohort was composed of the 349 patients who met study inclusion criteria. Distribution of tumor grade was as follows: grade 1, 80 (23%); grade 2, 182 (52%); and grade 3, 87 (25%). Overall, 30 patients (9%) had pelvic lymph node metastasis. The incidence of pelvic lymph node metastasis in relation to tumor grade and depth of myometrial invasion (none, inner half, and outer half) was as follows: grade 1-0%, 0%, and 0%, respectively; grade 2-4%, 10%, and 17%, respectively; and grade 3-0%, 7%, and 28%, respectively. We determined the incidence of pelvic nodal metastasis in a large cohort of endometrial cancer patients of uniform histologic subtype in relation to tumor grade and a one-half myometrial invasion cutoff. These data are more applicable to current surgical practice than the previously described one-third myometrial invasion cutoff results.
Collapse
|
136
|
Sonoda Y, Chi D, Carter J, Barakat R, Abu-Rustum N. Initial experience with Dargent's operation: The radical vaginal trachelectomy. Gynecol Oncol 2008; 108:214-9. [DOI: 10.1016/j.ygyno.2007.09.028] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 09/06/2007] [Accepted: 09/21/2007] [Indexed: 11/29/2022]
|
137
|
Sonoda Y, Matsumoto K, Kakuto Y, Nishino Y, Kumabe T, Tominaga T, Katakura R. Primary CNS lymphoma treated with combined intra-arterial ACNU and radiotherapy. Acta Neurochir (Wien) 2007; 149:1183-9; discussion 1189. [PMID: 17712511 DOI: 10.1007/s00701-007-1277-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Accepted: 07/24/2007] [Indexed: 10/22/2022]
Abstract
OBJECT To assess whether nimustine (ACNU), a drug that can cross the blood brain barrier, combined with radiotherapy, improved the survival of patients with primary central nervous system lymphoma (PCNSL). CLINICAL MATERIALS AND METHODS Between 1995 and 2005, we treated 63 immunocompetent PCNSL patients with combination therapy consisting of intra-arterial ACNU (100 mg/m(2)) and whole brain radiotherapy (36-50 Gy). Their median age was 60 years (range 28-81). The median follow-up was 24 months. FINDINGS With this regimen we achieved a complete response rate of 75% (43 of 57 patients). Kaplan-Meier estimates for median progression-free survival and median overall survival were 26 and 39 months, respectively. The 3- and 5-year survival rates were 51% (95% confidence interval [CI], 36-65%) and 32% (95% CI, 17-47%), respectively. By multivariate analysis, age (<60 vs. > or =60 years) was the only statistically significant prognostic factor; the WBRT dose, sex, and number of tumors were not significant prognostic factors in this study. Myelosuppression was the most frequent side effect, 60% of patients experienced grade 3-4 leukopenia. Late neurotoxicity as a result of treatment was observed in 14 of 43 patients (34%) and higher age (>60) was associated with a high risk of neurotoxicity. CONCLUSION The intra-arterial administration of ACNU combined with radiation therapy yielded a high response rate at acceptable toxicity levels in younger patients with PCNSL. However, late neurotoxicity was a serious complication in patients above 60 years of age.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Agents/administration & dosage
- Antineoplastic Agents/adverse effects
- Brain Neoplasms/drug therapy
- Brain Neoplasms/mortality
- Brain Neoplasms/radiotherapy
- Brain Neoplasms/surgery
- Chemotherapy, Adjuvant
- Combined Modality Therapy
- Cranial Irradiation
- Disease-Free Survival
- Female
- Humans
- Infusions, Intra-Arterial
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/radiotherapy
- Lymphoma, B-Cell/surgery
- Lymphoma, T-Cell/drug therapy
- Lymphoma, T-Cell/mortality
- Lymphoma, T-Cell/radiotherapy
- Lymphoma, T-Cell/surgery
- Male
- Middle Aged
- Nimustine/administration & dosage
- Nimustine/adverse effects
- Prognosis
- Radiotherapy Dosage
- Radiotherapy, Adjuvant
- Retrospective Studies
Collapse
|
138
|
Zivanovic O, Chi DS, Eisenhauer EL, Sonoda Y, Levine DA, Brown CL, Barakat RR. A contemporary analysis of the ability of preoperative serum CA-125 to predict primary cytoreductive outcome in patients with advanced ovarian, tubal, and peritoneal carcinoma. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5572 Background: We previously reported that preoperative CA-125 may predict primary cytoreductive outcome in patients (pts) with stage III ovarian carcinoma. We performed a contemporary analysis of the ability of preop CA-125 to predict cytoreductive outcome in advanced ovarian, tubal and peritoneal carcinoma. Methods: In 1/01, we initiated a programmatic change in our primary surgical approach to advanced gynecologic malignancies using extensive upper abdominal procedures to achieve maximal cytoreduction. We reviewed the records of all pts with advanced ovarian, tubal or peritoneal carcinoma who underwent primary cytoreduction at our institution between 1/01 and 4/05. Results: The study cohort included 277 pts. Primary disease site was: ovary; 232 (84%); tubal, 9 (3%); and peritoneum, 36 (13%). Stage was: IIIA, 6 (2%); IIIB, 12 (4%); IIIC, 215 (78%); and IV, 44 (16%). Tumor grade was: I, 6 (2%); II, 30 (11%), III, 235 (85%), and unknown, 6 (2%). Cytoreductive outcome was: no gross residual disease (RD), 68 (25%); ≤ 1 cm RD, 153 (55%); and > 1 cm RD, 56 (20%). There was no threshold CA-125 level that accurately predicted cytoreductive outcome. With CA-125 values > 500 U/mL, 50% (57/113) of pts required extensive upper abdominal surgery to achieve RD ≤ 1 cm, compared to 27% (25/93) for those with CA-125 < 500 U/mL (P = 0.03). The table demonstrates the number of pts cytoreduced to = 1 cm RD in relation to preoperative serum CA-125 and the proportion of pts who needed extensive upper abdominal surgery to achieve this degree of cytoreduction. Conclusions: After the incorporation of extensive upper abdominal procedures, preop CA-125 did not predict the primary cytoreductive outcome of pts with advanced ovarian, tubal or peritoneal carcinoma. With preoperative CA-125 > 500 U/mL, extensive upper abdominal procedures were necessary in 50% of pts to achieve residual disease ≤ 1 cm. These data may be useful as part of preoperative surgical counseling and planning. [Table: see text] No significant financial relationships to disclose.
Collapse
|
139
|
Chi DS, Eisenhauer EL, Sonoda Y, Abu-Rustum NR, Gemignani ML, Levine DA, Hensley ML, Sabbatini P, Brown CL, Barakat RR. Improved overall survival for patients with advanced ovarian, tubal, and primary peritoneal carcinoma as a result of a change in surgical approach: A follow-up study. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5530 Background: In January 2001, we initiated a programatic change in our primary surgical approach to advanced ovarian carcinoma utilizing extensive upper abdominal procedures as needed to achieve maximal cytoreduction. The objective of this study was to determine the impact of incorporating these procedures on overall survival in advanced ovarian, fallopian tube, and primary peritoneal carcinomas. Methods: Two groups of patients (pts) with stage IIIC and IV ovarian, tubal, and primary peritoneal carcinoma were identified for comparison. Group 1, the control group, consisted of all 168 pts who underwent primary cytoreduction between 1/96 and 12/99. Group 2, the study group, was composed of all 209 pts who underwent primary surgery between 1/01 and 12/04, during which time a more comprehensive debulking of upper abdominal disease was used, including diaphragm peritonectomy/resection, splenectomy, distal pancreatectomy, liver resection, resection of porta hepatis tumor, and cholecystectomy. Results: Comparison between the 2 groups revealed no significant difference in age, BMI, performance status, stage, tumor grade, proportion with primary ovarian cancer, preoperative CA-125 levels, preoperative platelet counts, percentage with ascites, or type of postoperative primary chemotherapy. The only 2 variables that differed significantly between the 2 groups were percentage of pts who had extensive upper abdominal surgery and percentage of pts cytoreduced to ≤1 cm residual disease (RD). Patients in Group 2 were more likely to have undergone extensive upper abdominal procedure(s) (37% vs. 1%; P <0.001). Cytoreduction to RD ≤1 cm was achieved in 50% of Group 1 pts compared to 80% of Group 2 pts (P <0.01). Overall median survival was significantly improved in Group 2 versus Group 1 pts (58 vs. 43 mos, [P=0.042], respectively). Conclusions: The recent incorporation of extensive upper abdominal surgical procedures to increase the rate of primary cytoreduction to residual disease ≤1 cm resulted in significantly improved overall survival. A paradigm shift toward more complete primary cytoreduction can improve survival for pts with advanced ovarian, fallopian tube, and primary peritoneal carcinomas. No significant financial relationships to disclose.
Collapse
|
140
|
Lewin SN, Soslow RA, Kim MJ, Derosa FA, Abu-Rustum NR, Sonoda Y, Brown CL, Baines MS, Flores R, Aghajanian CA. The role of surgery in high-risk gestational trophoblastic disease patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.5541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5541 Background: A survival rate of 81% has been reported in high-risk gestational trophoblastic disease (GTD) patients (pts) treated with multi-agent chemotherapy. We describe the surgical management in heavily treated pts with high-risk GTD. Methods: A retrospective chart review was performed of all pts receiving treatment for GTD at our institution from 1996–2006. High-risk pts who underwent surgery were selected. Results: Over the 10 year period, 32 pts with a median of two prior chemotherapy regimens (range 1–5) underwent 43 surgical procedures. 14 pts (44%) with undesired future fertility had hysterectomies to shorten their chemotherapy interval. 11 remain NED with median follow-up of 24 months (range 8–72). Surgeries to manage disease complications consisted of one craniotomy (for hemorrhage) and one laminectomy (for cord compression). Postoperatively the former received EMA/EP with interval hysterectomy followed by paclitaxel and carboplatin. She remains NED 75 months from diagnosis. The later died one month following laminectomy from pulmonary hemorrhage. Resection of solitary residual disease in chemotherapy refractory pts was attempted for cure in ten pts. Seven pts (70%) were cured following either thoracotomy with wedge resection or lobectomy (6) or radical abdominal trachelectomy (1) with median follow-up of 60 months (range 15 to 84). Of the remaining three, one developed brain metastasis following thoracotomy and was ultimately cured with EMA/EP. The other two with metastatic placental site trophoblastic tumor (PSTT) progressed and died, one and 60 months post-procedure. Planned hysterectomy due to non-metastatic PSTT was performed in two pts as their sole treatment. Both remain NED 19 and 26 months later. An additional seven PSTT pts had hysterectomies following EP/EMA treatment for metastatic disease. Three (43%) of the hysterectomy specimens had no residual disease. All required no further treatment and remain NED with median follow-up of 60 months (range 13 to 84 months). Conclusions: Surgical intervention during the management of high-risk GTD can be tailored to control disease complications, remove chemotherapy resistant disease or serve as therapy for PSTT. A multidisciplinary approach in specialized centers familiar with this disease entity is preferred. No significant financial relationships to disclose.
Collapse
|
141
|
Sonoda Y, Kawamoto M, Woods CN, Schloithe AC, Carati CJ, Toouli J, Saccone GTP. Sphincter of Oddi function in the Australian brush-tailed possum is inhibited by intragastric ethanol. Neurogastroenterol Motil 2007; 19:401-10. [PMID: 17509022 DOI: 10.1111/j.1365-2982.2007.00907.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The role of sphincter of Oddi (SO) function in alcoholic acute pancreatitis (AP) is unclear. We aimed to compare the effect of i.v. and intragastric (IG) ethanol on SO function (i.e. trans-sphincteric flow; TSF) and investigate possible neural mechanisms. The involvement of gastric mucosal damage was also investigated by pretreatment with pantoprazole. In anaesthetized Australian possums, blood pressure (BP), TSF and blood ethanol concentrations were measured after i.v. or IG ethanol. Possums were subjected to acute vagotomy, atropine, L-nitro arginine methyl ester (L-NAME) or pantoprazole pretreatment prior to IG ethanol. BP was not significantly altered by ethanol. Ethanol decreased TSF in a dose and route-dependent manner. The lowest dose of IG ethanol reduced TSF but this response was not duplicated by i.v. ethanol producing the same blood ethanol concentrations. Acute vagotomy, atropine or L-NAME pretreatment blocked the ethanol-induced decrease in TSF and simultaneously suppressed the blood ethanol concentration. Pantoprazole pretreatment reduced the TSF response and blood ethanol concentrations implicating mechanisms induced by gastric mucosal damage. We conclude that ethanol (and/or its metabolites) reduces TSF via humoral and neural mechanisms involving vagal pathways, muscarinic receptors and nitric oxide. Reduced TSF could contribute to the onset of AP.
Collapse
|
142
|
Mourton SM, Sonoda Y, Abu-Rustum NR, Bochner BH, Barakat RR, Chi DS. Resection of recurrent cervical cancer after total pelvic exenteration. Int J Gynecol Cancer 2007; 17:137-40. [PMID: 17291244 DOI: 10.1111/j.1525-1438.2007.00807.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to describe the management of patients with recurrent cervical cancer after total pelvic exenteration (TPE). We reviewed the records of patients who underwent TPE for recurrent cervical cancer between June 1992 and December 2003 and subsequently developed recurrent disease. Thirty-seven patients underwent TPE during the study period, and 25 (68%) subsequently developed recurrence proven by radiographic and/or biopsy studies. Recurrence sites included pelvic (12), inguinal (5), retroperitoneal (5), hepatic (4), vulva (2), perineum (1), transposed ovary (1), and lung (1). The median time to recurrence was 7 months (range 2-73 months), with 92% (23/25) occurring within 2 years of TPE. Management of recurrence was known in 21 of 25 patients, which included chemotherapy (10), surgical resection (7), and no further treatment (4). Surgically resected recurrences were isolated to the groin (2), vulva (2), perineum (1), transposed ovary (1), and psoas muscle (1). The four patients who underwent ovarian, perineal, and vulvar resections succumbed to their disease in a median time of 13 months (range 2-21 months). Of the two patients with surgically resected groin recurrences, one is alive with disease 21 months after initial recurrence and the other is alive without evidence of disease 85 months later. One patient had an isolated 4-cm recurrence involving the psoas muscle and the femoral nerve and is without the evidence of disease 9 months later. Resection of isolated recurrences after TPE is a reasonable option in selected patients, particularly in those with solitary inguinal metastases.
Collapse
|
143
|
Sakurada K, Sato S, Sonoda Y, Kokubo Y, Saito S, Kayama T. Surgical resection of tumors located in subcortex of language area. Acta Neurochir (Wien) 2007; 149:123-9; discussion 129-30. [PMID: 16990990 DOI: 10.1007/s00701-006-0857-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2004] [Accepted: 07/26/2006] [Indexed: 10/24/2022]
Abstract
OBJECT Although functional mapping facilitates the planning of surgery in and around eloquent areas, the resection of tumors adjacent to language areas remains challenging. In this report, we took notice that the language areas (Broca's and Wernicke's) present at the perisylvian fissure. We posit that if there is non-essential language area on the inner surface of the Sylvian fissure, safe tumor resection may be possible even if the tumor is located under the language cortex. METHODS The study population consisted of 5 patients with intrinsic brain tumors (frontal glioma, n = 3; temporal cavernous angioma, n = 1; primary malignant central nervous system lymphoma, n = 1) located in the perisylvian subcortex, in the language-dominant hemisphere. All patients underwent awake surgery and we performed intra-operative bipolar cortical functional language mapping. When the tumor was located under the language area, the Sylvian fissure was opened and the inner surface of the opercular cortex was exposed with the patient asleep, and additional functional mapping of that cortex was performed. This enabled us to remove the tumor from the non-functioning cortex. In our series, 4 of 5 patients had not language function on the inner surface of the operculum. Only one patient, a 52-year-old man with frontal glioblastoma (Case 3) had language function on the inner surface of the frontal operculum. CONCLUSION We suggest that even perisylvian tumors located in the subcortex of the language area may be resectable via the nonfunctioning intrasylvian cortex by a transopercular approach without resultant language dysfunction.
Collapse
|
144
|
Poynor EA, Marshall D, Sonoda Y, Slomovitz BM, Barakat RR, Soslow RA. Clinicopathologic features of early adenocarcinoma of the cervix initially managed with cervical conization. Gynecol Oncol 2006; 103:960-5. [PMID: 16860853 DOI: 10.1016/j.ygyno.2006.05.041] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2006] [Revised: 05/30/2006] [Accepted: 05/31/2006] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the clinicopathologic features of microinvasive adenocarcinoma of the cervix in order to guide the management of patients with this disease. MATERIALS AND METHODS A retrospective review was conducted of patients diagnosed with early invasive, <or=5 mm stromal invasion, adenocarcinoma of the cervix by a cervical conization between 1992 and 1999 at our institution. Information was abstracted on tumor histopathologic type, grade, and depth of invasion as well as presence or absence of disease at the margins of conization, lymphovascular spread, and the presence of disease in subsequent pathology specimens including the parametrium and pelvic lymph nodes (PLNs). RESULTS Thirty-three patients were identified. The mean age of the patients in the study population was 41.6 years (range, 29-53 years). Fifteen women were age 35 years or younger. Six patients had invasion<or=1 mm, 9 patients had invasion>1 mm and <or=2 mm, 6 patients had invasion>2 mm and <or=3 mm, 6 patients had invasion>3 mm and <or=4 mm, and 6 patients had invasion>4 mm and <or=5 mm. Three patients were treated with a conization only, 4 patients were treated with a simple hysterectomy, 25 patients were treated with a radical hysterectomy (RH) and PLN dissection (PLND), and 1 patient was treated with a radical trachelectomy and PLND. Ten patients had positive conization margins for invasive cancer, 3 patients had margins positive for adenocarcinoma in situ, 14 patients had negative margins, and in 6 patients the margin status could not be evaluated. Of the 10 patients with positive margins, 5 of 10 (50%) had residual disease in the subsequent surgical specimen. Three patients who underwent definitive management with conization alone originally had positive margins, underwent a second repeat conization, and are included in this group. Of the 16 patients with negative margins, no patient had residual disease in a subsequent surgical specimen. Of the 25 patients who underwent a RH and PLND, none had parametrial involvement and none had PLN involvement. All patients remained without evidence of disease at median follow-up of 30 months. CONCLUSIONS Historically, the standard management of early invasive adenocarcinoma of the cervix has been controversial, and some clinicians continue to favor radical treatments. Based on the absence of parametrial spread and PLN involvement in early lesions, physicians and patients should consider treatment with conization with negative margins (when future fertility is desired) or simple hysterectomy. Prospective studies are required to document the safety of this approach.
Collapse
|
145
|
Chi DS, Sonoda Y, Abu-Rustum NR, Awtrey CS, Huh J, Barakat RR, Kattan MW. Nomogram for survival after primary surgery for bulky stage IIIC ovarian carcinoma. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.5058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5058 Background: Nomograms have been developed for numerous malignancies to predict a specific individual’s probability of long-term survival based on known prognostic factors. To date, no prediction model has been developed for patients with ovarian cancer. The objective of this study was to develop a nomogram to predict the probability of 4-year survival after primary cytoreductive surgery for bulky stage IIIC ovarian carcinoma. Methods: Nomogram predictor variables included age, tumor grade, histologic type, preoperative platelet count, the presence or absence of ascites, and residual disease status after primary cytoreduction. Disease-specific survival was estimated using the Kaplan-Meier method. Cox proportional hazards regression was used for multivariable analysis. The Cox model was the basis for the nomogram. The concordance index was used as an accuracy measure, with bootstrapping to correct for optimistic bias. Calibration plots were constructed. Results: A total of 462patients with bulky stage IIIC ovarian carcinoma underwent primary cytoreductive surgery at our institution during the study period of 1/89 to 12/03, of whom 397 were evaluable for inclusion in the study. The median age of the study population was 60 years (range 22–87). The primary surgeon in all cases was an attending gynecologic oncologist. Postoperatively, all patients received platinum-based systemic chemotherapy. Ovarian cancer-specific survival at 4 years was 51%. A nomogram was constructed on the basis of a Cox regression model and the 6 predictor variables. This nomogram was internally validated using bootstrapping and shown to have excellent calibration with a bootstrap-corrected concordance index of 0.67. Conclusions: A nomogram was developed to predict 4-year disease-specific survival after primary cytoreductive surgery for bulky stage IIIC ovarian carcinoma. The nomogram utilizes 6 predictor variables that are readily accessible, assigns a point value to each variable, and then predicts the probability of 4-year survival based on the total point value for an individual patient. This tool should be useful for patient counseling, clinical trial eligibility determination, postoperative management, and follow-up. No significant financial relationships to disclose.
Collapse
|
146
|
Chi DS, Eisenhauer EL, Lang J, Huh J, Haddad L, Abu-Rustum NR, Sonoda Y, Levine DA, Hensley M, Barakat RR. What is the optimal goal of primary cytoreductive surgery for bulky stage IIIC epithelial ovarian carcinoma (EOC)? Gynecol Oncol 2006; 103:559-64. [PMID: 16714056 DOI: 10.1016/j.ygyno.2006.03.051] [Citation(s) in RCA: 433] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2005] [Revised: 03/14/2006] [Accepted: 03/31/2006] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Recent studies have suggested that the definition of optimal cytoreduction for advanced EOC should be changed from the current Gynecologic Oncology Group threshold of < or =1 cm residual disease to no gross residual disease owing to improved survival of patients (pts) rendered macroscopically disease-free. The objective of this study was to analyze survival rates at very specific residual disease diameters to determine the optimal goal of primary cytoreduction for bulky stage IIIC EOC. METHODS A prospectively kept database was used to identify and review the records of all pts with Stage IIIC EOC who underwent primary cytoreductive surgery at our institution between January 1989 and December 2003. To analyze a homogeneous cohort of cases, we excluded pts with stage IIIC disease based on nodal metastasis alone (without bulky abdominal tumor), fallopian tube or primary peritoneal carcinomas, and borderline tumors. Standard statistical analyses were utilized. RESULTS The study cohort included 465 pts. The median age was 60 years (range, 25-87), and the median follow-up was 38 months (range, 1-199). Univariate and multivariate analyses, which included various prognostic factors, identified amount of residual disease as a significant prognostic factor (P < 0.001). Median overall survival in relation to the 5 residual disease categories was: no gross residual, 106 months; gross < or =0.5 cm, 66 months; 0.6-1.0 cm, 48 months; 1-2 cm, 33 months; >2 cm, 34 months. Statistical comparison between the 5 residual disease categories revealed 3 distinct groups with significantly different survival rates (P < 0.01). These 3 groups were: (1) no gross residual; (2) gross < or =1 cm residual; and (3) >1 cm residual. Although the difference in survival did not reach statistical significance, within the gross < or =1 cm residual group, there was a trend toward improved survival in pts left with smaller volume, < or =0.5 cm residual compared with those with 0.6-1.0 cm residual (P = 0.06). CONCLUSION Our data suggest that removal of all evidence of macroscopic disease is associated with prolonged survival and should be the goal of primary cytoreductive surgery. If complete gross resection is not feasible, however, cytoreduction to as minimal residual tumor as possible should be the focus of cytoreductive efforts, as each incremental decrease in residual disease below 1 cm may be associated with an incremental improvement in overall survival.
Collapse
|
147
|
Kurono A, Arimura K, Watanabe O, Tomimitsu H, Nagado T, Sonoda Y, Kameyama M, Osame M. IgM-containing fraction suppressed voltage-gated potassium channels in acquired neuromyotonia. Acta Neurol Scand 2006; 113:185-8. [PMID: 16441249 DOI: 10.1111/j.1600-0404.2005.00569.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Acquired neuromyotonia (ANM) is an autoimmune disorder caused by antibodies to voltage-gated potassium channels (VGKC). Previously, we reported a patient with immunoglobulin M (IgM), instead of immunoglobulin G (IgG), anti-VGKC antibody. The purpose of this study was to determine the function of IgM-containing fraction in ANM patients. MATERIALS AND METHODS We determined whether anti-VGKC antibodies in the IgG or IgM-containing fractions suppressed outward potassium current (OKC) using the patch clamp method in three patients with ANM. Whole sera from all patients suppressed OKCs. RESULT Only the purified IgG, not the IgM-containing fractions from two patients suppressed VGKCs, whereas in a patient with IgM anti-VGKC antibody, only the IgM-containing fractions, not the IgG-containing fractions suppressed VGKCs. CONCLUSION Anti-VGKC antibodies belonging to the IgM subclass should be determined in seronegative ANM patients.
Collapse
|
148
|
Okuda K, Oda A, Sato Y, Nakayama A, Fujita H, Sonoda Y, Griffin JD. Signal transduction and cellular functions of the TEL/ARG oncoprotein. Leukemia 2005; 19:603-10. [PMID: 15729383 DOI: 10.1038/sj.leu.2403668] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The TEL/ARG oncogene is formed by t(1;12)(q25;p13) reciprocal translocation and is associated with human leukemia. We have previously demonstrated that the expression of TEL/ARG in Ba/F3 cells results in prolonged viability and hyper-responsiveness to IL-3. To determine the molecular mechanisms, a series of mutants of TEL/ARG were generated, and each cDNA was expressed in Ba/F3 or CHO cells. The PNT domain in TEL and K317 in ARG were essential for both signaling and biological effects. The SH3 domain in ARG was required for hyper-responsiveness to IL-3, but not for prolonged viability. The opposite was true for the SH2 domain in ARG. Mutation of Y314 in TEL, a putative GRB2-binding site, led to reduced viability, and loss of hyper-responsiveness to IL-3. All biological functions were profoundly impaired with deletion of the C-terminus in ARG, despite maintaining high levels of its kinase activity. When expressed in CHO cells, wild-type TEL/ARG induced the formation of fillopodia, in a fashion dependent on the C-terminal portion and intact kinase activity. Thus, these results suggest several critical domains within TEL/ARG necessary for function, and indicate that the signaling pathways necessary for viability, growth factor hyper-responsiveness and cytoskeletal reorganization are likely to be separate.
Collapse
|
149
|
Sonoda Y, Sakurada K, Saino M, Kondo R, Sato S, Kayama T. Multimodal strategy for managing meningiomas in the elderly. Acta Neurochir (Wien) 2005; 147:131-6; discussion 136. [PMID: 15570440 DOI: 10.1007/s00701-004-0391-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND The incidence of brain tumors in elderly patients is increasing. It has become possible to treat meningiomas in the elderly by several modalities. We developed a successful multimodal strategy to treat these patients. METHODS We registered 35 patients with meningiomas. Symptomatic meningiomas were treated surgically at the time of diagnosis (n=19). Of the 16 asymptomatic meningiomas, 5 were removed at the time of diagnosis. The other asymptomatic meningiomas (n=11) were treated conservatively and when the tumors increased in size, surgical treatment was considered. "Operated" patients with residual or recurrent tumors underwent radiosurgery with a gamma knife. FINDINGS Surgical mortality and morbidity were 4% and 16%, respectively. Of the 25 "operated" patients, 21 (84.0%) had a good Karnofsky scale (> or =80%) at discharge. In all but two of the 11 patients with asymptomatic, conservatively treated meningiomas, the tumors did not increase during the follow-up period. Gamma knife radiosurgery, performed to treat 3 residual and 1 recurrent tumor, resulted in very good tumor control and none of the tumors increased after gamma knife surgery. CONCLUSIONS Meningiomas in elderly patients require a multimodal approach. Our strategy, which includes surgery, radiosurgery, and conservative treatment, resulted in good tumor control and made it possible for patients to pursue their activities of daily life.
Collapse
|
150
|
Ng VS, Stier EA, Soslow R, Chuai S, Venkatraman ES, Sonoda Y. 423 UTERINE CANCER IN PATIENTS WITH A HISTORY OF BREAST CANCER—DO THESE PATIENTS ALWAYS BLEED? J Investig Med 2005. [DOI: 10.2310/6650.2005.00005.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|