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Zanoni DK, Demétrio De Souza França P, Valero C, Peterson G, Ardigo M, Ghossein R, Dusza SW, Matsuura D, Scholfield DW, Adilbay D, Montero PH, Migliacci J, Pillarsetty NVK, Kose K, Ganly I, Rajadhyaksha M, Patel SG. A Prospective Double-Blinded Comparison of Reflectance Confocal Microscopy with Conventional Histopathology for In Vivo Assessment in Oral Cancer. Clin Cancer Res 2024:741993. [PMID: 38526414 DOI: 10.1158/1078-0432.ccr-23-1361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/27/2023] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE We investigated reflectance confocal microscopy (RCM) as a possible non-invasive approach for the diagnosis of cancer and real-time assessment of surgical margins. PATIENTS AND METHODS In a phase I study on 20 patients, we established the RCM imaging morphological features that distinguish OSCC from normal tissue with a newly developed intra-oral RCM probe. Our subsequent phase II prospective double-blinded study in 60 patients tested the diagnostic accuracy of RCM against histopathology. Five RCM videos from the tumor and five from normal surrounding mucosa were collected on each patient, followed by a 3-mm punch biopsy of the imaged area. An experienced RCM reader, who was blinded to biopsy location and histological diagnosis, examined the videos from both regions and classified each as "tumor" or "not-tumor" based on RCM features established in phase I. Hematoxylin and eosin slides from the biopsies were read by a pathologist who was blinded to RCM results. Using histology as the gold standard, we calculated the sensitivity and specificity of RCM. RESULTS We report a high agreement between the blinded readers (95% for normal tissue and 81.7% for tumors), high specificity (98.3%) and negative predictive values (96.6%) for normal tissue identification, and high sensitivity (90%) and positive predictive values (88.2%) for tumor detection. CONCLUSIONS RCM imaging is a promising technology for non-invasive in vivo diagnosis of OSCC and for real-time intraoperative evaluation of mucosal surgical margins. Its inherent constraint, however, stems from the diminished capability to evaluate structures located at more substantial depths within the tissue.
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Affiliation(s)
- Daniella K Zanoni
- University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
| | | | - Cristina Valero
- Memorial Sloan Kettering Cancer Center, New York, United States
| | - Gary Peterson
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Ronald Ghossein
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | | | | | - Dauren Adilbay
- Memorial Sloan Kettering Cancer Center, New York, New York, United States
| | | | | | | | - Kivanc Kose
- Memorial Sloan Kettering Cancer Center, New York, United States
| | - Ian Ganly
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Snehal G Patel
- Memorial Sloan Kettering Cancer Center, New York, New York, United States
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2
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Migliacci J, Rodavitch A, Riely G, Sabbatini P, Houston C, Hanley S. One committee to review them all: A single, multi-disciplinary COVID-19 research committee. Contemp Clin Trials 2022; 117:106760. [PMID: 35460914 PMCID: PMC9020641 DOI: 10.1016/j.cct.2022.106760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/31/2022] [Accepted: 04/11/2022] [Indexed: 11/18/2022]
Abstract
On 1/20/2020 when the first case of a novel coronavirus (COVID-19) was confirmed in Washington state, its major impact was unknown. Memorial Sloan Kettering Cancer Center's (MSK) Hospital Incident Command System (HICS) was activated on 2/5, with our first COVID-19 case identified in early March. By 3/17, our Protocol Activation and Human Research Protection Program was fully remote and on 3/23, MSK leadership requested the creation of the COVID-19 Research Committee. Given the race to identify safe and effective treatments for COVID-19, modifications to workflows and review processes were needed. The goal was to provide quick access to COVID-19 treatments to our patients by creating a COVID-19 Committee as a “one-stop” committee, providing comprehensive review of clinical research related to COVID-19 including scientific review mandated by the Cancer Center Support Grant (CCSG) guidelines, prior to IRB review and protocol activation. Protocols that were reviewed by the COVID-19 Committee opened to accrual in an unprecedented 44 days from submission to the committee to open to accrual. Patients were accrued on most of the therapeutic protocols within 1 day of opening. These statistics have prompted our institution to explore how more protocols can benefit from this “one-stop” committee structure.
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3
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Rosenthal M, Baser RE, Migliacci J, Boyle JO, Morris LGT, Cohen MA, Singh B, Shah JP, Wong RJ, Patel S, Ganly I. Flexible fiber-based CO 2 laser vs monopolar cautery for resection of oral cavity lesions: A single center randomized controlled trial assessing pain and quality of life following surgery. Laryngoscope Investig Otolaryngol 2021; 6:690-698. [PMID: 34401493 PMCID: PMC8356859 DOI: 10.1002/lio2.572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 02/06/2021] [Accepted: 04/17/2021] [Indexed: 11/05/2022] Open
Abstract
IMPORTANCE This study reports the impact of laser surgery on quality of life in patients with oral cavity lesions. OBJECTIVE To compare postoperative pain and quality of life in patients treated with flexible fiberoptic CO2 laser vs electrocautery in patients with oral cavity precancerous lesions and early stage cancers. DESIGN Randomized controlled trial. SETTING Single center. PARTICIPANTS Patients with premalignant oral cavity lesions and early stage oral cancer. INTERVENTION Patients were randomized to have surgical resection using either flexible fiber carbon dioxide laser (Laser) or electrocautery (EC). The patients were then followed over a period of 28 days to assess for outcomes including pain, quality of life, performance status, return to work, and return to diet. Quality of life was measured by the University of Washington Quality of Life (UWQOL) questionnaire and the performance status score (PSS). MAIN OUTCOME MEASURE The primary endpoint for this study was the numerical pain rating on postoperative day (POD) 7. RESULTS Sixty-two patients were randomized (32 laser and 30 electrocautery). Lesions excised were carcinoma in 30(48%), dysplasia in 31(50%) and benign in 1(2%). There was no difference in the location of lesion, size of lesion, defect size, type of closure, resection time, and blood loss between Laser and EC arms. Patients who had Laser had less pain compared to EC (mean pain score on POD 7 L = 2.84 vs EC = 3.83, P = 0.11). better UW QOL scores and PSS scores, quicker return to normal diet (median days L = 26.0 vs EC = 28.5, P = 0.17) and faster return to work (median days L = 13.0 vs EC = 16.5, P = 0.14). However, these results were not statistically significant. CONCLUSION There was a trend for patients treated with laser to have less pain and better quality of life scores but these result were not statistically significant. Based on the actual observed difference, a large multicenter RCT with 90 patients in each arm is required to determine the clinical relevance of our results.
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Affiliation(s)
- Matthew Rosenthal
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Raymond E. Baser
- Department of Epidemiology and BiostatisticsMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jocelyn Migliacci
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jay O. Boyle
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Luc G. T. Morris
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Marc A. Cohen
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Bhuvanesh Singh
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jatin P. Shah
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Richard J. Wong
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Snehal Patel
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Ian Ganly
- Department of SurgeryHead and Neck Service, Memorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Ganly I, Pei Z, Hao Y, Ma Y, Rosenthal M, Wu Z, Migliacci J, Huang B, Katabi N, Tseng W, Brown S, Tang YW, Yang L. Case control study comparing the HPV genome in patients with oral cavity squamous cell carcinoma to normal patients using metagenomic shotgun sequencing. Sci Rep 2021; 11:3867. [PMID: 33594114 PMCID: PMC7886861 DOI: 10.1038/s41598-021-83197-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 01/27/2021] [Indexed: 12/13/2022] Open
Abstract
The aim of this study was to carry out a case control study comparing the HPV genome in patients with oral cavity squamous cell carcinoma (OC-SCC) to normal patients using metagenomic shotgun sequencing. We recruited 50 OC-SCC cases which were then matched with a control patient by age, gender, race, smoking status and alcohol status. DNA was extracted from oral wash samples from all patients and whole genome shotgun sequencing performed. The raw sequence data was cleaned, reads aligned with the human genome (GRCH38), nonhuman reads identified and then HPV genotypes identified using HPViewer. In the 50 patients with OC-SCC, the most common subsite was tongue in 26 (52%). All patients were treated with primary resection and neck dissection. All but 2 tumors were negative on p16 immunohistochemistry. There were no statistically significant differences between the cases and controls in terms of gender, age, race/ethnicity, alcohol drinking, and cigarette smoking. There was no statistically significant difference between the cancer samples and control samples in the nonhuman DNA reads (medians 4,228,072 vs. 5,719,715, P value = 0.324). HPV was detected in 5 cases (10%) of OC-SCC (genotypes 10, 16, 98) but only 1 tumor sample (genotype 16) yielded a high number of reads to suggest a role in the etiology of OC-SCC. HPV was detected in 4 control patients (genotypes 16, 22, 76, 200) but all had only 1–2 HPV reads per human genome. Genotypes of HPV are rarely found in patients with oral cancer.
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Affiliation(s)
- Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA.
| | - Zhiheng Pei
- Department of Pathology, New York University School of Medicine, New York, 10016, USA.,Department of Medicine, New York University School of Medicine, New York, 10016, USA.,Department of Veterans Affairs, New York Harbor Healthcare System, New York, USA
| | - Yuhan Hao
- Department of Pathology, New York University School of Medicine, New York, 10016, USA.,Applied Bioinformatics Laboratories, New York University School of Medicine, New York, 10016, USA.,Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY, 10016, USA
| | - Yingfei Ma
- Department of Medicine, New York University School of Medicine, New York, 10016, USA.,Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518000, China
| | - Matthew Rosenthal
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Zhenglin Wu
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Laboratory Medicine, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Jocelyn Migliacci
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bin Huang
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.,Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Wenzhi Tseng
- Department of Pathology, New York University School of Medicine, New York, 10016, USA
| | - Stuart Brown
- Applied Bioinformatics Laboratories, New York University School of Medicine, New York, 10016, USA
| | - Yi-Wei Tang
- Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, USA.,Medical Affairs, Cepheid, Danaher Diagnostic Platform, Shanghai, China
| | - Liying Yang
- Department of Pathology, New York University School of Medicine, New York, 10016, USA. .,Department of Medicine, New York University School of Medicine, New York, 10016, USA.
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5
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Hay AJ, Migliacci J, Karassawa Zanoni D, McGill M, Patel S, Ganly I. Minor salivary gland tumors of the head and neck-Memorial Sloan Kettering experience: Incidence and outcomes by site and histological type. Cancer 2019; 125:3354-3366. [PMID: 31174233 DOI: 10.1002/cncr.32208] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 03/13/2019] [Accepted: 04/04/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Minor salivary gland carcinomas of the head and neck are rare cancers with variable clinical behavior. This study explored the incidence, pathology, clinical behavior, and factors predictive of outcomes in a large cohort of patients treated at Memorial Sloan Kettering Cancer Center over a 30-year period (1985-2015). METHODS Clinical, pathological, treatment, and outcome data were collected. Unadjusted and adjusted hazard ratios for each variable were calculated with univariate and multivariable Cox regression for survival and recurrence outcomes. RESULTS Four hundred fifty patients were included: 55% were female, 56% were younger than 60 years, and the median follow-up was 74 months (range, 1-364 months). The most common site was the oral cavity with 305 tumors (68%), which was followed by the oropharynx with 96 (21%), the sinonasal cavity with 38 (8%), the trachea with 7 (2%), and the larynx with 4 (1%). The most common histological types were mucoepidermoid carcinoma (180 tumors [40%]), adenoid cystic carcinoma (141 tumors [31%]), and polymorphous low-grade adenocarcinoma (54 tumors [12%]). The 5-year predicted overall survival rate was 86%, and the disease-specific survival rate was 94% at 5 years. Pathology and tumor stage were significant variables on multivariate analysis for overall survival, disease-specific survival, recurrence-free survival, local recurrence-free survival, regional recurrence-free survival, and distant recurrence-free survival. CONCLUSIONS American Joint Committee on Cancer stage and pathology were the most predictive variables across all outcomes. Tumor site, postoperative radiotherapy, and margin status were not statistically significant variables after tumor stage and pathology were controlled for in most outcomes.
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Affiliation(s)
- Ashley J Hay
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jocelyn Migliacci
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daniella Karassawa Zanoni
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marlena McGill
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Snehal Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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6
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Dogan S, Xu B, Middha S, Vanderbilt CM, Bowman AS, Migliacci J, Morris LGT, Seshan VE, Ganly I. Identification of prognostic molecular biomarkers in 157 HPV-positive and HPV-negative squamous cell carcinomas of the oropharynx. Int J Cancer 2019; 145:3152-3162. [PMID: 31093971 DOI: 10.1002/ijc.32412] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 04/23/2019] [Accepted: 04/30/2019] [Indexed: 12/12/2022]
Abstract
The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been increasing due to high-risk HPV infection. We explored the significance of genetic alterations in HPV-positive (HPV-P) and HPV-negative (HPV-N) OPSCC patients on long-term outcome. A total of 157 cases of primary resected OPSCC diagnosed from 1978 to 2005 were subjected to a targeted exome sequencing by MSK-IMPACT™ interrogating somatic mutations in 410 cancer-related genes. Mutational profiles were correlated to recurrence and survival outcomes. OPSCC included 47% HPV-positive (HPV-P) and 53% HPV-negative (HPV-N) tumors arising in the base of tongue (BOT, 43%), palatine tonsil (30%) and soft palate (SP, 27%). HPV negative status, SP location and smoking were associated with poorer outcome. Poorer overall survival was found in NOTCH1-mutated HPV-P (p = 0.039), and in SOX2-amplified HPV-N cases (p = 0.036). Chromosomal arm gains in 8p and 8q, and 16q loss were more common in HPV-P (p = 0.005, 0.04 and 0.01, respectively), while 9p, 18q and 21q losses were more frequent in HPV-N OPSCC (p = 0.006, 0.002 and 0.01, respectively). Novel, potentially functional JAK3, MYC and EP300 intragenic deletions were found in HPV-P, and FOXP1, CDKN2A, CCND1 and RUNX1 intragenic deletions and one FGFR3 inversion were detected in HPV-N tumors. HPV-N/TP53-wild-type OPSCC harbored recurrent mutations in NOTCH1/3/4 (39%), PIK3CA, FAT1 and TERT. In comparison to their oral and laryngeal counterparts, HPV-N OPSCC were genetically distinct. In OPSCC, HPV status, tumor subsite and smoking determine outcome. Risk-stratification can be further refined based on the mutational signature, namely, NOTCH1 and SOX2 mutation status.
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Affiliation(s)
- Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sumit Middha
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Chad M Vanderbilt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Anita S Bowman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jocelyn Migliacci
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Luc G T Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.,Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Venkatraman E Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ian Ganly
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.,Department of Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, NY
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7
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Ganly I, Yang L, Giese RA, Hao Y, Nossa CW, Morris LGT, Rosenthal M, Migliacci J, Kelly D, Tseng W, Hu J, Li H, Brown S, Pei Z. Periodontal pathogens are a risk factor of oral cavity squamous cell carcinoma, independent of tobacco and alcohol and human papillomavirus. Int J Cancer 2019; 145:775-784. [PMID: 30671943 DOI: 10.1002/ijc.32152] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 12/18/2018] [Accepted: 01/02/2019] [Indexed: 12/29/2022]
Abstract
Over the past decade, there has been a change in the epidemiology of oral cavity squamous cell cancer (OC-SCC). Many new cases of OC-SCC lack the recognized risk factors of smoking, alcohol and human papilloma virus. The aim of this study was to determine if the oral microbiome may be associated with OC-SCC in nonsmoking HPV negative patients. We compared the oral microbiome of HPV-negative nonsmoker OC-SCC(n = 18), premalignant lesions(PML) (n = 8) and normal control patients (n = 12). Their oral microbiome was sampled by oral wash and defined by 16S rRNA gene sequencing. We report that the periodontal pathogens Fusobacterium, Prevotella, Alloprevotella were enriched while commensal Streptococcus depleted in OC-SCC. Based on the four genera plus a marker genus Veillonella for PML, we classified the oral microbiome into two types. Gene/pathway analysis revealed a progressive increase of genes encoding HSP90 and ligands for TLRs 1, 2 and 4 along the controls→PML → OC-SCC progression sequence. Our findings suggest an association between periodontal pathogens and OC-SCC in non smoking HPV negative patients.
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Affiliation(s)
- Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Liying Yang
- Department of Pathology, New York University School of Medicine, New York, NY.,Department of Medicine, New York University School of Medicine, New York, NY
| | - Rachel A Giese
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuhan Hao
- Department of Pathology, New York University School of Medicine, New York, NY.,Applied Bioinformatics Laboratories, New York University School of Medicine, New York, NY.,Center for Genomics and Systems Biology, Department of Biology, New York University, New York, NY
| | | | - Luc G T Morris
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Matthew Rosenthal
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jocelyn Migliacci
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Dervla Kelly
- Department of Pathology, New York University School of Medicine, New York, NY
| | - Wenzhi Tseng
- Department of Pathology, New York University School of Medicine, New York, NY
| | - Jiyuan Hu
- Department of Population Health and the Department of Environmental Medicine, New York, NY
| | - Huilin Li
- Department of Population Health and the Department of Environmental Medicine, New York, NY
| | - Stuart Brown
- Applied Bioinformatics Laboratories, New York University School of Medicine, New York, NY
| | - Zhiheng Pei
- Department of Pathology, New York University School of Medicine, New York, NY.,Department of Veterans Affairs New York Harbor Healthcare System, New York, NY
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Abstract
Ameloblastoma is a histologically benign but locally aggressive tumor of the jaws. We conducted a retrospective cohort study to review the clinical, radiologic, and pathologic features of patients with ameloblastoma of the mandible and maxilla and to report the outcomes of treatment. Our study population was made up of a series of 30 consecutively presenting patients-15 men and 15 women, aged 19 to 81 years (median: 61.5)-who had undergone their primary treatment of ameloblastoma of the mandible or maxilla at Memorial Sloan Kettering Cancer Center from January 1987 through December 2012. In addition to demographic data, we compiled information on clinical characteristics, imaging findings, the type of surgery, surgical margins, adjuvant treatments, histologic patterns, length of follow-up, time to recurrence, treatment of recurrence, and factors that had an influence on recurrence. All but 2 patients with negative margins were cured. Favorable outcomes were associated with the administration of adjuvant postoperative radiotherapy for patients with positive margins and a repeat resection for patients with recurrences. Complete excision with negative margins, however, remains the gold standard for curative treatment.
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Affiliation(s)
- Ivana D Petrovic
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Ave., New York, NY 10065, USA
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9
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Hay A, Migliacci J, Karassawa Zanoni D, Boyle JO, Singh B, Wong RJ, Patel SG, Ganly I. Haemorrhage following transoral robotic surgery. Clin Otolaryngol 2018; 43:638-644. [PMID: 29194991 PMCID: PMC5851834 DOI: 10.1111/coa.13041] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND To report our experience of postoperative haemorrhage in patients following transoral robotic surgery (TORS). METHODS Data were collected on patients having TORS. Postoperative haemorrhage within 30 days was graded using the Mayo Clinic grading system. RESULTS Transoral robotic surgery operations were performed on 122 patients. There were 23 bleeding events classified as minor to severe following 19 operations (16%). Haemorrhage requiring a return to the operating room occurred after 7 operations (6%). The odds of an emergent haemorrhage were 5.19 times greater in patients who had a staged neck dissection after TORS (P = .05). The odds of a postoperative bleeding event were 2.6 times greater in patients receiving a larger resection (P = .107). There were no haemorrhage events in the 36 patients who received a synchronous neck dissection with transcervical ligation of the external carotid artery. CONCLUSIONS Surgical intervention for TORS haemorrhage occurred in 6% patients. No haemorrhage occurred in patients who had ligation of the external carotid artery.
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Affiliation(s)
- A Hay
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J Migliacci
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - D Karassawa Zanoni
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - J O Boyle
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - B Singh
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - R J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - S G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - I Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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10
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Joshi R, Unsal A, Cracchiolo J, Migliacci J, Roman B, Cohen M. An Analysis of Endoscopic and Open Approaches to Sinonasal Malignancies in the National Cancer Database from 2010 to 2014. Skull Base Surg 2018. [DOI: 10.1055/s-0038-1633604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Rohan Joshi
- Memorial Sloan Kettering Cancer Center, New York, United States
| | - Aykuk Unsal
- Memorial Sloan Kettering Cancer Center, New York, United States
| | | | | | - Benjamin Roman
- Memorial Sloan Kettering Cancer Center, New York, United States
| | - Marc Cohen
- Memorial Sloan Kettering Cancer Center, New York, United States
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11
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Hay A, Migliacci J, Zanoni DK, Patel S, Yu C, Kattan MW, Ganly I. Validation of nomograms for overall survival, cancer-specific survival, and recurrence in carcinoma of the major salivary glands. Head Neck 2018; 40:1008-1015. [PMID: 29389040 DOI: 10.1002/hed.25079] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 10/10/2017] [Accepted: 12/06/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The purpose of this study was to investigate the performance of the Memorial Sloan Kettering Cancer Center salivary carcinoma nomograms predicting overall survival, cancer-specific survival, and recurrence with an external validation dataset. METHODS The validation dataset comprised 123 patients treated between 2010 and 2015 at our institution. They were evaluated by assessing discrimination (concordance index [C-index]) and calibration (plotting predicted vs actual probabilities for quintiles). RESULTS The validation cohort (n = 123) showed some differences to the original cohort (n = 301). The validation cohort had less high-grade cancers (P = .006), less lymphovascular invasion (LVI; P < .001) and shorter follow-up of 19 months versus 45.6 months. Validation showed a C-index of 0.833 (95% confidence interval [CI] 0.758-0.908), 0.807 (95% CI 0.717-0.898), and 0.844 (95% CI 0.768-0.920) for overall survival, cancer-specific survival, and recurrence, respectively. CONCLUSION The 3 salivary gland nomograms performed well using a contemporary validation dataset, despite limitations related to sample size, follow-up, and differences in clinical and pathology characteristics between the original and validation cohorts.
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Affiliation(s)
- Ashley Hay
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jocelyn Migliacci
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daniella Karassawa Zanoni
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Snehal Patel
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Changhong Yu
- Department of Quantitative Health Services, Cleveland Clinic, Cleveland, Ohio
| | - Michael W Kattan
- Department of Quantitative Health Services, Cleveland Clinic, Cleveland, Ohio
| | - Ian Ganly
- Department of Quantitative Health Services, Cleveland Clinic, Cleveland, Ohio
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12
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Ibrahimpasic T, Xu B, Landa I, Dogan S, Middha S, Seshan V, Deraje S, Carlson DL, Migliacci J, Knauf JA, Untch B, Berger MF, Morris L, Tuttle RM, Chan T, Fagin JA, Ghossein R, Ganly I. Genomic Alterations in Fatal Forms of Non-Anaplastic Thyroid Cancer: Identification of MED12 and RBM10 as Novel Thyroid Cancer Genes Associated with Tumor Virulence. Clin Cancer Res 2017. [PMID: 28634282 DOI: 10.1158/1078-0432.ccr-17-1183] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose: Patients with anaplastic thyroid cancer (ATC) have a very high death rate. In contrast, deaths from non-anaplastic thyroid (NAT) cancer are much less common. The genetic alterations in fatal NAT cancers have not been reported.Experimental Design: We performed next-generation sequencing of 410 cancer genes from 57 fatal NAT primary cancers. Results were compared with The Cancer Genome Atlas study (TCGA study) of papillary thyroid cancers (PTCs) and to the genomic changes reported in ATC.Results: There was a very high prevalence of TERT promoter mutations, comparable with that of ATC, and these co-occurred with BRAF and RAS mutations. A high incidence of chromosome 1q gain was seen highlighting its importance in tumor aggressiveness. Two novel fusion genes DLG5-RET and OSBPL1A-BRAF were identified. There was a high frequency of mutations in MED12 and these were mutually exclusive to TERT promoter mutations and also to BRAF and RAS mutations. In addition, a high frequency of mutations in RBM10 was identified and these co-occurred with RAS mutations and PIK3CA mutations. Compared with the PTCs in TCGA, there were higher frequencies of mutations in TP53, POLE, PI3K/AKT/mTOR pathway effectors, SWI/SNF subunits, and histone methyltransferases.Conclusions: These data support a model, whereby fatal NAT cancers arise from well-differentiated tumors through the accumulation of key additional genetic abnormalities. The high rate of TERT promoter mutations, MED12 mutations, RBM10 mutations, and chromosome 1q gain highlight their likely association with tumor virulence. Clin Cancer Res; 23(19); 5970-80. ©2017 AACR.
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Affiliation(s)
- Tihana Ibrahimpasic
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Iñigo Landa
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sumit Middha
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Venkatraman Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Shyam Deraje
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Diane L Carlson
- Department of Pathology, Cleveland Clinic, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jocelyn Migliacci
- Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jeffrey A Knauf
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Brian Untch
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael F Berger
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Luc Morris
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - R Michael Tuttle
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Timothy Chan
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - James A Fagin
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ronald Ghossein
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Ian Ganly
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York. .,Department of Head and Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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13
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Baxi SS, Cracchiolo JR, Patel SG, McBride SM, Migliacci J, Lee NY, Kurtzman R, Pfister DG, Wong RJ. Feasibility of incorporating patient reported outcomes (PROs) into routine care for oropharyngeal carcinoma (OPC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.e21652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21652 Background: We assessed the feasibility of using PROs as part of routine care to better understand the trajectory in quality of life (QOL) following treatment of OPC. Methods: The Memorial Sloan Kettering Cancer Center (MSK) head and neck disease management team (DMT) assembled a parsimonious paper survey composed of validated PRO measures (EORTC QLQ 30 and HN-35, Neck Dissection Impairment Index, Skindex-16, and COST-FACT) to assess QOL at baseline, immediately and 3 months post treatment. From Jan-May 2016, a DMT PRO coordinator identified patients with non-metastatic OPC and notified clinical teams to print the surveys to be completed in the waiting room. We assessed the feasibility of incorporating PROs into routine care across the DMT using this process by examining response rates (RR) and identifying potential barriers (i.e., regional site of treatment, number of treatment modalities, hospitalizations, demographic variables) to completing PROs. Results: Of 54 patients with non-metastatic OPC, 3 non-English speakers and 5 protocol patients were excluded. Median age was 61.3 years (43.8-78.4). Patients were mostly male (89%), married (74%) and presented with locally-advanced OPC (89%) due to HPV (89%). 89% received multimodality therapy (89%), of which 36 (88%) received chemoradiation, and nearly half (48%) were treated at MSK regional sites. The RR decreased substantially over time (Table 1). 2 patients died* and 17 patients were hospitalized within these 3 months. In bivariate analyses, no prespecified demographic or clinical barriers to completion of PROs were identified. On deeper investigation, decline in RR overtime resulted from not capturing change in scheduling, which occurs more frequently after treatment completion. Conclusions: Implementation of longitudinal PROs into routine care is feasible and generally acceptable by the patients, but requires a coordinated effort to sustain an acceptable RR. For future efforts, the project coordinator will use a portal messaging system to communicate directly with patients and use an electronic PRO format. [Table: see text]
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Affiliation(s)
| | | | | | | | | | - Nancy Y. Lee
- Memorial Sloan-Kettering Cancer Center, New York, NY
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14
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Hay A, Migliacci J, Karassawa Zanoni D, Boyle JO, Singh B, Wong RJ, Patel SG, Ganly I. Complications following transoral robotic surgery (TORS): A detailed institutional review of complications. Oral Oncol 2017; 67:160-166. [PMID: 28351571 PMCID: PMC5407467 DOI: 10.1016/j.oraloncology.2017.02.022] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/06/2017] [Accepted: 02/20/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To report the complications occurring following TORS and to identify the factors predictive of complications. METHODS Following IRB approval a retrospective analysis of all TORS operations at our institution was performed. Postoperative complications within 45days were collected and graded with the Clavien-Dindo system. Complications were categorized into groups: all complications, not related to TORS and TORS related. Unadjusted odds ratios were calculated to test association between patients with and without a complication. RESULTS 122 TORS operations were carried out between June 2010 and August 2015. 77% were male, with a median age of 57. There were 92 primary tumor resections, 10second head and neck primary resections, 13 salvage procedures and 7 other indications. Surgical resection involved 1, 2 or >3 sub-sites in 36%, 28% and 36% patients, respectively. Overall, there were 107 complications (66 TORS related, 41 non-TORS related) that occurred in 57 patients (47%). A major complication occurred in 23 patients (18%). 19 patients had a TORS related major complication and 6 patients experienced a non-TORS related major complication. There was a temporal trend in TORS related major complication rate decreasing from 33% in 2010 to 10% in 2015. Statistical analysis showed that the odds of having any complication were 3 times greater in patients over 60years old (p=0.017), and 2.5 times greater when there were more than 2 subsites resected (p=0.022). CONCLUSIONS Age over 60years and a larger extent of resection were the significant factors predictive of major complications.
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Affiliation(s)
- Ashley Hay
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Jocelyn Migliacci
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Daniella Karassawa Zanoni
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Jay O Boyle
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Bhuvanesh Singh
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Richard J Wong
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Snehal G Patel
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Ian Ganly
- Department of Surgery Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
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15
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Portlock CS, Hamlin PA, Gerecitano JF, Noy A, Palomba ML, Walkley J, Corcoran S, Migliacci J, Schoder H, Papanicolaou G, Markowitz AJ. A Positive Prospective Trial of Antibiotic Therapy in Advanced Stage, Non-Bulky Indolent Lymphoma. Tumor Microenviron Ther 2016; 2:14-18. [PMID: 26798624 DOI: 10.1515/tumor-2015-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND We have prospectively studied a three month course of clarithromycin (substituted by Prevpac®, lansoprazole/ amoxicillin/ clarithromycin, in the first two wks when stool H pylori+) for non-bulky, advanced stage indolent lymphoma. These patients are often candidates for expectant monitoring and it is during this period that a window of opportunity may exist to identify and treat associated infections. METHODS All previously untreated patients with a new diagnosis of indolent lymphoma (FL and non-FL) meeting GELF criteria were treated with 12 weeks of clarithromycin. There were 32 evaluable patients, 4 of whom had stool H pylori. RESULTS At one month post-antibiotic therapy, we have observed lymphoma responses in 7 of 32 patients (21.9%). Two additional patients had objective response during followup (28.1% overall response). The median treatment free survival for antibiotic responders is 69.9 months and for non-responders, 30.6 months (p = 0.019). CONCLUSION Three response patterns have been noted, perhaps suggestive of an immune-mediated response -- prompt PET negative; flair with delayed PET negative response; and gradual continuous improvement. This prospective study appears promising, may be a step toward developing a lymphoma prevention strategy by reducing "antigen drive," and deserves further clinical/biological study. http://clinicaltrials.gov/show/NCT00461084.
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Affiliation(s)
- Carol S Portlock
- Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Paul A Hamlin
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - John F Gerecitano
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Ariela Noy
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Maria Lia Palomba
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Janelle Walkley
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Stacie Corcoran
- Memorial Sloan Kettering Cancer Center, Office of Physician-in-Chief, 1275 York Avenue New York, NY, 10065 USA
| | - Jocelyn Migliacci
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Heiko Schoder
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 1275 York Avenue New York, NY, 10065 USA
| | - Genovefa Papanicolaou
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
| | - Arnold J Markowitz
- Memorial Sloan Kettering Cancer Center, Department of Medicine, 1275 York Avenue New York, NY, 10065 USA
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16
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Ulaner GA, Goldman DA, Sauter CS, Migliacci J, Lilienstein J, Gönen M, Schöder H, Moskowitz CH, Zelenetz AD. Prognostic Value of FDG PET/CT before Allogeneic and Autologous Stem Cell Transplantation for Aggressive Lymphoma. Radiology 2015; 277:518-26. [PMID: 26035588 DOI: 10.1148/radiol.2015142556] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To determine the prognostic value of performing fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) before allogeneic and autologous stem cell transplantation (SCT) in patients with aggressive lymphoma. MATERIALS AND METHODS A HIPAA-compliant retrospective review was performed under institutional review board waiver. Patients with aggressive lymphoma underwent allogeneic or autologous SCT between January 2005 and December 2010. FDG PET/CT was performed within the 3 months prior to transplantation. PET/CT images were evaluated for lesions with FDG avidity greater than that of the background liver. The relationship between pretransplantation PET and progression-free survival (PFS), disease-specific survival (DSS), and overall survival (OS) was assessed with Kaplan-Meier curves and a corresponding log-rank test for categorical variables and Cox regression for continuous variables. RESULTS A total of 175 patients were identified, of whom 73 underwent FDG PET/CT before allogeneic SCT and 102 underwent FDG PET/CT before autologous SCT. Before allogeneic SCT, 23 of 73 patients (32%) had FDG-avid lesions, and before autologous SCT, 11 of 102 patients (11%) had FDG-avid lesions. For allogeneic SCT, the 2-year PFS estimate was 68% (95% confidence interval [CI]: 56%, 82%) in patients without FDG-avid lesions, but only 35% (95% CI: 20%, 61%) for patients with FDG-avid lesions (P = .014). For autologous SCT, the 2-year PFS was 72% (95% CI: 64%, 82%) in patients without FDG-avid lesions, but only 18% (95% CI: 5%, 64%) for patients with FDG-avid lesions (P < .0001). Similar differences were seen in OS and DSS. The risk for posttransplantation recurrence correlated with higher lesional maximum standardized uptake values: for PFS, P < .0001 to P = .01; for DSS, P < .0001 to P = .002; and for OS, P < .0001 to P = .015. CONCLUSION Performing FDG PET/CT before SCT in patients with aggressive lymphoma has prognostic value. For patients with aggressive lymphomas, the presence of FDG-avid lesions at PET/CT performed before allogeneic and autologous SCT indicates a lower likelihood of SCT success.
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Affiliation(s)
- Gary A Ulaner
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Debra A Goldman
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Craig S Sauter
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Jocelyn Migliacci
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Joshua Lilienstein
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Mithat Gönen
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Heiko Schöder
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Craig H Moskowitz
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
| | - Andrew D Zelenetz
- From the Departments of Radiology (G.A.U., J.L., H.S.), Epidemiology and Biostatistics (D.A.G., M.G.), and Medicine (C.S.S., J.M., C.H.M., A.D.Z.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065; and Departments of Radiology (G.A.U., H.S.) and Medicine (C.S.S., C.H.M., A.D.Z.), Weill Cornell Medical College, New York, NY
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