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Osterman E, Hammarström K, Imam I, Osterlund E, Sjöblom T, Glimelius B. Completeness and accuracy of the registration of recurrences in the Swedish Colorectal Cancer Registry (SCRCR) and an update of recurrence risk in colon cancer. Acta Oncol 2021; 60:842-849. [PMID: 33689551 DOI: 10.1080/0284186x.2021.1896033] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND The completeness and accuracy of the registration of synchronous metastases and recurrences in the Swedish Colorectal Cancer Registry has not been investigated. Knowing how accurate these parameters are in the registry is a prerequisite to adequately measure the current recurrence risk. METHODS All charts for patients diagnosed with stage I-III colorectal cancer (CRC) in two regions were reviewed. In one of the regions, all registrations of synchronous metastases were similarly investigated. After the database had been corrected, recurrence risk in colon cancer was calculated stratified by risk group as suggested by ESMO in 2020. RESULTS In patients operated upon more than five years ago (N = 1235), there were 20 (1.6%) recurrences not reported. In more recent patients, more recurrences were unreported (4.0%). Few synchronous metastases were wrongly registered (3.6%) and, likewise, few synchronous metastases were not registered (about 1%). The five-year recurrence risk in stage II was 6% for low-risk, 11% for intermediate risk, and 23% for high-risk colon cancer patients. In stage III, it was 25% in low- and 45% in high-risk patients. Incorporation of risk factors in stage III modified the risks substantially even if this is not considered by ESMO. Adjuvant chemotherapy lowered the risk in stage III but not to any relevant extent in stage II. CONCLUSION The registration of recurrences in the registry after 5 years is accurate to between 1 and 2% but less accurate earlier. A small number of unreported recurrences and falsely reported recurrences were discovered in the chart review. The recurrence risk in this validated and updated patient series matches what has been recently reported, except for the risk of recurrence in stage II low risk colon cancers which seem to be even a few percentage points lower (6 vs. 9%).
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Affiliation(s)
- Erik Osterman
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- Department of Surgery, Region Gävleborg, Gävle Hospital, Gävle, Sweden
| | - Klara Hammarström
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Israa Imam
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Emerik Osterlund
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Tobias Sjöblom
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Bengt Glimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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2
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Ni M, Geng L, Kong F, Du C, Zhai R, Lyu Y, Hu C, Ying H. Induction Chemotherapy Combined With Intensity-Modulated Radiotherapy for 129 Nasopharyngeal Carcinoma Patients With Synchronous Metastases: A Retrospective Study. Front Oncol 2021; 11:654871. [PMID: 34094946 PMCID: PMC8175973 DOI: 10.3389/fonc.2021.654871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/28/2021] [Indexed: 12/03/2022] Open
Abstract
Objective To analyze the therapeutic effect and prognostic factors of nasopharyngeal carcinoma (NPC) patients with distant metastases at initial diagnosis receiving induction chemotherapy with intensity-modulated radiotherapy (IMRT). Methods A total of 129 patients who underwent platinum-based induction chemotherapy followed by definitive IMRT with or without concurrent or adjuvant chemotherapy for newly diagnosed distant metastatic NPC in our center between March 2008 and November 2018 were retrospectively analyzed. 41 patients underwent local therapy for metastatic sites. Kaplan-Meier method was used to estimate survival rates, Log-rank test and Cox proportional hazards model were used to figure out independent prognostic factors of overall survival (OS). Results A total of 66 patients had been dead (median follow-up time, 51.5 months). The median overall survival (OS) time was 54.2 months (range, 7-136 months), and the 1-year, 2-year, 3-year, 5-year overall survival rates were 88.0%,71.0%,58.0%, and 47.0%. Multivariate analysis found that the factors correlated with poor overall survival were pre-treatment serum lactate dehydrogenase (SLDH) >180U/L, chemotherapy cycles<4, and M1 stage subdivision (M1b, single hepatic metastasis and/or multiple metastases excluding the liver; and M1c, multiple hepatic metastases). The 5-year OS rates for M1a, M1b and M1c were 62.6%,40.4% and 0%, respectively. Conclusion Platinum-containing induction chemotherapy combined with IMRT seemed to be advantageous to prolong survival for some NPC patients with synchronous metastases at initial diagnosis. The independent factors to prognosticate OS were pre-treatment SLDH, number of chemotherapy cycles, and M1 subcategories. Prospective clinical trials are needed to confirm the result.
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Affiliation(s)
- Mengshan Ni
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Lijun Geng
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Fangfang Kong
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Chengrun Du
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Ruiping Zhai
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Yingchen Lyu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
| | - Hongmei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.,Shanghai Key Laboratory of Radiation Oncology, Shanghai, China
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Lan YT, Chang SC, Lin PC, Lin CC, Lin HH, Huang SC, Lin CH, Liang WY, Chen WS, Jiang JK, Yang SH, Lin JK. Clinicopathological and molecular features between synchronous and metachronous metastases in colorectal cancer. Am J Cancer Res 2021; 11:1646-1658. [PMID: 33948379 PMCID: PMC8085873] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 02/13/2021] [Indexed: 06/12/2023] Open
Abstract
The molecular difference between synchronous and metachronous metastases in colorectal cancer (CRC) remains unclear. Between 2000 and 2010, a total of 492 CRC patients were enrolled, including 280 with synchronous metastasis and 212 with metachronous metastasis. Clinicopathological and molecular features were compared between the two groups. Patients with synchronous metastasis were more likely to have right-sided CRC, poorly differentiated tumors, lymphovascular invasion, advanced pathological tumor (T) and node (N) categories, and liver metastases than those with metachronous metastasis. For right-sided CRC, patients with synchronous metastasis had more lymphovascular invasion and liver metastases than those with metachronous metastasis. For left-sided CRC, patients with synchronous metastasis were more likely to have poorly differentiated tumors, lymphovascular invasion, advanced pathological T and N categories, and liver metastases than those with metachronous metastasis. Regarding the genetic mutations, patients with metachronous metastasis had more mutations in TP53, NRAS, and HRAS and fewer mutations in APC than those with synchronous metastasis; for right-sided CRC, synchronous metastasis was associated with more APC mutations than metachronous metastasis, while for left-sided CRC, metachronous metastasis was associated with more TP53 and NRAS mutations than synchronous metastasis. The 5-year overall survival (OS) rates were significantly higher in metachronous metastasis patients than in synchronous metastasis patients, especially those with left-sided CRC. Multivariate analysis showed that age, sex, lymphovascular invasion, pathological N category, metachronous metastasis, and BRAF and NRAS mutations were independent prognostic factors affecting OS. CRC patients with synchronous metastasis had a worse OS than those with metachronous metastasis and exhibited distinct genetic mutations.
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Affiliation(s)
- Yuan-Tzu Lan
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Shih-Ching Chang
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Pei-Ching Lin
- Department of Clinical Pathology, Yang-Ming Branch, Taipei City HospitalTaipei, Taiwan
- Department of Health and Welfare, University of TaipeiTaipei Taiwan
| | - Chun-Chi Lin
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Hung-Hsin Lin
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Shen-Chieh Huang
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Chien-Hsing Lin
- Division of Genomic Medicine, National Health Research InstitutesZhunan, Taiwan
| | - Wen-Yi Liang
- Department of Pathology, Taipei Veterans General HospitalTaipei, Taiwan
| | - Wei-Shone Chen
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Jeng-Kai Jiang
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
| | - Shung-Haur Yang
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
- Department of Surgery, National Yang Ming Chiao Tung University HospitalYilan, Taiwan
| | - Jen-Kou Lin
- Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General HospitalTaipei, Taiwan
- Department of Surgery, Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung UniversityTaipei, Taiwan
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4
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Yao JH, Zhang WQ, Shao Y, Zhu Y, Liu J, Jin GS, Yang Y. Molecular phenotype discordance between primary and synchronous metastatic lesions of breast cancer and its determinant role in guiding treatment decisions: a case report. Am J Transl Res 2020; 12:5866-5873. [PMID: 33042465 PMCID: PMC7540159] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Molecular phenotype discordance between primary and metastatic tumors exists in a small proportion of breast cancer (BC) patients with accessible synchronous metastases. Reduced therapeutic effect and delays in treatment can occur when decisions on systemic therapy are determined by ignoring the differences in tumor type. Here we report a 54-year-old post-menopausal locally advanced BC patient, who showed no tumor response following routine treatment which included targeting anti-HER2, based on the phenotype of primary tumor (Luminal B, HER2-positive), during neoadjuvant therapy. However, following a secondary biopsy of the metastatic subclavian lymph node, a distinct pathological feature (Triple-negative) was revealed; chemotherapy was adjusted accordingly and resulted in a positive tumor response. Various subclones within primary and metastatic lesions were identified which might be attributed to tumor heterogeneity and in turn resulting in the phenotypic discordance in the receptor status. The patient died due to tumor progression related to triple-negative-featured lung metastasis, with overall survival time of 26.4 months. This study strengthens the value of concurrent biopsies of both primary and synchronous metastatic lesions in BC patients, and provides a reference for treating this kind of tumor when discordance in the molecular phenotype is observed.
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Affiliation(s)
- Jing-Hao Yao
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Wu-Qiong Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Yu Shao
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Yue Zhu
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Jing Liu
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Gong-Sheng Jin
- Department of Thyroid Breast Surgery, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
| | - Yan Yang
- Department of Medical Oncology, The First Affiliated Hospital of Bengbu Medical CollegeBengbu, Anhui, People’s Republic of China
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Wang J, Li S, Liu Y, Zhang C, Li H, Lai B. Metastatic patterns and survival outcomes in patients with stage IV colon cancer: A population-based analysis. Cancer Med 2020; 9:361-373. [PMID: 31693304 PMCID: PMC6943094 DOI: 10.1002/cam4.2673] [Citation(s) in RCA: 136] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/12/2019] [Accepted: 10/16/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The goal of this study was to delineate the patterns of distant metastasis from colon adenocarcinoma (CAC) and evaluate the survival differences by metastatic patterns. METHODS Using the Surveillance, Epidemiology, and End Results (SEER) database, we extracted patients diagnosed with stage IV CAC between 2010 and 2016. Kaplan-Meier survival curves were plotted with log-rank tests to compare overall survival (OS) of patients with different metastatic patterns. Univariate and multivariate Cox proportional hazards regression models were used to evaluate the effects of different metastatic patterns on survival outcomes in terms of OS and disease-specific survival (DSS). RESULTS A total of 26 170 patients were analyzed. The 3- and 5-year OS were 20.7% and 10.5%, respectively, for patients with stage IV CAC. The most common distant metastatic site was the liver, followed by the lung, bone, and brain, but the frequency differed greatly by histology subtypes. The site of metastasis was a significant prognostic factor for OS and DSS in patients with stage IV CAC, independent of the number of metastatic sites and other clinical and demographic prognostic factors. Using liver-only metastasis as reference, lung-only metastasis was associated with better OS (hazard ratio [HR] = 0.82, 95% confidence interval [CI], 0.71-0.94) and DSS (HR = 0.75, 95% CI, 0.64-0.88). Older age, black race, unmarried status, grade III/IV tumors, advanced tumor-node-metastasis (TNM) stage, proximal colon, elevated preoperative carcinoembryonic antigen (CEA), no surgery of the primary site, and no chemotherapy were independent predictors of poor OS. CONCLUSIONS The site of distant metastasis and number of metastasis site were independent prognostic factors for survival of patients with stage IV CAC. This study highlights the need for diverse treatment strategies for patients with different metastatic patterns.
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Affiliation(s)
- Jiwei Wang
- Department of UltrasoundThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Song Li
- Mudanjiang Medical CollegeMudanjiangChina
| | - Yanna Liu
- Department of UltrasoundThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Chunquan Zhang
- Department of UltrasoundThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Honglang Li
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
| | - Bin Lai
- Department of Gastrointestinal SurgeryThe Second Affiliated Hospital of Nanchang UniversityNanchangChina
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Shakir SI, Pelmus M, Florea A, Boileau JF, Guiot MC, Di Maio S, Muanza TM. Synchronous metastatic skull base chordoma to the breast: case report and literature review. ACTA ACUST UNITED AC 2016; 23:e154-7. [PMID: 27122985 DOI: 10.3747/co.23.2896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
CLINICAL SCENARIO During routine staging work-up for a left breast mass, a 68-year-old woman complained of dysphagia and dysphonia. During further investigations, a left-sided lesion at the foramen magnum was observed on brain imaging. Both lesions were biopsied and showed a classical chordoma. MANAGEMENT The skull-base lesion and the breast lesion were surgically resected, and adjuvant radiotherapy was given. SUMMARY Chordoma is a rare primary central nervous system tumour that seldom metastasizes. The lung is the most common site of metastasis. Synchronous breast metastasis from a skull-base chordoma is very rare, and a safe management option includes a maximum resection followed by adjuvant radiotherapy.
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Affiliation(s)
- S I Shakir
- Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, QC
| | - M Pelmus
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, QC
| | - A Florea
- Department of Pathology, Jewish General Hospital, McGill University, Montreal, QC
| | - J F Boileau
- Department of Surgery, Jewish General Hospital, McGill University, Montreal, QC
| | - M C Guiot
- Department of Pathology, Montreal Neurological Institute, McGill University, Montreal, QC
| | - S Di Maio
- Department of Neurosurgery, Jewish General Hospital, McGill University, Montreal, QC
| | - T M Muanza
- Department of Radiation Oncology, Jewish General Hospital, McGill University, Montreal, QC
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Öztürk H. Bilateral synchronous adrenal metastases of renal cell carcinoma: A case report and review of the literature. Oncol Lett 2015; 9:1897-1901. [PMID: 25789064 PMCID: PMC4356352 DOI: 10.3892/ol.2015.2915] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/31/2014] [Indexed: 11/23/2022] Open
Abstract
Renal cell carcinomas (RCCs) metastasize to the adrenal glands via various mechanisms, including lymphatic vessel arterial embolism and retrograde venous embolism. The rate of ipsilateral metastasis is 3–5% and the rate of contralateral metastasis is ~0.7%, however, synchronous bilateral adrenal metastases are extremely rare. Therefore, the optimal diagnosis and treatment strategy for this condition is yet to be thoroughly defined. In the present study, a 50-year-old male patient presented with right flank pain. Ultrasonography (US) revealed a right renal mass and bilateral adrenal metastases, and a computerized tomography (CT) scan determined the size of the lesions: An 86×83×66-mm mass in the lower pole of the right kidney, an 18×12×10-mm mass in the right adrenal gland, and a 69×51×53-mm mass in the left adrenal gland with central necrosis and peripheral contrast uptake. A US-guided biopsy was performed which determined a diagnosis of right RCC and bilateral synchronous adrenal metastasis. Immunohistochemical examination of the biopsy revealed clear cell carcinoma (Fuhrman grade, III). Consequently, right radical nephrectomy, right partial adrenalectomy (with frozen section examination) and left adrenalectomy were planned. The bilateral synchronous adrenal metastases posed a challenge in the diagnosis and treatment of the disease, as there is no standard approach in the literature for the treatment of such patients. However, metastasectomy was selected, as it appears to be the most effective treatment strategy for increasing the rate of cancer-specific survival. As an adrenal mass was present in the current patient, a hormonal examination was recommended and an adrenal-preserving minimally invasive surgical procedure using frozen section examination during surgery was particularly important to prevent the patient from developing adrenal insufficiency.
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Affiliation(s)
- Hakan Öztürk
- Department of Urology, School of Medicine, Sifa University, Izmir 35240, Turkey
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Agnese D, Belgioia L, Bacigalupo A, Marcenaro M, Vecchio S, Agostinelli S, Morbelli S, Corvò R. Prolonged complete remission after induction chemotherapy followed by chemoradiation with tomotherapy in metastatic nasopharyngeal cancer. Anticancer Res 2014; 34:5075-5078. [PMID: 25202093] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Nasopharyngeal carcinoma (NPC) is uncommon in the Western hemisphere and in Europe. The undifferentiated subtype has a relevant propensity to metastasize systemically, mostly in the skeleton. In patients with distant metastasis at presentation there is no consensus on the most appropriate approach. CASE REPORT Evaluation of a young patient with initially bony metastatic nasopharyngeal cancer treated with platinum-based induction chemotherapy followed by radiotherapy (performed with Tomotherapy) combined to chemotherapy on primary region with curative intent, and subsequent focal irradiation of the bone metastasis. CONCLUSION After 27 months from the end of the planned treatment the patient has not shown any late toxicity or complications in the treated areas and is without any evidence of progression. It seems appropriate to treat selected metastatic patients with a radical intent, using induction chemotherapy followed by radical chemoradiotherapy on the primary region and high dose radiation on the metastasis. Moreover, Tomotherapy demonstrated a tolerable grade of acute toxicity without any relevant late complications.
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Affiliation(s)
- Dario Agnese
- Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Liliana Belgioia
- Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Almalina Bacigalupo
- Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Michela Marcenaro
- Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Stefania Vecchio
- Division of Medical Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Stefano Agostinelli
- Division of Medical Physics, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Silvia Morbelli
- Division of Nuclear Medicine, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
| | - Renzo Corvò
- Division of Radiation Oncology, IRCCS San Martino - IST National Cancer Research Institute and University, Genoa, Italy
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Hsu HC, Chou WC, Shen WC, Wu CE, Chen JS, Liau CT, Lin YC, Yang TS. Efficacy of postoperative oxaliplatin- or irinotecan-based chemotherapy after curative resection of synchronous liver metastases from colorectal cancer. Anticancer Res 2013; 33:3317-3325. [PMID: 23898098] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Postoperative 5-fluorouracil (5-FU)-based chemotherapy improves survival after resection of synchronous liver metastases from colorectal cancer (CRLM). We retrospectively assessed the efficacy of postoperative chemotherapy with a modern regimen containing of oxaliplatin or irinotecan after curative resection of synchronous CRLM. PATIENTS AND METHODS Seventy-two patients who received postoperative chemotherapy following curative resection of synchronous CRLM were analyzed. Patients were categorized into fluorouracil plus leucovorin (5-FU/LV, n=25), irinotecan-based regimen (FOLFIRI/IFL, n=21) and oxaliplatin-based regimen (FOLFOX, n=26) groups, according to the postoperative chemotherapy regimen. The clinicopathological parameters of patients were analyzed to evaluate clinical outcome. RESULTS Median relapse-free survival (RFS) was 14.4 months in the 5-FU/LV group vs. 20.8 months in the FOLFIRI/IFL group (p=0.032) and 18.8 months in the FOLFOX regimen (p=0.123). Median overall survival (OS) was >60 months in the FOLFOX and FOLFIRI/IFL groups vs. 38.5 months in the 5-FU/LV group (p=0.002 and p=0.019, respectively). In multivariate analysis, administrations of FOLFIRI/IFL or FOLFOX regimens were independent predictive factors for favorable RFS. Administration of the FOLFIRI/IFL regimen was the only independent predictive factor for favorable OS. CONCLUSION Postoperative FOLFIRI/IFL and FOLFOX chemotherapy lead to more favorable RFS than 5-FU/LV following curative resection of synchronous CRLM.
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Affiliation(s)
- Hung-Chih Hsu
- Division of Hematology-Oncology, Chang Gung Memorial Hospital at Linkou, 5 Fu-Hsing Street, Kwei-Shan, Tao-Yuan 333, Taiwan, ROC.
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Tranchart H, Diop PS, Lainas P, Pourcher G, Catherine L, Franco D, Dagher I. Laparoscopic major hepatectomy can be safely performed with colorectal surgery for synchronous colorectal liver metastasis. HPB (Oxford) 2011; 13:46-50. [PMID: 21159103 PMCID: PMC3019541 DOI: 10.1111/j.1477-2574.2010.00238.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The optimal strategy for resectable synchronous colorectal liver metastases remains controversial. Although some authors advocate a staged treatment, an increasing number of studies have reported that combined colorectal and liver resection is safe. Laparoscopic combined resection in primary colorectal cancer with synchronous liver metastases has been reported but there are no specific data for major liver resections. In the present study, we evaluated the feasibility of a simultaneous entirely laparoscopic procedure, in the light of the benefits of laparoscopy in both colon and liver surgery, and discussed the benefits of this strategy. METHODS Two cases are presented of totally laparoscopic major liver resections associated with laparoscopic colorectal resections for synchronous liver metastases with the emphasis on the technical aspects. Duration of surgery, blood loss and post-operative outcome were evaluated. RESULTS Laparoscopic right hepatectomy or left hepatectomy with simultaneous colon resection for liver metastasis was feasible and safe with only one suprapubic 5-mm trocar added to the usual trocar sites. The mean duration of surgery was 327 min with a mean estimated blood loss of 200 ml. The post-operative course was uneventful. DISCUSSION In selected patients, laparoscopic major hepatectomies for unilobular synchronous metastases can be safely performed simultaneously with colorectal surgery.
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Affiliation(s)
| | | | | | | | | | - Dominique Franco
- Department of General SurgeryAP-HP, Clamart,University Paris-SudOrsay, France
| | - Ibrahim Dagher
- Department of General SurgeryAP-HP, Clamart,University Paris-SudOrsay, France
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