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Sample records for recurrent gynaecological cancer

  1. Rehabilitation of women with gynaecological cancer

    DEFF Research Database (Denmark)

    Adellund Holt, K; Jensen, P T; Gilså Hansen, D

    2016-01-01

    post-treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer. METHODS: Consecutive Danish-speaking women aged 20 to 75 years and treated surgically for primary...... gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face-to-face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory...

  2. Valid and complete data on endometrial cancer in the Danish Gynaecological Cancer Database

    DEFF Research Database (Denmark)

    Juhl, Caroline Sollberger; Hansen, Estrid S; Høgdall, Claus K;

    2014-01-01

    concerning data reported and comparability between the DGCD and a definite reference. MATERIAL AND METHODS: DGCD data on women with endometrial cancer or adenomatous hyperplasia supplemented with patient charts for data on recurrence were retrieved and compared with a definite reference (the pathology report......INTRODUCTION: It is a comparative register study designed for data validation of surgery, pathology and recurrence for endometrial cancer in the Danish Gynaecological Cancer Database (DGCD) in the 2005-2009 period. The main outcomes were completeness of the data registered in the DGCD, agreement...... was 71.6%. Completeness could not be determined due to the design of the database, where recurrence is composed of optional variables only. CONCLUSION: The data on endometrial cancer registered in the DGCD regarding surgery and pathology are valid and complete, and they provide a solid base for research...

  3. Validation of a questionnaire for self-rating of urological and gynaecological morbidity after treatment of gynaecological cancer

    DEFF Research Database (Denmark)

    Jensen, Pernille Tine; Klee, Marianne Carol; Groenvold, Mogens

    2002-01-01

    of the uro-gynaecological questionnaire (UGQ), a new instrument for patient self-assessment of urological-, genital-, menopausal-, and pain symptomatology in gynaecological cancer patients. MATERIAL AND METHODS: The UGQ was developed after literature review, patient- and expert interviews and pilot testing...

  4. Nurse-led rehabilitation after gynaecological cancer surgery

    DEFF Research Database (Denmark)

    Seibæk, Lene

    2009-01-01

      Abstract This article presents the preliminary results and experiences from an ongoing study aiming to: Develop and test a nurse-led multidisciplinary rehabilitation programme for women who undergo surgery for localised gynaecological cancers.Evaluate the effect of the programme prospectively o...

  5. The effect of lifestyle factors on gynaecological cancer.

    OpenAIRE

    Rieck, Gudrun; Fiander, Alison

    2006-01-01

    KEYWORDS CLASSIFICATION: adverse effects;Alcohol Drinking;complications;Contraceptives,Oral,Hormonal;Diet;etiology;Estrogen Replacement Therapy;Evaluation;Exercise;Female;Genital Neoplasms,Female;Humans;Life Style;lifestyle modulation of cancer & cancer biomarkers;Obesity;prevention & control;Papillomaviridae;Papillomavirus Infections;Reproductive History;Risk Factors;Smoking;Wales. Several lifestyle factors affect a woman's risk of gynaecological cancer and-potentially-can be modified to ...

  6. [Cyclooxygenase 2 inhibitors and urologic and gynaecologic cancers].

    Science.gov (United States)

    Eschwege, Pascal

    2004-05-01

    PGE2 is one of the most important prostaglandin involved in the oncogenesis. PGE2 is found at high concentration level in the most of epithelial cancer. Urologic and gynaecologic cancer express the enzyme which are at the origin of PGE2: cyclooxygenase 2. Cox2 inhibitors present anticancer properties demonstrated in wide varieties of cellular and animal models. Human applications are currently tested in many clinical trials for bladder, prostate and uterine carcinomas.

  7. Hope as experienced in women newly diagnosed with gynaecological cancer

    DEFF Research Database (Denmark)

    Hammer, Kristianna; Mogensen, Ole; Hall, Elisabeth O C

    2009-01-01

    AIM: This article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer. METHOD: Fifteen women were interviewed the day they were receiving the diagnosis at a gynaecol......AIM: This article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer. METHOD: Fifteen women were interviewed the day they were receiving the diagnosis...... at a gynaecological department of a Danish university hospital. The women, aged 24-87 (median 52yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer. RESULTS: Hope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received...... cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being...

  8. Intraoperative radiotherapy in gynaecological and genito-urinary malignancies: focus on endometrial, cervical, renal, bladder and prostate cancers.

    Science.gov (United States)

    Krengli, Marco; Pisani, Carla; Deantonio, Letizia; Surico, Daniela; Volpe, Alessandro; Surico, Nicola; Terrone, Carlo

    2017-01-19

    Intraoperative radiotherapy (IORT) refers to the delivery of a single radiation dose to a limited volume of tissue during a surgical procedure. A literature review was performed to analyze the role of IORT in gynaecological and genito-urinary cancer including endometrial, cervical, renal, bladder and prostate cancers.Literature search was performed by Pubmed and Scopus, using the words "intraoperative radiotherapy/IORT", "gynaecological cancer", "uterine/endometrial cancer", "cervical/cervix cancer", "renal/kidney cancer", "bladder cancer" and "prostate cancer". Forty-seven articles were selected from the search databases, analyzed and briefly described.Literature data show that IORT has been used to optimize local control rate in genito-urinary tumours mainly in retrospective studies. The results suggest that IORT could be advantageous in the setting of locally advanced and recurrent disease although further prospective trials are needed to confirm this findings.

  9. Early work patterns for gynaecological cancer survivors in the USA.

    Science.gov (United States)

    Nachreiner, N M; Ghebre, R G; Virnig, B A; Shanley, R

    2012-01-01

    Little is known about the balance between work demands and treatment plans for >4.3 million working-age cancer survivors in the USA. To describe changes in work status for gynaecological cancer survivors during the first 6 months following diagnosis and their experience with their employers' programmes and policies. One hundred and ten gynaecological cancer survivors who were working at the time of their cancer diagnosis completed a survey. Case record reviews documented their clinical characteristics and treatment details. Ninety-five women (86%) had surgery; 81 (74%) received chemotherapy, radiotherapy or both in addition to surgery. Nine per cent of women said that they changed their treatment plan because of their jobs; in contrast, 62% of women said that they changed their work situation to accommodate their treatment plan. Overall, the most common month for women to stop working was Month 1 (41%), to decrease hours was Month 2 (32%) and to increase hours was Month 6 (8%). Twenty-eight per cent of women were aware of employer policies that assisted the return to work process; 70% of women were familiar with the Family and Medical Leave Act (FMLA) and 56% with the Americans with Disabilities Act (ADA). Only 26% completed a formal request for work accommodations. After 6 months, 56 of 83 women (67%) remained working or had returned to work. Work patterns varied for these gynaecological cancer survivors over the first 6 months following diagnosis. Opportunities exist to improve communication about work and treatment expectations between cancer survivors, occupational health professionals, employers and treating clinicians.

  10. Hope as experienced in women newly diagnosed with gynaecological cancer.

    Science.gov (United States)

    Hammer, Kristianna; Mogensen, Ole; Hall, Elisabeth O C

    2009-09-01

    This article presents findings from a hermeneutic-phenomenological study with the aim to investigate the meaning of the lived experience of hope in women newly diagnosed with gynaecological cancer. Fifteen women were interviewed the day they were receiving the diagnosis at a gynaecological department of a Danish university hospital. The women, aged 24-87 (median 52 yrs), were diagnosed with ovarian, endometrial, cervical and vulvar cancer. Hope was found to be connected to both diagnosis, cure, family life and life itself and closely tied to hopelessness. The newly received cancer diagnosis made the women oscillate between hope and hopelessness, between positive expectations of getting cured and frightening feelings of the disease taking over. Five major interrelated themes of hope were identified: hope of being cured, cared for and getting back to normal, hope as being active and feeling well, hope as an internal power to maintain integration, hope as significant relationships and hope as fighting against hopelessness. Thus, hope was woven together with hopelessness in a mysterious way; it took command through inner strength and courage based on a trust in being cured and of being in relationship with significant others. The findings of the close relationship between the shades of hope and hopelessness support the need for nurses to continue to practice hope-inspiring nursing. Nurses need to understand the complexity of hope and its close connection to hopelessness when newly diagnosed with a threatening disease as cancer; and the findings might help nurses assist patients in fighting hopelessness.

  11. Sexual activity and functioning in women treated for gynaecological cancers.

    Science.gov (United States)

    Sekse, Ragnhild Johanne Tveit; Hufthammer, Karl Ove; Vika, Margrethe Elin

    2017-02-01

    A description and comparison of sexual activity and function in relation to various gynaecological cancer diagnoses, treatment modalities, age groups, psychological distress and health-related quality of life. Various forms of gynaecological cancer have the potential to negatively influence sexual functioning, but there are few studies that describe and compare sexual activity and functioning according to diagnosis. A descriptive cross-sectional study. The study includes 129 women from an intervention study. The questionnaires addressed sexuality, psychological distress, health-related quality of life and demographics. Disease and treatment characteristics were extracted from medical records. Close to two-thirds of the women were sexually active. However, 54% of the sexually active women reported that they were not satisfied or little satisfied with their sexual activity. About half of the women reported dryness in the vagina, and 41% reported pain and discomfort during penetration. There were no significant differences concerning pleasure and discomfort related to treatment modality, diagnoses or FIGO stage. Health personnel should make a priority of sexuality throughout a patient's cancer treatment and in the follow-up, as sexuality is a vital part of a good life. Since the patients experience relatively low satisfaction with their sexual activity and many report pain during penetration, health personnel need to be sensitive to the woman, her questions, and her needs. Of importance are also the personnel's ability to communicate and their expertise in diagnosing and treating difficulties relating to sexuality. © 2016 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  12. Insulin-Sensitizers, Polycystic Ovary Syndrome and Gynaecological Cancer Risk

    Science.gov (United States)

    Lauretta, Rosa; Lanzolla, Giulia; Vici, Patrizia; Mariani, Luciano; Moretti, Costanzo

    2016-01-01

    Preclinical, early phase clinical trials and epidemiological evidence support the potential role of insulin-sensitizers in cancer prevention and treatment. Insulin-sensitizers improve the metabolic and hormonal profile in PCOS patients and may also act as anticancer agents, especially in cancers associated with hyperinsulinemia and oestrogen dependent cancers. Several lines of evidence support the protection against cancer exerted by dietary inositol, in particular inositol hexaphosphate. Metformin, thiazolidinediones, and myoinositol postreceptor signaling may exhibit direct inhibitory effects on cancer cell growth. AMPK, the main molecular target of metformin, is emerging as a target for cancer prevention and treatment. PCOS may be correlated to an increased risk for developing ovarian and endometrial cancer (up to threefold). Several studies have demonstrated an increase in mortality rate from ovarian cancer among overweight/obese PCOS women compared with normal weight women. Long-term use of metformin has been associated with lower rates of ovarian cancer. Considering the evidence supporting a higher risk of gynaecological cancer in PCOS women, we discuss the potential use of insulin-sensitizers as a potential tool for chemoprevention, hypothesizing a possible rationale through which insulin-sensitizers may inhibit tumourigenesis. PMID:27725832

  13. European Society of Gynaecological Oncology Guidelines for the Management of Patients With Vulvar Cancer

    NARCIS (Netherlands)

    Oonk, Maaike H. M.; Planchamp, Francois; Baldwin, Peter; Bidzinski, Mariusz; Brannstrom, Mats; Landoni, Fabio; Mahner, Sven; Mahantshetty, Umesh; Mirza, Mansoor; Petersen, Cordula; Querleu, Denis; Regauer, Sigrid; Rob, Lukas; Rouzier, Roman; Ulrikh, Elena; van der Velden, Jacobus; Vergote, Ignace; Woelber, Linn; van der Zee, Ate G. J.

    Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecologic cancers across Europe. Methods The European Society of Gynaecological Oncology

  14. Nitric oxide and pH modulation in gynaecological cancer.

    Science.gov (United States)

    Sanhueza, Carlos; Araos, Joaquín; Naranjo, Luciano; Barros, Eric; Subiabre, Mario; Toledo, Fernando; Gutiérrez, Jaime; Chiarello, Delia I; Pardo, Fabián; Leiva, Andrea; Sobrevia, Luis

    2016-12-01

    Nitric oxide plays several roles in cellular physiology, including control of the vascular tone and defence against pathogen infection. Neuronal, inducible and endothelial nitric oxide synthase (NOS) isoforms synthesize nitric oxide. Cells generate acid and base equivalents, whose physiological intracellular concentrations are kept due to membrane transport systems, including Na(+) /H(+) exchangers and Na(+) /HCO3(-) transporters, thus maintaining a physiological pH at the intracellular (~7.0) and extracellular (~7.4) medium. In several pathologies, including cancer, cells are exposed to an extracellular acidic microenvironment, and the role for these membrane transport mechanisms in this phenomenon is likely. As altered NOS expression and activity is seen in cancer cells and because this gas promotes a glycolytic phenotype leading to extracellular acidosis in gynaecological cancer cells, a pro-inflammatory microenvironment increasing inducible NOS expression in this cell type is feasible. However, whether abnormal control of intracellular and extracellular pH by cancer cells regards with their ability to synthesize or respond to nitric oxide is unknown. We, here, discuss a potential link between pH alterations, pH controlling membrane transport systems and NOS function. We propose a potential association between inducible NOS induction and Na(+) /H(+) exchanger expression and activity in human ovary cancer. A potentiation between nitric oxide generation and the maintenance of a low extracellular pH (i.e. acidic) is proposed to establish a sequence of events in ovarian cancer cells, thus preserving a pro-proliferative acidic tumour extracellular microenvironment. We suggest that pharmacological therapeutic targeting of Na(+) /H(+) exchangers and inducible NOS may have benefits in human epithelial ovarian cancer.

  15. Goal setting in cancer rehabilitation and relation to quality of life among women with gynaecological cancer

    DEFF Research Database (Denmark)

    Holt, Kamila A; Mogensen, Ole; Jensen, Pernille T

    2015-01-01

    BACKGROUND: Rehabilitation should be integrated in the routine cancer care of women treated for gynaecological cancers. Goal setting is expected to facilitate the process through patient involvement and motivation. Our knowledge about goal setting in cancer rehabilitation is, however, sparse...... and emotional categories were the second and third most frequent among patients with endometrial and ovarian cancer. Sexual issues were dominant among the cervical cancer patients. Regression analysis showed significant association between quality of life scores and goal setting within the social and emotional...

  16. Factors Affecting Quality of Life and Fatigue in Gynaecologic Cancer Patients

    Directory of Open Access Journals (Sweden)

    Güngör İ

    2017-06-01

    Full Text Available Background: Cancer-related fatigue (CRF is the most commonly reported and most distressing symptom in cancer patients. Health-related quality of life (QOL is an important outcome in cancer management, the authors sought to better understand its determinants. Aim: This study aims to identify quality of life and fatigue levels and the affecting factors in gynaecologic cancer patients. Method: This descriptive and cross-sectional study was conducted with 154 volunteer women with gynaecologic cancer. The data were collected through the interview form, functional assessment of cancer therapy-general (FACT-G Quality of Life Scale, and Piper Fatigue Scale. Results: The mean score of total quality of life in gynaecologic cancer patients was low, 53.4 ± 15.4. Physical and emotional states were found to be the mostly affected states in the quality of life. According to the Piper Fatigue Scale, the total fatigue score was mild, 3.5 ± 2.4. Total fatigue scores were found to be high in metastatic cancers. Multivariate analyses indicate that the most important factor affecting the quality of life is economic condition, and the most important variables affecting fatigue are the level of activity and use of medicine. Conclusion: This study found that quality of life dimensions in women with gynaecologic cancer was affected by factors such as cancer type, time of diagnosis, and stage and spread of the cancer.

  17. Treatment optimisation using external beam radiation in gynaecological cancers

    Directory of Open Access Journals (Sweden)

    V. Sharma

    2004-03-01

    Full Text Available The majority of patients with gynaecological cancers present with advanced stages in which external beam radiation forms a major component of the treatment. These patients undergo simulation for treatment planning prior to radiation. Currently the lower extent of the disease is evaluated by vaginal examination and marked using a lead wire on the anterior abdominal wall in the pelvic region. A 2 cm margin inferior to this level is used as the lower border of the treatment field. The suggested modified technique includes the placement of an indigenously designed perspex vaginal obturator with graduations at 1 cm distance from its tip. Following vaginal examination the obturator can be inserted into the vagina and fixed at the predefined length using a fixation device. The radio-opaque markers can be seen even in the lateral films. Twentyfive consecutive patients underwent the procedure and the differences between the two methods of marking the lower border were calculated. The external lead wire was inferior to the internal obturator in 19 patients (76% ranging from 0.5 cm to 3 cm (median 1.5 cm, mean 1.37 cm. It was at the same level in 4 patients (16% and 1 cm superior to the internal obturator in 2 (8%. With the modified technique using the internal obturator application for delineating the lower border of vaginal disease or vault, it was possible to decrease the length of field thereby reducing the chances of treatment-related toxicity, especially groin and vulval reactions, as well as avoiding treatment interruptions.

  18. Lung Cancer Indicators Recurrence

    Science.gov (United States)

    This study describes prognostic factors for lung cancer spread and recurrence, as well as subsequent risk of death from the disease. The investigators observed that regardless of cancer stage, grade, or type of lung cancer, patients in the study were more

  19. Recurrent Breast Cancer

    Science.gov (United States)

    ... that can help you cope with distress include: Art therapy Dance or movement therapy Exercise Meditation Music ... mayoclinic.org/diseases-conditions/recurrent-breast-cancer/basics/definition/CON-20032432 . Mayo Clinic Footer Legal Conditions and ...

  20. Gynaecological cancer follow-up: national survey of current practice in the UK.

    Science.gov (United States)

    Leeson, Simon; Stuart, Nick; Sylvestre, Yvonne; Hall, Liz; Whitaker, Rhiannon

    2013-01-01

    To establish a baseline of national practice for follow-up after treatment for gynaecological cancer. Questionnaire survey. Gynaecological cancer centres and units. Members of the British Gynaecological Cancer Society and the National Forum of Gynaecological Oncology Nurses. A questionnaire survey. To determine schedules of follow-up, who provides it and what routine testing is used for patients who have had previous gynaecological cancer. A total of 117 responses were obtained; 115 (98%) reported hospital scheduled regular follow-up appointments. Two involved general practitioners. Follow-up was augmented or replaced by telephone follow-up in 29 responses (25%) and patient-initiated appointments in 38 responses (32%). A total of 80 (68%) cancer specialists also offered combined follow-up clinics with other specialties. Clinical examinations for hospital-based follow-up were mainly performed by doctors (67% for scheduled regular appointments and 63% for patient-initiated appointments) while telephone follow-up was provided in the majority by nurses (76%). Most respondents (76/117 (65%)) provided routine tests, of which 66/76 (87%) reported carrying out surveillance tests for ovarian cancer, 35/76 (46%) for cervical cancer, 8/76 (11%) for vulval cancer and 7/76 (9%) for endometrial cancer. Patients were usually discharged after 5 years (82/117 (70%)), whereas three (3%) were discharged after 4 years, nine (8%) after three years and one (1%) after 2 years. Practice varied but most used a standard hospital-based protocol of appointments for 5 years and routine tests were performed usually for women with ovarian cancer. A minority utilised nurse-led or telephone follow-up. General practitioners were rarely involved in routine care. A randomised study comparing various models of follow-up could be considered.

  1. Knowledge and attitudes of women regarding gynaecological cancer prevention in an urban area of Greece in financial crisis.

    Science.gov (United States)

    Saridi, Maria; Kapogeorgou, Eleni; Rekleiti, Maria; Geitona, Maria; Souliotis, Kyriakos

    2017-02-24

    Preventive gynaecological examinations (PGEs) are the main means of monitoring gynaecological cancers across the developed world. The purpose of this study was to investigate the perceptions and attitudes of women of a regional municipality of Greece, regarding preventive gynaecological examinations amid economic crisis. The study included 360 women aged 20-70 years, who lived in an urban area of Greece. A specialised, valid and anonymous questionnaire that included questions about perceptions and attitudes regarding preventive gynaecological examinations was used. The data analysis was performed using the statistical package spss 21. It was found that women who lived in less developed areas had had lower educational levels and higher abstinence rates from medical examinations. The main source of information about sexually transmitted diseases was their social circle (48%), but the gynaecologist is the one preferred (54.8) to inform about preventive gynaecological examinations. Thirty per cent of the participants had never have a mammogram, while 33.9% of the sample did not show the same result, although considered the Pap test necessary. The main cause of women's abstention of preventive gynaecological examinations is the financial crisis. The current financial crisis has negatively affected the women's ability to afford gynaecological examinations. Therefore, it is necessary to inform the population about the necessity of preventive gynaecological examinations starting from school age and at the same time, health information and promotion campaigns should be launched at a national level. © 2017 Nordic College of Caring Science.

  2. [HPV (Human Papilloma Virus) implication in other cancers than gynaecological].

    Science.gov (United States)

    Badoual, C; Tartour, E; Roussel, H; Bats, A S; Pavie, J; Pernot, S; Weiss, L; Mohamed, A Si; Thariat, J; Hoffmann, C; Péré, H

    2015-08-01

    Worldwide, approximately 5 to 10% of the population is infected by a Human Papilloma Virus (HPV). Some of these viruses, with a high oncogenic risk (HPV HR), are responsible for about 5% of cancer. It is now accepted that almost all carcinomas of the cervix and the vulva are due to an HPV HR (HPV16 and 18) infection. However, these viruses are known to be involved in the carcinogenesis of many other cancers (head and neck [SCCHN], penis, anus). For head and neck cancer, HPV infection is considered as a good prognostic factor. The role of HPV HR in anal cancer is also extensively studied in high-risk patient's population. The role of HPV infection in the carcinogenesis of esophageal, bladder, lung, breast or skin cancers is still debated. Given the multiple possible locations of HPV HR infection, the question of optimizing the management of patients with a HPV+ cancer arises in the implementation of a comprehensive clinical and biological monitoring. It is the same in therapeutics with the existence of a preventive vaccination, for example.

  3. The future for follow-up of gynaecological cancer in Europe. Summary of available data and overview of ongoing trials

    DEFF Research Database (Denmark)

    Leeson, Simon C.; Beaver, Kinta; Ezendam, Nicole P.M.

    2017-01-01

    is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up. The evidence base for traditional hospital based follow-up is limited. Alternative models have been reported for other cancer types but there are few evaluations of alternative approaches for gynaecological...... cancers. We identified five ongoing European studies; four were focused on endometrial cancer patients and one feasibility study included all gynaecological cancers. Only one study had reached the reporting stage. Alternative models included nurse-led telephone follow-up and comparisons of more intensive...... versus less intensive regimes. Outcomes included survival, quality of life, psychological morbidity, patient satisfaction and cost effectiveness of service. More work is needed on alternative strategies for all gynaecological cancer types. New models will be likely to include risk stratification...

  4. Support for coping after diagnosis of gynaecologic cancer

    DEFF Research Database (Denmark)

    Adellund, Kamila; Frandsen, Helle Nørtved; Juhl, Inger Rudbeck

    Background: Denmark has implemented several cancer schools that offer training and support after treatment. However, there are no offers to patients and relatives from the referral until definitive treatment. Therefore we focus on nursing care for patients and relatives in this period of time where...... their existence is threatened and their ability to cope weakened. The main question of this investigation was: How can the nurse in a multidisciplinary team support patients and relatives to master the first few days where cancer is suspected? We aimed to: Fase 1:          Explore the needs of support...

  5. [The impact of gynaecological cancers on woman's sexuality and her couple].

    Science.gov (United States)

    Vanlerenberghe, Edith; Sedda, Anne-Laure; Ait-Kaci, Fazya

    2015-05-01

    This article, devoted specifically to gynaecological cancers and their impact on the sexual and marital lives, is a collaboration between the psychologists and onco-gynaecologist within a cancer center. In oncology, gynaecological cancers' treatments involve at the same time anatomical, physiological and functional modifications impacting, in a major way, on the sexual life of women. All the phases of the sexual answer can be touched. Beyond the physical and aesthetic consequences of the treatments, the sexual dysfunctions are generally caused by the deep psychological upheaval induced by the disease affecting a strongly invested female body. Female cancer is also a true test for the couple challenged in its emotional, functional and sexual cohesion: emotional distress, attachment link dysfunction, change of role within the couple, disordered state of communication. The couple cannot survive and find a harmonious intimate life without communication about sexual health between the medical team, the patient and her partner. All doctors and nurses must be able to initiate the subject throughout the course of care by respecting four prerequisites: to be aware of the importance to approach this subject, to create a climate of trust, to dare the questions and to respect the rhythm of the patient and her partner. Copyright © 2015 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

  6. Opioids and breast cancer recurrence

    DEFF Research Database (Denmark)

    Cronin-Fenton, Deirdre P; Heide-Jørgensen, Uffe; Ahern, Thomas P

    2015-01-01

    BACKGROUND: Opioids may alter immune function, thereby potentially affecting cancer recurrence. The authors investigated the association between postdiagnosis opioid use and breast cancer recurrence. METHODS: Patients with incident, early stage breast cancer who were diagnosed during 1996 through...... 2008 in Denmark were identified from the Danish Breast Cancer Cooperative Group Registry. Opioid prescriptions were ascertained from the Danish National Prescription Registry. Follow-up began on the date of primary surgery for breast cancer and continued until breast cancer recurrence, death......, emigration, 10 years, or July 31, 2013, whichever occurred first. Cox regression models were used to compute hazard ratios and 95% confidence intervals associating breast cancer recurrence with opioid prescription use overall and by opioid type and strength, immunosuppressive effect, chronic use (≥6 months...

  7. Psychosocial adjustment to recurrent cancer.

    Science.gov (United States)

    Mahon, S M; Cella, D F; Donovan, M I

    1990-01-01

    This descriptive study of the perceptions and needs of people with recurrent malignancies asks three questions: How do patients describe the meaning of a recurrence of cancer? Do individuals perceive the diagnosis of recurrence and the initial diagnosis of cancer differently? What are the key psychosocial problems associated with recurrent cancer? The theoretical framework was based on Lazarus and Folkman's theory of stress, appraisal, and coping. Subjects completed the Impact of Event Scale (IES), the Psychosocial Adjustment to Illness Scale--Self-Report (PAIS), and a semistructured qualitative interview. The interview elicited perceptions of the event of recurrence and differences between the diagnosis of recurrence and the initial diagnosis. The convenience sample included 40 patients diagnosed with recurrent cancer within the last 30 days. Many subjects (78%) reported that the recurrence was more upsetting than the initial diagnosis. Scores on both the IES and the PAIS were high when compared to normative samples of patients with cancer suggesting that this sample of patients experienced a lot of psychological distress as well as problems at home, work, and in their social lives. These concerns often were unknown to caregivers. Although more research is needed, the authors propose that, with more accurate assessment, more effective intervention could be implemented and the quality of life improved for patients with recurrent cancer.

  8. Estradiol Metabolites and their Possible Role in Gynaecological Cancer

    Directory of Open Access Journals (Sweden)

    Seeger H

    2010-01-01

    Full Text Available Evidence is growing that certain estradiol metabolites are biologically active, especially in the field of cancer. Currently research focuses on the anticancerogenic effects of 2-hydroxyestrone and particularly 2-methoxyestradiol, as well as the possible carcinogenic properties of 4-hydroxyestrogens and 16α-hydroxyestrone. The clinical relevance of these activities, demonstrated in in vitro and animal experiments, remains unclear – it is proven, however, that the metabolite production can be altered in certain malignancies such as endometrial-, breast- and cervical carcinoma. Clinical studies, including own investigations, demonstrated a negative correlation between the ratio of 2-hydroxyestrone to 16α-hydroxyestrone and breast cancer risk. However, the design and interpretation of such studies should consider factors influencing metabolic pattern such as diet, physical activity, smoking as well as internal diseases and certain drugs.

  9. Imaging for Prostate Cancer Recurrence.

    Science.gov (United States)

    Maurer, Tobias; Eiber, Matthias; Fanti, Stefano; Budäus, Lars; Panebianco, Valeria

    2016-06-01

    Correct identification of metastatic sites in recurrent prostate cancer (PCa) is of crucial importance because it leads to further treatment decisions. To provide an overview on current imaging procedures and their performance in recurrent PCa. Medline search via PubMed was performed with the keywords imaging, recurrent, and prostate cancer as well as more detailed searches including the keywords bone scan, bone scintigraphy, computed tomography, magnetic resonance imaging, positron emission tomography, PET, choline, FDG, prostate-specific membrane antigen, and PSMA, with emphasis on recent literature from 2010 to the present. Non-English published literature was excluded. Abstracts and full-text articles were reviewed and assessed for relevant content. In diagnostic imaging and particularly with newer technologies like positron emission tomography (PET), a profound lack of prospectively designed studies in recurrent PCa has to be noted. In most studies histologic validation has only been performed in a subset of patient cohorts. Heterogeneity of included patient cohorts, lack of standardized assessment, as well as diverging end points, hamper systematic comparison of different image modalities. Thus evidence for currently used imaging in recurrent PCa is only presented descriptively. Computed tomography and magnetic resonance imaging (MRI) as well as bone scintigraphy still represent the standard imaging for recurrent PCa; however, particularly for detection of local recurrence, multiparametric MRI is a valuable imaging modality. PET using choline and particularly tracers against prostate-specific membrane antigen might improve visualization of metastatic lesions. These findings need to be validated in prospective trials. Imaging of recurrent prostate cancer (PCa) is important to guide further treatment. Computed tomography, magnetic resonance imaging, and bone scintigraphy represent the current standard. Positron emission tomography, especially with cancer

  10. Radiation-induced bowel injury: the impact of radiotherapy on survivorship after treatment for gynaecological cancers

    Science.gov (United States)

    Kuku, S; Fragkos, C; McCormack, M; Forbes, A

    2013-01-01

    Background: The number of women surviving cancer who live with symptoms of bowel toxicity affecting their quality of life continues to rise. In this retrospective study, we sought to describe and analyse the presenting clinical features in our cohort, and evaluate possible predictors of severity and chronicity in women with radiation-induced bowel injury after treatment for cervical and endometrial cancers. Methods: Review of records of 541 women treated within the North London Gynaecological Cancer Network between 2003 and 2010 with radiotherapy with or without chemotherapy for cervical and endometrial cancer identified 152 women who reported significant new bowel symptoms after pelvic radiation. Results: Factor analysis showed that the 14 most common and important presenting symptoms could be ‘clustered' into 3 groups with predictive significance for chronicity and severity of disease. Median follow-up for all patients was 60 months. Univariate analysis showed increasing age, smoking, extended field radiation, cervical cancer treatment and the need for surgical intervention to be significant predictors for severity of ongoing disease at last follow-up. On multivariate analysis, only age, cancer type (cervix) and symptom combinations/‘cluster' of (bloating, flatulence, urgency, rectal bleeding and per-rectal mucus) were found to be significant predictors of disease severity. Fifteen (19%) women in the cervical cancer group had radiation-induced bowel injury requiring surgical intervention compared with five (6.7%) in the endometrial cancer group. Conclusion: Women with cervical cancer are younger and appear to suffer more severe symptoms of late bowel toxicity, whereas women treated for endometrial cancer suffer milder more chronic disease. The impact of radiation-induced bowel injury and the effect on cancer survivorship warrants further research into investigation of predictors of severe late toxicity. There is a need for prospective trials to aid early

  11. Cancer immunology and colorectal cancer recurrence.

    Science.gov (United States)

    Vannucci, Luca

    2011-06-01

    The recurrence of a cancer - local or distant (metastasis) - is manifested by the persistence of cancer cells in the organism after the ablation of the primary lesion, an ineffective anticancer immune response, and by the activity of biological/immunological factors that can stimulate and sustain its development. This review focuses on colorectal carcinoma and discusses some aspects of cancer immunology regarding cancer development and its recurrence. It is addressed also to the clinician to provide new insights helpful for designing better therapeutic strategies and patient's follow up. Therapeutic approaches used during and after surgical treatments, found capable of modulating immunity (differently affecting disease outcome), will also be described.

  12. [Therapy of recurrent cervical cancer].

    Science.gov (United States)

    Sekiba, K; Hayase, R

    1990-09-01

    1,122 uterine cancer patients above FIGO stage I a were treated at our hospital in the decade from 1980 to 1989. Total 69 patients diagnosed as recurrent cervical cancer had 82 lesions in 11 sites. The most frequent recurrent sites were uterus, vaginal stump and vaginal wall; the second sites were parametrium and pelvic wall. Radiotherapy and hyperthermia were done to patients with these lesions. Chemotherapy and radiotherapy were used to patients with distant metastatic lesions to left supraclavicular lymph nodes and lung. But there has been no good results.

  13. Trialling computer touch-screen technology to assess psychological distress in patients with gynaecological cancer

    Directory of Open Access Journals (Sweden)

    Georgia Halkett

    2010-12-01

    Full Text Available BackgroundCancer impacts on the psychological well-being of many cancer patients. Appropriate tools can be used to assist health professionals in identifying patient needs and psychological distress. Recent research suggests that touchscreen technology can be used to administer surveys. The aim of this study was to evaluate the use of a touchscreen system in comparison to written questionnaires in a large tertiary hospital in Western Australia (WA.Method Patients who were scheduled to commence treatment for gynaecological cancer participated in this study. Patients were assigned to complete either a written questionnaire or the same survey using the touchscreen technology. Both methods of survey contained the same scales. All participants were asked to complete a follow-up patient satisfaction survey. Semi-structured interviews were conducted with health professionals to elicit views about the implementation of the technology and the available referral pathways. Data was analysed using descriptive statistics and content analysis. ResultsThirty patients completed the touchscreen questionnaires and an equal number completed the survey on paper. Participants who used the touchscreens were not significantly more satisfied than other participants. Four themes were noted in the interviews with health professionals: usability of technology, patients’ acceptance of technology, advantages of psychological screening and the value of the instruments included.ConclusionAlthough previous studies report that computerised assessments are a feasible option for assessing cancer patients’ needs, the data collected in this study demonstrates that the technology was not reliable with significant practical problems. The technology did not serve these patients better than pen and paper.

  14. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research

    Directory of Open Access Journals (Sweden)

    Kienle Gunver S

    2009-06-01

    Full Text Available Abstract Background Viscum album L. extracts (VAE, European mistletoe are a widely used medicinal plant extract in gynaecological and breast-cancer treatment. Methods Systematic review to evaluate clinical studies and preclinical research on the therapeutic effectiveness and biological effects of VAE on gynaecological and breast cancer. Search of databases, reference lists and expert consultations. Criteria-based assessment of methodological study quality. Results 19 randomized (RCT, 16 non-randomized (non-RCT controlled studies, and 11 single-arm cohort studies were identified that investigated VAE treatment of breast or gynaecological cancer. They included 2420, 6399 and 1130 patients respectively. 8 RCTs and 8 non-RCTs were embedded in the same large epidemiological cohort study. 9 RCTs and 13 non-RCTs assessed survival; 12 reported a statistically significant benefit, the others either a trend or no difference. 3 RCTs and 6 non-RCTs assessed tumour behaviour (remission or time to relapse; 3 reported statistically significant benefit, the others either a trend, no difference or mixed results. Quality of life (QoL and tolerability of chemotherapy, radiotherapy or surgery was assessed in 15 RCTs and 9 non-RCTs. 21 reported a statistically significant positive result, the others either a trend, no difference, or mixed results. Methodological quality of the studies differed substantially; some had major limitations, especially RCTs on survival and tumour behaviour had very small sample sizes. Some recent studies, however, especially on QoL were reasonably well conducted. Single-arm cohort studies investigated tumour behaviour, QoL, pharmacokinetics and safety of VAE. Tumour remission was observed after high dosage and local application. VAE application was well tolerated. 34 animal experiments investigated VAE and isolated or recombinant compounds in various breast and gynaecological cancer models in mice and rats. VAE showed increase of survival

  15. Metformin in reproductive health, pregnancy and gynaecological cancer: established and emerging indications.

    Science.gov (United States)

    Sivalingam, Vanitha N; Myers, Jenny; Nicholas, Susie; Balen, Adam H; Crosbie, Emma J

    2014-01-01

    Metformin is an effective oral anti-hyperglycaemic drug used as first-line medical treatment for type 2 diabetes. It improves systemic hyperglycaemia by reducing hepatic glucose production and enhancing peripheral insulin sensitivity. It also stimulates fat oxidation and reduces fat synthesis and storage. The molecular mechanism of this drug is thought to be secondary to its actions on the mitochondrial respiratory chain. This paper reviews the relevant literature (research articles up to October 2013) on the use of metformin in infertility, polycystic ovary syndrome (PCOS), pregnancy and gynaecological cancers. We present a comprehensive discussion of the evidence supporting the efficacy of metformin in these clinical conditions. Metformin is used clinically off-label in the management of hirsutism, acne and insulin resistance in PCOS, although the evidence for anti-androgenic effects is inconsistent. Metformin is also used to improve ovulation in women with PCOS both alone and in combination with clomiphene citrate. Trial findings are conflicting but metformin treatment in IVF/ICSI cycles may reduce the risk of ovarian hyperstimulation syndrome and increase live birth rates. Metformin also appears to be effective and safe for the treatment of gestational diabetes mellitus (GDM), particularly for overweight and obese women. Studies have shown that metformin is safe in pregnancy and women with GDM treated with metformin have less weight gain during pregnancy than those treated with insulin. One study with a 2-year follow-up demonstrated that babies born to women treated with metformin also developed less visceral fat, making them less prone to insulin resistance in later life. These findings have sparked interest in the use of metformin for pregnant, obese, non-diabetic women. On-going clinical trials are underway to determine if women treated prophylactically with metformin have a reduced incidence of GDM and demonstrate less weight gain during pregnancy. The

  16. Incidence of breast and gynaecological cancers by ethnic group in England, 2001-2007: a descriptive study.

    Science.gov (United States)

    Shirley, Megan H; Barnes, Isobel; Sayeed, Shameq; Finlayson, Alexander; Ali, Raghib

    2014-12-18

    Although international comparisons reveal large geographical differences in the incidence of breast and gynaecological cancers, incidence data for ethnic groups in England remains scarce. We compared the incidence of breast, ovarian, cervical and endometrial cancer in British Indians, Pakistanis, Bangladeshis, Black Africans, Black Caribbeans, Chinese and Whites between 2001 and 2007. We identified 357,476 cancer registrations from which incidence rates were calculated using mid-year population estimates from 2001 to 2007. Ethnicity was obtained through linkage to the Hospital Episodes Statistics database. Incidence rate ratios were calculated, comparing the 6 non-White ethnic groups to Whites, and were adjusted for age and income. We found evidence of differences in the incidence of all 4 cancers by ethnic group (pethnic group and that those groups typically grouped together are not homogenous with regards to their cancer risk. Furthermore, several of our findings cannot be readily explained by known risk factors and therefore warrant further investigation.

  17. Recurrent cervical cancer : detection and prognosis

    NARCIS (Netherlands)

    Duyn, A; Van Eijkeren, M; Kenter, G; Zwinderman, K; Ansink, A

    2002-01-01

    Background. Only a small proportion of cervical cancer recurrences is detected during routine follow-up. We investigated which percentage of recurrences is detected during follow-up, which diagnostic tools are helpful to detect recurrent disease and which factors are of prognostic significance once

  18. Development of 3D ultrasound needle guidance for high-dose-rate interstitial brachytherapy of gynaecological cancers

    Science.gov (United States)

    Rodgers, J.; Tessier, D.; D'Souza, D.; Leung, E.; Hajdok, G.; Fenster, A.

    2016-04-01

    High-dose-rate (HDR) interstitial brachytherapy is often included in standard-of-care for gynaecological cancers. Needles are currently inserted through a perineal template without any standard real-time imaging modality to assist needle guidance, causing physicians to rely on pre-operative imaging, clinical examination, and experience. While two-dimensional (2D) ultrasound (US) is sometimes used for real-time guidance, visualization of needle placement and depth is difficult and subject to variability and inaccuracy in 2D images. The close proximity to critical organs, in particular the rectum and bladder, can lead to serious complications. We have developed a three-dimensional (3D) transrectal US system and are investigating its use for intra-operative visualization of needle positions used in HDR gynaecological brachytherapy. As a proof-of-concept, four patients were imaged with post-insertion 3D US and x-ray CT. Using software developed in our laboratory, manual rigid registration of the two modalities was performed based on the perineal template's vaginal cylinder. The needle tip and a second point along the needle path were identified for each needle visible in US. The difference between modalities in the needle trajectory and needle tip position was calculated for each identified needle. For the 60 needles placed, the mean trajectory difference was 3.23 +/- 1.65° across the 53 visible needle paths and the mean difference in needle tip position was 3.89 +/- 1.92 mm across the 48 visible needles tips. Based on the preliminary results, 3D transrectal US shows potential for the development of a 3D US-based needle guidance system for interstitial gynaecological brachytherapy.

  19. Vulvovaginitis and other common childhood gynaecological conditions.

    Science.gov (United States)

    Garden, Anne S

    2011-04-01

    Paediatric gynaecological problems, especially those involving the vulvar area, are common in childhood. The conditions frequently seen include recurrent bacterial vulvovaginitis, vulvar irritation, labial adhesions and dermatological conditions. The presentation and management of these conditions will be reviewed.

  20. Imaging of recurrent prostate cancer

    NARCIS (Netherlands)

    Futterer, J.J.

    2012-01-01

    Approximately 30\\% of patients who underwent radical prostatectomy or radiation therapy will develop biochemical recurrent disease. Biochemical recurrent disease is defined as an increase in the serum value of prostate-specific antigen (PSA) after reaching the nadir. Prostate recurrence can present

  1. Characterization and functional capacity in women with breast cancer, gynaecological cancer and gestational trophoblastic disease

    Directory of Open Access Journals (Sweden)

    Thaís Cristina Elias

    Full Text Available Objective: to describe the social, demographic and clinical profile, and functional capacity of women diagnosed with gynecological cancer, breast cancer and gestational trophoblastic disease during chemotherapy. Method: longitudinal retrospective study that evaluated the records of women treated in hospital clinics from January 2000 to December 2012. Results: they evaluated the records of 438 women. The analysis showed that were not able to perform their daily activities, limited to the activities of self-care. Older patients had greater functional impairment during therapy. Conclusions: the sample was women 41 to 50 years, diagnosed with breast cancer (50.9% and made use of anthracycline based protocols (47%; the scores of the functional capacity of the sample fell from 78.22 to 73.57. It is evident that nursing care should focus on the control of signs and symptoms that impact the functional capacity of women under chemotherapy.

  2. Forequarter amputation for recurrent breast cancer

    Directory of Open Access Journals (Sweden)

    Krishna N. Pundi

    2015-01-01

    Conclusion: Forequarter amputation can be judiciously used for patients with recurrent or metastatic breast cancer. Patients with recurrent disease without evidence of distant metastases may be considered for curative amputation, while others may receive palliative benefit; disappointingly our patient achieved neither of these outcomes. In the long term, these patients may still have significant psychological problems.

  3. Forequarter amputation for recurrent breast cancer

    OpenAIRE

    Pundi, Krishna N.; AlJamal, Yazan N.; Ruparel, Raaj K.; Farley, David R.

    2015-01-01

    Introduction: Localized excision combined with radiation and chemotherapy represents the current standard of care for recurrent breast cancer. However, in certain conditions a forequarter amputation may be employed for these patients. Presentation of case: We present a patient with recurrent breast cancer who had a complicated treatment history including multiple courses of chemotherapy, radiation, and local surgical excision. With diminishing treatment options, she opted for a forequarter...

  4. Validation of a questionnaire for self-assessment of sexual function and vaginal changes after gynaecological cancer

    DEFF Research Database (Denmark)

    Jensen, Pernille T; Klee, Marianne C; Thranov, Ingrid;

    2004-01-01

    of partner, sexual activity, sexual satisfaction, and body image. Seven additional items assessing current levels of sexual and vaginal problems compared to pre-diagnosis are intended to be used only once in longitudinal studies. The SVQ was validated in two ways: first, the comprehensibility of each item...... of agreement between the patients' and the observer's ratings was high (median overall agreement 0.84, range 0.46-1.00; median kappa: 0.80, range 0.52-1.00). From the 10 items applicable to all patients, three scales were hypothesized: intimacy, sexual interest and global sexual satisfaction. For sexually......The Sexual function-Vaginal changes Questionnaire (SVQ), was developed to investigate sexual and vaginal problems in gynaecological cancer patients. The instrument consists of 20 core items, measuring sexual interest, lubrication, orgasm, dyspareunia, vaginal dimensions, intimacy, sexual problems...

  5. Anesthetic Techniques and Cancer Recurrence after Surgery

    Directory of Open Access Journals (Sweden)

    Vincenzo Fodale

    2014-01-01

    Full Text Available Many of the most common anesthetics are used in surgical oncology, yet effects on cancer cells are still not known. Anesthesia technique could differentially affect cancer recurrence in oncologic patients undergoing surgery, due to immunosuppression, stimulation of angiogenesis, and dissemination of residual cancer cells. Data support the use of intravenous anesthetics, such as propofol anesthesia, thanks to antitumoral protective effects inhibiting cyclooxygenase 2 and prostaglandins E2 in cancer cells, and stimulation of immunity response; a restriction in the use of volatile anesthetics; restriction in the use of opioids as they suppress humoral and cellular immunity, and their chronic use favors angiogenesis and development of metastases; use of locoregional anesthesia compared with general anesthesia, as locoregional appears to reduce cancer recurrence after surgery. However, these findings must be interpreted cautiously as there is no evidence that simple changes in the practice of anesthesia can have a positive impact on postsurgical survival of cancer patients.

  6. Potential proton beam therapy for recurrent endometrial cancer in the vagina.

    Science.gov (United States)

    Yanazume, Shintaro; Arimura, Takeshi; Kobayashi, Hiroaki; Douchi, Tsutomu

    2015-05-01

    Proton beam radiotherapy mainly has been used in the gynecological field in patients with cervical cancer. The efficacy of proton beam therapy in patients with recurrent endometrial cancer has not yet been determined. A 77-year-old endometrial cancer patient presented with recurrence in the vagina without distant metastasis following hysterectomy. A hard mass measuring 6 cm originated from the apex of the vagina, surrounded the vaginal cavity, and infiltrated the proximal and distal vagina. The patient received proton beam radiotherapy using a less invasive particle treatment system while minimizing the dose to the surrounding normal tissues. The dose to the planning target volume was 74 Gy (relative biological effectiveness) with 37 fractions. The patient was treated with 150-210-MeV proton beams for 53 days. Proton beam therapy led to the disappearance of tumors without any complications except for grade 1 cystitis although evidence of further complications is not available past our 6-month follow-up period. Proton beam therapy may become a useful treatment modality for recurrent endometrial cancer as well as cervical uterine cancer. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  7. Can antioxidants predispose to cancer recurrence?

    Institute of Scientific and Technical Information of China (English)

    Krishnananda Prabhu; Gummadi Maheshwar Reddy; Anjali Rao

    2010-01-01

    Objective:To measure and compare pre-and post-treatment levels of serum total glutathione-S-transferase (GST) in stage IV cervical cancer patients and erythrocytic glutathione (GSH) and malondialdehyde (MDA) and plasma ceruloplasmin (CP) and total GST in stage IV oral cancer patients and to correlate with the response to treatment during a two year follow-up period in respective cancer groups. Methods:Thirty-four biopsy-proven stage IV oral cancer and cervical cancer patients (n=17 in each group) who underwent same mode of treatment were chosen for this study. Erythrocytic MDA and GSH, CP and serum total GST were measured in all patients before the onset of treatment, and the GST level was only measured in cervical cancer patients after radiotherapy. The levels were compared with their respective prognosis in 2 years. Results:Oral cancer patients with higher pretreatment levels of GSH, CP and GST came with cancer recurrence within 2 years after the onset of treatment. Cervical cancer patients with higher post radiotherapy levels of serum total GST had higher recurrence tate. Conclusions:This study indicates there may be a role for these antioxidant parameters namely GST, GSH, CP in assessment of long term survival and prognosis of cancer patients.

  8. Recurrence after surgery due to cervical cancer - An evaluation of the follow-up program

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakær, Jan

    Objective During the last 20 years the follow-up program after surgical treatment for cervical cancer has remained unchanged. Surprisingly, little is communicated in relation to the follow-up program even though it has a huge impact on the life of the women and their relatives for five years....... The focus for this study is to evaluate the follow-up program in fulfilling the purpose for early diagnosis of recurrence while reminding and concerning women, who we consider healthy after surgery, 10 times during five years. Already politicians are focusing on the subject due to the socioeconomic...... consequences, but there is a need for a foundation prior to an adjustment of the follow-up program. Methods Design: retrospective study of a cohort of women attending follow-up program after surgery due to cervical cancer. Material: From the patient register at the Department of Gynaecology and Obstetrics...

  9. Current management of locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

    2011-01-01

    ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web...

  10. Cancer incidence and survival in Lynch syndrome patients receiving colonoscopic and gynaecological surveillance

    DEFF Research Database (Denmark)

    Møller, Pål; Seppälä, Toni; Bernstein, Inge;

    2016-01-01

    OBJECTIVE: Estimates of cancer risk and the effects of surveillance in Lynch syndrome have been subject to bias, partly through reliance on retrospective studies. We sought to establish more robust estimates in patients undergoing prospective cancer surveillance. DESIGN: We undertook a multicentr...

  11. Recurrent breast cancer: presentation, diagnosis, and treatment.

    Science.gov (United States)

    Jardines, L; Callans, L S; Torosian, M H

    1993-10-01

    Patients must be followed up closely after primary therapy for invasive breast cancer so that locoregional recurrences can be detected early. Once a recurrence has been detected, a thorough evaluation is indicated to exclude distant metastatic disease. If none is found, the patient may be a candidate for aggressive surgical intervention to render the patient disease-free. If distant disease is found, certain sites, such as the CNS or long bones, may warrant aggressive therapy because failure to treat these sites may lead to excessive morbidity. In most situations, patients with distant disease are treated with palliative measures. In selected instances, however, patients with metastatic breast cancer are candidates for aggressive intervention, including pulmonary or liver resection or high-dose chemotherapy in combination with autologous bone marrow transplantation, to rid the patient of the disease.

  12. SBRT for recurrent head and neck cancer

    Science.gov (United States)

    Garg, M.; Kabarriti, R.; Baliga, S.; Guha, C.; Tome, W.; Kalnicki, S.

    2017-01-01

    The management of patients with recurrent head and neck cancers is complex. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab.

  13. Management of recurrent epithelial ovarian cancer

    Science.gov (United States)

    Moreno-Eutimio, Mario Adan; Acosta-Altamirano, Gustavo; Vargas-Aguilar, Víctor Manuel

    2014-01-01

    Epithelial ovarian cancer is the fifth most common cancer in women. It is usually diagnosed at an advanced stage and is the leading cause of death from gynecologic cancers in women. The overall survival rate at five years is 50% and its treatment is still poor. We need new treatments for patients with recurrent ovarian cancer who are incurable with current management. We review the effectiveness of new biological agents and morbidity and mortality of cytoreductive surgery. Since the hyperthermic increases the effectiveness of chemotherapy and the chance of survival, hyperthermic intraperitoneal chemotherapy has been proven to be a promising option, however it still requires further study to be the standard treatment. PMID:25207212

  14. Assessment of deep myometrial invasion of endometrial cancer on MRI: added value of second-opinion interpretations by radiologists subspecialized in gynaecologic oncology

    Energy Technology Data Exchange (ETDEWEB)

    Woo, Sungmin [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Kim, Sang Youn [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Cho, Jeong Yeon; Kim, Seung Hyup [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Medical Research Center, Institute of Radiation Medicine and Kidney Research Institute, Seoul (Korea, Republic of)

    2017-05-15

    To investigate the added value of secondary reports issued by radiologists subspecializing in gynaecologic imaging for determining deep myometrial invasion of endometrial cancer on MRI. Initial (from referring institutions) and secondary (by subspecialized radiologists) interpretations of MRI of 55 patients with endometrial cancer were retrospectively reviewed. A radiologist blinded to clinicopathological information assessed both reports for the presence of deep myometrial invasion. Reference standard was based on hysterectomy specimens. Kappa coefficients (k) were used to measure their concordance. McNemar testing and receiver operating characteristic (ROC) analysis was used to compare sensitivities, specificities and areas under the curves (AUCs). Deep myometrial invasion was present in 25 (45.5 %) patients. Among 27.3 % (15/55; k = 0.458) patients with discrepant results, secondary interpretations were correct in 10 (66.7 %) cases. Sensitivity was higher in secondary than in initial reports (76.0 % vs. 48.0 %, p = 0.039) while no significant difference was seen in specificity (70.0 % vs. 76.7 %, p = 0.668). At ROC analysis, there was a tendency for higher AUCs in secondary reports (0.785 vs 0.669, p = 0.096). Secondary readings of MRI by subspecialized gynaecologic oncologic radiologists may provide incremental value in determining deep myometrial invasion of endometrial cancer. (orig.)

  15. A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors.

    Science.gov (United States)

    Donnelly, C M; Blaney, J M; Lowe-Strong, A; Rankin, J P; Campbell, A; McCrum-Gardner, E; Gracey, J H

    2011-09-01

    To determine the feasibility and efficacy of a physical activity behavioural change intervention in managing cancer-related fatigue among gynaecological cancer survivors during and post anti-cancer treatments. A two arm, single blind, randomised controlled trial was conducted within the Northern Ireland regional Cancer Centre. Thirty three sedentary gynaecological cancer survivors (stage I-III; ≤3 years post diagnosis), experiencing cancer-related fatigue (mild-severe) took part. Participants were randomly assigned to a behavioural change, moderate intensity physical activity intervention (n=16) or a Contact Control group (n=17). The primary outcome was fatigue (Multidimensional Fatigue Symptom Inventory-Short Form and Functional Assessment in Chronic Illness Therapy-Fatigue subscale). Secondary outcomes included quality of life, physical functioning, positive and negative affect, depression, body composition, sleep dysfunction and self-reported physical activity. Feasibility was assessed based on the recruitment rate, programme and physical activity adherence and participants' programme evaluation, including optional focus groups (n=16). Twenty five percent of eligible women took part (33/134). Participants were 8.7 (SD=9.1) months post diagnosis, with a mean age of 53 (SD=10.3) years. The majority of the sample had a diagnosis of ovarian (n=12) or endometrial cancer (n=11). Significant differences favouring the intervention group were observed for fatigue at 12 weeks and 6 months follow-up (12 week: mean difference=-11.06; 95% confidence interval (CI)=-21.89 to -0.23; effect size (d)=0.13; p=0.046; 6 month: mean difference=-19.48; 95% CI=-19.67 to -19.15; effect size (d)=0.20; p=0.01). A mean of 10 calls (SD=1.2 calls) were delivered to the Physical Activity Group, and 10 (SD=1.6 calls) to the CC group. The intervention was positively perceived based on exit questionnaire and focus group findings. A physical activity behavioural change intervention for

  16. Experiencing Health Advocacy During Cervical Cancer Awareness Week: A National Initiative for Obstetrics and Gynaecology Residents.

    Science.gov (United States)

    Posner, Glenn; Finlayson, Sarah; Luna, Vilma; Miller, Dianne; Fung-Kee-Fung, Michael

    2015-07-01

    Objectif : Le Collège royal des médecins et chirurgiens du Canada exige que les résidents fassent preuve de compétence dans le rôle de promoteur de la santé (PS ou promotion de la santé). Nous avons cherché à élaborer et à mettre en œuvre, à l’intention des résidents en obstétrique-gynécologie, un module pédagogique national traitant de ce rôle de PS. Ce programme pilote était centré sur la prévention du cancer du col utérin, soit un sujet se prêtant bien à l’application des principes de la promotion de la santé. Méthodes : Un module pédagogique a été élaboré et transmis à tous les programmes de résidence en obstétrique-gynécologie au Canada. Ce module décrit les options de PS mettant en jeu le dépistage de la dysplasie cervicale (telles qu’une clinique visant l’élargissement de la population desservie ou un forum d’éducation visant le public / la population étudiante) qui devaient être mises en œuvre au cours de la Semaine de sensibilisation au cancer du col de l’utérus. La réussite a été mesurée en fonction du nombre de programmes mettant en œuvre le curriculum, du nombre de résidents y ayant participé, de la diversité des projets mis en œuvre, de la nature des personnes (patientes ou apprenants) atteintes par le programme et de l’expérience globale des stagiaires. Résultats : Trois programmes ont mis en œuvre le curriculum en 2011, un programme l’a fait en 2012 et sept l’ont fait en 2013. Après trois ans, le module s’est attiré la participation directe ou indirecte de sept des 16 facultés de médecine, de plus de 100 résidents et de milliers de femmes. De plus, les attributs de la PS vécus par les résidents ont été identifiés : travail d’équipe, leadership, connaissances accrues au sujet des systèmes, capital social accru au sein de la communauté, créativité, innovation et adaptabilité. Conclusion : Nous avons démontré qu’un module pédagogique, visant

  17. Towards focal salvage therapy for prostate cancer recurrences

    NARCIS (Netherlands)

    Moman, M.R.

    2010-01-01

    The diagnosis and treatment of patients with recurrent prostate cancer after radiotherapy is problematic in current clinical practice. Diagnostic possibilities for the detection of recurrences are limited. Further, conventional salvage techniques for the treatment of recurrences are known to have lo

  18. Primary vaginal cancer: role of MRI in diagnosis, staging and treatment

    Science.gov (United States)

    Sunil, J; Klopp, A H; Devine, C E; Sagebiel, T; Viswanathan, C; Bhosale, P R

    2015-01-01

    Primary carcinoma of the vagina is rare, accounting for 1–3% of all gynaecological malignancies. MRI has an increasing role in diagnosis, staging, treatment and assessment of complications in gynaecologic malignancy. In this review, we illustrate the utility of MRI in patients with primary vaginal cancer and highlight key aspects of staging, treatment, recurrence and complications. PMID:25966291

  19. Sentinel Lymph Node Dissection in Locally Recurrent Breast Cancer

    DEFF Research Database (Denmark)

    Uth, Charlotte Caspara; Christensen, Mette Haulund; Oldenbourg, Mette Holmqvist

    2015-01-01

    BACKGROUND: The aim of this study was to investigate the use of sentinel lymph node dissection (SLND) in the treatment of patients with locally recurrent breast cancer. METHODS: A total of 147 patients with locally recurrent breast cancer were included from five different breast surgery departments...

  20. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  1. [Evaluation of modalities for recurrent breast cancer patients].

    Science.gov (United States)

    Tohnosu, N; Onoda, S; Okuyama, K; Koide, Y; Awano, T; Kinoshita, H; Matsubara, H; Sano, T; Nakaichi, H; Isono, K

    1990-12-20

    Of 342 breast cancer patients radically operated on in the Second Department of Surgery, School of Medicine, Chiba University during 1965-1988, treatment for 75 recurrent patients were evaluated by the initial modes of recurrence. The modes of recurrence were classified into distant metastases, local lymph node recurrence (axillary, parasternal and supraclavicular nodes) and chest wall recurrence according to the General Rules for Clinical and Pathological Recording of Breast Cancer. Of 75 recurrent patients, distant metastases were seen as common as 77.3%, followed by recurrences of local lymph nodes (14.7%) and chest wall (8.0%). The number of patients in each mode of recurrence increased in relation to increase in the size of tumor and the number of metastatic lymph nodes at the time of the first operation. Histologically, scirrhous carcinoma was most common in chest wall recurrence. 2-year disease-free survival rates of distant metastases, local lymph node recurrence and chest wall recurrence were 44.6%, 24.2% and 16.7%, respectively. 5-year survival of bone metastasis with chemo-endocrine therapy was as significantly favorable as 60%, compared to chemo- or radiotherapy alone (p less than 0.01). However, 5-year survival of lung metastasis with or without endocrine therapy revealed no significant difference. Local lymph node recurrence with the combination of resection, radio- and/or chemotherapy produced a trend toward showing more favorable survival than that without resection.

  2. Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After Therapy

    Science.gov (United States)

    2015-10-01

    AD_________________ (Leave blank) Award Number: W81XWH-14-1-0350 TITLE: Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After...30 Sep 2014 - 29 Sep 2015 4. TITLE AND SUBTILE Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After Therapy 5a. CONTRACT NUMBER...Innovative reporter gene systems are designed to mark quiescent or proliferating lung cancer cells (Aim 1) and then used to track and trace the dynamics of

  3. Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After Therapy

    Science.gov (United States)

    2016-12-01

    AD_________________ Award Number: W81XWH-14-1-0350 TITLE: Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After Therapy PRINCIPAL...30 Sep 2014 - 29 Sep 2016 4. TITLE AND SUBTILE Targeting Quiescent Cancer Cells to Eliminate Tumor Recurrence After Therapy 5a. CONTRACT NUMBER... cancer . To eradicate chemoresistant tumor cells, it is important to identify the subset of tumor cells that can survive from chemotherapy and

  4. Adjustment of women and their husbands to recurrent breast cancer.

    Science.gov (United States)

    Northouse, L L; Laten, D; Reddy, P

    1995-12-01

    The psychosocial adjustment of women with recurrent breast cancer (N = 81) and their husbands (N = 74) were compared to determine if they report different levels of adjustment, support, symptom distress, hopelessness, and uncertainty. Women with recurrent breast cancer reported more emotional distress than their husbands, but both had a similar number of psychosocial role problems. Women and husbands differed in the amount of support and uncertainty they reported but not in the levels of symptom distress or hopelessness they perceived. Women, in contrast to their husbands, expressed more surprise that their cancer recurred and found the recurrent phase of illness more distressing than the initial diagnosis.

  5. Time to surgery and the risk of cancer progression in patients with gynaecologic cancers of the lower genital tract.

    Science.gov (United States)

    Vair, Brett; Altman, Alon D; Nelson, Gregg

    2015-04-01

    Objectif : Nous ne disposons que de peu de données probantes contemporaines pour définir ce qui constitue un délai approprié avant la tenue d’une chirurgie chez des patientes atteintes d’un cancer. Cette étude avait pour but d’examiner si la prolongation du délai avant la tenue d’une chirurgie donne lieu, chez des patientes qui présentent des cancers de stade précoce affectant les voies génitales inférieures, à un risque d’évolution du cancer.  Méthodes : Nous avons mené une étude de cohorte rétrospective en population générale auprès de femmes qui présentaient un carcinome malpighien de stade I affectant le col utérin, la vulve et le vagin, et qui subissaient un traitement chirurgical à Calgary, en Alberta, entre 2000 et 2010. Le stade du cancer et les caractéristiques de la maladie ont été comparées à deux moments distincts : au cours de la consultation initiale auprès du service de gynéco-oncologie et au moment de la chirurgie.  Résultats : Cent cinquante-six patientes ont répondu aux critères d’admissibilité. Une évolution du stade du cancer a été constatée dans 10 cas (6,4 %). Conformément aux cibles actuelles en matière de temps d’attente, le délai avant la tenue d’une chirurgie a été classé comme étant ≤ 28 jours (59 patientes; 38 %) et > 28 jours (97 patientes; 62 %). Une évolution s’est manifestée dans sept des 123 cas de cancer du col utérin (9 %). Dans chacun de ces sept cas, le délai avant la tenue d’une chirurgie avait été > 28 jours (P = 0,095). Aucun des trois cas de cancer du vagin n’a connu une évolution de la maladie. Une évolution s’est manifestée dans trois (10 %) des 30 cas de cancer de la vulve. Dans deux de ces trois cas, le délai avant la tenue d’une chirurgie avait été > 28 jours (P = 0,586). Pour toutes les femmes de la cohorte, le risque relatif d’évolution de la maladie attribuable à la prolongation du délai avant la tenue

  6. Changing patterns of recurrent disease in colorectal cancer

    NARCIS (Netherlands)

    Grossmann, I.; Doornbos, P. M.; Klaase, J. M.; de Bock, G. H.; Wiggers, T.

    2014-01-01

    Background: Due to changes in staging, (neo)-adjuvant treatment and surgical techniques for colorectal cancer (CRC), it is expected that the recurrence pattern will change as well. This study aims to report the current incidence of, and time to recurrent disease (RD), further the localization(s) and

  7. Clinical features and radiotherapy of recurrent breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Moriyama, Rinko (Kurume Univ., Fukuoka (Japan). School of Medicine)

    1990-10-01

    We treated 85 patients with recurrent breast cancer between April 1977 and March 1985. We evaluated the clinical features of recurrence, response to radiotherapy and prognosis. The following results were obtained. The first recurrence occurred in local (chest wall) or regional lymph nodes in about one half of the cases. Tumor response rate to radiotherapy for local recurrence was 77.4%, and the nodular type exhibited the best response. Tumor response rate to radiotherapy for regional lymph node recurrence was 70.6%. Axillary and supraclavicular lymph node recurrence also showed high response rates of 100% and 87.5%, respectively. The highest survival rate was seen with first recurrence in regional lymph nodes, nodular tissue type with local recurrence and in the lung with distant recurrence. The disease free interval (DFI) was less than two years in about 2/3 of the cases. The survival rate increased according to prolongation of the DFI. Radiotherapy for recurrent breast cancer was effective for improvement in quality of life. (author).

  8. Defining Therapy for Recurrent Platinum-sensitive Ovarian Cancer

    Science.gov (United States)

    In this phase III clinical trial, women with platinum-sensitive, recurrent ovarian epithelial, fallopian tube, or primary peritoneal cancer will be randomly assigned to undergo secondary cytoreductive surgery, if they are candidates for such surgery, and

  9. Caspase-3 activity predicts local recurrence in rectal cancer.

    NARCIS (Netherlands)

    Heer, P. de; Bruin, E.C. de; Klein-Kranenbarg, E.; Aalbers, R.I.; Marijnen, C.A.M.; Putter, H.; Bont, H.J. de; Nagelkerke, J.F.; Krieken, J.H.J.M. van; Verspaget, H.W.; Velde, C.J. van de; Kuppen, P.J.

    2007-01-01

    PURPOSE: Radiotherapy followed by total mesorectal excision surgery has been shown to significantly reduce local recurrence rates in rectal cancer patients. Radiotherapy, however, is associated with considerable morbidity. The present study evaluated the use of biochemical detection of enzymatic

  10. Sunitinib Malate in Treating Patients With Iodine-Refractory Recurrent or Metastatic Thyroid Cancer

    Science.gov (United States)

    2015-09-28

    Recurrent Thyroid Cancer; Stage IVA Follicular Thyroid Cancer; Stage IVA Papillary Thyroid Cancer; Stage IVB Follicular Thyroid Cancer; Stage IVB Papillary Thyroid Cancer; Stage IVC Follicular Thyroid Cancer; Stage IVC Papillary Thyroid Cancer; Thyroid Gland Medullary Carcinoma

  11. Primary Recurrence in the Lung is Related to Favorable Prognosis in Patients with Pancreatic Cancer and Postoperative Recurrence.

    Science.gov (United States)

    Zheng, Biao; Ohuchida, Kenoki; Yan, Zilong; Okumura, Takashi; Ohtsuka, Takao; Nakamura, Masafumi

    2017-06-20

    The pattern of recurrence affects the clinical outcome in tumor patients. However, the clinical significance of lung metastasis as the primary recurrence site after resection in patients with pancreatic cancer remains unclear. This study aimed to clarify the clinical significance of the primary recurrence site in patients with pancreatic cancer, in terms of prognosis and clinicopathological features. This retrospective cohort study included 220 patients with postoperative recurrence after pancreatectomy for pancreatic cancer and classified by primary site of recurrence. We focused on patients with lung metastasis as the primary recurrence and investigated its correlation with prognosis and clinicopathological factors. Twenty-four (11%) patients had lung metastasis as the primary recurrence. This recurrence pattern had the best prognosis among all recurrence patterns, including liver metastasis and local recurrence. Patients with lung metastasis as the primary recurrence had favorable overall survival and survival from the date of recurrence compared with patients with other primary recurrence sites in both univariate (P = 0.0008 and P = 0.0005) and multivariate analyses (P = 0.0051 and P = 0.0068). In terms of clinicopathological features of resected pancreatic tumors, lung metastasis as the primary recurrence was associated with lower tumor stage and histologic grade, and less vascular invasion and residual tumor volume than liver metastasis. Pancreatic cancer patients with lung metastasis as the primary recurrence after pancreatectomy have a better prognosis than those with other recurrence patterns.

  12. Acute Recurrent Pancreatitis: A Possible Clinical Manifestation of Ampullary Cancer

    Directory of Open Access Journals (Sweden)

    Athanasios Petrou

    2011-11-01

    Full Text Available Context Acute recurrent pancreatitis still poses diagnostic difficulties. The coexistence or moreover the causative relationship of carcinoma of the ampulla of Vater and acute recurrent pancreatitis is fairly rare. Case report We present a case of carcinoma of the ampulla of Vater that presented with acute recurrent necrotizing pancreatitis complicated with pseudocysts. A diagnosis of malignancy in the ampulla was only made after several ERCP attempts due to residual inflammation at the periampullary area. Conclusion Malignancy at the ampulla of Vater causing recurrent episodes of pancreatitis represents a realistic risk and attempts to diagnose the underlying cause should always take into account the possibility of cancer.

  13. Burden of malignancy after a primary skin cancer: recurrence, multiple skin cancers and second primary cancers.

    Science.gov (United States)

    Krueger, Hans; Williams, Dan

    2010-01-01

    The current paper summarizes relevant recent research on the high risk of recurrence, multiple skin cancers and second primary cancers in the growing number of people with a history of skin cancer; the ultimate purpose is to better assess the burden of malignancy following skin cancer. A number of challenges exist in identifying and tracking both melanoma and non-melanoma skin cancer (NMSC) cases. Most jurisdictions do not routinely track NMSC cases and, even if they do, it is customary to only include the first diagnosis. There are variable rules for counting multiple melanoma cancers, and recurrences are not considered for either major type of skin cancer. Applying insights from recent studies of this issue to Canadian cancer statistics would increase reported diagnoses of NMSC by about 26% and melanoma by 10% in this country. This approach to a fuller assessment of the burden of skin cancers has been called a "diagnosis-based incidence approach" as compared with a "patient-based incidence approach". A further issue that is not usually taken into account when assessing the burden of skin cancers is the 20% to 30% elevated risk of noncutaneous second primary cancers following a primary skin tumour. In summary, individuals with skin cancer are subject to a high risk of recurrence, multiple skin cancers and second primary cancers. This burden should be a special concern in the large and growing pool of individuals with a history of skin cancer, as well as among prevention planners.

  14. Supraclavicular recurrence after early breast cancer: a curable condition?

    DEFF Research Database (Denmark)

    Pedersen, Anders N; Møller, Susanne; Dahl Steffensen, Karina

    2011-01-01

    The prognosis of ipsilateral supraclavicular lymph node recurrence after early breast cancer appears to be worse than for other loco-regional recurrences, but better than for distant metastases. The purpose of the present study was to investigate the relationship between different types of salvage...... treatment and primary patient characteristics, treatment response, and survival after supraclavicular recurrence (SR) in a large patient population. From the Danish Breast Cancer Cooperative Group treatment database 1977-2003, 305 patients were identified with SR without distant disease as site of first...

  15. Hormone therapy for patients with advanced or recurrent endometrial cancer.

    Science.gov (United States)

    Lee, Wen-Ling; Yen, Ming-Shyen; Chao, Kuan-Chong; Yuan, Chiou-Chung; Ng, Heung-Tat; Chao, Hsiang-Tai; Lee, Fa-Kung; Wang, Peng-Hui

    2014-05-01

    The "gold standard" treatment for endometrial cancer is completely staged surgery, followed by radiation or chemotherapy, based on the final pathological surgical stage and requirements. In the primary treatment of endometrial cancers, hormones are rarely taken into consideration after primary surgery. Primary treatment with hormones to preserve fertility in younger women with endometrial cancer is an attractive option, and many successful cases have been reported, although the majority of them finally received definite therapy, including total hysterectomy. The role of hormone therapy is often delayed in recurrent disease; response rates to progestins and tamoxifen or aromatase inhibitors in advanced/recurrent endometrial cancers are approximately 15-20% and nearly ≤ 10%, respectively. This review is focused on updated information and recent knowledge on the use of hormones in the management of women with advanced or recurrent endometrial cancers.

  16. Pulmonary recurrence in patients with endometrial cancer

    Directory of Open Access Journals (Sweden)

    Taner Turan

    2016-04-01

    Conclusion: Advanced stage is associated with PR. If recurrence is only in the lung, survival is better. Systemic treatment after PR is associated with improved survival. However, multi-center studies are required to standardize the treatment for PR.

  17. Management of locally advanced primary and recurrent rectal cancer

    NARCIS (Netherlands)

    J.H.W. de Wilt (Johannes); M. Vermaas (Maarten); F.T.J. Ferenschild (Floris); C. Verhoef (Kees)

    2007-01-01

    textabstractTreatment for patients with locally advanced and recurrent rectal cancer differs significantly from patients with rectal cancer restricted to the mesorectum. Adequate preoperative imaging of the pelvis is therefore important to identify those patients who are candidates for multimodality

  18. Real-time RT-PCR systems for CTC detection from blood samples of breast cancer and gynaecological tumour patients (Review).

    Science.gov (United States)

    Andergassen, Ulrich; Kölbl, Alexandra C; Mahner, Sven; Jeschke, Udo

    2016-04-01

    Cells, which detach from a primary epithelial tumour and migrate through lymphatic vessels and blood stream are called 'circulating tumour cells'. These cells are considered to be the main root of remote metastasis and are correlated to a worse prognosis concerning progression-free and overall survival of the patients. Therefore, the detection of the minimal residual disease is of great importance regarding therapeutic decisions. Many different detection strategies are already available, but only one method, the CellSearch® system, reached FDA approval. The present review focusses on the detection of circulating tumour cells by means of real-time PCR, a highly sensitive method based on differences in gene expression between normal and malignant cells. Strategies for an enrichment of tumour cells are mentioned, as well as a large panel of potential marker genes. Drawbacks and advantages of the technique are elucidated, whereas, the greatest advantage might be, that by selection of appropriate marker genes, also tumour cells, which have already undergone epithelial to mesenchymal transition can be detected. Finally, the application of real-time PCR in different gynaecological malignancies is described, with breast cancer being the most studied cancer entity.

  19. Risk Factors of the Invasive Breast Cancer Locoregional Recurrence

    Directory of Open Access Journals (Sweden)

    R. V. Liubota

    2015-01-01

    Full Text Available Background. The aim of the research was to estimate the frequency of the locoregional breast cancer recurrence appearance, the recurrence-free period continuance, and the 3- and 5-year survival depending on the scope of the surgical intervention, menstrual profile, and histological and molecular-biologic characteristics of the primary tumor. Patients and Methods. Among 218 patients with a breast cancer, 99 patients had breast-conserving surgery (BCS and 119 underwent radical mastectomy (RME; all patients had regional lymphatic nodes dissection. The size and the primary tumor differentiation degree, metastasis presence in the regional lymph nodes, ER expression, PR, and Her/2neu were assessed as the prognostics factors. Results. It was defined that the locoregional recurrence appearance frequency in patients with BCS turned out to be 13%, and in patients after RME it turned out to be 9%; the recurrence-free period continuance was 53±8 months and 56±10 months, respectively. Conclusions. The locoregional cancer recurrence frequency is higher in women with the menstrual function being preserved at the moment of the primary tumor detection than in postmenopausal patients and also in patients having the hyperexpression of the Her/2neu. The ipsilateral cancer recurrence decreases the 3-year survival by 7,1% and the 5-year one by 20,3%, respectively.

  20. Early and late vulval cancer recurrences: Are they different?

    Science.gov (United States)

    Ragupathy, Kalpana; Grandidge, Lisa; Strelley, Katie; Wang, Huan; Tidy, John

    2016-05-01

    Vulval cancers are rare, but after primary treatment, known to recur with a high frequency (30%). Clinico-pathological predictors of recurrence have been established to a great extent. However, there is paucity of literature on predictors of early versus late recurrence. We sought to identify such predictors through a retrospective study of vulval cancer recurrences in a single cancer centre over 11 years. Age of women, depth of invasion/site of primary tumour and presence of background VIN/lichen sclerosus do not appear to affect timing of recurrence. However, vulval cancers that recur after 2 years of primary tumour recognition are more likely to be well-differentiated tumours, have undergone radical surgery and have had a closest disease-free margin >1 cm. Late recurrences are entirely local rather than distant metastases and this translates into a better survival as shown in our study (40 months median survival in the early group versus 112 in the late recurrence group).

  1. GYNAECOLOGICAL TURP SYNDROME

    Directory of Open Access Journals (Sweden)

    Vincent

    2015-07-01

    Full Text Available Hysteroscopy is used extensively in Gynaecological practice both for diagnostic & therapeutic conditions . The technique of endoscopy guided electrosurgical resection was adapted from urology to gynaecology for the removal of uterine leiomyomas . . Under normal circumstances uterine cavity is a potential space and the anterior & posteri or walls are in apposition . A distension medium is required to expand the endometrial cavity for viewing . These may be of 2 types . 1 . Gaseous e . g ., co 2 . 2 . Liquid media . e. g ., Glycine 1 . 5%, 3 . 3% sorbitol, Mannitol, Cytal & urea . Each one, is having its ow n advantages & dis advantages . We used glycine 1 . 5% as distending media because it is readily available, cheap, fairly good visibility, compatible with electrocautery . Major disadvantage is, it intravasates into vascular tree in significant amounts causing profound Hyponatremia, Hypervolemia and finally pulmonary congestion or pulmonary edema depending upon to patients cardiac reserve . We named this complication as “Gynaecological TURP syndrome as, similar complication usually occur in TURP surgery for Benign enlargement of prostate . 1 We report this complication as a case report . A young patient aged 32 years under went hysteroscopic submucous resection of fibroid using Glycine 1 . 5% as distending media and because positve fluid over load of 2 litres , Patient developed Hyponatremia, pulmonary edema, Diagnosed immediately & successfully treated .

  2. Chemotherapy and molecular targeting therapy for recurrent cervical cancer

    Science.gov (United States)

    Tsuda, Naotake; Watari, Hidemichi; Ushijima, Kimio

    2016-01-01

    For patients with primary stage ⅣB, persistent, or recurrent cervical cancer, chemotherapy remains the standard treatment, although it is neither curative nor associated with long-term disease control. In this review, we summarized the history of treatment of recurrent cervical cancer, and the current recommendation for chemotherapy and molecular targeted therapy. Eligible articles were identified by a search of the MEDLINE bibliographical database for the period up to November 30, 2014. The search strategy included the following any or all of the keywords: “uterine cervical cancer”, “chemotherapy”, and “targeted therapies”. Since cisplatin every 21 days was considered as the historical standard treatment for recurrent cervical cancer, subsequent trials have evaluated and demonstrated activity for other agents including paclitaxel, gemcitabine, topotecan and vinorelbine among others. Accordingly, promising agents were incorporated into phase Ⅲ trials. To examine the best agent to combine with cisplatin, several landmark phase Ⅲ clinical trials were conducted by Gynecologic Oncology Group (GOG) and Japan Clinical Oncology Group (JCOG). Through, GOG204 and JCOG0505, paclitaxel/cisplatin (TP) and paclitaxel/carboplatin (TC) are now considered to be the recommended therapies for recurrent cervical cancer patients. However, the prognosis of patients who are already resistant to chemotherapy, are very poor. Therefore new therapeutic strategies are urgently required. Molecular targeted therapy will be the most hopeful candidate of these strategies. From the results of GOG240, bevacizumab combined with TP reached its primary endpoint of improving overall survival (OS). Although, the prognosis for recurrent cervical cancer patients is still poor, the results of GOG240 shed light on the usefulness of molecular target agents to chemotherapy in cancer patients. Recurrent cervical cancer is generally considered incurable and current chemotherapy regiments

  3. Everolimus, Erlotinib Hydrochloride, and Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer Previously Treated With Radiation Therapy

    Science.gov (United States)

    2016-03-01

    Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Tongue Cancer

  4. Stromal myofibroblasts predict disease recurrence for colorectal cancer.

    Science.gov (United States)

    Tsujino, Tadashi; Seshimo, Iwao; Yamamoto, Hirofumi; Ngan, Chew Yee; Ezumi, Koji; Takemasa, Ichiro; Ikeda, Masataka; Sekimoto, Mitsugu; Matsuura, Nariaki; Monden, Morito

    2007-04-01

    Myofibroblasts, which are specifically differentiated fibroblasts, are thought to play a central role in the desmoplastic reaction, a dynamic stromal change closely associated with cancer development. Although fundamental studies suggest that myofibroblasts may either facilitate or inhibit cancer progression, cumulative evidence supports their role in promoting tumor progression. The aim of this study was to assess the value of myofibroblasts in the cancer stroma as an indicator of disease recurrence after colorectal cancer surgery. Using computer-assisted image analysis, we quantified myofibroblasts in the cancer-associated stroma of 192 colorectal cancers using alpha-smooth muscle actin as a marker. The cancer-associated stroma contained various numbers of myofibroblasts (0.35-19.0%; mean, 5.55 +/- 3.85%). Tumors with abundant myofibroblasts were associated with shorter disease-free survival rate (P = 0.001) for stage II and III colorectal cancer. Multivariate analysis indicated that alpha-smooth muscle actin was a significant prognostic factor comparable with lymph node metastasis and superior to other tumor and stromal components, including histology of the tumor invasive front, peritumoral lymphocytic infiltration, and Crohn's-like lymphoid reaction. Moreover, colorectal cancers with synchronous liver metastasis generally displayed an active desmoplastic reaction, which was retained in the metastatic lesion to a similar extent. The results suggest that the abundance of myofibroblasts in cancer-associated stroma may be a useful indicator of disease recurrence after curative colorectal cancer surgery.

  5. Smoking and prostate cancer survival and recurrence

    Institute of Scientific and Technical Information of China (English)

    Roberto L Muller; Daniel M Moreira

    2011-01-01

    Smooking is associated with several major benign and malignant diseases,representing one of the most important modifiable risk factors.Among urothelial neoplasms,smoking is pivotal in tumor carcinogenesis,but its role in prostate cancer is still controversial.Many authors have failed to demonstrate an association between smoking and prostate cancer.1-3 However,large epidemiological studies have shown that smoking is associated with higher risk of developing and dying of prostate cancer.4 Thus,large sample sizes and long follow-ups are important when studying prostate cancer given that its natural history can be quite long.

  6. Breast cancer with inguinal node recurrence

    Directory of Open Access Journals (Sweden)

    Shikha Goyal

    2015-03-01

    Full Text Available Surgery and irradiation for breast cancer may interfere with conventional pathways of spread, leading to bizarre patterns of dissemination through lymphatics or through hematogenous route. Lymphoscintigraphic studies may help identify nodal involvement. Other possible reasons could be occurrence of primary breast cancer in accessory breast tissue retained in the vulva following involution of milk line. We describe a case of triple negative breast cancer, who developed contralateral breast cancer during treatment. Three years later, she developed isolated inguinal nodal metastases, which responded to local radiotherapy and chemotherapy. However, the patient relapsed after 2 years and could not be salvaged thereafter.

  7. Manganese superoxide dismutase and breast cancer recurrence

    DEFF Research Database (Denmark)

    Cronin-Fenton, Deirdre P; Christensen, Mariann; Lash, Timothy L

    2014-01-01

    BACKGROUND: Manganese superoxide dismutase (MnSOD) inhibits oxidative damage and cancer therapy effectiveness. A polymorphism in its encoding gene (SOD2: Val16Ala rs4880) may confer poorer breast cancer survival, but data are inconsistent. We examined the association of SOD2 genotype and breast...

  8. Imaging of prostate cancer local recurrences: why and how?

    Energy Technology Data Exchange (ETDEWEB)

    Rouviere, Olivier; Lyonnet, Denis [Universite de Lyon, Lyon (France); Universite Lyon 1, Faculte de Medecine Lyon Nord (France); Service d' Imagerie Urinaire et Vasculaire, Hospices Civils de Lyon, Hopital Edouard Herriot, Lyon (France); INSERM U 556, Lyon (France); Vitry, Thierry [Service d' Imagerie Urinaire et Vasculaire, Hospices Civils de Lyon, Hopital Edouard Herriot, Lyon (France)

    2010-05-15

    Because prostate cancer local recurrences can be efficiently treated by salvage therapies, it becomes critical to detect them early. The first alert is the rise of the prostate specific antigen (PSA) level after the post-treatment nadir, which can correspond to a distant recurrence, a local recurrence or both. This so-called biochemical failure (BF) is defined as PSA level >0.2 ng/ml after radical prostatectomy (RP) and PSA level > nadir+2 ng/ml after radiotherapy. There is no consensual definition of BF after cryotherapy, high-intensity focused ultrasound (HIFU) ablation or brachytherapy. Local recurrences after RP are treated by radiotherapy, those after radiotherapy by RP, cryotherapy, brachytherapy or HIFU ablation. Recurrences after cryotherapy or HIFU ablation can be treated by a second session or radiotherapy. Recurrences after brachytherapy are difficult to treat. In patients with BF, MRI can detect local recurrences, whatever the initial treatment was. Dynamic contrast-enhanced MRI seems particularly accurate. The role of spectroscopy remains controversial. Ultrasound-based techniques are less accurate, but this may change with the advent of ultrasonic contrast media. These recent advances in imaging may improve the outcome of salvage therapies (by improving patient selection and treatment targeting) and should open the way to focal salvage treatments in the near future. (orig.)

  9. Biochemical recurrence of prostate cancer: the controversial recognition and management

    Institute of Scientific and Technical Information of China (English)

    XIA Shu-jie; JING Yi-feng

    2011-01-01

    @@ Over the past decaade, more and more patients diagnosed as prostate cancer have received radical management attributing to the advent of prostate-specific antigen (PSA) based medical screening.Radical prostatectomy (RP) and radiation therapy (RT) are the most commonly used forms of definitive therapy for clinically localized prostate cancer.However, despite these technique advances, biochemical recurrence (BCR),as determined by subsequent rises in the serum PSA level,is still a challenge that urologists face.

  10. Convolutional neural networks for prostate cancer recurrence prediction

    Science.gov (United States)

    Kumar, Neeraj; Verma, Ruchika; Arora, Ashish; Kumar, Abhay; Gupta, Sanchit; Sethi, Amit; Gann, Peter H.

    2017-03-01

    Accurate prediction of the treatment outcome is important for cancer treatment planning. We present an approach to predict prostate cancer (PCa) recurrence after radical prostatectomy using tissue images. We used a cohort whose case vs. control (recurrent vs. non-recurrent) status had been determined using post-treatment follow up. Further, to aid the development of novel biomarkers of PCa recurrence, cases and controls were paired based on matching of other predictive clinical variables such as Gleason grade, stage, age, and race. For this cohort, tissue resection microarray with up to four cores per patient was available. The proposed approach is based on deep learning, and its novelty lies in the use of two separate convolutional neural networks (CNNs) - one to detect individual nuclei even in the crowded areas, and the other to classify them. To detect nuclear centers in an image, the first CNN predicts distance transform of the underlying (but unknown) multi-nuclear map from the input HE image. The second CNN classifies the patches centered at nuclear centers into those belonging to cases or controls. Voting across patches extracted from image(s) of a patient yields the probability of recurrence for the patient. The proposed approach gave 0.81 AUC for a sample of 30 recurrent cases and 30 non-recurrent controls, after being trained on an independent set of 80 case-controls pairs. If validated further, such an approach might help in choosing between a combination of treatment options such as active surveillance, radical prostatectomy, radiation, and hormone therapy. It can also generalize to the prediction of treatment outcomes in other cancers.

  11. [Ultrasound semiotics in recurrent ovarian cancer after optimal cytoreductive surgery].

    Science.gov (United States)

    Baklanova, N S; Kolomiets, L A; Frolova, I G; Viatkina, N V; Krasil'nikov, S É

    2014-01-01

    Features of ultrasound picture of morphologically verified recurrence of ovarian cancer in 21 patients are presented, who received combined treatment including cytoreductive surgery in the form of hysterectomy with oophorectomy, resection of the greater omentum and 6 courses of chemotherapy CAP for ovarian cancer stage III (FIGO). In all patients cytoreductive surgery was optimal--without residual tumor. Recurrence of the disease was detected in 12-48 months in 80.9% of the cases. Three variants of recurrence was revealed by ultrasonography: isolated peritoneal dissemination, in 14.2% of the cases, which was mainly detected during the first 12 months; single entities in the projection of the small pelvis (61.9%) and mixed form (local lesions of small pelvis and peritoneal dissemination) in 23.8% of the cases.

  12. Analysis of Recurrence Factor of Postoperative Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    XING Lan-lan;CHEN Song;LI Ya-ming

    2014-02-01

    Full Text Available To investigate the factors that influences the recurrence of papillary thyroid cancer,69 patients with papillary thyroid cancer since January 1, 2011 to march 30, 2013 were analyzed respectively. They meet the inclusion criteria and complete clinical data, 18 males and 51 females,average age: 40.17±12.97.Thyroid ultrasonography, thyroid function test, thyroglobulin and antibody measurement were performed on all patients and thyroid function were checked three or more times on the premise of continuously levothyroxine. Single factor analysis were performed using SPSS17.0 in these respects including patients' gender, age, tumor size, type of opetation, the inhibition degree of TSH with taking levothyroxine postoperative and whether to perform 131I thyroid remnant ablation. Binary Logistic regression analysis were used for studying recurrence factors in multivariate analysis. The ROC curve were drawn, and then determine the threshold of TSH to evaluate tumor recurrence using Youden index method. Unvaried analysis showed that there was no statistically significance between papillary thyroid cancer recurrence and patients' age, surgical approach (P =0.373, P = 0.226,but were related to patient's gender, tumor size, postoperative TSH suppression degree and the removal of residual thyroid tissue postoperative(P= 0.031, P = 0.004, P = 0.000 01, P = 0.000 05. Males, large tumors, high postoperative TSH values and patients who didn't remove the residual thyroid tissue after surgery had higher recurrence rate. Logistic regression analysis showed that tumor size, postoperative TSH suppression degree and whether to remove the residual thyroid tissue were the influencing factors of tumor recurrence. The postoperative TSH supressive degree evaluation of critical point of tumor recurrence was determined by 0.223 5 mU/L using the Yueden index method. Large tumors, high postoperative TSH values,and no removal of the residual thyroid tissue had more influence

  13. Multiparametric Magnetic Resonance Imaging of Recurrent Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Daniel Corey Oppenheimer

    2016-01-01

    Full Text Available Multiparametric magnetic resonance (MR imaging of the prostate combines both morphological and functional MR techniques by utilizing small field of view T1-weighted, T2-weighted, diffusion-weighted imaging, dynamic contrast-enhanced imaging, and MR spectroscopy to accurately detect, localize, and stage primary and recurrent prostate cancer. Localizing the site of recurrence in patients with rising prostate-specific antigen following treatment affects decision making regarding treatment and can be accomplished with multiparametric prostate MR. Several different treatment options are available for prostate cancer including radical prostatectomy, external beam radiation therapy, brachytherapy, androgen deprivation therapy, or a number of focal therapy techniques. The findings of recurrent prostate cancer can be different depending on the treatment the patient has received, and the radiologist must be able to recognize the variety of imaging findings seen with this common disease. This review article will detail the findings of recurrent prostate cancer on multiparametric MR and describe common posttreatment changes which may create challenges to accurate interpretation.

  14. Electrochemotherapy for large cutaneous recurrence of breast cancer

    DEFF Research Database (Denmark)

    Matthiessen, Louise Wichmann; Johannesen, Helle Hjorth; Hendel, Helle Westergren;

    2012-01-01

    Cutaneous recurrences of breast cancer may cause considerable discomfort due to ulceration, oozing, and pain and can also be difficult to treat. Electrochemotherapy is a localised anticancer treatment using electric pulses to make cell membranes permeable, augmenting uptake of chemotherapeutic dr...

  15. Exemestane Following Tamoxifen Reduces Breast Cancer Recurrences and Prolongs Survival

    Science.gov (United States)

    Postmenopausal women with early-stage hormone receptor-positive breast cancer had delayed disease recurrence and longer survival after taking 2-3 years of tamoxifen followed by exemestane for a total of 5 years compared to taking tamoxifen for 5 years.

  16. Drug combination may be highly effective in recurrent ovarian cancer

    Science.gov (United States)

    Significant improvement with the use of a combination drug therapy for recurrent ovarian cancer was reported at the annual meeting of the American Society of Clinical Oncology meeting in Chicago. The trial compared the activity of a combination of the dru

  17. Prevalence of local recurrence of colorectal cancer at the Iranian Cancer Institute.

    Science.gov (United States)

    Omranipour, Ramesh; Mahmoodzadeh, Habibollah; Safavi, Farinaz

    2014-01-01

    Although a great deal of progress has been made in the management of colorectal cancer in terms of neoadjuvant modalities, surgical techniques and adjuvant therapies, the recurrence of tumors remains an enigmatic complication in patients. A better understanding of colorectal cancer and of factors that lead to recurrence of disease can provide helpful information for designing more effective screening and surveillance methods. To investigate the factors that may lead to local recurrence of colorectal cancers. The current retrospective case study evaluated 617 patients admitted to the Iranian Cancer Institute (the largest referral cancer center in the country) from 1995 to 2009 with confirmed colorectal cancer. Patients with distant metastasis, or with pathology other than adenocarcinoma and no follow-up, were excluded (175 patients). The remainder (442) included 294 (66.5%) with rectal cancer and 148 (33.5%) with colon cancer. The median duration of follow-up was 26 months. The total rate of recurrence was 17.4%, comprising 19.6% and 16.3% recurrence rates in colon and rectal cancer, respectively. Recurrence of colorectal cancer was significantly correlated to tumor grade (p<0.008).

  18. RECURRENCE OF BREAST CANCER AFTER SUBCUTANEOUS MASTECTOMY WITH SIMULTANEOUS RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    A. D. Zikiryakhodzhaev

    2014-01-01

    Full Text Available Objective. To analyze the recurrence after radical subcutaneous mastectomy or konohana of mastectomy.Materials and methods. In FMIC them.P. A. Herzen patients performed radical subcutaneous mastectomy (95,5% or konohana radical mastectomy (4.5 per cent. When radical subcutaneous mastectomy keep the skin of the breast, the nipple-areola complex (NAC, submammary fold, remove the entire gland tissue together with the axillary, subclavian and subscapularis lymph nodes. Konohana mastectomy differs from subcutaneous mastectomy with removal of the nipple-areola complex. Distribution of patients according to tumor stage process as follows: 0 (ТisN0М0 - 33 (4,3%, I - 180 (23,2%, IIA - 283 (36,6%, IIB - 123 (15,9%, IIIA - 91 (11,7%, IIIБ - 1 (0,1%, IIIС - 41 (5,3 % IY - 6 (0,8%, 16 (2,1% patients the operation was performed after recurrence of breast cancer.Results. In our study the recurrence was diagnosed in 37 (4,8% patients. A minimum of recurrences of 8 months, maximum 10 years. Repeated local recurrences after treatment was 2. Local recurrence was diagnosed in 35 (4,5% patients. Regional recurrence was diagnosed in 3 (0,4% of patients, in one case after local recurrence. Regional recurrences detected in 2 (0,3% cases in the armpit and 1 (0,1% case in the infraclavicular region. The likelihood of regional recurrence is often associated with errors in surgical technique the operation. During follow-up revealed 3 (0,4% cases of cancer Paget’s disease in the area of the nipple-areola complex. All 3 (0,4% of cases the treatment was surgical and meant excision of the nipple-areola complex. In 1 (0,1% patients diagnosed with breast cancer in the second breast after 7 years.In the area of the nipple-areola complex in the Central quadrant of the recurrence was diagnosed in 6 of the 35 local recurrence, which amounted to 17,1%. Among patients with konohana radical mastectomy recurrence in the Central quadrant is not

  19. nMET, A New Target in Recurrent Cancer.

    Science.gov (United States)

    Xie, Yingqiu; Istayeva, Sholpan; Chen, Zhanlin; Tokay, Tursonjan; Zhumadilov, Zhaxybay; Wu, Denglong; Hortelano, Gonzalo; Zhang, Jinfu

    2016-01-01

    Membranous Met is classically identified with its role in cancer metastases, while nuclear Met is associated with a more invasive, aggressive and proliferative form of cancer. Full-length Met or N-terminal transmembrane domain cleaved Met can translocate into nucleus in a cell growth and pH dependent but both ligand-dependent (full length Met) and -independent (cleaved Met) manner. nMET may play greater essential roles in cancer recurrence than membranous Met. For example, in prostate cancer, it has been found that androgen receptor (AR) may inhibit the expression of membranous Met so anti-androgen based prostate cancer therapy may promote the expression of nuclear Met (nMET). We recently found a novel nMET/SOX9/ β-Catenin/AR pathway in relapsed prostate cancer which may contribute to the formation of the feedback loop of AR reactivation via MET/nMET. Emerging evidence suggests the possibility of nMET as a prognostic marker in relapsed cancer. This review summarizes recent findings about nMET and its unique role in recurrent cancer.

  20. Impact of anesthesia on cancer recurrence.

    Science.gov (United States)

    Lee, B M; Cata, J P

    2015-12-01

    Surgery remains the mainstay treatment in the majority of solid cancers. Anesthetics and analgesics used during the perioperative period may modulate the innate and adaptive immune system, inflammation and angiogenesis, and have a direct effect on cancer cells that could ultimately modify oncological outcomes. For instance, volatile anesthetics and opioid analgesics have shown predominantly pro-tumor effects, while propofol, non-steroid anti-inflammatory drugs have mostly anticancer effects. Researchers have been especially interested in investigating the association between the use of regional anesthesia techniques and the postoperative survival of patients with cancers. Since the results of the current retrospective studies are conflicting, several researchers are conducting prospective randomized trials. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Paclitaxel Albumin-Stabilized Nanoparticle Formulation and Carboplatin Followed By Chemoradiation in Treating Patients With Recurrent Head and Neck Cancer

    Science.gov (United States)

    2017-05-22

    Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Tongue Cancer

  2. Prognostic Aspects of DCE-MRI in Recurrent Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Gollub, M.J.; Gultekin, D.H.; Sohn, M. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Cao, K. [Peking University Cancer Hospital and Institute, Department of Radiology, Beijing (China); Kuk, D.; Gonen, M. [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics, New York, NY (United States); Schwartz, L.H. [Columbia University Medical Center/New York Presbyterian Hospital, Department of Radiology, New York, NY (United States); Weiser, M.R.; Temple, L.K.; Nash, G.M.; Guillem, J.G.; Garcia-Aguilar, J.; Paty, P.B. [Memorial Sloan-Kettering Cancer Center, Department of Surgery, New York, NY (United States); Wang, M. [Fudan University Shanghai Cancer Center, Department of Colorectal Surgery, Shanghai (China); Goodman, K. [Memorial Sloan-Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States)

    2013-12-15

    To explore whether pre-reoperative dynamic contrast-enhanced (DCE)-MRI findings correlate with clinical outcome in patients who undergo surgical treatment for recurrent rectal carcinoma. A retrospective study of DCE-MRI in patients with recurrent rectal cancer was performed after obtaining an IRB waiver. We queried our PACS from 1998 to 2012 for examinations performed for recurrent disease. Two radiologists in consensus outlined tumour regions of interest on perfusion images. We explored the correlation between K{sup trans}, K{sub ep}, V{sub e}, AUC90 and AUC180 with time to re-recurrence of tumour, overall survival and resection margin status. Univariate Cox PH models were used for survival, while univariate logistic regression was used for margin status. Among 58 patients with pre-treatment DCE-MRI who underwent resection, 36 went directly to surgery and 18 had positive margins. K{sup trans} (0.55, P = 0.012) and K{sub ep} (0.93, P = 0.04) were inversely correlated with positive margins. No significant correlations were noted between K{sup trans}, K{sub ep}, V{sub e}, AUC90 and AUC180 and overall survival or time to re-recurrence of tumour. K{sup trans} and K{sub ep} were significantly associated with clear resection margins; however overall survival and time to re-recurrence were not predicted. Such information might be helpful for treatment individualisation and deserves further investigation. (orig.)

  3. Multimodality treatment of recurrent pancreatic cancer: Mith or reality?

    Institute of Scientific and Technical Information of China (English)

    Cosimo; Sperti; Lucia; Moletta; Stefano; Merigliano

    2015-01-01

    Pancreatic adenocarcinoma is the fourth cause of cancerrelated death in the United States. Surgery is the only potentially curative treatment, but most patients present at diagnosis with unresectable or metastatic disease. Moreover, even with an R0 resection, the majority of patients will die of disease recurrence. Most recurrencesoccur in the first 2-year after pancreatic resection, and are commonly located in the abdomen, even if distant metastases can occur. Recurrent pancreatic adenocarcinoma remains a significant therapeutic challenge, due to the limited role of surgery and radiochemotherapy. Surgical management of recurrence is usually unreliable because tumor relapse typically presents as a technically unresectable, or as multifocal disease with an aggressive growth. Therefore, treatment of patients with recurrent pancreatic adenocarcinoma has historically been limited to palliative chemotherapy or supportive care. Only few data are available in the Literature about this issue, even if in recent years more studies have been published to determine whether treatment after recurrence have any effect on patients outcome. Recent therapeutic advances have demonstrated the potential to improve survival in selected patients who had undergone resection for pancreatic cancer. Multimodality management of recurrent pancreatic carcinoma may lead to better survival and quality of life in a small but significant percentage of patients; however, more and larger studies are needed to clarify the role of the different therapeutic options and the optimal way to combine them.

  4. Neurotrophin in obstetrics and gynaecology.

    Science.gov (United States)

    Bose, Chinmoy K

    2009-01-01

    Since Rita Levi Montalcini and Stanley Cohen received Nobel Prize for their pioneering work on nerve growth factor (NGF), its role in female reproductive system has been reinforced in last two decades. The neurotrophins (NT) including nerve growth factor (NGF) are a family of related growth factors and their respective receptor tyrosine kinases that are of major importance in the regulation of neuronal survival and differentiation. While role of NGF in mast cell-mediated egg implantation and inhibition of rejection were primary concern at their time, in the ovary NGF can help in the differentiation process by which ovarian follicles become responsive to gonadotrophins. They help in follicular maturation, steroid secretion and ovulation in the ovary, by inducing the FSH receptor (FSHR). Due to the pleiotropism, NGF is mandatory for the success of pregnancy, while progesterone helping to maintain local levels of NGF in utero. In endometriosisi and polycystic ovarian disease it has major role to play. An autocrine role of NGF in breast cancer and epithelial ovarian cancer (EOC) is evident now. Thus its study will infuse new insight in diseases of both obstetrics and gynaecology.

  5. Beliefs and Behaviors about Breast Cancer Recurrence Risk Reduction among African American Breast Cancer Survivors

    Directory of Open Access Journals (Sweden)

    Benjamin Ansa

    2015-12-01

    Full Text Available A growing body of evidence suggests that breast cancer recurrence risk is linked to lifestyle behaviors. This study examined correlations between breast cancer recurrence, risk reduction beliefs, and related behaviors among African American breast cancer survivors (AA BCSs. Study participants included 191 AA BCSs, mean age = 56.3 years, who completed a lifestyle assessment tool. Most respondents believed that being overweight (52.7%, lack of physical activity (48.7%, and a high fat diet (63.2% are associated with breast cancer recurrence. Over 65% considered themselves overweight; one third (33.5% agreed that losing weight could prevent recurrence, 33.0% disagreed, while the remaining 33.5% did not know; and nearly half (47.9% believed that recurrence could be prevented by increasing physical activity. Almost 90% survivors with BMI < 25 Kg/M2 reported no recurrence compared to 75.7% with BMI ≥ 25 Kg/M2 (p = 0.06; nearly all of the women (99.2% answered “yes” to seeking professional help to lose weight, 79.7% of which were recurrence-free (p = 0.05. These results provide information about AA BCSs’ beliefs and behaviors protective against breast cancer recurrence. Additional research is warranted to determine the effectiveness of educational interventions for AA BCSs that promote consumption of a healthy diet and engaging in regular physical activity.

  6. Eliminating Late Recurrence to Eradicate Breast Cancer

    Science.gov (United States)

    2014-09-01

    Polyak K , Weinberg RA . Transitions between epithelial and mesen- chymal states: acquisition of malignant and stem cell traits . Nat Rev...mediated autophagy (CMA) (Mizushima, 2007). CMA warrants special attention because of its emerging role in cancer (Kon et al., 2011; Lv et al., 2011...bisphosphate, and the levels of ATP ( Lv et al., 2011). Recently, PKM2- specific deletion was shown to have increased mammary tumor formation driven by

  7. Metformin: A Potential Therapeutic Agent for Recurrent Colon Cancer

    Science.gov (United States)

    Nangia-Makker, Pratima; Yu, Yingjie; Vasudevan, Anita; Farhana, Lulu; Rajendra, Sindhu G.; Levi, Edi; Majumdar, Adhip P. N.

    2014-01-01

    Accumulating evidence suggests that metformin, a biguanide class of anti-diabetic drugs, possesses anti-cancer properties. However, most of the studies to evaluate therapeutic efficacy of metformin have been on primary cancer. No information is available whether metformin could be effectively used for recurrent cancer, specifically colorectal cancer (CRC) that affects up to 50% of patients treated by conventional chemotherapies. Although the reasons for recurrence are not fully understood, it is thought to be due to re-emergence of chemotherapy-resistant cancer stem/stem-like cells (CSCs/CSLCs). Therefore, development of non-toxic treatment strategies targeting CSCs would be of significant therapeutic benefit. In the current investigation, we have examined the effectiveness of metformin, in combination with 5-fluorouracil and oxaliplatin (FuOx), the mainstay of colon cancer therapeutics, on survival of chemo-resistant colon cancer cells that are highly enriched in CSCs/CSLCs. Our data show that metformin acts synergistically with FuOx to (a) induce cell death in chemo resistant (CR) HT-29 and HCT-116 colon cancer cells, (b) inhibit colonospheres formation and (c) enhance colonospheres disintegration. In vitro cell culture studies have further demonstrated that the combinatorial treatment inhibits migration of CR colon cancer cells. These changes were associated with increased miRNA 145 and reduction in miRNA 21. Wnt/β-catenin signaling pathway was also down-regulated indicating its pivotal role in regulating the growth of CR colon cancer cells. Data from SCID mice xenograft model of CR HCT-116 and CR HT-29 cells show that the combination of metformin and FuOX is highly effective in inhibiting the growth of colon tumors as evidenced by ∼50% inhibition in growth following 5 weeks of combination treatment, when compared with the vehicle treated controls. Our current data suggest that metformin together with conventional chemotherapy could be an effective treatment

  8. Metformin: a potential therapeutic agent for recurrent colon cancer.

    Directory of Open Access Journals (Sweden)

    Pratima Nangia-Makker

    Full Text Available Accumulating evidence suggests that metformin, a biguanide class of anti-diabetic drugs, possesses anti-cancer properties. However, most of the studies to evaluate therapeutic efficacy of metformin have been on primary cancer. No information is available whether metformin could be effectively used for recurrent cancer, specifically colorectal cancer (CRC that affects up to 50% of patients treated by conventional chemotherapies. Although the reasons for recurrence are not fully understood, it is thought to be due to re-emergence of chemotherapy-resistant cancer stem/stem-like cells (CSCs/CSLCs. Therefore, development of non-toxic treatment strategies targeting CSCs would be of significant therapeutic benefit. In the current investigation, we have examined the effectiveness of metformin, in combination with 5-fluorouracil and oxaliplatin (FuOx, the mainstay of colon cancer therapeutics, on survival of chemo-resistant colon cancer cells that are highly enriched in CSCs/CSLCs. Our data show that metformin acts synergistically with FuOx to (a induce cell death in chemo resistant (CR HT-29 and HCT-116 colon cancer cells, (b inhibit colonospheres formation and (c enhance colonospheres disintegration. In vitro cell culture studies have further demonstrated that the combinatorial treatment inhibits migration of CR colon cancer cells. These changes were associated with increased miRNA 145 and reduction in miRNA 21. Wnt/β-catenin signaling pathway was also down-regulated indicating its pivotal role in regulating the growth of CR colon cancer cells. Data from SCID mice xenograft model of CR HCT-116 and CR HT-29 cells show that the combination of metformin and FuOX is highly effective in inhibiting the growth of colon tumors as evidenced by ∼ 50% inhibition in growth following 5 weeks of combination treatment, when compared with the vehicle treated controls. Our current data suggest that metformin together with conventional chemotherapy could be an

  9. [Use of misoprostol in gynaecology].

    Science.gov (United States)

    Lesavre, M; Legendre, G; Fernandez, H

    2014-02-01

    To assess the interest of misoprostol in gynaecology and particularly for cervical priming. Research in PubMed in English and French about misoprostol and its use in gynaecology. We summarized the results of 3 meta-analyses, randomized controlled trials and literature review. Results show that misoprostol did not scientifically prove a benefit for cervical priming before hysteroscopy or before intra-uterine device (IUD). Results are the same with post-menopausal or nulliparous women. It did not lead either to lower the complications but increase adverse effects. It is not indicated to use misoprostol for cervical priming in gynaecology. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  10. Anaesthesia for robotic gynaecological surgery.

    Science.gov (United States)

    Gupta, K; Mehta, Y; Sarin Jolly, A; Khanna, S

    2012-07-01

    Robotic surgery is gaining widespread popularity due to advantages such as reduced blood loss, reduced postoperative pain, shorter hospital stay and better visualisation of fine structures. Robots are being used in urological, cardiac, thoracic, orthopaedic, gynaecological and general surgery. Robotic surgery received US Food and Drug Administration approval for use in gynaecological surgery in 2005. The various gynaecological robotic operations being performed are myomectomy, total and supracervical hysterectomy, ovarian cystectomy, sacral colpopexy, tubal reanastomosis, lymph node dissection, surgery of retroperitoneal ectopic pregnancy, Moskowitz procedure and endometriosis surgery. The anaesthetic considerations include difficult access to the patient intraoperatively, steep Trendelenburg position, long surgical duration and the impact of pneumoperitoneum. We highlight the complications encountered in these surgeries and methods to prevent these complications. Robotic gynaecological surgery can be safely performed after considering the physiological effects of the steep Trendelenburg position and of pneumoperitoneum. The benefits of the surgical procedure should be weighed against the risks in patients with underlying cardiorespiratory problems.

  11. Factors affecting couples' adjustment to recurrent breast cancer.

    Science.gov (United States)

    Northouse, L L; Dorris, G; Charron-Moore, C

    1995-07-01

    The purpose of this study was to identify factors that affect the adjustment of women and their husbands to recurrent breast cancer and to examine the mutual effect that partners have on one another. An exploratory study was designed to determine the relationship between four predictor variables (support, uncertainty, symptom distress, hopelessness) and women's and husbands' adjustments. The sample consisted of 155 subjects; 81 women, who had a first recurrence of breast cancer, and 74 husbands. Multiple standardized instruments with established reliability and validity were used to measure the study variables. The independent variables were measured with the Social Support Questionnaire, the Mishel Uncertainty in Illness Scale, McCorkle Symptom Distress Scale and the Beck Hopelessness Scale. The dependent variable, psychosocial adjustment, was measured with the Brief Symptom Inventory and the Psychosocial Adjustment to Illness Scale. The results indicated that the independent variables accounted for 43% of the variance in women's distress and 32% of the variance in husbands' distress; they also explained 66% of the variance in women's role adjustment problems and 57% of the variance in husbands' role problems. Symptom distress and hopelessness accounted for the most variance in women's and husbands' levels of adjustment. A significant and positive relationship was found between women's and husbands' adjustment scores, indicating that partners have a mutual influence on one another. The findings suggest that there are multiple factors that influence couples' adjustment to recurrent breast cancer, and that these factors need to be taken into consideration when planning care for women and their partners.

  12. Disease recurrence patterns and analysis of clinicopathological prognostic factors for recurrence after resection for distal bile duct cancer.

    Science.gov (United States)

    Choi, Sae Byeol; Han, Hyung Joon; Park, Pyoung Jae; Kim, Wan Bae; Song, Tae Jin; Kim, Jae Seon; Suh, Sung Ock; Choi, Sang Yong

    2015-03-01

    Surgical resection is the treatment of choice for bile duct cancers. The aim of this study was to investigate disease recurrence patterns and prognostic factors for recurrence of distal bile duct cancers after surgical resection. A retrospective study was performed on 122 patients with distal bile duct cancers who underwent R0 or R1 surgical resection at Korea University Guro Hospital from 1991 to 2010. Sites of initial disease recurrence were classified as locoregional or distant. Univariate and multivariate analyses were performed to investigate the factors affecting recurrence. Of the 122 patients, 80 patients developed recurrence. The disease-free survival rate was 63.1 per cent at one year and 36.4 per cent at three years. The patterns of recurrence at diagnosis were locoregional in 25 patients, locoregional and distant metastasis in 14 patients, and distant metastasis in 41 patients. Multivariate analyses revealed that recurrence pattern, lymph node metastasis, and differentiation are independent prognostic factors affecting disease-free survival. R status (marginal significance) and tumor differentiation were independent prognostic factors associated with locoregional recurrence. Differentiation and lymph node metastasis were independent prognostic factors associated with distant metastasis. The prognosis after recurrence was poor with a 1-year survival rate after recurrence of 26.1 per cent. Adjuvant chemo- or radiation therapy, delivered in patients mainly with R1 resection or with presence of lymph node metastasis, did not demonstrate the survival benefit. Significant factors for recurrence were tumor differentiation and lymph node metastasis. Therefore, close follow-up and adjuvant therapy will be necessary in patients with lymph node metastasis or poorly differentiated tumor.

  13. Photodynamic therapy for chest wall recurrence from breast cancer.

    Science.gov (United States)

    Allison, R R; Sibata, C; Mang, T S; Bagnato, V S; Downie, G H; Hu, X H; Cuenca, R

    2004-09-01

    Breast cancer is common with over 230,000 new cases diagnosed each year in North America alone. While great strides have been made to achieve excellent cancer control and survival, a significant minority of patients fail locally. While initial salvage to regain disease control is of the utmost importance, it is not universally successful. This leads to a therapeutic quagmire. Additional surgery, radiation and chemo-hormonal therapy are possible, but they are usually highly morbid with low success rates. Photodynamic therapy appears to be an underutilized salvage modality for this unfortunate patient population. This report analyzes and reviews the role of photodynamic therapy for patients with chest wall re-recurrence from breast cancer.

  14. Highlights on recurrence after surgery for cervical cancer

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Petersen, Lone Kjeld; Blaakær, Jan

    Objective After surgery due to cervical cancer women are offered to attend a follow-up program 10 times during five years with the purpose for early diagnosis of recurrence. The aim of this study is to evaluate the follow-up program, which has remained unchanged for 20 years even though reminding...... and concerning women, who we consider healthy after surgery. Methods A retrospective longitudinal study of women attending follow-up program after surgery due to cervical cancer at the Department of Gynecology and Obstetrics, Aarhus University Hospital. 524 patients were identified from 1996 to 2011...... with the diagnosis of cervical cancer combined with a surgical procedure. From the national pathological database and patient files information was extracted. Information was stored in Epidata. Associations were calculated using stratified analysis and logistic regression. Results 133(25%) women of 524 needed...

  15. The cancer worry scale: detecting fear of recurrence in breast cancer survivors.

    NARCIS (Netherlands)

    Custers, J.A.E.; Berg, S.W. van den; Laarhoven, H.W.M. van; Bleiker, E.M.; Gielissen, M.F.M.; Prins, J.B.

    2014-01-01

    BACKGROUND: In 9% to 34% of cancer patients, the fear of cancer recurrence becomes so overwhelming that it affects quality of life. Clinicians need a brief questionnaire with a cutoff point that is able to differentiate between high- and low-fearful survivors. OBJECTIVE: This study investigated if t

  16. Prevalence of epithelial ovarian cancer stem cells correlates with recurrence in early-stage ovarian cancer

    DEFF Research Database (Denmark)

    Steffensen, Karina Dahl; Alvero, Ayesha B; Yang, Yingkui

    2011-01-01

    Epithelial ovarian cancer stem cells (EOC stem cells) have been associated with recurrence and chemoresistance. CD44 and CK18 are highly expressed in cancer stem cells and function as tools for their identification and characterization. We investigated the association between the number of CD44+ ...

  17. Resection of recurrent neck cancer with carotid artery replacement.

    Science.gov (United States)

    Illuminati, Giulio; Schneider, Fabrice; Minni, Antonio; Calio, Francesco G; Pizzardi, Giulia; Ricco, Jean-Baptiste

    2016-05-01

    The management of patients with recurrent neck cancer invading the carotid artery is controversial. The purpose of this study was to evaluate overall survival rate, primary patency of vascular reconstructions, and quality-adjusted life-years (QALYs) after en bloc resection of the carotid artery and tumor with in-line polytetrafluoroethylene (PTFE) carotid grafting, followed by radiotherapy. From 2000 to 2014, 31 consecutive patients with recurrent neck cancer invading the carotid artery underwent en bloc resection and simultaneous carotid artery reconstruction with a PTFE graft, which was associated in 18 cases with a myocutaneous flap. The primary tumor was a squamous cell carcinoma of the larynx in 17 patients and of the hypopharynx in 7, an undifferentiated carcinoma of unknown origin in 4, and an anaplastic carcinoma of the thyroid in 3. All of the patients underwent postoperative radiotherapy (50-70 Gy), and 10 of them also underwent chemotherapy (doxorubicin and cisplatin). None of the patients died or sustained a stroke during the first 30 days after the index procedure. Postoperative morbidity consisted of 6 transitory dysphagias, 3 vocal cord palsies, 2 wound dehiscences, 1 transitory mandibular claudication, and 1 partial myocutaneous flap necrosis. No graft infection occurred during follow-up. Fifteen patients (48%) died from metastatic cancer during a mean follow-up of 45.4 months (range, 8-175 months). None of the patients showed evidence of local recurrence, stroke, or thrombosis of the carotid reconstruction. The 5-year survival rate was 49 ± 10%. The overall number of QALYs was 3.12 (95% confidence interval, 1.87-4.37) with a significant difference between patients without metastasis at the time of redo surgery (n = 26; QALYs, 3.74) and those with metastasis (n = 5; QALYs, 0.56; P = .005). QALYs were also significantly improved in patients with cancer of the larynx (n = 17; QALYs, 4.69) compared to patients presenting with other types of

  18. Suberoylanilide Hydroxamic Acid in Treating Patients With Metastatic and/or Locally Advanced or Locally Recurrent Thyroid Cancer

    Science.gov (United States)

    2014-07-23

    Insular Thyroid Cancer; Recurrent Thyroid Cancer; Stage II Follicular Thyroid Cancer; Stage II Papillary Thyroid Cancer; Stage IV Follicular Thyroid Cancer; Stage IV Papillary Thyroid Cancer; Thyroid Gland Medullary Carcinoma

  19. Antiangiogenic drugs used with chemotherapy for patients with recurrent ovarian cancer: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Yi SY

    2017-02-01

    Full Text Available SuYi Yi, LongJia Zeng, Yan Kuang, ZhiJuan Cao, ChengJun Zheng, Yue Zhang, Meng Liao, Lu Yang Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People’s Republic of China Objective: The value of antiangiogenic inhibitors for patients with recurrent ovarian cancer has not been completely affirmed. Therefore, we aimed to assess the effectiveness and toxicities of various antiangiogenic drugs for the treatment of recurrent ovarian cancer. Methods: In this meta-analysis, we searched PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials databases for complete randomized controlled trials. The searches were extended to May 15, 2016. The risk of bias of the included studies was evaluated via a Cochrane systematic evaluation, and the statistical analyses were performed using RevMan 5.2 software. Results: In total, we included 8 randomized controlled trials involving 3,211 patients and divided them into 3 groups, vascular endothelial growth factor receptor inhibitors (VEGFRIs, vascular endothelial growth factor (VEGF inhibitors (bevacizumab, and angiopoietin inhibitors (trebananib. The progression-free survival improved significantly in all the groups being given antiangiogenic drugs (hazard ratio [HR]: 0.55, 95% confidence interval [CI]: 0.45–0.67, I2=0%, P<0.00001 for the VEGFRI group; HR: 0.53, 95% CI: 0.45–0.63, I2=51%, P<0.00001 for the VEGF inhibitor group; HR: 0.67, 95% CI: 0.58–0.77, I2=0%, P<0.00001 for the trebananib group. Overall survival was obviously prolonged in the VEGFRI (HR: 0.76, 95% CI: 0.59–0.97, I2=0%, P=0.03, the VEGF inhibitor (HR: 0.87, 95% CI: 0.77–0.99, I2=0%, P=0.03, and trebananib groups (HR: 0.81, 95% CI: 0.67–0.99, I2=0%, P=0.04. The incidence of grade 3/4 side effects was different among the 3 groups, for example, proteinuria, hypertension, gastrointestinal perforation, and arterial thromboembolism were presented in the

  20. RECURRENT ORAL CANCER: CURRENT AND EMERGING THERAPEUTIC APPROACHES

    Directory of Open Access Journals (Sweden)

    Sabrina Daniela Silva

    2012-07-01

    Full Text Available Oral cancer cavity (OCC is associated with high incidence of loco-regional recurrences, which account for the majority of treatment failures post-surgery and radiotherapy. The time-course of relapse manifestation and metastasis are unpredictable. Relapsed OCC represents a major clinical challenge in part due to their aggressive and invasive behaviors. Chemotherapy remains the only option for advanced OCC whenever salvage surgery or re-irradiation is not feasible, but its efficacy is limited as a result of the drug resistance development. Alternatives to use of different permutations of standard cytotoxic drugs or combinations with modulators of drug resistance have led to incremental therapeutic benefits. The introduction of targeted agents and biologics against selective targets that drive cancer progression has opened-up optimism to achieve superior therapeutic activity and overcome drug resistance because, unlike the non-selective cytotoxic, the target can be monitored at molecular levels to identify patients who can benefit from the drug. This review discusses the multifactorial aspects of clinical drug resistance and emerging therapeutic approaches in recurrent OCC, emphasizing recent advances in targeted therapies, immunotherapy, and potential relevance of new concepts such as epithelial-mesenchymal transition and cancer stem cell hypothesis to drug resistance.

  1. Can anaesthetic and analgesic techniques affect cancer recurrence or metastasis?

    LENUS (Irish Health Repository)

    Heaney, A

    2012-12-01

    Summary Cancer is a leading cause of morbidity and mortality worldwide and the ratio of incidence is increasing. Mortality usually results from recurrence or metastases. Surgical removal of the primary tumour is the mainstay of treatment, but this is associated with inadvertent dispersal of neoplastic cells into the blood and lymphatic systems. The fate of the dispersed cells depends on the balance of perioperative factors promoting tumour survival and growth (including surgery per se, many anaesthetics per se, acute postoperative pain, and opioid analgesics) together with the perioperative immune status of the patient. Available evidence from experimental cell culture and live animal data on these factors are summarized, together with clinical evidence from retrospective studies. Taken together, current data are sufficient only to generate a hypothesis that an anaesthetic technique during primary cancer surgery could affect recurrence or metastases, but a causal link can only be proved by prospective, randomized, clinical trials. Many are ongoing, but definitive results might not emerge for a further 5 yr or longer. Meanwhile, there is no hard evidence to support altering anaesthetic technique in cancer patients, pending the outcome of the ongoing clinical trials.

  2. A Review of Current Machine Learning Methods Used for Cancer Recurrence Modeling and Prediction

    Energy Technology Data Exchange (ETDEWEB)

    Hemphill, Geralyn M. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-09-27

    Cancer has been characterized as a heterogeneous disease consisting of many different subtypes. The early diagnosis and prognosis of a cancer type has become a necessity in cancer research. A major challenge in cancer management is the classification of patients into appropriate risk groups for better treatment and follow-up. Such risk assessment is critically important in order to optimize the patient’s health and the use of medical resources, as well as to avoid cancer recurrence. This paper focuses on the application of machine learning methods for predicting the likelihood of a recurrence of cancer. It is not meant to be an extensive review of the literature on the subject of machine learning techniques for cancer recurrence modeling. Other recent papers have performed such a review, and I will rely heavily on the results and outcomes from these papers. The electronic databases that were used for this review include PubMed, Google, and Google Scholar. Query terms used include “cancer recurrence modeling”, “cancer recurrence and machine learning”, “cancer recurrence modeling and machine learning”, and “machine learning for cancer recurrence and prediction”. The most recent and most applicable papers to the topic of this review have been included in the references. It also includes a list of modeling and classification methods to predict cancer recurrence.

  3. Rupture of an expander prosthesis mimics axillary cancer recurrence.

    LENUS (Irish Health Repository)

    Ismael, T

    2005-10-01

    Regional silicone gel migration from a ruptured breast implant has been reported at different locations including the upper extremity, chest wall muscles, axilla and back. We report a patient who presented with an axillary mass that mimicked a regional recurrence 5 years after breast cancer reconstruction with a latissimus dorsi musculocutaneous flap and silicon gel expander-prosthesis. Surgical exploration revealed that the mass contained silicone gel around the port of the breast expander that had ruptured. The mass was confluent with an intracapsular silicone leak through a tract along the tube of the expander port.

  4. Anesthesia and cancer recurrences: The current knowledge and evidence

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available Surgical removal of solid tumors is of utmost importance as total resection can be curative. The surgical insult however itself may result in tumor micrometastasis coupled with depression of cell-mediated immunity culminating in tumor recurrence. Recent research suggests that few anesthetic agents or procedures can influence pathophysiology of metastasis in the postoperative period. Whereas opioids and volatile anesthetics have been implicated in angiogenesis and immunosuppression, evidences accumulated over the recent years have undoubtedly highlighted the attenuation of immunosuppression by regional anesthetic agents thereby making it superior over general anesthesia in preventing cancer recurrence. As anesthetic drugs are given at that time when patient is at the maximum risk of spread of metastasis, thus an understanding of the effect of anesthesia drugs and their impact on tumor metastasis is important so that appropriate anesthetic strategy can be made to improve long term survival in these patients. The purpose of the present review is therefore to emphasize the pivotal role of various anesthetic agents and anesthesia techniques in preventing tumor recurrence after surgery.

  5. Predictors of loco-regional recurrence and cancer-related death after breast cancer surgery.

    Science.gov (United States)

    Rausei, Stefano; Rovera, Francesca; Dionigi, Gianlorenzo; Tornese, Deborah; Fachinetti, Anna; Boni, Luigi; Dionigi, Renzo

    2010-01-01

    To determine which tumor-related factors might predispose the patient to loco-regional recurrence or death and the impact of these factors on the different types of events. We retrospectively analyzed the data of 1991 women between January 1998 and March 2010 for a first primary nonmetastatic breast cancer and treated with surgery and neo-adjuvant/adjuvant therapy. The overall survival distribution was estimated using the Kaplan-Meier method. The prognostic impact of several factors on cumulative overall and loco-regional recurrence free survival was evaluated by univariate (log-rank test) and multivariate analysis (Cox regression). At log-rank test, pT, nodal status, histotype, grading, lymphangioinvasive growth, tumor diameter, estrogen receptors (ER) status, progesterone receptors (PR) status, expression of Ki67, and expression of Her2/neu had a prognostic value on loco-regional recurrence or overall survival. In the multivariate analysis grading remained the only independent predictor of loco-regional recurrences. With regard to overall survival, the Cox model selected grading along with nodal status and PR status. Loco-regional recurrences after breast cancer surgery are not frequent events. They are markers of tumor aggressiveness and predictor of an increased likelihood of cancer-related death. However, loco-regional recurrence and systemic tumor progression are partially independent events, since some prognostic factors differ.

  6. Present and future of PET and PET/CT in gynaecologic malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Musto, Alessandra [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rampin, Lucia [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Nanni, Cristina [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Marzola, Maria Cristina [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy); Fanti, Stefano [Department of Nuclear Medicine, PET Center, Policlinico Sant' Orsola Malpighi, Bologna University, Bologna (Italy); Rubello, Domenico, E-mail: domenico.rubello@libero.it [Department of Nuclear Medicine, PET Center, Radiology, Medical Physics, Santa Maria della Misericordia Hospital, viale tre martiri 140, 45100 Rovigo (Italy)

    2011-04-15

    Objectives: To review the published data in literature on patients affected by gynaecological malignancies to establish the role of {sup 18}F-FDG positron emission tomography (PET) and PET/CT in comparison to conventional imaging (CI). Materials and methods: All papers specifically addressed to the role of {sup 18}F-FDG PET and PET/CT in gynaecological malignancies published on PubMed/Medline, in abstracts from the principal international congresses, in the guidelines from national Societies that had appeared in literature until November 2009 were considered for the purpose of the present study. Results and conclusions: The use of {sup 18}F-FDG PET, and even more of {sup 18}F-FDG PET/CT, is increasing in the follow up of patients with gynaecologic malignancies and suspected recurrent disease: there is evidence in the literature that {sup 18}F-FDG PET/CT has a higher sensitivity than CI in depicting occult metastatic spread. An interesting issue is represented by patients with ovarian cancer with an increase of the specific biomarker, CA-125, and negative/inconclusive findings at CI. The use of {sup 18}F-FDG PET in differential diagnosis and staging is more controversial, but there is some evidence that a baseline PET examination performed before commencing therapy, for staging purpose, is also useful to evaluate the response to chemoradiation treatment. In several papers it has been suggested a relevant role of {sup 18}F-FDG PET/CT in evaluating the entity of response to treatment and therefore to plan the subsequent therapeutic strategy.

  7. Classification of Cancer Recurrence with Alpha-Beta BAM

    Directory of Open Access Journals (Sweden)

    María Elena Acevedo

    2009-01-01

    Full Text Available Bidirectional Associative Memories (BAMs based on first model proposed by Kosko do not have perfect recall of training set, and their algorithm must iterate until it reaches a stable state. In this work, we use the model of Alpha-Beta BAM to classify automatically cancer recurrence in female patients with a previous breast cancer surgery. Alpha-Beta BAM presents perfect recall of all the training patterns and it has a one-shot algorithm; these advantages make to Alpha-Beta BAM a suitable tool for classification. We use data from Haberman database, and leave-one-out algorithm was applied to analyze the performance of our model as classifier. We obtain a percentage of classification of 99.98%.

  8. Survival after recurrence of stage I-III breast, colorectal, or lung cancer.

    Science.gov (United States)

    Hassett, Michael J; Uno, Hajime; Cronin, Angel M; Carroll, Nikki M; Hornbrook, Mark C; Fishman, Paul; Ritzwoller, Debra P

    2017-08-01

    The experiences of patients with recurrent cancer are assumed to reflect those of patients with de novo stage IV disease; yet, little is truly known because most registries lack recurrence status. Using two databases with excellent recurrence and death information, we examined determinants of survival duration after recurrence of breast (BC), colorectal (CRC), and lung cancers (LC). Recurrence status was abstracted from the medical records of patients who participated in the Cancer Care Outcomes Research and Surveillance study and who received care at two Cancer Research Network sites-the Colorado and Northwest regions of Kaiser Permanente. The analysis included 1653 patients who developed recurrence after completing definitive therapy for stages I-III cancer. Multivariable modeling identified independent determinants of survival duration after recurrence, controlling for other factors. Through 60 months' average follow-up, survival after recurrence for BC, CRC, and LC were 28.4, 23.1 and 16.1 months, respectively. Several factors were independently associated with shorter survival for all three cancers, including higher initial stage (III vs. I: BC -9.9 months; CRC -6.9 months; LC -7.4 months; P≤0.01). Factors associated with shorter survival for selected cancers included: distant/regional recurrence for BC and CRC; current/former smoker for LC; high grade for CRC; and recurrence for BC. Initial stage predicts survival duration after recurrence, whereas time-to-recurrence usually does not. The impact of biologic characteristics (e.g., grade, hormone-receptor status) on survival duration after recurrence needs further study. Predictors of survival duration after recurrence may help facilitate patient decision-making. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Determinants of recurrence after intended curative resection for colorectal cancer

    DEFF Research Database (Denmark)

    Wilhelmsen, Michael; Kring, Thomas; Jorgensen, Lars N;

    2014-01-01

    in development of recurrence. It is well established that emergency surgery is a major determinant of recurrence. Moreover, anastomotic leakages, postoperative bacterial infections, and blood transfusions increase the recurrence rates although the exact mechanisms still remain obscure. From pathology studies...

  10. Impact of Recurrence and Salvage Surgery on Survival After Multidisciplinary Treatment of Rectal Cancer.

    Science.gov (United States)

    Ikoma, Naruhiko; You, Y Nancy; Bednarski, Brian K; Rodriguez-Bigas, Miguel A; Eng, Cathy; Das, Prajnan; Kopetz, Scott; Messick, Craig; Skibber, John M; Chang, George J

    2017-08-10

    Purpose After preoperative chemoradiotherapy followed by total mesorectal excision for locally advanced rectal cancer, patients who experience local or systemic relapse of disease may be eligible for curative salvage surgery, but the benefit of this surgery has not been fully investigated. The purpose of this study was to characterize recurrence patterns and investigate the impact of salvage surgery on survival in patients with rectal cancer after receiving multidisciplinary treatment. Patients and Methods Patients with locally advanced (cT3-4 or cN+) rectal cancer who were treated with preoperative chemoradiotherapy followed by total mesorectal excision at our institution during 1993 to 2008 were identified. We examined patterns of recurrence location, time to recurrence, treatment factors, and survival. Results A total of 735 patients were included. Tumors were mostly midrectal to lower rectal cancer, with a median distance from the anal verge of 5.0 cm. The most common recurrence site was the lung followed by the liver. Median time to recurrence was shorter in liver-only recurrence (11.2 months) than in lung-only recurrence (18.2 months) or locoregional-only recurrence (24.7 months; P = .001). Salvage surgery was performed in 57% of patients with single-site recurrence and was associated with longer survival after recurrence in patients with lung-only and liver-only recurrence ( P recurrence ( P = .353). Conclusion We found a predilection for lung recurrence in patients with rectal cancer after multidisciplinary treatment. Salvage surgery was associated with prolonged survival in patients with lung-only and liver-only recurrence, but not in those with locoregional recurrence, which demonstrates a need for careful consideration of the indications for resection.

  11. Cetuximab and Everolimus in Treating Patients With Metastatic or Recurrent Colon Cancer or Head and Neck Cancer

    Science.gov (United States)

    2012-07-06

    Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Colon Cancer; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage IV Adenoid Cystic Carcinoma of the Oral Cavity; Stage IV Basal Cell Carcinoma of the Lip; Stage IV Lymphoepithelioma of the Nasopharynx; Stage IV Lymphoepithelioma of the Oropharynx; Stage IV Mucoepidermoid Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Stage IVA Colon Cancer; Stage IVA Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage IVA Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Colon

  12. Dual-time FDG-PET/CT in patients with potential breast cancer recurrence

    DEFF Research Database (Denmark)

    Baun, Christina; Falch Braas, Kirsten; Gerke, Oke;

    Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy......Dual-time FDG-PET/CT in patients with potential breast cancer recurrence: head-to-head comparison with CT and bonescintigraphy...

  13. Ezrin expression in rectal cancer predicts time to development of local recurrence

    DEFF Research Database (Denmark)

    Jörgren, Fredrik; Nilbert, Mef; Rambech, Eva

    2012-01-01

    : Immunohistochemical expression of ezrin was analysed in 104 primary rectal cancers from patients who developed local recurrences despite being treated with R0 major abdominal surgery. Time to local recurrence and distant metastasis as well as 5-year overall and cancer-specific survival were used as end points...

  14. CD44 expression predicts local recurrence after radiotherapy in larynx cancer.

    NARCIS (Netherlands)

    Jong, M.C.J. de; Pramana, J.; Wal, J.E. van der; Lacko, M.; Peutz-Kootstra, C.J.; Jong, J.M. de; Takes, R.P.; Kaanders, J.H.A.M.; Laan, B.F.A.M. van der; Wachters, J.; Jansen, J.C.; Rasch, C.R.; Velthuysen, M.L. van; Grenman, R.; Hoebers, F.J.; Schuuring, E.; Brekel, M.W. van den; Begg, A.C.

    2010-01-01

    PURPOSE: To find molecular markers from expression profiling data to predict recurrence of laryngeal cancer after radiotherapy. EXPERIMENTAL DESIGN: We generated gene expression data on pre-treatment biopsies from 52 larynx cancer patients. Patients developing a local recurrence were matched for T-s

  15. CD44 Expression Predicts Local Recurrence after Radiotherapy in Larynx Cancer

    NARCIS (Netherlands)

    de Jong, Monique C.; Pramana, Jimmy; van der Wal, Jacqueline E.; Lacko, Martin; Peutz-Kootstra, Carine J.; Takes, Robert P.; Kaanders, Johannes H.; van der Laan, Bernard F.; Wachters, Jasper; Jansen, Jeroen C.; Rasch, Coen R.; van Velthuysen, Marie-Louise F.; Grenman, Reidar; Hoebers, Frank J.; Schuuring, Ed; van den Brekel, Michiel W.; Begg, Adrian C.; de Jong, Johan

    2010-01-01

    Purpose: To find molecular markers from expression profiling data to predict recurrence of laryngeal cancer after radiotherapy. Experimental Design: We generated gene expression data on pre-treatment biopsies from 52 larynx cancer patients. Patients developing a local recurrence were matched for T-s

  16. Clinical review: surgical management of locally advanced and recurrent colorectal cancer.

    LENUS (Irish Health Repository)

    Courtney, D

    2014-01-01

    Recurrent and locally advanced colorectal cancers frequently require en bloc resection of involved organs to achieve negative margins. The aim of this review is to evaluate the most current literature related to the surgical management of locally advanced and recurrent colorectal cancer.

  17. Isolated mandibular condylar metastases: An uncommon manifestation of recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Ameya D Puranik

    2013-01-01

    Full Text Available Bone metastases from recurrent cervical cancer is a rare scenario, with commonly involved sites being lumbar spine and pelvic bones report an extremely rare manifestation of cervical cancer recurrence presenting as a painful jaw swelling due to metastasis to the mandibular condyle.

  18. Clinical progression of lobaplatin in combination chemotherapy for patients with recurrence or metastatic cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Peng; Jiangkui Liu; Qiang Lin

    2014-01-01

    The-platinum-based-combination-chemotherapy-has-become-one-of-the-major-modalities-in-anti-cancer-treatment.-After-the-first-line-chemotherapy,-many-patients-need-further-chemotherapy-because-of-recurrence-or-metastasis.-Lobaplatin-is-one-of-the-third-generation-platinum-drugs,and-this-article-briefly-reviews-the-clinical-progression-of-lobaplatin-in-combination-chemotherapy-for-patients-with-recurrence-or-metastatic-cancer.

  19. Anastomotic Leak Increases Distant Recurrence and Long-Term Mortality After Curative Resection for Colonic Cancer

    DEFF Research Database (Denmark)

    Krarup, Peter-Martin; Nordholm-Carstensen, Andreas; Jorgensen, Lars N

    2014-01-01

    OBJECTIVE: To investigate the impact of anastomotic leak (AL) on disease recurrence and long-term mortality in patients alive 120 days after curative resection for colonic cancer. BACKGROUND: There is no solid data as to whether AL after colonic cancer surgery increases the risk of disease recurr...

  20. Iodine-125 radioactive seed tissue implantation as a remedy treatment for recurrent cervical cancer

    Directory of Open Access Journals (Sweden)

    Lei Han

    2016-01-01

    Conclusion: Iodine-125 radioactive seed tissue implantation is a feasible, effective, and safe treatment method for remedying or palliative treatment of recurrent cervical cancer. Patients who have recurrent cervical cancer and responded effectively to radioactive seed implantation will have a longer survival period.

  1. Radiofrequency Ablation of Benign Thyroid Nodules and Recurrent Thyroid Cancers: Consensus Statement and Recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Na, Dong Gyu [Human Medical Imaging and Intervention Center, Seoul (Korea, Republic of); Lee, Jeong Hyun [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Jung, So Lyung [Seoul St. Marys Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2012-06-15

    Radiofrequency ablation is a new non-surgical treatment modality for patients with benign thyroid nodules and recurrent thyroid cancers. The Task Force Committee of the Korean Society of Thyroid Radiology has developed recommendations for the treatment of benign thyroid nodules and recurrent thyroid cancers using radiofrequency ablation. These recommendations are based on evidence from the current literature and expert consensus

  2. cDNA Clones with Rare and Recurrent Mutations Found in Cancers | Office of Cancer Genomics

    Science.gov (United States)

    The CTD2 Center at UT- MD Anderson Cancer Center has developed High-Throughput Mutagenesis and Molecular Barcoding (HiTMMoB)1,2 pipeline to construct mutant alleles open reading frame expression clones that are either recurrent or rare in cancers. These barcoded genes can be used for context-specific functional validation, detection of novel biomarkers (pathway activation) and targets (drug sensitivity).

  3. Distribution and Prevalence of Locoregional Recurrence after Video-Assisted Thoracoscopic Surgery for Primary Lung Cancer.

    Science.gov (United States)

    Haruki, Tomohiro; Miwa, Ken; Araki, Kunio; Taniguchi, Yuji; Nakamura, Hiroshige

    2016-09-01

    Background The aim of this study is to evaluate cases with locoregional recurrence after video-assisted thoracoscopic surgery (VATS) for primary lung cancer. Methods We reviewed 248 patients with primary lung cancer who underwent lobectomy or segmentectomy with mediastinal lymph node dissection by VATS between January 2005 and December 2011. Locoregional recurrence is defined as per its occurrence in (1) bronchial stump or lung parenchymal cut end, (2) ipsilateral pleura, and (3) ipsilateral hilar and mediastinal lymph nodes, and we analyzed recurrence rate and significant associated factors for locoregional recurrence by logistic regression analysis. Results There were 47 cases of postoperative recurrence, which consisted of 26 distant, 6 locoregional and distant, and 15 locoregional recurrences. The locoregional recurrence rate was 6.0%. Of the 15 locoregional recurrence cases, there were two cases of bronchial stump and lung parenchyma cut end (0.4%), five cases of ipsilateral pleura (2.0%), and eight cases of ipsilateral hilar and mediastinal lymph nodes (3.2%). Pleural and lymphovascular invasion and advanced stages were significant associated factors in univariate analysis. Multivariate analysis revealed that advanced stages were only a significant associated factor for locoregional recurrence (p recurrence rates of our surgical treatments for primary lung cancer by VATS might be acceptable, we should explore more effective modalities against pathologically proven local advanced lung cancer for preventing not only distant but also locoregional recurrences. Georg Thieme Verlag KG Stuttgart · New York.

  4. Use of magnetic resonance imaging in detection of breast cancer recurrence: a systematic review.

    LENUS (Irish Health Repository)

    Quinn, Edel Marie

    2012-09-01

    Diagnosis of breast cancer recurrence can be difficult as a result of the presence of scar tissue in the breast. Magnetic resonance imaging (MRI) may be superior to traditional imaging in diagnosis of recurrence because of its ability to differentiate malignancy from scarring. Current guidelines on investigation of suspected breast cancer recurrence recommend MRI when other investigations have equivocal findings. We performed the first systematic review on this topic.

  5. Anastomotic Recurrence of Sigmoid Colon Cancer over Five Years after Surgery

    Directory of Open Access Journals (Sweden)

    Takahiro Yamauchi

    2013-10-01

    Full Text Available The incidence of anastomotic recurrence after curative resection of colorectal cancer is relatively low compared to that of other types of recurrence, such as hepatic, lung and local recurrence. However, almost all cases of anastomotic recurrence of colorectal cancer occur within 3 years after surgery. We experienced a rare case of anastomotic recurrence in whom colonoscopy revealed no signs of recurrence 3 years after surgery; however, anastomotic recurrence was detected over 5 years after surgery. A 60-year-old female with a history of surgery for cancer of the cecum in her forties underwent sigmoidectomy and right colectomy with D3 lymph node dissection for both stage IIA sigmoid colon cancer and stage IIA transverse colon cancer. Computed tomography and colonoscopy revealed no signs of recurrence 3 years after surgery; however, 5 years and 4 months after surgery, colonoscopy demonstrated surrounding flaring and swelling in the anastomotic area of the sigmoid colon, and a biopsy revealed an adenocarcinoma. Under the diagnosis of anastomotic recurrence over 5 years after surgery, lower anterior resection was performed. The patient has exhibited no other signs of recurrence in the 2 years since the last operation.

  6. Reirradiation of recurrent breast cancer with and without concurrent chemotherapy

    Directory of Open Access Journals (Sweden)

    Kretschmer Matthias

    2008-09-01

    Full Text Available Abstract Background Treatment options for loco-regional recurrent breast cancer after previous irradiation are limited. The efficacy of chemotherapy might be hampered because of impaired tissue perfusion in preirradiated tissue. Thus, mastectomy or local excision and reconstructive surgery are the preferred treatments. However, in recent years evidence accumulates that a second breast conserving approach with reirradiation as part of the treatment might be feasible and safe and, furthermore, reirradiation might be an option for palliation. Here we report on the experience of a single community centre in reirradiation of recurrent breast cancer. Methods The report is based on 29 patients treated with reirradiation. All data were prospectively collected. The median age was 63 years (range 35 to 82 yrs. The interval between initial diagnosis and diagnosis before start of reirradiation was 11.6 months to 295.5 months. The mean total dose (initial dose and reirradiation dose was 106.2 Gy (range 80.4 to 126 Gy and the mean BED3 Gy 168,5 Gy (range 130,6 to 201,6. The mean interval between initial radiotherapy and reirradiation was 92.9 months (range 8.7 to 290.1. Inoperable or incompletely resected patients were offered concurrent chemotherapy with either 5-FU or capecitabine. All patients received 3D-conformal radiotherapy with 1.6 to 2.5 Gy/fraction five times weekly. The treatment volume comprised all visible lesions or lesions detectable on CT/MRI/FDG-PET/CT or the tumour bed or recurrent tumour. Results The local progression-free survival of all patients at one and two years was 81% and 63%. Patients who had no surgery of the recurrence (16/29 had local progression-free survival at one and two years of 72% and 25% with a median progression-free survival time of 17 months. Partial remission and good symptom relief was achieved in 56% (9/16 or complete response of symptoms and/or tumour in 44% (7/16. Patients who had no distant metastases and had at

  7. Hypertension, obesity and prostate cancer biochemical recurrence after radical prostatectomy.

    Science.gov (United States)

    Asmar, R; Beebe-Dimmer, J L; Korgavkar, K; Keele, G R; Cooney, K A

    2013-03-01

    The metabolic syndrome (MetS) comprises a constellation of risk factors associated with an increased risk for cardiovascular disease. Components of MetS have emerged as putative risk factors for prostate carcinoma. In this study, we examine the association between three features of the MetS (obesity, hypertension and diabetes) and the risk of biochemical recurrence (BCR) after radical prostatectomy (RP). We examined data from 1428 men in the University of Michigan Prostate Cancer Data Bank who elected to have RP as their primary treatment. We calculated body mass index from patients' weight and height measured at the time of prostate cancer diagnosis. We used the University of Michigan's Electronic Medical Record Search Engine to identify subjects with hypertension and/or diabetes before their prostate cancer diagnosis. Of 1428 men who underwent RP, 107 (8%) subsequently developed BCR with a median length of follow-up post-surgery of 3.6 years. Obesity and hypertension were each associated with an increased risk of BCR (adjusted hazard ratio (aHR) = 1.37; 95% CI 0.92-2.09 and aHR = 1.51, 95% CI 1.01-2.26), whereas no association was observed between diabetes and BCR (aHR = 0.73; 95% CI 0.40-1.33). Obesity and hypertension were each associated with an increased risk for BCR of prostate cancer after RP, independent of age at diagnosis and tumor pathological features. Given the increasing rates of obesity, hypertension and prostate cancer, a better understanding of the relationship between these entities is of significant public health importance. Elucidation of the involved pathogenic mechanisms will be needed to establish causality.

  8. Carboplatin and Gemcitabine Hydrochloride With or Without ATR Kinase Inhibitor VX-970 in Treating Patients With Recurrent and Metastatic Ovarian, Primary Peritoneal, or Fallopian Tube Cancer

    Science.gov (United States)

    2017-01-31

    High Grade Ovarian Serous Adenocarcinoma; Ovarian Endometrioid Tumor; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer

  9. SB-715992 in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    Science.gov (United States)

    2017-01-13

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity

  10. CT findings of locoregional recurrence after curative resection of colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Sang Soo [Chonnam National University Hospital, Gwangju (Korea, Republic of); Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hwasun Hospital, Hwasun (Korea, Republic of)

    2006-10-15

    Postoperative recurrence is a major cause of mortality and morbidity for the patients suffering with colorectal cancer. Therefore, patients with colorectal cancer are routinely followed up with CT to detect the presence of locoregional recurrence and distant metastases. A central goal of postoperative surveillance for colorectal cancer is to improve survival through the earlier identification of tumor recurrence. Locoregional recurrence refers to tumor occurring at or adjacent to the surgical site and at the regional lymph nodes. It has been reported that metastatic spread based on the site of the primary tumor shows a relatively predictable pattern. Given the prevalence of colorectal cancer and the role of CT for postoperative surveillance, radiologists should be familiar with the CT findings of locoregional recurrence after curative resection for colorectal cancer.

  11. Perioperative brachytherapy for pretreated chest wall recurrence of breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mayer, A.; Naszaly, A.; Patyanik, M. [Municipal Center of Oncoradiology, Budapest (Hungary)

    2002-11-01

    Purpose: To demonstrate the technical aspects of high-dose-rate afterloading (HDR-AL) brachytherapy for isolated local chest wall recurrence of breast cancer pretreated with mastectomy and axillary node dissection plus postoperative radiotherapy. Case Report: A 63-year-old female patient with left ductal breast cancer, pT2pN1biMO, was reoperated for an isolated local chest wall recurrence 13 years after primary treatment (mastectomy, axillary dissection, and 50 Gy postoperative irradiation). Radical surgery would have involved extreme multilation. Reoperative surgical margins of 3 mm width were involved, and four parallel afterloading catheters were placed intraoperatively in this histologically positive margin site. Perioperative HDR-AL (Ir-192 stepping source, 370 GBq activity, dose rate: reference air kerma rate at 1 m 40.84 mGy/h kg) was performed. Dose per fraction: 6 Gy to the reference line, two fractions per week, total dose 30 Gy. Follow-up after secondary treatment: 5 years. Results: Firm local control and 5-year disease-free survival were obtained with perioperative HDR-AL therapy; staging procedures (clinical exam, MRI, abdominal ultrasound, and bone scan) showed no evidence of disease. The development of radiodermatitis did not exceed grade 2 level and healed spontaneously within 6 weeks. Conclusions: Isolated local chest all relapse can be effectively controlled by wide surgical excision and perioperative reirradiation with HDR-AL. This technique may represent a treatment alternative to ultraradical surgery, with equal healing probability and a better quality of life. Small-volume irradiation of the postoperative scar can be performed with HDR-AL brachytherapy, and long-term local control can be achieved with a total dose of 30 Gy. (orig.)

  12. Risk of regional recurrence in triple-negative breast cancer patients: a Dutch cohort study

    NARCIS (Netherlands)

    Roozendaal, van Lori M.; Smit, Leonie H.M.; Duijsens, Gaston H.N.M.; Vries, de Bart; Siesling, Sabine; Lobbes, Marc B.I.; Boer, de Maaike; Wilt, de Johannes H.W.; Smidt, Marjolein L.

    2016-01-01

    Triple-negative breast cancer is associated with early recurrence and low survival rates. Several trials investigate the safety of a more conservative approach of axillary treatment in clinically T1-2N0 breast cancer. Triple-negative breast cancer comprises only 15 % of newly diagnosed breast cancer

  13. Postoperative oligo-recurrence of non-small-cell lung cancer: clinical features and survival†.

    Science.gov (United States)

    Hishida, Tomoyuki; Yoshida, Junji; Aokage, Keiju; Nagai, Kanji; Tsuboi, Masahiro

    2016-03-01

    Postoperative recurrences of non-small-cell lung cancer (NSCLC) are usually disseminated and systemic. Recently, the concept of oligo-recurrence, which is theoretically curable by definitive local therapy (DLT), has been proposed in several cancers. The aim of this study was to clarify clinical features and outcomes of patients with postoperative oligo-recurrence of NSCLC. From 3275 patients with resected pathological stage IA-IIIB NSCLC between 1993 and 2011, a total of 768 patients who developed recurrence were included in this study. Oligo-recurrence was defined as 1-3 loco-regional or distant recurrent lesions restricted to a single organ. Other recurrences were classified as poly-recurrence. Second primary lung cancers and suspected lesions were excluded. DLT included surgery, stereotactic radiotherapy and radiotherapy with a 45 Gy or higher dose, performed with curative intent. Oligo-recurrence was identified in 162 (21%) patients, mainly as a solitary recurrence (n = 129, 80%) in regional lymph nodes, brain, lung, bone and adrenal gland, and the proportion of patients with oligo-recurrence increased gradually year by year. The patients with oligo-recurrence had more early-staged disease at initial surgery and a longer time to recurrence than those with poly-recurrence. The entire population of oligo-recurrence patients had better post-recurrence survival (PRS) than those with poly-recurrence (5-year PRS: 32.9 vs 9.9%, P recurrence, DLT was totally conducted in 105 (65%) patients as initial treatment. Multivariate analyses revealed that the initial DLT was associated with improved PRS [odds ratio (OR) 0.44; 95% confidence interval (CI) 0.29-0.68]. The recurrence location and initial pathological stage did not affect PRS. The 5-year PRS and postoperative progression-free survival rates after DLT were 38.6 and 22.3%, respectively. Of the 10 long-term (≥5-year) progression-free survivors, 9 were those with a solitary recurrence. Initial DLT for oligo-recurrence

  14. A family-based model to predict fear of recurrence for cancer survivors and their caregivers.

    Science.gov (United States)

    Mellon, Suzanne; Kershaw, Trace S; Northouse, Laurel L; Freeman-Gibb, Laurie

    2007-03-01

    Although fear of cancer recurrence is a great concern among survivors and their families, few studies have examined predictors of fear of recurrence. The purpose of this study was to identify factors associated with fear of recurrence in a population-based sample (N = 246) and determine if survivors and family caregivers influenced one another's fear of recurrence. A family framework guided the study and analyses included multilevel modeling using the Actor-Partner Interdependence Model. Results indicated that survivors and family caregivers influenced each other's fear of recurrence and that caregivers had significantly more fear of recurrence than survivors. More family stressors, less positive meaning of the illness, and age were related to elevated fear of cancer recurrence for both survivors and caregivers.

  15. A rare presentation of locally re-recurrent colon cancer involving the iliac bone and a review of the literature.

    Science.gov (United States)

    Schumacher, Andrew; Babikir, Osman Mahdi; Abboud, Amer; Theodorakis, Spyridon

    2014-10-29

    Colorectal cancer is a leading cause of cancer death in the USA. While locally advanced rectal cancer involving bone has been described extensively, colon cancer locally involving bone has only been described, to our knowledge, in a single case report. In this case report, we describe the presentation and treatment of locally advanced re-recurrent colon cancer involving the iliac bone. We also discuss the available literature on treatment for recurrent and re-recurrent colorectal cancer.

  16. Vaginal vault recurrences of endometrial cancer in non-irradiated patients

    DEFF Research Database (Denmark)

    Hardarson, Hordur Alexander; Nyhøj Heidemann, Lene; Christensen, René dePont;

    2015-01-01

    are few and limited to previously irradiated patients or patients with advanced disease. Investigation of surgical treatment for isolated vaginal vault recurrence is practically nonexistent. The aim of this study is to evaluate the efficacy of RT and ST in a non-irradiated group with recurrent endometrial......BACKGROUND: The treatment of locally recurrent endometrial cancer is based on limited evidence. The standard treatment is radiotherapy (RT) which is effective for local control and the effect has been documented in prospective studies. Investigations of surgical treatment (ST) of recurrences...... cancer limited to the vaginal vault. METHODS: Patients treated for recurrent endometrial cancer at Odense University Hospital, Denmark between 2003 and 2012 were identified, n = 118. Thirty-three patients had an isolated vaginal vault recurrence and were treated with either RT, ST or both. Re...

  17. Cancer/Testis antigens as potential predictors of biochemical recurrence of prostate cancer following radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Trock Bruce

    2011-09-01

    Full Text Available Abstract Background The Cancer/Testis Antigens (CTAs are an important group of proteins that are typically restricted to the testis in the normal adult but are aberrantly expressed in several types of cancers. As a result of their restricted expression patterns, the CTAs could serve as unique biomarkers for cancer diagnosis/prognosis. The aim of this study was to identify promising CTAs that are associated with prostate cancer (PCa recurrence following radical prostatectomy (RP. Methods The expression of 5 CTAs was measured by quantitative multiplex real-time PCR using prostate tissue samples obtained from 72 patients with apparently clinically localized PCa with a median of two years follow-up (range, 1 to 14 years. Results The expression of CTAs namely, CEP55, NUF2, PBK and TTK were significantly higher while PAGE4 was significantly lower in patients with recurrent disease. All CTAs with the exception of TTK were significantly correlated with the prostatectomy Gleason score, but none were correlated with age, stage, or preoperative PSA levels. In univariate proportional hazards models, CEP55 (HR = 3.59, 95% CI: 1.50-8.60, p = 0.004; NUF2 (HR = 2.28, 95% CI: 1.11-4.67, p = 0.024; and PAGE4 (HR = 0.44, 95% CI: 0.21-0.93, p = 0.031 were significantly associated with the risk of PCa recurrence. However, the results were no longer significant after adjustment for prostatectomy Gleason score. Conclusions To our knowledge, this is the first study to identify CTAs as biomarkers that can differentiate patients with recurrent and non-recurrent disease following RP and underscores its potential impact on PCa prognosis and treatment.

  18. Adherence to Needed Adjuvant Therapy Could Decrease Recurrence Rates for Rural Patients With Early Breast Cancer.

    Science.gov (United States)

    Xuan, Qijia; Gao, Kun; Song, Ying; Zhao, Shu; Dong, Lina; Zhang, Zhongbai; Zhang, Qingyuan; Wang, Jingxuan

    2016-12-01

    The purpose of this study was to evaluate the differences in stage upon diagnosis, adherence to adjuvant treatment, and recurrence between rural and urban patients with early breast cancer. This retrospective study included 3640 patients with primary breast cancer recruited from 2000 to 2009. Patients who developed recurrence or metastasis were verified by adequate diagnostic imaging modalities and pathology. The χ(2) test was used to compare groups with respect to variables (recurrence and clinicopathologic features). A multivariable Cox proportional hazard regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) for breast cancer recurrence risk. Compared with tumors in urban patients, those in rural patients showed higher histologic grade, larger size, more lymphatic metastasis, and higher Ki-67 index; therapy adherence was strongly associated with recurrence in both. Compared with urban patients, the female rural patients had a higher recurrence rate. However, no significant difference in recurrence rates was observed between urban and rural patients following guideline adherence. The results of our study suggest that the later stage upon diagnosis and nonadherence to treatment contribute toward worse breast cancer outcomes among rural patients with breast cancer. Adherence to needed adjuvant therapy could decrease recurrence rates for rural patients with early breast cancer. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. [Treatment outcomes of patients with cervical lymph node recurrence after esophagectomy for esophageal cancer].

    Science.gov (United States)

    Takemura, Masashi; Kaibe, Nobuaki; Takii, Mamiko; Yoshida, Kayo; Niwa, Hirotaka; Oshima, Tsutomu; Kikuchi, Shoujiro; Sasako, Mitsuru

    2014-11-01

    Herein, we report the treatment outcomes of patients with limited cervical lymph node recurrence after esophagectomy for esophageal cancer. Between April 2010 and December 2013, 8 patients with cervical lymph nodes recurrence were diagnosed and treated in our department. All patients were detected with recurrent disease by using positron emission tomography computed tomography(PET-CT), and among these, 5 patients had solitary node recurrence. Initial treatments were irradiation therapy in 5 patients and lymphadenectomy in 3 patients. Four of 5 patients underwent irradiation therapy and lymphadenectomy. Four of 5 patients with solitary node recurrence are still alive without relapse of disease. In conclusion, PET-CT can be useful for early detection of recurrent disease after esophagectomy. Appropriate therapy for patients with solitary cervical lymph node recurrence is associated with long-term survival after recurrence.

  20. Contribution of problem-solving skills to fear of recurrence in breast cancer survivors.

    Science.gov (United States)

    Akechi, Tatuo; Momino, Kanae; Yamashita, Toshinari; Fujita, Takashi; Hayashi, Hironori; Tsunoda, Nobuyuki; Iwata, Hiroji

    2014-05-01

    Although fear of recurrence is a major concern among breast cancer survivors after surgery, no standard strategies exist that alleviate their distress. This study examined the association of patients' problem-solving skills and fear of recurrence and psychological distress among breast cancer survivors. Randomly selected, ambulatory, female patients with breast cancer participated in this study. They were asked to complete the Concerns about Recurrence Scale (CARS) and the Hospital Anxiety and Depression Scale. Multiple regression analyses were used to examine their associations. Data were obtained from 317 patients. Patients' problem-solving skills were significantly associated with all subscales of fear of recurrence and overall worries measured by the CARS. In addition, patients' problem-solving skills were significantly associated with both their anxiety and depression. Our findings warrant clinical trials to investigate effectiveness of psychosocial intervention program, including enhancing patients' problem-solving skills and reducing fear of recurrence among breast cancer survivors.

  1. Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer.

    Science.gov (United States)

    Mirza, Mansoor R; Monk, Bradley J; Herrstedt, Jørn; Oza, Amit M; Mahner, Sven; Redondo, Andrés; Fabbro, Michel; Ledermann, Jonathan A; Lorusso, Domenica; Vergote, Ignace; Ben-Baruch, Noa E; Marth, Christian; Mądry, Radosław; Christensen, René D; Berek, Jonathan S; Dørum, Anne; Tinker, Anna V; du Bois, Andreas; González-Martín, Antonio; Follana, Philippe; Benigno, Benedict; Rosenberg, Per; Gilbert, Lucy; Rimel, Bobbie J; Buscema, Joseph; Balser, John P; Agarwal, Shefali; Matulonis, Ursula A

    2016-12-01

    Niraparib is an oral poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) 1/2 inhibitor that has shown clinical activity in patients with ovarian cancer. We sought to evaluate the efficacy of niraparib versus placebo as maintenance treatment for patients with platinum-sensitive, recurrent ovarian cancer. In this randomized, double-blind, phase 3 trial, patients were categorized according to the presence or absence of a germline BRCA mutation (gBRCA cohort and non-gBRCA cohort) and the type of non-gBRCA mutation and were randomly assigned in a 2:1 ratio to receive niraparib (300 mg) or placebo once daily. The primary end point was progression-free survival. Of 553 enrolled patients, 203 were in the gBRCA cohort (with 138 assigned to niraparib and 65 to placebo), and 350 patients were in the non-gBRCA cohort (with 234 assigned to niraparib and 116 to placebo). Patients in the niraparib group had a significantly longer median duration of progression-free survival than did those in the placebo group, including 21.0 vs. 5.5 months in the gBRCA cohort (hazard ratio, 0.27; 95% confidence interval [CI], 0.17 to 0.41), as compared with 12.9 months vs. 3.8 months in the non-gBRCA cohort for patients who had tumors with homologous recombination deficiency (HRD) (hazard ratio, 0.38; 95% CI, 0.24 to 0.59) and 9.3 months vs. 3.9 months in the overall non-gBRCA cohort (hazard ratio, 0.45; 95% CI, 0.34 to 0.61; P<0.001 for all three comparisons). The most common grade 3 or 4 adverse events that were reported in the niraparib group were thrombocytopenia (in 33.8%), anemia (in 25.3%), and neutropenia (in 19.6%), which were managed with dose modifications. Among patients with platinum-sensitive, recurrent ovarian cancer, the median duration of progression-free survival was significantly longer among those receiving niraparib than among those receiving placebo, regardless of the presence or absence of gBRCA mutations or HRD status, with moderate bone marrow toxicity. (Funded by

  2. Long-term survival outcome after postoperative recurrence of non-small-cell lung cancer: who is 'cured' from postoperative recurrence?

    Science.gov (United States)

    Sekihara, Keigo; Hishida, Tomoyuki; Yoshida, Junji; Oki, Tomonari; Omori, Tomokazu; Katsumata, Shinya; Ueda, Takuya; Miyoshi, Tomohiro; Goto, Masaki; Nakasone, Syoko; Ichikawa, Tomohiro; Matsuzawa, Reiko; Aokage, Keiju; Goto, Koichi; Tsuboi, Masahiro

    2017-09-01

    Since survival after postoperative non-small-cell lung cancer (NSCLC) recurrence is extremely poor, the long-term post-recurrence outcomes are not well understood. The purpose of this study was to evaluate the long-term post-recurrence outcomes and clarify who are possibly 'cured' in recent clinical practice. We reviewed the medical records of 635 patients who developed postoperative recurrence until 2012 after R0 resection for pathological Stage IA-IIIA NSCLC between 1993 and 2006. Factors associated with post-recurrence survival (PRS) and the characteristics of the long-term (≥5 years) survivors were analysed retrospectively. The 5-year PRS rate of all 635 patients was 13%. Multivariable analysis revealed that female [hazard ratio (HR) = 0.78], adenocarcinoma (HR = 0.77), locoregional (only) recurrence (HR = 0.59) and longer recurrence-free survival (HR = 0.99) were favourably associated with PRS. A total of 51 patients achieved 5-year PRS; however, 32 (63%) were cancer-bearing patients in their fifth post-recurrent year who were mainly treated by epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). Subsequent PRS curves for cancer-controlled and cancer-bearing groups were different (8-year PRS: 94% vs 31%, P = 0.003). Among 19 cancer-controlled patients in their fifth post-recurrent year, 17 (89%) patients initially received radical local therapy for their recurrence. Two-thirds of 5-year survivors after postoperative NSCLC recurrence had a cancer-bearing status and showed deteriorated subsequent survival. Curability of postoperative NSCLC recurrence should be evaluated in terms of the 'cancer-controlled' status, and 'cured' population is included in the patients who are 'cancer controlled' at the fifth post-recurrent year.

  3. S0420, Sorafenib in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    Science.gov (United States)

    2013-02-27

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  4. Serum uPAR as Biomarker in Breast Cancer Recurrence: A Mathematical Model.

    Science.gov (United States)

    Hao, Wenrui; Friedman, Avner

    2016-01-01

    There are currently over 2.5 million breast cancer survivors in the United States and, according to the American Cancer Society, 10 to 20 percent of these women will develop recurrent breast cancer. Early detection of recurrence can avoid unnecessary radical treatment. However, self-examination or mammography screening may not discover a recurring cancer if the number of surviving cancer cells is small, while biopsy is too invasive and cannot be frequently repeated. It is therefore important to identify non-invasive biomarkers that can detect early recurrence. The present paper develops a mathematical model of cancer recurrence. The model, based on a system of partial differential equations, focuses on tissue biomarkers that include the plasminogen system. Among them, only uPAR is known to have significant correlation to its concentration in serum and could therefore be a good candidate for serum biomarker. The model includes uPAR and other associated cytokines and cells. It is assumed that the residual cancer cells that survived primary cancer therapy are concentrated in the same location within a region with a very small diameter. Model simulations establish a quantitative relation between the diameter of the growing cancer and the total uPAR mass in the cancer. This relation is used to identify uPAR as a potential serum biomarker for breast cancer recurrence.

  5. Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

    Directory of Open Access Journals (Sweden)

    Schnabel Freya

    2012-06-01

    Full Text Available Abstract Introduction Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation We describe the case of a Caucasian woman who was initially treated for pregnancy-associated breast cancer at age 23, three months after the birth of her third child. She underwent a total mastectomy with axillary node dissection, followed by chemotherapy and hormonal therapy. Ten years later, when the patient was 24 weeks pregnant with her fourth child, she presented with an ipsilateral chest wall recurrence of breast cancer. To the best of our knowledge, this represents the first reported case of a pregnancy-associated recurrence in a patient previously treated for pregnancy-associated breast cancer. Conclusion The case described here is the first report of a second occurrence of pregnancy-associated breast cancer. This case raises the possibility that pregnancy may represent a unique trigger for breast malignancy in a specific cohort of women. Although there is data showing no increase in the risk of recurrence for women who become pregnant after breast cancer treatment, pregnancy-associated breast cancer may be a distinct clinical category where subsequent pregnancies after treatment may confer an increased risk of recurrent disease.

  6. The Frank Ellis memorial lecture: the use of three-dimensional imaging in gynaecological radiation therapy.

    Science.gov (United States)

    Viswanathan, A N

    2008-02-01

    The use of three-dimensional image guidance in radiation therapy has increased dramatically over the past decade. In gynaecological malignancies, three-dimensional image guidance assists with both external beam and brachytherapy treatment planning, increasing the accuracy of dose delivery. During his lifetime, Frank Ellis made significant contributions to gynaecological brachytherapy. This lecture will focus on novel advances in three-dimensional image-guided radiation therapy for cervical cancer, with the ultimate goal of improving outcomes for our patients.

  7. Thalidomide in Treating Patients With Recurrent or Persistent Endometrial Cancer

    Science.gov (United States)

    2013-01-23

    Endometrial Adenoacanthoma; Endometrial Adenocarcinoma; Endometrial Adenosquamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma

  8. Late-onset peritoneal recurrence of advanced gastric cancer 20 years after primary resection

    Directory of Open Access Journals (Sweden)

    Mohri Yasuhiko

    2010-11-01

    Full Text Available Abstract Late onset of peritoneal recurrence of gastric cancer more than 10 years after surgery is extremely rare, and only three cases have been reported. We present the case of a 61-year-old man who was diagnosed finally with peritoneal recurrence of gastric cancer 20 years after primary curative resection. As a result of small-bowel obstruction caused by peritoneal recurrence, diverting ileostomy with partial ileal resection was performed. The resected specimen revealed tubular adenocarcinoma that resembled the primary gastric cancer. The clinical course after the second operation was unfavorable and systemic chemotherapy had no effect. He died at 62 years of age, 21 years and 7 months after initial gastrectomy. Immunohistochemical analysis using antibodies against proliferating cell nuclear antigen (PCNA, Ki-67, and p53 was performed to investigate the phenotype of primary and recurrence cancer. Protein expression of proliferation markers such as PCNA and Ki-67 was down-regulated, but p53 was overexpressed at the site of recurrence. These data suggest that late peritoneal recurrence has a low proliferation rate and is resistant to chemoradiotherapy. In conclusion, we present late onset of peritoneal recurrence of gastric cancer more than 20 years after primary surgery, and speculate on the mechanism of late-onset recurrence in our case.

  9. Dasatinib in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    Science.gov (United States)

    2014-09-17

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  10. [Magnetic resonance imaging (MRI) in the diagnosis of recurrences of ovarian cancer in the small pelvis].

    Science.gov (United States)

    Bulanova, I M; Bulanova, T V; Burenchev, D V

    2005-01-01

    The paper provides the results of small pelvic magnetic resonance tomography (MRI) in 62 patients with ovarian cancer after primary special treatment. Out of them 50 patients were found to have recurrences and metastases of the underlying disease, 12 patients had clinical remission. The study yielded MR signs and MR semiotics of recurrences of ovarian cancer in the small pelvis. The capacities of MRI with low and high intensities of a magnetic field were comparatively studied in the diagnosis of recurrences and metastases of ovarian cancer.

  11. Coffee Intake, Recurrence, and Mortality in Stage III Colon Cancer: Results From CALGB 89803 (Alliance)

    Science.gov (United States)

    Guercio, Brendan J.; Sato, Kaori; Niedzwiecki, Donna; Ye, Xing; Saltz, Leonard B.; Mayer, Robert J.; Mowat, Rex B.; Whittom, Renaud; Hantel, Alexander; Benson, Al; Atienza, Daniel; Messino, Michael; Kindler, Hedy; Venook, Alan; Hu, Frank B.; Ogino, Shuji; Wu, Kana; Willett, Walter C.; Giovannucci, Edward L.; Meyerhardt, Jeffrey A.; Fuchs, Charles S.

    2015-01-01

    Purpose Observational studies have demonstrated increased colon cancer recurrence in states of relative hyperinsulinemia, including sedentary lifestyle, obesity, and increased dietary glycemic load. Greater coffee consumption has been associated with decreased risk of type 2 diabetes and increased insulin sensitivity. The effect of coffee on colon cancer recurrence and survival is unknown. Patients and Methods During and 6 months after adjuvant chemotherapy, 953 patients with stage III colon cancer prospectively reported dietary intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. We examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards regression. Results Patients consuming 4 cups/d or more of total coffee experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% CI, 0.34 to 0.99), compared with never drinkers (Ptrend = .002). Patients consuming 4 cups/d or more of caffeinated coffee experienced significantly reduced cancer recurrence or mortality risk compared with abstainers (HR, 0.48; 95% CI, 0.25 to 0.91; Ptrend = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR, 0.66 across extreme quintiles; 95% CI, 0.47 to 0.93; Ptrend = .006). Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes seemed consistent across other predictors of cancer recurrence and mortality. Conclusion Higher coffee intake may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer. PMID:26282659

  12. Photodynamic Therapy Using Temoporfin Before Surgery in Treating Patients With Recurrent Oral Cavity or Oropharyngeal Cancer

    Science.gov (United States)

    2014-09-02

    Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage II Squamous Cell Carcinoma of the Oropharynx; Stage II Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  13. Pregnancy-associated breast cancer and increased risk of pregnancy-associated recurrence: a case report

    OpenAIRE

    Schnabel Freya; Billig Jessica; Cimeno Arielle; Chun Jennifer

    2012-01-01

    Abstract Introduction Pregnancy-associated breast cancer refers to breast cancer diagnosed during pregnancy, lactation, or within twelve months postpartum. Recent studies suggest that, when matched for age and stage, the prognosis of pregnancy-associated breast cancer is comparable to non-pregnancy-associated breast cancer. However, the risk for breast cancer recurrence associated with subsequent pregnancies in this population is not clear. Case presentation We describe the case of a Caucasia...

  14. Fear of cancer recurrence and its predictive factors among Iranian cancer patients

    Directory of Open Access Journals (Sweden)

    Alireza Mohajjel Aghdam

    2014-01-01

    Full Text Available Context: Fear of cancer recurrence (FOCR is one of the most important psychological problems among cancer patients. In extensive review of related literature there were no articles on FOCR among Iranian cancer patients. Aim: The aim of present study was to investigation FOCR and its predictive factors among Iranian cancer patients. Materials and Methods: In this descriptive-correlational study 129 cancer patients participated. For data collection, the demographic checklist and short form of fear of progression questionnaire was used. Logistic regression was used to determine predictive factors of FOCR. Result: Mean score of FOCR among participants was 44.8 and about 50% of them had high level of FOCR. The most important worries of participants were about their family and the future of their children and their lesser worries were about the physical symptoms and fear of physical damage because of cancer treatments. Also, women, breast cancer patient, and patients with lower level of education have more FOCR. Discussion: There is immediate need for supportive care program designed for Iranian cancer patients aimed at decreasing their FOCR. Especially, breast cancer patients and the patient with low educational level need more attention.

  15. Local recurrence following lung cancer surgery: incidence, risk factors, and outcomes.

    Science.gov (United States)

    Fedor, David; Johnson, W Rainey; Singhal, Sunil

    2013-09-01

    To date, few large-scale original studies have focused specifically on local recurrence following curative lung cancer surgery. This review seeks to consolidate and analyze data from these studies regarding local recurrence incidence, risk factors, salvage treatments, and outcomes to increase awareness in the Oncology community and to spark new research in this area. PubMed literature was searched for large-scale cohort studies involving recurrence following lung cancer surgery. Studies with a primary focus on local recurrence and studies that examined overall recurrence but provided relevant numerical data on local recurrence were included. Each chosen study's methods were critically analyzed to reconcile as best as possible large differences in reported results across the studies. Up to 24% of patients recur locally following lung cancer surgery. Risk of local recurrence increases with the stage of the primary cancer, but even stage I patients experience local recurrence up to 19% of the time. Overall survival time following local recurrence varies widely across studies, from 7 to 26 months, and may be related to frequency of follow-up visits. Salvage therapy appears to increase survival time. However, estimates of this increase vary widely, and measurements of benefits of the various salvage options are confounded by lack of control of subjects' condition at the time of salvage therapy administration. Local recurrence following lung cancer surgery is a significant problem warranting additional research. At present, data on this topic is scarce. We recommend initiation of additional large-scale studies to clearly define the parameters of local recurrence in order to provide useful guidance to clinicians. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cvek, Jakub; Knybel, Lukas; Skacelikova, Eva; Otahal, Bretislav; Molenda, Lukas; Feltl, David [University Hospital Ostrava, Department of Oncology, Ostrava (Czech Republic); Stransky, Jiri; Res, Oldrich [University Hospital Ostrava, Department of Maxilofacial Surgery, Ostrava (Czech Republic); Matousek, Petr; Zelenik, Karol [University Hospital Ostrava, Department of Otolaryngology, Ostrava (Czech Republic)

    2016-01-15

    The goal of this work was to evaluate the efficacy and toxicity of hyperfractionated stereotactic reirradiation (re-RT) as a treatment for inoperable, recurrent, or second primary head and neck squamous cell cancer (HNSCC) that is not suitable for systemic treatment. Forty patients with recurrent or second primary HNSCC were included in this study. The patients had a median gross tumor volume of 76 ml (range 14-193 ml) and a previous radiotherapy dose greater than 60 Gy. Treatment was designed to cover 95 % of the planning target volume (PTV, defined as gross tumor volume [GTV] + 3 mm to account for microscopic spreading, with no additional set-up margin) with the prescribed dose (48 Gy in 16 fractions b.i.d.). Treatment was administered twice daily with a minimum 6 h gap. Uninvolved lymph nodes were not irradiated. Treatment was completed as planned for all patients (with median duration of 11 days, range 9-14 days). Acute toxicity was evaluated using the RTOG/EORTC scale. A 37 % incidence of grade 3 mucositis was observed, with recovery time of ≤ 4 weeks for all of these patients. Acute skin toxicity was never observed to be higher than grade 2. Late toxicity was also evaluated according to the RTOG/EORTC scale. Mandible radionecrosis was seen in 4 cases (10 %); however, neither carotid blowout syndrome nor other grade 4 late toxicity occurred. One-year overall survival (OS) and local progression-free survival (L-PFS) were found to be 33 and 44 %, respectively. Performance status and GTV proved to be significant prognostic factors regarding local control and survival. Hyperfractionated stereotactic re-RT is a reasonable treatment option for patients with recurrent/second primary HNSCC who were previously exposed to high-dose irradiation and who are not candidates for systemic treatment or hypofractionation. (orig.) [German] Ziel der Studie war es, die Effektivitaet und Toxizitaet der hyperfraktionierten akzelerierten stereotaktischen Wiederbestrahlung (re

  17. Prognostic Factors and Recurrence in Breast Cancer: Experience at the National Cancer Institute of Mexico

    OpenAIRE

    Stankov, A.; J. E. Bargallo-Rocha; A. Ñamendys-Silva Silvio; Ramirez, M. T.; Stankova-Ninova, K.; Meneses-Garcia, A.

    2012-01-01

    The purpose of this study was to analyze the prognostic and predictive factors that relate to locoregional or distant recurrences in breast cancer patients who have been treated at the National Cancer Institute of Mexico. Multivariate, time-dependent Cox regression analyses indicate that the pN status (positive versus negative lymph node; P = 0.003; HR (hazard ratio), 3.47; CI (confidence interval), 1.52–7.91) and the pathological complete response of the patient to neoadjuvant chemotherapy (...

  18. Analysis of diferentially expressed protein from primary and recurrent ovarian cancer serum

    Institute of Scientific and Technical Information of China (English)

    Yuan Wang; Jin-Jin Yu; Ting Zhu; Ling Xu; Ming Xu; Yu-Zheng Huang; Hong Pu; Chun-Qing Yu

    2012-01-01

    ABSTRACT Objective:To study the value of the differentially expressed proteins from primary and recurrent ovarian cancer serum for early diagnosis of primary and recurrent ovarian cancer.Methods:WCX kit(BrukerDaltonicsGraBH) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS) technology were used to detect serum samples from49 patients with primary ovarian cancer and21 patients with recurrent disease.Results:In the mass range(Mr) from1000 to12000Da, eight differentially expressed protein peaks were screened from primary ovarian cancer serum.Among them, four protein peaks withMr1457,1857,2202, 7761 were lowly expressed and the others withMr2946,5333,5859,5901 were highly expressed. Ten diferentially expressed protein peaks were screened from recurrent ovarian cancer serum. Among them,1944,1980,2080,2661,2993,4450,4659,5359Da protein expressions were increased significantly, and1897,7868Da protein expressions were decreased significantly.The pattern of primary ovarian cancer was applied to8 early-stage ovarian cancer serum samples, and7 serum samples were successfully predicted with the accuracy of87.5%.The pattern of recurrent ovarian cancer was applied to9 without pelvic or abdominal mass recurrent ovarian cancer serum samples, and8 serum samples were successfully predicted with the accuracy of 88.9%.Conclusions:Combination ofMALDI-TOF-MS andWCX kit technology can directly screen the diferrential expressed protein from primary and recurrent ovarian cancer serum.They have clinical significance for enhancement of sensitivity and specificity of ovarian cancer diagnosis.

  19. [Post-recurrence survival after surgical resection of non-small cell lung cancer with local recurrence].

    Science.gov (United States)

    Yokouchi, Hideoki; Miyazaki, Masaki; Miyamoto, Takeaki; Tsuji, Fumio; Ebisui, Chikara; Murata, Kohei

    2014-11-01

    We retrospectively evaluated the clinical outcomes of 192 consecutive patients with local recurrence after complete resection of non-small cell lung cancer NSCLC). The initial local recurrent site was the resection stump in 5 patients the chest wall in 3 patients, mediastinum in 1 patient, and diaphragm in 1 patient), and the hilar and/or mediastinal lymph node (HMLN) in 17 patients. The sites of distant metastasis were the lungs in 10 patients, pleura in 4 patients, brain in 7 patients, liver in 5 patients, bone in 4 patients, and other sites in 4 patients. Treatments after initial recurrence included surgery in 2 patients, radiotherapy in 5 patients, chemotherapy in 9 patients, and chemo-radiotherapy in 5 patients. Only 1 patient received supportive care. The response to radiotherapy was a complete response (R) in 1 patient, partial response (PR) in 5 patients, stable disease (SD )in 3 patients, and progressive disease (PD )in 1 patient. The best response of all lines of chemotherapy was CR in 3 patients, PR in 4 patients, SD in 3 patients, and PD in 4 patients. The median post-recurrence survival (PRS) time with local recurrence was better than that with distant metastasis (23 vs 14 months); however, the best PRS was obtained in patients with recurrence in the lungs (29 months). A CR for more than 2 years was obtained in 1 patient after surgery, in 1 patient after radiotherapy, and in 2 patients after chemotherapy. Although local recurrence of resected NSCLC can be potentially controlled by using local treatments - such as surgery and radiotherapy - or systemic chemotherapy, curative aggressive treatment should be considered when required.

  20. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-10-26

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  1. Integrative gene network construction to analyze cancer recurrence using semi-supervised learning.

    Directory of Open Access Journals (Sweden)

    Chihyun Park

    Full Text Available BACKGROUND: The prognosis of cancer recurrence is an important research area in bioinformatics and is challenging due to the small sample sizes compared to the vast number of genes. There have been several attempts to predict cancer recurrence. Most studies employed a supervised approach, which uses only a few labeled samples. Semi-supervised learning can be a great alternative to solve this problem. There have been few attempts based on manifold assumptions to reveal the detailed roles of identified cancer genes in recurrence. RESULTS: In order to predict cancer recurrence, we proposed a novel semi-supervised learning algorithm based on a graph regularization approach. We transformed the gene expression data into a graph structure for semi-supervised learning and integrated protein interaction data with the gene expression data to select functionally-related gene pairs. Then, we predicted the recurrence of cancer by applying a regularization approach to the constructed graph containing both labeled and unlabeled nodes. CONCLUSIONS: The average improvement rate of accuracy for three different cancer datasets was 24.9% compared to existing supervised and semi-supervised methods. We performed functional enrichment on the gene networks used for learning. We identified that those gene networks are significantly associated with cancer-recurrence-related biological functions. Our algorithm was developed with standard C++ and is available in Linux and MS Windows formats in the STL library. The executable program is freely available at: http://embio.yonsei.ac.kr/~Park/ssl.php.

  2. Salvage Lymph Node Dissection for Node-only Recurrence of Prostate Cancer: Ready for Prime Time?

    Science.gov (United States)

    Suardi, Nazareno; Briganti, Alberto; Gandaglia, Giorgio; Fossati, Nicola; Montorsi, Francesco

    2016-12-30

    Several studies show that salvage lymph-node dissection for node-only recurrence of prostate cancer after radical treatment might represent a viable treatment modality for node-only recurrent PCa. However, as long as high quality data is not available, this approach should still be considered experimental.

  3. Prognostic Factors for Local, Loco-regional and Systemic Recurrence in Early-stage Breast Cancer.

    Science.gov (United States)

    Kümmel, A; Kümmel, S; Barinoff, J; Heitz, F; Holtschmidt, J; Weikel, W; Lorenz-Salehi, F; du Bois, A; Harter, P; Traut, A; Blohmer, J U; Ataseven, B

    2015-07-01

    Aim: The risk of recurrence in breast cancer depends on factors such as treatment but also on the intrinsic subtype. We analyzed the risk factors for local, loco-regional and systemic recurrence, evaluated the differences and analyzed the risk of recurrence for different molecular subtypes. Material and Methods: A total of 3054 breast cancer patients who underwent surgery followed by adjuvant treatment at HSK hospital or Essen Mitte Hospital between 1998 and 2011 were analyzed. Based on immunohistochemical parameters, cancers were divided into the following subgroups: luminal A, luminal B (HER2-), luminal B (HER2+), HER2+ and TNBC (triple negative breast cancer). Results: 67 % of tumors were classified as luminal A, 13 % as luminal B (HER2-), 6 % as luminal B (HER2+), 3 % as HER2+ and 11 % as TNBC. After a median follow-up time of 6.6 years there were 100 local (3.3 %), 32 loco-regional (1 %) and 248 distant recurrences (8 %). Five-year recurrence-free survival for the overall patient collective was 92 %. On multivariate analysis, positive nodal status, TNBC subtype and absence of radiation therapy were found to be independent risk factors for all forms of recurrence. Age loco-regional recurrence was low. In addition to nodal status, subgroup classification was found to be an important factor affecting the risk of recurrence.

  4. Individual Risk Profiling For Breast Cancer Recurrence: Towards Tailored Follow-Up Schemes

    NARCIS (Netherlands)

    Kraeima, J.; Vliegen, I.; Siesling, S.; Klaase, J.; IJzerman, M.J.

    2013-01-01

    Objectives Current international guidelines for breast cancer follow-up are not specific to individual risk of local regional recurrences. Instead, for personalised follow-up it is required to have more precise estimates of local regional recurrence probability as a function of time. The objective o

  5. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes

    NARCIS (Netherlands)

    Kraeima, J.; Siesling, Sabine; Vliegen, Ingrid; Klaase, J.M.; IJzerman, Maarten Joost

    2013-01-01

    Background: Breast cancer follow-up is not tailored to the risk of locoregional recurrences in individual patients or as a function of time. The objective of this study was to identify prognostic factors, and to estimate individual and time dependent locoregional recurrence risk rates, in order to

  6. Individual Risk Profiling For Breast Cancer Recurrence: Towards Tailored Follow-Up Schemes

    NARCIS (Netherlands)

    Kraeima, J.; Vliegen, I.; Siesling, Sabine; Klaase, J.; IJzerman, Maarten Joost

    2013-01-01

    Objectives Current international guidelines for breast cancer follow-up are not specific to individual risk of local regional recurrences. Instead, for personalised follow-up it is required to have more precise estimates of local regional recurrence probability as a function of time. The objective

  7. Sugar-sweetened beverage intake and cancer recurrence and survival in CALGB 89803 (Alliance.

    Directory of Open Access Journals (Sweden)

    Michael A Fuchs

    Full Text Available BACKGROUND: In colon cancer patients, obesity, sedentary lifestyle, and high dietary glycemic load have been associated with increased risk of cancer recurrence. High sugar-sweetened beverage intake has been associated with obesity, diabetes, and cardio-metabolic diseases, but the influence on colon cancer survival is unknown. METHODS: We assessed the association between sugar-sweetened beverage consumption on cancer recurrence and mortality in 1,011 stage III colon cancer patients who completed food frequency questionnaires as part of a U.S. National Cancer Institute-sponsored adjuvant chemotherapy trial. Hazard ratios (HRs and 95% confidence intervals (CIs were calculated with Cox proportional hazard models. RESULTS: Patients consuming ≥ 2 servings of sugar-sweetened beverages per day experienced an adjusted HR for disease recurrence or mortality of 1.67 (95% CI, 1.04-2.68, compared with those consuming <2 servings per month (P(trend = 0.02. The association of sugar-sweetened beverages on cancer recurrence or mortality appeared greater among patients who were both overweight (body mass index ≥ 2 5 kg/m(2 and less physically active (metabolic equivalent task-hours per week <18 (HR = 2.22; 95% CI, 1.29-3.81, P(trend = 0.0025. CONCLUSION: Higher sugar-sweetened beverage intake was associated with a significantly increased risk of cancer recurrence and mortality in stage III colon cancer patients.

  8. Ixabepilone in Treating Patients With Metastatic or Recurrent Squamous Cell Cancer of the Head and Neck

    Science.gov (United States)

    2013-02-26

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  9. Vaginal vault recurrences of endometrial cancer in non-irradiated patients — Radiotherapy or surgery

    Directory of Open Access Journals (Sweden)

    Hordur Alexander Hardarson

    2015-01-01

    Conclusion: This study indicates that ST is an appropriate treatment for locally recurrent endometrial cancer. Our study involves a limited number of patients and is made retrospectively, therefore prospective and ideally randomized trials evaluating both survival and complications are warranted.

  10. Making sense of living under the shadow of death: adjusting to a recurrent breast cancer illness.

    Science.gov (United States)

    Kenne Sarenmalm, Elisabeth; Thorén-Jönsson, Anna-Lisa; Gaston-Johansson, Fannie; Ohlén, Joakim

    2009-08-01

    Women with recurrent breast cancer face many difficulties and challenges, from clinical symptoms of disease progression and treatment to a range of emotional responses. Guided by grounded theory methodology, we explored the main concerns of women with recurrent breast cancer, and how they were dealing with their situations. Data were collected from 40 in-depth interviews with 20 women diagnosed with recurrent breast cancer. The core category illustrated the process of "making sense of living under the shadow of death," and was based on the women's experiences of adjusting to living with a persistent life-threatening illness. Confronting a recurrence of breast cancer was a life-altering event. Moving through a difficult and challenging time, women eased their distress by letting go of losses and reassessing important values. Through a personal transition women transcended living with a life-threatening illness. These findings emphasize the importance of recognizing existential distress in clinical practice.

  11. Efficacy of intraperitoneal thermochemotherapy and immunotherapy in intraperitoeal recurrence after grastrointestinal cancer resecction

    Institute of Scientific and Technical Information of China (English)

    Qing-GuoFu; Fan-DongMeng; Xiao-DognShen; Ren-XuanGuo

    2002-01-01

    AIM:To investigate the prophylactic and therapeutic efficacy of intraperitoneal IL-2 innunotherapy following intraperitoneal thermochemotheray int the metastasis and recurrence of gastric and colorectal cancer after operation.

  12. Treatment of locally advanced/locally recurrent breast cancer and inflammatory breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Murakami, Masao [Tenri Hospital, Nara (Japan)

    2000-10-01

    This paper summarizes the treatment of locally advanced breast cancer, inflammatory breast cancer, and locally recurrent breast cancer. A multidisciplinary approach considering subclinical distant metastases is needed to treat these types of breast cancer. Subclinical distant metastasis is observed in about 80% of case of locally advanced cancer, and treatment of subclinical distant metastases, e.g., by endocrinotherapy and chemotherapy, is therefore essential to improving the prognosis. The standard therapy for unresectable locally advanced breast cancer consists of induction chemotherapy with anthracyclines and local treatment with mastectomy or irradiation. Previous reports have stated that induction chemotherapy was effective in 60-80% of the primary lesions or lymph node metastasis, and the CR rates were in the 10-20% range. Combination therapy with induction chemotherapy clearly improved the outcome over local treatment alone. The usual irradiation dose is 50 to 60 Gy/5 to 7 weeks to the whole breast or the thoracic wall. Boost irradiation at a dose of 10 to 25 Gy is performed in unresectable cases. The boost irradiation dose to the lymph node area is usually 45 to 50 Gy/5 to 6 weeks in cases without gross lesions and 10 to 15 Gy in cases with gross lesions. Combination therapy consisting of conservative pectoral mastectomy and postoperative adjuvant chemo- endocrino-therapy (i.e., adjuvant therapy) has become the standard regimen for treating resectable locally advanced breast cancer, because it significantly improves the recurrence rate and survival rate compared to local treatment alone. Some clinical have studies indicated that neoadjuvant therapy (i.e., induction chemotherapy + surgery/radiation therapy) is comparable or superior to adjuvant therapy in terms of improving the prognosis. However, the efficacy and most appropriate method of breast-conserving therapy after induction chemotherapy are still unclear. More clinical trials are needed. It has been

  13. FXYD-3 expression in relation to local recurrence of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Loftas, Per; Arbman, Gunnar; Sun, Xiao Feng; Hallbook, Olof [Dept. of Clinical and Experimental Medicine, Linkoping University, Norrkoping (Sweden); Edler, David [Dept. of Surgery, Karolinska Institute, Stockholm (Sweden); Syk, Erik [Dept. of Surgery, Ersta Hospital, Stockholm (Sweden)

    2016-03-15

    In a previous study, the transmembrane protein FXYD-3 was suggested as a biomarker for a lower survival rate and reduced radiosensitivity in rectal cancer patients receiving preoperative radiotherapy. The purpose of preoperative irradiation in rectal cancer is to reduce local recurrence. The aim of this study was to investigate the potential role of FXYD-3 as a biomarker for increased risk for local recurrence of rectal cancer. FXYD-3 expression was immunohistochemically examined in surgical specimens from a cohort of patients with rectal cancer who developed local recurrence (n = 48). The cohort was compared to a matched control group without recurrence (n = 81). Weak FXYD-3 expression was found in 106/129 (82%) of the rectal tumors and strong expression in 23/129 (18%). There was no difference in the expression of FXYD-3 between the patients with local recurrence and the control group. Furthermore there was no difference in FXYD-3 expression and time to diagnosis of local recurrence between patients who received preoperative radiotherapy and those without. Previous findings indicated that FXYD-3 expression may be used as a marker of decreased sensitivity to radiotherapy or even overall survival. We were unable to confirm this in a cohort of rectal cancer patients who developed local recurrence.

  14. Hyperglycemia and prostate cancer recurrence in men treated for localized prostate cancer

    Science.gov (United States)

    Wright, Jonathan L; Plymate, Stephen R.; Porter, Michael P; Gore, John L; Lin, Dan W; Hu, Elaine; Zeliadt, Steven B

    2013-01-01

    Introduction Obesity is consistently linked with prostate cancer (PCa) recurrence and mortality although the mechanism is unknown. Impaired glucose regulation, which is common among obese individuals, has been hypothesized as a potential mechanism for PCa tumor growth. In this study we explore the relationship between serum glucose at time of treatment and risk of PCa recurrence following initial therapy. Methods The study group was comprised of 1,734 men treated with radical prostatectomy (RP) or radiation therapy (RT) for localized PCa between 2001–2010. Serum glucose levels closest to date of diagnosis were determined. PCa recurrence was determined based on PSA progression (nadir PSA + 2 for RT; PSA ≥ 0.2 for RP) or secondary therapy. Multivariate Cox regression was performed to determine whether glucose level was associated with BCR after adjusting for age, race, BMI, comorbidity, diagnosis of diabetes, Gleason Sum, PSA, treatment, and treatment year. Results Recurrence was identified in 16% of men over a mean follow-up period 41 months (range 1 – 121 months). Those with elevated glucose (≥ 100 mg/dL) had a 50% increased risk of recurrence (HR 1.5, 95% CI: 1.1–2.0) compared to those with a normal glucose level (< 100 mg/dL). This effect was seen in both those undergoing RP (HR 1.9, 95% CI 1.0–3.6) and those treated with RT (HR 1.4, 95% CI 1.0–2.0). Conclusion Glucose levels at the time of PCa diagnosis are an independent predictor of PCa recurrence for men undergoing treatment for localized disease. PMID:23459096

  15. Legal termination of a pregnancy resulting from transplanted cryopreserved ovarian tissue due to cancer recurrence

    DEFF Research Database (Denmark)

    Ernst, EH; Offersen, Birgitte Vrou; Andersen, Claus Yding

    2013-01-01

    To report on a woman who conceived naturally and had a normal intrauterine pregnancy following transplantation of frozen/thawed ovarian tissue but decided to have an early abortion due to recurrence of breast cancer.......To report on a woman who conceived naturally and had a normal intrauterine pregnancy following transplantation of frozen/thawed ovarian tissue but decided to have an early abortion due to recurrence of breast cancer....

  16. Vaginal delivery of carboplatin-loaded thermosensitive hydrogel to prevent local cervical cancer recurrence in mice.

    Science.gov (United States)

    Wang, Xue; Wang, Jin; Wu, Wenbin; Li, Hongjun

    2016-11-01

    Local tumor recurrence after cervical cancer surgery remains a clinical problem. Vaginal delivery of thermosensitive hydrogel may be suited to reduce tumor relapse rate with more efficacy and safety. A pilot study was carried out to evaluate the efficacy of carboplatin-loaded poloxamer hydrogel to prevent local recurrence of cervical cancer after surgery. In vivo vaginal retention evaluation of 27% poloxamer hydrogel in mice was proven to be a suitable vaginal drug delivery formulation due to its low gelation temperature. A mimic orthotopic cervical/vaginal cancer recurrence model after surgery was established by injecting murine cervical cancer cell line U14 into the vaginal submucosa to simulate the residual tumor cells infiltrated in the surgical site, followed by drug administration 24 h later to interfere with the formation/recurrence of the tumor. By infusing fluorescein sodium-loaded hydrogel into the vagina of mice, a maximized accumulation of fluorescein sodium (Flu) in the vagina was achieved and few signals were observed in other organs. When used in the prevention of the cervical cancer formation/recurrence in mice, the carboplatin-loaded poloxamer hydrogel exhibited great efficacy and systemic safety. In conclusion, thermosensitive hydrogel presents a simple, practical approach for the local drug delivery via vagina against cervical cancer recurrence.

  17. Pre-diagnostic alcohol consumption and breast cancer recurrence and mortality

    DEFF Research Database (Denmark)

    Holm, Marianne; Olsen, Anja; Christensen, Jane

    2013-01-01

    The association between pre-diagnostic alcohol consumption and breast cancer recurrence and breast cancer specific mortality was investigated in 1,052 women diagnosed with early breast cancer in a prospective cohort of 29,875 women. Known clinical, lifestyle and socioeconomic risk factors were...... evaluated and adjusted for in multivariate analysis. We found a modest but significant association between pre-diagnostic alcohol consumption and breast cancer recurrence with a median follow-up of six years after date of diagnosis, both when using baseline measures of alcohol intake (HR, 1.65; 95% CI, 1...

  18. Predictors of venous thromboembolism recurrence and bleeding among active cancer patients: a population-based cohort study

    Science.gov (United States)

    Chee, Cheng E.; Ashrani, Aneel A.; Marks, Randolph S.; Petterson, Tanya M.; Bailey, Kent R.; Melton, L. Joseph; Heit, John A.

    2014-01-01

    Active cancer is the major predictor of venous thromboembolism (VTE) recurrence, but further stratification of recurrence risk is uncertain. In a population-based cohort study of all Olmsted County, Minnesota, residents with active cancer-related incident VTE during the 35-year period from 1966 to 2000 who survived 1 day or longer, we estimated VTE recurrence, bleeding on anticoagulant therapy, and survival and tested cancer and noncancer characteristics and secondary prophylaxis as predictors of VTE recurrence and bleeding, using Cox proportional hazards modeling. Of 477 patients, 139 developed recurrent VTE over the course of 1533 person-years of follow-up. The adjusted 10-year cumulative VTE recurrence rate was 28.6%. The adjusted 90-day cumulative incidence of major bleeding on anticoagulation was 1.9%. Survival was significantly worse for patients with cancer who had recurrent VTE (particularly pulmonary embolism) and with bleeding on anticoagulation. In a multivariable model, brain, lung, and ovarian cancer; myeloproliferative or myelodysplastic disorders; stage IV pancreatic cancer; other stage IV cancer; cancer stage progression; and leg paresis were associated with an increased hazard, and warfarin therapy was associated with a reduced hazard, of recurrent VTE. Recurrence rates were significantly higher for cancer patients with 1 or more vs no predictors of recurrence, suggesting these predictors may be useful for stratifying recurrence risk. PMID:24782507

  19. Risk of regional recurrence in triple-negative breast cancer patients: a Dutch cohort study.

    Science.gov (United States)

    van Roozendaal, Lori M; Smit, Leonie H M; Duijsens, Gaston H N M; de Vries, Bart; Siesling, Sabine; Lobbes, Marc B I; de Boer, Maaike; de Wilt, Johannes H W; Smidt, Marjolein L

    2016-04-01

    Triple-negative breast cancer is associated with early recurrence and low survival rates. Several trials investigate the safety of a more conservative approach of axillary treatment in clinically T1-2N0 breast cancer. Triple-negative breast cancer comprises only 15 % of newly diagnosed breast cancers, which might result in insufficient power for representative results for this subgroup. We aimed to provide a nationwide overview on the occurrence of (regional) recurrences in triple-negative breast cancer patients with a clinically T1-2N0 status. For this cohort study, 2548 women diagnosed between 2005 and 2008 with clinically T1-2N0 triple-negative breast cancer were selected from the Netherlands Cancer Registry. Follow-up data until 2014 were analyzed using Kaplan-Meier. Sentinel lymph node biopsy was performed in 2486 patients, and (completion) axillary lymph node dissection in 562 patients. Final pathologic nodal status was pN0 in 78.5 %, pN1mi in 4.5 %, pN1 in 12.3 %, pN2-3 in 3.6 %, and pNx in 1.1 %. During a follow-up of 5 years, regional recurrence occurred in 2.9 %, local recurrence in 4.2 % and distant recurrence in 12.2 %. Five-year disease-free survival was 78.7 %, distant disease-free survival 80.5 %, and 5-year overall survival 82.3 %. Triple-negative clinically T1-2N0 breast cancer patients rarely develop a regional recurrence. Their disease-free survival is more threatened by distant recurrence, affecting their overall survival. Consequently, it seems justified to include triple-negative breast cancer patients in randomized controlled trials investigating the safety of minimizing axillary staging and treatment.

  20. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report.

    Science.gov (United States)

    Tanaka, Tomohito; Ohmichi, Masahide

    2012-07-02

    The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  1. Recurrent ovarian cancer presenting in the right supraclavicular lymph node with isolated metastasis: a case report

    Directory of Open Access Journals (Sweden)

    Tanaka Tomohito

    2012-07-01

    Full Text Available Abstract Introduction The majority of ovarian cancer recurrences are in the abdomen. However, some cases relapse as isolated lymph node metastases, mostly in pelvic or para-aortic nodes. Peripheral isolated lymph node metastasis is rare. Case presentation A 69-year-old Japanese woman had recurrent ovarian cancer presenting with isolated right supraclavicular lymph node metastasis. After surgical resection and combination chemotherapy with carboplatin and paclitaxel, her right supraclavicular lymph node completely regressed. Conclusions Peripheral isolated lymph nodes, including right supraclavicular lymph node, can recur without a macroscopic abdominal lesion. Clinicians should carefully examine peripheral lymph nodes for recurrence.

  2. Surgical resection of late solitary locoregional gastric cancer recurrence in stomach bed.

    Science.gov (United States)

    Watanabe, Masanori; Suzuki, Hideyuki; Maejima, Kentaro; Komine, Osamu; Mizutani, Satoshi; Yoshino, Masanori; Bo, Hideki; Kitayama, Yasuhiko; Uchida, Eiji

    2012-07-01

    Late-onset and solitary recurrence of gastric signet ring cell (SRC) carcinoma is rare. We report a successful surgical resection of late solitary locoregional recurrence after curative gastrectomy for gastric SRC carcinoma. The patient underwent total gastrectomy for advanced gastric carcinoma at age 52. Seven years after the primary operation, he visited us again with sudden onset of abdominal pain and vomiting. We finally decided to perform an operation, based on a diagnosis of colon obstruction due to the recurrence of gastric cancer by clinical findings and instrumental examinations. The laparotomic intra-abdominal findings showed that the recurrent tumor existed in the region surrounded by the left diaphragm, colon of splenic flexure, and pancreas tail. There was no evidence of peritoneal dissemination, and peritoneal lavage fluid cytology was negative. We performed complete resection of the recurrent tumor with partial colectomy, distal pancreatectomy, and partial diaphragmectomy. Histological examination of the resected specimen revealed SRC carcinoma, identical in appearance to the previously resected gastric cancer. We confirmed that the intra-abdominal tumor was a locoregional gastric cancer recurrence in the stomach bed. The patient showed a long-term survival of 27 months after the second operation. In the absence of effective alternative treatment for recurrent gastric carcinoma, surgical options should be pursued, especially for late and solitary recurrence.

  3. Prediction of prostate cancer recurrence using quantitative phase imaging: Validation on a general population

    Science.gov (United States)

    Sridharan, Shamira; Macias, Virgilia; Tangella, Krishnarao; Melamed, Jonathan; Dube, Emily; Kong, Max Xiangtian; Kajdacsy-Balla, André; Popescu, Gabriel

    2016-09-01

    Prediction of biochemical recurrence risk of prostate cancer following radical prostatectomy is critical for determining whether the patient would benefit from adjuvant treatments. Various nomograms exist today for identifying individuals at higher risk for recurrence; however, an optimistic under-estimation of recurrence risk is a common problem associated with these methods. We previously showed that anisotropy of light scattering measured using quantitative phase imaging, in the stromal layer adjacent to cancerous glands, is predictive of recurrence. That nested-case controlled study consisted of specimens specifically chosen such that the current prognostic methods fail. Here we report on validating the utility of optical anisotropy for prediction of prostate cancer recurrence in a general population of 192 patients, with 17% probability of recurrence. Our results show that our method can identify recurrent cases with 73% sensitivity and 72% specificity, which is comparable to that of CAPRA-S, a current state of the art method, in the same population. However, our results show that optical anisotropy outperforms CAPRA-S for patients with Gleason grades 7–10. In essence, we demonstrate that anisotropy is a better biomarker for identifying high-risk cases, while Gleason grade is better suited for selecting non-recurrence. Therefore, we propose that anisotropy and current techniques be used together to maximize prediction accuracy.

  4. Solitary mediastinal lymph node recurrence after curative resection of colon cancer

    Institute of Scientific and Technical Information of China (English)

    Yasuhiro; Matsuda; Masahiko; Yano; Norikatsu; Miyoshi; Shingo; Noura; Masayuki; Ohue; Keijiro; Sugimura; Masaaki; Motoori; Kentaro; Kishi; Yoshiyuki; Fujiwara; Kunihito; Gotoh; Shigeru; Marubashi; Hirofumi; Akita; Hidenori; Takahashi; Masato; Sakon

    2014-01-01

    We report two cases of solitary mediastinal lymph node recurrence after colon cancer resection. Both cases had para-aortic lymph node metastasis at the time of initial surgery and received adjuvant chemotherapy for 4 years in case 1 and 18 mo in case 2. The time to recurrence was more than 8 years in both cases. After resection of the recurrent tumor, the patient is doing well with no recurrence for 6 years in case 1 and 4 mo in case 2. Patients should be followed up after colon cancer surgery considering the possibility of solitary mediastinal lymph node recurrence if they had para-aortic node metastasis at the time of initial surgery.

  5. Clinical outcomes of chemoradiotherapy for locally recurrent rectal cancer

    Directory of Open Access Journals (Sweden)

    Oh Jae Hwan

    2011-05-01

    Full Text Available Abstract Background To assess the clinical outcome of chemoradiotherapy with or without surgery for locally recurrent rectal cancer (LRRC and to find useful and significant prognostic factors for a clinical situation. Methods Between January 2001 and February 2009, 67 LRRC patients, who entered into concurrent chemoradiotherapy with or without surgery, were reviewed retrospectively. Of the 67 patients, 45 were treated with chemoradiotherapy plus surgery, and the remaining 22 were treated with chemoradiotherapy alone. The mean radiation doses (biologically equivalent dose in 2-Gy fractions were 54.6 Gy and 66.5 Gy for the chemoradiotherapy with and without surgery groups, respectively. Results The median survival duration of all patients was 59 months. Five-year overall (OS, relapse-free (RFS, locoregional relapse-free (LRFS, and distant metastasis-free survival (DMFS were 48.9%, 31.6%, 66.4%, and 40.6%, respectively. A multivariate analysis demonstrated that the presence of symptoms was an independent prognostic factor influencing OS, RFS, LRFS, and DMFS. No statistically significant difference was found in OS (p = 0.181, RFS (p = 0.113, LRFS (p = 0.379, or DMFS (p = 0.335 when comparing clinical outcomes between the chemoradiotherapy with and without surgery groups. Conclusions Chemoradiotherapy with or without surgery could be a potential option for an LRRC cure, and the symptoms related to LRRC were a significant prognostic factor predicting poor clinical outcome. The chemoradiotherapy scheme for LRRC patients should be adjusted to the possibility of resectability and risk of local failure to focus on local control.

  6. [A case of locally recurrent breast cancer difficult to differentiate from nodular fasciitis].

    Science.gov (United States)

    Kakimoto, Masaki; Nakata, Takuya; Imaizumi, Ken; Hirano, Takayuki; Yamamoto, Youhei; Chikatani, Kenichi; Hoshino, Mayumi; Matsuyama, Takatoshi; Motoyama, Kazuo; Goto, Hiroshi; Yoshimura, Tetsunori; Koshiishi, Haruya; Tsuruta, Kouji

    2014-11-01

    Breast-conserving surgery was performed on a 78-year-old woman for left breast cancer 5 years previously (invasive ductal carcinoma, T1cN2M0, stage IIIA, ER[+], PR[-], HER2[-]). Chemotherapy, radiotherapy, and hormonal therapy were administered. A left subclavian tumor was detected, and an excisional biopsy was performed. Histological examination showed spindle cells, different from primary breast cancer histology, and nodular fasciitis was diagnosed negative cytokeratin and vimentin immunostaining results. After 12 months, a mass had developed in the same region, and reoperation was performed for resection. Similar spindle cells were observed, but they tested positive for cytokeratin. Carcinoma was diagnosed and thought to be locally recurrent breast cancer. Despite postoperative chemotherapy, the patient experienced bone and lung metastasis and a third local recurrence. She died 13 months following the last surgery. Recurrent breast cancer sometimes displays different histology from the initial cancer, and mimics stromal tumors in certain cases.

  7. Prospective cohort comparison of flavonoid treatment in patients with resected colorectal cancer to prevent recurrence

    Institute of Scientific and Technical Information of China (English)

    Harald Hoensch; Bertram Groh; Lutz Edler; Wilhelm Kirch

    2008-01-01

    AIM: To investigate biological prevention with flavonoids the recurrence risk of neoplasia was studied in patients with resected colorectal cancer and after adenoma polypectomy.METHODS: Eighty-seven patients, 36 patients with resected colon cancer and 51 patients after polypectomy,were divided into 2 groups: one group was treated with a flavonoid mixture (daily standard dose 20 mg apigenin and 20 mg epigallocathechin-gallat, n = 31)and compared with a matched control group (n = 56).Both groups were observed for 3-4 years by surveillance colonoscopy and by questionnaire.RESULTS: Of 87 patients enrolled in this study, 36 had resected colon cancer and 29 of these patients had surveillance colonoscopy. Among the flavonoid-treated patients with resected colon cancer (n = 14), there was no cancer recurrence and one adenoma developed. In contrast the cancer recurrence rate of the 15 matched untreated controls was 20% (3 of 15) and adenomas evolved in 4 of those patients (27%). The combined recurrence rate for neoplasia was 7% (1 of 14) in the treated patients and 47% (7 of 15) in the controls (p = 0.027).CONCLUSION: Sustained long-term treatment with a flavonoid mixture could reduce the recurrence rate of colon neoplasia in patients with resected colon cancer.

  8. Prognostic factors and patterns of recurrence in esophageal cancer assert arguments for extended two-field transthoracic esophagectomy

    NARCIS (Netherlands)

    Smit, Justin K.; Pultrum, Bareld B.; van Dullemen, Hendrik M.; Van Dam, Gooitzen M.; Groen, Henk; Plukker, John T. M.

    2010-01-01

    BACKGROUND: High recurrence rates determine the dismal outcome in esophageal cancer. We reviewed our experiences and defined prognostic factors and patterns of recurrences after curatively, intended transthoracic esophagectomy. METHODS: Between January 1991 and December 2005, 212 consecutive patient

  9. Lung cancer prognosis before and after recurrence in a population-based setting.

    Science.gov (United States)

    Consonni, Dario; Pierobon, Mariaelena; Gail, Mitchell H; Rubagotti, Maurizia; Rotunno, Melissa; Goldstein, Alisa; Goldin, Lynn; Lubin, Jay; Wacholder, Sholom; Caporaso, Neil E; Bertazzi, Pier Alberto; Tucker, Margaret A; Pesatori, Angela C; Landi, Maria Teresa

    2015-06-01

    Population-based estimates of absolute risk of lung cancer recurrence, and of mortality rates after recurrence, can inform clinical management. We evaluated prognostic factors for recurrences and survival in 2098 lung cancer case patients from the general population of Lombardy, Italy, from 2002 to 2005. We conducted survival analyses and estimated absolute risks separately for stage IA to IIIA surgically treated and stage IIIB to IV non-surgically treated patients. Absolute risk of metastases exceeded that of local recurrence in every stage and cell type, highlighting the systemic threat of lung cancer. In stage I, the probability of dying within the first year after diagnosis was 2.7%, but it was 48.3% within first year after recurrence; in stage IV, the probabilities were 57.3% and 80.6%, respectively. Over half the patients died within one year of first metastasis. Although in stages IA to IB about one-third of patients had a recurrence, stage IIA patients had a recurrence risk (61.2%) similar to stage IIB (57.9%) and IIIA (62.8%) patients. Risk of brain metastases in stage IA to IIIA surgically treated non-small cell lung cancer patients increased with increasing tumor grade. Absolute risk of recurrence was virtually identical in adenocarcinoma and squamous cell carcinoma patients. This population-based study provides clinically useful estimates of risks of lung cancer recurrence and mortality that are applicable to the general population. These data highlight the need for more effective adjuvant treatments overall and within specific subgroups. The estimated risks of various endpoints are useful for designing clinical trials, whose power depends on absolute numbers of events. Published by Oxford University Press 2015.

  10. Lapatinib Ditosylate in Treating Patients With Metastatic or Recurrent Head and Neck Cancer

    Science.gov (United States)

    2015-04-14

    Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  11. Pattern of distant recurrence according to the molecular subtypes in Korean women with breast cancer

    Directory of Open Access Journals (Sweden)

    Park Hyung Seok

    2012-01-01

    Full Text Available Abstract Background Distant recurrence is one of the most important risk factors in overall survival, and distant recurrence is related to a complex biologic interaction of seed and soil factors. The aim of the study was to investigate the association between the molecular subtypes and patterns of distant recurrence in patients with breast cancer. Methods In an investigation of 313 women with breast cancer who underwent surgery from 1994 and 2000, the expressions of estrogen and progestrone receptor (ER/PR, and human epithelial receptor-2 (HER2 were evaluated. The subtypes were defined as luminal-A, luminal-HER2, HER2-enriched, and triple negative breast cancer (TNBC according to ER, PR, and HER2 status. Results Bone was the most common site of distant recurrence. The incidence of first distant recurrence site was significantly different among the subtypes. Brain metastasis was more frequent in the luminal-HER2 and TNBC subtypes. In subgroup analysis, overall survival in patients with distant recurrence after 24 months after surgery was significantly different among the subtypes. Conclusions Organ-specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer may be considered.

  12. When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.

    Science.gov (United States)

    Mutsaers, Brittany; Jones, Georden; Rutkowski, Nicole; Tomei, Christina; Séguin Leclair, Caroline; Petricone-Westwood, Danielle; Simard, Sébastien; Lebel, Sophie

    2016-10-01

    Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR. A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed. Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores. While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.

  13. Metastatic bone cancer as a recurrence of early gastric cancer - characteristics and possible mechanisms

    Institute of Scientific and Technical Information of China (English)

    Michiya Kobayashi; Takehiro Okabayashi; Takeshi Sano; Keijiro Araki

    2005-01-01

    The surgical outcome of most early gastric cancer (EGC)is usually satisfactory. Some cases show bone metastasis even though the depth of cancer invasion is confined to the mucosa. The most frequent site for recurrence of EGC is the liver. Cases of EGC with bone metastasis are reviewed to clarify the clinicopathological characteristics of EGC giving rise to bone metastasis. Possible mechanisms and risk factors underlying this rare condition are proposed.Forty-six cases of bone metastasis from EGC are reviewed from published reports and meeting proceedings in Japan.This investigation suggests that risk factors for bone metastasis from EGC include depressed-type signet-ring cell carcinoma, poorly differentiated carcinoma, and/or the likely involvement of lymph node metastasis, even though the cancer is confined to the gastric mucosa. The risk factors do not include recurrence of EGC in the liver. We speculate that the mechanism of bone metastasis from EGC is via lymphatic channels and systemic circulation. Postoperative follow-up of cases should consider the development of bone metastasis from EGC. We propose the use of elevated alkaline phosphatase levels for the detection of bone metastasis and recommend bone scintigraphy in positive cases.

  14. Treatment Options for Recurrent Lip and Oral Cavity Cancer

    Science.gov (United States)

    ... Oropharyngeal Cancer Screening Research Lip and Oral Cavity Cancer Treatment (PDQ®)–Patient Version General Information About Lip and ... clinical trials before, during, or after starting their cancer treatment. Some clinical trials only include patients who have ...

  15. Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil

    DEFF Research Database (Denmark)

    Ording, Anne Gulbech; Cronin Fenton, Deirdre; Christensen, Mariann

    2013-01-01

    Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil......Manganese Superoxide Dismtase Polymorphism and Breast Cancer Recurrence: A Danish Population-Based Case-Control Study of Breast Cancer Patients Treated with Cyclophosphamide Epirubicin and 5-fluorouracil...

  16. Therapeutic resistance and cancer recurrence mechanisms: Unfolding the story of tumour coming back

    Indian Academy of Sciences (India)

    MOHAMMAD JAVAD DEHGHAN ESMATABADI; BABAK BAKHSHINEJAD; FATEMEH MOVAHEDI MOTLAGH; SADEGH BABASHAH; MAJID SADEGHIZADEH

    2016-09-01

    Cancer recurrence is believed to be one of the major reasons for the failure of cancer treatment strategies. Thisbiological phenomenon could arise from the incomplete eradication of tumour cells after chemo- and radiotherapy.Recent developments in the design of models reflecting cancer recurrence and in vivo imaging techniques have ledresearchers to gain a deeper and more detailed insight into the mechanisms underlying tumour relapse. Here, weprovide an overview of three important drivers of recurrence including cancer stem cells (CSCs), neosis, and phoenixrising. The survival of cancer stem cells is well recognized as one of the primary causes of therapeutic resistance inmalignant cells. CSCs have a relatively latent metabolism and show resistance to therapeutic agents through a varietyof routes. Neosis has proven to be as an important mechanism behind tumour self-proliferation after treatment whichgives rise to the expansion of tumour cells in the injured site via production of Raju cells. Phoenix rising is a prorecurrencepathway through which apoptotic cancer cells send strong signals to the neighbouring diseased cellsleading to their multiplication. The mechanisms involved in therapeutic resistance and tumour recurrence have not yetbeen fully understood and mostly remain unexplained. Without doubt, an improved understanding of the cellularmachinery contributing to recurrence will pave the way for the development of novel, sophisticated and effective antitumourtherapeutic strategies which can eradicate tumour without the threat of relapse.

  17. XIAP as a prognostic marker of early recurrence of nonmuscular invasive bladder cancer

    Institute of Scientific and Technical Information of China (English)

    LI Ming; SONG Tao; YIN Zhen-fei; NA Yan-qun

    2007-01-01

    Background Dysregulation of apoptosis has been implicated not only in carcinogenesis and tumor progression but also in tumor recurrence. We investigated whether the expression of X-linked inhibitor of apoptosis (XIAP) might predict early recurrence in patients with non-muscular invasive bladder cancer.Methods The cohort comprised 176 consecutive patients with primary superficial bladder cancer treated with transurethral resection. Immunohistochemical staining using the standard avidin-biotin-peroxidase technique and RT-PCR were used to detect XIAP protein and mRNA expressions in cancer tissues. The relationship between XIAP expression and clinicopathological characteristics, cancer recurrence were analyzed.Results XIAP expression was observed in 108 cases (61.4%) and no expression in 68. There was no correlation between XIAP expression rate and the tumor pathological grade, but was an apparent trend toward the increased XIAP levels from well (G1) to poor (G3) differentiated cancer. Eighty-two (46.6%) patients experienced tumor recurrence at a mean of 28.6 months of the follow-up; 66 of them expressed XIAP (61.1%) and 16 were XIAP negative (23.5%). Twelve patients presented with invasive disease at the time of relapse and all of them expressed XIAP. Patients without XIAP expression or with low tumor grades had significantly higher recurrence-free survival than those with XIAP expression(log rank test P=0.0015) or high tumor grades (log rank test P<0.001). Multivariate analysis revealed that XIAP expression, tumor grade, and tumor number were independent predictors for the recurrence of non-muscular invasive bladder cancer (P=-0.004, 0.016, and 0.043, respectively).Conclusions XIAP may be considered as a new independent prognostic marker for early recurrence of non-muscular invasive bladder cancer.

  18. DEGRO practical guidelines for radiotherapy of breast cancer VI: therapy of locoregional breast cancer recurrences

    Energy Technology Data Exchange (ETDEWEB)

    Harms, Wolfgang [St. Claraspital, Abteilung fuer Radioonkologie, Basel (Switzerland); Budach, W. [Heinrich-Heine-University, Duesseldorf (Germany); Dunst, J. [University Hospital Schleswig-Holstein, Kiel (Germany); Feyer, P. [Vivantes Hospital Neukoelln, Berlin (Germany); Fietkau, R.; Sauer, R. [University Hospital Erlangen, Erlangen (Germany); Krug, D. [University Hospital Heidelberg, Heidelberg (Germany); Piroth, M.D. [Witten/Herdecke University, HELIOS-Hospital Wuppertal, Wuppertal (Germany); Sautter-Bihl, M.L. [Municipal Hospital, Karlsruhe (Germany); Sedlmayer, F. [Paracelsus Medical University Hospital, Salzburg (Austria); Wenz, F. [University of Heidelberg, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Haase, W.; Souchon, R.; Collaboration: Breast Cancer Expert Panel of the German Society of Radiation Oncology (DEGRO)

    2016-04-15

    To update the practical guidelines for radiotherapy of patients with locoregional breast cancer recurrences based on the current German interdisciplinary S3 guidelines 2012. A comprehensive survey of the literature using the search phrases ''locoregional breast cancer recurrence'', ''chest wall recurrence'', ''local recurrence'', ''regional recurrence'', and ''breast cancer'' was performed, using the limits ''clinical trials'', ''randomized trials'', ''meta-analysis'', ''systematic review'', and ''guidelines''. Patients with isolated in-breast or regional breast cancer recurrences should be treated with curative intent. Mastectomy is the standard of care for patients with ipsilateral breast tumor recurrence. In a subset of patients, a second breast conservation followed by partial breast irradiation (PBI) is an appropriate alternative to mastectomy. If a second breast conservation is performed, additional irradiation should be mandatory. The largest reirradiation experience base exists for multicatheter brachytherapy; however, prospective clinical trials are needed to clearly define selection criteria, long-term local control, and toxicity. Following primary mastectomy, patients with resectable locoregional breast cancer recurrences should receive multimodality therapy including systemic therapy, surgery, and radiation +/- hyperthermia. This approach results in high local control rates and long-term survival is achieved in a subset of patients. In radiation-naive patients with unresectable locoregional recurrences, radiation therapy is mandatory. In previously irradiated patients with a high risk of a second local recurrence after surgical resection or in patients with unresectable recurrences, reirradiation should be strongly considered. Indication and dose concepts

  19. Focal salvage therapy for local prostate cancer recurrences after primary radiotherapy : a comprehensive review

    NARCIS (Netherlands)

    Duijzentkunst, D A Smit; Peters, M; van der Voort van Zyp, J R N; Moerland, M A; van Vulpen, M

    2016-01-01

    BACKGROUND/AIM: Patients with locally recurrent prostate cancer after primary radiotherapy can be eligible for salvage treatment. Whole-gland salvage techniques carry a high risk of toxicity. A focal salvage approach might reduce the risk of adverse events while maintaining cancer control in careful

  20. Perineal recurrence of prostate cancer six years after trans-perineal brachytherapy

    NARCIS (Netherlands)

    Eppinga, Wietse; Vijverberg, Peter; Moerland, Rien; Brand, Eric; van der Voort van Zyp, Jochem; Noteboom, Juus; van Vulpen, Marco

    2015-01-01

    We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer. The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision. We report the use of stereotac

  1. [Expression of CD10 in tumor-associated fibroblast of cancerized or recurrent colorectal adenomas].

    Science.gov (United States)

    Zheng, Jiangjiang; Zhu, Yin; Li, Changshui; Li, Yinya; Nie, Qianqian; Zhu, Ziling; Deng, Hong

    2016-05-25

    Objective: To investigate the expression of CD10 in tumor-associated fibroblasts (TAF) in colorectal adenomas and its relation to cancerization and recurrence of adenoma. Methods: Tissue samples of low-grade adenoma (n=50), high-grade adenoma (n=50) and colorectal adenocarcinoma (n=50) were collected, and tissue samples at the distal margin of corresponding colorectal lesions were taken as controls. The expression of CD10 in the stromal TAFs, and the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells were detected by immunohistochemistry (Envision). The correlation of CD10 expression in stromal TAFs with the expressions of β-catenin, Ki-67, p53 and CyclinD1 in tumor cells was analyzed by Spearmen. One hundred samples of low-grade colorectal adenoma were collected, including 57 non-recurrent cases and 43 recurrent cases (16 cases of recurrent adenoma and 27 cases of recurrent adenocarcinoma); the expression of stromal TAF CD10 were determined and compared among groups. Results: There was no TAF in normal colorectal mucosa. The expression rates of TAF CD10 in low-grade adenoma, high-grade adenoma and colorectal adenocarcinoma were 22%, 50% and 78%, respectively (all P0.05). The expression of p53 in colorectal adenocarcinoma and high-grade adenoma was higher than that in low grade adenoma (all P0.05). The TAF CD10 level was significantly higher in low-grade adenoma with recurrence than that in those without recurrence (Pcancer, indicating that it may play an important role in the canceration of adenoma. Adenomas with high expression of CD10 TAF are likely to be recurrent and cancerized, and detection of TAF CD10 combined with p53, Ki-67 and β-catenin may be of value in predicting canceration or recurrence of colorectal adenoma.

  2. Microvessel density and p53 in detecting cervical cancer by FDG PET in cases of suspected recurrence

    NARCIS (Netherlands)

    A.A.M. van der Veldt; L. Hooft; P.J. van Diest; J. Berkhof; M.R. Buist; E.F.I. Comans; O.S. Hoekstra; C.F.M. Molthoff

    2006-01-01

    Purpose: Cervical cancer is the second most frequently diagnosed cancer in women worldwide. About one-third of patients experience recurrent disease. A better chance of survival might be achieved by the early detection of recurrent cervical cancer. [F-18] fluoro-2-deoxy- D-glucose (FDG) PET could be

  3. Weight Gain, Metabolic Syndrome, and Breast Cancer Recurrence: Are Dietary Recommendations Supported by the Data?

    Directory of Open Access Journals (Sweden)

    Colin E. Champ

    2012-01-01

    Full Text Available Metabolic syndrome, which can include weight gain and central obesity, elevated serum insulin and glucose, and insulin resistance, has been strongly associated with breast cancer recurrence and worse outcomes after treatment. Epidemiologic and prospective data do not show conclusive evidence as to which dietary factors may be responsible for these results. Current strategies employ low-fat diets which emphasize supplementing calories with increased intake of fruit, grain, and vegetable carbohydrate sources. Although results thus far have been inconclusive, recent randomized trials employing markedly different dietary strategies in noncancer patients may hold the key to reducing multiple risk factors in metabolic syndrome simultaneously which may prove to increase the long-term outcome of breast cancer patients and decrease recurrences. Since weight gain after breast cancer treatment confers a poor prognosis and may increase recurrence rates, large-scale randomized trials are needed to evaluate appropriate dietary interventions for our breast cancer patients.

  4. Artificial neural network in studying factors of hepatic cancer recurrence after hepatectomy

    Institute of Scientific and Technical Information of China (English)

    HE Jia; HE Xian-min; ZHANG Zhi-jian

    2002-01-01

    Objective: To explore the affecting factors of liver cancer recurrence after hepatectomy. Methods:The BP artificial neural network - Cox regression was introduced to analyze the factors of recurrence in1 457 patients. Results: The affecting factors statistically significant to liver cancer prognosis was selected.There were 18 factors to be selected by uni-factor analysis, and 9 factors to be selected by multi-factor analysis. Conclusion: The 9 factors selected can be used as important indexes to evaluate the recurrence of liver cancer after hepatectomy. The artificial neural network is a better method to analyze the clinical data, which provides scientific and objective data for evaluating prognosis of liver cancer.

  5. A Novel Graph-based Algorithm to Infer Recurrent Copy Number Variations in Cancer

    Science.gov (United States)

    Chi, Chen; Ajwad, Rasif; Kuang, Qin; Hu, Pingzhao

    2016-01-01

    Many cancers have been linked to copy number variations (CNVs) in the genomic DNA. Although there are existing methods to analyze CNVs from individual samples, cancer-causing genes are more frequently discovered in regions where CNVs are common among tumor samples, also known as recurrent CNVs. Integrating multiple samples and locating recurrent CNV regions remain a challenge, both computationally and conceptually. We propose a new graph-based algorithm for identifying recurrent CNVs using the maximal clique detection technique. The algorithm has an optimal solution, which means all maximal cliques can be identified, and guarantees that the identified CNV regions are the most frequent and that the minimal regions have been delineated among tumor samples. The algorithm has successfully been applied to analyze a large cohort of breast cancer samples and identified some breast cancer-associated genes and pathways.

  6. Complex pattern of colon cancer recurrence including a kidney metastasis: A case report

    Institute of Scientific and Technical Information of China (English)

    Helfried Waleczek; Moritz N Wente; Jürgen Kozianka

    2005-01-01

    We report a case of a 77-year-old female with a local recurrence of cancer after right hemicolectomy which infiltrated the pancreatic head affording pancreatoduodenectomy, who developed 3 years later recurrent tumor masses localized in the mesentery of the jejunum and in the lower pole of the left kidney. Partial nephrectomy and a segment resection of the small bowel were performed. Histological examination of both specimens revealed a necrotic metastasis of the primary carcinoma of the colon. Although intraluminal implantation of colon cancer cells in the renal pelvic mucosa from ureteric metastasis has been described, metastasis of a colorectal cancer in the kidney parenchyma is extremely rare and can be treated in an organ preserving manner. A complex pattern of colon cancer recurrence with unusual and rare sites of metastasis is reported.

  7. Exemestane With or Without Entinostat in Treating Patients With Recurrent Hormone Receptor-Positive Breast Cancer That is Locally Advanced or Metastatic

    Science.gov (United States)

    2017-08-01

    Estrogen Receptor Positive; HER2/Neu Negative; Male Breast Carcinoma; Progesterone Receptor Positive; Recurrent Breast Carcinoma; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

  8. Recurrence and metastasis of lung cancer demonstrate decreased diffusion on diffusion-weighted magnetic resonance imaging.

    Science.gov (United States)

    Usuda, Katsuo; Sagawa, Motoyasu; Motomo, Nozomu; Ueno, Masakatsu; Tanaka, Makoto; Machida, Yuichiro; Maeda, Sumiko; Matoba, Munetaka; Tonami, Hisao; Ueda, Yoshimichi; Sakuma, Tsutomu

    2014-01-01

    Diffusion-weighted magnetic resonance imaging (DWI) is reported to be useful for detecting malignant lesions. The purpose of this study is to clarify characteristics of imaging, detection rate and sensitivity of DWI for recurrence or metastasis of lung cancer. A total of 36 lung cancer patients with recurrence or metastasis were enrolled in this study. While 16 patients underwent magnetic resonance imaging (MRI), computed tomography (CT) and positron emission tomography-computed tomography (PET-CT), 17 underwent MRI and CT, and 3 underwent MRI and PET-CT. Each recurrence or metastasis showed decreased diffusion, which was easily recognized in DWI. The detection rate for recurrence or metastasis was 100% (36/36) in DWI, 89% (17/19) in PET-CT and 82% (27/33) in CT. Detection rate of DWI was significantly higher than that of CT (p=0.0244) but not significantly higher than that of PET-CT (p=0.22). When the optimal cutoff value of the apparent diffusion coefficient value was set as 1.70?10-3 mm2/sec, the sensitivity of DWI for diagnosing recurrence or metastasis of lung cancer was 95.6%. DWI is useful for detection of recurrence and metastasis of lung cancer.

  9. Gene Methylation Biomarkers in Sputum and Plasma as Predictors for Lung Cancer Recurrence.

    Science.gov (United States)

    Belinsky, Steven A; Leng, Shuguang; Wu, Guodong; Thomas, Cynthia L; Picchi, Maria A; Lee, Sandra J; Aisner, Seena; Ramalingam, Suresh; Khuri, Fadlo R; Karp, Daniel D

    2017-09-13

    Detection of methylated genes in exfoliated cells from the lungs of smokers provides an assessment of the extent of field cancerization, is a validated biomarker for predicting lung cancer, and provides some discrimination when interrogated in blood. The potential utility of this 8-gene methylation panel for predicting tumor recurrence has not been assessed. The Eastern Cooperative Oncology Group initiated a prevention trial (ECOG-ACRIN5597) that enrolled resected Stage I non-small cell lung cancer patients who were randomized 2:1 to receive selenized yeast versus placebo for four years. We conducted a correlative biomarker study to assess prevalence for methylation of the 8-gene panel in longitudinally collected sputum and blood after tumor resection to determine if selenium alters their methylation profile and whether this panel predicts local and/or distant recurrence. Patients (n=1561) were enrolled into the prevention trial, 565 participated in the biomarker study with 122 recurrences among that group. Assessing the association between recurrence and risk of gene methylation longitudinally for up to 48 months showed a 1.4-fold increase in odds ratio for methylation in sputum in the placebo group independent of location (local or distant). Kaplan Meier curves evaluating the association between number of methylated genes and time to recurrence showed no increased risk in sputum, while a significant hazard ratio of 1.5 was seen in plasma. Methylation detection in sputum and blood is associated with risk for recurrence. Copyright ©2017, American Association for Cancer Research.

  10. Transcription factor-microRNA-target gene networks associated with ovarian cancer survival and recurrence.

    Science.gov (United States)

    Delfino, Kristin R; Rodriguez-Zas, Sandra L

    2013-01-01

    The identification of reliable transcriptome biomarkers requires the simultaneous consideration of regulatory and target elements including microRNAs (miRNAs), transcription factors (TFs), and target genes. A novel approach that integrates multivariate survival analysis, feature selection, and regulatory network visualization was used to identify reliable biomarkers of ovarian cancer survival and recurrence. Expression profiles of 799 miRNAs, 17,814 TFs and target genes and cohort clinical records on 272 patients diagnosed with ovarian cancer were simultaneously considered and results were validated on an independent group of 146 patients. Three miRNAs (hsa-miR-16, hsa-miR-22*, and ebv-miR-BHRF1-2*) were associated with both ovarian cancer survival and recurrence and 27 miRNAs were associated with either one hazard. Two miRNAs (hsa-miR-521 and hsa-miR-497) were cohort-dependent, while 28 were cohort-independent. This study confirmed 19 miRNAs previously associated with ovarian cancer and identified two miRNAs that have previously been associated with other cancer types. In total, the expression of 838 and 734 target genes and 12 and eight TFs were associated (FDR-adjusted P-value cancer survival and recurrence, respectively. Functional analysis highlighted the association between cellular and nucleotide metabolic processes and ovarian cancer. The more direct connections and higher centrality of the miRNAs, TFs and target genes in the survival network studied suggest that network-based approaches to prognosticate or predict ovarian cancer survival may be more effective than those for ovarian cancer recurrence. This study demonstrated the feasibility to infer reliable miRNA-TF-target gene networks associated with survival and recurrence of ovarian cancer based on the simultaneous analysis of co-expression profiles and consideration of the clinical characteristics of the patients.

  11. Transcription factor-microRNA-target gene networks associated with ovarian cancer survival and recurrence.

    Directory of Open Access Journals (Sweden)

    Kristin R Delfino

    Full Text Available The identification of reliable transcriptome biomarkers requires the simultaneous consideration of regulatory and target elements including microRNAs (miRNAs, transcription factors (TFs, and target genes. A novel approach that integrates multivariate survival analysis, feature selection, and regulatory network visualization was used to identify reliable biomarkers of ovarian cancer survival and recurrence. Expression profiles of 799 miRNAs, 17,814 TFs and target genes and cohort clinical records on 272 patients diagnosed with ovarian cancer were simultaneously considered and results were validated on an independent group of 146 patients. Three miRNAs (hsa-miR-16, hsa-miR-22*, and ebv-miR-BHRF1-2* were associated with both ovarian cancer survival and recurrence and 27 miRNAs were associated with either one hazard. Two miRNAs (hsa-miR-521 and hsa-miR-497 were cohort-dependent, while 28 were cohort-independent. This study confirmed 19 miRNAs previously associated with ovarian cancer and identified two miRNAs that have previously been associated with other cancer types. In total, the expression of 838 and 734 target genes and 12 and eight TFs were associated (FDR-adjusted P-value <0.05 with ovarian cancer survival and recurrence, respectively. Functional analysis highlighted the association between cellular and nucleotide metabolic processes and ovarian cancer. The more direct connections and higher centrality of the miRNAs, TFs and target genes in the survival network studied suggest that network-based approaches to prognosticate or predict ovarian cancer survival may be more effective than those for ovarian cancer recurrence. This study demonstrated the feasibility to infer reliable miRNA-TF-target gene networks associated with survival and recurrence of ovarian cancer based on the simultaneous analysis of co-expression profiles and consideration of the clinical characteristics of the patients.

  12. Laboratory errors leading to nonmelanoma skin cancer recurrence after Mohs micrographic surgery.

    Science.gov (United States)

    Zabielinski, Marilyn; Leithauser, Laurel; Godsey, Tonja; Gloster, Hugh M

    2015-08-01

    Compared with standard surgical excision, Mohs micrographic surgery (MMS) provides superior cure rates for nonmelanoma skin cancer (NMSC). Although cure rates of NMSC approach 99% with MMS, local recurrences occasionally occur. The authors sought to identify histological features during frozen section examination that were associated with local recurrence of NMSC after MMS. A retrospective chart review was performed of patients undergoing a second MMS procedure to treat locally recurrent NMSC over a 20-month period. Histological slides were reviewed to assess for possible causes of local recurrence. Of 3,169 NMSCs treated, 22 were locally recurrent. Possible causes of recurrence identified after MMS included dense inflammation in the final margin at sites affected by tumor in prior slides (27%), visible remaining tumor (23%), missing epidermal or dermal tissue (23%), and actinic keratosis (4%). One recurrence was possibly explained by incorrect mapping. No abnormality could be detected in 18% of cases. Possible limitations include the small sample size, retrospective design, and the possibility that some patients may have been lost to follow-up. Local recurrences after MMS are extremely rare. When recurrences do occur, they can be attributed to errors in histological interpretation or tumor mapping.

  13. Examination of the clinical efficacy of eribulin and trastuzumab in HER2-positive recurrent breast cancer.

    Science.gov (United States)

    Kiba, Takayoshi; Morii, Nao; Takahashi, Hirotoshi; Ozaki, Shinji; Atsumi, Misao; Masumoto, Fumi; Shitakubo, Yoshimi; Yamashiro, Hiroyasu

    2016-01-01

    There are limited studies reported that describe the efficacy of eribulin and trastuzumab in the treatment of recurrent breast cancer. The present study examined the therapeutic efficacy of eribulin and trastuzumab in the treatment of recurrent breast cancer. Between October 2011 and August 2013, 5 recurrent breast cancer patients who were treated with eribulin and trastuzumab were included in the study. The cancer stages in the 5 women who received this regimen were stage IIIB in 1 (20%) and stage IV in 4 (80%). The sites of recurrence were the lung in 3 patients, liver in 2, bone in 1, brain in 1, supraclavicular lymph nodes in 1, infraclavicular lymph nodes in 1 and mediastinal lymph nodes in 1. The median number of prior treatment regimens was 5 (range, 5-11). Complete response was achieved in 0 patients, 1 achieved partial response, 3 had stable disease, and 1 had progressive disease. The overall response rate was 20%, and the clinical benefit rate was 80%. Patients also reported grade 3/4 neutropenia (80.0%). However, hematological toxicity was reversible and manageable. The most common grade 3/4 nonhematological toxicities were fatigue (20.0%), peripheral neuropathy (20.0%) and appetite loss (20.0%). No patients withdrew from treatment, and favorable compliance was achieved in the study. The results indicated that eribulin and trastuzumab have the potential to be one of the drugs for treatment of recurrent breast cancer.

  14. Upregulation of APE/ref-1 in recurrence stage I, non small cell lung cancer.

    Science.gov (United States)

    Kang, Min-Woong; Kang, Shin Kwang; Choi, Songyi; Lee, Choong Sik; Jeon, Byeong Hwa; Lim, Seung Pyung

    2012-02-01

    Lung cancer, the leading cause of cancer-related death, still lacks reliable biomarkers. Apurinic/apyrimidinic endonuclease 1/Ref-1 is a multifunctional protein involved in the base excision repair of DNA damaged by oxidative stress or alkylating compounds, as well as in the regulation of multiple transcription factors. To validate apurinic/apyrimidinic endonuclease 1/Ref-1 as a biomarker for prediction of lung cancer recurrence, we studied 42 patients who received curative resection and mediastinal lymph node dissection for stage I non-small-cell lung cancer. They were divided into 2 groups based on recurrence, and compared by immunohistochemistry staining of paraffin-embedded tissues and Western blot analysis. Immunohistochemical staining showed a significant difference between the cytoplasm and nucleus in patients who had a recurrence compared to those with nonrecurrent adenocarcinoma. In Western blot analysis, the recurrent adenocarcinoma group showed increased expression of apurinic/apyrimidinic endonuclease 1/Ref-1 in cytoplasm, nucleus, and in total. This indicates that apurinic/apyrimidinic endonuclease 1/Ref-1 is unregulated in recurrent stage I adenocarcinoma. For clinical application as a prognostic marker for non-small-cell lung cancer, further investigation into the role of apurinic/apyrimidinic endonuclease 1/Ref-1 in carcinogenesis is needed in an expanded prospective study.

  15. The Effects of Combined Hepatectomy and Immunochemotherapy on Postoperative Recurrence of Primary Liver Cancer

    Institute of Scientific and Technical Information of China (English)

    ZHOUWeiping; WUMengchao; 等

    2002-01-01

    Ojbective To Study the effects of combined hepatectomy and immunochemotherapy on postoperative recurrence of primary liver cancer.Methods 121 caes were divided into four groups:operation only(OP group);combined operation and chemotherapy(OC group);combined operation and immunotherapy(OI group);combined operation and immunochemotherapy(OIC group).Chemotherapy was performed through hepatic arter or port vein,and the immunotherapy was used with LAK cell IL-2 and IFN-γ。Results Three-yeau recurrence rate in the four groups was 76.7%,55.6%,45.2% and 36.4%,respectively.The recurrence rate of OI group and OIC group was significantly lower than that of OP group.Conclusion Combined operation and immunochemotherapy in useful in preventing postoperative recurrence of primary liver cancer.

  16. Effects of Preoperative Biopsies on Recurrence in Head and Neck Skin Cancer

    OpenAIRE

    Ji Eun Jung; Dong Kyun Rah; Yong Oock Kim

    2012-01-01

    Background Skin cancer is the most common malignant tumor in humans. Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most common types of skin cancers. When skin cancer is clinically suspected, preoperative biopsies are recommended for a definite diagnosis. However, despite a concern over potential increased risk of metastasis associated with mechanical manipulation, there have been few investigations into whether a preoperative biopsy affected the recurrence of BCC a...

  17. Bilateral metachronous breast cancer with bilateral recurrences: A case report and literature review

    Energy Technology Data Exchange (ETDEWEB)

    Park, So Hyun; Sohn, Yu Mee [Dept. of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Kim, Eun Kyung [Dept. of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-05-15

    The incidence of bilateral breast cancer has been reported to range from 0.4% to 14%, and it increases gradually as a result of improved early detection capabilities and longer survival times. We report a rare case where the bilateral breast cancers occurred as a metachronous bilateral breast cancer with bilateral recurrences, detected by mammography, and the rapid growth of tumor that manifested as microcalcification and skin thickening within 3 months.

  18. Low dose intravesical heparin as prophylaxis against recurrent noninvasive (stage Ta) bladder cancer

    DEFF Research Database (Denmark)

    Bitsch, M; Hermann, G G; Andersen, J P;

    1990-01-01

    A controlled randomized clinical trial was conducted to examine the efficacy of topical low dose heparin (0.125 gm./l., 25,000 units per l.) as prophylaxis against recurrent noninvasive (stage Ta) transitional cell bladder cancer. Transurethral tumor resection was done with irrigation fluid...... containing either 1.5% glycine with heparin or glycine solution alone. Tumor recurrence was determined by cystoscopy 4 to 6 months later. There were 70 patients evaluated: 38 in the heparin and 32 in the control group, respectively. The recurrence rate (heparin 74%, control 66%) and the median number...... of recurrences (heparin 3, range 1 to 15 and control 3, range 1 to 30) were similar (p greater than 0.05) in the 2 groups of patients. These observations show that low dose heparin administered in the irrigation fluid during transurethral resection does not decrease the recurrence rate of noninvasive (stage Ta...

  19. Saracatinib in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    Science.gov (United States)

    2014-04-02

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage III Squamous Cell Carcinoma of the Hypopharynx; Stage III Squamous Cell Carcinoma of the Larynx; Stage III Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage III Squamous Cell Carcinoma of the Nasopharynx; Stage III Squamous Cell Carcinoma of the Oropharynx; Stage III Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage III Verrucous Carcinoma of the Larynx; Stage III Verrucous Carcinoma of the Oral Cavity; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of

  20. Translational potential of cancer stem cells: A review of the detection of cancer stem cells and their roles in cancer recurrence and cancer treatment.

    Science.gov (United States)

    Islam, Farhadul; Gopalan, Vinod; Smith, Robert A; Lam, Alfred K-Y

    2015-07-01

    Cancer stem cells (CSCs) are a subpopulation of cancer cells with many clinical implications in most cancer types. One important clinical implication of CSCs is their role in cancer metastases, as reflected by their ability to initiate and drive micro and macro-metastases. The other important contributing factor for CSCs in cancer management is their function in causing treatment resistance and recurrence in cancer via their activation of different signalling pathways such as Notch, Wnt/β-catenin, TGF-β, Hedgehog, PI3K/Akt/mTOR and JAK/STAT pathways. Thus, many different therapeutic approaches are being tested for prevention and treatment of cancer recurrence. These may include treatment strategies targeting altered genetic signalling pathways by blocking specific cell surface molecules, altering the cancer microenvironments that nurture cancer stem cells, inducing differentiation of CSCs, immunotherapy based on CSCs associated antigens, exploiting metabolites to kill CSCs, and designing small interfering RNA/DNA molecules that especially target CSCs. Because of the huge potential of these approaches to improve cancer management, it is important to identify and isolate cancer stem cells for precise study and application of prior the research on their role in cancer. Commonly used methodologies for detection and isolation of CSCs include functional, image-based, molecular, cytological sorting and filtration approaches, the use of different surface markers and xenotransplantation. Overall, given their significance in cancer biology, refining the isolation and targeting of CSCs will play an important role in future management of cancer.

  1. Gallbladder cancer manifesting as recurrent common bile duct stone and duodenal ulcer bleeding.

    Science.gov (United States)

    Tsai, Tzung-Jiun; Lai, Kwok-Hung; Hsu, Ping-I; Tsai, Cheng-Chung; Fu, Ting-Ying

    2009-08-01

    Gallbladder cancer (GBC) is an uncommon disease and is usually asymptomatic. Poor prognosis and high mortality rate have been noted in patients with delayed diagnosis. We report a case of locally advanced GBC with duodenum and colon invasion manifesting as bleeding duodenal ulcer and recurrent common bile duct (CBD) stones. The patient was successfully treated with extended surgery. In patients who have multiple recurrence of CBD stones without common risk factors, concomitant biliary tract malignancy should be included in the differential diagnosis.

  2. Mechanisms driving local breast cancer recurrence in a model of breast-conserving surgery.

    LENUS (Irish Health Repository)

    Smith, Myles J

    2012-02-03

    OBJECTIVE: We aimed to identify mechanisms driving local recurrence in a model of breast-conserving surgery (BCS) for breast cancer. BACKGROUND: Breast cancer recurrence after BCS remains a clinically significant, but poorly understood problem. We have previously reported that recurrent colorectal tumours demonstrate altered growth dynamics, increased metastatic burden and resistance to apoptosis, mediated by upregulation of phosphoinositide-3-kinase\\/Akt (PI3K\\/Akt). We investigated whether similar characteristics were evident in a model of locally recurrent breast cancer. METHODS: Tumours were generated by orthotopic inoculation of 4T1 cells in two groups of female Balb\\/c mice and cytoreductive surgery performed when mean tumour size was above 150 mm(3). Local recurrence was observed and gene expression was examined using Affymetrix GeneChips in primary and recurrent tumours. Differential expression was confirmed with quantitative real-time polymerase chain reaction (qRT-PCR). Phosphorylation of Akt was assessed using Western immunoblotting. An ex vivo heat shock protein (HSP)-loaded dendritic cell vaccine was administered in the perioperative period. RESULTS: We observed a significant difference in the recurrent 4T1 tumour volume and growth rate (p < 0.05). Gene expression studies suggested roles for the PI3K\\/Akt system and local immunosuppression driving the altered growth kinetics. We demonstrated that perioperative vaccination with an ex vivo HSP-loaded dendritic cell vaccine abrogated recurrent tumour growth in vivo (p = 0.003 at day 15). CONCLUSION: Investigating therapies which target tumour survival pathways such as PI3K\\/Akt and boost immune surveillance in the perioperative period may be useful adjuncts to contemporary breast cancer treatment.

  3. Ten Years of Tamoxifen Reduces Breast Cancer Recurrences, Improves Survival

    Science.gov (United States)

    ... Antonio Breast Cancer Symposium (SABCS) and published in The Lancet on December 5, 2012—are likely to change ... Cancer Center London in an accompanying editorial in The Lancet . "No data are available to suggest that [the ...

  4. [Predictive factors for locally recurrent rectal cancer after primary curative surgery].

    Science.gov (United States)

    Gao, Haoji; Zhang, Tao; Zhao, Ren

    2015-11-01

    Local recurrence is a major clinical challenge after primary rectal cancer surgery. Although there is a possibility that R0 resection can be achieved, the outcome is still not favorable due to the low R0 resection rate and complexity of the surgery. Therefore prevention has a higher priority over treatment afterwards. As TME principle is accepted worldwide, the local recurrence rate has been reduced dramatically. And there are other factors associated with local recurrence including CRM, operation type, staging and PNI. Proper chemoradiotherapy may reduce the risk, however benefit always comes with side effect, therefore risk stratification is important.

  5. Low 25-OH vitamin D levels at time of diagnosis and recurrence of ovarian cancer.

    Science.gov (United States)

    Granato, Teresa; Manganaro, Lucia; Petri, Luca; Porpora, Maria Grazia; Viggiani, Valentina; Angeloni, Antonio; Anastasi, Emanuela

    2016-02-01

    The objective of this study was to evaluate the correlation between 25-OH vitamin D and ovarian cancer as a diagnostic marker or recurrence disease marker. We studied the following: (1) 61 women without gynecologic diseases, (2) 45 women affected by benign ovarian disease, (3) 46 women with recent diagnosis of ovarian cancer, (4) 26 follow-up women with recurrent ovarian cancer, and (5) 32 follow-up women with stable ovarian cancer. The 25-OH vitamin D was quantified with LUMIPULSE® G 25-OH vitamin D on LUMIPULSE® G 1200 (Fujirebio, Japan). As a threshold value, identified by ROC curve analysis, 20.2 ng/mL (sensitivity 73.3 %, specificity 84 %) was chosen corresponding to the limit between sufficient and insufficient 25-OH vitamin D according to the WHO. Low 25-OH vitamin D levels were observed in 26 % of women without gynecologic diseases, in 80 % of women with recent diagnosis of ovarian cancer and in 24 % women affected by benign ovarian diseases (p < 0.001). The follow-up study showed an insufficient level of 25-OH vitamin D in 73 % women with recurrent ovarian cancer and in 47 % women with stable ovarian cancer (p < 0.0003). This study showed that patients with ovarian cancer are often insufficient in 25-OH vitamin D compared to women with benign ovarian diseases. The women with recurrent ovarian cancer presented more often low levels compared to women with stable ovarian cancer. This study suggests that 25-OH vitamin D, due to its antiproliferative properties, can be a good marker for ovarian cancer also.

  6. CanWalk: a feasibility study with embedded randomised controlled trial pilot of a walking intervention for people with recurrent or metastatic cancer

    Science.gov (United States)

    Tsianakas, Vicki; Ream, Emma; Van Hemelrijck, Mieke; Purushotham, Arnie; Mucci, Lorelei; Green, James S A; Fewster, Jacquetta; Armes, Jo

    2017-01-01

    Objectives Walking is an adaptable, inexpensive and accessible form of physical activity. However, its impact on quality of life (QoL) and symptom severity in people with advanced cancer is unknown. This study aimed to assess the feasibility and acceptability of a randomised controlled trial (RCT) of a community-based walking intervention to enhance QoL in people with recurrent/metastatic cancer. Design We used a mixed-methods design comprising a 2-centre RCT and nested qualitative interviews. Participants Patients with advanced breast, prostate, gynaecological or haematological cancers randomised 1:1 between intervention and usual care. Intervention The intervention comprised Macmillan's ‘Move More’ information, a short motivational interview with a recommendation to walk for at least 30 min on alternate days and attend a volunteer-led group walk weekly. Outcomes We assessed feasibility and acceptability of the intervention and RCT by evaluating study processes (rates of recruitment, consent, retention, adherence and adverse events), and using end-of-study questionnaires and qualitative interviews. Patient-reported outcome measures (PROMs) assessing QoL, activity, fatigue, mood and self-efficacy were completed at baseline and 6, 12 and 24 weeks. Results We recruited 42 (38%) eligible participants. Recruitment was lower than anticipated (goal n=60), the most commonly reported reason being unable to commit to walking groups (n=19). Randomisation procedures worked well with groups evenly matched for age, sex and activity. By week 24, there was a 45% attrition rate. Most PROMs while acceptable were not sensitive to change and did not capture key benefits. Conclusions The intervention was acceptable, well tolerated and the study design was judged acceptable and feasible. Results are encouraging and demonstrate that exercise was popular and conveyed benefit to participants. Consequently, an effectiveness RCT is warranted, with some modifications to the

  7. Efficacy of vinorelbine and zoledronate combination therapy against postoperative recurrence of lung cancer.

    Science.gov (United States)

    Ishida, Junzo; Furukawa, Kinya; Hosaka, Makoto; Saito, Makoto; Matsushima, Yasushi

    2012-04-01

    We report a case of a response to long-term treatment with vinorelbine and zoledronate in a patient with lymph node and multiple bone metastases after lung cancer surgery. The patient was a 70-year-old male initially examined by a local physician for an abnormal shadow that had been detected on a chest X-ray during a screening examination. CT revealed a mass shadow measuring 28 mm in diameter in the left S10, and because lung cancer was suspected, the patient was admitted to our hospital for the first time and examined. Lung cancer was diagnosed intraoperatively, and left lower lobectomy was performed. The pathological stage was III a, and postoperative adjuvant chemotherapy was performed, but recurrences in the form of lymph node and multiple bone metastases were detected. After diagnosis of the recurrence, the patient was treated with long-term vinorelbine (VNR)biweekly and zoledronate (ZOL) monthly, and a response was obtained. A patient with postoperative recurrence of lung cancer associated with multiple bone metastases responded to combination chemotherapy with VNR and ZOL. VNR was effective against postoperative recurrence in an elderly lung cancer patient with complications, and could be administered safely long-term. ZOL also had a favorable protective effect against skeletal-related events (SREs) in lung cancer, and the results suggested that it also had an antitumor effect in this patient.

  8. Prevention of lung cancer recurrence using cisplatin-loaded superhydrophobic nanofiber meshes.

    Science.gov (United States)

    Kaplan, Jonah A; Liu, Rong; Freedman, Jonathan D; Padera, Robert; Schwartz, John; Colson, Yolonda L; Grinstaff, Mark W

    2016-01-01

    For early stage lung cancer patients, local cancer recurrence after surgical resection is a significant concern and stems from microscopic disease left behind after surgery. Here we apply a local drug delivery strategy to combat local lung cancer recurrence after resection using non-woven, biodegradable nanofiber meshes loaded with cisplatin. The meshes are fabricated using a scalable electrospinning process from two biocompatible polymers--polycaprolactone and poly(glycerol monostearate-co-caprolactone)--to afford favorable mechanical properties for use in a dynamic tissue such as the lung. Owing to their rough nanostructure and hydrophobic polymer composition, these meshes exhibit superhydrophobicity, and it is this non-wetting nature that sustains the release of cisplatin in a linear fashion over ∼90 days, with anti-cancer efficacy demonstrated using an in vitro Lewis Lung carcinoma (LLC) cell assay. The in vivo evaluation of cisplatin-loaded superhydrophobic meshes in the prevention of local cancer recurrence in a murine model of LLC surgical resection demonstrated a statistically significant increase (p = 0.0006) in median recurrence-free survival to >23 days, compared to standard intraperitoneal cisplatin therapy of equivalent dose. These results emphasize the importance of supplementing cytoreductive surgery with local drug delivery strategies to improve prognosis for lung cancer patients undergoing tumor resection. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Intraarterial Scintigraphy in recurrent Cervix Cancer - The Evaluation of Radionuclide therapeutic Trials -

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Young; Suh, Jin Suck; Park, Chang Yun; Lee, Jong Tae; Yoo, Hyung Sik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1990-07-15

    We performed 17 intraarterial scintigraphies in six patients with recurrent cervix cancer. With Seldinger method, the agent (four different radiopharmaceuticals) was perfused at the same speed of infusion of anticancer drugs (25 cc/hour) through internal iliac artery. There were four different radiopharmaceuticals; {sup 131}I-Lipiodol, {sup 99m}Tc(Technetium)-HSA (Human Serum Albumin), {sup 99m}Tc-Sucralfate and {sup 99m}Tc-MAA (Macroaggregated Albumin). We evaluate the distribution pattern of radioactivity by the use of ratio of Tumor/Extratumor uptake (T/ET ratio). Our results reveals that {sup 99m}Tc-MAA scan showed the highest T/ET ratio and the other were not ideal agents for intraarterial therapy of recurrent cervix cancer. In conclusion, an ideal radioisotope and tracer which can block capillary, for example MAA, should be re-evaluated or produced in order to treat the patient with recurrent cervix cancer.

  10. Amplification of LAPTM4B and YWHAZ contributes to chemotherapy resistance and recurrence of breast cancer

    DEFF Research Database (Denmark)

    Szallasi, Zoltan Imre; Li, Yang; Zou, Lihua

    2010-01-01

    Adjuvant chemotherapy for breast cancer after surgery has effectively lowered metastatic recurrence rates. However, a considerable proportion of women suffer recurrent cancer at distant metastatic sites despite adjuvant treatment. Identification of the genes crucial for tumor response to specific...... chemotherapy drugs is a challenge but is necessary to improve outcomes. By using integrated genomics, we identified a small number of overexpressed and amplified genes from chromosome 8q22 that were associated with early disease recurrence despite anthracycline-based adjuvant chemotherapy. We confirmed...... of LAPTM4B resulted in sequestration of the anthracycline doxorubicin, delaying its appearance in the nucleus. Overexpression of these two genes was associated with poor tumor response to anthracycline treatment in a neoadjuvant chemotherapy trial in women with primary breast cancer. Our results suggest...

  11. Outcomes after curative or palliative surgery for locoregional recurrent breast cancer

    DEFF Research Database (Denmark)

    Juhl, Alexander Andersen; Mele, Marco; Damsgaard, Tine Engberg

    2014-01-01

    Background Locoregional recurrence (LRR) after breast cancer is an independent predictor for later systemic disease and poor long-term outcome. As the surgical treatment is complex and often leaves the patient with extensive defects, reconstructive procedures involving flaps, and thus plastic...... surgical assistance, are often required. The aim of the present study was to evaluate our institution’s approach to surgical treatment for locoregional recurrence of a breast cancer. Methods In the present retrospective, single-centre study, we evaluate our experience with 12 patients who underwent surgery...... for locally recurrent breast cancer at Aarhus University Hospital between 2006 and 2010. Nine patients underwent wide local excision. The remaining three patients underwent full thickness chest wall resection. Results There was no perioperative mortality and no major complications. Minor complications...

  12. Vulval cancer and HPV vaccination in recurrent disease

    DEFF Research Database (Denmark)

    Gustafson, L W; Gade, Melina; Blaakær, Jan

    2014-01-01

    KEY CLINICAL MESSAGE: A woman diagnosed with a recurrent vulval carcinoma after initial treatment with radiochemotherapy is presented. After three additional relapses she was vaccinated with Gardasil. She has had no relapses in her vulvar area for 39 months and an overall progression-free survival...

  13. Antioxidant supplementation during oncology treatment has no effect on cervical cancer recurrence

    Directory of Open Access Journals (Sweden)

    Karolina Álvarez-Altamirano

    Full Text Available Introduction and aim: Antioxidant therapy with chemotherapy and radiotherapy in cervical cancer patients is controversial. While some evidence suggests that the use of antioxidants diminishes side effects from anticancer therapy, there is also data to suggest that antioxidants increase the risk of recurrence by affecting oncology treatments. Methods: We conducted a controlled clinical trial in cervical cancer patients supplemented with an antioxidant mixture or a placebo during four years after their antineoplastic treatment was completed and the effect on recurrence. We also conducted data on used hemoglobin and albumin levels. Differences between groups were analyzed using chi-square test. Survival was calculated by the Multivariate COX regression with omnibus test and the enter method. Results: 103 treated patients were in clinical stages IIB and IIIB of cervical cancer, 48% (n = 49 of the patients were treated with antioxidant supplementation and 52% (n =54 of the patients were in the placebo group. Of the original 103 patients, were able to follow up on 88 patients for an additional four years.23.9% (n = 21 of the patients presented cancer recurrence and 76.1% (n = 67 did not, 21.6% (n = 19 patients showed metastasis. 8% (n = 7 patients were in the antioxidant group and 15.9% (n = 14 were in the placebo group (p > 0.05. Regarding implications of cancer survivors, antioxidant supplementation apparently seems not to have interference with recurrence in cervical cancer patients but there is not enough evidence to prove it. A different dosage may have the expected effect; however, further studies with another dosage and criteria are necessary. Conclusions: Supplementation with antioxidants during treatment of cervical cancer has no effect on cancer recurrence after 4 years of follow-up.

  14. Detection of Recurrent Cervical Cancer by Whole-body FDG PET Scans

    Institute of Scientific and Technical Information of China (English)

    Jiaxin Yang; Jinhui Wang; Zhaohui Zhu; Keng Shen; Bocheng Wang

    2008-01-01

    OBJECTIVE To evaluate the role of whole-body {18F} fluro-2-dexoxyglucose (FDG) positron emission tomography (PET) scans in the detection of recurrent cervical cancer.METHODS Between June, 2000 and January, 2006, 25 patients had undergone a PET scan at the Peking Union Medical College Hospital to evaluate possible recurrent cervical cancer. All the PET findings were reviewed and compared to available clinical data to classify each PET scan result as a true positive, true negative, false positive, or false negative.RESULTS A total of 38 PET scans were conducted on the 25patients whose median age was 46 years. The Stage distributions were IA (n = 1), IB (n = 11), IIA (n = 5), IIB (n = 4), IIIB (n = 2), WB (n= 1), and unknown Stage (n = 1). There were 22 cases of squamous cell carcinoma and 3 cases of adenocarcinoma resulting in 9 true positive PET scans, 27 true negatives, 2 false positives and no false negatives. The sensitivity of the FDG PET scans for detecting recurrent cervical cancer was 100%, specificity 93.1%, positive predictive value 81.8%, and negative predictive value 100%.CONCLUSION The whole body FDG PET scans are a sensitive and specific imaging modality for the detection of recurrent cervical cancer. However the cost of PET scans is too high at this time. A large prospective study will determine whether this modality should be used routinely and take the place of other imaging methods in the early detection of recurrent cervical carcinoma

  15. Bolus electron conformal therapy for the treatment of recurrent inflammatory breast cancer: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Michelle M., E-mail: mmkim@mdanderson.org [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Kudchadker, Rajat J.; Kanke, James E.; Zhang, Sean; Perkins, George H. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States)

    2012-07-01

    The treatment of locoregionally recurrent breast cancer in patients who have previously undergone radiation therapy is challenging. Special techniques are often required that both eradicate the disease and minimize the risks of retreatment. We report the case of a patient with an early-stage left breast cancer who developed inflammatory-type recurrence requiring re-irradiation of the chest wall using bolus electron conformal therapy with image-guided treatment delivery. The patient was a 51-year-old woman who had undergone lumpectomy, axillary lymph node dissection, and adjuvant whole-breast radiation therapy for a stage I left breast cancer in June 1998. In March 2009, she presented at our institution with biopsy-proven recurrent inflammatory carcinoma and was aggressively treated with multi-agent chemotherapy followed by mastectomy that left a positive surgical margin. Given the patient's prior irradiation and irregular chest wall anatomy, bolus electron conformal therapy was used to treat her chest wall and draining lymphatics while sparing the underlying soft tissue. The patient still had no evidence of disease 21 months after treatment. Our results indicate that bolus electron conformal therapy is an accessible, effective radiation treatment approach for recurrent breast cancer in patients with irregular chest wall anatomy as a result of surgery. This approach may complement standard techniques used to reduce locoregional recurrence in the postmastectomy setting.

  16. Moderating effects of perceived growth on the association between fear of cancer recurrence and health-related quality of life among adolescent and young adult cancer survivors.

    Science.gov (United States)

    Cho, Dalnim; Park, Crystal L

    2017-01-01

    We examined whether (1) fear of cancer recurrence was related to lower health-related quality of life and (2) perceived growth moderated the link between fear of recurrence and health-related quality of life. About 292 adolescent and young adult cancer survivors (diagnosed with cancer at ages 15-34) completed a cross-sectional survey. Fear of recurrence was related to poorer physical and mental health-related quality of life. The negative association between fear of recurrence and mental health-related quality of life was moderated by perceived growth. Fostering perceived growth may mitigate the adverse associations of fear of recurrence and health-related quality of life.

  17. Sirolimus and Auranofin in Treating Patients With Advanced or Recurrent Non-Small Cell Lung Cancer or Small Cell Lung Cancer

    Science.gov (United States)

    2016-08-25

    Extensive Stage Small Cell Lung Carcinoma; Lung Adenocarcinoma; Recurrent Non-Small Cell Lung Carcinoma; Recurrent Small Cell Lung Carcinoma; Squamous Cell Lung Carcinoma; Stage IIIA Non-Small Cell Lung Cancer; Stage IIIB Non-Small Cell Lung Cancer; Stage IV Non-Small Cell Lung Cancer

  18. Carboplatin, Paclitaxel, Cetuximab, and Erlotinib Hydrochloride in Treating Patients With Metastatic or Recurrent Head and Neck Squamous Cell Cancer

    Science.gov (United States)

    2017-04-11

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Salivary Gland Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Larynx; Stage IV Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IV Squamous Cell Carcinoma of the Oropharynx; Stage IV Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IV Verrucous Carcinoma of the Larynx; Stage IV Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  19. Expression of Annexin A2 and Its Correlation With Drug Resistance and Recurrence of Bladder Cancer.

    Science.gov (United States)

    Hu, Huihui; Zhao, Jin; Zhang, Man

    2016-12-01

    To explore the expressions of annexin A2 in bladder cancer cell lines and bladder cancer tissues, we want to find the relationship among annexin A2, drug resistance, and recurrence of bladder cancer. Our laboratory established the PUMC-91 bladder cancer cell line against gradient concentration of Adriamycin (0.3, 0.6, and 1.0 μg/mL), and we also collected 60 cases of surgically resected bladder cancer recurrent tissue samples. The tissues were classified into 2 groups according to the frequency of recurrence (2 years) after initial surgery. The method of immunohistochemistry was used to examine the differences in the expression of annexin A2. There were statistical differences in annexin A2 among normal bladder epithelial cell line SV-HUC-1, PUMC-91, PUMC-91 against 0.3 μg/mL Adriamycin, and PUMC-91 against 1.0 μg/mL Adriamycin (P 2 years (P = .002) in the bladder cancer tissues and that recurred at <6 months after initial surgery. It was also associated with invasion depth (stage) of bladder cancer, such as higher expression in T2 (invasive muscular) group than Tis (carcinoma in situ) and T1 (invasive mucosa lamina propria) groups (P = .003 and P = .000, respectively). But, it did not correlate with the differentiation (grade) of cancer cells in bladder cancer tissues (P = .593). Annexin A2 can act as a valuable biomarker for predicting the drug resistance and recurrence of bladder cancer. © The Author(s) 2015.

  20. Photodynamic Therapy Using HPPH in Treating Patients Undergoing Surgery for Primary or Recurrent Head and Neck Cancer

    Science.gov (United States)

    2017-03-28

    Recurrent Adenoid Cystic Carcinoma of the Oral Cavity; Recurrent Basal Cell Carcinoma of the Lip; Recurrent Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Recurrent Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Recurrent Lymphoepithelioma of the Nasopharynx; Recurrent Lymphoepithelioma of the Oropharynx; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Recurrent Mucoepidermoid Carcinoma of the Oral Cavity; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Thyroid Cancer; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Stage I Adenoid Cystic Carcinoma of the Oral Cavity; Stage I Basal Cell Carcinoma of the Lip; Stage I Esthesioneuroblastoma of the Paranasal Sinus and Nasal Cavity; Stage I Follicular Thyroid Cancer; Stage I Inverted Papilloma of the Paranasal Sinus and Nasal Cavity; Stage I Lymphoepithelioma of the Nasopharynx; Stage I Lymphoepithelioma of the Oropharynx; Stage I Midline Lethal Granuloma of the Paranasal Sinus and Nasal Cavity; Stage I Mucoepidermoid Carcinoma of the Oral Cavity; Stage I Papillary Thyroid Cancer; Stage I Salivary Gland Cancer; Stage I Squamous Cell Carcinoma of the Hypopharynx; Stage I Squamous Cell Carcinoma of the Larynx; Stage I Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage I Squamous Cell Carcinoma of the Oropharynx; Stage I Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage I Verrucous Carcinoma of the Larynx; Stage I Verrucous Carcinoma of the Oral Cavity; Stage II Adenoid Cystic Carcinoma of the

  1. Pelvic exenteration for recurrent or persistent cervical cancer: experience of five years at the National Cancer Institute in Mexico.

    Science.gov (United States)

    Terán-Porcayo, M A; Zeichner-Gancz, I; del-Castillo, R A C Gomez; Beltrán-Ortega, A; Solorza-Luna, G

    2006-01-01

    Cervical cancer constitutes a major health problem in Mexico and other developing countries. The purpose of our study was to assess the experience of a comprehensive national oncological reference center on pelvic exenteration for post-radiotherapy recurrent or persistent cervical cancer, describing the prognostic value of time to recurrence, procedure complications, and survival. Medical records from 42 patients with post-radiotherapy recurrent or persistent cervical cancer who underwent a pelvic exenteration with curative purposes from 1984 to 1989 were retrospectively reviewed. Histological diagnoses were squamous cell carcinoma (32 patients), adenosquamous carcinoma (9 patients), and adenocarcinoma (1 patient). Average follow up was of 56.3 mo after the procedure and global survival at 5 yr was 65.8%. Survival for patients with early recurrence was 56.9% vs 78% for patients with late recurrence (p = 0.05). Complications were observed in 65.3% of the cases with a surgical mortality of 4.8%. Pelvic exenteration is a surgical procedure with high morbidity in spite of the recent medical advances. Pelvic exenteration should not be indicated with palliative purposes owing to the high rate of complications. Patients with tumor persistence or early recurrence have a worse prognosis. In well-selected cases, exenteration may provide a survival benefit.

  2. Early detection of recurrence after curative resection for colorectal cancer - obstacles when using soluble biomarkers?

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Jess, Per; Aldulaymi, Bahir Hadi Mohammed

    2013-01-01

    Abstract Objective. Results from monitoring studies using biomarkers in blood samples aiming at early detection of recurrent colorectal cancer (CRC) are presently evaluated. However, some serological biomarker levels are influenced by the surgical trauma, which may complicate translation...... were recorded at each visit to the outpatient clinic. Results. Among the 165 patients, 49 developed recurrence (R+), 107 did not (R-) and 11 developed a new primary cancer, including 2 in the R+ group. Within the 3 years of observation, 78 (47.3%) of the 165 patients underwent 117 (range 1...

  3. Management of recurrent rectal cancer: A population based study in greater Amsterdam

    Institute of Scientific and Technical Information of China (English)

    Roel Bakx; Otto Visser; Judith Josso; Sybren Meijer; J Frederik M Slors; J Jan B van Lanschot

    2008-01-01

    AIM: To analyze, retrospectively in a population-based study, the management and survival of patients with recurrent rectal cancer initially treated with a macroscopically radical resection obtained with total mesorectal excision (TME).METHODS: All rectal carcinomas diagnosed during 1998 to 2000 and initially treated with a macroscopically radical resection (632 patients) were selected from the Amsterdam Cancer Registry. For patients with recurrent disease, information on treatment of the recurrence was collected from the medical records.RESULTS: Local recurrence with or without clinically apparent distant dissemination occurred in 62 patients (10%). Thirty-two patients had an isolated local recurrence. Ten of these 32 patients (31%) underwent radical re-resection and experienced the highest survival (three quarters survived for at least 3 years). Eight patients (25%) underwent non-radical surgery (median survival 24 too), seven patients (22%) were treated with radio- and/or chemotherapy without surgery (median survival 15 mo) and seven patients (22%) only received best supportive care (median survival 5 mo). Distant dissemination occurred in 124 patients (20%) of whom 30 patients also had a local recurrence. The majority (54%) of these patients were treated with radio- and/or chemotherapy without surgery (median survival 15 mo). Twenty-seven percent of these patients only received best supportive care (median survival 6 mo), while 16% underwent surgery for their recurrence. Survival was best in the latter group (median survival 32 mo).CONCLUSION: Although treatment options and survival are limited in case of recurrent rectal cancer after radical local resection obtained with TME, patients can benefit from additional treatment, especially if a radical resection is feasible.

  4. Patterns and prognosis of locally recurrent rectal cancer following multidisciplinary treatment

    Institute of Scientific and Technical Information of China (English)

    Jun Zhao; Chang-Zheng Du; Ying-Shi Sun; Jin Gu

    2012-01-01

    AIM:To investigate the patterns and decisive prognostic factors for local recurrence of rectal cancer treated with a multidisciplinary team (MDT) modality.METHODS:Ninety patients with local recurrence were studied,out of 1079 consecutive rectal cancer patients who underwent curative surgery from 1999 to 2007.For each patient,the recurrence pattern was assessed by specialist radiologists from the MDT using imaging,and the treatment strategy was decided after discussion by the MDT.The associations between clinicopathological factors and long-term outcomes were evaluated using both univariate and multivariate analysis.RESULTS:The recurrence pattern was classified as follows:Twenty-seven (30%) recurrent tumors were evaluated as axial type,21 (23.3%) were anterior type,8 (8.9%) were posterior type,and 13 (25.6%) were lateral type.Forty-one patients had tumors that were evaluated as resectable by the MDT and ultimately received surgery,and R0 resection was achieved in 36 (87.8%) of these patients.The recurrence pattern was closely associated with resectability and R0 resection rate (P < 0.001).The recurrence pattern,interval to recurrence,and RO resection were significantly associated with 5-year survival rate in univariate analysis.Multivariate analysis showed that the R0 resection was the unique independent factor affecting long-term survival.CONCLUSION:The MDT modality improves patient selection for surgery by enabling accurate classification of the recurrence pattern; RO resection is the most significant factor affecting long-term survival.

  5. Abdominal obesity, hypertension, antihypertensive medication use and biochemical recurrence of prostate cancer after radical prostatectomy.

    Science.gov (United States)

    Ohwaki, Kazuhiro; Endo, Fumiyasu; Hattori, Kazunori

    2015-03-01

    The aim of this study was to determine whether abdominal obesity, including visceral adipose tissue (VAT) measured by computed tomography and blood pressure (BP) were associated with biochemical recurrence of prostate cancer after prostatectomy. We investigated 283 patients who underwent radical prostatectomy for prostate cancer retrospectively. We obtained information on body mass index (BMI), waist circumference (WC), VAT, BP, antihypertensive drug use, pretreatment prostate-specific antigen levels, pathological Gleason scores and postoperative surgical margin status. Hypertension was defined as systolic BP (SBP)⩾130mmHg or diastolic BP⩾85mmHg. Among 283 patients, 41 (14%) developed biochemical recurrence subsequently. We performed a Cox proportional hazard regression analysis to assess the association of each obesity measurement and SBP with biochemical recurrence using clinical predictors as potential confounders. No association was observed between any obesity measurement assessed and biochemical recurrence. Adjusting for each of BMI, WC and VAT, a higher SBP was associated significantly with biochemical recurrence (hazard ratio [HR], adjusted for VAT=1.04; 95% confidence interval [CI]=1.02-1.07). Adjusting for obesity (BMI⩾25kg/m(2)), hypertension was also associated significantly with biochemical recurrence (HR=2.08; 95% CI=1.09-3.97). Compared with normotensive patients, those with untreated and uncontrolled hypertension had a significantly increased risk of biochemical recurrence (HR=2.45; 95% CI=1.06-5.66). A higher BP and untreated, uncontrolled hypertension were independent risk factors for biochemical recurrence after prostatectomy. Control of hypertension could be an important treatment strategy for preventing biochemical recurrence. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. [The perioperative period in cancer surgery: a critical moment! Is there a role for regional anesthesia in preventing cancer recurrence?].

    Science.gov (United States)

    Beloeil, H; Nouette-Gaulain, K

    2012-06-01

    Surgical treatment of cancer is usually necessary but it can paradoxically aggravate the patient outcome by increasing the risk of recurrence. Many perioperative factors have been shown to contribute to the dissemination of the tumor: surgery itself, stress, inflammation, pain, anaesthetic drugs, blood transfusion, etc. The type of anaesthesia chosen in the cancer patient could then be crucial and influence the evolution of the disease. Experimental, preclinical and retrospective studies have suggested that a regional anesthesia associated or not with a general anesthesia for carcinologic surgery might reduce the risk of cancer recurrence. This text reviews the factors promoting the recurrence of tumors after carcinologic surgery and the potential possibilities of protection associated with the type of anaesthesia chosen.

  7. The recurrence rate of breast cancer conserving operation in Yokohama Citizen's Hospital

    Energy Technology Data Exchange (ETDEWEB)

    Ishiyama, Akira; Chishima, Takashi; Hayashi, Kazushige; Kito, Fumihiko; Fukushima, Tumeo [Yokohama Municipal Citizen' s Hospital (Japan)

    2000-05-01

    During the last nine year period from Jan. 1991 to Dec. 1999, a total of 615 patients with primary breast cancer were experienced at our hospital. Eighty-eight patients underwent breast conserving therapy, 9 out of 88 patients received radiation therapy after surgical procedures. Recurrence were observed in five patients (5.7%). One of them had skin metastasis which looked like inflammatory breast cancer. This case was treated by postoperative 50 Gy radiation therapy to the remnant breast tissue but was unsuccessful in this case. We believe that postoperative radiation therapy is indicated for breast cancer patients with cancer-positive surgical margin or massive lymph node metastases. The other recurrent cases included one patient with supraclavicular lymph node metastases and three patients with local recurrence of remnant breast tissue cancer as a result of multicentricity. Our five recurrent patients are now alive after the various salvage therapies. Breast conserving therapy without radiation is thought to be useful in certain indicated cases. (author)

  8. Variability in CRP, regulatory T cells and effector T cells over time in gynaecological cancer patients: a study of potential oscillatory behaviour and correlations

    OpenAIRE

    2014-01-01

    Background The inflammatory marker, C reactive protein has been proposed to also be a biomarker for adaptive immune responses in cancer patients with a possible application in time based chemotherapy. Fluxes in serum CRP levels were suggested to be indicative of a cyclical process in which, immune activation is followed by auto-regulating immune suppression. The applicability of CRP as a biomarker for regulatory or effector T cells was therefore investigated in a cohort of patients with gynae...

  9. Identification of prognostic genes for recurrent risk prediction in triple negative breast cancer patients in Taiwan.

    Directory of Open Access Journals (Sweden)

    Lee H Chen

    Full Text Available Discrepancies in the prognosis of triple negative breast cancer exist between Caucasian and Asian populations. Yet, the gene signature of triple negative breast cancer specifically for Asians has not become available. Therefore, the purpose of this study is to construct a prediction model for recurrence of triple negative breast cancer in Taiwanese patients. Whole genome expression profiling of breast cancers from 185 patients in Taiwan from 1995 to 2008 was performed, and the results were compared to the previously published literature to detect differences between Asian and Western patients. Pathway analysis and Cox proportional hazard models were applied to construct a prediction model for the recurrence of triple negative breast cancer. Hierarchical cluster analysis showed that triple negative breast cancers from different races were in separate sub-clusters but grouped in a bigger cluster. Two pathways, cAMP-mediated signaling and ephrin receptor signaling, were significantly associated with the recurrence of triple negative breast cancer. After using stepwise model selection from the combination of the initial filtered genes, we developed a prediction model based on the genes SLC22A23, PRKAG3, DPEP3, MORC2, GRB7, and FAM43A. The model had 91.7% accuracy, 81.8% sensitivity, and 94.6% specificity under leave-one-out support vector regression. In this study, we identified pathways related to triple negative breast cancer and developed a model to predict its recurrence. These results could be used for assisting with clinical prognosis and warrant further investigation into the possibility of targeted therapy of triple negative breast cancer in Taiwanese patients.

  10. Hypomanic episode during recurrent gastric cancer treatment: report of a rare case and literature review.

    Science.gov (United States)

    Matsunaga, Mototsugu; Onishi, Hideki; Ishida, Mayumi; Miwa, Keisuke; Araki, Kazuhiro; Kaneta, Toshikado; Sunakawa, Yu; Nakayama, Hirofumi; Shimada, Ken; Noguchi, Tsuyoshi; Narabayashi, Masaru; Sasaki, Yasutsuna

    2012-10-01

    S-1 plus cisplatin is the standard chemotherapy for recurrent gastric cancer. While depression and delirium are frequent in cancer patients, hypomania during chemotherapy is rare. We describe a rare case of hypomania during S-1 plus cisplatin treatment for recurrent gastric cancer. A 66-year-old woman, with no previous psychiatric disorder, received S-1 plus cisplatin for recurrent gastric cancer. She showed peculiar behavior. Physical examination, urine, blood and imaging findings were normal. There was no gastric cancer progression. During psychiatric consultation, she behaved inappropriately. However, she behaved normally while performing daily activities. She manifested a persistently elevated, expansive or irritable mood, clearly different from her usual non-depressed state, meeting hypomania diagnostic criteria. Her condition did not require chemotherapy discontinuation or additional medication. During the second and subsequent S-1 plus cisplatin cycles, symptoms were stable. Cancer patients often have adjustment disorders, depression and delirium, but rarely hypomania. Our patient showed no significant changes in blood biochemistry and brain and whole body imaging. While S-1 plus cisplatin-induced hypomania cannot be excluded, hypomanic symptoms did not improve during the chemotherapy rest period, nor was there deterioration during subsequent cycles, suggesting drug-induced mania to be unlikely. Possible onset mechanisms include manic defense phenomena, common with stressful life events. There are no reports of recurrent gastric cancer patients experiencing hypomania during S-1 or S-1 plus cisplatin therapy, i.e. our patient represents a rare course. Clinicians should recognize psychosis or mood disorders during gastric cancer treatment. Further accumulation of such rare cases might elucidate pathological mechanisms underlying hypomania in cancer patients.

  11. Gamma-secretase/Notch Signalling Pathway Inhibitor RO4929097 in Treating Patients With Advanced, Metastatic, or Recurrent Triple Negative Invasive Breast Cancer

    Science.gov (United States)

    2017-02-28

    Estrogen Receptor-negative Breast Cancer; HER2-negative Breast Cancer; Male Breast Cancer; Progesterone Receptor-negative Breast Cancer; Recurrent Breast Cancer; Stage IIIA Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer; Triple-negative Breast Cancer

  12. Recurrent advanced colonic cancer occurring 11 years after initial endoscopic piecemeal resection: a case report

    Directory of Open Access Journals (Sweden)

    Kishino Takayoshi

    2010-08-01

    Full Text Available Abstract Background The high frequency of local recurrence occurring after endoscopic piecemeal resection (EPMR for large colorectal tumors is a serious problem. However, almost all of these cases of local recurrence can be detected within 1 year and cured by additional endoscopic resection. We report a rare case of recurrent advanced colonic cancer diagnosed 11 years after initial EPMR treatment. Case presentation A 65-year-old male was diagnosed with a sigmoid colon lesion following a routine health check-up. Total colonoscopy revealed a 12 mm type 0-Is lesion in the sigmoid colon, which was diagnosed as an adenoma or intramucosal cancer and treated by EPMR in 1996. The post-resection defect was closed completely using metallic endoclips to avoid delayed bleeding. In 2007, at the third follow up, colonoscopy revealed a 20 mm submucosal tumor (SMT like recurrence at the site of the previous EPMR. The recurrent lesion was treated by laparoscopic assisted sigmoidectomy with lymph node dissection. Conclusion When it is difficult to evaluate the depth and margins of resected tumors following EPMR, it is important that the defect is not closed in order to avoid tumor implantation, missing residual lesions and to enable earlier detection of recurrence. It is crucial that the optimal follow-up protocol for EPMR cases is clarified, particularly how often and for how long they should be followed.

  13. Early localization of recurrent prostate cancer after prostatectomy by endorectal coil magnetic resonance imaging.

    Science.gov (United States)

    Linder, Brian J; Kawashima, Akira; Woodrum, David A; Tollefson, Matthew K; Karnes, Jeffrey; Davis, Brian J; Rangel, Laureano J; King, Bernard F; Mynderse, Lance A

    2014-06-01

    To evaluate the ability of endorectal coil (e-coil) magnetic resonance imaging (MRI) to identify early prostatic fossa recurrence after radical prostatectomy. We identified 187 patients from 2005-2011 who underwent e-coil MRI with dynamic gadolinium-contrast enhancement followed by transrectal ultrasound (TRUS) guided prostatic fossa biopsy for possible local prostate cancer recurrence. For analysis, local recurrence was defined as a negative evaluation for distant metastatic disease with a positive prostatic fossa biopsy, decreased prostate-specific antigen (PSA) following salvage radiation therapy, or increased lesion size on serial imaging. Local recurrence was identified in 132 patients, with 124 (94%) detected on e-coil MRI. The median PSA was 0.59 ng/mL (range coil MRI was 86%. When a lesion was identified on MRI, the positive biopsy rate was 65% and lesion size was a significant predictor of positive biopsies. The positive biopsy rates were 51%, 74%, and 88% when the lesion was 2 cm, respectively (p = 0.0006). E-coil MRI has a high level of sensitivity in identifying local recurrence of prostate cancer following radical prostatectomy, even at low PSA levels. E-coil MRI should be considered as the first imaging evaluation for biochemical recurrence for identifying patients suitable for localized salvage therapy.

  14. Allelic imbalance analysis using a single-nucleotide polymorphism microarray for the detection of bladder cancer recurrence.

    NARCIS (Netherlands)

    Coenen, M.J.H.; Ploeg, M.; Schijvenaars, M.M.V.A.P.; Cornel, E.B.; Karthaus, H.F.M.; Scheffer, H.; Witjes, J.A.M.; Franke, B.; Kiemeney, L.A.L.M.

    2008-01-01

    PURPOSE: Non-muscle-invasive bladder cancer is a frequently occurring cancer, with an extremely high recurrence risk. Recurrence detection is based on cytology and urethrocystoscopy. A previous study suggested that a single-nucleotide polymorphism (SNP) array may be effective for noninvasive detecti

  15. Advanced and Recurrent Endometrial Cancer; current concepts of treatment

    NARCIS (Netherlands)

    F.H. van Wijk (Heidy)

    2008-01-01

    textabstractEndometrial cancer is the most common gynecological malignancy in Western Countries. In the United States approximately 39,000 cases will be diagnosed in 2007 and 7,400 deaths will occur. Women have a 2.6% lifetime risk of developing endometrial cancer and it accounts for 6% of all cance

  16. Study Confirms Letrozole Prevents More Breast Cancer Recurrences than Tamoxifen

    Science.gov (United States)

    After a median of 8 years of follow-up, women with estrogen-receptor positive breast cancer who received 5 years of letrozole were less likely to have their cancer recur or to die during follow-up than women who received 5 years of tamoxifen.

  17. Performance of FDG-PET/CT for diagnosis of recurrent uterine cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kitajima, Kazuhiro [Dokkyo University School of Medicine, Departments of Radiology, Shimotuka-gun, Tochigi (Japan); Dokkyo Medical University Hospital, PET Center, Mibu (Japan); Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan); Murakami, Koji; Yamasaki, Erena; Domeki, Yasushi [Dokkyo Medical University Hospital, PET Center, Mibu (Japan); Kaji, Yasushi [Dokkyo University School of Medicine, Departments of Radiology, Shimotuka-gun, Tochigi (Japan); Sugimura, Kazuro [Kobe University Graduate School of Medicine, Department of Radiology, Kobe (Japan)

    2008-10-15

    The purpose is to evaluate the accuracy of integrated FDG-PET/CT, compared with PET alone, for diagnosis of suspected recurrence of uterine cervical cancer. Fifty-two women who had undergone treatment for histopathologically proven cervical cancer received PET/CT with suspected recurrence. PET-alone and integrated PET/CT images were evaluated by two different experienced radiologists by consensus for each investigation. A final diagnosis was confirmed by histopathology, radiological imaging, and clinical follow-up for over 1 year. Patient-based analysis showed that the sensitivity, specificity, and accuracy of PET/CT were 92.0% (23/25), 92.6% (25/27), and 92.3% (48/52), respectively, while for PET, the corresponding figures were 80.0% (20/25), 77.8% (21/27), and 78.8% (41/52), respectively. PET/CT resolved the false-positive PET results due to hypermetabolic activity of benign/inflammatory lesions and physiological variants, and was able to detect lung metastasis, local recurrence, peritoneal dissemination, para-aortic lymph node metastasis, and pelvic lymph node metastasis missed by PET alone. However, tiny local recurrence and lymph node metastasis could not be detected even by PET/CT. FDG-PET/CT is a useful complementary modality for providing good anatomic and functional localization of sites of recurrence during follow-up of patients with cervical cancer. (orig.)

  18. Extracapsular invasion as a risk factor for disease recurrence in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Takaaki Fujii; Yuichi Tabe; Reina Yajima; Satoru Yamaguchi; Soichi Tsutsumi; Takayuki Asao; Hiroyuki Kuwano

    2011-01-01

    AIM: To evaluate the presence of extracapsular invasion (ECI) in positive nodes as a predictor of disease recur-rence disease in colorectal cancer. METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identi-fied for inclusion in this study, of which 46 had positive lymph nodes. Among 46 cases with stage Ⅲcolorectal cancer, 16 had ECI at positive nodes and 8 had disease recurrence. The clinical and pathological features of these cases were reviewed.RESULTS: In the univariate analysis, the number of positive lymph nodes and depth of tumor invasion were significantly associated with the presence of ECI at posi-tive nodes. Multivariate analysis demonstrated that only ECI was a predictor of recurrence. The recurrence-free interval differed significantly among patients with ECI at positive nodes. CONCLUSION: Our results suggest that ECI at meta-static nodes can identify which cases are at high risk of short-term disease recurrence in colorectal cancer.

  19. Functionally recurrent rearrangements of the MAST kinase and Notch gene families in breast cancer.

    Science.gov (United States)

    Robinson, Dan R; Kalyana-Sundaram, Shanker; Wu, Yi-Mi; Shankar, Sunita; Cao, Xuhong; Ateeq, Bushra; Asangani, Irfan A; Iyer, Matthew; Maher, Christopher A; Grasso, Catherine S; Lonigro, Robert J; Quist, Michael; Siddiqui, Javed; Mehra, Rohit; Jing, Xiaojun; Giordano, Thomas J; Sabel, Michael S; Kleer, Celina G; Palanisamy, Nallasivam; Natrajan, Rachael; Lambros, Maryou B; Reis-Filho, Jorge S; Kumar-Sinha, Chandan; Chinnaiyan, Arul M

    2011-11-20

    Breast cancer is a heterogeneous disease that has a wide range of molecular aberrations and clinical outcomes. Here we used paired-end transcriptome sequencing to explore the landscape of gene fusions in a panel of breast cancer cell lines and tissues. We observed that individual breast cancers have a variety of expressed gene fusions. We identified two classes of recurrent gene rearrangements involving genes encoding microtubule-associated serine-threonine kinase (MAST) and members of the Notch family. Both MAST and Notch-family gene fusions have substantial phenotypic effects in breast epithelial cells. Breast cancer cell lines harboring Notch gene rearrangements are uniquely sensitive to inhibition of Notch signaling, and overexpression of MAST1 or MAST2 gene fusions has a proliferative effect both in vitro and in vivo. These findings show that recurrent gene rearrangements have key roles in subsets of carcinomas and suggest that transcriptome sequencing could identify individuals with rare, targetable gene fusions.

  20. The effect of obesity on recurrence pattern in early breast cancer patients.

    Science.gov (United States)

    Yazici, Ozan; Aksoy, Sercan; Sendur, Mehmet An; Babacan, Taner; Ozdemir, Nuriye; Ozisik, Yavuz; Zengin, Nurullah; Altundag, Kadri

    2015-01-01

    Obesity is a well known risk factor for breast cancer recurrence and poor prognosis. We studied the effect of body mass index (BMI) on recurrence pattern in early breast cancer patients. This retrospective cross-sectional study analyzed the data of 2731 early stage breast cancer patients. Patients who had metastatic disease at the time of diagnosis and with unknown BMI values were excluded from study (N=276). Patients were classified into three BMI categories: normal body weight, overweight, and obese. The recurrent/metastatic sites of patients were grouped in 8 categories: local, contralateral, lymph node, bone, lung, liver, brain and others. The association between first relapse site of early breast cancer patients and BMI categories were evaluated. The median patient age was 48 years (range 18-92). The median follow up time was 40 months (range 1-284). During follow-up, 469 (17.1%) patients developed recurrence and/or metastasis. Of 2455 total patients, 853 (34.6%) were classified as having normal weight, 898 (36.2%) were overweighted and 704 (29.2%) were obese. In the whole patient group no relation between metastatic sites and BMI groups was noticed. The first primary metastatic sites were also not associated with BMI groups in pre and postmenopausal subpopulations. In obese patients, disease free survival (DFS) was shorter compared to normal weighted patients, but the difference was not significant. There was no significant difference between site-specific DFS in relation to BMI categorization. Obese and overweighted patients had significantly shorter overall survival (OS) compared to the normal-weight group (p=0.003). Although obesity had no effect on recurrence pattern of early breast cancer patients, obese early breast cancer patients had shorter OS compared to their normal-weight counterparts.

  1. Targeting LSD1 Epigenetic Signature in Castration-Recurrent Prostate Cancer

    Science.gov (United States)

    2014-10-01

    addition to cell lines with DHT -activated AR. Validation of this approach in our pre-clinical studies can have a beneficial impact on PCa patients...specific demethylase 1A), PCa(prostate cancer), CRPCa(castration recurrent PCa), DHT (dihydroxy testosterone) 16. SECURITY CLASSIFICATION OF: 17...cell line, androgen independent DHT - dehydroxy testosterone LNCaP - androgen sensitive prostate cancer cell line LNCAP-C42 - castration

  2. Intrathoracic anastomotic leakage after gastroesophageal cancer resection is associated with increased risk of recurrence

    DEFF Research Database (Denmark)

    Kofoed, Steen C; Calatayud, Dan; Jensen, Lone S

    2015-01-01

    OBJECTIVE: Intrathoracic anastomotic leakage after intended curative resection for cancer in the esophagus or gastroesophageal junction has a negative impact on long-term survival. The aim of this study was to investigate whether an anastomotic leakage was associated with an increased recurrence......]: 1.17-2.29, P = .004) and all-cause mortality (HR = 1.57; 95% CI: 1.23-2.05, P cancer resection....

  3. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    OpenAIRE

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite...

  4. Single-Nucleotide Polymorphisms and Cancer Risk, Tumor Recurrence, or Survival of Head and Neck Cancer Patients.

    Science.gov (United States)

    Laytragoon-Lewin, Nongnit; Cederblad, Lena; Andersson, Bengt-Åke; Olin, Mattias; Nilsson, Mats; Rutqvist, Lars Erik; Lundgren, Jan; Engström, Mats; Tytor, Wieslaw; Löfgren, Sture; Lewin, Freddi

    2017-01-01

    This paper aims at studying the influence of single-nucleotide polymorphisms (SNPs) on cancer risk, tumor recurrence, and survival in head and neck (H&N) cancer patients. A total of 45 SNPs in 41 genes were investigated. A total of 174 Caucasian H&N cancer patients and 245 healthy blood donors were enrolled in the study. Ten SNPs were associated with H&N cancer risk, but the identified SNPs differed among males and females. Some of the SNPs were related to immune response genes. The immune response gene SNPs were also related to survival. In particular, we noted that the tumor necrosis factor alpha (TNFα) rs1800629 could have an influence on cancer risk, tumor recurrence as well as survival. Genetic variation of the TNFα rs1800629 might be useful as a biomarker in clinical decision-making since it was found to be related to cancer risk, tumor recurrence, and survival of H&N cancer patients. © 2016 S. Karger AG, Basel.

  5. [Perineal recurrence of resected penile cancer. A case report].

    Science.gov (United States)

    Rabii, R; Rais, H; el Moussaoui, A; Joual, A; el Mrini, M; Benjelloun, S

    1999-01-01

    The authors report an unusual case of perineal recurrence of squamous carcinoma of the penis in a 50-year-old, white man, circumcised during infancy and operated 5 years previously for stage T3N0M0 squamous carcinoma of the penis by total amputation of the penis. Clinical examination revealed a very large, infected perineal tumour associated with bilateral inguinal lymphadenopathy. This stage T4N2M0 tumour was treated palliatively by cystostomy, emasculation with perineal tumour reduction and antibiotics. The patient became afebrile and the infection resolved and was referred to the radiotherapy department for further treatment.

  6. Detection of Local Cancer Recurrence After Stereotactic Ablative Radiation Therapy for Lung Cancer: Physician Performance Versus Radiomic Assessment.

    Science.gov (United States)

    Mattonen, Sarah A; Palma, David A; Johnson, Carol; Louie, Alexander V; Landis, Mark; Rodrigues, George; Chan, Ian; Etemad-Rezai, Roya; Yeung, Timothy P C; Senan, Suresh; Ward, Aaron D

    2016-04-01

    Stereotactic ablative radiation therapy (SABR) is a guideline-specified treatment option for early-stage lung cancer. However, significant posttreatment fibrosis can occur and obfuscate the detection of local recurrence. The goal of this study was to assess physician ability to detect timely local recurrence and to compare physician performance with a radiomics tool. Posttreatment computed tomography (CT) scans (n=182) from 45 patients treated with SABR (15 with local recurrence matched to 30 with no local recurrence) were used to measure physician and radiomic performance in assessing response. Scans were individually scored by 3 thoracic radiation oncologists and 3 thoracic radiologists, all of whom were blinded to clinical outcomes. Radiomic features were extracted from the same images. Performances of the physician assessors and the radiomics signature were compared. When taking into account all CT scans during the whole follow-up period, median sensitivity for physician assessment of local recurrence was 83% (range, 67%-100%), and specificity was 75% (range, 67%-87%), with only moderate interobserver agreement (κ = 0.54) and a median time to detection of recurrence of 15.5 months. When determining the early prediction of recurrence within recurrence, with a mean error of 35%, false positive rate (FPR) of 1%, and false negative rate (FNR) of 99%. At the same time point, a radiomic signature consisting of 5 image-appearance features demonstrated excellent discrimination, with an area under the receiver operating characteristic curve of 0.85, classification error of 24%, FPR of 24%, and FNR of 23%. These results suggest that radiomics can detect early changes associated with local recurrence that are not typically considered by physicians. This decision support system could potentially allow for early salvage therapy of patients with local recurrence after SABR. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Tumor markers in finding recurrent disease iin colorectal cancer: a diagnostic review

    DEFF Research Database (Denmark)

    Verberne, Charlotte; de Jong, W.H.; Grossmann, Irene;

    2013-01-01

    Aim: In the search for evidence-based follow-up of patients after resection for colorectal cancer, numerous tumor markers have been proposed. This review has evaluated these markers and comments on the diagnostic accuracy in finding recurrent disease in relation to Carcino-Embryonic Antigen (CEA...

  8. Axillary recurrence rate 5 years after negative sentinel node biopsy for breast cancer

    NARCIS (Netherlands)

    Andersson, Y.; de Boniface, J.; Jonsson, P. -E.; Ingvar, C.; Liljegren, G.; Bergkvist, L.; Frisell, J.

    2012-01-01

    Background: Sentinel lymph node (SLN) biopsy has replaced axillary lymph node dissection (ALND) as the standard axillary staging procedure in breast cancer. Follow-up studies in SLN-negative women treated without ALND report low rates of axillary recurrence, but most studies have short follow-up, an

  9. SUVmax by dual time point FDG-PET/CT in recurrent breast cancer

    DEFF Research Database (Denmark)

    Hildebrandt, Malene; Blomberg, Björn; Falch Braas, Kirsten

    Objectives Calculation of standardized uptake values (SUV) seems to be an important discriminatory factor for accurately diagnosing recurrent breast cancer. We examined the variability in maximum SUV (SUVmax) calculation between observers and types of software at two scan time points. Methods 18F...

  10. Re-irradiation of recurrent esophageal cancer after primary definitive radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Suk; Lee, Chang Geol; Kim, Kyung Hwan; Kim, Tae Hyung [Dept. of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-12-15

    For recurrent esophageal cancer after primary definitive radiotherapy, no general treatment guidelines are available. We evaluated the toxicities and clinical outcomes of re-irradiation (re-RT) for recurrent esophageal cancer. We analyzed 10 patients with recurrent esophageal cancer treated with re-RT after primary definitive radiotherapy. The median time interval between primary radiotherapy and re-RT was 15.6 months (range, 4.8 to 36.4 months). The total dose of primary radiotherapy was a median of 50.4 Gy (range, 50.4 to 63.0 Gy). The total dose of re-RT was a median of 46.5 Gy (range, 44.0 to 50.4 Gy). The median follow-up period was 4.9 months (range, 2.6 to 11.4 months). The tumor response at 3 months after the end of re-RT was complete response (n = 2), partial response (n = 1), stable disease (n = 2), and progressive disease (n = 5). Grade 5 tracheoesophageal fistula developed in three patients. The time interval between primary radiotherapy and re-RT was less than 12 months in two of these three patients. Late toxicities included grade 1 dysphagia (n = 1). Re-RT of recurrent esophageal cancer after primary radiotherapy can cause severe toxicity.

  11. Recurrent Coding Sequence Variation Explains Only A Small Fraction of the Genetic Architecture of Colorectal Cancer

    NARCIS (Netherlands)

    Timofeeva, Maria N.; Ben Kinnersley, [Unknown; Farrington, Susan M.; Whiffin, Nicola; Palles, Claire; Svinti, Victoria; Lloyd, Amy; Gorman, Maggie; Ooi, Li-Yin; Hosking, Fay; Barclay, Ella; Zgaga, Lina; Dobbins, Sara; Martin, Lynn; Theodoratou, Evropi; Broderick, Peter; Tenesa, Albert; Smillie, Claire; Grimes, Graeme; Hayward, Caroline; Campbell, Archie; Porteous, David; Deary, Ian J.; Harris, Sarah E.; Northwood, Emma L.; Barrett, Jennifer H.; Smith, Gillian; Wolf, Roland; Forman, David; Morreau, Hans; Ruano, Dina; Tops, Carli; Wijnen, Juul; Schrumpf, Melanie; Boot, Arnoud; Vasen, Hans F. A.; Hes, Frederik J.; van Wezel, Tom; Franke, Andre; Lieb, Wolgang; Schafmayer, Clemens; Hampe, Jochen; Buch, Stephan; Propping, Peter; Hemminki, Kari; Foersti, Asta; Westers, Helga; Hofstra, Robert; Pinheiro, Manuela; Pinto, Carla; Teixeira, Manuel; Ruiz-Ponte, Clara; Fernandez-Rozadilla, Ceres; Carracedo, Angel; Castells, Antoni; Castellvi-Bel, Sergi; Campbell, Harry; Bishop, D. Timothy; Tomlinson, Ian P. M.; Dunlop, Malcolm G.; Houlston, Richard S.

    2015-01-01

    Whilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs cases and 29,0

  12. Recurrent Coding Sequence Variation Explains Only A Small Fraction of the Genetic Architecture of Colorectal Cancer

    NARCIS (Netherlands)

    Timofeeva, Maria N.; Ben Kinnersley, [Unknown; Farrington, Susan M.; Whiffin, Nicola; Palles, Claire; Svinti, Victoria; Lloyd, Amy; Gorman, Maggie; Ooi, Li-Yin; Hosking, Fay; Barclay, Ella; Zgaga, Lina; Dobbins, Sara; Martin, Lynn; Theodoratou, Evropi; Broderick, Peter; Tenesa, Albert; Smillie, Claire; Grimes, Graeme; Hayward, Caroline; Campbell, Archie; Porteous, David; Deary, Ian J.; Harris, Sarah E.; Northwood, Emma L.; Barrett, Jennifer H.; Smith, Gillian; Wolf, Roland; Forman, David; Morreau, Hans; Ruano, Dina; Tops, Carli; Wijnen, Juul; Schrumpf, Melanie; Boot, Arnoud; Vasen, Hans F. A.; Hes, Frederik J.; van Wezel, Tom; Franke, Andre; Lieb, Wolgang; Schafmayer, Clemens; Hampe, Jochen; Buch, Stephan; Propping, Peter; Hemminki, Kari; Foersti, Asta; Westers, Helga; Hofstra, Robert; Pinheiro, Manuela; Pinto, Carla; Teixeira, Manuel; Ruiz-Ponte, Clara; Fernandez-Rozadilla, Ceres; Carracedo, Angel; Castells, Antoni; Castellvi-Bel, Sergi; Campbell, Harry; Bishop, D. Timothy; Tomlinson, Ian P. M.; Dunlop, Malcolm G.; Houlston, Richard S.

    2015-01-01

    Whilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs cases and 29,0

  13. Recurrent Coding Sequence Variation Explains only A Small Fraction of the Genetic Architecture of Colorectal Cancer

    NARCIS (Netherlands)

    M.N. Timofeeva (Maria N.); B. Kinnersley (Ben); S.M. Farrington (Susan M.); N. Whiffin (Nicola); C. Palles (Claire); V. Svinti (Victoria); A. Lloyd (Amy); M. Gorman (Maggie); L.-Y. Ooi (Li-Yin); F. Hosking (Fay); E. Barclay (Ella); L. Zgaga (Lina); S.E. Dobbins (Sara E.); L. Martin (Lynn); E. Theodoratou (Evropi); P. Broderick (Peter); A. Tenesa (Albert); C. Smillie (Claire); G. Grimes (Graeme); C. Hayward (Caroline); A. Campbell (Archie); D. Porteous (David); I.J. Deary (Ian J.); S.E. Harris (Sarah); J.B. Northwood (John Blackman); J.H. Barrett (Jennifer H.); G. Smith (Gillian); R. Wolf (Roland); D. Forman (David); H. Morreau (Hans); D. Ruano (Dina); C. Tops (Carli); J.T. Wijnen (Juul); M. Schrumpf (Melanie); A. Boot (Arnoud); H. Vasen (Hans); F.J. Hes (Frederik); T. van Wezel (Tom); A. Franke (Andre); W. Lieb (Wolgang); C. Schafmayer (Clemens); J. Hampe (Jochen); T. Buch (Thorsten); P. Propping (Peter); K. Hemminki (Kari); A. Försti (Asta); H. Westers (Helga); R.M.W. Hofstra (Robert); M. Pinheiro (Manuela); C. Pinto (Carla); P.J. Teixeira; C. Ruiz-Ponte (Clara); C. Fernández-Rozadilla (Ceres); A. Carracedo (Angel); A. Castells; S. Castellví-Bel; H. Campbell (Harry); D.T. Bishop (David Timothy); I. Tomlinson (Ian); M.G. Dunlop (Malcolm); R. Houlston (Richard)

    2015-01-01

    textabstractWhilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs ca

  14. Recurrent Coding Sequence Variation Explains only A Small Fraction of the Genetic Architecture of Colorectal Cancer

    NARCIS (Netherlands)

    M.N. Timofeeva (Maria N.); B. Kinnersley (Ben); S.M. Farrington (Susan M.); N. Whiffin (Nicola); C. Palles (Claire); V. Svinti (Victoria); A. Lloyd (Amy); M. Gorman (Maggie); L.-Y. Ooi (Li-Yin); F. Hosking (Fay); E. Barclay (Ella); L. Zgaga (Lina); S.E. Dobbins (Sara E.); L. Martin (Lynn); E. Theodoratou (Evropi); P. Broderick (Peter); A. Tenesa (Albert); C. Smillie (Claire); G. Grimes (Graeme); C. Hayward (Caroline); A. Campbell (Archie); D. Porteous (David); I.J. Deary (Ian J.); S.E. Harris (Sarah); J.B. Northwood (John Blackman); J.H. Barrett (Jennifer H.); G. Smith (Gillian); R. Wolf (Roland); D. Forman (David); H. Morreau (Hans); D. Ruano (Dina); C. Tops (Carli); J.T. Wijnen (Juul); M. Schrumpf (Melanie); A. Boot (Arnoud); H. Vasen (Hans); F.J. Hes (Frederik); T. van Wezel (Tom); A. Franke (Andre); W. Lieb (Wolgang); C. Schafmayer (Clemens); J. Hampe (Jochen); T. Buch (Thorsten); P. Propping (Peter); K. Hemminki (Kari); A. Försti (Asta); H. Westers (Helga); R.M.W. Hofstra (Robert); M. Pinheiro (Manuela); C. Pinto (Carla); P.J. Teixeira; C. Ruiz-Ponte (Clara); C. Fernández-Rozadilla (Ceres); A. Carracedo (Angel); A. Castells; S. Castellví-Bel; H. Campbell (Harry); D.T. Bishop (David Timothy); I. Tomlinson (Ian); M.G. Dunlop (Malcolm); R. Houlston (Richard)

    2015-01-01

    textabstractWhilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs ca

  15. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes

    NARCIS (Netherlands)

    Kraeima, J.; Siesling, Sabine; Vliegen, Ingrid; Klaase, J.M.; IJzerman, Maarten Joost

    2013-01-01

    Background: Breast cancer follow-up is not tailored to the risk of locoregional recurrences (LRRs) in individual patients or as a function of time. The objective of this study was to identify prognostic factors and to estimate individual and time-dependent LRR risk rates. Methods: Prognostic factors

  16. Local treatment in young breast cancer patients : Recurrence, toxicity and quality of life

    NARCIS (Netherlands)

    Joppe, Enje Jacoba

    2015-01-01

    Local treatment options for early stage breast cancer include mastectomy or breast-conserving therapy (BCT), the latter consisting of local excision followed by radiotherapy. For all age groups, the risk of local recurrence after BCT is higher than after mastectomy, with similar survival rates.

  17. Magnetic resonance imaging guided reirradiation of recurrent and second primary head and neck cancer

    Directory of Open Access Journals (Sweden)

    Allen M. Chen, MD

    2017-04-01

    Conclusions: Our preliminary findings show that reirradiation with MRI guided radiation therapy results in effective disease control with relatively low morbidity for patients with recurrent and second primary cancers of the head and neck. The superior soft tissue resolution of the MRI scans that were used for planning and delivery has the potential to improve the therapeutic ratio.

  18. Recurrent Coding Sequence Variation Explains only A Small Fraction of the Genetic Architecture of Colorectal Cancer

    NARCIS (Netherlands)

    M.N. Timofeeva (Maria N.); B. Kinnersley (Ben); S.M. Farrington (Susan M.); N. Whiffin (Nicola); C. Palles (Claire); V. Svinti (Victoria); A. Lloyd (Amy); M. Gorman (Maggie); L.-Y. Ooi (Li-Yin); F. Hosking (Fay); E. Barclay (Ella); L. Zgaga (Lina); S.E. Dobbins (Sara E.); L. Martin (Lynn); E. Theodoratou (Evropi); P. Broderick (Peter); A. Tenesa (Albert); C. Smillie (Claire); G. Grimes (Graeme); C. Hayward (Caroline); A. Campbell (Archie); D. Porteous (David); I.J. Deary (Ian J.); S.E. Harris (Sarah); J.B. Northwood (John Blackman); J.H. Barrett (Jennifer H.); G. Smith (Gillian); R. Wolf (Roland); D. Forman (David); H. Morreau (Hans); D. Ruano (Dina); C. Tops (Carli); J.T. Wijnen (Juul); M. Schrumpf (Melanie); A. Boot (Arnoud); H. Vasen (Hans); F.J. Hes (Frederik); T. van Wezel (Tom); A. Franke (Andre); W. Lieb (Wolgang); C. Schafmayer (Clemens); J. Hampe (Jochen); T. Buch (Thorsten); P. Propping (Peter); K. Hemminki (Kari); A. Försti (Asta); H. Westers (Helga); R.M.W. Hofstra (Robert); M. Pinheiro (Manuela); C. Pinto (Carla); P.J. Teixeira; C. Ruiz-Ponte (Clara); C. Fernández-Rozadilla (Ceres); A. Carracedo (Angel); A. Castells; S. Castellví-Bel; H. Campbell (Harry); D.T. Bishop (David Timothy); I. Tomlinson (Ian); M.G. Dunlop (Malcolm); R. Houlston (Richard)

    2015-01-01

    textabstractWhilst common genetic variation in many non-coding genomic regulatory regions are known to impart risk of colorectal cancer (CRC), much of the heritability of CRC remains unexplained. To examine the role of recurrent coding sequence variation in CRC aetiology, we genotyped 12,638 CRCs

  19. Surgery for Locally Recurrent Rectal Cancer: Tips, Tricks, and Pitfalls.

    Science.gov (United States)

    Warrier, Satish K; Heriot, Alexander G; Lynch, Andrew Craig

    2016-06-01

    Rectal cancer can recur locally in up to 10% of the patients who undergo definitive resection for their primary cancer. Surgical salvage is considered appropriate in the curative setting as well as select cases with palliative intent. Disease-free survival following salvage resection is dependent upon achieving an R0 resection margin. A clear understanding of applied surgical anatomy, appropriate preoperative planning, and a multidisciplinary approach to aggressive soft tissue, bony, and vascular resection with appropriate reconstruction is necessary. Technical tips, tricks, and pitfalls that may assist in managing these cancers are discussed and the roles of additional boost radiation and intraoperative radiation therapy in the management of such cancers are also discussed.

  20. Reirradiation on recurrent cervical cancer case: Treatment response and side effects

    Science.gov (United States)

    Siregar, M. F.; Supriana, N.; Nuranna, L.; Prihartono, J.

    2017-08-01

    Management of recurrent cervical cancer by reirradiation after radiation treatment remains controversial. In Indonesia, there is currently no data about reirradiation tumor response and side effects. This study aims to assess the tumor response to and side effects of reirradiation, the effect of time interval between first radiation treatment and cancer recurrence on the tumor response and side effects, and the effect of tumor size on tumor response. A cohort retrospective study with no comparison was done with the Radiotherapy Department at Cipto Mangunkusumo General Hospital, Jakarta. Participants were recurrent cervical cancer patients undergoing reirradiation. Data was collected from patients’ medical records and follow-up phone calls. Twenty-two patients participated in this study. Nine patients (40.9%) had complete responses, 10 patients (45.5%) had partial responses, 1 patient (4.5%) had a stable response, and 2 patients (9.1%) had tumor progressions. In general, 15 patients (68.2%) had no to light side effects (grade 0-2 RTOG) and 7 patients (31.8%) had severe side effects (grade 3-4 RTOG). Four patients (18.1%) had severe gastrointestinal acute side effects, 6 patients (27.3%) had severe gastrointestinal late side effects, 2 patients (9.1%) had severe urogenital side effects, and there were no patients had severe urogenital late side effects. There was no significant difference in tumor response between patients with time interval between first radiation treatment and recurrence of 4 cm. Reirradiation can be considered as a modality in recurrent cervical cancer management since good tumor response was achieved and the majority of patients had no to light side effects (grade 0-2 RTOG). This study found no correlation between tumor response, side effects, and time gap between first radiation treatment and recurrence of 4 cm.

  1. Predictive value of Sp1/Sp3/FLIP signature for prostate cancer recurrence.

    Directory of Open Access Journals (Sweden)

    Roble G Bedolla

    Full Text Available Prediction of prostate cancer prognosis is challenging and predictive biomarkers of recurrence remain elusive. Although prostate specific antigen (PSA has high sensitivity (90% at a PSA level of 4.0 ng/mL, its low specificity leads to many false positive results and considerable overtreatment of patients and its performance at lower ranges is poor. Given the histopathological and molecular heterogeneity of prostate cancer, we propose that a panel of markers will be a better tool than a single marker. We tested a panel of markers composed of the anti-apoptotic protein FLIP and its transcriptional regulators Sp1 and Sp3 using prostate tissues from 64 patients with recurrent and non-recurrent cancer who underwent radical prostatectomy as primary treatment for prostate cancer and were followed with PSA measurements for at least 5 years. Immunohistochemical staining for Sp1, Sp3, and FLIP was performed on these tissues and scored based on the proportion and intensity of staining. The predictive value of the FLIP/Sp1/Sp3 signature for clinical outcome (recurrence vs. non-recurrence was explored with logistic regression, and combinations of FLIP/Sp1/Sp3 and Gleason score were analyzed with a stepwise (backward and forward logistic model. The discrimination of the markers was identified by sensitivity-specificity analysis and the diagnostic value of FLIP/Sp1/Sp3 was determined using area under the curve (AUC for receiver operator characteristic curves. The AUCs for FLIP, Sp1, Sp3, and Gleason score for predicting PSA failure and non-failure were 0.71, 0.66, 0.68, and 0.76, respectively. However, this increased to 0.93 when combined. Thus, the "biomarker signature" of FLIP/Sp1/Sp3 combined with Gleason score predicted disease recurrence and stratified patients who are likely to benefit from more aggressive treatment.

  2. Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy.

    Science.gov (United States)

    Dimopoulos, Johannes C A; Petrow, Peter; Tanderup, Kari; Petric, Primoz; Berger, Daniel; Kirisits, Christian; Pedersen, Erik M; van Limbergen, Erik; Haie-Meder, Christine; Pötter, Richard

    2012-04-01

    The GYN GEC-ESTRO working group issued three parts of recommendations and highlighted the pivotal role of MRI for the successful implementation of 3D image-based cervical cancer brachytherapy (BT). The main advantage of MRI as an imaging modality is its superior soft tissue depiction quality. To exploit the full potential of MRI for the better ability of the radiation oncologist to make the appropriate choice for the BT application technique and to accurately define the target volumes and the organs at risk, certain MR imaging criteria have to be fulfilled. Technical requirements, patient preparation, as well as image acquisition protocols have to be tailored to the needs of 3D image-based BT. The present recommendation is focused on the general principles of MR imaging for 3D image-based BT. Methods and parameters have been developed and progressively validated from clinical experience from different institutions (IGR, Universities of Vienna, Leuven, Aarhus and Ljubljana) and successfully applied during expert meetings, contouring workshops, as well as within clinical and interobserver studies. It is useful to perform pelvic MRI scanning prior to radiotherapy ("Pre-RT-MRI examination") and at the time of BT ("BT MRI examination") with one MR imager. Both low and high-field imagers, as well as both open and close magnet configurations conform to the requirements of 3D image-based cervical cancer BT. Multiplanar (transversal, sagittal, coronal and oblique image orientation) T2-weighted images obtained with pelvic surface coils are considered as the golden standard for visualisation of the tumour and the critical organs. The use of complementary MRI sequences (e.g. contrast-enhanced T1-weighted or 3D isotropic MRI sequences) is optional. Patient preparation has to be adapted to the needs of BT intervention and MR imaging. It is recommended to visualise and interpret the MR images on dedicated DICOM-viewer workstations, which should also assist the contouring

  3. New Diagnostic and Therapeutic Approaches to Eradicating Recurrent Breast Cancer

    Science.gov (United States)

    2015-09-01

    international scientific conference, where they gave poster or oral presentations . For example, students attended the San Antonio Breast Cancer Conference...cancer research/patient advocates (Liz Frank and Ruth Fax. The retreat was held over a 2-day period in which investigators gave formal presentations ...of their work in progress and we had dedicated discussion time for feedback and exchange of ideas. C. What opportunities for training and

  4. Obesity and cancer--mechanisms underlying tumour progression and recurrence.

    Science.gov (United States)

    Park, Jiyoung; Morley, Thomas S; Kim, Min; Clegg, Deborah J; Scherer, Philipp E

    2014-08-01

    Over the past several years, the field of cancer research has directed increased interest towards subsets of obesity-associated tumours, which include mammary, renal, oesophageal, gastrointestinal and reproductive cancers in both men and women. The increased risk of breast cancer that is associated with obesity has been widely reported; this has drawn much attention and as such, warrants investigation of the key mechanisms that link the obese state with cancer aetiology. For instance, the obese setting provides a unique adipose tissue microenvironment with concomitant systemic endocrine alterations that favour both tumour initiation and progression. Major metabolic differences exist within tumours that distinguish them from non-transformed healthy tissues. Importantly, considerable metabolic differences are induced by tumour cells in the stromal vascular fraction that surrounds them. The precise mechanisms that underlie the association of obesity with cancer and the accompanying metabolic changes that occur in the surrounding microenvironment remain elusive. Nonetheless, specific therapeutic agents designed for patients with obesity who develop tumours are clearly needed. This Review discusses recent advances in understanding the contributions of obesity to cancer and their implications for tumour treatment.

  5. Body mass index, PAM50 subtype, recurrence, and survival among patients with nonmetastatic breast cancer.

    Science.gov (United States)

    Cespedes Feliciano, Elizabeth M; Kwan, Marilyn L; Kushi, Lawrence H; Chen, Wendy Y; Weltzien, Erin K; Castillo, Adrienne L; Sweeney, Carol; Bernard, Philip S; Caan, Bette J

    2017-07-01

    Studies of obesity and survival among patients with breast cancer produce conflicting results, possibly because of heterogeneity by molecular subtype. This study examined whether the association of body mass index (BMI) at diagnosis with breast cancer recurrence and survival varied across subtypes defined by PAM50 (Prediction Analysis of Microarray 50) gene expression. Included were 1559 Kaiser Permanente Northern California members ages 18 to 79 years who had PAM50 assays and were diagnosed with American Joint Committee on Cancer stage I through III breast cancer from 1996 to 2013. Patients reported weight and height. Cox regression models were adjusted for age, menopause, race/ethnicity, stage, and chemotherapy. Over a median of 9 years (maximum, 19 years), 378 women developed recurrent disease, and 312 died from breast cancer. Overall, BMI was not associated with breast cancer recurrence or survival when controlling for subtype (eg, the hazard ratio per 5 kg/m(2) of BMI was 1.05 [95% confidence interval, 0.95-1.15] for breast cancer-specific death). However, associations varied by subtype. Among women with luminal A cancers, those who had class II/III obesity, but not class I obesity or overweight, had worse outcomes. When women who had a BMI ≥35 kg/m(2) were compared with those who had a BMI from 18.5 to breast cancer-specific death and 1.24 (95% confidence interval, 1.00-1.54) for recurrence. There was no association within luminal B, basal-like or human epidermal growth factor over-expressing subtypes. Among patients who had accurately classified breast cancer subtypes based on gene expression, a BMI ≥35 kg/m(2) was adversely associated with outcomes only among those who had luminal A cancers. Research is needed into whether tailoring recommendations for weight management to tumor characteristics will improve outcomes. Cancer 2017;123:2535-42. © 2017 American Cancer Society. © 2017 American Cancer Society.

  6. The effect of neuraxial anesthesia on cancer recurrence and survival after cancer surgery: an updated meta-analysis

    Science.gov (United States)

    Weng, Meilin; Chen, Wankun; Hou, Wenting; Li, Lihong; Ding, Ming; Miao, Changhong

    2016-01-01

    Several animal and observational studies have evaluated the effects of neuraxial anesthesia on the recurrence and survival of cancer surgery; studies reported benefit, whereas others did not. To provide further evidence that neuraxial anesthesia(combined with or without general anesthesia (GA))may be associated with reduced cancer recurrence and long-term survival after cancer surgery, we conducted this meta-analysis. A total of 21 studies were identified and analyzed, based on searches conducted using PubMed, Web of Science, EMBASE database and the Cochrane Database of Systematic Reviews. After data abstraction, adjusted hazard ratios (HR) with 95% confidence intervals (CIs) were used to assess the impact of neuraxial anesthesia (combined with or without GA) and GA on oncological outcomes after cancer surgery. For overall survival (OS), a potential association between neuraxial anesthesia and improved OS (HR 0.853, CI 0.741-0.981, P = 0.026, the random-effects model) was observed compared with GA. Specifically, we found a positive association between neuraxial anesthesia and improved OS in colorectal cancer (HR 0.653, CI 0.430-0.991, P = 0.045, the random-effects model). For recurrence-free survival (RFS), a significant association between neuraxial anesthesia and improved RFS (HR 0.846, CI 0.718-0.998, P = 0.047, the random-effects model) was detected compared with GA. Our meta-analysis suggests that neuraxial anesthesia may be associated with improved OS in patients with cancer surgery, especially for those patients with colorectal cancer. It also supports a potential association between neuraxial anesthesia and a reduced risk of cancer recurrence. More prospective studies are needed to elucidate whether the association between neuraxial use and survival is causative. PMID:26918830

  7. Training of the gynaecological examination in The Netherlands.

    NARCIS (Netherlands)

    Ravesteijn, H.J. van; Hageraats, E.; Rethans, J.J.

    2007-01-01

    BACKGROUND: Competent performance of the gynaecological examination requires good technical and interpersonal skills, which are best mastered in an educationally sound atmosphere. Research has shown that effective teaching sessions of the gynaecological examination require the presence of

  8. Pattern and Outcome of Gynaecological Admissions at a Nigerian ...

    African Journals Online (AJOL)

    Pattern and Outcome of Gynaecological Admissions at a Nigerian Tertiary Care Centre. ... Abortion accounted for 15.6% of total gynaecological admissions and was ... This was followed by infections, 43.5% with post abortal sepsis contributing ...

  9. Cohort study of adherence to adjuvant endocrine therapy, breast cancer recurrence and mortality.

    Science.gov (United States)

    Makubate, B; Donnan, P T; Dewar, J A; Thompson, A M; McCowan, C

    2013-04-16

    Adjuvant endocrine therapy is recommended for women with oestrogen receptor-positive breast cancer, but many women do not take the medication as directed and they stop treatment before completing the standard 5-year duration. This retrospective cohort study conducted between 1993 and 2008 of all women with incident breast cancer, who are residing in the Tayside region of Scotland, examined adherence to prescribed adjuvant tamoxifen or aromatase inhibitors (AIs). Survival analysis examined the effect of adherence on all-cause mortality, breast cancer death and recurrence, using linked prescribing, cancer registry, clinical cancer audit, hospital discharge and death records. A total of 3361 women with breast cancer were followed for a median 4.47 years (interquartile range (IQR)=2.04-8.55). The median overall adherence was 90% (IQR=90-100%), but the annual adherence reduced after a longer period from diagnosis. Low adherence of adherence over the treatment period and recurrence, or breast cancer death, but patients with high annual adherence for 5 years had better outcomes than those with 3 or less. Low adherence to all adjuvant endocrine therapy for women with breast cancer, whether tamoxifen or AI, increases the risk of death.

  10. Prospects in cancer immunotherapy: treating advanced stage disease or preventing tumor recurrence?

    Science.gov (United States)

    Manjili, Masoud H; Payne, Kyle K

    2015-06-01

    Human vaccines against infectious agents are often effective in a prophylactic setting. However, they are usually not effective when used post-exposure. Rabies vaccine is one of the exceptions, which can be used post-exposure, but is effective only when used in combination with other treatments. Similar results have been obtained with cancer vaccines and immunotherapies. Cancer immunotherapies generally prolong patients' survival when they are used during advanced stage disease. The potential of immunotherapy to cure cancer could be revealed when it is applied in a prophylactic setting. This article provides a brief overview of cancer immunotherapeutics and suggests that immunotherapy can cure cancer if used at the right time against the right target; we suggest that targeting cancer during dormancy in order to prevent tumor recurrence as advanced stage disease is potentially curative.

  11. Interstitial Photodynamic Therapy in Treating Patients With Recurrent Head and Neck Cancer

    Science.gov (United States)

    2017-09-11

    Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Tongue Carcinoma

  12. Effect of methylphenidate on fatigue in women with recurrent gynecologic cancer.

    Science.gov (United States)

    Johnson, Rhonda L; Block, Ingrid; Gold, Michael A; Markwell, Stephen; Zupancic, Melanie

    2010-09-01

    Fatigue is the most common and often the most bothersome complaint of individuals who are treated for cancer. One intervention now commonly suggested to treat fatigue is the use of psychostimulant medication. Early studies indicate some success in individuals with a mixed cancer diagnoses. This study evaluates the effect of methylphenidate on fatigue in women with recurrent gynecologic cancer. Thirty-two women treated for recurrent gynecologic cancer were prescribed methylphenidate at morning and noon over a 8-week period. Participants completed the Fatigue Symptom Inventory (FSI) along with assessments of quality of life and mood at baseline, week 2, 4 and 8 to determine changes in levels of fatigue experienced. Patients reported significant declines in fatigue (p=0.0001), and improvement in both mood (p=0.0020) and quality of life (p=0.0351) when comparing baseline scores to study end. This study provides support for the use of a psychostimulant to treat fatigue in women who have recurrent gynecologic cancer. It is particularly relevant for these patients with incurable disease who are facing the end of life. (c) 2010 John Wiley & Sons, Ltd.

  13. Survival analysis of colorectal cancer patients with tumor recurrence using global score test methodology

    Energy Technology Data Exchange (ETDEWEB)

    Zain, Zakiyah, E-mail: zac@uum.edu.my; Ahmad, Yuhaniz, E-mail: yuhaniz@uum.edu.my [School of Quantitative Sciences, Universiti Utara Malaysia, UUM Sintok 06010, Kedah (Malaysia); Azwan, Zairul, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com; Raduan, Farhana, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com; Sagap, Ismail, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com [Surgery Department, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Bandar Tun Razak, Kuala Lumpur (Malaysia); Aziz, Nazrina, E-mail: nazrina@uum.edu.my

    2014-12-04

    Colorectal cancer is the third and the second most common cancer worldwide in men and women respectively, and the second in Malaysia for both genders. Surgery, chemotherapy and radiotherapy are among the options available for treatment of patients with colorectal cancer. In clinical trials, the main purpose is often to compare efficacy between experimental and control treatments. Treatment comparisons often involve several responses or endpoints, and this situation complicates the analysis. In the case of colorectal cancer, sets of responses concerned with survival times include: times from tumor removal until the first, the second and the third tumor recurrences, and time to death. For a patient, the time to recurrence is correlated to the overall survival. In this study, global score test methodology is used in combining the univariate score statistics for comparing treatments with respect to each survival endpoint into a single statistic. The data of tumor recurrence and overall survival of colorectal cancer patients are taken from a Malaysian hospital. The results are found to be similar to those computed using the established Wei, Lin and Weissfeld method. Key factors such as ethnic, gender, age and stage at diagnose are also reported.

  14. Altered expression patterns of syndecan-1 and -2 predict biochemical recurrence in prostate cancer.

    Science.gov (United States)

    Ledezma, Rodrigo; Cifuentes, Federico; Gallegos, Iván; Fullá, Juan; Ossandon, Enrique; Castellon, Enrique A; Contreras, Héctor R

    2011-05-01

    The clinical features of prostate cancer do not provide an accurate determination of patients undergoing biochemical relapse and are therefore not suitable as indicators of prognosis for recurrence. New molecular markers are needed for proper pre-treatment risk stratification of patients. Our aim was to assess the value of altered expression of syndecan-1 and -2 as a marker for predicting biochemical relapse in patients with clinically localized prostate cancer treated by radical prostatectomy. The expression of syndecan-1 and -2 was examined by immunohistochemical staining in a series of 60 paraffin-embedded tissue samples from patients with localized prostate cancer. Ten specimens from patients with benign prostatic hyperplasia were used as non-malignant controls. Semiquantitative analysis was performed to evaluate the staining patterns. To investigate the prognostic value, Kaplan-Meier survival curves were performed and compared by a log-rank test. In benign samples, syndecan-1 was expressed in basal and secretory epithelial cells with basolateral membrane localisation, whereas syndecan-2 was expressed preferentially in basal cells. In prostate cancer samples, the expression patterns of both syndecans shifted to granular-cytoplasmic localisation. Survival analysis showed a significant difference (P < 0.05) between normal and altered expression of syndecan-1 and -2 in free prostate-specific antigen recurrence survival curves. These data suggest that the expression of syndecan-1 and -2 can be used as a prognostic marker for patients with clinically localized prostate cancer, improving the prostate-specific antigen recurrence risk stratification.

  15. [Resection of the remnant pancreas for recurrent pancreatic cancer after distal pancreatectomy-a case report].

    Science.gov (United States)

    Kinoshita, Shoichi; Sho, Masayuki; Akahori, Takahiro; Nomi, Takeo; Yamato, Ichiro; Hokutoh, Daisuke; Yasuda, Satoshi; Nakajima, Yoshiyuki

    2012-11-01

    The standard treatment for metastatic pancreatic cancer is chemotherapy. The effect of surgical resection for localized recurrence in the remnant pancreas after pancreatectomy for pancreatic cancer is unknown, but is reported to have a moderately good outcome in a few reports. We herein report a case of curative resection for recurrence in the remnant pancreas, 24 months after distal pancreatectomy for pancreatic cancer. A 71-year-old man was diagnosed with pancreas tail cancer. Neoadjuvant treatment with chemoradiotherapy[ weekly full-dose gemcitabine(GEM) and radiation therapy 50 Gy/25 Fr] was followed by distal pancreatectomy. Postoperative adjuvant therapy with hepatic arterial infusion of 5-FU and systemic GEM therapy was completed. Twenty-four months after surgery, follow-up computed tomography scan results showed a lesion of 15-mm diameter in the remnant pancreas. Resection of the remnant pancreas was performed. The pathological findings showed moderately differentiated adenocarcinoma, morphologically similar to the primary pancreatic cancer. Six months following surgery, there are no signs of recurrence at present.

  16. Altered expression patterns of syndecan-1 and -2 predict biochemical recurrence in prostate cancer

    Institute of Scientific and Technical Information of China (English)

    Rodrigo Ledezma; Federico Cifuentes; Iván Gallegos; Juan Fullá; Enrique Ossandon; Enrique A Castellon; Héctor R Contreras

    2011-01-01

    The clinical features of prostate cancer do not provide an accurate determination of patients undergoing biochemical relapse and are therefore not suitable as indicators of prognosis for recurrence. New molecular markers are needed for proper pre-treatment risk stratification of patients. Our aim was to assess the value of altered expression of syndecan-1 and -2 as a marker for predicting biochemical relapse in patients with clinically localized prostate cancer treated by radical prostatectomy. The expression of syndecan-1 and -2 was examined by immunohistochemical staining in a series of 60 paraffin-embedded tissue samples from patients with localized prostate cancer. Ten specimens from patients with benign prostatic hyperplasia were used as non-malignant controls. Semiquantitative analysis was performed to evaluate the staining patterns. To investigate the prognostic value, Kaplan-Meier survival curves were performed and compared by a log-rank test. In benign samples, syndecan-1 was expressed in basal and secretory epithelial cells with basolateral membrane localisation, whereas syndecan-2 was expressed preferentially in basal cells. In prostate cancer samples, the expression patterns of both syndecans shifted to granular-cytoplasmic localisation. Survival analysis showed a significant difference (P<0.05) between normal and altered expression of syndecan-1 and -2 in free prostate-specific antigen recurrence survival curves. These data suggest that the expression of syndecan-1 and -2 can be used as a prognostic marker for patients with clinically localized prostate cancer, improving the prostate-specific antigen recurrence risk stratification.

  17. Evaluation of contrast-enhanced computed tomographic colonography in detection of local recurrent colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    Yau-Tong You; Chung-Rong Chang Chien; Jeng-Yi Wang; Koon-Kwan Ng; Jinn-Shiun Chen; Reiping Tang; Jy-Ming Chiang; Chien-Yuh Yeh; Pao-Shiu Hsieh

    2006-01-01

    AIM: To evaluate the diagnostic accuracy, sensitivity,specificity of contrast-enhanced computed tomographic colonography in detecting local recurrence of colorectal cancer.METHODS: From January 2000 to December 2004,434 patients after potentially curative resection for invasive colorectal cancer were followed up for a period ranging from 20 to 55 mo. Eighty of the four hundred and thirty-four patients showing strong clinical evidence for recurring colorectal cancer during the last followup were enrolled in this study. Each patient underwent contrast-enhanced computed tomographic colonography and colonoscopy on the same day. Any lesions, biopsies,identified during the colonoscopic examination, immediate complications and the duration of the procedure were recorded. The results of contrast-enhanced computed tomographic colonography were evaluated by comparing to those of colonoscopy, surgical finding, and clinical follow-up.RESULTS: Contrast-enhanced computed tomographic colonography had a sensitivity of 100%, a specificity of 83% and an overall accuracy of 94% in detecting local recurrent colorectal cancer.CONCLUSION: Conventional colonoscopy and contrastenhanced tomographic colonography can complement each other in detecting local recurrence of colorectal cancer.

  18. Hormone Replacement Therapy: An Increased Risk of Recurrence and Mortality for Breast Cancer Patients?

    Science.gov (United States)

    Lupo, Molly; Dains, Joyce E.; Madsen, Lydia T.

    2015-01-01

    Historically, randomized controlled trials (RCTs) have shown an increased risk of recurrence and mortality among women who have used primarily oral HRT after breast cancer. However, many of these studies have had design flaws that may impact the findings. Numerous investigators have concluded that additional RCTs should be performed, but because of ethical issues and logistic challenges, large-scale RCTs are unlikely. Thus, the authors conducted an integrative review investigating recurrence and mortality data among breast cancer survivors who have used hormone replacement therapy (HRT). They recommend a stepwise algorithm for treating vaginal symptoms in breast cancer survivors: (1) start with nonhormonal treatments; (2) progress to a detailed discussion among patients and health-care professionals about the current known risks and benefits of vaginal estrogen; and (3) conclude with mutual decision-making between health-care providers and patients regarding the use of vaginal estrogen treatment. PMID:26705493

  19. Diverticular Bleeding of the Colon during Combination Chemotherapy with Bevacizumab and Paclitaxel for Recurrent Breast Cancer

    Directory of Open Access Journals (Sweden)

    Yoshie Nakayama

    2013-01-01

    Full Text Available Background: Bevacizumab has been increasingly used in combination chemotherapy with paclitaxel for treatment of metastatic or recurrent breast cancer. The aim of this report is to underline possible risks associated with the new combination chemotherapy. Case Presentation: A 39-year-old woman with recurrent breast cancer was treated with bevacizumab and paclitaxel. Positron emission tomography revealed breast cancer metastasis to the left supraclavicular lymph nodes and right axillary lymph nodes, with no distant metastasis. Results: After the third cycle of bevacizumab and paclitaxel, the patient developed a bloody bowel discharge. Emergent colonoscopy demonstrated diverticular bleeding on one of the multiple diverticula in the ascending colon. The bleeding point was successfully clipped colonoscopically. Conclusion: The factors for diverticular bleeding are believed to be non-steroidal anti-inflammatory drugs, constipation, and bevacizumab. We recommend reviewing anamneses for diverticulitis, multiple prior abdominal surgeries, peritoneal carcinomatosis, and regular use of certain drugs.

  20. THE RECURRENCE AFTER ORGAN-SAVING SURGERY OF PATIENTS WITH MUSCLE-INVASIVE BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    T. A. Sveklina

    2014-08-01

    Full Text Available The article represents the study of frequency and nature of the recurrence and survival rate (common, oncology-specific, disease-free after organ-saving surgery of patients with muscle-invasive bladder cancer stages T2b and T3a. Oncology-speсific and disease-free survival rates were much higher if full diagnosis of bladder mucosa, the adjuvant intravesical chemotherapy had been on pre-operative and intra-operative stages than in the absence of these diagnosis and therapy. Recurrentes of bladder cancer which appeared in the absence of diagnosis and combination therapy, statistically reliably occured at another location other than the zone of operation, stage of recurrentes and degree of differentiation of recurrents were less than the original tumor. This information confirms the existence of foci of cancer in situ which have not been identified on the diagnostic stage.

  1. Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Valeria Panebianco

    2014-01-01

    Full Text Available Currently the diagnosis of local recurrence of prostate cancer (PCa after radical prostatectomy (RT is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

  2. Advanced imaging for the early diagnosis of local recurrence prostate cancer after radical prostatectomy.

    Science.gov (United States)

    Panebianco, Valeria; Barchetti, Flavio; Musio, Daniela; De Felice, Francesca; Proietti, Camilla; Indino, Elena Lucia; Megna, Valentina; Schillaci, Orazio; Catalano, Carlo; Tombolini, Vincenzo

    2014-01-01

    Currently the diagnosis of local recurrence of prostate cancer (PCa) after radical prostatectomy (RT) is based on the onset of biochemical failure which is defined by two consecutive values of prostate-specific antigen (PSA) higher than 0.2 ng/mL. The aim of this paper was to review the current roles of advanced imaging in the detection of locoregional recurrence. A nonsystematic literature search using the Medline and Cochrane Library databases was performed up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of PET/CT in the restaging of PCa after RP; the second part is intended to provide the impact of multiparametric-MRI (mp-MRI) in the depiction of locoregional recurrence. Published data indicate an emerging role for mp-MRI in the depiction of locoregional recurrence, while the performance of PET/CT still remains unclear. Moreover Mp-MRI, thanks to functional techniques, allows to distinguish between residual glandular healthy tissue, scar/fibrotic tissue, granulation tissue, and tumour recurrence and it may also be able to assess the aggressiveness of nodule recurrence.

  3. Postoperative follow-up strategy based on recurrence dynamics for non-small-cell lung cancer.

    Science.gov (United States)

    Watanabe, Katsuya; Tsuboi, Masahiro; Sakamaki, Kentaro; Nishii, Teppei; Yamamoto, Taketsugu; Nagashima, Takuya; Ando, Kohei; Ishikawa, Yoshihiro; Woo, Tekkan; Adachi, Hiroyuki; Kumakiri, Yutaka; Maehara, Takamitsu; Nakayama, Haruhiko; Masuda, Munetaka

    2016-06-01

    Our study was designed to visually represent recurrence patterns after surgery for non-small-cell lung cancer (NSCLC) with the use of event dynamics and to clarify postoperative follow-up methods based on the times of recurrence. A total of 829 patients with NSCLC who underwent complete pulmonary resection from 2005 to 2007 in 9 hospitals affiliated with the Yokohama Consortium of Thoracic Surgeons were studied. Event dynamics, based on the hazard rate, were evaluated. Only first events involving the development of distant metastases, local recurrence or both were considered. The effects of sex, histological type, pathological stage and age were studied. The hazard rate curve displayed an initial surge that peaked about 6-8 months after surgery. The next distinct peak was noted at the end of the second year of follow-up. On non-parametric kernel smoothing, the maximum peak was found 6-8 months after surgery in men. In women, the highest peak occurred 22-24 months after surgery, which was about 16 months later than the peak in men. The peak timing of the hazard curve was not affected by histological type, pathological stage or age in either sex. Our results suggest that the timing of recurrence after surgery for lung cancer is characterized by a bimodal pattern, and the times with the highest risk of recurrence were suggested to differ between men and women. Postoperative follow-up strategies should be based on currently recommended follow-up programmes, take into account the recurrence patterns of lung cancer, and be modified as required to meet the needs of individual patients. © The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  4. Prostate Cancer Biochemical Recurrence Rates After Robotic-Assisted Laparoscopic Radical Prostatectomy

    Science.gov (United States)

    Ginzburg, Serge; Nevers, Thomas; Staff, Ilene; Tortora, Joseph; Champagne, Alison; Kesler, Stuart S.; Laudone, Vincent P.

    2012-01-01

    Background and Objectives: To determine prostate cancer biochemical recurrence rates with respect to surgical margin (SM) status for patients undergoing robotic-assisted laparoscopic radical prostatectomy (RALP). Methods: IRB-approved radical prostatectomy database was queried. Patients were stratified as low, intermediate, and high risk according to D’Amico's risk classification. Postoperative prostate-specific antigen (PSA) values were obtained every 3 mo for the first year, then biannually and annually thereafter. Biochemical recurrence was defined as ≥0.2ng/mL. Patients receiving adjuvant or salvage treatment were included. Positive surgical margin was defined as presence of cancer cells at inked resection margin in the final specimen. Margin presence (negative/positive), margin multiplicity (single/multiple), and margin length (≤3mm focal and >3mm extensive) were noted. Kaplan-Meier curves of biochemical recurrence-free survival (BRFS) as a function of SM were generated. Forward stepwise multivariate Cox regression was performed, with preoperative PSA, Gleason score, pathologic stage, prostate gland weight, and SM as covariates. Results: At our institution, 1437 patients underwent RALP (2003-2009). Of these, 1159 had sufficient data and were included in our analysis. Mean follow-up was 16 mo. Kaplan-Meier curves demonstrated significant increase in BRFS in low-risk and intermediate-risk groups with negative SM. Overall BRFS at 5 y was 72%. Gleason score, pathologic stage, and SM status were significant prognostic factors in multivariate analysis. Conclusions: Negative surgical margins resulted in lower biochemical recurrence rates for low-risk and intermediate-risk groups. Multifocal and longer positive margins were associated with higher biochemical recurrence rates compared with unifocal and shorter positive margins. Documenting biochemical recurrence rates for RALP is important, because this treatment for localized prostate cancer is validated. PMID

  5. Ovarian cancer mimicking recurrence at colorectal anastomosis: report of a case.

    LENUS (Irish Health Repository)

    Reardon, C M

    2012-02-03

    PURPOSE: The aim of this article is to emphasize the increased risk of developing metachronous ovarian tumors after resection of rectal cancer. METHOD AND RESULTS: We report the case of a postmenopausal female patient who, five years after anterior resection, developed a primary ovarian malignancy that invaded a rectal anastomosis and in so doing mimicked a recurrence of a Dukes A rectal cancer. To our knowledge, such an occurrence has not been described previously in the literature. CONCLUSION: This case illustrates the possible benefits of routine prophylactic oophorectomy at the time of colorectal cancer resection.

  6. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...... complications. CONCLUSION: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for cancer surgery.......BACKGROUND: Perioperative blood transfusion and subsequent development of postoperative infectious complications may lead to poor prognosis of patients with colorectal cancer. It has been suggested that the development of postoperative infectious complications may be related to the storage time...

  7. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    BACKGROUND: Perioperative blood transfusion and subsequent development of postoperative infectious complications may lead to poor prognosis of patients with colorectal cancer. It has been suggested that the development of postoperative infectious complications may be related to the storage time...... of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...... complications. CONCLUSION: Transfusion of buffy-coat-depleted red cells suspended in saline, adenine, glucose, and mannitol blood stored for cancer surgery....

  8. Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer

    DEFF Research Database (Denmark)

    Mirza, Mansoor R; Monk, Bradley J; Herrstedt, Jørn

    2016-01-01

    Background Niraparib is an oral poly(adenosine diphosphate [ADP]-ribose) polymerase (PARP) 1/2 inhibitor that has shown clinical activity in patients with ovarian cancer. We sought to evaluate the efficacy of niraparib versus placebo as maintenance treatment for patients with platinum-sensitive, ...

  9. Analysis of secondary cytoreduction for recurrent ovarian cancer by robotics, laparoscopy and laparotomy.

    Science.gov (United States)

    Magrina, Javier F; Cetta, Rachel L; Chang, Yu-Hui; Guevara, Gregory; Magtibay, Paul M

    2013-05-01

    Analysis of perioperative outcomes and survival of patients with recurrent ovarian cancer undergoing secondary cytoreduction by robotics, laparoscopy, or laparotomy. Retrospective analysis of 52 selected patients with recurrent ovarian cancer undergoing secondary cytoreduction by laparoscopy (9), laparotomy (33) or robotics (10) between January 2006 and December 2010. Comparison was made by a total of 21 factors including age, BMI, number of previous surgeries, tumor type and grade, number of procedures, and 15 types of procedures performed at secondary cytoreduction. For all patients, the mean operating time was 213.8 min, mean blood loss 657.4 ml; and mean hospital stay 7.5 days. Complete debulking was achieved in 75% of patients. Postoperative complications were noted in 36.5% of patients. Overall and progression-free survival at 3-years were 58.8% and 34.1%, respectively. Laparoscopy and robotics had reduced blood loss and hospital stay, while no differences were observed among the three groups for operating time, complications, complete debulking, and survival. Selected patients with recurrent ovarian cancer benefit from a laparoscopic or robotic secondary cytoreduction without compromising survival. Robotics and laparoscopy provide similar perioperative outcomes, and reduced blood loss and shorter hospital stay as compared to laparotomy. Laparotomy seems preferable for patients with widespread peritoneal implants, multiple sites of recurrence, and/or extensive adhesions. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Resection of the vaginal vault for vaginal recurrence of cervical cancer after hysterectomy and brachytherapy.

    Science.gov (United States)

    Abe, Akiko; Matoda, Maki; Okamoto, Sanshiro; Kondo, Eiji; Kato, Kazuyoshi; Omatsu, Kohei; Umayahara, Kenji; Utsugi, Kuniko; Takeshima, Nobuhiro

    2015-04-02

    We describe our experiences with vaginal vault resection for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. After operative treatment, the rate of vaginal vault recurrence of uterine cervical cancer is reported to be about 5%. There is no consensus regarding the treatment for these cases. Between 2004 and 2012, eight patients with vaginal vault recurrence underwent removal of the vaginal wall via laparotomy after hysterectomy and radiotherapy. The median patient age was 45 years (range 35 to 70 years). The median operation time was 244.5 min (range 172 to 590 min), the median estimated blood loss was 362.5 mL (range 49 to 1,890 mL), and the median duration of hospitalization was 24.5 days (range 11 to 50 days). Two patients had intraoperative complications: a grade 1 bowel injury and a grade 1 bladder injury. The following postoperative complications were observed: one patient had vaginal vault bleeding, three patients developed vesicovaginal fistulae, and one patient had repeated ileus. Two patients needed clean intermittent catheterization. Local control was achieved in five of the eight cases. Vaginal vault resection is an effective treatment for vaginal recurrence of cervical cancer after hysterectomy and radiotherapy. However, complications of this procedure can be expected to reduce quality of life. Therefore, this operation should be selected with great care.

  11. Gallbladder Cancer Manifesting as Recurrent Common Bile Duct Stone and Duodenal Ulcer Bleeding

    Directory of Open Access Journals (Sweden)

    Tzung-Jiun Tsai

    2009-08-01

    Full Text Available Gallbladder cancer (GBC is an uncommon disease and is usually asymptomatic. Poor prognosis and high mortality rate have been noted in patients with delayed diagnosis. We report a case of locally advanced GBC with duodenum and colon invasion manifesting as bleeding duodenal ulcer and recurrent common bile duct (CBD stones. The patient was successfully treated with extended surgery. In patients who have multiple recurrence of CBD stones without common risk factors, concomitant biliary tract malignancy should be included in the differential diagnosis.

  12. The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics.

    Science.gov (United States)

    Agalliu, Ilir; Williams, Steve; Adler, Brandon; Androga, Lagu; Siev, Michael; Lin, Juan; Xue, Xiaonan; Huang, Gloria; Strickler, Howard D; Ghavamian, Reza

    2015-06-01

    Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17-4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence-BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity-PrCa recurrence relationship are warranted.

  13. Dual-energy perfusion-CT in recurrent pancreatic cancer. Preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Fritz, F.; Skornitzke, S.; Kauczor, H.U.; Stiller, W.; Klauss, M. [Heidelberg Univ. (Germany). Clinic of Diagnostic and Interventional Radiology; Hackert, T. [Heidelberg Univ. (Germany). Clinic of Surgery; Grenacher, L. [Diagnostik Muenchen (Germany). Diagnostic Imaging Center

    2016-06-15

    To evaluate the diagnostic performance of dual energy (DE) perfusion-CT for the differentiation between postoperative soft-tissue formation and tumor recurrence in patients after potentially curative pancreatic cancer resection. 24 patients with postoperative soft-tissue formation in the conventional regular follow-up CT acquisition after pancreatic cancer resection with curative intent were included prospectively. They were examined with a 64-row dual-source CT using a dynamic sequence of 34 DE acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). Weighted average (linearly blended M0.5) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool for estimating blood flow, permeability, and blood volume. Diagnosis was confirmed by histological study (n=4) and by regular follow-up. Final diagnosis was local recurrence of pancreatic cancer in 15 patients and unspecific postoperative tissue formation in 9 patients. The blood-flow values for recurrence tissue trended to be lower compared to postoperative tissue formation with 16.6 ml/100 ml/min and 24.7 ml/100 ml/min, respectively for weighted average 120 kVp-equivalent image data, which was not significant (n.s.) (p=0.06, significance level 0.05). Permeability- and blood-volume values were only slightly lower in recurrence tissue (n.s.). DE perfusion-CT is feasible in patients after pancreatic cancer resection and a promising functional imaging technique. As only a trend for lower perfusion values in local recurrence compared to unspecific postoperative alterations was found, the perfusion differences are not yet sufficient to differentiate between malignancy and unspecific postoperative alterations for this new technique. Further studies and technical improvements are needed to generate reliable data for this clinically highly relevant differentiation.

  14. Patterns of Disease Recurrence Following Treatment of Oropharyngeal Cancer With Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Garden, Adam S., E-mail: agarden@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Dong, Lei [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Morrison, William H. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Stugis, Erich M. [Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Department of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Glisson, Bonnie S. [Department of Thoracic/Head and Neck Medicine, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Frank, Steven J.; Beadle, Beth M.; Gunn, Gary B. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Schwartz, David L. [Department of Radiation Medicine, Long Island Jewish Medical Center, New Hyde Park, NY (United States); Kies, Merill S. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Department of Thoracic/Head and Neck Medicine, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Weber, Randal S. [Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX (United States); Ang, K. Kian; Rosenthal, David I. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2013-03-15

    Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.

  15. A tissue biomarker panel predicting systemic progression after PSA recurrence post-definitive prostate cancer therapy.

    Directory of Open Access Journals (Sweden)

    Tohru Nakagawa

    Full Text Available BACKGROUND: Many men develop a rising PSA after initial therapy for prostate cancer. While some of these men will develop a local or metastatic recurrence that warrants further therapy, others will have no evidence of disease progression. We hypothesized that an expression biomarker panel can predict which men with a rising PSA would benefit from further therapy. METHODOLOGY/PRINCIPAL FINDINGS: A case-control design was used to test the association of gene expression with outcome. Systemic (SYS progression cases were men post-prostatectomy who developed systemic progression within 5 years after PSA recurrence. PSA progression controls were matched men post-prostatectomy with PSA recurrence but no evidence of clinical progression within 5 years. Using expression arrays optimized for paraffin-embedded tissue RNA, 1021 cancer-related genes were evaluated-including 570 genes implicated in prostate cancer progression. Genes from 8 previously reported marker panels were included. A systemic progression model containing 17 genes was developed. This model generated an AUC of 0.88 (95% CI: 0.84-0.92. Similar AUCs were generated using 3 previously reported panels. In secondary analyses, the model predicted the endpoints of prostate cancer death (in SYS cases and systemic progression beyond 5 years (in PSA controls with hazard ratios 2.5 and 4.7, respectively (log-rank p-values of 0.0007 and 0.0005. Genes mapped to 8q24 were significantly enriched in the model. CONCLUSIONS/SIGNIFICANCE: Specific gene expression patterns are significantly associated with systemic progression after PSA recurrence. The measurement of gene expression pattern may be useful for determining which men may benefit from additional therapy after PSA recurrence.

  16. The dynamic pattern of recurrence in curatively resected non-small cell lung cancer patients: Experiences at a single institution.

    Science.gov (United States)

    Yamauchi, Yoshikane; Muley, Thomas; Safi, Seyer; Rieken, Stefan; Bischoff, Helge; Kappes, Jutta; Warth, Arne; Herth, Felix J F; Dienemann, Hendrik; Hoffmann, Hans

    2015-11-01

    To investigate the hazard function of tumor recurrence in patients with completely (R0) resected non-small cell lung cancer. A total of 1374 patients treated between 2003 and 2009 with complete resection and systematic lymph node dissection were studied. The risk of recurrence at a given time after operation was studied utilizing the cause-specific hazard function. Recurrence was categorized as local recurrence or distant recurrence. The risk distribution was assessed using clinical and pathological factors. The hazard function for recurrence presented an early peak at approximately 10 months after surgery and maintained a tapered plateau-like tail extending up to 8 years. A similar risk pattern was detected for both local recurrence and distant recurrence, while the risk of distant recurrence was higher than that of local recurrence. The double-peaked pattern of hazard rate was present in several subgroups, such as p-stage IA patients. A comparison of histology and status of nodal involvement showed that pN1-2 adenocarcinoma patients demonstrated a high hazard rate of distant recurrence and that pN0 adenocarcinoma patients exhibited a small recurrent risk for a longer time. Squamous cell carcinoma patients showed only little difference in risk. The data may be useful to select patients at high risk of recurrence and may provide information for each patient to decide how to manage the postoperative follow-up individually. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Health-Related Quality of Life after surgery for primary advanced rectal cancer and recurrent rectal cancer

    DEFF Research Database (Denmark)

    Thaysen, Henriette Vind; Jess, Per; Laurberg, Søren

    2012-01-01

    Aim: A review of the literature was undertaken to provide an overview of Health-related quality of life (HRQoL) after surgery for primary advanced or recurrent rectal cancer and to outline proposals for future HRQoL studies in this area. Method: A systematic literature search was undertaken. Only...... studies concerning surgery for primary advanced or recurrent rectal cancer and describing methods used for measuring HRQoL were considered. Results Seven studies were identified including two prospective longitudinal, three cross-sectional and two based on qualitative data. Global quality of life...... cancer. Larger prospective longitudinal studies are needed to improve information on the effects of this extensive surgery on quality of life....

  18. Prognostic impact of serum albumin levels on the recurrence of stage I non-small cell lung cancer.

    Science.gov (United States)

    Jin, Ying; Zhao, Li; Peng, Fang

    2013-05-01

    Patients with stage I non-small cell lung cancer who have undergone complete surgical resection harbor a 30% risk for tumor recurrence. Thus, the identification of factors that are predictive for tumor recurrence is urgently needed. The aim of this study was to test the prognostic value of serum albumin levels on tumor recurrence in patients with stage I non-small cell lung cancer. Stage I non-small cell lung cancer patients who underwent complete surgical resection of the primary tumor at Zhejiang Hospital were analyzed in this study. Serum albumin levels were measured before surgery and once again after surgery in 101 histologically diagnosed non-small cell lung cancer patients. Correlations between the pre- and post-operative serum albumin levels and various clinical demographics and recurrence-free survival rates were analyzed. Patients with pre-operative hypoalbuminemia (recurrence. Serum albumin levels appear to be a significant independent prognostic factor for tumor recurrence in patients with stage I non-small cell lung cancer who have undergone complete resection. Patient pre-treatment and post-treatment serum albumin levels provide an easy and early means of discrimination between patients with a higher risk for recurrence and patients with a low risk of recurrence.

  19. Study on the relationship between the serum VEGF, MMP, MK and recurrence and metastasis after gastric cancer surgery

    Institute of Scientific and Technical Information of China (English)

    Bo Li; Lan Zhou

    2016-01-01

    Objective:To study and investigate the relationship between the serum vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP), midkine (MK) and recurrence and metastasis after gastric cancer surgery.Methods:A total of 78 patients with recurrence and metastasis after gastric cancer surgery in our hospital from January 212 to June 2015 were selected as Group A, 78 patients without recurrence and metastasis at the same time were selected as Group B and 78 healthy persons were selected as Group C. Then the serum VEGF, MMP and MK levels of the 3 groups were compared. The detection levels of local recurrence, regional lymphatic metastasis and distant metastasis in Group A were also compared, and the relationship between the serum VEGF, MMP, MK and recurrence and metastasis after gastric cancer surgery was analyzed by the Logistic analysis.Results:The serum VEGF, MMP and MK indexes of Group A were all higher than those of Group B and Group C. The levels of Group B and Group C had no significant differences. Meanwhile, in Group A, the detection levels of regional lymphatic metastasis and distant metastasis were all higher than those of patients with local recurrence. According to the Logistic analysis, the above indexes all had close relationship with the recurrence and metastasis after gastric cancer surgery.Conclusions:The serum VEGF, MMP and MK of patients with recurrence and metastasis after gastric cancer surgery show higher expression state, and those indexes all have close relationship with the disease.

  20. Relationship between serum VEGF, HIF-1α content and tumor recurrence as well as the malignant degree of cancer cells in recurrent lesions after radical operation for colon cancer

    Institute of Scientific and Technical Information of China (English)

    Zhao-Di Xie; Qiang Wu; Jian Huang; Jing Lu

    2016-01-01

    Objective:To study the relationship between serum VEGF, HIF-1α content and tumor recurrence as well as the malignant degree of cancer cells in recurrent lesions after radical operation for colon cancer.Methods:A total of 134 patients who received radical operation for colon cancer in our hospital between August 2012 and May 2013 were followed up for three years and divided into the recurrence group and non-recurrence group according to tumor recurrence, and the VEGF and HIF-1αcontent in serum as well as the expression levels of proto-oncogenes and tumor suppressor genes in recurrent tumor lesions were detected on the 7th day after operation.Results: VEGF and HIF-1αcontent in serum of recurrence group after operation were significantly higher than those of non-recurrence group; tumor suppressor genes RNF181, p53, ASPP2, TSPYL5 andPTEN mRNA content in recurrent lesions of recurrence group of patients with high VEGF and HIF-1α content were significantly lower than those of patients with low VEGF and HIF-1αcontent, and proto-oncogenesSurvivin, hTERT, LTEM1 andHes1 mRNA content were significantly higher than those of patients with low VEGF and HIF-1αcontent.Conclusions:Increased VEGF and HIF-1α content in serum after radical operation for colon cancer are associated with postoperative recurrence, and the higher the VEGF and HIF-1α content in serum, the higher the malignant degree of cancer cells.

  1. PI3K Inhibitor BKM120 and Cetuximab in Treating Patients With Recurrent or Metastatic Head and Neck Cancer

    Science.gov (United States)

    2017-05-22

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Recurrent Metastatic Squamous Neck Cancer With Occult Primary; Recurrent Salivary Gland Cancer; Recurrent Squamous Cell Carcinoma of the Hypopharynx; Recurrent Squamous Cell Carcinoma of the Larynx; Recurrent Squamous Cell Carcinoma of the Lip and Oral Cavity; Recurrent Squamous Cell Carcinoma of the Nasopharynx; Recurrent Squamous Cell Carcinoma of the Oropharynx; Recurrent Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Recurrent Verrucous Carcinoma of the Larynx; Recurrent Verrucous Carcinoma of the Oral Cavity; Salivary Gland Squamous Cell Carcinoma; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer

  2. The role of hepatic ischemia-reperfusion injury and liver parenchymal quality on cancer recurrence.

    Science.gov (United States)

    Orci, Lorenzo A; Lacotte, Stéphanie; Oldani, Graziano; Morel, Philippe; Mentha, Gilles; Toso, Christian

    2014-09-01

    Hepatic ischemia/reperfusion (I/R) injury is a common clinical challenge. Despite accumulating evidence regarding its mechanisms and potential therapeutic approaches, hepatic I/R is still a leading cause of organ dysfunction, morbidity, and resource utilization, especially in those patients with underlying parenchymal abnormalities. In the oncological setting, there are growing concerns regarding the deleterious impact of I/R injury on the risk of post-surgical tumor recurrence. This review aims at giving the last updates regarding the role of hepatic I/R and liver parenchymal quality injury in the setting of oncological liver surgery, using a "bench-to-bedside" approach. Relevant medical literature was identified by searching PubMed and hand scanning of the reference lists of articles considered for inclusion. Numerous preclinical models have depicted the impact of I/R injury and hepatic parenchymal quality (steatosis, age) on increased cancer growth in the injured liver. Putative pathophysiological mechanisms linking I/R injury and liver cancer recurrence include an increased implantation of circulating cancer cells in the ischemic liver and the upregulation of proliferation and angiogenic factors following the ischemic insult. Although limited, there is growing clinical evidence that I/R injury and liver quality are associated with the risk of post-surgical cancer recurrence. In conclusion, on top of its harmful early impact on organ function, I/R injury is linked to increased tumor growth. Therapeutic strategies tackling I/R injury could not only improve post-surgical organ function, but also allow a reduction in the risk of cancer recurrence.

  3. Radiomics versus physician assessment for the early prediction of local cancer recurrence after stereotactic radiotherapy for lung cancer

    Science.gov (United States)

    Mattonen, Sarah A.; Johnson, Carol; Palma, David A.; Rodrigues, George; Louie, Alexander V.; Senan, Suresh; Yeung, Timothy P. C.; Ward, Aaron D.

    2016-03-01

    Stereotactic ablative radiotherapy (SABR) has recently become a standard treatment option for patients with early-stage lung cancer, which achieves local control rates similar to surgery. Local recurrence following SABR typically presents after one year post-treatment. However, benign radiological changes mimicking local recurrence can appear on CT imaging following SABR, complicating the assessment of response. We hypothesize that subtle changes on early post- SABR CT images are important in predicting the eventual incidence of local recurrence and would be extremely valuable to support timely salvage interventions. The objective of this study was to extract radiomic image features on post-SABR follow-up images for 45 patients (15 with local recurrence and 30 without) to aid in the early prediction of local recurrence. Three blinded thoracic radiation oncologists were also asked to score follow-up images as benign injury or local recurrence. A radiomic signature consisting of five image features demonstrated a classification error of 24%, false positive rate (FPR) of 24%, false negative rate (FNR) of 23%, and area under the receiver operating characteristic curve (AUC) of 0.85 at 2-5 months post-SABR. At the same time point, three physicians assessed the majority of images as benign injury for overall errors of 34-37%, FPRs of 0-4%, and FNRs of 100%. These results suggest that radiomics can detect early changes associated with local recurrence which are not typically considered by physicians. We aim to develop a decision support system which could potentially allow for early salvage therapy of patients with local recurrence following SABR.

  4. The Role of Nuclear Receptor Coactivators in Recurrent Prostate Cancer

    Science.gov (United States)

    2006-02-01

    10, 1527–1535 35. Newmark, J. R., Hardy, D. O., Tonb , D. C., Carter, B. S., Epstein, J. I., Isaacs, W. B., Brown, T. R., and Barrack, E. R. (1992...J.R., Hardy, D.O., Tonb , D.C., Carter, B.S., Epstein, J.I., 42293–42301. Isaacs, W.B., Brown, T.R., and Barrack, E.R. (1992). Androgen recep- tor gene...Mohler, J. L., French, F. S., and Wilson, E. M. (2001) Cancer Res. 61, 4315–4319 43. Newmark, J. R., Hardy, D. O., Tonb , D. C., Carter, B. S

  5. Accessory breast tissue in axilla masquerading as breast cancer recurrence

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    Goyal Shikha

    2008-01-01

    Full Text Available Ectopic or accessory breast tissue is most commonly located in the axilla, though it may be present anywhere along the milk line. Development is hormone dependent, similar to normal breast tissue. These lesions do not warrant any intervention unless they produce discomfort, thus their identification and distinction from other breast pathologies, both benign and malignant, is essential. We report a case with locally advanced breast cancer who presented with an ipsilateral axillary mass following surgery, radiotherapy, and chemotherapy. Subsequent evaluation with excision biopsy showed duct ectasia in axillary breast tissue and the patient was continued on hormone therapy with tamoxifen.

  6. Risk of Recurrence and Mortality in a Multi-Ethnic Breast Cancer Population.

    Science.gov (United States)

    Kabat, Geoffrey C; Ginsberg, Mindy; Sparano, Joseph A; Rohan, Thomas E

    2016-12-21

    Compared to non-Hispanic whites, African-American women tend to be diagnosed with breast cancer at an earlier age, to have less favorable tumor characteristics, and to have poorer outcomes from breast cancer. The extent to which differences in clinical characteristics account for the black/white disparity in breast cancer mortality is unclear. The purpose of this investigation was to examine the association of clinical, demographic, and treatment variables with total mortality and breast cancer recurrence by race/ethnicity in a cohort of women diagnosed with invasive breast cancer. To this end, we used data on 3890 invasive breast cancer cases diagnosed at a single medical center. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of tumor characteristics and treatment variables with mortality and recurrence. Compared to white women, black women with breast cancer presented with tumors that had worse prognostic factors, particularly higher stage, lower frequency of hormone-receptor positive tumors, and higher frequency of comorbidities. Hispanics also generally had less favorable prognostic factors compared to non-Hispanic whites. Among estrogen receptor-positive cases, blacks had roughly a two-fold increased risk of recurrence compared to non-Hispanic whites. However, ethnicity/race was not associated with total mortality. Tumor stage, tumor size, and Charlson comorbidity index were positively associated with mortality, and mammography and chemotherapy and hormone therapy were inversely associated with mortality. In spite of poorer prognostic factors among blacks compared whites, race/ethnicity was not associated with total mortality in our study.

  7. Fruit and vegetable intakes and risk of colorectal cancer and incident and recurrent adenomas in the PLCO cancer screening trial.

    Science.gov (United States)

    Kunzmann, Andrew T; Coleman, Helen G; Huang, Wen-Yi; Cantwell, Marie M; Kitahara, Cari M; Berndt, Sonja I

    2016-04-15

    The roles of fruits and vegetables in colorectal cancer development are unclear. Few prospective studies have assessed the association with adenoma, a known precursor to colorectal cancer. Our aim was to evaluate the association between fruit and vegetable intake and colorectal cancer development by evaluating the risk of incident and recurrent colorectal adenoma and colorectal cancer. Study participants were identified from the intervention arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Fruit and vegetable intake was measured using a self-reported dietary questionnaire. Total fruit and vegetable intake was not associated with reduced incident or recurrent adenoma risk overall, but a protective association was observed for multiple adenomas (Odds ratio 3rd tertile vs. 1st tertile = 0.61, 95% confidence interval (CI): 0.38, 1.00). Higher fruit and vegetable intakes were associated with a borderline reduced risk of colorectal cancer (Hazard ratio (HR) 3rd tertile vs. 1st tertile = 0.82, 95% CI: 0.67, 1.01), which reached significance amongst individuals with high processed meat intakes (HR = 0.74, 95% CI: 0.55, 0.99). Our results suggest that increased fruit and vegetable intake may protect against multiple adenoma development and may reduce the detrimental effects of high processed meat intakes on colorectal cancer risk.

  8. How oncologists communicate information to women with recurrent ovarian cancer in the context of treatment decision making in the medical encounter.

    Science.gov (United States)

    Elit, Lorraine M; Charles, Cathy; Gafni, Amiram; Ranford, Jennifer; Tedford-Gold, Sara; Gold, Irving

    2015-10-01

    Women with recurrent ovarian cancer depend on their physicians to provide them with information about their diagnosis and available treatment options if they wish to participate in the process of choosing the treatment. There is no information on how oncologists give information to women during the physician-patient encounter at the time the disease recurs. To explore from the oncologists' perspective (i) the extent to which oncologists provide their own patients who are experiencing their first recurrence of ovarian cancer with the same information about management options, and (ii) any explicit or implicit criteria they use to decide whether and how to tailor the information to individual patients. We adopted a qualitative, exploratory descriptive approach to begin to understand oncologists' perspectives on how they gave information to patients within the context of their clinical practice. Individual interviews were used to identify themes related to the study objectives. Fifteen gynaecologic and five medical oncologists participated. Theme 1 describes the extent to which oncologists give information to their patients in the same way or in different ways. This section describes how the same oncologist may modify the depth of information transfer based on several factors. Theme 2 focuses on the factors that influence what information is given. For example, the amount and type of information given is based on the oncologist's on-going assessment of how the patient is assimilating the information shared during the medical encounter, the oncologists' perception of their relationship with the patient and the oncologist's assessment of what role they should take in decision making. Theme 3 involves the factors that influenced how information is given. For example, the information shared may vary based on the oncologist's perception of the patient's vitality, the patient's comprehension of the information, the patient's emotional well-being. In addition, the oncologist

  9. Recurrent Intrathoracic Locking of the Scapula after Lung Cancer Resection and Combined Rib Resection

    Directory of Open Access Journals (Sweden)

    Akinori Kimura

    2017-01-01

    Full Text Available We report a case of recurrent locking of the scapula in the thorax after combined lobectomy and thoracic wall resection for advanced lung cancer. The patient was a 52-year-old man with advanced spindle cell carcinoma in his right lung. He had undergone right lung lobectomy and thoracic wall excision (Th1–5. Intrathoracic repair had not been performed to address the defect in the thoracic wall. Two months after the operation he experienced sudden acute pain in the right shoulder. Three-dimensional computed tomography revealed locking of the scapula intrathoracically. The diagnosis was recurrent locking of the scapula in the thorax. He underwent conservative treatment. Because his symptoms were not alleviated and he continued to experience recurrent locking, we performed partial resection of the inferior part of the scapula. Although scapular locking diminished after this procedure, there were still some pain and “catching” between the scapula and the thoracic wall (T6 when he undertook certain movements. No further surgery could be performed, however, because the cancer from the primary lesion had recurred near the previously operated thoracic wall. A procedure for recurrent intrathoracic locking of the scapula was not successful in this case.

  10. Clinical outcomes following 3D image-guided brachytherapy for vaginal recurrence of endometrial cancer.

    Science.gov (United States)

    Lee, Larissa J; Damato, Antonio L; Viswanathan, Akila N

    2013-12-01

    To evaluate clinical outcomes for women with recurrent endometrial cancer treated with 3D image-guided brachytherapy 44 women, of whom 13 had received prior RT, received salvage RT for vaginal recurrence from 9/03 to 8/11. HDR or LDR interstitial brachytherapy was performed under MR or CT guidance in 35 patients (80%); 9 (20%) had CT-guided HDR cylinder brachytherapy. The median cumulative dose in EQD2 was 75.5 Gy. Actuarial estimates of local failure (LF), disease-free (DFS) and overall survival (OS) were calculated by Kaplan-Meier. Histologic subtypes were endometrioid (EAC, 33), papillary serous/clear cell (UPSC/CC, 5) and carcinosarcoma (CS, 6). The 2-year DFS/OS rates were 75%/89% for EAC and 11%/24% for UPSC/CC/CS (both pradiotherapy. 3D image-guided brachytherapy results in excellent local control for women with recurrent endometrial cancer, particularly with cumulative EQD2 doses greater than 70 Gy. Successful salvage of vaginal recurrence is related to tumor grade and histologic subtype. © 2013.

  11. Loss of TIMP-1 immune expression and tumor recurrence in localized prostate cancer

    Directory of Open Access Journals (Sweden)

    Sabrina Thalita dos Reis

    2015-12-01

    Full Text Available Introduction and objective: Overexpression of MMPs has been related to biochemical recurrence after radical prostatectomy. TIMP1 and TIMP2 are controllers of MMPs and the aim of this study is to evaluate the expression levels of MMPs and their regulators using immunohistochemistry in tissue microarray of localized prostate cancer (PC. Materials and Methods: Immune-expression of MMP-9, MMP-2, TIMP1, TIMP-2, MMP-14 and IL8, were analyzed by immunohistochemistry in radical prostatectomy specimens of 40 patients with localized PC who underwent surgery between September 1997 and February 2000. Protein expression was considered as categorical variables, negative or positive. The results of the immune-expression were correlated to Gleason score (GS, pathological stage (TNM, pre-operatory PSA serum levels and biochemical recurrence in a mean follow up period of 92.5 months. Results: The loss of TIMP1 immune-expression was related to biochemical recurrence. When TIMP1 was negative, 56.3% patients recurred versus 22.2% of those whose TIMP1 was positive (p=0.042. MMP-9, MMP-2, IL8 and MMP-14 were positive in the majority of PC. TIMP-2 was negative in all cases. Conclusion: Negative immune-expression of TIMP1 is correlated with biochemical recurrence in patients with PC possibly by failing to control MMP-9, an important MMP related to cancer progression.

  12. Patterns of recurrence in bladder cancer treated by irradiation and/or cystectomy

    Energy Technology Data Exchange (ETDEWEB)

    Batata, M.A.; Whitmore, W.F. Jr.; Chu, F.C.H.; Hilaris, B.S.; Unal, A.; Chung, S.

    1980-02-01

    Between 1949 and 1971, 451 patients with bladder cancer were treated by radiation therapy and/or radical cystectomy at the Memorial Sloan-Kettering Cancer Center. Radical cystectomy alone was the treatment for 137 patients in Group 1. In Group 2, 109 patients received radiation therapy to an average tumor dose of 6000 rad in 6 weeks +- 1 year before radical cystectomy for persistent, recurrent or new lesions. Planned preoperative irradiation consisted of either 4000 rad in 4 weeks for 119 patients in Group 3, or 2000 rad in 1 week for 86 patients in Group 4, +- 6 weeks and 2 days, respectively, before radical cystectomy. The determinate over-all distant and/or local recurrence rate was 49% for Group 1 and 37 to 45% for Groups 2 to 4. Local recurrence alone occurred in 28% of Group 1 patients and 14 to 16% of those in Groups 2 to 4. Distant metastases developed in 21% of Group 1 patients and 22 to 28% of Group 2 to 4 patients. A reduced incidence of pelvic recurrence was associated with radiation-induced stage reduction for Group 2 to 4 clinically high and low stage tumors, especially when the histologic grade was high. Similar frequencies of extrapelvic metastases in the four groups were maintained in clinically low and high stage tumors of low or high histological grade.

  13. Concurrent chemoradiotherapy for patients with postoperative recurrence of surgically resected non-small-cell lung cancer.

    Science.gov (United States)

    Takenaka, Tomoyoshi; Takenoyama, Mitsuhiro; Toyozawa, Ryo; Inamasu, Eiko; Yoshida, Tsukihisa; Toyokawa, Gouji; Shiraishi, Yoshimasa; Hirai, Fumihiko; Yamaguchi, Masafumi; Seto, Takashi; Ichinose, Yukito

    2015-01-01

    A few reports have evaluated the outcomes of concurrent chemoradiotherapy (CRT) for patients with postoperative recurrence of non-small cell lung cancer (NSCLC). From 2000 through 2011, 1237 consecutive patients with NSCLC underwent pulmonary resection at our institution. Of those, 280 patients had experienced postoperative recurrence by the end of 2012. Thirty-five patients received concurrent CRT as initial treatment of the recurrent disease. We retrospectively reviewed these cases, analyzed the outcomes of concurrent CRT after surgical resection, and examined the factors that predict long-term postrecurrence survival. The most common sites of recurrence in this cohort were the lymph nodes in 24 patients, followed by the lung in 5 patients and bone in 6 patients. The median radiation dose given as the initial treatment of recurrence was 60 Gy (range, 30-60 Gy). Chemotherapy included a platinum agent in all cases; cisplatin-based chemotherapy was administered in 23 cases, and a carboplatin-based chemotherapy regimen was administered in 12. The median progression-free and postrecurrence survival after CRT was 13 months (range, 4-127 months) and 31 months (range, 5-127 months), respectively. Seven patients were still alive without evidence of disease for > 3 years after the recurrence diagnosis. The ECOG performance status (PS), surgical procedure, and types of platinum agents used were independent prognostic factors for postrecurrence survival. Concurrent CRT for recurrent NSCLC is a promising therapy for selected patients. A poor PS and postpneumonectomy state were poor prognostic factors for patients who received concurrent CRT. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Radiotherapy for locoregional recurrent tumors after resection of non-small cell lung cancer.

    Science.gov (United States)

    Kagami, Y; Nishio, M; Narimatsu, N; Mjoujin, M; Sakurai, T; Hareyama, M; Saito, A

    1998-04-01

    Thirty-two patients with locoregional recurrence without documented distant metastasis after resection of non-small cell lung cancer were treated with radiotherapy. There were 29 male patients and three female patients. The age range was 49-79 years (median 66 years). Twenty patients had squamous cell carcinoma, 11 patients adenocarcinoma and one patient large cell carcinoma. Ten patients had bronchial stump recurrence alone, 14 patients bronchial stump recurrence with mediastinal and/or supraclavicular fossa lymph nodes recurrence, and eight patients mediastinal and/or supraclavicular fossa lymph nodes recurrence without bronchial stump recurrence. The total dose delivered ranged from 47.5 to 65 Gy. We achieved good results on improving on subjective complaints. Eighty-nine percent (17/19) of patients indicated subjective improvement. Eight of 32 (25%) patients showed a complete response, and 13 of 32 (40.6%) patients showed a partial response. Only one of seven patients (14.3%) with less than 60 Gy showed a complete response, but seven of 25 patients (28%) with 60 Gy and more showed a complete response. The survival rate was 56.2% at 1 year and 12.5% at 5 years. Four patients have survived more than 5 years. The survival rate of the patients with complete response was 50% at 3 and 5 years, that of the patients with non-complete was 12.5% at 3 years and 0% at 5 years (Cox-Mantel test, P recurrent tumors after resection was effective for palliation and improved survival.

  15. The impact of obesity on prostate cancer recurrence observed after exclusion of diabetics

    Science.gov (United States)

    Agalliu, Ilir; Williams, Steve; Adler, Brandon; Androga, Lagu; Siev, Michael; Lin, Juan; Xue, Xiaonan; Huang, Gloria; Strickler, Howard D.; Ghavamian, Reza

    2016-01-01

    Purpose Although overall there is a positive association between obesity and risk of prostate cancer (PrCa) recurrence, results of individual studies are somewhat inconsistent. We investigated whether the failure to exclude diabetics in prior studies could have increased the likelihood of conflicting results. Methods A total of 610 PrCa patients who underwent radical prostatectomy between 2005 and 2012 were followed for recurrence, defined as a rise in serum PSA ≥ 0.2 ng/ml following surgery. Body mass index (BMI) and history of type 2 diabetes were documented prior to PrCa surgery. The analysis was conducted using Cox proportional hazard models. Results Obesity (25.6 %) and diabetes (18.7 %) were common in this cohort. There were 87 (14.3 %) recurrence events during a median follow-up of 30.8 months after surgery among the 610 patients. When analyzed among all PrCa patients, no association was observed between BMI/obesity and PrCa recurrence. However, when analysis was limited to non-diabetics, obese men had a 2.27-fold increased risk (95 % CI 1.17–4.41) of PrCa recurrence relative to normal weight men, after adjusting for age and clinical/pathological tumor characteristics. Conclusions This study found a greater than twofold association between obesity/BMI and PrCa recurrence in non-diabetics. We anticipated these results because the relationship between BMI/obesity and the biologic factors that may underlie the PrCa recurrence–BMI/obesity association, such as insulin, may be altered by the use of anti-diabetes medication or diminished beta-cell insulin production in advanced diabetes. Studies to further assess the molecular factors that explain the BMI/obesity–PrCa recurrence relationship are warranted. PMID:25771797

  16. Thioredoxin and thioredoxin-interacting protein as prognostic markers for gastric cancer recurrence

    Institute of Scientific and Technical Information of China (English)

    Jae Yun Lim; Sun Och Yoon; Soon Won Hong; Jong Won Kim; Seung Ho Choi; Jae Yong Cho

    2012-01-01

    To evaluate the potential of thioredoxin (TXN)and thioredoxin-interacting protein (TXNIP) expression as biomarkers for predicting gastric cancer recurrence.METHODS:TXN and TXNIP expression levels were acquired from gene expression microarray data for 65human gastric cancer tissues.We determined whether each gene expression level was associated with cancer recurrence and investigated the relationship between the two genes.For validation,the expression levels of TXN and TXNIP were measured by quantitative realtime reverse transcription polymerase chain reaction in 68 independent stage Ⅲ gastric cancer patients.The correlation between gene expression and cancer prognosis was evaluated.Immunohistochemical staining was performed to investigate the protein expression levels of TXN and TXNIP and to characterize the expression patterns of each protein.RESULTS:TXN was a prognosis-related gene (P =0.009),whereas TXNIP,a TXN inhibitor,demonstrated a negative correlation with TXN in the gene expression microarray data.In the 68 stage Ⅲ patients,the expression levels of both TXN and TXNIP had a statistically significant effect on recurrence-free survival (RFS,P =0.008 and P =0.036,respectively).The low TXN and high TXNIP expression group exhibited a better prognosis than the other groups,and the high TXN and low TXNIP expression group exhibited a poorer prognosis (P < 0.001 for RFS and P =0.001 for overall survival).More than half of the patients in the simultaneously high TXN and low TXNIP expression group experienced a recurrence within 1 year after curative surgery,and the 5-year survival rate of the patients in this group was 29%,compared with 89% in the low TXN and high TXNIP expression group.The TXN protein was overexpressed in 65% of the gastric cancer tissues,whereas the TXNIP protein was underexpressed in 85% of the cancer cells.In a correlation analysis,TXN and TXNIP were highly correlated with many oncogenes and tumor suppressors as well as with genes

  17. Local recurrence in patients treated for rectal cancer using total mesorectal excision or transection of mesorectum

    Directory of Open Access Journals (Sweden)

    Milojković Bobana

    2016-01-01

    Full Text Available Background/Aim. Rectal cancer is a major health problem throughout the world, despite the great progress in the treatment and control of the disease. The aim of this study was to determine the effect of mesorectal excision type on local recurrence in patients operated on for rectal cancer within a 3- year period. Methods. The clinical retrospective study was conducted at the Clinic for General Surgery at the Clinical Center in Niš, Serbia, and included 225 patients with rectal cancer. Postoperatively, the patients were observed 36 months. Total mesorectal excision (TME method was used in 129 (57.33% patients, and partial mesorectal excision (PME in 96 (42.66%. There were 145 (64.44% man and 80 (35.55% women, average age 66.8 years. Results. In 58 (25.77% of the patients cancer was localized in the proximal third of the rectum, in 99 (44% in the medium third, in 68 (30.22% it was 8 cm of the anocutaneous line. In 167 (74.22% patients rectal cancer was in T3 stadium. TME was performed in all the patients with cancer in the distal third of the rectum and in 61.61% of the patients with cancer in the medium third of the rectum. PME was performed in all the patients with localized cancer in the proximal third and in 38.38% of the patients with cancer in the medium third of the rectum. Local recurrence occurred in 20 (8.88% patients, 12 (9.30% in the TME group and 8 (8.33% in the PME group, which was not a statistically significant difference. In 75% of the cases, relapse occurred in the patients in T3 stage. Relapse occurred in 55% of the cases in the second year after the surgery. The median survival of all the patients amounted to 35 months. The total mortality of all respondents in a 3-year period amounted to 5.3%. Conclusion. There were no statistically significant differences in the incidence of local recurrence and survival among patients who underwent TME and those underwent PME. The type of mesorectal excision does not affect the incidence of

  18. Multiparametric MRI for recurrent prostate cancer post radical prostatectomy and postradiation therapy.

    Science.gov (United States)

    Barchetti, Flavio; Panebianco, Valeria

    2014-01-01

    The clinical suspicion of local recurrence of prostate cancer (PCa) after radical prostatectomy (RP) and after radiation therapy (RT) is based on the onset of biochemical failure. The aim of this paper was to review the current role of multiparametric-MRI (mp-MRI) in the detection of locoregional recurrence. A systematic literature search using the Medline and Cochrane Library databases was performed from January 1995 up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of mp-MRI in the detection of PCa local recurrence after RP; the second part provides an insight about the impact of mp-MRI in the depiction of locoregional recurrence after RT (interstitial or external beam). Published data indicate an emerging role for mp-MRI in the detection and localization of locally recurrent PCa both after RP and RT which represents an information of paramount importance to perform focal salvage treatments.

  19. Multiparametric MRI for Recurrent Prostate Cancer Post Radical Prostatectomy and Postradiation Therapy

    Directory of Open Access Journals (Sweden)

    Flavio Barchetti

    2014-01-01

    Full Text Available The clinical suspicion of local recurrence of prostate cancer (PCa after radical prostatectomy (RP and after radiation therapy (RT is based on the onset of biochemical failure. The aim of this paper was to review the current role of multiparametric-MRI (mp-MRI in the detection of locoregional recurrence. A systematic literature search using the Medline and Cochrane Library databases was performed from January 1995 up to November 2013. Bibliographies of retrieved and review articles were also examined. Only those articles reporting complete data with clinical relevance for the present review were selected. This review article is divided into two major parts: the first one considers the role of mp-MRI in the detection of PCa local recurrence after RP; the second part provides an insight about the impact of mp-MRI in the depiction of locoregional recurrence after RT (interstitial or external beam. Published data indicate an emerging role for mp-MRI in the detection and localization of locally recurrent PCa both after RP and RT which represents an information of paramount importance to perform focal salvage treatments.

  20. Whither surgical quality assurance of breast cancer surgery (surgical margins and local recurrence) after paterson.

    Science.gov (United States)

    Bundred, N J; Thomas, J; Dixon, J M J

    2017-07-05

    The Kennedy report into the actions of the disgraced Breast Surgeon, Paterson focussed on issues of informed consent for mastectomy, management of surgical margins and raised concerns about local recurrence rates and the increasing emphasis on cosmesis after mastectomy for breast cancer. This article assesses whether Kennedy's recommendations apply to the UK as a whole and how to address these issues. New GMC advice on consent and newer nonevidenced innovations in immediate reconstruction have altered the level of informed consent required. Patients deserve a better understanding of the issues of oncological versus cosmetic outcomes on which to base their decisions. Involvement of the whole multidisciplinary team including Oncologists is necessary in surgical planning. Failure to obtain clear microscopic margins at mastectomy leads to an increased local recurrence, yet has received little attention in the UK. Whereas, other countries have used surgical quality assurance audits to reduce local recurrence; local recurrence rates are not available and the extent of variation across the UK in margin involvement after surgery, its management and relationship to local recurrence needs auditing prospectively to reduce unnecessary morbidity. To reassure public, patients and the NHS management, an accreditation system with more rigour than NHSBSP QA and peer review is now required. Resource and efforts to support its introduction will be necessary from the Royal College of Surgeons and the Association of Breast Surgeons. New innovations require careful evaluation before their backdoor introduction to the NHS. Private Hospitals need to have the same standards imposed.

  1. Peritoneal expression of Matrilysin helps identify early post-operative recurrence of colorectal cancer.

    Science.gov (United States)

    Sica, Giuseppe S; Fiorani, Cristina; Stolfi, Carmine; Monteleone, Giovanni; Candi, Eleonora; Amelio, Ivano; Catani, Valeria; Sibio, Simone; Divizia, Andrea; Tema, Giorgia; Iaculli, Edoardo; Gaspari, Achille L

    2015-05-30

    Recurrence of colorectal cancer (CRC) following a potentially curative resection is a challenging clinical problem. Matrix metalloproteinase-7 (MMP-7) is over-expressed by CRC cells and supposed to play a major role in CRC cell diffusion and metastasis. MMP-7 RNA expression was assessed by real-time PCR using specific primers in peritoneal washing fluid obtained during surgical procedure. After surgery, patients underwent a regular follow up for assessing recurrence. transcripts for MMP-7 were detected in 31/57 samples (54%). Patients were followed-up (range 20-48 months) for recurrence prevention. Recurrence was diagnosed in 6 out of 55 patients (11%) and two patients eventually died because of this. Notably, all the six patients who had relapsed were positive for MMP-7. Sensitivity and specificity of the test were 100% and 49% respectively. Data from patients have also been corroborated by computational approaches. Public available coloncarcinoma datasets have been employed to confirm MMP7 clinical impact on the disease. Interestingly, MMP-7 expression appeared correlated to Tgfb-1, and correlation of the two factors represented a poor prognostic factor. This study proposes positivity of MMP-7 in peritoneal cavity as a novel biomarker for predicting disease recurrence in patients with CRC.

  2. Management of afferent loop obstruction from recurrent metastatic pancreatic cancer using a venting gastrojejunostomy.

    Science.gov (United States)

    Bakes, Debbie; Cain, Christian; King, Michael; Dong, Xiang Da Eric

    2013-12-15

    Pancreatic cancer is an aggressive malignancy potentially curable with surgical intervention. Following pancreaticoduodenectomy for suspected pancreatic head malignancy, patients have a high risk for both immediate and delayed problems due to surgical complications and recurrent disease. We report here a patient with pancreatic cancer treated with pancreaticoduodenectomy who developed recurrent disease resulting in obstruction of the afferent limb. The patient developed biliary obstruction and cholangitis at presentation. Her biliary tree failed to dilate which precluded safe percutaneous biliary decompression. During surgical exploration, she was found to have a dilated afferent limb at the level of the transverse mesocolon. The patient underwent decompression of the afferent limb as well as the biliary tree using a venting gastrojejunostomy to the blind loop. This represents a novel surgical approach for management of this complicated and difficult problem.

  3. Storage time of transfused blood and disease recurrence after colorectal cancer surgery

    DEFF Research Database (Denmark)

    Mynster, T; Nielsen, Hans Jørgen

    2001-01-01

    of the transfused blood. Therefore, we studied the relationship between blood storage time and the development of disease recurrence and long-term survival after colorectal cancer surgery. METHODS: Preoperative and postoperative data were prospectively recorded in 740 patients undergoing elective resection...... transfused patients (P = 0.004). The survival of patients receiving blood exclusively stored blood stored > or = 21 days, survival was 3.7 years (P = 0.12). Among patients with curative resection (n = 532), the hazard ratio of disease recurrence was 1.5 (95......BACKGROUND: Perioperative blood transfusion and subsequent development of postoperative infectious complications may lead to poor prognosis of patients with colorectal cancer. It has been suggested that the development of postoperative infectious complications may be related to the storage time...

  4. Outcomes after curative or palliative surgery for locoregional recurrent breast cancer

    DEFF Research Database (Denmark)

    Juhl, Alexander Andersen; Mele, Marco; Damsgaard, Tine Engberg

    2014-01-01

    Background Locoregional recurrence (LRR) after breast cancer is an independent predictor for later systemic disease and poor long-term outcome. As the surgical treatment is complex and often leaves the patient with extensive defects, reconstructive procedures involving flaps, and thus plastic...... surgical assistance, are often required. The aim of the present study was to evaluate our institution’s approach to surgical treatment for locoregional recurrence of a breast cancer. Methods In the present retrospective, single-centre study, we evaluate our experience with 12 patients who underwent surgery...... occurred in four (33 %) of the patients. Median overall survival was 22 months, regardless of the surgery being curative or palliative. A median disease-free survival of 18 months was achieved for patients having achieved radicality. Conclusions Both wide local excision and full thickness chest wall...

  5. Predictors of early recurrence for node-negative t1 to t2b non-small cell lung cancer.

    Science.gov (United States)

    Kiankhooy, Armin; Taylor, Matthew D; LaPar, Damien J; Isbell, James M; Lau, Christine L; Kozower, Benjamin D; Jones, David R

    2014-10-01

    Recurrence develops in nearly one-third of patients who undergo complete resection for non-small cell lung cancer (NSCLC). We sought to identify predictors of early recurrence (lung cancer database. Exclusion criteria included carcinoid, adenocarcinoma in situ, and minimally invasive adenocarcinoma histologies, and any induction therapy. Patient demographics, clinical, and pathologic variables were analyzed. Recurrence was confirmed histologically in 86 patients (85%) or radiographically in 16 (15%). Univariable and multivariable logistic regression (C statistic = 0.7) and Cox proportional hazards analyses were performed (p Recurrence was present in 102 patients (19%) and was locoregional in 33 (32%), distant in 40 (39%), and multisite in 29 (29%). T size, tumor histology, tumor grade, smoking status, maximum standardized uptake value, and albumin were not associated with recurrence. Multivariable predictors of recurrence were lymphovascular invasion (odds ratio, 2.48), sublobar resection (odds ratio, 2.37), and age (odds ratio, 0.96). Recurrence was independently associated with lung cancer-specific death (relative risk, 11.78; 95% confidence interval, 5.46 to 25.36; p recurrence rate in R0 resected node-negative T1 to T2b NSCLC. The identification of unique predictors of recurrence is an important step toward defining a patient population that may benefit from adjuvant therapy. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  6. A rare case of repeated anastomotic recurrence due to tumor implantation after curative surgery for sigmoid colon cancer

    Directory of Open Access Journals (Sweden)

    Shiokawa Hiroyuki

    2007-08-01

    Full Text Available Abstract Background Anastomotic recurrence is often experienced at colocolic or colorectal anastomoses. Tumor cell implantation has been reported as the mechanism of anastomotic recurrence. However, anastomotic recurrence occurring repeatedly after curative surgery is rare. We herein report a rare case of repeated anastomotic recurrence after curative surgery for sigmoid colon cancer. Case presentation A 51-year-old man underwent radical surgery for sigmoid colon cancer. However, anastomotic recurrence developed three times during three years and six months after the initial operation in spite of irrigation with 5% povidone-iodine before anastomosis. The serum carcinoembryonic antigen (CEA level had been within normal limits after sigmoidectomy. Finally, the patient underwent abdominoperineal resection. The clinico-pathological findings revealed that possible tumor cell implantation caused these anastomotic recurrences. The patients survived without recurrence during the follow-up period of seven years and nine months. Conclusion We experienced a rare case of repeated anastomotic recurrence due to possible tumor implantation after curative surgery for sigmoid colon cancer; however the prognosis was ultimately very good. CEA monitoring was insensitive for detection of anastomotic recurrence in this case.

  7. The psychosocial needs of gynaecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Hansson, Helena; Ottesen, Bent

    2015-01-01

    with key healthcare professionals, a literature review and six semi-structured interviews with women who attended the existing follow-up program. The Guided Self-Determination (GSD) method developed in diabetes care was identified as an appropriate framework for the intervention. GSD consists of reflection....... This modification involved the development of additional reflection sheets and a fidelity assessment tool. A systematic training program was arranged for the GSD-GYN-C-nurses. Phase 4 involved secondary pilot testing where nurses and women confirmed the applicability of GSD-GYN-C and final adjustments were made....... Selected measurements were tested for sensitivity during pilot testing. Data from phase 2 and 4 were also used to select the primary outcome and calculate power for a future randomized clinical trial (RCT). RESULTS: Pilot testing supported our hypothesis that GSD-GYN-C may be transferable and useful...

  8. DNA methylation patterns in bladder cancer and washing cell sediments: a perspective for tumor recurrence detection

    Directory of Open Access Journals (Sweden)

    Goldberg José

    2008-08-01

    Full Text Available Abstract Background Epigenetic alterations are a hallmark of human cancer. In this study, we aimed to investigate whether aberrant DNA methylation of cancer-associated genes is related to urinary bladder cancer recurrence. Methods A set of 4 genes, including CDH1 (E-cadherin, SFN (stratifin, RARB (retinoic acid receptor, beta and RASSF1A (Ras association (RalGDS/AF-6 domain family 1, had their methylation patterns evaluated by MSP (Methylation-Specific Polymerase Chain Reaction analysis in 49 fresh urinary bladder carcinoma tissues (including 14 cases paired with adjacent normal bladder epithelium, 3 squamous cell carcinomas and 2 adenocarcinomas and 24 cell sediment samples from bladder washings of patients classified as cancer-free by cytological analysis (control group. A third set of samples included 39 archived tumor fragments and 23 matched washouts from 20 urinary bladder cancer patients in post-surgical monitoring. After genomic DNA isolation and sodium bisulfite modification, methylation patterns were determined and correlated with standard clinic-histopathological parameters. Results CDH1 and SFN genes were methylated at high frequencies in bladder cancer as well as in paired normal adjacent tissue and exfoliated cells from cancer-free patients. Although no statistically significant differences were found between RARB and RASSF1A methylation and the clinical and histopathological parameters in bladder cancer, a sensitivity of 95% and a specificity of 71% were observed for RARB methylation (Fisher's Exact test (p RASSF1A gene, respectively, in relation to the control group. Conclusion Indistinct DNA hypermethylation of CDH1 and SFN genes between tumoral and normal urinary bladder samples suggests that these epigenetic features are not suitable biomarkers for urinary bladder cancer. However, RARB and RASSF1A gene methylation appears to be an initial event in urinary bladder carcinogenesis and should be considered as defining a panel of

  9. Annexin-A1 and caldesmon are associated with resistance to tamoxifen in estrogen receptor positive recurrent breast cancer

    NARCIS (Netherlands)

    T. de Marchi (Tommaso); A.M. Timmermans (Anne M.); M. Smid (Marcel); M.P. Look (Maxime); C. Stingl (Christoph); M. Opdam (Mark); S.C. Linn (Sabine); F.C. Sweep (Fred); P.N. Span (Paul); M. Kliffen (Mike); C.H.M. van Deurzen (Carolien); T.M. Luider (Theo); J.A. Foekens (John); J.W.M. Martens (John); A. Umar (Arzu)

    2016-01-01

    textabstractTamoxifen therapy resistance constitutes a major cause of death in patients with recurrent estrogen receptor (ER) positive breast cancer. Through high resolution mass spectrometry (MS), we previously generated a 4-protein predictive signature for tamoxifen therapy outcome in recurrent

  10. Photodynamic therapy trials with lutetium texaphyrin (Lu-Tex) in patients with locally recurrent breast cancer

    Science.gov (United States)

    Renschler, Markus F.; Yuen, Alan R.; Panella, Timothy J.; Wieman, Thomas J.; Dougherty, Shona; Esserman, Laura; Panjehpour, Masoud; Taber, Scott W.; Fingar, Victor H.; Lowe, Elizabeth; Engel, Julie S.; Lum, Bert; Woodburn, Kathryn W.; Cheong, Wai-Fung; Miller, Richard A.

    1998-05-01

    Photodynamic therapy (PDT) of locally recurrent breast cancer has been limited to treatment of small lesions because of non- selective necrosis of adjacent normal tissues in the treatment field. Lutetium Texaphyrin (PCI-0123, Lu-Tex) is a photosensitizer with improved tumor localization that is activated by 732 nm light, which can penetrate through larger tumors. We have evaluated Lu-Tex in a Phase I trial and in an ongoing Phase II trial in women with locally recurrent breast cancer with large tumors who have failed radiation therapy. Patients received Lu-Tex intravenously by rapid infusion 3 hours before illumination of cutaneous or subcutaneous lesions. In Phase I, Lu-Tex doses were escalated from 0.6 to 7.2 mg/kg in 7 cohorts. Sixteen patients with locally recurrent breast cancer lesions were treated. Dose limiting toxicities above 5.5 mg/kg were pain in the treatment field during therapy, and dysesthesias in light exposed areas. No necrosis of normal tissues in the treated field was noticed. Responses were observed in 60% of evaluable patients [n equals 15, 27% complete remission (CR), 33% partial remission (PR)], with 63% of lesions responding (n equals 73: 45% CR, 18% PR). In Phase II, 25 patients have been studied to date, receiving two treatments ranging from 1.0 to 3.0 mg/kg at a 21 day interval. Treatment fields up to 480 cm2 in size were treated successfully and activity has been observed. Patients have experienced pain at the treatment site but no tissue necrosis. These studies demonstrate the feasibility of Lu-Tex PDT to large chest wall areas in women who have failed radiation therapy for the treatment of locally recurrent breast cancer. Treatment conditions are currently being optimized in the ongoing Phase II trials.

  11. Fucoidan reduces the toxicities of chemotherapy for patients with unresectable advanced or recurrent colorectal cancer

    OpenAIRE

    Ikeguchi, Masahide; Yamamoto, Manabu; Arai, Yosuke; Maeta, Yoshihiko; Ashida, Keigo; Katano, Kuniyuki; Miki, Yasunari; Kimura, Takayuki

    2011-01-01

    Combination chemotherapy with oxaliplatin plus 5-fluorouracil/leucovorin (FOLFOX) or irinotecan plus 5-fluorouracil/leucovorin (FOLFIRI) has become a standard regimen for advanced or recurrent colorectal cancer. Numerous studies have reported that long-term use of FOLFOX or FOLFIRI leads to better survival for these patients. Thus, control of the toxicity of these drugs may be crucial to prolonging survival. Fucoidan is one of the major sulfated polysaccharides of brown seaweeds and exhibits ...

  12. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pellizzon, Antonio Cassio Assis, E-mail: acapellizzon@hcancer.org.br [A.C. Camargo Cancer Center, Sao Paulo, SP (Brazil). Departamento de Radioterapia

    2016-05-15

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. (author)

  13. Efficacy of intraperitoneal thermochemotherapy and immunotherapy in intraperitoneal recurrence after gastrointestinal cancer resection

    Institute of Scientific and Technical Information of China (English)

    Qing-Guo Fu; Fan-Dong Meng; Xiao-Dong Shen; Ren-Xuan Guo

    2002-01-01

    AIM: To investigate the prophylactic and therapeutic efficacy of intraperitoneal IL-2 immunotherapy following intraperitoneal thermochemotherapy in the metastasis and recurrence of gastric and colorectal cancer after operation.METHODS: Forty-two gastric cancer patients at T3Ⅱ-T4 ⅢB stages and 96 patients with colorectal cancer at B to D stages admitted from January1996 to October 1998 were randomly divided into control group (group Ⅰ, 65 cases) receiving intraperitoneal thermochemotherapy, and group Ⅱ (73cases) receiving both intraperitoneal thermochemotherapy andintraperitoneal IL-2 immunotherapy. Distilled water at 43-45℃ containing 5-Fu 0.5 g/L and MMC 8 mg/L was perfused into peritoneal cavity before closure at the end of operation for 1 h, and from the third day, IL-2 10 million IU in 500 ml 0.9 % sodium chloride was intraperitoneallyadministrated daily for 10 times. One month after operation, all the patients underwent regular intravenous chemotherapy. Before and after the IL-2 immunotherapy, some Th1 type cytokines in the peripheral blood of the patients in the two groups were detected by ELISA, and the intraperitoneal recurrence and liver metastasis rates and the 3-year survival rate were statistically evaluated after intensive follow-up. RESULTS: IL-2 intraperitoneal immunotherapy significantly elevated the level of some Th1 type cytokines (P<0.01compared with that of control group), and the 3-year survival rate of group Ⅱ was 18.1% higher and the rates of intraperitoneal recurrence and liver metastasis were 16.9 % and 6.0 % lower than those of group I significantly (P<0.05-0.01).CONCLUSION: The combination of intraperitoneal IL-2 immunotherapy and thermochemotherapy could promote Th1 immune paradigm and enforce anti-tumor activity of bodies, which plays a positive role in preventing gastric and colorectal cancer from intraperitoneal recurrence and development.

  14. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    Science.gov (United States)

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. PMID:27403021

  15. Boron neutron capture therapy for recurrent oral cancer and metastasis of cervical lymph node

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, Y. [Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan)], E-mail: ora018@poh.osaka-med.ac.jp; Ariyoshi, Y.; Shimahara, M. [Department of Dentistry and Oral Surgery, Division of Medicine for Function and Morphology of Sensory Organs, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan); Miyatake, S.; Kawabata, S. [Department of Neurosurgery, Division of Surgery, Osaka Medical College, 2-7 Daigaku-machi Takatsuki City, Osaka (Japan); Ono, K.; Suzuki, M. [Particle Radiation Oncology Research Center, Kyoto University, Kumatori-cho, Sennan-gun, Osaka (Japan); Maruhashi, A. [Medical Physics, Department of Radiation Life Sciences, Research Reactor Institute, Kyoto University, Kumatori-cho, Sennan-gun, Osaka (Japan)

    2009-07-15

    We treated 6 patients with recurrent oral cancer and metastasis to the cervical lymph nodes after conventional treatments in 5 and non-conventional in 1 using BNCT, and herein report our results. The clinical response in our patients ranged from CR to PD. In 5 cases, spontaneous pain decreased immediately after BNCT. Three of the 6 are alive at the time of writing and we found that BNCT contributed to QOL improvement in all.

  16. Treatment of platinum-resistant recurrent ovarian cancer using a "predictive molecule targeted routine chemotherapy" system

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-dong; WEI Feng-hua; ZHANG Yi; HE Shu-rong; YANG Li

    2009-01-01

    Background Correct drug selection, the key to successful chemotherapy, is one of the most difficult clinical decisions for the treatment of platinum-resistant recurrent ovarian cancer worldwide. The exact procedures for choosing drugs are undefined, currently relying on clinical trials and personal experience, which often results in disappointing outcomes. Here, we propose a new drug selection method, the "predictive molecule targeted routine chemotherapy", to choose relatively sensitive routine drugs and avoid relatively resistant routine drugs based on the specific predictive molecule expression of the individual tumor tissue.Methods From January 2004 to June 2008,26 cases of platinum-resistant recurrent ovarian cancer were prospectively recruited. Their routine chemotherapy drug choice was based on the expression of 6 predictive molecules (including p53) as determined by immunohistochemistry (the predictive molecule targeted routine chemotherapy group). A further 18 cases of platinum-resistant recurrent ovarian cancer were treated by experience and formed the control group. The response rate and the overall survival were compared between the two groups.Results The response rate to second-line chemotherapy was 28% in the control group and 77% in the predictive molecule targeted routine chemotherapy group (P=0.002). The response rate to third-line chemotherapy was 14% in the control group and 33% in the predictive molecule targeted routine chemotherapy group (P=0.268). The median overall survival of the predictive molecule targeted routine chemotherapy group (88 weeks) was significantly longer than the median overall survival of the control group (56 weeks) (P=0.0315).Conclusion The predictive molecule targeted routine chemotherapy is a new effective protocol for choosing drugs when treating platinum-resistant recurrent ovarian cancer.

  17. Predictive Factors for Local Recurrence and Incomplete Resection of Early Gastric Cancer Treated by Endoscopic Resection: A Western Experience

    Directory of Open Access Journals (Sweden)

    Fábio Yuji Hondo

    2009-01-01

    Full Text Available BACKGROUND: Early gastric cancer (EGC is defined as adenocarcinoma limited to the mucosa or submucosa regardless of lymph node involvement. Local EGC recurrence rates have been described in up to 6% of cases.

  18. [A successful treatment by surgery for axillary lymph node recurrence of lung cancer].

    Science.gov (United States)

    Oda, Goshi; Kobayashi, Toshiko; Yokosuka, Tetsuya; Yasuno, Masamichi

    2012-11-01

    This case concerns a 78-year-old man, who was diagnosed with lung cancer at the age of 73. He underwent right lobectomy and lymph node dissection, and pathological analysis revealed a poorly differentiated adenocarcinoma, pT1N0M0 pStage IA. 15 months after surgery, computed tomography showed recurrence of lung cancer at the apex of thoracic cavity. He underwent radiation to the recurrence site, and 33 months after surgery, fluorodeoxyglucose uptake was observed at the axillary and infraclavicular lymph nodes in positron emission tomography examination. Treatment with pemetrexed was started because carcinomatous pericarditis was also found. Although pericardial effusion disappeared, the patient complained of the enlarged size of the axillary and infraclavicular lymph nodes and severe numbness in an arm. Beyond lymph node involvement, no other metastatic sites were found. An operation was performed to relieve the pain and the pathological analysis of lymph nodes showed metastases of lung cancer. The operation successfully reduced the pain experienced by the patient. There has been no further recurrence in the 9 months following surgery. Axillary lymph node metastasis is thought to be a distant metastasis; however, this is a case where local control was needed and was effective.

  19. Dynamic prediction of risk of death using history of cancer recurrences in joint frailty models.

    Science.gov (United States)

    Mauguen, Audrey; Rachet, Bernard; Mathoulin-Pélissier, Simone; MacGrogan, Gaetan; Laurent, Alexandre; Rondeau, Virginie

    2013-12-30

    Evaluating the prognosis of patients according to their demographic, biological, or disease characteristics is a major issue, as it may be used for guiding treatment decisions. In cancer studies, typically, more than one endpoint can be observed before death. Patients may undergo several types of events, such as local recurrences and distant metastases, with death as the terminal event. Accuracy of clinical decisions may be improved when the history of these different events is considered. Thus, it may be useful to dynamically predict patients' risk of death using recurrence history. As previously applied within the framework of joint models for longitudinal and time to event data, we propose a dynamic prediction tool based on joint frailty models. Joint modeling accounts for the dependence between recurrent events and death, by the introduction of a random effect shared by the two processes. We estimate the probability of death between the prediction time t and a horizon t + w, conditional on information available at time t. Prediction can be updated with the occurrence of a new event. We proposed and compared three prediction settings, taking into account three different information levels. The proposed tools are applied to patients diagnosed with a primary invasive breast cancer and treated with breast-conserving surgery, followed for more than 10 years in a French comprehensive cancer center.

  20. Pre-Ablation Thyroglobulin Levels and Persistence / Recurrence Associated to Early Differentiated Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Arturo Mejía López

    2014-01-01

    Full Text Available Introduction: Differentiated thyroid cancer is the most frequent endocrine neoplasm in the world and its incidence is growing rapidly. The relationship between levels of pre-ablation thyroglobulin (Tg and early persistence/recurrence of differentiated thyroid cancer was studied. Materials and Methods: 91 patients with papillary thyroid cancer who underwent post-surgical ablation with radioactive iodine registered in the Fundacion Cardioinfantil between January 2006 and January 2010 were evaluated. The analysis of the results was performed using the SPSS statistical package and the research hypothesis was evaluated using nonparametric methods. Results: The disease progressed in 20 patients during the first year post-ablation, at the end of this period (p=0.000 a significant relationship between pre-ablation Tg and disease status was found. In the group of individuals by whom the disease progressed there was no significant change in Tg between the first and the second semester post-ablation (p = 0.554; there were no cases of recurrence/persistence in those with levels less than or equal to 2.7 ng/mL; 80 % of these cases involved individuals with initial levels higher than 24 ng/mL. Conclusion: In patients with papillary thyroid cáncer the serum pre-ablation Tg is related to the disease status at the end of the first year post-ablation. The persistence/recurrence is less frequent in low levels and more frequent in higher levels.

  1. Comparative analysis of methods for identifying recurrent copy number alterations in cancer.

    Directory of Open Access Journals (Sweden)

    Xiguo Yuan

    Full Text Available Recurrent copy number alterations (CNAs play an important role in cancer genesis. While a number of computational methods have been proposed for identifying such CNAs, their relative merits remain largely unknown in practice since very few efforts have been focused on comparative analysis of the methods. To facilitate studies of recurrent CNA identification in cancer genome, it is imperative to conduct a comprehensive comparison of performance and limitations among existing methods. In this paper, six representative methods proposed in the latest six years are compared. These include one-stage and two-stage approaches, working with raw intensity ratio data and discretized data respectively. They are based on various techniques such as kernel regression, correlation matrix diagonal segmentation, semi-parametric permutation and cyclic permutation schemes. We explore multiple criteria including type I error rate, detection power, Receiver Operating Characteristics (ROC curve and the area under curve (AUC, and computational complexity, to evaluate performance of the methods under multiple simulation scenarios. We also characterize their abilities on applications to two real datasets obtained from cancers with lung adenocarcinoma and glioblastoma. This comparison study reveals general characteristics of the existing methods for identifying recurrent CNAs, and further provides new insights into their strengths and weaknesses. It is believed helpful to accelerate the development of novel and improved methods.

  2. Cardiac Recurrence in a Patient with Long-Term Survival from Metastatic Colon Cancer

    Directory of Open Access Journals (Sweden)

    Annabelle Butler

    2012-04-01

    Full Text Available Metastatic colorectal cancer represents a major health problem in the US and worldwide. Forty percent of patients undergoing resection of the primary tumor will experience relapse. In this brief review, we describe a case of a woman with metastatic disease and long-term survival culminating with an unusual myocardial recurrence. Over three decades, a multimodality approach has evolved to allow for long-term survival in selected patients with metastatic colorectal cancer. In this case report, the role of multiple aggressive surgical resections is emphasized.

  3. [Ultrasonography and magnetic resonance imaging in diagnosing recurrent and metastatic ovarian cancer].

    Science.gov (United States)

    Bulanova, I M; Bulanova, T V; Burenchev, D V

    2006-01-01

    The paper deals with the capacities of ultrasonography (USG) and magnetic resonance imaging (MRI) in diagnosing recurrent and metastatic ovarian cancer along with routine clinical and laboratory studies (physical examination, measurement of the tumor-associated serum antigen CA-125) in 95 patients with ovarian cancer after primary special treatment. MRI is preferable to USG in evaluating the extent of a tumorous process and the invasion of a tumor into the adjacent tissues, which is of great value in defining a further treatment policy.

  4. Mucoadhesive Oral Wound Rinse in Preventing and Treating Stomatitis in Patients With ER- or PR-Positive Metastatic or Locally Recurrent Breast Cancer That Cannot be Removed by Surgery Receiving Everolimus

    Science.gov (United States)

    2016-09-07

    Estrogen Receptor-positive Breast Cancer; HER2-negative Breast Cancer; Oral Complications; Progesterone Receptor-positive Breast Cancer; Recurrent Breast Cancer; Stage IIIB Breast Cancer; Stage IIIC Breast Cancer; Stage IV Breast Cancer

  5. A Case of Recurrent Breast Cancer Identified by Pulmonary Tumor Thrombotic Microangiopathy

    Directory of Open Access Journals (Sweden)

    Tomomi Abe

    2017-07-01

    Full Text Available Pulmonary tumor thrombotic microangiopathy (PTTM is a rare, cancer-related, pulmonary complication that causes hypoxia and pulmonary hypertension. We report on a 42-year-old woman who was diagnosed with recurrent breast cancer that was detected due to the presence of PTTM. Eleven months after surgery for heterochronous bilateral cancer of the left breast, she developed progressive dyspnea but computerized tomography showed no pulmonary thromboembolism, and a transthoracic echocardiography revealed mild pulmonary hypertension. She was diagnosed with PTTM by cytology from pulmonary artery catheterization and perfusion lung scintigraphy. Also, the patients complained of back pain after admission, bone scintigraphy showed multiple bone metastases. Despite the early diagnosis of PTTM, her platelet count decreased, her performance status rapidly deteriorated, and her dyspnea worsened. Thus, we could not treat her with chemotherapy. She died due to respiratory failure 19 days after admission. To the best of our knowledge, this is the first report of recurrent breast cancer identified by the manifestation of PTTM. Although PTTM is a rare phenomenon, it should be considered in the differential diagnosis of acute dyspnea or pulmonary hypertension in patients with breast cancer. Furthermore, upon diagnosis, the patient should be referred to a cardiologist as soon as possible.

  6. The value of postoperative hepatic regional chemotherapy in prevention of recurrence after radical resection of primary liver cancer

    Institute of Scientific and Technical Information of China (English)

    Zhi Quan Wu; Jia Fan; Shuang Jian Qiu; Jian Zhou; Zhao You Tang

    2000-01-01

    @@ INTRODUCTION In China, primary liver cancer (PLC) ranks second in cancer mortality since the 1990s. In the field of PLC treatment, surgical resection remains the best,which includes large PLC resection, small PLC resection, re-resection of subclinical recurrence, as well as cytoreduction and sequential resection for unresectable PLC. However, recurrence and metastasis have become the major obstacles for further prolonging survival after resection.

  7. Comparison of cost-effectiveness of regorafenib and trifluridine/tipiracil combination tablet for treating advanced and recurrent colorectal cancer

    OpenAIRE

    Kimura, Michio; Usami, Eiseki; IWAI, MINA; Go, Makiko; TERAMACHI, HITOMI; YOSHIMURA, TOMOAKI

    2016-01-01

    Regorafenib and trifluridine/tipiracil combination tablet regimens are standard third-line or later treatments for advanced and recurrent colorectal cancer with no significant difference in efficacy. The present study aimed to compare the cost-effectiveness of using regorafenib vs. the trifluridine/tipiracil combination tablet. The expected cost was calculated based on data from patients with advanced and recurrent colorectal cancer who were treated with regorafenib or trifluridine/tipiracil ...

  8. Impact of the oncogenic status on the mode of recurrence in resected non-small cell lung cancer.

    Science.gov (United States)

    Mizuno, Tetsuya; Yatabe, Yasushi; Kuroda, Hiroaki; Sakakura, Noriaki; Sakao, Yukinori

    2016-10-01

    Surgical resection is employed in patients with resectable non-small cell lung cancer. Despite complete resection, recurrence is sometimes observed. Oncogenic mutations promote initiation and progression of lung cancer, and mutation status predicts treatment outcome of advanced non-small cell lung cancer; however, their impact on the recurrence patterns remains poorly understood. We retrospectively studied 401 patients showing recurrence after complete resection of non-small cell lung cancer. Clinicopathological factors were reviewed for time to recurrence, and recurrence patterns were compared according to oncogenic status and examined according to EGFR mutational subtype. Among 401 patients, 185 with EGFR mutation, 46 with KRAS mutation, 15 with ALK rearrangement and 155 with triple-negative mutation were identified. Multivariate analysis following univariate analyses showed that younger age, well-moderately-differentiated histology, earlier pathologic stage and presence of EGFR or ALK mutation were favorable prognostic factors for time to recurrence. Locoregional recurrence was observed in 53.3% of ALK-positive patients, being significantly common in these patients than in EGFR- and KRAS-positive patients. EGFR-positive patients mostly experienced pleural recurrence, the incidence of which was significantly higher in triple-negative mutation patients. Adrenal recurrence was observed in 7.2% of triple-negative mutation patients, but it was rarely identified in EGFR-positive patients. Among EGFR-positive patients, the incidence of brain metastases was significantly higher in L858R cohort than in Del Ex19 cohort. In resected non-small cell lung cancer, younger age, well-moderately-differentiated histology, earlier pathologic stage and presence of EGFR or ALK mutation were favorable factors for TTR, and distinct recurrence patterns were revealed according to oncogenic mutation status and mutational EGFR subtype. Our results may provide suggestions for developing a

  9. Recurrent HOXB13 mutations in the Dutch population do not associate with increased breast cancer risk.

    Science.gov (United States)

    Liu, Jingjing; Prager-van der Smissen, Wendy J C; Schmidt, Marjanka K; Collée, J Margriet; Cornelissen, Sten; Lamping, Roy; Nieuwlaat, Anja; Foekens, John A; Hooning, Maartje J; Verhoef, Senno; van den Ouweland, Ans M W; Hogervorst, Frans B L; Martens, John W M; Hollestelle, Antoinette

    2016-01-01

    The HOXB13 p.G84E mutation has been firmly established as a prostate cancer susceptibility allele. Although HOXB13 also plays a role in breast tumor progression, the association of HOXB13 p.G84E with breast cancer risk is less evident. Therefore, we comprehensively interrogated the entire HOXB13 coding sequence for mutations in 1,250 non-BRCA1/2 familial breast cancer cases and 800 controls. We identified two predicted deleterious missense mutations, p.G84E and p.R217C, that were recurrent among breast cancer cases and further evaluated their association with breast cancer risk in a larger study. Taken together, 4,520 familial non-BRCA1/2 breast cancer cases and 3,127 controls were genotyped including the cases and controls of the whole gene screen. The concordance rate for the genotyping assays compared with Sanger sequencing was 100%. The prostate cancer risk allele p.G84E was identified in 18 (0.56%) of 3,187 cases and 16 (0.70%) of 2,300 controls (OR = 0.81, 95% CI = 0.41-1.59, P = 0.54). Additionally, p.R217C was identified in 10 (0.31%) of 3,208 cases and 2 (0.087%) of 2,288 controls (OR = 3.57, 95% CI = 0.76-33.57, P = 0.14). These results imply that none of the recurrent HOXB13 mutations in the Dutch population are associated with breast cancer risk, although it may be worthwhile to evaluate p.R217C in a larger study.

  10. Long-term outcomes of ethanol injection therapy for locally recurrent papillary thyroid cancer.

    Science.gov (United States)

    Kim, Soo Young; Kim, Seok-Mo; Chang, Hojin; Kim, Bup-Woo; Lim, Chi Young; Lee, Yong Sang; Chang, Hang-Seok; Park, Cheong Soo

    2017-06-29

    The standard treatment regimen for locally recurrent lesions is total thyroidectomy, or complete removal of the recurrent thyroid lesion within the thyroid bed. However, reoperation increases the risk of complications and patients have to undergo general anesthesia. Percutaneous ethanol injection therapy represents a far less invasive procedure without general anesthesia and with lower risk of complications. Thirty-four patients who received PEIT at Yonsei University Medical Center between October 2002 and August 2009 for recurrent cervical nodal metastases of differentiated papillary thyroid cancer were included in this retrospective study. During a minimum follow-up of 60 months, treatment outcomes were determined by measuring the lesion size prior to the first injection and 3 months after the last injection. A total of 46 recurrent lesions were detected in 34 patients. Five patients underwent surgery and PEIT was administered to the remaining 19 and 22 lesions in the central compartment and lateral neck lymph nodes, respectively. Size increases were observed in seven (17.1%) lesions, whereas no changes in size and decreases were detected in 10 (24.4%) and 24 (58.5%) lesions. Patients with increased lymph nodes were significantly older (65.3 ± 14.4 vs. 48.2 ± 16.3 years; p = 0.02) and had smaller sizes (9.3 ± 1.0 vs. 12.3 ± 6.4 mm; p = 0.012). Although reoperation remains the first-line treatment for recurrent thyroid cancer, PEIT may be considered as a treatment option in selected patients with lesions larger than 1 cm who are ineligible for surgery or have refused reoperation.

  11. Risk of breast cancer recurrence in patients receiving manual lymphatic drainage: a hospital-based cohort study

    Directory of Open Access Journals (Sweden)

    Hsiao PC

    2015-02-01

    Full Text Available Pei-Chi Hsiao,1,2 Jung-Tai Liu,3 Chien-Liang Lin,4 Willy Chou,1,2 Shiang-Ru Lu5 1Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan; 2Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 3Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 4Department of Hematology and Oncology, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 5Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Background: This retrospective cohort study evaluated whether manual lymphatic drainage (MLD therapy increases the risk of recurrence of breast cancer. Methods: We analyzed 1,106 women who were diagnosed with stage 0­–3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The patients were divided into two groups: group A (n=996, in which patients did not participate in any MLD therapy, regardless of whether they developed breast cancer-related lymphedema (BCRL after cancer treatment; and group B (n=110, in which patients participated in MLD therapy for BCRL. All patients were monitored until October 2013 to determine whether breast cancer recurrence developed, including local or regional recurrence and distant metastasis. Patients who developed cancer recurrence prior to MLD therapy were excluded from analysis. Risk factors associated with cancer recurrence were evaluated using Cox proportional hazards models. Results: During the monitoring period, 166 patients (15.0% developed cancer recurrence, including 154 (15.5% in group A and 12 (10.9% in group B. The median period from surgery to cancer recurrence was 1.85 (interquartile range 1.18–2.93 years. Independent risk factors for cancer recurrence were tumor histological grading of grade 3, high number (≥3 of axillary lymph node invasion, and a large tumor size (>5 cm. Factors

  12. 3D radiation therapy or intensity-modulated radiotherapy for recurrent and metastatic cervical cancer: the Shanghai Cancer Hospital experience.

    Directory of Open Access Journals (Sweden)

    Su-Ping Liu

    Full Text Available We evaluate the outcomes of irradiation by using three-dimensional radiation therapy (3D-RT or intensity-modulated radiotherapy (IMRT for recurrent and metastatic cervical cancer. Between 2007 and 2010, 50 patients with recurrent and metastatic cervical cancer were treated using 3D-RT or IMRT. The median time interval between the initial treatment and the start of irradiation was 12 (6-51 months. Salvage surgery was performed before irradiation in 5 patients, and 38 patients received concurrent chemotherapy. Sixteen patients underwent 3D-RT, and 34 patients received IMRT. Median follow-up for all the patients was 18.3 months. Three-year overall survival and locoregional control were 56.1% and 59.7%, respectively. Three-year progression-free survival and disease-free survival were 65.3% and 64.3%, respectively. Nine patients developed grade 3 leukopenia. Grade 5 acute toxicity was not observed in any of the patients; however, 2 patients developed Grade 3 late toxicity. 3D-RT or IMRT is effective for the treatment of recurrent and metastatic cervical cancer, with the 3-year overall survival of 56.1%, and its complications are acceptable. Long-term follow-up and further studies are needed to confirm the role of 3D-RT or IMRT in the multimodality management of the disease.

  13. Early prediction of lung cancer recurrence after stereotactic radiotherapy using second order texture statistics

    Science.gov (United States)

    Mattonen, Sarah A.; Palma, David A.; Haasbeek, Cornelis J. A.; Senan, Suresh; Ward, Aaron D.

    2014-03-01

    Benign radiation-induced lung injury is a common finding following stereotactic ablative radiotherapy (SABR) for lung cancer, and is often difficult to differentiate from a recurring tumour due to the ablative doses and highly conformal treatment with SABR. Current approaches to treatment response assessment have shown limited ability to predict recurrence within 6 months of treatment. The purpose of our study was to evaluate the accuracy of second order texture statistics for prediction of eventual recurrence based on computed tomography (CT) images acquired within 6 months of treatment, and compare with the performance of first order appearance and lesion size measures. Consolidative and ground-glass opacity (GGO) regions were manually delineated on post-SABR CT images. Automatic consolidation expansion was also investigated to act as a surrogate for GGO position. The top features for prediction of recurrence were all texture features within the GGO and included energy, entropy, correlation, inertia, and first order texture (standard deviation of density). These predicted recurrence with 2-fold cross validation (CV) accuracies of 70-77% at 2- 5 months post-SABR, with energy, entropy, and first order texture having leave-one-out CV accuracies greater than 80%. Our results also suggest that automatic expansion of the consolidation region could eliminate the need for manual delineation, and produced reproducible results when compared to manually delineated GGO. If validated on a larger data set, this could lead to a clinically useful computer-aided diagnosis system for prediction of recurrence within 6 months of SABR and allow for early salvage therapy for patients with recurrence.

  14. PET/MRI and PET/CT in advanced gynaecological tumours: initial experience and comparison

    Energy Technology Data Exchange (ETDEWEB)

    Queiroz, Marcelo A.; Schulthess, Gustav von; Veit-Haibach, Patrick [University Hospital Zurich, Department Medical Radiology, Nuclear Medicine, Zurich (Switzerland); University Hospital Zurich, Department Medical Radiology, Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Zurich, Zurich (Switzerland); Kubik-Huch, Rahel A.; Freiwald-Chilla, Bianka [Kantonsspital Baden AG, Department of Radiology, Baden (Switzerland); Hauser, Nik [Kantonsspital Baden AG, Department of Gynaecology, Baden (Switzerland); Froehlich, Johannes M. [Guerbet AG, Zurich (Switzerland)

    2015-08-15

    To compare the diagnostic accuracy of PET/MRI and PET/CT for staging and re-staging advanced gynaecological cancer patients as well as identify the potential benefits of each method in such a population. Twenty-six patients with suspicious or proven advanced gynaecological cancer (12 ovarian, seven cervical, one vulvar and four endometrial tumours, one uterine metastasis, and one primary peritoneal cancer) underwent whole-body imaging with a sequential trimodality PET/CT/MR system. Images were analysed regarding primary tumour detection and delineation, loco-regional lymph node staging, and abdominal/extra-abdominal distant metastasis detection (last only by PET/CT). Eighteen (69.2 %) patients underwent PET/MRI for primary staging and eight patients (30.8 %) for re-staging their gynaecological malignancies. For primary tumour delineation, PET/MRI accuracy was statistically superior to PET/CT (p < 0.001). Among the different types of cancer, PET/MRI presented better tumour delineation mainly for cervical (6/7) and endometrial (2/3) cancers. PET/MRI for local evaluation as well as PET/CT for extra-abdominal metastases had therapeutic consequences in three and one patients, respectively. PET/CT detected 12 extra-abdominal distant metastases in 26 patients. PET/MRI is superior to PET/CT for primary tumour delineation. No differences were found in detection of regional lymph node involvement and abdominal metastases detection. (orig.)

  15. Lymphatic drainage from the treated versus untreated prostate: feasibility of sentinel node biopsy in recurrent cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vermeeren, Lenka; Valdes Olmos, Renato A. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Nuclear Medicine, Amsterdam (Netherlands); Meinhardt, Willem; Poel, Henk G. van der [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam (Netherlands)

    2010-11-15

    The goal of this study was to establish the feasibility of sentinel node biopsy in patients with recurrent prostate cancer after initial local treatment and to compare lymphatic drainage patterns of the treated versus untreated prostate. In ten patients with a proven local recurrence after initial local treatment (four external beam radiation, four brachytherapy and two high-intensity focused ultrasound), the radiotracer ({sup 99m}Tc-nanocolloid, GE Healthcare) was injected into the prostate. Planar images after 15 min and 2 h were followed by SPECT/CT (Symbia T, Siemens) to visualize lymphatic drainage. Laparoscopic sentinel lymphadenectomy was assisted by a gamma probe (Europrobe, EuroMedical Instruments) and a portable gamma camera (Sentinella, S102, Oncovision). Sentinel node identification and lymphatic drainage patterns were compared to a consecutive series of 70 untreated prostate carcinoma patients from our institute. Lymphatic drainage was visualized in all treated patients, with a median of 3.5 sentinel nodes per patient. Most sentinel nodes were localized in the pelvic area, although the percentage of patients with a sentinel node outside the pelvic para-iliac region (para-aortic, presacral, inguinal or near the ventral abdominal wall) was high compared to the untreated patients (80 versus 34%, p = 0.01). In patients with recurrent prostate cancer, 95% of the sentinel nodes could be harvested and half of the patients had at least one positive sentinel node on pathological examination. Lymphatic mapping of the treated prostate appears feasible, although sentinel nodes are more frequently found in an aberrant location. Larger trials are needed to assess the sensitivity and therapeutic value of lymphatic mapping in recurrent prostate cancer. (orig.)

  16. Novel recurrently mutated genes and a prognostic mutation signature in colorectal cancer

    Science.gov (United States)

    Yu, Jun; Wu, William K K; Li, Xiangchun; He, Jun; Li, Xiao-Xing; Ng, Simon S M; Yu, Chang; Gao, Zhibo; Yang, Jie; Li, Miao; Wang, Qiaoxiu; Liang, Qiaoyi; Pan, Yi; Tong, Joanna H; To, Ka F; Wong, Nathalie; Zhang, Ning; Chen, Jie; Lu, Youyong; Lai, Paul B S; Chan, Francis K L; Li, Yingrui; Kung, Hsiang-Fu; Yang, Huanming; Wang, Jun; Sung, Joseph J Y

    2015-01-01

    Background Characterisation of colorectal cancer (CRC) genomes by next-generation sequencing has led to the discovery of novel recurrently mutated genes. Nevertheless, genomic data has not yet been used for CRC prognostication. Objective To identify recurrent somatic mutations with prognostic significance in patients with CRC. Method Exome sequencing was performed to identify somatic mutations in tumour tissues of 22 patients with CRC, followed by validation of 187 recurrent and pathway-related genes using targeted capture sequencing in additional 160 cases. Results Seven significantly mutated genes, including four reported (APC, TP53, KRAS and SMAD4) and three novel recurrently mutated genes (CDH10, FAT4 and DOCK2), exhibited high mutation prevalence (6–14% for novel cancer genes) and higher-than-expected number of non-silent mutations in our CRC cohort. For prognostication, a five-gene-signature (CDH10, COL6A3, SMAD4, TMEM132D, VCAN) was devised, in which mutation(s) in one or more of these genes was significantly associated with better overall survival independent of tumor-node-metastasis (TNM) staging. The median survival time was 80.4 months in the mutant group versus 42.4 months in the wild type group (p=0.0051). The prognostic significance of this signature was successfully verified using the data set from the Cancer Genome Atlas study. Conclusions The application of next-generation sequencing has led to the identification of three novel significantly mutated genes in CRC and a mutation signature that predicts survival outcomes for stratifying patients with CRC independent of TNM staging. PMID:24951259

  17. Impact of FDG PET in optimizing patient selection for cytoreductive surgery in recurrent ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Ebina, Yasuhiko; Yamada, Hideto [Kobe University Graduate School of Medicine, Department of Obstetrics and Gynecology, Kobe (Japan); Watari, Hidemichi; Kaneuchi, Masanori; Takeda, Mahito; Hosaka, Masayoshi; Kudo, Masataka; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan)

    2014-03-15

    To investigate the impact of PET and PET/CT scanning on decision-making in management planning and to identify the optimal setting for selecting candidates for surgery in suspicious recurrent ovarian cancer. A retrospective chart review was performed in patients with possible recurrent ovarian cancer after primary optimal cytoreduction and taxane/carboplatin chemotherapy who had undergone FDG PET or FDG PET/CT scans from July 2002 to August 2008 to help make treatment decisions. The analysis included 44 patients who had undergone a total of 89 PET scans. The positive PET scans were classified as follows. (1) localized (one or two localized sites of FDG uptake), (2) multiple (three or more sites of FDG uptake), (3) diffuse (extensive low-grade activity outlining serosal and peritoneal surfaces). Of the 89 PET scans, 52 (58.4 %) led to a change in management plan. The total number of patients in whom cytoreductive surgery was selected as the treatment of choice increased from 12 to 35. Miliary disseminated disease, which was not detected by PET scan, was found in 22.2 % of those receiving surgery. Miliary disseminated disease was detected in 6 of the 12 patients with recurrent disease whose treatment-free interval (TFI) was <12 months, whereas none of those with a TFI of ≥12 months had such disease (P = 0.0031). PET or PET/CT is useful for selecting candidates for cytoreductive surgery among patients with recurrent ovarian cancer. To avoid surgical attempts in those with miliary dissemination, patients with a TFI of ≥12 months are the best candidates for cytoreductive surgery. (orig.)

  18. Loss of PTEN expression is associated with increased risk of recurrence after prostatectomy for clinically localized prostate cancer.

    Science.gov (United States)

    Chaux, Alcides; Peskoe, Sarah B; Gonzalez-Roibon, Nilda; Schultz, Luciana; Albadine, Roula; Hicks, Jessica; De Marzo, Angelo M; Platz, Elizabeth A; Netto, George J

    2012-11-01

    PTEN (phosphatase and tensin homolog on chromosome 10) is one of the most frequently lost tumor suppressor genes in human cancers and it has been described in more than two-thirds of patients with advanced/aggressive prostate cancer. Previous studies suggest that, in prostate cancer, genomic PTEN loss is associated with tumor progression and poor prognosis. Thus, we evaluated whether immunohistochemical PTEN expression in prostate cancer glands was associated with higher risk of recurrence, using a nested case-control study that included 451 men who recurred and 451 men who did not recur with clinically localized prostate cancer treated by radical prostatectomy. Recurrence was defined as biochemical recurrence (serum prostate-specific antigen >0.2 ng/ml) or clinical recurrence (local recurrence, systemic metastases, or prostate cancer-related death). Cases and controls were matched on pathological T stage, Gleason score, race/ethnicity, and age at surgery. Odds ratios of recurrence and 95% confidence intervals were estimated using conditional logistic regression to account for the matching factors and to adjust for year of surgery, preoperative prostate-specific antigen concentrations, and status of surgical margins. Men who recurred had a higher proportion of PTEN negative expression (16 vs 11%, P=0.05) and PTEN loss (40 vs 31%, P=0.02) than controls. Men with markedly decreased PTEN staining had a higher risk of recurrence (odds ratio=1.67; 95% confidence intervals 1.09, 2.57; P=0.02) when compared with all other men. In summary, in patients with clinically localized prostate cancer treated by prostatectomy, decreased PTEN expression was associated with an increased risk of recurrence, independent of known clinicopathological factors.

  19. Cervicovaginal cytology in the detection of recurrence after cervical cancer treatment.

    Science.gov (United States)

    Rimel, B J; Ferda, Aaron; Erwin, Jamie; Dewdney, Summer B; Seamon, Leigh; Gao, Feng; DeSimone, Christopher; Cotney, Kristen K; Huh, Warner; Massad, L Stewart

    2011-09-01

    To evaluate the utility of liquid-based cytology in detecting recurrent cervical cancer among treated cervical cancer patients. A retrospective multi-institution study identified patients treated for cervical cancer from January 1, 2000, to November 1, 2009, through local cancer registries and patient databases. Patients were excluded if they lacked follow-up or treatment data. In all, 4,167 cytology results from 929 women were identified. Of these, 626 (15%) Pap test results from 312 (34%) women were abnormal, including 296 atypical squamous cells of undetermined significance (ASC-US; 47%); 179 low-grade squamous intraepithelial lesions (LSIL; 29%), 59 atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions (ASC-H; 9%); 55 high-grade squamous intraepithelial lesions (HSIL; 9%); 14 atypical glandular cells (2%), and 23 favor neoplasia (4%). Abnormal Pap test results led to 201 colposcopies in 135 women. Only 45 women had cervical intraepithelial neoplasia (CIN) 2 or worse, 25 had CIN 3, and 12 had cancer. Only 5 of 475 (1%) women with ASC-US or LSIL had CIN 3. Cancer recurred in 147 women, with 12 (8.1%) detected by Pap test; all but one had Pap test results of ASC-H or worse. One patient with ASC-US and human papillomavirus had a visible lesion on return for assessment 2 months after Pap testing. Colposcopy for cytology less than HSIL without a visible lesion on examination did not detect any recurrence or CIN 3. When stratified by stage and institution, patients treated with radiation had a higher risk of abnormal Pap test results (P<.001). A third of cervical cancer survivors will have abnormal cytology during follow-up, but in the absence of a visible lesion, those with ASC-US or LSIL can be followed without colposcopy unless abnormalities persist. Women with ASC-H, HSIL, and similar abnormalities deserve colposcopy. II.

  20. Toward four-dimensional image-guided adaptive brachytherapy in locally recurrent endometrial cancer.

    Science.gov (United States)

    Fokdal, Lars; Ørtoft, Gitte; Hansen, Estrid S; Røhl, Lisbeth; Pedersen, Erik Morre; Tanderup, Kari; Lindegaard, Jacob Christian

    2014-01-01

    To evaluate clinical outcome and feasibility of a four-dimensional image-guided adaptive brachytherapy concept in patients with locally recurrent endometrial cancer. Forty-three patients with locally recurrent endometrial cancer were included. Treatment consisted of conformal external beam radiotherapy followed by a boost using pulsed-dose-rate brachytherapy (BT). Large tumors were treated with MRI-guided interstitial BT. Small tumors were treated with CT-guided intracavitary BT. The planning aim (total external beam radiotherapy and BT) for high-risk clinical target volume was D90 > 80 Gy, whereas constraints for organs at risk were D2cc ≤ 90 Gy for bladder and D2cc ≤ 70 Gy for rectum, sigmoid, and bowel in terms of equivalent dose in 2 Gy fractions. Median high-risk clinical target volume was 18 cm(3) (range, 0-91). D90 was 82 Gy (range, 77-88). D2cc to bladder, rectum, and sigmoid were 67 Gy (range, 50-81), 67 Gy (range, 51-77), and 55 Gy (range, 44-68), respectively. Median followup was 30 months (6-88). Two-year local control rate was 92% (standard error [SE], 5). Disease-free survival rate and overall survival rate was 59% (SE, 8) and 78% (SE, 7), respectively. Patients with low- to intermediate-risk for recurrence had a 2-year disease-free survival rate of 72% (SE, 9) compared with 42% (SE, 12) in patients with high risk for recurrence (p = 0.04). Late morbidity Grade 3 was recorded in 5 (12%) patients. Four-dimensional image-guided adaptive brachytherapy is feasible in locally recurrent endometrial cancer. Local control rate is good. Systemic control remains a problem in patients with high risk for recurrence. Copyright © 2014 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  1. ADOLESCENT GYNAECOLOGICAL PROBLEMS: A CLINICAL STUD Y

    Directory of Open Access Journals (Sweden)

    Archana

    2013-03-01

    Full Text Available ABSTRACT: OBJECTIVES (S : To study the type of gynaecological problems in ad olescents and its causative factors. METHOD(S : A total of 112 girls (13-18 years attending gyna ec OPD and emergency were included in the study. A detailed hi story and physical examination was done. Investigations like haemogram, coagulation profile, hormonal assays, sonography, karyotyping etc. were done as and when indicated. RESULT(S : Menstrual disorders were commonest gynaecological problems (74.1% followed by vaginal discharge (14.3% and ovarian tumours (4.5%. Menstrual abnormalities were in form of amenorrhoea 27/83 (32.5%, irregular menstruation 45/83 (54.2% and dysmenorrhoea 11/83( 13.3%. Dysfunctional uterine bleeding was the commonest cause of irregular menst ruation (28/45. Endocrinal abnormalities like hyperprolactinemia (4cases, and h ypothyroidism (3 cases were present among 21 cases of oligomenorrhoea. Teenage pregnancy was cause of secondary amenorrhoea in 9/20 cases. CONCLUSION(S : Menstrual abnormalities are the most common proble m of adolescents. Adolescent gynaecology needs increased awareness and greater attention in order to protect and promote the health of teenagers. This can perhaps best be done by setting up specialized adolescent clinics.

  2. Low-dose aspirin, non-steroidal anti-inflammatory drugs, selective COX-2 inhibitors and breast cancer recurrence

    DEFF Research Database (Denmark)

    Cronin-Fenton, Deirdre P; Heide-Jørgensen, Uffe; Ahern, Thomas P

    2016-01-01

    BACKGROUND: Aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), and selective COX-2 inhibitors may improve outcomes in breast cancer patients. We investigated the association of aspirin, NSAIDs, and use of selective COX-2 inhibitors with breast cancer recurrence. METHODS: We identified incident...... stage I-III Danish breast cancer patients in the Danish Breast Cancer Cooperative Group registry, who were diagnosed during 1996-2008. Prescriptions for aspirin (>99% low-dose aspirin), NSAIDs, and selective COX-2 inhibitors were ascertained from the National Prescription Registry. Follow-up began...... on the date of breast cancer primary surgery and continued until the first of recurrence, death, emigration, or 1 January 2013. We used Cox regression models to compute hazard ratios (HR) and corresponding 95% confidence intervals (95% CI) associating prescriptions with recurrence, adjusting for confounders...

  3. [Recurrence of esophageal cancer treated by combination TS-1/CDDP therapy].

    Science.gov (United States)

    Hiraki, Masatsugu; Yunotani, Seiji; Noguchi, Ryo; Shinozaki, Yukari; Tani, Hiroki; Sakai, Masashi; Ishimitsu, Toshiyuki; Tabuchi, Masanobu

    2005-02-01

    A 68-year-old man underwent subtotal esophagectomy with two fields lymphadenectomy and postoperative chemotherapy so called low dose FP therapy for advanced esophageal cancer (Stage IIIa, pT 3, pN 1, M 0) in October 1999. As he was diagnosed with a recurrence of esophageal cancer as metastatic lymph node tumors which were placed in the right anterocervical and supraclavicular region in March 2001, he underwent enucleation of metastatic lymph node tumors and postoperative chemoradiation therapy, so-called low-dose FP-R therapy. Recently, since other metastatic lymph node tumors in the neck appeared again in August 2001, he underwent radical neck lymph node dissection and postoperative chemoradiation treatment, so-called FAP-R therapy. In October 2003, a chest CT showed multiple lung tumors. He was diagnosed with multiple metastatic lung tumors originating from esophageal cancer. Then, two courses of a combined chemotherapy consisting of TS-1 and CDDP were administered at an interval of one month. We judged the effect of this chemotherapy to be a partial response (PR), because the largest metastatic lung tumor 18 mm in diameter showed a reduction rate of 81.9%, and other tumors had almost disappeared in the chest CT after the combined therapy. No severe adverse effects of more than grade 3 were observed during this combined therapy. This combined chemotherapy consisting of TS-1 and CDDP may prove effective for treating recurrent cases of esophageal cancer.

  4. Implication of human telomerase reverse transcriptase in cervical carcinogenesis and cancer recurrence.

    Science.gov (United States)

    Wang, P-H; Ko, J-L

    2006-01-01

    The objective of this study was to evaluate the implication of human telomerase reverse transcriptase (hTERT) in cervical carcinogenesis and cancer recurrence. One hundred three cases of uterine cervix, including 20 normal, 13 low-grade squamous intraepithelial lesion (LSIL), 30 high-grade squamous intraepithelial lesion (HSIL), and 40 squamous cell carcinoma (SCC) tissues, were evaluated for hTERT immunoreactivity. The expressions of hTERT in normal, LSIL, HSIL, and SCC tissues were compared by Fisher exact or Chi-square test. The relationships between hTERT and clinicopathologic variables of SCC were also assessed. Furthermore, SCC patients were subdivided into negative and positive hTERT expression subgroups, and Kaplan-Meier curves were used to plot the cumulative recurrence hazard for 5 years. There was a significant difference for hTERT expression between LSIL and HSIL subgroups (P recurrence hazard for 5 years was about 29% in positive hTERT expression subgroup compared to 0% in negative hTERT subgroup (P = 0.2866). In conclusion, a point stage of HSIL exists in the progression of cervical carcinogenesis when the hTERT expression increases significantly. Moreover, SCC patients with positive hTERT expression may have higher cumulative recurrence hazard.

  5. Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer.

    Science.gov (United States)

    Yamashita, Hiroko; Ogiya, Akiko; Shien, Tadahiko; Horimoto, Yoshiya; Masuda, Norikazu; Inao, Touko; Osako, Tomofumi; Takahashi, Masato; Endo, Yumi; Hosoda, Mitsuchika; Ishida, Naoko; Horii, Rie; Yamazaki, Kieko; Miyoshi, Yuichiro; Yasojima, Hiroyuki; Tomioka, Nobumoto

    2016-11-01

    Most studies analyzing prognostic factors for late relapse have been performed in postmenopausal women who received tamoxifen or aromatase inhibitors as adjuvant endocrine therapy for estrogen receptor (ER)-positive breast cancer. A total of 223 patients (108 premenopausal and 115 postmenopausal) with early distant recurrence and 149 patients (62 premenopausal and 87 postmenopausal) with late distant recurrence of ER-positive, HER2-negative breast cancer who were given their initial treatment between 2000 and 2004 were registered from nine institutions. For each late recurrence patient, approximately two matched control patients without relapse for more than 10 years were selected. Clinicopathological factors and adjuvant therapies were compared among the three groups by menopausal status and age. Factors predicting early recurrence in premenopausal women were large tumor size, high lymph node category and high tumor grade, whereas predictors for late recurrence were large tumor size and high lymph node category. In postmenopausal women under 60 years of age, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, low PgR expression and high Ki67 labeling index (LI), while predictors for late recurrence were large tumor size and high lymph node category. On the other hand, in postmenopausal women aged 60 years or older, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, high tumor grade, low ER expression and high Ki67 LI, whereas predictors for late recurrence were high lymph node category, low ER expression and short duration of adjuvant endocrine therapy. Predictors of early and late distant recurrence might differ according to menopausal status and age.

  6. Paclitaxel and Carboplatin or Ifosfamide in Treating Patients With Newly Diagnosed Persistent or Recurrent Uterine, Ovarian, Fallopian Tube, or Peritoneal Cavity Cancer

    Science.gov (United States)

    2014-12-23

    Ovarian Carcinosarcoma; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Ovarian Cancer; Stage IA Fallopian Tube Cancer; Stage IA Ovarian Cancer; Stage IA Uterine Sarcoma; Stage IB Fallopian Tube Cancer; Stage IB Ovarian Cancer; Stage IB Uterine Sarcoma; Stage IC Fallopian Tube Cancer; Stage IC Ovarian Cancer; Stage IC Uterine Sarcoma; Stage II Ovarian Cancer; Stage IIA Fallopian Tube Cancer; Stage IIA Ovarian Cancer; Stage IIA Uterine Sarcoma; Stage IIB Fallopian Tube Cancer; Stage IIB Ovarian Cancer; Stage IIB Uterine Sarcoma; Stage IIC Fallopian Tube Cancer; Stage IIC Ovarian Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Sarcoma; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Sarcoma; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Sarcoma; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

  7. Salvage high-dose-rate brachytherapy for isolated vaginal recurrence of endometrial cancer.

    Science.gov (United States)

    Baek, Sungjae; Isohashi, Fumiaki; Yamaguchi, Hiroko; Mabuchi, Seiji; Yoshida, Ken; Kotsuma, Tadayuki; Yamazaki, Hideya; Tanaka, Eiichi; Sumida, Iori; Tamari, Keisuke; Otani, Keisuke; Seo, Yuji; Suzuki, Osamu; Yoshioka, Yasuo; Kimura, Tadashi; Ogawa, Kazuhiko

    We have retrospectively analyzed the outcomes of high-dose-rate (HDR) brachytherapy as a salvage therapy for vaginal recurrence of endometrial cancer. From 1997 to 2012, salvage HDR brachytherapy was performed in 43 patients. The median age was 64 years (range, 41-88 years). HDR brachytherapy was performed by interstitial brachytherapy in 34 patients (79%) and by intracavity brachytherapy in nine patients (21%). Seventeen (40%) of the 43 patients were treated with external beam radiotherapy. The median followup period was 58 months (range, 6-179 months). The 5-year overall survival (OS), progression-free survival (PFS), and local control rates (LC) were 84%, 52%, and 78%, respectively. Patients who received brachytherapy with external beam radiotherapy experienced no nodal recurrence (0 of 17 patients), whereas 23% of the patients (6 of 26 patients) who received brachytherapy alone experienced nodal recurrence (p = 0.047). The pathologic grade at the time of initial surgery (G1-2 vs. G3) was found to be a significant prognostic factor for both OS and PFS. The respective 5-year OS was 96% vs. 40% (p endometrial cancer. Pathologic grade, age, and modality were significant prognostic factors. Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.

  8. Magnetic resonance imaging for localization of prostate cancer in the setting of biochemical recurrence.

    Science.gov (United States)

    Panebianco, Valeria; Barchetti, Flavio; Grompone, Marcello Domenico; Colarieti, Anna; Salvo, Vincenzo; Cardone, Gianpiero; Catalano, Carlo

    2016-07-01

    The clinical suspicion of local recurrence of prostate cancer after radical treatment is based on the onset of biochemical failure. The use of multiparametric magnetic resonance imaging (MRI) for prostate cancer has increased over recent years, mainly for detection, staging, and active surveillance. However, suspicion of recurrence in the set of biochemical failure is becoming a significant reason for clinicians to request multiparametric MRI. Radiologists should be able to recognize the normal posttreatment MRI findings. Fibrosis and atrophic remnant seminal vesicles (SV) after radical prostatectomy are often found and must be differentiated from local relapse. Moreover, brachytherapy, external beam radiotherapy, and focal therapies tend to diffusely decrease the signal intensity of the peripheral zone on T2-weighted images due to the loss of water content, consequently mimicking tumor and hemorrhage. The combination of T2-weighted images and functional studies like diffusion-weighted imaging and dynamic contrast-enhanced imaging improves the identification of local relapse. Tumor recurrence tends to restrict on diffusion images and avidly enhances after contrast administration. The authors provide a review of the normal findings and the signs of local tumor relapse after radical prostatectomy, external beam radiotherapy, brachytherapy and focal therapies. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Individual risk profiling for breast cancer recurrence: towards tailored follow-up schemes.

    Science.gov (United States)

    Kraeima, J; Siesling, S; Vliegen, I M H; Klaase, J M; IJzerman, M J

    2013-08-20

    Breast cancer follow-up is not tailored to the risk of locoregional recurrences (LRRs) in individual patients or as a function of time. The objective of this study was to identify prognostic factors and to estimate individual and time-dependent LRR risk rates. Prognostic factors for LRR were identified by a scoping literature review, expert consultation, and stepwise multivariate regression analysis based on 5 years of data from women diagnosed with breast cancer in the Netherlands in 2005 or 2006 (n=17,762). Inter-patient variability was elucidated by examples of 5-year risk profiles of average-, medium-, and high-risk patients, whereby 6-month interval risks were derived from regression estimates. Eight prognostic factors were identified: age, tumour size, multifocality, gradation, adjuvant chemo-, adjuvant radiation-, hormonal therapy, and triple-negative receptor status. Risk profiles of the low-, average-, and high-risk example patients showed non-uniform distribution of recurrence risks (2.9, 7.6, and 9.2%, respectively, over a 5-year period). Individual risk profiles differ substantially in subgroups of patients defined by prognostic factors for recurrence and over time as defined in 6-month time intervals. To tailor follow-up schedules and to optimise allocation of scarce resources, risk factors, frequency, and duration of follow-up should be taken into account.

  10. CD147 expression in human gastric cancer is associated with tumor recurrence and prognosis.

    Directory of Open Access Journals (Sweden)

    Dake Chu

    Full Text Available CD147 is correlated with tumor aggressiveness in various human malignancies. Here, we investigated CD147 protein expression in 223 patients with gastric cancer by immunohistochemistry and analyzed its association with disease-free and overall survival. CD147 was increased in gastric cancer compared to normal tissues. Additionally, CD147 expression was associated with gastric cancer invasion, metastasis and TNM stage, whereas it was not related to age, sex, differentiation status, tumor site or Lauren classification. Kaplan-Meier analysis confirmed that CD147 was associated with disease-free and overall survival in patients with gastric cancer; i.e., patients with positive CD147 staining tend to have worse disease-free and overall survival. Moreover, Cox's proportional hazards analysis demonstrated that CD147 was an independent marker of disease-free and overall survival for patients with gastric cancer. These results confirm the association of CD147 with gastric cancer invasion and metastasis and prove that CD147 might be an indicator of tumor recurrence and prognosis in gastric cancer.

  11. CD147 expression in human gastric cancer is associated with tumor recurrence and prognosis.

    Science.gov (United States)

    Chu, Dake; Zhu, Shaojun; Li, Jipeng; Ji, Gang; Wang, Weizhong; Wu, Guosheng; Zheng, Jianyong

    2014-01-01

    CD147 is correlated with tumor aggressiveness in various human malignancies. Here, we investigated CD147 protein expression in 223 patients with gastric cancer by immunohistochemistry and analyzed its association with disease-free and overall survival. CD147 was increased in gastric cancer compared to normal tissues. Additionally, CD147 expression was associated with gastric cancer invasion, metastasis and TNM stage, whereas it was not related to age, sex, differentiation status, tumor site or Lauren classification. Kaplan-Meier analysis confirmed that CD147 was associated with disease-free and overall survival in patients with gastric cancer; i.e., patients with positive CD147 staining tend to have worse disease-free and overall survival. Moreover, Cox's proportional hazards analysis demonstrated that CD147 was an independent marker of disease-free and overall survival for patients with gastric cancer. These results confirm the association of CD147 with gastric cancer invasion and metastasis and prove that CD147 might be an indicator of tumor recurrence and prognosis in gastric cancer.

  12. Prognostic factors of tumor recurrence in completely resected non-small cell lung cancer

    Directory of Open Access Journals (Sweden)

    Tantraworasin A

    2013-06-01

    Full Text Available Apichat Tantraworasin,1 Somcharean Seateang,1 Nirush Lertprasertsuke,2 Nuttapon Arreyakajohn,3 Choosak Kasemsarn,4 Jayanton Patumanond5 1General Thoracic Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand; 2Department of Pathology, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand; 3Cardiovascular Thoracic Unit, Department of Surgery, Lampang Hospital, Lampang, Thailand; 4Cardiovascular Thoracic Unit, Department of Surgery, Chest Institute, Nonthaburi, Thailand; 5Department of Community Medicine, Faculty of Medicine, Chiang Mai University Hospital, Chiang Mai, Thailand Background: Patients with completely resected non-small cell lung cancer (NSCLC have an excellent outcome; however tumor recurs in 30%-77% of patients. This study retrospectively analyzed the clinicopathologic features of patients with any operable stage of NSCLC to identify the prognostic factors that influence tumor recurrence, including intratumoral blood vessel invasion (IVI, tumor size, tumor necrosis, and nodal involvement. Methods: From January 2002 to December 2011, 227 consecutive patients were enrolled in this study. They were divided into two groups: the “no recurrence” group and the “recurrence” group. Recurrence-free survival was analyzed by multivariable Cox regression analysis, stratified by tumor staging, chemotherapy, and lymphatic invasion. Results: IVI, tumor necrosis, tumor diameter more than 5 cm, and nodal involvement were identified as independent prognostic factors of tumor recurrence. The hazard ratio (HR of patients with IVI was 2.1 times higher than that of patients without IVI (95% confident interval [CI]: 1.4–3.2 (P = 0.001.The HR of patients with tumor necrosis was 2.1 times higher than that of patients without tumor necrosis (95% CI: 1.3–3.4 (P = 0.001. Patients who had a maximum tumor diameter greater than 5 cm had significantly higher risk of recurrence than

  13. Identification and validation of a multigene predictor of recurrence in primary laryngeal cancer.

    Directory of Open Access Journals (Sweden)

    Elena Fountzilas

    Full Text Available PURPOSE: Local recurrence is the major manifestation of treatment failure in patients with operable laryngeal carcinoma. Established clinicopathological factors cannot sufficiently predict patients that are likely to recur after treatment. Additional tools are therefore required to accurately identify patients at high risk for recurrence. This study attempts to identify and independently validate gene expression models, prognostic of disease-free survival (DFS in operable laryngeal cancer. MATERIALS AND METHODS: Using Affymetrix U133A Genechips, we profiled fresh-frozen tumor tissues from 66 patients with laryngeal cancer treated locally with surgery. We applied Cox regression proportional hazards modeling to identify multigene predictors of recurrence. Gene models were then validated in two independent cohorts of 54 and 187 patients (fresh-frozen and formalin-fixed tissue validation sets, respectively. RESULTS: We focused on genes univariately associated with DFS (p<0.01 in the training set. Among several models comprising different numbers of genes, a 30-probe set model demonstrated optimal performance in both the training (log-rank, p<0.001 and 1(st validation (p=0.010 sets. Specifically, in the 1(st validation set, median DFS as predicted by the 30-probe set model, was 34 and 80 months for high- and low-risk patients, respectively. Hazard ratio (HR for recurrence in the high-risk group was 3.87 (95% CI 1.28-11.73, Wald's p=0.017. Testing the expression of selected genes from the above model in the 2(nd validation set, with qPCR, revealed significant associations of single markers, such as ACE2, FLOT1 and PRKD1, with patient DFS. High PRKD1 remained an unfavorable prognostic marker upon multivariate analysis (HR=2.00, 95% CI 1.28-3.14, p=0.002 along with positive nodal status. CONCLUSIONS: We have established and validated gene models that can successfully stratify patients with laryngeal cancer, based on their risk for recurrence. It seems

  14. Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging.

    Science.gov (United States)

    Panebianco, Valeria; Barchetti, Flavio; Sciarra, Alessandro; Musio, Daniela; Forte, Valerio; Gentile, Vincenzo; Tombolini, Vincenzo; Catalano, Carlo

    2013-06-01

    To validate the role of 3-T diffusion-weighted imaging (DWI) in the detection of local prostate cancer recurrence after radical prostatectomy (RP). T2-weighted imaging, DWI and dynamic contrast-enhanced MRI (DCE-MRI) were performed with a 3-T magnet in 262 patients after RP. Twenty out of 262 patients evaluated were excluded. MRI results were validated by prostate-specific antigen (PSA) reduction after external beam radiotherapy in group A (126 patients, local recurrence size range 4-8 mm) and by transrectal ultrasound biopsy in group B (116 patients, local recurrence size range 9-15 mm). In group A combined T2-weighted and DCE-MRI (T2+DCE) shows 98 % sensitivity, 94 % specificity and 93 % accuracy in identifying local recurrence; combined T2-weighted and DWI with a b value of 3,000 s/mm(2) (T2+DW3) displays 97 % sensitivity, 95 % specificity and 92 % accuracy, while with a b value of 1,000 s/mm(2) (T2+DW1) affords 93 % sensitivity, 89 % specificity and 88 % accuracy. In group B T2+DCE shows 100 % sensitivity, 97 % specificity and 91 % accuracy in detecting local cancer recurrence; T2+DW3 displays 98 % sensitivity, 96 % specificity and 89 % accuracy; T2+DW1 has 94 % sensitivity, 92 % specificity and 86 % accuracy. DCE-MRI is the most reliable technique in detecting local prostate cancer recurrence after RP, though DWI can be proposed as a reliable alternative. • Diffusion-weighted magnetic resonance imaging (DWI-MRI) is being increasingly used in oncology. • PSA analysis does not distinguish prostate cancer recurrence from distant metastasis. • DWI-MR can diagnose local prostate cancer recurrence after radical prostatectomy. • DWI-MR is almost comparable to DCE-MRI in detecting local recurrence.

  15. [18F]Fluorodeoxyglucose (FDG)-Positron Emission Tomography (PET)/Computed Tomography (CT) in Suspected Recurrent Breast Cancer

    DEFF Research Database (Denmark)

    Hildebrandt, Malene Grubbe; Gerke, Oke; Baun, Christina;

    2016-01-01

    PURPOSE: To prospectively investigate the diagnostic accuracy of [(18)F]fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) with dual-time-point imaging, contrast-enhanced CT (ceCT), and bone scintigraphy (BS) in patients with suspected breast cancer recurrence....... PATIENTS AND METHODS: One hundred women with suspected recurrence of breast cancer underwent 1-hour and 3-hour FDG-PET/CT, ceCT, and BS within approximately 10 days. The study was powered to estimate the precision of the individual imaging tests. Images were visually interpreted using a four...... the receiver operating curve and higher sensitivity, specificity, and superior likelihood ratios. CONCLUSION: FDG-PET/CT was accurate in diagnosing recurrence in breast cancer patients. It allowed for distant recurrence to be correctly ruled out and resulted in only a small number of false-positive cases...

  16. Loss of signal transducer and activator of transcription 1 is associated with prostate cancer recurrence.

    Science.gov (United States)

    Hatziieremia, Sophia; Mohammed, Zahra; McCall, Pamela; Willder, Jennifer M; Roseweir, Antonia K; Underwood, Mark A; Edwards, Joanne

    2016-11-01

    STAT1 loss has previously been implicated in cell line studies to modify prostate cancer cell growth and survival, however the clinical significance of this has not previously been established. This study investigated if STAT1 loss was associated with patient outcome measures and the phenotypic consequence of STAT1 silencing. STAT1 expression was assessed in two patient cohorts with localised (n = 78) and advanced prostate cancer at initial diagnosis (n = 39) by immunohistochemistry (IHC). Impact of STAT1 silencing on prostate cancer cells lines was assessed using Cell Death detection ELISA, TLDA gene signature apoptosis arrays, WST-1 assay, xCELLigence system, clonogenic assay, and wound healing assay. In the localised patient cohort, low expression of STAT1 was associated with shorter time to disease recurrence (3.8 vs 7.3 years, P = 0.02) and disease specific survival (6.6 vs 9.3 years, P = 0.05). In the advanced patient cohort, low expression was associated with shorter time to disease recurrence (2.0 vs 3.9 years, P = 0.001). When STAT1 was silenced in PC3 cells (AR negative) and LNCaP cells (AR positive) silencing did not influence levels of apoptosis in either cell line and had little effect on cell viability in the LNCaP cells. In contrast, STAT1 silencing in the PC3 cells resulted in a pronounced increase in cell viability (WST-1 assay: mock silenced vs STAT1 silenced, P < 0.001), clonagenicity (clonogenic assay: mock silenced vs STAT1 silenced, P < 0.001), and migration (wound healing: mock silenced vs STAT1 silenced, P < 0.001). In conclusion, loss of STAT1 may promote prostate cancer recurrence in AR negative patients via increasing cell viability. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

  17. Clinical evaluation of intra-arterial infusion chemoradiotherapy for advanced or recurrent cervical cancer

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    Kaneyasu, Yuko; Fukuhara, Noboru; Karasawa, Kumiko; Isobe, Madoka; Himei, Kengo; Kojima, Nahoko; Toda, Jo; Okawa, Tomohiko [Tokyo Women`s Medical Coll. (Japan); Kita, Midori

    1999-01-01

    Fifty two patients with advanced or recurrent cervical cancer were treated by intraarterial infusion chemotherapy (IAIC) with or without radiotherapy. IAIC regimen was separated into two groups: group I consisted of 5-FU+MMC{+-}ADR (30 patients) and group II consisted of CDDP+MMC{+-}5-FU (22 patients). The tip of the catheter was placed in the bifurcation of abdominal aorta or the bilateral internal iliac arteries (7 patients). Overall response rate (CR+PR) was 71% for all patients, 87% in patients who received radiotherapy, 50% in those not receiving radiotherapy, and 100% in primary patients. Five-year survival rate was 20% in primary patients, 14% in recurrent patients, 3% in group I and 38% in group II (p=0.00182) by chemotherapy regimen, 30% in CR patients, and 13% in non-CR patients (p=0.00436), respectively. Acute hematological side effects of grade III-IV was 48% for all patients, but recovered from by interruption of drugs. Among the 7 patients which the tip of the catheter was placed in internal iliac arteries, there were severe skin ulcers in 2 cases, and severe leg or gluteal region pain, for which narcotics were needed in 2 patients. These data suggest that IAIC mainly with cisplatin with or without radiotherapy was not particularly effective treatment for advanced cervical cancer, but it might be one of the effective treatment for residual cervical cancer after surgery and recurrent cervical cancer once the patient has obtained CR. One should check the blood flow distribution periodically, and control the concentration of drugs. In order to improve prognosis of these patients, one should furthermore consider a combination of IAIC and systemic chemotherapy. (author)

  18. Re-irradiation for recurrent and second primary cancers of the head and neck.

    Science.gov (United States)

    Velez, Maria A; Veruttipong, Darlene; Wang, Pin-Chieh; Chin, Robert; Beron, Philip; Abemayor, Elliot; St John, Maie; Chen, Allen M

    2017-04-01

    To evaluate a single-institutional experience with the use of re-irradiation for recurrent and new primary cancers of the head and neck. The medical charts of 80 consecutive patients who underwent re-irradiation for local-regionally recurrent or second primary head and neck cancer between November 1998 and December 2015 were analyzed. Multivariate analysis was performed using Cox proportional hazard and logistic regression to determine predictors of clinical outcomes. Seventy-six of the 80 patients were evaluable. The median age was 57.5 (range 26.6-84.9); Intensity-modulated radiotherapy (IMRT) was used in 71 (93.4%) patients with a median dose of 60Gy. Thirty-one patients (40.8%) underwent salvage surgery before re-irradiation and 47 (61.8%) received concurrent systemic therapy. The median time interval between radiation courses was 25.3months (range 2-322months). The 2-year estimates of overall survival, progression free survival, locoregional control, and distant control were 51.0%, 31.3%, 36.8% and 68.3%, respectively. Patients who underwent salvage surgery prior to re-irradiation had significantly improved locoregional control, progression free survival, and overall survival (p<0.05, for all). On multivariate analysis, gross tumor volume (GTV) at re-irradiation and interval between radiation courses were associated with improved overall survival. Severe (grade⩾3) late complications were observed in 25 patients (32.8%). Re-irradiation for recurrent or second primary head and neck cancer is feasible and effective in select patients with head and neck cancer. The high observed rate of treatment-related morbidity highlights the continue challenges that accompany this approach. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Prognostic factors for post-recurrence survival in patients with completely resected Stage I non-small-cell lung cancer.

    Science.gov (United States)

    Song, In Hag; Yeom, Sung Won; Heo, Seohee; Choi, Won Suk; Yang, Hee Chul; Jheon, Sanghoon; Kim, Kwhanmien; Cho, Sukki

    2014-02-01

    The clinical course from recurrence to cancer-related death after curative resection has not been clearly elucidated in non-small-cell lung cancer (NSCLC). This study examined the clinical outcomes after postoperative recurrence in patients with completely resected Stage I NSCLC. This study included patients who had recurrence after complete resection for pathological Stage I NSCLC between 2003 and 2009. Clinical data evaluated in this study included the diagnostic process of recurrence, recurrence pattern, treatment process and prognosis. A number of clinicopathological factors were analysed for post-recurrence survival by univariate and multivariate analyses. Seventy-two patients experienced recurrence during a median follow-up period of 37.5 months. Thirteen patients (18%) presented symptoms at the initial recurrence. Tumour markers, computed tomography (CT) and positron emission tomography/CT were chosen as the initial diagnostic tools and detected recurrences in 1 (1%), 51 (71%) and 7 (10%) patients, respectively. The mean recurrence-free interval (RFI) was 15.4 months (≤12 months in 34, >12 months in 38 patients). The patterns of recurrence were presented as loco-regional recurrence in 36 (50%) and distant metastasis in 36 patients (50%). Types of the initial treatment included operations in 28 (39%), chemotherapy and/or radiotherapy in 38 (53%) and radiofrequency ablation in 2 patients (3%). Four patients (6%) rejected treatment. Forty-three patients (62%) presented a good response to the initial treatment. Thirty-seven patients (51%) died, and the cause of death in all of these patients was cancer-related. The median survival duration after recurrence was 43.6 (1-136) months. Univariate analysis identified no recurrence of symptoms, a good response to treatment and a longer RFI as good prognostic factors, while a good response to treatment and a longer RFI were independent prognostic factors in multivariate analysis. Most postoperative recurrences were

  20. Identification of subsets of patients with favorable prognosis after recurrence in completely resected non-small cell lung cancer.

    Science.gov (United States)

    Sonobe, Makoto; Yamada, Tetsu; Sato, Masaaki; Menju, Toshi; Aoyama, Akihiro; Sato, Toshihiko; Chen, Fengshi; Omasa, Mitsugu; Bando, Toru; Date, Hiroshi

    2014-08-01

    This retrospective study aimed to determine prognostic factors associated with postrecurrence survival of completely resected non-small cell cancer patients with postoperative recurrence. Characteristics, treatment modality, and postrecurrence survival of 234 patients (157 males and 77 females, mean age at recurrence: 68.7 years, 152 adenocarcinomas and 82 non-adenocarcinomas), who underwent complete resection for non-small cell lung cancer between 2003 and 2009 at our hospital and experienced recurrence, were analyzed for prognostic factors. Cox proportional hazard model was applied for multivariate analysis. Among 234 patients, the median survival time after the diagnosis of recurrence was 21 months, and the 5-year postrecurrence survival rate was 19.9 %. Eastern Cooperative Oncology Group Performance Status (ECOG PS) (hazard ratio [HR]: ECOG PS-0/PS-1/PS-2 = 1/3.313/7.622), time to recurrence after surgery (HR: >2 years/1-2 years/recurrent organs (HR: 1 organ/2 organs/3 or more organs = 1/1.896/2.818) were independent prognostic factors. Patients who received resection or stereotactic irradiation for limited number of brain metastases or solitary extracranial metastasis, and those who received mediastinal radiation or chemoradiation for recurrence at regional lymph nodes and/or resected stump had better survival (median survival time after recurrence: 34, 64, and 25 months, respectively). Poor ECOG PS, shorter time from initial surgery to recurrence, and increasing number of initial recurrent regions are associated with poor prognosis after recurrence. When the number of recurrent lesions is limited, intensive local treatment with curative intent should be applied for achieving long-term postrecurrence survival.

  1. Colovesical fistula in a patient with recurrent cervical cancer detected by FDG PET/CT.

    Science.gov (United States)

    Chen, Kuan-Yung; Hsu, Chih-Hung; Kao, Chia-Hung; Hung, Guang-Uei; Chiu, Jainn-Shiun; Ho, Kuo-Wei

    2010-10-01

    We report the case of a 57-year-old woman with the history of stage IB cervical cancer. She was found to have a metastatic squamous cell carcinoma in sigmoid colon. FDG PET/CT was then performed for whole-body cancer work-up. Intense FDG activity accumulated in the sigmoid tumor, with an unusually high SUVmax of 72.42, and was seen downwardly connected with the activity of urinary bladder on PET images. On the coregistered CT images, irregular wall thickening was noted for both sigmoid colon and urinary bladder with a hypodensity tract communicating with each other. It was concluded that recurrent cervical cancer involving urinary bladder and sigmoid colon resulted in colovesical fistula.

  2. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy.

    Science.gov (United States)

    Allen, Valerie A; Manahan, Kelly J; Geisler, John P

    2016-01-01

    Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI). Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient's diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  3. Recurrent Pseudomembranous Colitis in an Ovarian Cancer Patient Undergoing Carboplatin Chemotherapy

    Directory of Open Access Journals (Sweden)

    Valerie A. Allen

    2016-01-01

    Full Text Available Background. Diarrhea is a common problem in ovarian cancer patients undergoing chemotherapy and Clostridium difficile infection has been identified as a cause. The proper diagnosis and treatment of diarrhea are critical to patient care, especially to prevent the serious complications from a severe Clostridium difficile infection (CDI. Case. We present a heavily pretreated ovarian cancer patient who developed recurrent pseudomembranous colitis while receiving carboplatin chemotherapy. Despite treatment with oral metronidazole for fourteen days, the patient’s diarrhea relapsed and colonoscopy revealed extensive pseudomembranous colitis. The infection eventually resolved with the combination of oral vancomycin and metronidazole. Conclusions. Diarrhea is a common problem in patients undergoing chemotherapy for ovarian cancer. Management requires obtaining the proper diagnosis. Clostridium difficile associated pseudomembranous colitis must be part of the differential diagnosis. Treatment must be sufficient to prevent relapses of the Clostridium difficile infection to prevent serious consequences in an already vulnerable patient population.

  4. Patient Counseling and Management of Symptoms During Olaparib Therapy for Recurrent Ovarian Cancer.

    Science.gov (United States)

    Moore, Kathleen N; Monk, Bradley J

    2016-08-01

    : Our primary objective is to review the safety and tolerability profile of olaparib, a novel anticancer therapy, and to discuss key considerations for symptom management in patients with advanced ovarian cancer. Olaparib is the first of a new class of anticancer therapies, poly (ADP-ribose) polymerase (PARP) inhibitors that target tumors that have deficits in homologous recombination repair (such as BRCA mutations) by a process known as synthetic lethality. Through this process, neither the deficiency in homologous recombination repair nor PARP inhibition alone is cytotoxic, but the combination of these two conditions leads to cell death. In December 2014, olaparib received accelerated approval by the U.S. Food and Drug Administration (FDA) as monotherapy for patients with known or suspected deleterious germline BRCA-mutated (as detected by an FDA-approved test) advanced ovarian cancer who had been treated with at least three lines of chemotherapy. Most adverse events (AEs) reported during olaparib clinical trials conducted in patients with recurrent ovarian cancer and measurable disease were of grade 2 or less severity according to the National Cancer Institute's Common Terminology Criteria for Adverse Events. Fatigue and gastrointestinal AEs are among the most common in ovarian cancer clinical trials and can be particularly bothersome to patients. We focus on interventions to address these AEs in patients who are candidates for treatment with olaparib and allow them to remain on therapy for as long as clinically indicated. Olaparib therapy represents a new approach to treating recurrent ovarian cancer. Some associated adverse events can have a substantial effect on quality of life. It is therefore important for patients, caregivers, and health care providers to have realistic expectations and a thorough understanding of the safety and tolerability profile of olaparib to prevent or alleviate key symptoms so that therapy can continue uninterrupted if possible

  5. Radiation Field Design and Patterns of Locoregional Recurrence Following Definitive Radiotherapy for Breast Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Susie A. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Schuster, David M. [Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Mister, Donna; Liu Tian; Godette, Karen [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Torres, Mylin A., E-mail: matorre@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2013-02-01

    Purpose: Locoregional control is associated with breast cancer-specific and overall survival in select women with breast cancer. Although several patient, tumor, and treatment characteristics have been shown to contribute to locoregional recurrence (LRR), studies evaluating factors related to radiotherapy (XRT) technique have been limited. We investigated the relationship between LRR location and XRT fields and dose delivered to the primary breast cancer in women experiencing subsequent locoregional relapse. Methods and Materials: We identified 21 women who were previously treated definitively with surgery and XRT for breast cancer. All patients developed biopsy-result proven LRR and presented to Emory University Hospital between 2004 and 2010 for treatment. Computed tomography (CT) simulation scans with XRT dose files for the initial breast cancer were fused with {sup 18}F-labeled fluorodeoxyglucose positron emission tomography (FDG PET)/CT images in DICOM (Digital Imaging and Communications in Medicine) format identifying the LRR. Each LRR was categorized as in-field, defined as {>=}95% of the LRR volume receiving {>=}95% of the prescribed whole-breast dose; marginal, defined as LRR at the field edge and/or not receiving {>=}95% of the prescribed dose to {>=}95% of the volume; or out-of-field, that is, LRR intentionally not treated with the original XRT plan. Results: Of the 24 identified LRRs (3 patients experienced two LRRs), 3 were in-field, 9 were marginal, and 12 were out-of-field. Two of the 3 in-field LRRs were marginal misses of the additional boost XRT dose. Out-of-field LRRs consisted of six supraclavicular and six internal mammary nodal recurrences. Conclusions: Most LRRs in our study occurred in areas not fully covered by the prescribed XRT dose or were purposely excluded from the original XRT fields. Our data suggest that XRT technique, field design, and dose play a critical role in preventing LRR in women with breast cancer.

  6. Five recurrent BRCA1/2 mutations are responsible for cancer predisposition in the majority of Slovenian breast cancer families

    Directory of Open Access Journals (Sweden)

    Novakovic Srdjan

    2008-09-01

    Full Text Available Abstract Background Both recurrent and population specific mutations have been found in different areas of the world and more specifically in ethnically defined or isolated populations. The population of Slovenia has over several centuries undergone limited mixing with surrounding populations. The current study was aimed at establishing the mutation spectrum of BRCA1/2 in the Slovenian breast/ovarian cancer families taking advantage of a complete cancer registration database. A second objective was to determine the cancer phenotype of these families. Methods The original population database was composed of cancer patients from the Institute of Oncology Ljubljana in Slovenia which also includes current follow-up status on these patients. The inclusion criteria for the BRCA1/2 screening were: (i probands with at least two first degree relatives with breast and ovarian cancer; (ii probands with only two first degree relatives of breast cancer where one must be diagnosed less than 50 years of age; and (iii individual patients with breast and ovarian cancer, bilateral breast cancer, breast cancer diagnosed before the age of 40 and male breast cancer without any other cancer in the family. Results Probands from 150 different families met the inclusion criteria for mutation analysis of which 145 consented to testing. A BRCA1/2 mutation was found in 56 (39%. Two novel large deletions covering consecutive exons of BRCA1 were found. Five highly recurrent specific mutations were identified (1806C>T, 300T>G, 300T>A, 5382insC in the BRCA1 gene and IVS16-2A>G in the BRCA2 gene. The IVS16-2A>G in the BRCA2 gene appears to be a unique founder mutation in the Slovenian population. A practical implication is that only 4 PCR fragments can be used in a first screen and reveal the cancer predisposing mutation in 67% of the BRCA1/2 positive families. We also observed an exceptionally high frequency of 4 different pathogenic missense mutations, all affecting one of

  7. [A CASE OF ASCENDING COLON CANCER RECURRENCE WITH INTRALUMINAL URETERAL DISSEMINATION MIMICKING PRIMARY URETERAL CANCER, DETECTED DURING INVESTIGATION FOR FEVER].

    Science.gov (United States)

    Nishiyama, Ryuichi; Kubota, Masashi; Kanno, Toru; Okada, Takashi; Higashi, Yoshihito; Yamada, Hitoshi

    2015-10-01

    A 69-year-old woman visited our hospital with a chief complaint of fever. Five years ago, she was diagnosed as ascending colon cancer and received right hemi-colectomy. One year later, local recurrence with right hydronephrosis was detected, and she received chemotherapy -4 cycles of modified fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) plus bevacizumab, and 12 cycles of fluorouracil, leucovorin, and irinotecan (FOLFIRI) plus bevacizumab- for two years. Local recurrence and right hydronephrosis disappeared on positron emission tomography performed 4 years postoperatively. This time, abdominal computed tomography for investigation of fever showed a relapse of right hydronephrosis and pyonephrosis. Cystoscopy revealed non-papillary tumor from the right ureteral orifice. Pelvic magnetic resonance imaging showed multiple tumors in the right ureter, and the distal lesion projecting into the bladder. After the general condition became well by right nephrostomy for infection control, transurethral resection of bladder tumor was performed. Histological examination of the specimen revealed a metastatic tubular adenocarcinoma (colon origin). Although right nephrectomy was performed for pyonephrosis control, she died of local progression of ascending colon cancer 10 months after first visit. Intraluminal ureteral progression of carcinoma originating from organs other than urinary tract is very rare. To our knowledge, this is the 9th report in the English or Japanese literature. In this case we could not rule out primary ureteral cancer preoperatively, and histological examination revealed intraluminal ureteral dissemination of ascending colon cancer.

  8. Local treatment of oligometastatic recurrence in patients with resected non-small cell lung cancer.

    Science.gov (United States)

    Yano, Tokujiro; Okamoto, Tatsuro; Haro, Akira; Fukuyama, Seiichi; Yoshida, Tsukihisa; Kohno, Mikihiro; Maehara, Yoshihiko

    2013-12-01

    We previously reported a retrospective study indicating the prognostic impact of the local treatment of oligometastatic recurrence after a complete resection for non-small cell lung cancer (NSCLC). In the present study, we prospectively observed postoperative oligometastatic patients and investigated the effects of local treatment on progression-free survival (PFS). Using a prospectively maintained database of patients with completely resected NSCLC treated between October 2007 and December 2011, we identified 52 consecutive patients with postoperative recurrence, excluding second primary lung cancer. Of these patients, 31 suffering from distant metastases alone without primary site recurrence were included in this study. According to the definition of 'oligometastases' as a limited number of distant metastases ranging from one to three, 17 patients had oligometastatic disease. Of those 17 patients, four patients with only brain metastasis were excluded from the analysis. The oligometastatic sites included the lungs in five patients, bone in four patients, the lungs and brain in two patients, the adrenal glands in one patient and soft tissue in one patient. Eleven of the 13 patients first received local treatment. Three patients (lung, adrenal gland, soft tissue) underwent surgical resection, and the remaining eight patients received radiotherapy. The median PFS was 20 months in the oligometastatic patients who received local treatment. There were five patients with a PFS of longer than two years. The metastatic sites in these patients varied, and one patient had three lesions. On the other hand, the two remaining patients first received a systemic chemotherapy of their own selection. The PFS of these two patients was five and 15 months, respectively. Local therapy is a choice for first-line treatment in patients with postoperative oligometastatic recurrence. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Milani, V.; Issels, R.D.; Buecklein, V. [Ludwig-Maximilians-Univ., Muenchen (Germany). Univ. Hospital Grosshadern, Dept. of Internal Medicine III; Institute of Molecular Immunology, Muenchen (Germany). KKG Hyperthermie GSF-Haematologikum; Pazos, M.; Schaffer, P.; Wilkowski, R.; Duehmke, E. [Ludwig-Maximilians-Univ., Muenchen (Germany). Univ. Hospital Grosshadern, Dept. of Radiation Oncology; Rahman, S.; Tschoep, K.; Schaffer, M. [Ludwig-Maximilians-Univ., Muenchen (Germany). Univ. Hospital Grosshadern, Dept. of Internal Medicine III

    2008-03-15

    Background and Purpose: Encouraging results of phase II studies combining chemotherapy with radiotherapy have been published. In this study, the results of a multimodal salvage therapy including radiochemotherapy (RCT) and regional hyperthermia (RHT) in preirradiated patients with recurrent rectal cancer are reported. Patients and Methods: All patients enrolled had received previous pelvic irradiation (median dose 50.4 Gy). The median time interval between prior radiotherapy and the onset of local recurrence was 34 months. The combined treatment consisted of reirradiation with a median dose of 39.6 Gy (30.0-45.0 Gy), delivered in fractions of 1.8 Gy/day. 5-fluorouracil was given as continuous infusion 350 mg/m2/day five times weekly, and RHT (BSD-2000 system) was applied twice a week within 1 h after radiotherapy. The primary endpoint was local progression-free survival (LPFS); secondary endpoints were overall survival, symptom control, and toxicity. Results: 24 patients (median age 59 years) with a previously irradiated locally recurrent adenocarcinoma of the rectum were enrolled. The median LPFS was 15 months (95% confidence interval 12-18 months) with a median follow-up of 27 months (16-37 months). The overall 1-year and 3-year survival rates were 87% and 30%, respectively. Pain was the main symptom in 17 patients. Release of pain was achieved in 12/17 patients (70%). No grade 3 or 4 hematologic or skin toxicity occurred. Grade 3 gastrointestinal acute toxicity was observed in 12.5% of the patients. Paratumoral thermometry revealed a homogeneous distribution of temperatures. Conclusion: RCT combined with RHT is an efficient salvage therapy showing high efficacy with acceptable toxicity and can be recommended as treatment option for this unfavorable group of preirradiated patients with local recurrence of rectal cancer. (orig.)

  10. Thermochemoradiotherapy for advanced or recurrent head and neck cancer. Analysis of clinical results and background variables

    Energy Technology Data Exchange (ETDEWEB)

    Hoshina, Hideyuki; Takagi, Ritsuo; Nagashima, Katsuhiro; Fujita, Hajime; Miyamoto, Takeshi; Sohma, Yoh; Fukuda, Jun-ichi; Imai, Nobuyuki; Nagata, Masaki [Niigata Univ. (Japan). Faculty of Dentistry

    2001-03-01

    Eighteen patients with 25 unresectable advanced or recurrent head and neck cancers (squamous cell carcinomas) received thermochemotherapy in combination with radiotherapy. The total radiation dose ranged from 50 to 82 Gy (mean, 65.6 Gy). Patients received thermochemotherapy twice a week, for a total number of 8.8 sessions, on average. The temperature in the tumor, as a result of the hyperthermia, was over 42 deg C in 185 (84.5%) of the 219 treatments. Three kinds of heating systems were used: a 13.56-MHz radiofrequency system, a 2450-MHz microwave system, and a radiofrequency interstitial system. The total amount of administered CDDP ranged from 40 to 300 mg (mean, 110 mg), combined with PEP and/or 5FU. Background factors (tumor factors and treatment factors) were investigated in detail, and the clinical results (tumor response and the 5-year cumulative focal control rate) were evaluated. The relationship between these two results was then analyzed using univariate and multivariate statistics. The clinical results of patients with a WHO histological classification of grade 3 were poor compared with patients with a classification of grade 1 or 2. The difference between these two results was significant when analyzed using univariate statistics, but not significant when analyzed using multivariate statistics. The clinical results of patients with primary lesions surrounded by bony tissues were slightly poor compared with those of patients whose lesions were surrounded by soft tissues, but the difference between these two results was not significant. Successful treatment of refractory recurrent tumors, large tumor masses, and diffuse invasive carcinomas was not affected by the treatment factors (heating systems, heating sessions, radiation dose, and CDDP dose and drug combination). These results suggest that refractory recurrence, proximity to bony tissues, tumor size, and histological malignancy might not be prognostic variables for thermochemoradiotherapy strategy

  11. Comparative performance of PET tracers in biochemical recurrence of prostate cancer: a critical analysis of literature.

    Science.gov (United States)

    Yu, Chung Yao; Desai, Bhushan; Ji, Lingyun; Groshen, Susan; Jadvar, Hossein

    2014-01-01

    Positron emission tomography (PET) with a number of tracers targeted to particular biological features of cancer has been explored for the imaging evaluation of patients with biochemical recurrence of prostate cancer after curative primary treatment. However, these reports are often heterogeneous in study design, patient cohorts, standards of reference for the imaging findings, data analysis, and data reporting. The aim of our study was to address these limitations by extracting and re-analyzing the PET detection data only from studies that satisfied pre-defined sets of patient selection criteria and verification standards. Our investigation analyzed the effects of 5 tracers ((18)F-fluorodeoxyglucose (FDG), (11)C-acetate (ACET), (11)C- or (18)F-choline (CHOL), anti-1-amino-3-(18)F-fluorocyclobutane-1-carboxylic acid (FACBC), and radiolabeled ligand targeted to prostate-specific membrane antigen (PSMA)), 2 treatment types (radical prostatectomy and radiation therapy), and whether the detected disease was local or metastatic, including lesion type (bone, lymph node, soft tissue). FDG exhibited the lowest detection rate for any suspected disease. ACET tended to be advantageous over CHOL in detecting local recurrence and lymph node lesions, even though the difference was not statistically significant. FACBC had greater likelihood of detecting local recurrence, when compared to CHOL, though this difference was not statistically significant. PSMA tended to show a higher proportion of patients with suspected disease compared to the other four tracers. Patients treated with radiation therapy had greater odds of displaying local recurrence on PET than those treated with radical prostatectomy. We also provide suggestions for future investigations that facilitate communication and the impact of the findings.

  12. Margin Distance Does Not Influence Recurrence and Survival After Wedge Resection for Lung Cancer.

    Science.gov (United States)

    Maurizi, Giulio; D'Andrilli, Antonio; Ciccone, Anna Maria; Ibrahim, Mohsen; Andreetti, Claudio; Tierno, Simone; Poggi, Camilla; Menna, Cecilia; Venuta, Federico; Rendina, Erino Angelo

    2015-09-01

    The relationship between the free margin distance and the recurrence rate and overall survival after R0 wedge resection for non-small cell lung cancer (NSCLC) is still not clear. We retrospectively evaluated the long-term oncologic outcome of patients who had undergone wedge resection for NSCLC to assess the prognostic effect of margin distance in this setting. Between 2003 and 2013, 243 consecutive patients with a functional contraindication to major lung resection underwent wedge resection with systematic lymph node dissection for clinical stage I NSCLC. The study enrolled 182 patients with pathologic stage I and R0 resection and divided them into three subgroups according to margin distance of less than 1 cm (n = 30), 1 to 2 cm (n = 80), and more than 2 cm (n = 72). The histologic assessment was adenocarcinoma in 112 patients, squamous cell in 30, and other in 40. Postoperative morbidity was 18.7%, and postoperative mortality was 1.1%. The median follow-up was 31 months (range, 2 to 133 months). The locoregional (lung parenchyma, hilum, mediastinum) recurrence rate was 26.4% (n = 48). The distant recurrence rate was 11% (n = 20). Overall 5-year survival was 70.4%. Disease-free 5-year survival was 51.7%. There was no statistical difference in locoregional (p = 0.9) and distant (p = 0.3) recurrence rate and no difference in overall survival (p = 0.07) when the three groups were compared. Wedge resection is a viable option for the surgical treatment of stage I NSCLC when lobectomy is contraindicated. The distance between the tumor and the parenchymal suture margin does not influence recurrence or the survival rate when an R0 resection is achieved. Copyright © 2015 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Long term outcomes after salvage radiotherapy for postoperative locoregionally recurrent non-small-cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Ji; Song, Chang Hoon; Kim, Jae Sung [Dept. of Radiation Oncology, Seoul National University College of Medicine, Seoul (Korea, Republic of); Kim, Mi Young [Dept. of Radiation Oncology, Kyungpook National University Medical Center, Daegu (Korea, Republic of)

    2017-03-15

    The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

  14. The role of FDG-PET/CT in the detection of recurrent colorectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Votrubova, Jana; Belohlavek, Otakar; Jaruskova, Monika [Na Homolce Hospital, PET Centre, Prague (Czech Republic); Oliverius, Martin [Institute of Clinical and Experimental Medicine, Prague (Czech Republic); Lohynska, Radka [University Hospital Motol, Department of Radiotherapy and Oncology, Prague (Czech Republic); Trskova, Kristina [Na Homolce Hospital, Department of Oncology, Prague (Czech Republic); Sedlackova, Eva [General Teaching Hospital and 1st Faculty of Medicine, Department of Oncology, Prague (Czech Republic); Lipska, Ludmila [Thomayer' s Teaching Hospital and 1st Faculty of Medicine, Department of Surgery, Prague (Czech Republic); Stahalova, Vladimira [Na Bulovce Teaching Hospital, Institute of Radiation Oncology, Prague (Czech Republic)

    2006-07-15

    The conventional diagnostic techniques used to assess recurrence of colorectal cancer (CRCR) often yield unspecific findings. Integrated FDG-PET/CT seems to offer promise for the differential diagnosis of benign and malignant lesions. The aim of this study was to compare the value of FDG-PET and PET/CT in the detection of CRCR subsequent to colonic resection or rectal amputation. The population for this retrospective study comprised 84 patients with suspected CRCR. The sensitivity, specificity and accuracy of PET and PET/CT were calculated for (a) intra-abdominal extrahepatic recurrences, (b) extra-abdominal and/or hepatic recurrences and (c) all recurrences, and tumour marker levels were analysed. The sensitivity, specificity and overall accuracy of PET in detecting intra-abdominal extrahepatic CRCR were 82%, 88% and 86%, respectively, compared with 88%, 94% and 92%, respectively, for PET/CT. The corresponding figures for detection of extra-abdominal and/or hepatic CRCR were 74%, 88% and 85% for PET and 95%, 100% and 99% for PET/CT. Considering the entire population, the sensitivity, specificity and overall accuracy of PET were 80%, 69% and 75%, respectively, compared with 89%, 92% and 90%, respectively, for PET/CT. FDG-PET/CT examination correctly detected 40 out of a total of 45 patients with CRCR. Two of five patients with falsely negative FDG-PET/CT findings had local microscopic recurrences and one had miliary liver metastases. Of 39 patients without CRCR, three showed false positive FDG-PET/CT results. Two of these cases were due to increased accumulation in inflammatory foci in the bowel wall, while one was due to haemorrhaging into the adrenal gland. FDG-PET/CT appears to be a very promising method for distinguishing a viable tumour from fibrous changes, thereby avoiding unnecessary laparotomy. (orig.)

  15. Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

    Directory of Open Access Journals (Sweden)

    Kui-Kai Lau

    Full Text Available BACKGROUND AND PURPOSE: Cancer patients are at increased risk of cardiovascular and cerebrovascular events. It is unclear whether cancer confers any additional risk for recurrent stroke or cardiovascular mortality after stroke. METHODS: This was a single center, observational study of 1,105 consecutive Chinese ischemic stroke patients recruited from a large stroke rehabilitation unit based in Hong Kong. We sought to determine whether patients with cancer are at higher risk of recurrent stroke and cardiovascular mortality. RESULTS: Amongst 1,105 patients, 58 patients (5.2% had cancer, of whom 74% were in remission. After a mean follow-up of 76 ± 18 months, 241 patients developed a recurrent stroke: 22 in patients with cancer (38%, annual incidence 13.94%/year, substantially more than those without cancer (21%, 4.65%/year (p<0.01. In a Cox regression model, cancer, age and atrial fibrillation were the 3 independent predictors of recurrent stroke with a hazard ratio (HR of 2.42 (95% confidence interval (CI: 1.54-3.80, 1.01 (1.00-1.03 and 1.35 (1.01-1.82 respectively. Likewise, patients with cancer had a higher cardiovascular mortality compared with those without cancer (4.30%/year vs. 2.35%/year, p = 0.08. In Cox regression analysis, cancer (HR: 2.08, 95% CI: 1.08-4.02, age (HR: 1.04, 95% CI 1.02-1.06, heart failure (HR: 3.06, 95% CI 1.72-5.47 and significant carotid atherosclerosis (HR: 1.55, 95% CI 1.02-2.36 were independent predictors for cardiovascular mortality. CONCLUSIONS: Stroke patients with a past history of cancer are at increased risk of recurrent stroke and cardiovascular mortality.

  16. Body mass index is not a predictor of biochemical recurrence after radical prostatectomy in Dutch men diagnosed with prostate cancer

    NARCIS (Netherlands)

    Kok, D.E.G.; Roermond, van J.G.; Aben, K.K.; Luijtgaarden, van de M.W.; Karthaus, H.F.; Vierssen Trip, van O.B.; Kampman, E.; Witjes, A.J.; Kiemeney, L.A.

    2011-01-01

    Purpose To determine the eVect of body mass index (BMI) on clinical and pathological characteristics at time of diagnosis and on risk of biochemical recurrence after radical prostatectomy among Dutch men diagnosed with prostate cancer. Methods In total, 1,116 prostate cancer patients with known BMI,

  17. Exacerbation of Dermatomyositis with Recurrence of Rectal Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Yuka Nagano

    2015-11-01

    Full Text Available Dermatomyositis (DM is a rare idiopathic inflammatory myopathy characterized by cutaneous and muscle manifestations. The association between DM and malignancy has been well recognized for many years. The clinical course of paraneoplastic DM may be affected by malignancies, although the cause and effect relationship between exacerbation of DM and cancer progression is uncertain. Herein, we report a 44-year-old woman who presented with progressive DM associated with rectal cancer. After curative resection of rectal cancer, DM symptoms resolved. Three months after surgery, blood test surveillance showed elevation of serum carcinoembryonic antigen levels, although the patient remained asymptomatic. One month later she had a DM flare-up, and multiple lung and liver metastases were found. She immediately underwent cancer chemotherapy with prednisolone therapy for DM. However, her condition deteriorated and she was unable to swallow. Percutaneous endoscopic gastrostomy was constructed, allowing alimentation and oral delivery, which made it possible to keep her on chemotherapy. She had remarkable response for unresectable metastases 8 weeks after the administration of chemotherapy. Seven months after onset of recurrence, her condition improved considerably and she had stable disease. Moreover, she can now eat food of soft consistency. Our case provides further support for the clinical importance of cancer chemotherapy for patients who have progressive DM and unresectable rectal cancer.

  18. Exacerbation of Dermatomyositis with Recurrence of Rectal Cancer: A Case Report.

    Science.gov (United States)

    Nagano, Yuka; Inoue, Yasuhiro; Shimura, Tadanobu; Fujikawa, Hiroyuki; Okugawa, Yoshinaga; Hiro, Junichiro; Toiyama, Yuji; Tanaka, Koji; Mohri, Yasuhiko; Kusunoki, Masato

    2015-01-01

    Dermatomyositis (DM) is a rare idiopathic inflammatory myopathy characterized by cutaneous and muscle manifestations. The association between DM and malignancy has been well recognized for many years. The clinical course of paraneoplastic DM may be affected by malignancies, although the cause and effect relationship between exacerbation of DM and cancer progression is uncertain. Herein, we report a 44-year-old woman who presented with progressive DM associated with rectal cancer. After curative resection of rectal cancer, DM symptoms resolved. Three months after surgery, blood test surveillance showed elevation of serum carcinoembryonic antigen levels, although the patient remained asymptomatic. One month later she had a DM flare-up, and multiple lung and liver metastases were found. She immediately underwent cancer chemotherapy with prednisolone therapy for DM. However, her condition deteriorated and she was unable to swallow. Percutaneous endoscopic gastrostomy was constructed, allowing alimentation and oral delivery, which made it possible to keep her on chemotherapy. She had remarkable response for unresectable metastases 8 weeks after the administration of chemotherapy. Seven months after onset of recurrence, her condition improved considerably and she had stable disease. Moreover, she can now eat food of soft consistency. Our case provides further support for the clinical importance of cancer chemotherapy for patients who have progressive DM and unresectable rectal cancer.

  19. Early detection of recurrences in the follow-up of primary breast cancer in an asymptomatic or symptomatic phase.

    Science.gov (United States)

    Perrone, Maria Antonietta; Musolino, Antonino; Michiara, Maria; Di Blasio, Beatrice; Bella, Mariangela; Franciosi, Vittorio; Cocconi, Giorgio; Camisa, Roberta; Todeschini, Renata; Cascinu, Stefano

    2004-01-01

    Periodic follow-up after primary treatment for breast cancer is a common procedure for the early detection of recurrent disease in the asymptomatic state. Anyway, there is no clinical evidence that treatment of metastases may improve the prognosis if applied in the asymptomatic state. The aim of the present study was to investigate the modality of detection of the first relapse in the asymptomatic vs the symptomatic state. We retrospectively analyzed 717 breast cancer patients who had been consecutively referred to the Parma Oncology Division during the period 1986 to December 1988. Recurrences were detected in the course of periodic follow-up. A total of 211 of the 408 patients evaluated had a first relapse with a median follow-up of 94.7 months. Local and distant recurrences were 49% and 47%, respectively. Bone recurrences represented 24% of the total first recurrences, then chest wall recurrences in 23%, local regional nodes in 13%, lung in 7%, liver in 4%, and brain in 2%. The distribution of the studied patients according to recurrence site and asymptomatic or symptomatic state was different: 69% of asymptomatic patients (110) had a local recurrence vs 31% of symptomatic patients (101). A difference in survival was recorded in favor of cases detected in the asymptomatic state (P <0.001). The present study suggests that an early detection of local recurrence might have a favorable impact on the prognosis of patients followed after primary treatment for breast cancer. It should be considered that any difference in survival could also be explained by several "biases" and that breast cancer follow-up is still an area of investigation open to discussion in which many questions remain to be clarified.

  20. The sum of all fears: conceptual challenges with measuring fear of cancer recurrence.

    Science.gov (United States)

    Costa, Daniel S J; Smith, Allan Ben; Fardell, Joanna E

    2016-01-01

    Fear of cancer recurrence (FCR) is increasingly recognised as a major concern for people with cancer once active treatment is completed. Several instruments have been designed to assess FCR; however, no gold standard has emerged. Many instruments conceptualise FCR as a multidimensional construct. However, this potentially conflates FCR as an outcome with its antecedents and consequences. This is problematic when an aggregate of distinct dimensions is calculated, as is commonly recommended. For example, the total score on the Fear of Cancer Recurrence Inventory is an aggregate of items from seven sub-scales: triggers, severity, psychological distress, coping strategies, functioning impairments, insight and reassurance. Similarly, the total score on the Fear of Progression Questionnaire is an aggregate of affective reaction, partnership/family, work and loss of autonomy. Arguably, the severity and affective reaction domains represent fear, and the other sub-scales represent related concepts, rather than "dimensions" of FCR. The total score represents a combination of concepts whose meaning is unclear. The same total score could be produced by patients with very different experiences, and patients with the same level of fear could have very different total scores. Therefore, we argue that although the level of FCR may be determined by a complex network of antecedents and modifiers and have variable consequences, FCR itself may be a simple concept, which can be assessed using a smaller number of items. Conceptual clarity in its research infancy should prevent FCR becoming a construct that is vaguely operationalised and interpreted.

  1. Radiotherapy for locally recurrent rectal cancer treated with surgery alone as the initial treatment

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hidekazu; Yamaguchi, Takahiro; Hachiya, Kae; Okada, Sunaho; Kitahara, Masashi; Matsuyama, Katsuya; Matsuo, Masayuki [Gifu University, Gifu (Japan)

    2017-03-15

    Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0–3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (≥75 Gy10) than for the lower BED group (<75 Gy10). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than 75 Gy10, if the dose to the organ at risk is within acceptable levels.

  2. Recurrent or residual pelvic bowel cancer: Accuracy of MRI local extent before salvage surgery

    Energy Technology Data Exchange (ETDEWEB)

    Robinson, Philip; Carrington, Bernadette M.; Swindell, Ric; Shanks, Johnathan H.; O' Dwyer, Sarah T

    2002-06-01

    PURPOSE: To determine pre-operative MRI accuracy in assessing local disease extent in recurrent/residual pelvic bowel cancer by comparing MRI assessment and staging examination under anaesthesia (EUA), with laparotomy/histopathological findings. MATERIALS AND METHODS: Twenty-seven consecutive patients with recurrent (n = 21) or residual (n = 6) pelvic bowel cancer (13 of the rectum, eleven of the anus and three of the colon) underwent EUA and pelvic MRI (1T) using a phased array pelvic coil. Retrospective analysis of eight specific anatomical regions for tumour involvement on MRI was performed. Findings at EUA and biopsy were recorded. The MRI and EUA findings were correlated with findings at surgery and histopathology. Statistical comparison between MRI and EUA results was performed using the chi-squared test . RESULTS: Overall MRI accuracy in determining tumour invasion for all sites assessed was 452/499 (91%), sensitivity was 95/109 (87%), specificity was 357/390 (92%), positive predictive value (PPV) was 95/128 (74%) and negative predictive value (NPV) was 357/371 (96%). PPV and NPV for specific areas were 21/38 (55%) and 134/136 (99%) for genitourinary tract, 4/6 (67%) and 61/65 (94%) for pelvic side wall, 21/26 (81%) and 40/41 (98%) for pelvic floor, 1/6 (17%) and 40/43 (93%) for the posterior pelvis pre-sacrum/sacrum. For those anatomical sites evaluated by both EUA and MRI, MRI was superior to EUA, with an accuracy of 89% vs 73%(P < 0.05) . CONCLUSION: MRI is an accurate technique for assessing disease extent in recurrent/residual pelvic bowel cancer. Robinson, P. et al. (2002)

  3. Hypoalbuminemia is a Predictive Factor for Fistula Formation in Recurrent Cervical Cancer.

    Science.gov (United States)

    Palavalli Parsons, Lavanya H; Roane, Brandon; Manders, Dustin B; Richardson, Debra L; Kehoe, Siobhan M; Carlson, Matthew; Miller, David S; Lea, Jayanthi S

    2017-08-16

    Antivascular endothelial growth factor monoclonal antibodies inhibit tumor angiogenesis, consequently impeding the recruitment of new vasculature to existing and new tumor lesions. We sought to evaluate toxicities in women with recurrent cervical cancer after receiving bevacizumab combination chemotherapy. A review was conducted of women with recurrent and metastatic cervical cancer who were treated with salvage chemotherapy with or without bevacizumab between 2005 and 2015. Clinicopathologic data and reasons for treatment discontinuation were recorded. Patients that were excluded had other histology than squamous or adenocarcinoma, received 1 cycle of salvage chemotherapy, single agent bevacizumab, currently on treatment, or noncompliant. Statistical analysis was performed using the Fishers Exact Test, logistic regression, and Kaplan-Meier Survival Analysis. A total of 74 patients were included in analysis. Twenty-six patients were treated with bevacizumab (BEV) and chemotherapy and 48 patients with chemotherapy alone (chemotherapy). The progression free survival was significant with median 12 months versus 7 months for the BEV cohort (P<0.01) and the overall survival was a median 74 months versus 23 months for the BEV cohort (P=0.06). Cessation of treatment secondary to severe toxicities was seen in 46% (n=12) of BEV cohort versus 15% (n=7) of chemotherapy cohort (P<0.01). Twenty-seven percent (n=7) of patients in the BEV cohort stopped secondary because of fistula formations. Lower albumin levels and use of bevacizumab were identified as an independent predictor factors for fistula formation (P=0.004 and 0.024, respectively). Hypoalbuminemia and bevacizumab treatments are significant predictive factors of fistula formation in patients treated for recurrent cervical cancer.

  4. PHASE Ⅱ STUDY OF GEMCITABINE COMBINED WITH PLATINUM CHEMOTHERAPY FOR RECURRENT EPITHELIAL OVARIAN CANCER

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To evaluate the anti-tumor effect and toxicity of gemcitabine combined with platinum chemotherapy on recurrent epithelial ovarian cancer.Methods Phase Ⅱ study of gemcitabine combined with platinum chemotherapy was carried out in 22 patients with recurrent epithelial ovarian cancer. Median age of patients was 50. 5 years old. Seven patients were platinum-sensitive and 15 patients were platinum-resistant or -refractor. All patients received gemcitabine combined with carboplatin or oxaliplatin chemotherapy. Patients' response rate (RR) and toxicity of gemcitabine combined with platinum chemotherapy were evaluated.Results A total of 98 gemcitabine-based chemotherapy cycles were performed. Total RR was 36.4%, RR of platinum-sensitive patients was 4/7 and platinum-resistant and -refractory patients was 4/15. The estimated median survival time was 10. 0 months (95% CI: 7.0-13.0) after initiation of gemcitabine combined with platinum chemotherapy.There was no significant difference in survival time between platinum-resistant/refractory group and platinum-sensitive group (P = 0. 061 ). Side effects of gemcitabine combined with platinum chemotherapy were observed in 81.8 % of patients. Grade Ⅱ/Ⅲ anemia (54.5%) and grade Ⅲ/Ⅳ neutropenia (54.5%) were most common toxicities. Ten (45.5%) patients had to delay their chemotherapy cycles or reduce the dose of chemotherapeutic drugs because of the severe side effects. Fourteen (63.6%) patients received granulocyte colony-stimulating factor to relieve neutropenia,and 8 (36. 4% ) patients received component blood transfusion to treat anemia or thrombocytopenia. There was no treatment-associated death.Conclusion Gemcitabine combined with platinum chemotherapy appears to be an effective and well-tolerant treatment for recurrent epithelial ovarian cancer, including platinum-resistant or -refractory diseases.

  5. Gene expression profiling to predict the risk of locoregional recurrence in breast cancer: a pooled analysis.

    Science.gov (United States)

    Drukker, C A; Elias, S G; Nijenhuis, M V; Wesseling, J; Bartelink, H; Elkhuizen, P; Fowble, B; Whitworth, P W; Patel, R R; de Snoo, F A; van 't Veer, L J; Beitsch, P D; Rutgers, E J Th

    2014-12-01

    The 70-gene signature (MammaPrint) has been developed to predict the risk of distant metastases in breast cancer and select those patients who may benefit from adjuvant treatment. Given the strong association between locoregional and distant recurrence, we hypothesize that the 70-gene signature will also be able to predict the risk of locoregional recurrence (LRR). 1,053 breast cancer patients primarily treated with breast-conserving treatment or mastectomy at the Netherlands Cancer Institute between 1984 and 2006 were included. Adjuvant treatment consisted of radiotherapy, chemotherapy, and/or endocrine therapy as indicated by guidelines used at the time. All patients were included in various 70-gene signature validation studies. After a median follow-up of 8.96 years with 87 LRRs, patients with a high-risk 70-gene signature (n = 492) had an LRR risk of 12.6% (95% CI 9.7-15.8) at 10 years, compared to 6.1% (95% CI 4.1-8.5) for low-risk patients (n = 561; P risk model for the clinicopathological factors such as age, tumour size, grade, hormone receptor status, LVI, axillary lymph node involvement, surgical treatment, endocrine treatment, and chemotherapy resulted in a multivariable HR of 1.73 (95% CI 1.02-2.93; P = 0.042). Adding the signature to the model based on clinicopathological factors improved the discrimination, albeit non-significantly [C-index through 10 years changed from 0.731 (95% CI 0.682-0.782) to 0.741 (95% CI 0.693-0.790)]. Calibration of the prognostic models was excellent. The 70-gene signature is an independent prognostic factor for LRR. A significantly lower local recurrence risk was seen in patients with a low-risk 70-gene signature compared to those with high-risk 70-gene signature.

  6. Late results following flap reconstruction for chest wall recurrent breast cancer.

    Science.gov (United States)

    Lindford, A J; Jahkola, T A; Tukiainen, E

    2013-02-01

    Locally extensive recurrent breast cancer usually portends a poor prognosis but certain cases can be treated surgically by wide soft-tissue resection as well as full-thickness chest wall resection (FTCWR). The resulting defect usually necessitates immediate flap coverage. The aim of this study was to assess local control, morbidity, choice of flap reconstruction, patient selection and overall long-term survival following surgical salvage of patients with chest wall recurrent breast cancer. Forty patients were treated with wide soft-tissue resection and immediate flap reconstruction from 1984 to 2011 in a single institution. Demographic, treatment and mortality data were obtained from patients' files. Mean age at surgery was 54 years. FTCWR was performed in 19 cases including three extended forequarter amputations. Chest wall stabilisation involved a synthetic mesh in 12 patients, fascia lata in two patients, free rib grafts in one patient and synthetic mesh and free rib graft in one patient. Soft-tissue reconstruction consisted of microvascular free flaps in seven patients and pedicled flaps in 33 patients. In-hospital mortality was 0%, 30-day mortality was 5%; there were two re-operations, six minor wound complications and one pulmonary embolism. There were no flap losses. In patients operated on with curative intent (n=31) median disease-free interval was 31 months and median survival was 52 months. In selected cases wide resections for extensive chest wall recurrent breast cancer can result in reasonable local control and survival. Several flap options exist for soft-tissue reconstruction. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Chemotherapy for isolated locoregional recurrence of breast cancer (CALOR): a randomised trial.

    Science.gov (United States)

    Aebi, Stefan; Gelber, Shari; Anderson, Stewart J; Láng, István; Robidoux, André; Martín, Miguel; Nortier, Johan W R; Paterson, Alexander H G; Rimawi, Mothaffar F; Cañada, José Manuel Baena; Thürlimann, Beat; Murray, Elizabeth; Mamounas, Eleftherios P; Geyer, Charles E; Price, Karen N; Coates, Alan S; Gelber, Richard D; Rastogi, Priya; Wolmark, Norman; Wapnir, Irene L

    2014-02-01

    Patients with isolated locoregional recurrences (ILRR) of breast cancer have a high risk of distant metastasis and death from breast cancer. We aimed to establish whether adjuvant chemotherapy improves the outcome of such patients. The CALOR trial was a pragmatic, open-label, randomised trial that accrued patients with histologically proven and completely excised ILRR after unilateral breast cancer who had undergone a mastectomy or lumpectomy with clear surgical margins. Eligible patients were enrolled from hospitals worldwide and were centrally randomised (1:1) to chemotherapy (type selected by the investigator; multidrug for at least four courses recommended) or no chemotherapy, using permuted blocks, and stratified by previous chemotherapy, oestrogen-receptor and progesterone-receptor status, and location of ILRR. Patients with oestrogen-receptor-positive ILRR received adjuvant endocrine therapy, radiation therapy was mandated for patients with microscopically involved surgical margins, and anti-HER2 therapy was optional. The primary endpoint was disease-free survival. All analyses were by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00074152. From Aug 22, 2003, to Jan 31, 2010, 85 patients were randomly assigned to receive chemotherapy and 77 were assigned to no chemotherapy. At a median follow-up of 4·9 years (IQR 3·6-6 ·0), 24 (28%) patients had disease-free survival events in the chemotherapy group compared with 34 (44%) in the no chemotherapy group. 5-year disease-free survival was 69% (95% CI 56-79) with chemotherapy versus 57% (44-67) without chemotherapy (hazard ratio 0·59 [95% CI 0·35-0·99]; p=0·046). Adjuvant chemotherapy was significantly more effective for women with oestrogen-receptor-negative ILRR (pinteraction=0·046), but analyses of disease-free survival according to the oestrogen-receptor status of the primary tumour were not statistically significant (pinteraction=0·43). Of the 81 patients who

  8. Recurrence Risk Factors Analysis for Stage I Non-small Cell Lung Cancer.

    Science.gov (United States)

    Wu, Ching-Feng; Fu, Jui-Ying; Yeh, Chi-Ju; Liu, Yun-Hen; Hsieh, Ming-Ju; Wu, Yi-Cheng; Wu, Ching-Yang; Tsai, Ying-Huang; Chou, Wen-Chi

    2015-08-01

    Lung cancer is the leading cause of cancer-related death worldwide. Even early-stage patients might encounter disease recurrence with relative high risk. Effective postoperative therapy is based on an accurate assessment of treatment failure after surgery. The aim of this study is to construct a disease-free survival (DFS) prediction model and stratify patients into different risk score groups.A total of 356 pathological stage I patients (7th American Joint Committee on Cancer) who underwent lung resection from January 2005 through June 2011 were retrospectively reviewed. Of these patients, 63 patients were eliminated for this study. A total of 293 p-stage I patients were included for further univariate and multivariate analysis. Clinical, surgical, and pathological factors associated with high risk of recurrence were analyzed, including age, gender, smoking status, additional primary malignancy (APM), operation method, histology, visceral pleural invasion, angiolymphatic invasion, tumor necrosis, and tumor size.Of the 293 p-stage I non-small cell lung cancer (NSCLC) patients examined, 143 were female and 150 were male, with a mean age of 62.8-years old (range: 25-83-years old). The 5-year DFS and overall survival rates after surgery were 58.9% and 75.3%, respectively. On multivariate analysis, current smoker (hazards ratio [HR]: 1.63), APM (HR: 1.86), tumor size (HR: 1.54, 2.03), nonanatomic resections (HR: 1.81), adenocarcinoma histology (HR: 2.07), visceral pleural invasion (HR: 1.54), and angiolymphatic invasion (HR: 1.53) were found to be associated with a higher risk of tumor recurrence. The final model showed a fair discrimination ability (C-statistic = 0.68). According to the difference risk group, we found patients with intermediate or higher risk group had a higher distal relapse tendency as compared with low risk group (P = 0.016, odds ratio: 3.31, 95% confidence interval: 1.21-9.03).Greater than 30% of disease recurrences occurred after surgery

  9. A case of radiation gastritis required surgical treatment in consequence of radiotherapy for recurrent ovarian cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hagino, Daisuke; Arai, Yuko; Komatsu, Atsushi; Inoue, Kumiko; Takechi, Kimihiro [Ibaraki Prefectural Central Hospital, Tomobe (Japan)

    2002-12-01

    We report a case of radiation gastritis in consequence of radiotherapy for recurrent ovarian cancer. A 61-year-old woman received irradiation of a metastatic lesion of the second lumbar vertebra. Six months later she complained of fatigue and presented with severe anemia, and her diagnosis was hemorrhagic radiation gastritis. She was treated endoscopically, but that failed to control the bleeding, making it necessary to resect surgically. The incidence of radiation gastritis is very low because the stomach is rarely within the treated field, but it is of importance to be aware that the stomach is by no means more radioresistant than other organs. (author)

  10. A case of recurrent spontaneous vesical rupture subsequent to irradiation for uterine cancer

    Energy Technology Data Exchange (ETDEWEB)

    Takemura, Hiroshi; Baba, Katsuyuki; Yajima, Michitaka; Yamakawa, Katsunori; Nishida, Shigehito; Iwamoto, Teruaki [St. Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    2000-04-01

    The patient, a 68-year-old woman, had undergone radical hysterectomy and post-operative radiotherapy for uterine cancer in 1974. She was admitted to our hospital complaining of abdominal pain in February, 1996. Contrast-enhanced computed tomographic scan and cystography showed leakage of contrast medium around the bladder. We diagnosed her with spontaneous vesical rupture, and performed conservative therapy. Two months later, she was re-admitted with recurrent vesical rupture. We again performed conservative therapy. We consider that conservative therapy can be indicated for spontaneous vesical rupture with good general condition and no severe urinary tract infection. (author)

  11. Novel use of an air-filled breast prosthesis to allow radiotherapy to recurrent colonic cancer.

    LENUS (Irish Health Repository)

    O'Duffy, F

    2011-03-01

    AiM: The authors present the novel and successful use of an air-filled breast prosthesis for extra pelvic exclusion of small bowel to facilitate adjuvant radiotherapy following resection of recurrent adenocarcinoma of the ascending bowel. The therapeutic use of radiotherapy in colon cancer can cause acute or chronic radiation enteropathy. Mobile small bowel can be sequestered in \\'dead space\\' or by adhesions exposing it to adjuvant radiotherapy. A variety of pelvic partitioning methods have been described to exclude bowel from radiation fields using both native and prosthetic materials.

  12. The leadership of topotecan in the treatment of recurrent platinum-resistant ovarian cancer

    Directory of Open Access Journals (Sweden)

    K. E. Borisov

    2012-01-01

    Full Text Available The review presents data on the efficacy of topoisomerase I inhibitor topotecan in patients with recurrent ovarian cancer when compared with other chemotherapeutic agents. It is shown that topotecan may be the drug of choice for platinum-resistant relapse. To reduce the hemato- logic toxicity is recommended weekly injection of 4 mg/m2 in 1, 8, 15 days of a 28-day cycle of therapy, as its effectiveness is comparable to the effectiveness of the standard 5-day regime.

  13. Photoimmunotherapy lowers recurrence after pancreatic cancer surgery in orthotopic nude mouse models

    Science.gov (United States)

    Maawy, Ali A.; Hiroshima, Yukihiko; Zhang, Yong; Garcia-Guzman, Miguel; Luiken, George A.; Kobayashi, Hisataka; Hoffman, Robert M.; Bouvet, Michael

    2015-01-01

    Introduction Photoimmunotherapy (PIT) is based on the use of a monoclonal antibody specific to cancer epitopes conjugated to a photosensitizer near-infrared (NIR) phthalocyanine dye (IR700). In this study, PIT with IR700 conjugated to anti-carcinoembryonic antigen (CEA) was used as an adjunct to surgery in orthotopically-implanted human pancreatic cancer in a nude mouse model in order to eliminate microscopic disease in the tumor bed and prevent local as well as metastatic recurrence. Materials & Methods Athymic nude mice were orthotopically implanted with the human pancreatic cancer cell line BxPC3 expressing green fluorescent protein (GFP). After tumor engraftment, the mice were divided into two groups: bright light surgery (BLS) + anti-CEA-IR700 + 690 nm laser (PIT) and BLS only. Anti-CEA-IR700 (100 μg) was administered to the treatment group via tail vein injection 24 hours prior to therapy. Tumors were resected and the surgical bed was treated with intraoperative phototherapy at an intensity of 150 mW/cm2 for 30 minutes. Mice were imaged non-invasively for 8 weeks using an OV-100 small animal fluorescence imager. Results BLS+PIT reduced local recurrence to 1/7 mice to 7/7 mice with BLS-only (p=0.001) and metastatic recurrence to 2/7 mice compared to 6/7 mice with BLS-only (p=0.03). Local tumor growth continued at a rapid rate after BLS only compared to BLS+PIT where almost no local growth occurred. There was a significant difference in tumor size between mice in the BLS+PIT (2.14 mm2, 95% CI [6.34, −2.06] and BLS-only groups (115.2 mm2, 95% CI [141.6, 88.8]) (p<0.001) at 6 weeks after surgery. There was also a significant difference in tumor weight between the BLS+PIT group (6.65 mg, 95% CI [19.65, −6.35] and BLS-only group (1100 mg, 95% CI [1406, 794] at 8 weeks (p<0.001) after surgery. Conclusions PIT holds promise in the treatment of pancreatic cancer and may serve as a useful adjunct to surgery in the eradication of microscopic residual disease that

  14. The diagnostic accuracy of carcinoembryonic antigen to detect colorectal cancer recurrence

    DEFF Research Database (Denmark)

    Sørensen, Caspar G; Karlsson, William K; Pommergaard, Hans-Christian;

    2016-01-01

    was to assess the diagnostic accuracy of CEA in detecting recurrence after intended curative surgery for primary colorectal cancer. METHODS: Systematic literature searches were performed in PubMed, EMBASE and Cochrane databases, and articles were chosen based on predefined inclusion criteria. Reference lists...... from included articles were manually searched for additional publications of relevance. RESULTS: Forty-two original studies with generally representative populations and long follow-up were included. Data were reported on outcomes from 9,834 CEA tests during follow-up. Reporting on the reference...

  15. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance.

    Science.gov (United States)

    Lou, Feiran; Huang, James; Sima, Camelia S; Dycoco, Joseph; Rusch, Valerie; Bach, Peter B

    2013-01-01

    At present, there is no consensus on the optimal strategy for follow-up care after curative resection for lung cancer. We sought to understand the patterns of recurrence and second primary lung cancer, and their mode of detection, after resection for early-stage non-small cell lung cancer in patients who were followed by routine surveillance computed tomography scan. We reviewed the outcomes of consecutive patients who underwent resection for early-stage non-small cell lung cancer at Memorial Sloan-Kettering Cancer Center between 2004 and 2009. A total of 1294 consecutive patients with early-stage non-small cell lung cancer underwent resection. The median length of follow-up was 35 months. Recurrence was diagnosed in 257 patients (20%), and second primary lung cancer was diagnosed in 91 patients (7%). The majority of new primary cancers (85 [93%]) were identified by scheduled routine computed tomography scan, as were a smaller majority of recurrences (157 [61%]). During the first 4 years after surgery, the risk of recurrence ranged from 6% to 10% per person-year but decreased thereafter to 2%. Conversely, the risk of second primary lung cancer ranged from 3% to 6% per person-year and did not diminish over time. Additional testing after false-positive surveillance computed tomography scan results was performed for 329 patients (25%), but only 4 of these patients (0.3%) experienced complications as a result of subsequent invasive diagnostic procedures. Almost all second primary cancers and the majority of recurrences were detected by post-therapeutic surveillance computed tomography scan. The risk of recurrence for early-stage non-small cell lung cancer survivors persisted during the first 4 years after resection, and vigilance in surveillance should be maintained. Copyright © 2013 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  16. Prospective Evaluation of Intraprostatic Inflammation and Focal Atrophy as a Predictor of Risk of High-Grade Prostate Cancer and Recurrence after Prostatectomy

    Science.gov (United States)

    2016-09-01

    manuscript on mast cells and recurrence was submitted for publication (to Cancer Immunology Research). Presentations and abstracts: Talks in which...Grade Prostate Cancer and Recurrence after Prostatectomy PRINCIPAL INVESTIGATOR: Elizabeth A. Platz RECIPIENT: Johns Hopkins University Baltimore, MD...Intraprostatic Inflammation and Focal Atrophy as a Predictor of Risk of High-Grade Prostate Cancer and Recurrence after 5b. GRANT NUMBER PC110754

  17. Omega-3 fatty acid is a potential preventive agent for recurrent colon cancer.

    Science.gov (United States)

    Vasudevan, Anita; Yu, Yingjie; Banerjee, Sanjeev; Woods, James; Farhana, Lulu; Rajendra, Sindhu G; Patel, Aamil; Dyson, Gregory; Levi, Edi; Maddipati, Krishna Rao; Majumdar, Adhip P N; Nangia-Makker, Pratima

    2014-11-01

    Increasing evidence supports the contention that many malignancies, including sporadic colorectal cancer, are driven by the self-renewing, chemotherapy-resistant cancer stem/stem-like cells (CSC/CSLC), underscoring the need for improved preventive and therapeutic strategies targeting CSCs/CSLCs. Omega-3 polyunsaturated fatty acids (ω-3 PUFA), have been reported to inhibit the growth of primary tumors, but their potential as a preventive agent for recurring cancers is unexplored. The primary objectives of this investigation are (i) to examine whether eicosapentaenoic acid (EPA; one of the ω-3 PUFA) synergizes with FuOx (5-FU+Oxaliplatin), the backbone of colon cancer chemotherapy, and (ii) whether EPA by itself or in combination with conventional chemotherapy prevents the recurrence of colon cancer via eliminating/suppressing CSCs/CSLCs. FuOx-resistant (chemoresistant; CR) colon cancer cells, highly enriched in CSCs, were used for this study. Although EPA alone was effective, combination of EPA and FuOx was more potent in (i) inhibiting cell growth, colonosphere formation, and sphere-forming frequency, (ii) increasing sphere disintegration, (iii) suppressing the growth of SCID mice xenografts of CR colon cancer cells, and (iv) decreasing proinflammatory metabolites in mice. In addition, EPA + FuOx caused a reduction in CSC/CSLC population. The growth reduction by this regimen is the result of increased apoptosis as evidenced by PARP cleavage. Furthermore, increased pPTEN, decreased pAkt, normalization of β-catenin expression, localization, and transcriptional activity by EPA suggests a role for the PTEN-Akt axis and Wnt signaling in regulating this process. Our data suggest that EPA by itself or in combination with FuOx could be an effective preventive strategy for recurring colorectal cancer.

  18. Loss-of-heterozygosity on chromosome 19q in early-stage serous ovarian cancer is associated with recurrent disease

    Directory of Open Access Journals (Sweden)

    Skirnisdottir Ingiridur

    2012-09-01

    Full Text Available Abstract Background Ovarian cancer is a heterogeneous disease and prognosis for apparently similar cases of ovarian cancer varies. Recurrence of the disease in early stage (FIGO-stages I-II serous ovarian cancer results in survival that is comparable to those with recurrent advanced-stage disease. The aim of this study was to investigate if there are specific genomic aberrations that may explain recurrence and clinical outcome. Methods Fifty-one women with early stage serous ovarian cancer were included in the study. DNA was extracted from formalin fixed samples containing tumor cells from ovarian tumors. Tumor samples from thirty-seven patients were analysed for allele-specific copy numbers using OncoScan single nucleotide polymorphism arrays from Affymetrix and the bioinformatic tool Tumor Aberration Prediction Suite. Genomic gains, losses, and loss-of-heterozygosity that associated with recurrent disease were identified. Results The most significant differences (p  Conclusions The results of our study indicate that presence of two aberrations in TP53 on 17p and LOH on 19q in early stage serous ovarian cancer is associated with recurrent disease. Further studies related to the findings of chromosomes 17 and 19 are needed to elucidate the molecular mechanism behind the recurring genomic aberrations and the poor clinical outcome.

  19. A successful live birth with in vitro fertilization and thawed embryo transfer after conservative treatment of recurrent endometrial cancer.

    Science.gov (United States)

    Kim, Sung Woo; Kim, Hoon; Ku, Seung-Yup; Suh, Chang Suk; Kim, Seok Hyun; Choi, Young Min

    2017-06-26

    Estrogen-dependent early stage endometrial cancer is relatively common in young women of reproductive age. The standard treatment is hysterectomy and bilateral salpingo-oophorectomy (BSO), even in early stage well-differentiated endometrial cancer patients. This surgical option results in permanent loss of fertility. There have been some reports of live births using in vitro fertilization after conservative management of endometrial cancer with high-dose progestin for the purpose of fertility preservation. However, most were not recurrent cases and pregnancy was achieved through conventional in vitro fertilization, which usually raises serum estradiol levels and may lead to the recurrence of endometrial cancer. To date, it is hard to find a case that can be referred for any possible different approach needed for the patients who experience recurrence. Here we report a successful live birth with in vitro fertilization using letrozole to maintain physiological levels of estradiol, and subsequent thawed embryo transfer after elective cryopreservation of embryos in a patient with recurrent endometrial cancer. There has been no evidence of disease recurrence at one year after delivery.

  20. Entero-enteric fistula from the stump of an end-to-side ileocolic anastomosis mimicking cancer recurrence.

    Science.gov (United States)

    Elsafty, N; Clancy, C; Bajwa, R; Memeh, K; Joyce, M R

    2015-09-15

    Enteric fistulae are a complex and technically frustrating complication of any bowel surgery. The constellation of associated non-specific symptoms often leads to extensive investigation and, in this case, suspicion of disease recurrence. A 71-year-old gentleman with a history of previous colorectal cancer presented with chronic diarrhoea, weight loss and left lower quadrant pain. Elective exploratory laparoscopy was performed to investigate possible disease recurrence due to elevated carcinoembryonic antigen levels and a positron emission tomography positive area within the mesentery. A jejunal-ileal fistula was found at laparotomy where the blind ileal stump of the end-to-side ileocolic anastomosis had fistulated into the jejunum. Resection of the affected jejunum was performed with end-to-end jejuno-jejunal re-anastomosis and stapling of the ileal stump. Specimen histology was negative for recurrence. Intestinal fistulae represent a diagnostic challenge. This is the first case report describing an enteric fistula mimicking cancer recurrence.

  1. Solitary Skeletal Muscle Metastasis as First Site of Recurrence of Cervical Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Indumathy Varadarajan

    2017-08-01

    Full Text Available Cervical cancer is the fourth most common cancer in women worldwide, with a large majority of prevalence (85% in developing countries. As of 2012, it accounts for 7.5% of all female cancer deaths. Despite its high prevalence, skeletal muscle metastasis from cervical cancer is extremely uncommon. In our extensive literature search, we were able to find only 8 cases where skeletal muscle metastasis was the only site of recurrence. We report a case of a 52-year-old African-American woman with a past medical history of cervical cancer (stage IIIB who presented with pain and swelling in her left upper arm over the preceding 2 months. MRI of the left upper arm showed a solid well-circumscribed mass measuring 7.0 × 2.8 × 2.5 cm, deep to the biceps. Biopsy of the mass revealed a metastatic squamous cell carcinoma that was p16-positive. PET scan showed that the lesion was the sole site of metastasis. She received local radiation with concurrent chemotherapy. Follow-up MRI 6 months after the completion of therapy showed resolution of the mass. She has remained disease-free for the last 24 months as evidenced by a PET/CT scan in May 2016. In this case report, we discuss the role of imaging and pathology in the diagnosis of a solitary metastatic lesion. This case also emphasizes the importance of a close follow-up which aids in early intervention, increasing overall survival.

  2. Comparison of recurrence and survival rates after breast-conserving therapy and mastectomy in young women with breast cancer

    OpenAIRE

    Cao, J Q; Olson, R. A.; Tyldesley, S.K.

    2013-01-01

    Multiple randomized trials have demonstrated that breast-conserving therapy with partial mastectomy and radiotherapy provides survival equivalent to that seen with mastectomy for patients with early-stage breast cancer. Breast-conserving therapy has been associated with better quality of life relative to mastectomy and has become the standard of care for patients with early-stage breast cancer. Young age has been identified as a risk factor for recurrence and death from breast cancer. Some st...

  3. Varying recurrence rates and risk factors associated with different definitions of local recurrence in patients with surgically resected, stage I nonsmall cell lung cancer.

    Science.gov (United States)

    Varlotto, John M; Recht, Abram; Flickinger, John C; Medford-Davis, Laura N; Dyer, Anne-Marie; DeCamp, Malcolm M

    2010-05-15

    The objective of this study was to examine the effects of different definitions of local recurrence on the reported patterns of failure and associated risk factors in patients who undergo potentially curative resection for stage I nonsmall cell lung cancer (NSCLC). The study included 306 consecutive patients who were treated from 2000 to 2005 without radiotherapy. Local recurrence was defined either as 'radiation' (r-LR) (according to previously defined postoperative radiotherapy fields), including the bronchial stump, staple line, ipsilateral hilum, and ipsilateral mediastinum; or as 'comprehensive' (c-LR), including the same sites plus the ipsilateral lung and contralateral mediastinal and hilar lymph nodes. All recurrences that were not classified as "local" were considered to be distal. The median follow-up was 33 months. The proportions of c-LR and r-LR at 2 years, 3 years, and 5 years were 14%, 21%, and 29%, respectively, and 7%, 12%, and 16%, respectively. Significant risk factors for c-LR on multivariate analysis were diabetes, lymphatic vascular invasion, and tumor size; and significant factors for r-LR were resection of less than a lobe and lymphatic vascular invasion. The proportions of distant (non-local) recurrence using these definitions at 2 years, 3 years, and 5 years were 10%, 12%, and 18%, respectively, and 14%, 19%, and 29%, respectively. Significant risk factors for distant failure were histology when using the c-LR definition and tumor size when using the r-LR definition. Local recurrence increased nearly 2-fold when a broad definition was used instead of a narrow definition. The definition also affected which factors were associated significantly with both local and distant failure on multivariate analysis. Comparable definitions must be used when analyzing different series. (c) 2010 American Cancer Society.

  4. Transcriptome analysis of recurrently deregulated genes across multiple cancers identifies new pan-cancer biomarkers

    DEFF Research Database (Denmark)

    Kaczkowski, Bogumil; Tanaka, Yuji; Kawaji, Hideya;

    2016-01-01

    RNAs which are upregulated in cancer, defining promoters which overlap with repetitive elements (especially SINE/Alu and LTR/ERV1 elements) that are often upregulated in cancer. Lastly, we documented for the first time upregulation of multiple copies of the REP522 interspersed repeat in cancer. Overall...

  5. True Local Recurrences after Breast Conserving Surgery have Poor Prognosis in Patients with Early Breast Cancer

    Science.gov (United States)

    Sarsenov, Dauren; Ilgun, Serkan; Ordu, Cetin; Alco, Gul; Bozdogan, Atilla; Elbuken, Filiz; Nur Pilanci, Kezban; Agacayak, Filiz; Erdogan, Zeynep; Eralp, Yesim; Dincer, Maktav

    2016-01-01

    Background: This study was aimed at investigating clinical and histopathologic features of ipsilateral breast tumor recurrences (IBTR) and their effects on survival after breast conservation therapy. Methods: 1,400 patients who were treated between 1998 and 2007 and had breast-conserving surgery (BCS) for early breast cancer (cT1-2/N0-1/M0) were evaluated. Demographic and pathologic parameters, radiologic data, treatment, and follow-up related features of the patients were recorded. Results: 53 patients (3.8%) had IBTR after BCS within a median follow-up of 70 months. The mean age was 45.7 years (range, 27-87 years), and 22 patients (41.5%) were younger than 40 years. 33 patients (62.3%) had true recurrence (TR) and 20 were classified as new primary (NP). The median time to recurrence was shorter in TR group than in NP group (37.0 (6-216) and 47.5 (11-192) months respectively; p = 0.338). Progesterone receptor positivity was significantly higher in the NP group (p = 0.005). The overall 5-year survival rate in the NP group (95.0%) was significantly higher than that of the TR group (74.7%, p 20 mm), high grade tumor and triple-negative molecular phenotype along with developing TR negatively affected overall survival (hazard ratios were 4.2 (CI 0.98-22.76), 4.6 (CI 1.07-13.03), 4.0 (CI 0.68-46.10), 6.5 (CI 0.03-0.68), and 6.5 (CI 0.02- 0.80) respectively, p 2 cm), high grade, triple negative phenotype, and having true recurrence were identified as independent prognostic factors with a negative impact on overall survival in this dataset of patients with recurrent breast cancer. In conjunction with a more intensive follow-up program, the role of adjuvant therapy strategies should be explored further in young patients with large and high-risk tumors to reduce the risk of TR. PMID:27158571

  6. Robotic Image-Guided Stereotactic Radiotherapy, for Isolated Recurrent Primary, Lymph Node or Metastatic Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jereczek-Fossa, Barbara Alicja, E-mail: barbara.jereczek@ieo.it [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Beltramo, Giancarlo [CyberKnife Center CDI, Milan (Italy); Fariselli, Laura [Radiotherapy Unit, Carlo Besta Neurological Institute Foundation, Milan (Italy); Fodor, Cristiana [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Santoro, Luigi [Department of Epidemiology and Statistics, European Institute of Oncology, Milan (Italy); Vavassori, Andrea; Zerini, Dario [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Gherardi, Federica [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Ascione, Carmen [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); Seconda Universita degli Studi di Napoli, Naples (Italy); Bossi-Zanetti, Isa; Mauro, Roberta [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy); Bregantin, Achille; Bianchi, Livia Corinna [CyberKnife Center CDI, Milan (Italy); De Cobelli, Ottavio [Department of Urology, European Institute of Oncology, Milan (Italy); Orecchia, Roberto [Department of Radiotherapy, European Institute of Oncology, Milan (Italy); University of Milan, Milan (Italy)

    2012-02-01

    Purpose: To evaluate the outcome of robotic CyberKnife (Accuray, Sunnyvale, CA)-based stereotactic radiotherapy (CBK-SRT) for isolated recurrent primary, lymph node, or metastatic prostate cancer. Methods and Materials: Between May 2007 and December 2009, 34 consecutive patients/38 lesions were treated (15 patients reirradiated for local recurrence [P], 4 patients reirradiated for anastomosis recurrence [A], 16 patients treated for single lymph node recurrence [LN], and 3 patients treated for single metastasis [M]). In all but 4 patients, [{sup 11}C]choline positron emission tomography/computed tomography was performed. CBK-SRT consisted of reirradiation and first radiotherapy in 27 and 11 lesions, respectively. The median CBK-SRT dose was 30 Gy in 4.5 fractions (P, 30 Gy in 5 fractions; A, 30 Gy in 5 fractions; LN, 33 Gy in 3 fractions; and M, 36 Gy in 3 fractions). In 18 patients (21 lesions) androgen deprivation was added to CBK-SRT (median duration, 16.6 months). Results: The median follow-up was 16.9 months. Acute toxicity included urinary events (3 Grade 1, 2 Grade 2, and 2 Grade 3 events) and rectal events (1 Grade 1 event). Late toxicity included urinary events (3 Grade 1, 2 Grade 2, and 2 Grade 3 events) and rectal events (1 Grade 1 event and 1 Grade 2 event). Biochemical response was observed in 32 of 38 evaluable lesions. Prostate-specific antigen stabilization was seen for 4 lesions, and in 2 cases prostate-specific antigen progression was reported. The 30-month progression-free survival rate was 42.6%. Disease progression was observed for 14 lesions (5, 2, 5, and 2 in Groups P, A, LN, and M respectively). In only 3 cases, in-field progression was seen. At the time of analysis (May 2010), 19 patients are alive with no evidence of disease and 15 are alive with disease. Conclusions: CyberKnife-based stereotactic radiotherapy is a feasible approach for isolated recurrent primary, lymph node, or metastatic prostate cancer, offering excellent in-field tumor

  7. Identification of Known and Novel Recurrent Viral Sequences in Data from Multiple Patients and Multiple Cancers

    DEFF Research Database (Denmark)

    Friis-Nielsen, Jens; Kjartansdóttir, Kristín Rós; Mollerup, Sarah

    2016-01-01

    have developed a species independent pipeline that utilises sequence clustering for the identification of nucleotide sequences that co-occur across multiple sequencing data instances. We applied the workflow to 686 sequencing libraries from 252 cancer samples of different cancer and tissue types, 32......Virus discovery from high throughput sequencing data often follows a bottom-up approach where taxonomic annotation takes place prior to association to disease. Albeit effective in some cases, the approach fails to detect novel pathogens and remote variants not present in reference databases. We...... non-template controls, and 24 test samples. Recurrent sequences were statistically associated to biological, methodological or technical features with the aim to identify novel pathogens or plausible contaminants that may associate to a particular kit or method. We provide examples of identified...

  8. Cicatricial Fibromatosis Diagnosis after Suspected Local Recurrence at the Bronchial Stump Following Lobectomy for Lung Cancer.

    Science.gov (United States)

    Hwang, Wan Jin; Lee, Yeiwon; Jung, Soo Young; Yeh, Daewook; Park, Soon Hyo; Yoon, Yoo Sang

    2016-04-01

    A mass excision surrounding the bronchial stump was performed to exclude malignancy in a 42-year-old man who had undergone a right lower lobectomy for lung cancer. The mass was identified as a cicatricial fibroma. Cicatricial fibromatosis, which is desmoid fibromatosis that arises in a surgical scar, is a well-known clinical condition. It consists of histologically benign neoplasms. Their occurrence after thoracic surgery is extremely rare. Biopsy or excision of suspicious lesions is very important for diagnosis. R0 resection remains the principal outcome for intra-thoracic desmoid fibromatosis. We report that a cicatricial fibromatosis in the subcarinal space was removed after suspicion of local recurrence at the bronchial stump follwing lobectomy for lung cancer.

  9. Recurrent Venous Thromboembolism as the Initial Clinical Presentation of Gastric Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Fariba Rezaeetalab

    2017-09-01

    Full Text Available Pulmonary thromboembolism (PTE is a clinically critical disease, misdiagnosis or delayed diagnosis of which can lead to increased rate of mortality. For prevention of recurrence of PTE, recognition of its risk factors or underlying diseases is of great importance. PTE is common in patients with cancer and has high morbidity and mortality rates. Although cancer is a lethal condition, PTE accelerates death in these patients. In the current study, we reported the case of a 50-year-old male presenting with dyspnea, pleuritic chest pain, and non-massive hemoptysis indicating pulmonary embolism. Anticoagulant therapy was initiated, but after 12 days of treatment, new deep vein thromboses in the left upper and right lower limbs were diagnosed. However, no specific risk factors or laboratory abnormalities were detected. History of weight loss during the recent months encouraged further investigation for ruling out malignancy, which led a diagnosis of gastric adenocarcinoma. He did not have any complaints of gastrointestinal disorders.

  10. Trabectedin therapy as an emerging treatment strategy for recurrent platinum-sensitive ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    Jos Antonio Lpez-Guerrero; Ignacio Romero; Andrs Poveda

    2015-01-01

    Epithelial ovarian cancer (OC) is a common gynecologic malignancy in women. The standard treatment for OC is maximal cytoreductive surgical debulking folowed by platinum-based chemotherapy. Despite the high response rate to primary therapy, approximately 85% of patients wil develop recurrent ovarian cancer (ROC). This review identifies the clinical use of trabectedin in the treatment algorithm for ROC, with specific emphasis on platinum-sensitive ROC, for which trabectedin in combination with pegylated liposomal doxorubicin has been approved as a treatment protocol. The main mechanisms of action of trabectedin at the celular level and in the tumor microenvironment is also discussed as bases for identifying biomarkers for selecting patients who may largely benefit from trabectedin-based therapies.

  11. Role of blood tumor markers in predicting metastasis and local recurrence after curative resection of colon cancer

    Science.gov (United States)

    Peng, Yifan; Zhai, Zhiwei; Li, Zhongmin; Wang, Lin; Gu, Jin

    2015-01-01

    Aim: To investigate the prognostic value of carcinoembryonic antigen (CEA), CA199, CA724 and CA242 in peripheral blood and local draining venous blood in colon cancer patients after curative resection. Methods: 92 colon cancer patients who received curative resection were retrospectively analyzed. The CEA, CA199, CA724 and CA242 were detected in peripheral blood and local draining venous blood. Results: Metastasis or local recurrence was found in 29 (29/92, 31.5%) patients during follow-up period. 92 patients were divided into two groups: metastasis/local recurrence group (n = 29) and non-metastasis/local recurrence group (n = 63). Peripheral venous CEA, CA199, CA724 and CA242 (p-CEA, p-CA199, p-CA724 and p-CA242) were comparable between two groups (P > 0.05). The median draining venous CEA (d-CEA) in metastases/local recurrence group (23.7 ± 6.9 ng/ml) was significantly higher than that in non-metastases/local recurrence group (18.1 ± 6.3 ng/ml; P 0.05). The optimal cut-off value of d-CEA was 2.76 ng/ml, with the sensitivity and specificity of 90% and 40% in the prediction of metastasis or local recurrence, respectively. d-CEA correlated with tumor differentiation, T stage, TNM stage, metastasis and local recurrence. Subgroup analysis showed that, of 41 patients with stage II colon cancer, the optimal cut-off value of d-CEA was 8.78 ng/mL, and the sensitivity and specificity were 87.5% and 69.7% in the prediction of metastasis or local recurrence, respectively. Conclusion: d-CEA may be a prognostic factor for stage II colon cancer patients. PMID:25785084

  12. ESMO-ESGO-ESTRO consensus conference on endometrial cancer

    DEFF Research Database (Denmark)

    Colombo, Nicoletta; Creutzberg, Carien; Amant, Frederic

    2015-01-01

    The first joint European Society for Medical Oncology (ESMO), European SocieTy for Radiotherapy & Oncology (ESTRO) and European Society of Gynaecological Oncology (ESGO) consensus conference on endometrial cancer was held on 11-13 December 2014 in Milan, Italy, and comprised a multidisciplinary...... panel of 40 leading experts in the management of endometrial cancer. Before the conference, the expert panel prepared three clinically-relevant questions about endometrial cancer relating to the following four areas: Prevention and screening, surgery, adjuvant treatment and advanced and recurrent...

  13. Chemotherapy for Isolated Locoregional Recurrence of Breast Cancer: The CALOR Randomised Trial

    Science.gov (United States)

    Aebi, Stefan; Gelber, Shari; Anderson, Stewart J.; Láng, István; Robidoux, André; Martín, Miguel; Nortier, Johan W.R.; Paterson, Alexander H.G.; Rimawi, Mothaffar F.; Cañada, José Manuel Baena; Thürlimann, Beat; Murray, Elizabeth; Mamounas, Eleftherios P.; Geyer, Charles E.; Price, Karen N.; Coates, Alan S.; Gelber, Richard D.; Rastogi, Priya; Wolmark, Norman; Wapnir, Irene L.

    2014-01-01

    BACKGROUND Patients with isolated locoregional recurrences (ILRR) of breast cancer have a high risk of distant metastasis and death from breast cancer. We investigated adjuvant chemotherapy for such patients in a randomised clinical trial. METHODS The CALOR trial (clinicaltrials.gov NCT00074152) accrued patients 2003-2010. The 162 patients with resected ILRR were centrally randomised using permuted blocks and stratified by prior chemotherapy, ER/PgR status, and location of ILRR. Eighty-five were allocated to chemotherapy (type selected by the investigator; multidrug for at least four courses recommended) and 77 to no chemotherapy. Patients with oestrogen receptor-positive ILRR received adjuvant endocrine therapy; radiation therapy was mandated for patients with microscopically involved surgical margins, and anti-HER2 therapy was optional. The primary endpoint was disease-free survival (DFS). All analyses were by intention to treat. FINDINGS At a median follow up of 4·9 (IQR 3.6,6.0) years we observed 24 DFS events and nine deaths in the chemotherapy group compared with 34 DFS events and 21 deaths in the no chemotherapy group. Five-year DFS was 69% vs. 57%, (hazard ratio for chemotherapy versus no chemotherapy, 0·59; 95% confidence interval 0·35 to 0·99; P=0·046) and five-year overall survival was 88% vs. 76%, (hazard ratio, 0·41; 95% CI, 0·19 to 0·89; P=0·02). Adjuvant chemotherapy was significantly more effective for women with oestrogen receptor-negative disease measured in the recurrence (interaction P=0·04), but analyses of DFS based on the oestrogen receptor status of the primary tumour were not statistically significant (interaction P=0·43). Among the 85 patients who received standard chemotherapy, 12 reported SAEs. INTERPRETATION Adjuvant chemotherapy should be recommended for patients with completely resected isolated locoregional recurrences of breast cancer, especially if the recurrence is oestrogen receptor negative. FUNDING Public Service

  14. Texture analysis of automatic graph cuts segmentations for detection of lung cancer recurrence after stereotactic radiotherapy

    Science.gov (United States)

    Mattonen, Sarah A.; Palma, David A.;