Thymic hyperplasia is a common phenomenon in both children and young adults after chemotherapy and may explain the finding of a mediastinal mass in patients with malignant lymphoma after complete ...remission. In the present study, we report 5 cases with malignant lymphoma presenting with a mediastinal mass on CT scan after completion of chemotherapy diagnosed as thymic hyperplasia by PET-CT imaging. We retrospectively analyzed 5 patients who presented with anterior mediastinal masses a median of 4 months (range 3–6) after achieving complete remission following successful treatment for malignant lymphoma. Three patients were diagnosed with Hodgkin’s lymphoma (HL) and the others with non-Hodgkin’s lymphoma (NHL). The median age of the patients was 23 (range of 18–47). PET-CT was performed on these patients to determine the characteristics of a mass which had been detected on CT. PET-CT was performed for all patients, and the thymic masses demonstrated only mild FDG uptake considered to be consistent with thymic hyperplasia. During a median of 24 months of follow-up, all patients were recurrence-free with a median survival of 15 months (range 10–26 months). It is important to be aware of the possibility of thymic hyperplasia after chemotherapy to avoid misdiagnosis or over-staging of disease, as well as unnecessary biopsies, especially when the presenting anterior mediastinal mass was originally located near the thymus on CT scan. Mild FDG PET uptake was sufficient for the diagnosis of benign disease in the cases in this study.
Aim of the Study: Although surgery is considered to be curative treatment, recurrence rates are high in gastric cancer. Adjuvant 5-fluorouracil (5-FU) based chemoradiotherapy has been shown to ...improve the prognosis. We compared tolerability and efficacy of the two different chemotherapy regimens; 5-FU/leucovorin (LV) versus cisplatin with capecitabine (XP) combined with radiotherapy (RT) in the adjuvant therapy of the lymph node positive locally advanced gastric cancer.
Materials and Methods: Totally, 104 patients who underwent curative surgery with lymph node resection were evaluated, respectively. Patients were stratified two group based on the adjuvant chemoradiotherapy regimen. Group 1 (n = 46) received XP followed capecitabine with RT (XRT) then XP. Group 2 (n = 58) received 5-FU/LV combined with RT postoperatively. Two groups were compared based on clinicopathological parameters. Factors related with disease-free survival (DFS) and overall survival (OS) were analyzed.
Results: Totally, 32 patients had recurrent disease, and there was no difference between two groups. While peritoneal metastasis was more common in XP arm, distant metastasis was commonly seen in 5-FU/LV arm. There was no significant difference between two groups in regard of Grade 3/4 toxicitis; hematologic toxicities were more in 5-FU/LV group than XP arm. In addition, dose modification because of toxicities were more frequent in 5-FU/LV arm (P = 0.003). For all groups, lymph node dissection type was related with DFS, surgical margin and recurrence were important for OS.
Conclusion: XP-XRT regimen is well tolerated with lower toxicity compared the standard 5-FU/LV-RT. Although there is no difference with respect to outcome, patients with XP arm without the necessity of intravenous catheter admitted hospital less frequent than bolus5-FU/LV arm.
Following metastasis resection, 5-year survival rate has been reported as approximately 40%. There is no consensus regarding prognostic factors related to progression-free survival after repeated ...metastasectomies.
A total of 21 patients with metastatic colorectal cancer who underwent repeated metastasectomies were retrospectively analyzed. The periods between the first and second metastasectomies and that between the second metastasectomy and progression were defined as metastasis-free survival 1 (MFS1) and metastasis-free survival 2 (MFS2), respectively. Univariate analysis was used to analyze factors related to MFS1 and MFS2.
Approximately two-thirds of the patients had synchronous metastasis, which were localized mostly in the liver (90%). During a 49-months follow-up, MFS1 was 15.7 (8.4-23) months and MFS2 was 26.3 (12.3-40.4) months. Systemic chemotherapy followed the first metastasectomy (p=0.01), and the recurrence site (p=0.03) was found to be related to MFS1. Furthermore, the number of metastases during the first metastasectomy (p=0.02), the type of the chemotherapy regimen administered following the first metastasectomy (p=0.04), and the number of metastases before the second metastasectomy (p=0.03) were significantly related to MFS2.
Surgical resection is currently the most effective and curative form of therapy for colorectal metastasis, whenever possible. Repeated metastasectomies can be achieved safely in experienced centers; thus, the operability of the patients should be evaluated by a multidisciplinary approach during treatment.
Amaç: Akciğer kanserinde cinsiyet, tümör tipi ve diğer klinik özelliklerin sıklık ve mortalitedeki artışa sebep olduğu belirtilmiştir. Çalışmamızda, akciğer kanserli hastalarda klinik ve patolojik ...özelliklerin sağkalım üzerine etkilerini araştırdık. Hastalar ve Yöntem: Merkezimizde 2005-2012 yılları arasında akciğer kanseri tanısı almış 1031 olgunun dosyaları geriye dönük olarak incelendi. Bulgular: Kadınlarda en sık rastlanan akciğer kanseri tipi adenokarsinom (%42,2), erkeklerde en sık rastlanan tip skuamöz hücreli karsinom (% 41,5) olarak bulundu. Akciğer kanserinin sigara ile ilişkisinde, tiplendirilemeyen küçük hücreli dışı akciğer kanseri hariç, diğer akciğer kanseri hücreleri analiz edildiğinde,sigara içenlerde en sık skuamöz hücreli tip (%40,7) ve sigara içmeyenlerde ise en sık histopatolojik tanı adenokarsinom (% 39,8) olarak bulundu ve istatiksel olarak anlamlı bir ilişki saptandı. Tüm grup için medyan sağkalım süresi 12,09 ay olarak saptandı. Tek değişkenli analizlerde 60 yaşın altında olma, Doğu Kooperatif Onkoloji Grubu Performans Skoru (The Eastern Cooperative Oncology Group Performance Score- (ECOG PS))’na göre iyi performans durumu (0-1), % 5’den az kilo kaybı, primer tümörün büyüklüğü, metastaz olmaması ve erken evre hastalık faktörlerinin sağkalımı olumlu etkilediği saptandı. Çok değişkenli analizlerde sağkalımı olumlu etkileyen faktörler iyi performans durumu ve % 5’den az kilo kaybı olarak bulundu. Sonuç: Çalışmamız sonucunda, akciğer kanserinde cinsiyetler arasında histopatoloji tipinin farklılık gösterdiği saptandı. Sigara da histopatoloji tipini etkilemektedir. Ancak, cinsiyet, tümörün histopatoloji tipi ve sigara ile sağkalım arasında istatistiksel bir ilişkisi gösterilememiştir.
Purpose
The prognosis of gallbladder cancer is poor. Lymph node metastasis and the stage are known to be the strongest prognostic factors for survival. The aim of this study was to determine the ...importance of complementary surgery and other prognostic factors for survival of operated gallbladder cancer.
Material and Method
We retrospectively analyzed 62 localized gallbladder cancers. The prognostic factors for survival were evaluated by univariate and multivariate analysis.
Results
The 3-year overall survival (OS) and disease-free survival (DFS) rates were 52.8 and 43.5%, respectively. Totally, 37 patients (59.6%) were diagnosed incidentally during simple cholecystectomy which was performed for benign causes but only 56.4% of them underwent complementary surgery. 51.6% of the recurrence was detected during 18.4 months of follow-up time. R0 resection, T stage, and pathological stage were found to be related with both OS and DFS by univariate analysis. Grade, lymph node metastasis, and adjuvant chemotherapy were also related with DFS. Presence of recurrence, recurrence side, performance score (PS), and perineural invasion (PNI) were related with OS. Peritoneal metastasis, advanced stage disease, and lymph node metastasis were more common among patients who did not undergo complementary surgery. Adjuvant chemotherapy was given more frequently to patients who undergone complementary surgery group. The multivariate analysis indicated that grade, lymph node metastasis, stage, recurrence site, PS, and adjuvant chemotherapy stage were independent prognostic factors for DFS on the other and only stage was a prognostic factor for OS.
Conclusion
Our results showed that incidental diagnosis or complementary surgery was not related with DFS or OS but stage was only an independent prognostic factor for both OS and DFS in resected gallbladder cancer.
Abstract only
e12037
Background: Neoadjuvant chemotherapy(NAC) is the accepted approach for women with locally advanced breast cancer with technically inoperable disease. Systemic treatment is mainly ...based on the presence of the Estrogen (ER) receptor, Progesterone (PR) receptor and HER2 status on the core needle biopsy prior to treatment. Previously, discordance of the hormone receptor (HR) status was reported as 8-33% in the breast cancer patients after NAC. In here, we evaluated the HR and HER2 discordance after NAC in locally advanced breast cancer patients. Methods: We reviewed the data of 849 breast cancer patients retrospectively. The pathological specimens of core needle biopsy and operation specimens were re-evaluated for HR and HER2 status in 38 patients who had been treated with NAC. The changing of HR and HER2 status after chemotherapy was defined as discordance. The relationship between clinicopathological parameters and discordance and significance of them for disease-free survival (DFS) was analyzed by chi-square and univariaty test. Results: Over 80% of patients were clinically stage III breast cancer. Out of 24 patients were premenapouse and median age was 44.5(30-94). The patients were received median 4(1-6) cycles of NAC as 2 of them were only hormonotherapy, 8 were only antracycline and others were both antracycline and taxanes. Nearly 80% of patients were performed modified radical mastectomy(MRM).Postoperatively median tumor size was 1.6cm(0-10) and median dissected lymph nodes was 14(0-28). After operation, 4(10.5%), 8(21.1%) and 8(21.1%) discordance were detected for ER, PR and HER2 respectively. While HER2 discordance were related with recurrence(p=0.01) and PR discordance(p=0.04), ER discordance was related with only patological stage(p=0.03). At the median follow-up of 15.7 months, 5 year DFS rate and time were 30% and 30.4 months(18.7-42.2), respectively. Operation type, stage, lymphovascular invasion, perineural invasion were found to be significant for DFS, HR and HER2 discordance was not related with DFS. Conclusions: Until more definitive results will be obtained from future studies, receptor status of the residual tumor after NAC should be retested.
To evaluate patient profile for epidemiological and clinicopathological characteristics and potential risk/prognostic factors in newly diagnosed hepatocellular carcinoma (HCC) patients across Turkey.
...A total of 547 patients (mean (SD) age 62.6 (10.3) years, 81.9% were males) were included in this registry study. Data on patient characteristics, etiologies of HCC, laboratory values, and tumor characteristics and stages were recorded at study enrollment.
HBV infection (68.2%) was the leading etiology, followed by HCV infection (17.2%), HDV infection (5.5%), alcohol (6.4%), and NAFLD (3.5%), as the major etiologies. Considering that 51.6% of the patients had >5 cm HCC, 44% were Child-Pugh B/C and 57% were BCLC B-D, it appears that a significant group of HCC patients were diagnosed at advanced stages. Of 540 patients, 271 (50.2%) were referred or applied with the diagnosis of HCC. Patients with HCC at presentation had larger tumor size (median (min-max) 6.6 (0-30) vs. 4.8 (0-90) cm, P < .001) and more advanced BCLC stage (Stage C-D in 40.8% vs. 26.4%, respectively, P = .005), compared to patients who were diagnosed during follow-up.
Our findings revealed that HBV infection was the leading etiology and a moderate-to-advanced disease was evident in more than half of patients at the time of diagnosis. HCC patients diagnosed at follow-up had smaller tumor size and earlier BCLC stage.
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