Background
Stabilization or spontaneous regressions are demonstrated in more than half of patients affected by primary desmoid-type fibromatosis (DF) in retrospective studies. The objective of this ...phase II study was to prospectively assess the behavior of primary sporadic DT managed by active surveillance (AS).
Methods
This prospective, multicenter, observational study (NCT01801176) included patients ≥18 years of age with primary sporadic DF located in an extremity or the abdominal/thoracic wall. At inclusion, all patients were initially placed on AS. Follow-up was based on clinical and radiological evaluation by magnetic resonance imaging (MRI) performed at 1, 3, 6, 9, and 12 months, and then every 6 months for 3 years. The primary endpoint was progression-free survival (PFS) at 3 years according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1, as evaluated by a Central Review Board.
Results
Between 2012 and 2015, 100 patients were enrolled. The female/male ratio was 8 and the median age was 34 years (interquartile range IQR 30.8–43.9). Median follow-up was 46.6 months (IQR 36.8–61.1) and the 3-year PFS was 53.4% (95% confidence interval 43.5–63.1%). At progression (48 patients), 23 patients received active treatment. Fifty-eight patients (58%) presented with spontaneous tumor regression (decrease > 0% compared with the initial size) during the first 3 months (
n
= 35, 35%) or after an initial progression (
n
= 23, 23%), of whom 26 (26%) had partial responses (PRs). The median time to PR was 31.7 months (25.3–not available).
Conclusions
These data support the use of AS as the primary approach to select patients with peripheral DF who require aggressive treatment.
Background
The benefits of systematic re-excision (RE) after initial unplanned excision (UE) of soft tissue sarcoma (STS) are unknown.
Objective
The aim of this study was to evaluate the impact of ...delayed RE versus systematic RE after UE on overall survival (OS), metastatic relapse-free survival (MRFS), local relapse-free survival (LRFS), and rate of amputation.
Methods
Patients who underwent complete UE, without metastasis or residual disease, for primary extremity or superficial STS between 2007 and 2013 were analyzed. The amputation rate, LRFS, MRFS, and OS were assessed in cases of systematic RE in sarcoma referral centers (Group A), systematic RE outside of community centers (Group B), or without RE (Group C).
Results
Groups A, B, and C included 300 (48.2%), 71 (11.4%), and 251 (40.4%) patients, respectively. Median follow-up was 61 months and 5-year OS was 88.4%, 87.3%, and 88% in Groups A, B, and C, respectively (
p
= 0.22), while 5-year MFRS was 85.4%, 86.2%, and 84.9%, respectively (
p
= 0.938); RE (
p
= 0.55) did not influence MRFS. The 5-year LRFS was 83%, 73.5%, and 63.8% in Groups A, B and C, respectively (
p
= 0.00001). Of the 123 local recurrences observed, 0/28, 1/15, and 5/80 patients in Groups A, B, and C, respectively, required amputation (
p
= 0.41). Factors influencing LRFS were adjuvant radiotherapy hazard ratio (HR) 0.21;
p
= 0.0001, initial R0 resection (HR 0.24,
p
= 0.0001), and Group A (HR 0.44;
p
= 0.01).
Conclusion
Systematic RE in sarcoma centers offers best local control but does not impact OS. Delayed RE at the time of local relapse, if any, could be an option.
To evaluate the outcomes of adult patients with spermatic cord sarcoma (SCS).
All consecutive patients with SCS managed by the French Sarcoma Group from 1980 to 2017 were analysed retrospectively. ...Multivariate analysis (MVA) was used to identify independent correlates of overall survival (OS), metastasis-free survival (MFS), and local relapse-free survival (LRFS).
A total of 224 patients were recorded. The median age was 65.1 years. Forty-one (20.1%) SCSs were discovered unexpectedly during inguinal hernia surgery. The most common subtypes were liposarcoma (LPS) (73%) and leiomyosarcoma (LMS) (12.5%). The initial treatment was surgery for 218 (97.3%) patients. Forty-two patients (18.8%) received radiotherapy, 17 patients (7.6%) received chemotherapy. The median follow-up was 5.1 years. The median OS was 13.9 years. In MVA, OS decreased significantly with histology (HR, well-differentiated LPS versus others = 0.096; p = 0.0224), high grade (HR, 3 versus 1–2 = 2.7; p = 0.0111), previous cancer and metastasis at diagnosis (HR = 6.8; p = 0.0006). The five-year MFS was 85.9% 95% CI: 79.3–90.6. In MVA, significant factors associated with MFS were LMS subtype (HR = 4.517; p < 10-4) and grade 3 (HR = 3.664; p < 10-3). The five-year LRFS survival rate was 67.9% 95% CI: 59.6–74.9. In MVA, significant factors associated with local relapse were margins and wide reresection (WRR) after incomplete resection. OS was not significantly different between patients with initial R0/R1 resection and R2 patients who underwent WRR.
Unplanned surgery affected 20.1% of SCSs. A nonreducible painless inguinal lump should suggest a sarcoma. WRR with R0 resection achieved similar OS to patients with correct surgery upfront.
High-k ZrO2 thin films suitable formicroelectronics applications were deposited by DLI-MOCVD methodon planar Si (1 0 0) and pores etched in Si (1 0 0). The effects of various experimental parameters ...such astemperature of substrates, injection frequency, concentration of the precursor and oxygen partialpressure in the reactive chamber, were investigated in order to produce a single tetragonal ZrO2 phasewhich exhibits, according to the literature, the best permittivity.Taking into account the crystal structure, microstructure and chemistry of the films, the expectedphase was successfully deposited for high temperature of substrates, relatively high feeding rate and lowoxygen partial pressure. Although the 3D coverage is actually not perfect in high aspect ratio pores, theelectric properties of this sample are very promising with permittivity up to 27.
This work deals with high-density integrated capacitors for output filters in future micro DC-DC converters. To reach high capacitance density, 3D structures were created in silicon with DRIE ...followed by MOCVD of ZrO(2) (100 nm thick). The step coverage revealed two deposition regimes: a surface reaction controlled regime for cavities aspect ratio lower than 2 and a diffusion-controlled regime for higher aspect ratios. The ZrO(2) films present mostly a cubic/tetragonal structure. The permittivity extracted from the measurement is 26.4. These results are discussed with static dielectric responses calculated in literature.
This work deals with high-density integrated capacitors for output filters in future micro DC–DC converters. To reach high capacitance density, 3D structures were created in silicon with DRIE ...followed by MOCVD of ZrO
2 (100
nm thick). The step coverage revealed two deposition regimes: a surface reaction controlled regime for cavities aspect ratio lower than 2 and a diffusion-controlled regime for higher aspect ratios. The ZrO
2 films present mostly a cubic/tetragonal structure. The permittivity extracted from the measurement is 26.4. These results are discussed with static dielectric responses calculated in literature.
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