Disease-free survival for 9 years after liver resection for stage IV gallbladder cancer: Report of a case

Surgery Today ◽  
1995 ◽  
Vol 25 (8) ◽  
pp. 750-753 ◽  
Author(s):  
Masayuki Yamamoto ◽  
Kazuo Miura ◽  
Masakazu Yoshioka ◽  
Yoshiro Matsumoto
Keyword(s):  
Liver Resection ◽  
Gallbladder Cancer ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Free Survival ◽  
Disease Free

scholarly journals 300 Final analysis of a prospective, randomized, double-blind, placebo-controlled phase IIb trial of tumor lysate, particle-loaded, dendritic cell vaccine in stage III/IV melanoma: 36-month analysis

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A327-A327
Author(s):  
Lexy Adams ◽  
Robert Chick ◽  
Guy Clifton ◽  
Timothy Vreeland ◽  
Patrick McCarthy ◽  
...  
Keyword(s):  
Disease Free Survival ◽  
Stage Iv ◽  
Standard Of Care ◽  
Stage Iii ◽  
Tumor Lysate ◽  
Double Blind ◽  
Free Survival ◽  
Resected Stage ◽  
Disease Free ◽  
Stage Iv Melanoma

BackgroundThe tumor lysate, particle-loaded, dendritic cell (TLPLDC) vaccine is created ex vivo by loading autologous dendritic cells (DC) with yeast cell wall particles (YCWP) containing autologous tumor lysate, thus delivering tumor antigens to the DC cytoplasm via phagocytosis. TLPLDC then activates a robust T cell response against the unique antigens for each patient. The primary analysis of the prospective, randomized, multi-center, double-blind, placebo-controlled phase IIb trial in patients with resected stage III/IV melanoma showed TLPLDC improved 24-month disease-free survival (DFS) in the per-treatment (PT) analysis (patients completing the 6-month primary vaccine series). Here, we examine the secondary endpoint of 36-month DFS and overall survival (OS).MethodsPatients with resected stage III/IV melanoma were randomized 2:1 to TLPLDC vaccine or placebo (autologous DC loaded with empty YCWP). Treatments were given at 0, 1, 2, 6, 12 and 18 months. The protocol was amended to include patients receiving concurrent checkpoint inhibitors (CPIs) to follow changes in standard of care. The co-primary endpoints were 24-month DFS by intention-to-treat (IT) analysis and per-treatment (PT) analysis, with secondary endpoints including 36-month DFS and OS by ITT and PT analysis, pre-specified analysis by stage, and safety as measured by CTCAE v4.03.ResultsOverall, 103 patients received TLPLDC and 41 placebo. In PT analysis, 65 patients received TLPLDC and 32 placebo. Total adverse events (AEs), grade 3+ AEs, and serious AEs (SAEs) were similar in placebo vs TLPLDC groups, with one related SAE per treatment arm. By ITT analysis, 36-month OS was 76.2% for TLPLDC vs 70.3% for placebo (HR 0.72, p=0.437) and 36-month DFS was 35.6% vs 27.1% (HR 0.95, p=0.841). By PT analysis, 36-month DFS was improved with TLPLDC (57.5% vs 35.0%; HR 0.50, p=0.025, figure 1). This effect was even more dramatic in resected stage IV patients (36-month DFS: 60.9% vs 0%; HR 0.12, p=0.001, figure 2).ConclusionsThis phase IIb trial again demonstrates the safety of the TLPLDC vaccine, and an improved 36-month DFS in patients with resected stage III/IV melanoma who complete the primary vaccine series, particularly in the stage IV subgroup. Next, a phase III trial will evaluate the efficacy of TLPLDC vaccine as adjuvant treatment for resected stage IV melanoma, with patients randomized to receive standard of care PD-1 inhibitors + TLPLDC versus PD-1 inhibitors + placebo.Abstract 300 Figure 136-month disease free survival for patients receiving TLPLDC vs placebo by PT analysisAbstract 300 Figure 236-month disease free survival for subset of stage IV melanoma patients receiving TLPLDC vs placebo by PT analysisTrial RegistrationThis is a phase IIb clinical trial registered under NCT02301611Ethics ApprovalThis study was approved by Western IRB, protocol 20141932.

Treatment of relapsed non-Hodgkin's lymphomas with dexamethasone, high-dose cytarabine, and cisplatin before marrow transplantation.

1991 ◽  
Vol 9 (3) ◽  
pp. 423-431 ◽  
Author(s):  
O W Press ◽  
R Livingston ◽  
J Mortimer ◽  
C Collins ◽  
F Appelbaum
Keyword(s):  
Marrow Transplantation ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Large Cell ◽  
High Dose ◽  
Primary Therapy ◽  
Bulky Disease ◽  
Free Survival ◽  
Hodgkin's Lymphomas ◽  
Disease Free

Combination chemotherapy is capable of curing many patients with newly diagnosed intermediate- and high-grade non-Hodgkin's lymphomas (NHL), but treatment of relapsed NHL remains problematic. Bone marrow transplantation (BMT) offers the best chance for disease-free survival, but interim chemotherapy is often necessary while awaiting BMT, especially for patients with bulky disease. We report here 39 patients (median age, 44 years) who failed primary therapy with doxorubicin-based regimens and subsequently were treated with one to six cycles of dexamethasone, 40 mg intravenous (IV) every day on days 1 to 4, cisplatin 100 mg/m2 by continuous infusion on day 1, and cytarabine 2 g/m2 IV every 12 hours x two doses on day 2 (DHAP) before the planned BMT. Histologies included 16 diffuse large-cell, six diffuse mixed, five diffuse small-cleaved, four lymphoblastic, and eight other. Twenty-eight patients had stage IV disease, 13 had B symptoms, and 20 had an elevated lactate dehydrogenase (LDH). Patients had been treated with a median of three previous chemotherapy regimens. Sixty-one percent of patients had high tumor burdens according to the MD Anderson criteria. Objective responses to DHAP were seen in 26 patients (67%) including nine complete responses (CRs) (23%) and 17 partial responses (PRs) (44%), and responses lasted a median of 7.5 months. Myelosuppression was the major toxicity, but there were no treatment-related deaths. To date, 17 patients have undergone subsequent BMT with a projected 3-year disease-free survival of 15%. We conclude that the DHAP regimen is effective short-term salvage therapy for relapsed NHL patients, but the long-term prognosis of multiply relapsed patients remains poor.

Biologic behavior for patterns of recurrence and survival in ovarian versus uterine papillary serous carcinoma

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15056-15056
Author(s):  
B. de Souza
Keyword(s):  
Overall Survival ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Serous Carcinoma ◽  
Free Survival ◽  
Histological Features ◽  
Papillary Serous Carcinoma ◽  
Disease Free ◽  
Patterns Of Recurrence

15056 Background: Papillary serous carcinoma of the ovary (OPSC) and uterus (UPSC) are relatively uncommon malignancies with similar histological features. Information for their comparative behavior is lacking, hence a review was done to compare patterns of recurrence, disease-free and overall survival between the 2 groups. Methods: A retrospective review of 352 consecutive patients (pts) at a single institution with ovarian and uterine malignancies from 1991 through 2004 was done. Of these, 48 patients were identified with OPSC (n = 32) and UPSC (n = 16). To control surgeon as a prognostic factor, only pts undergoing surgery by a single surgeon were included. Stages at diagnosis, patterns of recurrence and survival for FIGO stages I-III with a minimum follow-up of 8 months were obtained from tumor registry, hospital and office records. The median follow-up for UPSC was 25 months and for OPSC was 46 months. Stage IV pts were excluded. Results: The mean age for OPSC and UPSC was 64 and 63 years respectively. Of the 32 OPSC pts, 94% had optimal debulking. In the UPSC group 88% had proper staging with lymph node dissection. The pts with OPSC had a mean overall survival of 60 months and a mean disease-free survival of 38 months for all stages combined. The pts with UPSC had a mean overall survival of 51 months and a mean disease-free survival of 40 months for all stages combined. Ten (31%) pts with OPSC had no recurrence. The remaining 22 (69%) pts had a total of 36 recurrences, the most common (17%) being pelvic masses (mean interval of 24 months). In the UPSC group, 9 (56%) had no recurrences. The remaining 7 (44%) had a total of 10 recurrences, the most common (30%) being peritoneal implants (mean interval of 17 months). Conclusions: UPSC is detected at an earlier stage twice as often as OPSC and yet it has lower overall survival. The disease-free interval is comparable, which shows that even after recurrence, the survival for OPSC is longer. Although OPSC and UPSC share similar histological features UPSC behaves more aggressively. [Table: see text] No significant financial relationships to disclose.

scholarly journals The Impact of Sarcopenia on Overall and Disease-free Survival after Liver Resection for Colorectal Liver Metastasis

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S735
Author(s):  
C.F. Fernández Mancilla ◽  
R. Rumenova Smilevska ◽  
B. Madrid Baños ◽  
J. Aparicio Navarro ◽  
M. Pujante Menchon ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Disease Free Survival ◽  
Free Survival ◽  
The Impact ◽  
Disease Free

scholarly journals Complete Response to Stage IV Colorectal Adenocarcinoma with Disease-free Survival at 24 Months: Case Report and Overview of the Literature

2020 ◽  
Vol 6 (2) ◽  
pp. 29
Author(s):  
Madison N Crank ◽  
Arslan Iqbal ◽  
Michael Abdelmasseh ◽  
Mohamed Alsharedi ◽  
Doreen Griswold ◽  
...  
Keyword(s):  
Case Report ◽  
Colorectal Adenocarcinoma ◽  
Disease Free Survival ◽  
Stage Iv ◽  
Complete Response ◽  
Free Survival ◽  
Disease Free

Role of adjuvant therapy in resected gallbladder cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 452-452
Author(s):  
Mohamed Abdelrahim Muddathir Hassan ◽  
Nicha Wongjarupong ◽  
Cristobal T. Sanhueza ◽  
Mindy L. Hartgers ◽  
Fatima Hassan ◽  
...  
Keyword(s):  
Overall Survival ◽  
Adjuvant Therapy ◽  
Gallbladder Cancer ◽  
Cancer Patients ◽  
Surgical Resection ◽  
Adjuvant Treatment ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free

452 Background: Surgical resection is the only curative treatment for patients with gallbladder cancer, despite surgical advances many patients ultimately develop recurrent disease. Management of resected gallbladder cancer mostly relies on single-arm trials and retrospective observations. The purpose of our study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer patients who have undergone surgical resection. Methods: Clinical data were collected on 251 patients who underwent surgical resection for stage I-III gallbladder cancer and presented to Mayo clinic from January 2000-December 2015. Patients were then classified into adjuvant treatment group and surveillance only group. Overall survival and recurrence were compared between the two groups. Results: 78 (31.1%) patients received adjuvant therapy while 173 patients were observed only. Patients who received adjuvant tended to be younger (63.0[SD 11] vs 66.2 [SD 13.1]), have higher stage, and underwent extended surgery. Most patients received chemoradiotherapy (55) with 5-Fluorouracil (67.3%) and capecitabine (25.5%) as radiosensitizing agents. 21 patients received additional adjuvant chemotherapy. 27% of patients received chemotherapy as the sole adjuvant treatment. The most common chemo regimens included gemcitabine (52.3%) and gemcitabine plus cisplatin combination (23.8%). On multivariate analysis patients > 65 years(HR 1.53 [1.07-2.19], p = 0.02), males (HR 1.7 [1.2-2.4], p = 0.003), positive margins (2.77 [1.69-4.38], p < 0.01), and stage III (HR 1.91 [1.35-2.70], p < 0.01) had worse overall survival. Patients who underwent extended radical resection (HR 0.73 [0.51-1.05], p = 0.09) had better overall survival. Adjuvant therapy had no statistical significant effect on overall survival (HR 1.10 [0.75-1.59], p = 0.63 or disease free survival (HR 1.05 [0.69-1.59], p = 0.81) on overall population. However, in stage IIIB, patients receiving adjuvant therapy had better overall survival (HR 0.51 [0.25-1.01], p = 0.05) and disease free survival (HR 0.45 [0.19-1.09], p = 0.06). Conclusions: In our study, adjuvant treatment, especially chemoradiation therapy, was only beneficial in patients with stage IIIb gallbladder cancer patients.

PTH-104 Tumour doubling time of colorectal metastases in patients selected for liver resection does not influence post-operative disease-free survival

Gut ◽  
2015 ◽  
Vol 64 (Suppl 1) ◽  
pp. A454.1-A454
Author(s):  
M Wiggans ◽  
G Shahtahmassebi ◽  
S Aroori ◽  
M Bowles ◽  
C Briggs ◽  
...  
Keyword(s):  
Liver Resection ◽  
Doubling Time ◽  
Disease Free Survival ◽  
Colorectal Metastases ◽  
Free Survival ◽  
Tumour Doubling Time ◽  
Disease Free

Efficacy of RICE as Second Line Chemotherapy in Transplant Ineligible Patients with Diffuse Large B Cell Lymphoma: a Single Institution Experience.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4757-4757
Author(s):  
Mousami Shah ◽  
Shylendra B Sreenivasappa ◽  
Barbara Yim ◽  
Bety Ciobanu ◽  
Rosalind Catchatourian
Keyword(s):  
Cell Lymphoma ◽  
Disease Free Survival ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
Second Line ◽  
Free Survival ◽  
Large B Cell Lymphoma ◽  
Line Therapy ◽  
Disease Free ◽  
Large B Cell

Abstract Abstract 4757 Background The response of patients with relapse/refractory (s/p CHOPR) Diffuse large B Cell Lymphoma (DLBCL) to RICE chemotherapy in transplant ineligible patients (pts) is not well studied. Methods 28 consecutive pts with DLBCL, relapsed/refractory to CHOPR chemotherapy diagnosed in 2003 to 2008 were studied as a retrospective cohort for clinical presentation, prognostic characteristics and long term survival. Prognostic characteristics and survival was analyzed using fisher's exact test, exact logistic regression and Kaplan Meier analysis. Multiple imputation methods were used for missing data. Results 28 pts, 11(39%) were female, 17(61%) male. 11 (39.3%) African Americans, 12 (42.9%) Hispanic, 3 (11%) Caucasian and 2 (7%) Asians. 3 (10.7%) presented with stage I at diagnosis, 1(3.6%) stage II, 5(17.9%) stage III and 19 (67.9%) stage IV. The median age at diagnosis was 50.5 years (yrs) (22-71). 4 (14.3%) presented with stage I, 5(17.9%) stage II, 9(32.1%) stage III, 10(35.7%) stage IV. 14(50%) had intermediate risk Revised IPI score, 14 (50%) had high risk disease at presentation. 21(75%) had relapse and 7(25%) had refractory disease. Median time to relapse was 12 months (0-40). Median age at relapse was 51.5 yrs (23-72). 4 (14.3%) presented with stage I at relapse, 5 (17.9%) stage II, 9(32.1%) stage III and 10 (35.7%) stage IV. 12(42.8%) had intermediate risk R-IPI score at relapse and 16(57.2%) had high risk R-IPI score. The median follow up was 30 months (8-60). All patients received first line therapy with CHOPR 6-8 cycles. RICE was used as second line therapy. Median number of cycles was 4 (1-7). 10 (35.7%) had a complete response. 13 (46.4%) had partial response and 5 (17.9%) had progression of disease. Disease free survival was 10 months (0-55). Median overall survival was 30.5 months (8-60). There was no treatment related mortality. Extra nodal involvement (p=0.0094) was the only factor that significantly influenced response to RICE chemotherapy. Race (p=0.081) had boarder line significance with African American having poor response compared to other race. Pt with relapsed disease (p=0.013) and extra nodal involvement at relapse (p=0.049) had better disease free survival. The LDH at presentation (p=0.012), no extra nodal involvement at presentation (p=0.004), relapsed disease (p=0.048) and CR to RICE (0.001) significantly influenced overall survival. Conclusion In transplant ineligible patients with relapsed/refractory Diffuse Large B Cell Lymphoma, RICE can be considered as a second line therapy with a response rate of over 80%. The median disease free survival was 10 months, overall survival was 30.5 months. Pt with lower LDH and chemo sensitive disease had better over all survival. Poor response of African Americans to second line chemotherapy needs to be further investigated. Disclosures: No relevant conflicts of interest to declare.

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