scholarly journals Complete Radiologic Response and Long-Term Survival With Use of Systemic High-Dose Methotrexate for Breast Cancer–Associated Leptomeningeal Disease

2012 ◽  
Vol 12 (6) ◽  
pp. 445-449 ◽  
Author(s):  
Cesar A. Santa-Maria ◽  
Ashley Cimino-Mathews ◽  
Kendall F. Moseley ◽  
Antonio C. Wolff ◽  
Jaishri O. Blakeley ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Leptomeningeal Disease ◽  
High Dose ◽  
High Dose Methotrexate ◽  
Term Survival ◽  
Long Term Survival ◽  
Dose Methotrexate

Long Term Survival After High-Dose Chemotherapy with Autologous Hematopoietic Cell Transplantation in Metastatic Breast Cancer.

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3072-3072
Author(s):  
Betty K. Hamilton ◽  
Brian J. Bolwell ◽  
Lisa Rybicki ◽  
Shawnda Tench ◽  
Matt Kalaycio ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Metastatic Disease ◽  
Hematopoietic Cell Transplantation ◽  
Metastatic Breast ◽  
High Dose ◽  
Term Survival ◽  
Long Term Survival ◽  
Oligometastatic Disease

Abstract Abstract 3072 In the 1990s, the most common indication for high dose chemotherapy (HDC) and autologous hematopoietic cell transplantation (AHCT) was breast cancer. Several randomized controlled trials for metastatic breast cancer (MBC), performed to address the role of HDC and AHCT, found no survival benefit over conventional therapy. A recently published meta-analysis confirmed a lack of significant survival benefit and failed to identify any subset of patients that benefited from this approach. Many trials of HDC for MBC, however, demonstrate better than expected 10–15 year progression free and overall survival occurring in 5–15% of patients. These data prompted us to evaluate the long term results of treatment with HDC and AHCT in MBC at our institution. Two-hundred eighty five patients underwent HDC followed by AHCT for metastatic breast cancer from 1984–2000. Preparative regimens included STAMP V (cyclophosphamide [Cy], carboplatin, thiotepa [TT]), n=98; CBT (Cy, carmustine, TT), n=79; busulfan and Cy, n=54; TT, n=27; STAMP I (Cisplatin, Cy, BCNU), n=26; and BCNU, n=1. With a median follow up of 169 months (range 77–283 months) in survivors, 34 (12%) of these patients remain alive. Of the 251 patients who died, 218 (87%) died of relapsed/metastatic disease. Other causes of death included infectious or cardiopulmonary etiologies. Incidence of death from secondary malignancies was less than 1%. Her2 status was unavailable in the majority of the patients, but comparison by age (<50 and >50) and hormonal status did not demonstrate any significant differences in relapse (p=0.33 and p=0.32 respectively) or survival (p=0.13 and p=0.42). Using Cox analysis, we identified three prognostic factors for survival in multivariable analysis: number of prior chemotherapy regimens (HR 1.48 per 1 regimen increase, p<0.001); disease status, (HR 1.34, p=0.029 for partial response and HR 2.66, p=0.008 for relapsed/refractory disease); and source of hematopoietic cells (HR 2.45, p=0.012 for bone marrow compared to peripheral stem cells). Data regarding number and type of metastatic sites was not available for the entire cohort. Of the 34 long term survivors identified, sufficient data was available on 28 patients. In this cohort, 10 patients had metastatic disease at presentation while 18 patients had recurrent metastatic disease. Of the 10 patients with primary metastatic disease, 4 patients had oligometastatic involvement of the ipsilateral supraclavicular lymph node which would now be classified as stage IIIC disease by current AJCC staging guidelines. Three patients had limited bone disease and 3 had oligometastatic disease that had been resected. Of the 18 patients with recurrent metastatic disease, 9 had local recurrence at the site of the incision or chest wall, and 6 had a single site of recurrence primarily in the lung or loco-regional lymph nodes, also classified as primarily oligometastatic disease. Most of these lesions were surgically resected. Of the remaining patients, one had recurrent lesions in the liver, one had bilateral breast recurrence, and one had recurrence in the lung with additional possible bone involvement. This retrospective evaluation of patients who underwent HDC and AHCT for metastatic breast cancer demonstrates long term survival in a small subset of MBC patients, primarily those with primary or recurrent oligometastatic disease. Previous studies have suggested that oligometastatic breast cancer is a distinct subgroup with long-term prognosis that is superior to MBC. While the use of HDC and AHCT has largely been abandoned in the United States, several recent long term follow up studies such as this one questions its role for select populations. The use of HDC in subsets such as oligometastatic breast cancer may be beneficial, and may warrant further study; however, overall there remains no demonstrable benefit to HDC and long term survival is rare in the population of patients with metastatic disease. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Is It Definitely Clear That Long-Term Survival after Breast Cancer Surgery Is Not Affected by Anaesthetics?

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3390
Author(s):  
Mats Enlund
Keyword(s):  
Breast Cancer ◽  
Survival Data ◽  
Retrospective Studies ◽  
Breast Cancer Surgery ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival ◽  
Significant Difference ◽  
One Year

Retrospective studies indicate that cancer survival may be affected by the anaesthetic technique. Propofol seems to be a better choice than volatile anaesthetics, such as sevoflurane. The first two retrospective studies suggested better long-term survival with propofol, but not for breast cancer. Subsequent retrospective studies from Asia indicated the same. When data from seven Swedish hospitals were analysed, including 6305 breast cancer patients, different analyses gave different results, from a non-significant difference in survival to a remarkably large difference in favour of propofol, an illustration of the innate weakness in the retrospective design. The largest randomised clinical trial, registered on clinicaltrial.gov, with survival as an outcome is the Cancer and Anesthesia study. Patients are here randomised to propofol or sevoflurane. The inclusion of patients with breast cancer was completed in autumn 2017. Delayed by the pandemic, one-year survival data for the cohort were presented in November 2020. Due to the extremely good short-term survival for breast cancer, one-year survival is of less interest for this disease. As the inclusions took almost five years, there was also a trend to observe. Unsurprisingly, no difference was found in one-year survival between the two groups, and the trend indicated no difference either.

scholarly journals Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

2017 ◽  
Vol 44 ◽  
pp. 16-21 ◽  
Author(s):  
Michael H. Antoni ◽  
Jamie M. Jacobs ◽  
Laura C. Bouchard ◽  
Suzanne C. Lechner ◽  
Devika R. Jutagir ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Depressive Symptoms ◽  
Cancer Patients ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Carcinomatous Pericarditis in 3 Breast Cancer Patients with Long-Term Survival

2012 ◽  
Vol 5 (1) ◽  
pp. 195-201 ◽  
Author(s):  
Takanori Konishi ◽  
Rikiya Nakamura ◽  
Naohito Yamamoto ◽  
Yasuhide Onai ◽  
Toshi Okada ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Term Survival ◽  
Long Term Survival
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