Hypofractionated External Beam Radiotherapy to Boost the Prostate with ≥85 Gy/Equivalent Dose for Patients with Localised Disease at High Risk of Lymph Node Involvement: Feasibility, Tolerance and Outcome

2014 ◽  
Vol 26 (6) ◽  
pp. 316-322 ◽  
Author(s):  
T. Zilli ◽  
S. Jorcano ◽  
L. Escudé ◽  
D. Linero ◽  
M. Rouzaud ◽  
...  
Keyword(s):  
Lymph Node ◽  
High Risk ◽  
External Beam Radiotherapy ◽  
Lymph Node Involvement ◽  
Equivalent Dose ◽  
External Beam ◽  
Node Involvement ◽  
Localised Disease

scholarly journals PD-0461: Characterization of nodal metastases in prostate cancer patients at high risk for lymph node involvement

2013 ◽  
Vol 106 ◽  
pp. S179
Author(s):  
S. Isebaert ◽  
E. Lerut ◽  
L. Van den Bergh ◽  
S. Joniau ◽  
R. Oyen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Cancer Patients ◽  
Lymph Node Involvement ◽  
Nodal Metastases ◽  
Node Involvement

scholarly journals Reliability of sentinel node procedure for lymph node staging in prostate cancer patients at high risk for lymph node involvement

2015 ◽  
Vol 54 (6) ◽  
pp. 896-902 ◽  
Author(s):  
Laura Van den Bergh ◽  
Steven Joniau ◽  
Karin Haustermans ◽  
Christophe M. Deroose ◽  
Sofie Isebaert ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Sentinel Node ◽  
Cancer Patients ◽  
Lymph Node Involvement ◽  
Lymph Node Staging ◽  
Sentinel Node Procedure ◽  
Node Involvement

Evaluating the prognostic significance of lymphovascular invasion in stage II and III colon cancer.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 685-685 ◽  
Author(s):  
Dorotea Mutabdzic ◽  
Shalana BL O'Brien ◽  
Elizabeth A. Handorf ◽  
Karthik Devarajan ◽  
Sanjay S. Reddy ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Lymph Node ◽  
High Risk ◽  
Adjuvant Chemotherapy ◽  
Lymphovascular Invasion ◽  
Lymph Node Involvement ◽  
Stage Ii ◽  
Stage Iii ◽  
Node Involvement

685 Background: Presence of lymphovascular invasion (LVI) is known to be a predictor of lymph node involvement in colon adenocarcinoma (CA). Lymph node involvement is associated with poorer prognosis necessitating adjuvant therapy. While some studies have suggested that LVI is a predictor of worse overall survival in early stage colon cancer, the significance of LVI on prognosis has not been tested in a comprehensive North American data set. Methods: Patients with stage II and III CA with LVI data available and those who received predefined standard of care treatment were identified from the National Cancer Data Base (NCDB) from 2011 to 2015. The relationship between LVI and overall survival was tested using Kaplan-Meier survival curves and Cox proportional hazards regression analysis after adjusting for relevant clinical and demographic variables. Hazard ratios and 95% confidence intervals are reported along with median overall survival (OS) where available. Results: The dataset included 93,070 patients with stage II and 66,701 patients with stage III CA. The proportion of patients with LVI was 13% in stage II and 47% in stage III CA. After adjusting for age, sex, gender, race, comorbidities, socioeconomic status, T, and N stage, LVI was associated with worse OS in stage II, HR 1.2 (1.15-1.25, p < 0.001), and in stage III, HR 1.25 (1.21-1.30, p < 0.001), CA. Median OS was 6.51 years with LVI versus. 6.85 years without LVI in stage II compared with 6.57 years with LVI versus not reached without LVI in stage III CA. Of the stage II patients with LVI, 20% received adjuvant chemotherapy (CT) and median OS was 6.91 years for those who did versus 6.07 years for those who did not receive CT. Conclusions: Our data suggest that LVI is an important predictor of OS in stage II and III CA. There is evidence that adjuvant chemotherapy improves OS in advanced CA but there remains uncertainty as to the benefit in stage II. Despite this uncertainty, guidelines suggest consideration of adjuvant CT in patients with high-risk stage II disease. Our data support the recommendation that LVI be considered a high-risk feature in stage II disease. Further studies are necessary to examine whether the type or duration of CT should differ for patients with CA and LVI.

scholarly journals Pelvic Radiotherapy versus Radical Prostatectomy with Limited Lymph Node Sampling for High-Grade Prostate Adenocarcinoma

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Christopher B. Baker ◽  
Andrew M. McDonald ◽  
Eddy S. Yang ◽  
Rojymon Jacob ◽  
Soroush Rais-Bahrami ◽  
...  
Keyword(s):  
Lymph Node ◽  
Radical Prostatectomy ◽  
Distant Metastasis ◽  
External Beam Radiotherapy ◽  
Lymph Node Involvement ◽  
Prostate Adenocarcinoma ◽  
Oncologic Outcomes ◽  
Lymph Node Sampling ◽  
Node Involvement

Purpose. To compare oncologic outcomes for patients with Gleason score (GS) ≥ 8 prostate adenocarcinoma treated with radical prostatectomy (RP) versus external beam radiotherapy combined with androgen deprivation (RT + ADT).Methods. Between 2001 and 2014, 121 patients with GS ≥ 8 were treated at our institution via RT + ADT (n=71) or RP (n=50) with ≥ 1 year of biochemical follow-up. Endpoints included biochemical failure (BF), distant metastasis, and initiation of salvage ADT.Results. The RT + ADT group was older, had higher biopsy GS, and had greater risk of lymph node involvement. All other pretreatment characteristics were similar between groups. Mean number of lymph nodes (LNs) sampled for patients undergoing RP was 8.2 (±6.18). Mean biochemical follow-up for all patients was 61 months. Five-year estimates of BF for the RT + ADT and RP groups were 7.2% versus 42.3%, (p<0.001). The RT + ADT group also had lower rates of distant metastasis (2% versus 7.8%) and salvage ADT (8% versus 33.8%).Conclusion. In this analysis, RT + ADT was associated with improved biochemical and metastatic control when compared to RP with limited LN sampling. How RT + ADT compares with more aggressive lymphadenectomy, as is currently our institutional standard, remains an important unanswered question.

Identification and characterization of nodal metastases in prostate cancer patients at high risk for lymph node involvement

2013 ◽  
Vol 52 (7) ◽  
pp. 1336-1344 ◽  
Author(s):  
Sofie Isebaert ◽  
Karin Haustermans ◽  
Laura Van den Bergh ◽  
Steven Joniau ◽  
Piet Dirix ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Cancer Patients ◽  
Lymph Node Involvement ◽  
Nodal Metastases ◽  
Node Involvement ◽  
Identification And Characterization

Neoadjuvant therapy for adenocarcinomas of the duodenum and ampulla of Vater.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 279-279
Author(s):  
G. Manoukian ◽  
A. Lal ◽  
S. Wen ◽  
Z. Jiang ◽  
R. T. Shroff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Neoadjuvant Therapy ◽  
Ampulla Of Vater ◽  
Lymph Node Involvement ◽  
High Risk Factors ◽  
High Risk Disease ◽  
Node Involvement

279 Background: Adenocarcinomas of the ampulla of Vater and duodenum are both rare periampullary tumors with limited data regarding the use of neoadjuvant therapy. We sought to better define the role of neoadjuvant therapy as compared to adjuvant therapy in patients with high-risk disease. Methods: Retrospective review of the M. D. Anderson Cancer Center (MDACC) tumor registry from 5/1990 to 1/2009 identified 66 cases of ampullary (26 neoadjuvant, 40 adjuvant) and 41 cases of duodenal adenocarcinoma (18 neoadjuvant, 23 adjuvant). Only patients who received adjuvant or neoadjuvant therapy and underwent surgical resection at MDACC where included. High-risk factors were defined as T3 or T4, poor differentiation, or lymph node involvement. Relapse-free survival (RFS) and overall survival (OS) were calculated from the start of surgical resection. Results: Median age was 61 yrs (range 30-82) and 39% were female. Neoadjuvant (n=44) and adjuvant therapy (n=63) consisted of 5-FU chemoradiation in 93% and 65%, systemic 5-FU based chemotherapy only in 5% and 24%, and gemcitabine or irinotecan based therapy in 2% and 11%, respectively. Pathological high-risk factors were seen in 77% and 95% of neoadjuvant and adjuvant patients, respectively. Indications for neoadjuvant therapy were high risk disease (70%), poor surgical candidate (16%), and concern for possible metastatic disease (14%). In the neoadjuvant group T and N downstaging were observed in 25% and 32% of patients, respectively; 3 patients (7%) had a pathological complete response. Neoadjuvant as compared to adjuvant therapy had similar 5-year OS (66% vs. 59%, p =0.8) and 5-year RFS (54% vs. 59%, p=0.4). Variables significant (p <0.05) in the multivariate analysis for OS were age >60 yrs, lymph node involvement, and margin positivity; and for RFS were lymph node involvement and margin positivity. Neither tumor type (duodenal vs. ampullary; OS HR: 1.6, p =0.2; RFS HR: 0.9, p=0.8) nor treatment type (neoadjuvant vs. adjuvant; OS HR: 1.2, p =0.6; RFS HR: 1.1, p=0.7) were significant for OS or RFS in the multivariate model. Conclusions: Neoadjuvant therapy appears to be a viable approach for high-risk duodenal and ampullary adenocarcinomas. Further investigation of this treatment approach is needed. [Table: see text]

scholarly journals A Retrospective, Observational Study to Determine the Patient and Tumor Characteristics of HER2-Positive Breast Cancer Patients Treated at Five Main Public Cancer Centers in Malaysia

2020 ◽  
Vol 6 (01) ◽  
pp. 10-19
Author(s):  
Ros Suzanna Ahmad Bustamam ◽  
Yu Kong Leong ◽  
Flora Li Tze Chong ◽  
Florence Wong Yoke Fui ◽  
Yew-Teik Cheong ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
High Risk ◽  
Cancer Patients ◽  
Lymph Node Involvement ◽  
Tumor Characteristics ◽  
Limited Information ◽  
Breast Cancer Patients ◽  
Her2 Breast Cancer ◽  
Node Involvement

Abstract Introduction Human epidermal growth factor receptor 2 (HER2) overexpressing breast cancer is a high-risk subtype with poor prognosis. The incidence of HER2 expressing tumors is high in Malaysia; however, there is limited information on the characteristics of these tumors. Therefore, we sought to collect the patient and tumor characteristics of HER2+ breast cancer cases at five centers in Malaysia. Patients and Methods A retrospective review was conducted of the data from charts of patients diagnosed with HER2+ breast cancer between January 2014 and December 2015 at Hospital Kuala Lumpur, Institute Kanser Negara, Hospital Pulau Pinang, Hospital Besar Sarawak, and Hospital Likas in Malaysia. Results Of the 1,519 screened patient’ charts, 396 were included for the analysis. The average age of HER2+ breast cancer cases at diagnosis was 51.07 years. A high percentage of cases presented at an advanced stage (38.89 and 12.12% with stage 3 and 4, respectively). About 58.84% of patients were categorized as “high-risk,” with one or more lymph node involvement. Close to half (47.98%) of cases presented with T2 stage tumors, and infiltrating ductal carcinomas were reported in 85.35% of tumors. The most common immunohistochemical subtype was estrogen receptor (ER)+/progesterone receptor (PR)+/HER2+ (47.47%), followed by ER–/PR–/HER2+ (37.12%). Conclusion HER2 overexpressing tumors represent an aggressive subtype in Malaysia with large tumor size, high tumor grade, and lymph node involvement. Early diagnosis and management of these tumors may help improve the survival rates. Future studies should help elucidate the treatment patterns and outcomes in HER2+ breast cancer patients in Malaysia.

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