Primary tumour resection for synchronously metastatic phaeochromocytoma and paraganglioma: A population‐based study

2020 ◽  
Author(s):  
Kan Wu ◽  
Chuan Zhou ◽  
Zhihong Liu ◽  
Yiping Lu ◽  
Xiang Li
Keyword(s):  
Primary Tumour ◽  
Population Based ◽  
Tumour Resection ◽  
Population Based Study ◽  
Primary Tumour Resection

The impact of primary tumour resection and sidedness in patients with synchronous metastatic colorectal cancer (mCRC): Findings from the South Australian Metastatic Colorectal Cancer Registry (SAMCRC).

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 739-739
Author(s):  
Myron Klevansky ◽  
Sina Vatandoust ◽  
Lukah Dykes ◽  
Rob Padbury ◽  
Timothy Jay Price ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumour ◽  
Large Population ◽  
Population Based ◽  
Tumour Resection ◽  
Colorectal Tumour ◽  
Population Based Registry ◽  
The Impact ◽  
Primary Tumour Resection

739 Background: The benefit of primary tumour resection (PTR) in patients with synchronous mCRC is not clear. The influence of tumour location on PTR benefit is also uncertain. Methods: SAMCRC is a population based registry collating data from all patients in South Australia diagnosed with mCRC from February 2006. We examined outcomes according to whether the primary colorectal tumour was excised within 3 months of diagnosis or remained in situ; we also examined whether outcomes were affected by tumour side (right v left). Registry data was included for patients with synchronous metastic adenocarcinoma from colon or rectum. Exclusion criteria included metastasectomy, tumour resection within 7 days or death within 3 months of mCRC diagnosis. Kaplan Meier analysis was used for Survival. Tumour sidedness and PTR were analysed with a multivariate Cox proportional hazards model. Survival was measured from the landmark date (3 months from date of diagnosis). Results: 2575 patients with synchronous mCRC have entered the database, of which 1869 patients were eligible for the PTR analysis. 50.2% (n = 938) underwent PTR. 481 patients (51.3%) of the PTR analysis group had left-sided primary tumours whilst 436 had right sided tumours (46.5%) which was significant (p < 0.001). 63% of the PTR cohort were male (n = 1006). Site and age metastases were included in the multivariate analysis. PTR was associated with improved survival from landmark compared to no resection (15.0 mo vs 11.2 mo, 95% CI 15.0 – 16.3 vs 11.2 – 12.3, p = 0.031). In the entire synchronous mCRC group, left-sided tumours (62.1%) had a longer median survival (17.8 mo vs 10.4 mo, 95% CI 15.7 – 19.5 vs 10.4 – 11.7 p = < 0.001). An interaction test was performed for sidedness and was not significant. Conclusions: PTR was associated was associated with improvement in survival in this large population based registry. This finding did not differ signifcantly between right and left sided tumours. Survival was superior for patients with left sided tumours, in keeping with established data. Criteria for selection of patients with mCRC who benefit from PTR need to be defined.

scholarly journals Influence of primary tumour sidedness on survival after upfront primary tumour resection (PTR) in synchronous metastatic colon cancer (mCC)

2018 ◽  
Vol 29 ◽  
pp. viii177-viii178
Author(s):  
K.L. van Rooijen ◽  
S.A. Kurk ◽  
D.E.W. van der Kruijssen ◽  
S. Elias ◽  
A.M. May ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Primary Tumour ◽  
Tumour Resection ◽  
Metastatic Colon Cancer ◽  
Primary Tumour Resection

Pitfalls of using denosumab preoperatively to treat refractory severe hypercalcaemia

2020 ◽  
Vol 13 (4) ◽  
pp. e233665 ◽  
Author(s):  
Yulong Li ◽  
Chris Y Fan ◽  
Andrea Manni ◽  
William F Simonds
Keyword(s):  
Primary Tumour ◽  
Tumour Resection ◽  
Debulking Surgery ◽  
Off Label ◽  
Conventional Management ◽  
History Of ◽  
Lung Metastasectomy ◽  
Vitamin D Supplements ◽  
Severe Hypercalcaemia ◽  
Primary Tumour Resection

A 40-year-old man, with a history of metastatic parathyroid carcinoma, status post primary tumour resection and lung metastasectomy, was hospitalised for persistent severe hypercalcaemia and elevated parathyroid hormone levels despite conventional management and escalating doses of cinacalcet. A single dose (120 mg) of denosumab was given and his calcium level plummeted from 14.8 mg/dL to 5.5 mg/dL. After second lung metastasectomy, he developed prolonged hypocalcaemia that required calcium and vitamin D supplements for more than 3 years. In patients with severe hypercalcaemia refractory to conventional therapies, denosumab has been used off-label with some success. A known side effect of denosumab is hypocalcaemia, which is often short-lived. The risk of prolonged hypocalcaemia should be fully evaluated before using denosumab preoperatively, especially in patients with renal insufficiency, prolonged hyperparathyroidism or anticipated tumour debulking surgery.

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