scholarly journals Leiomyosarcoma of the Prostate: Case Report and Review of 54 Previously Published Cases

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-5 ◽  
Author(s):  
Gerasimos P. Vandoros ◽  
Theodoros Manolidis ◽  
Michalis V. Karamouzis ◽  
Maria Gkermpesi ◽  
Maria Lambropoulou ◽  
...  
Keyword(s):  
Case Report ◽  
Median Survival ◽  
Metastatic Disease ◽  
Multidisciplinary Approach ◽  
Survival Rates ◽  
Surgical Margins ◽  
Actuarial Survival ◽  
Term Survival ◽  
Uncommon Tumor

Prostate leiomyosarcoma is an extremely rare and highly aggressive neoplasm that accounts for less than 0.1% of primary prostate malignancies. We present a patient with primary leiomyosarcoma of the prostate and review 54 cases reported in the literature to discuss the clinical, diagnostic and therapeutic aspects of this uncommon tumor. Median survival was estimated at 17 months (95% C.I. 20.7–43.7 months) and the 1-, 3-, and 5-year actuarial survival rates were 68%, 34%, and 26%, respectively. The only factors predictive of long-term survival were negative surgical margins and absence of metastatic disease at presentation. A multidisciplinary approach is necessary for appropriate management of this dire entity.

scholarly journals Leiomyosarcoma of Prostate

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdeljalil Heddat ◽  
Younes Houry ◽  
Redouane Rabii
Keyword(s):  
Therapeutic Approach ◽  
Multidisciplinary Approach ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Multicenter Trial ◽  
Advanced Stage ◽  
Rare Tumor ◽  
Actuarial Survival ◽  
Term Survival

Prostate leiomyosarcoma is an extremely rare and very aggressive neoplasm that represents less than 0.1% of primary malignant tumors of the prostate. We present a patient with primary leiomyosarcoma of  prostate and examine the cases reported in the literature to discuss the clinical, diagnostic and therapeutic aspects of this rare tumor. Median survival was estimated at 17 months (95% CI 20.7–43.7 months) and the actuarial survival rates at 1, 3 and 5 years were 68%, 34% and 26%, respectively. The only predictors of long-term survival were negative surgical margins and the absence of metastatic disease at presentation. A multidisciplinary approach is necessary for the proper management of this terrible entity. Surgery with or without chemotherapy seems to be the main therapeutic method for operable leimyosarcomas, but in general there is no consensus on the best therapeutic approach. Most cases are diagnosed at an advanced stage of the disease. A global multicenter trial is needed to find therapies that would improve the prognosis.

scholarly journals An Early Periprosthetic Fracture of a Cementless Oxford Unicompartmental Knee Arthroplasty: Risk Factors and Mitigation Strategies

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Li Zong Xian ◽  
Andrew Tan Hwee Chye
Keyword(s):  
Case Report ◽  
Knee Arthroplasty ◽  
Periprosthetic Fracture ◽  
Perioperative Complications ◽  
Survival Rates ◽  
Mitigation Strategies ◽  
Term Survival ◽  
Revision Total Knee Replacement ◽  
Total Knee

Introduction: The cementless Oxford partial knee arthroplasty is associated with low perioperative complications and good long-term survival rates. However, perioperative fractures remain a serious morbidity for patients. Case Report: This case report describes an early post-operative tibial periprosthetic fracture through the keel slot, which we believe may be contributed by the deep implant keel design and the presence of a narrow metaphysis in the Asian knee. The patient subsequently underwent a revision total knee replacement and fixation of the periprosthetic fracture. Conclusion: This paper discusses the ways to identify patients at high risk of developing periprosthetic fractures and to minimize such occurrences, including adopting a modified tibial preparation, doing precise saw cuts, and considering a cemented tibial implant. Keywords: Cementless, Oxford, unicompartmental, periprosthetic, keel.

scholarly journals Natural History of C282Y Homozygotes for Hemochromatosis

2002 ◽  
Vol 16 (5) ◽  
pp. 297-302 ◽  
Author(s):  
John P Wojcik ◽  
Mark R Speechley ◽  
Ann E Kertesz ◽  
Subrata Chakrabarti ◽  
Paul C Adams
Keyword(s):  
Clinical Symptoms ◽  
Survival Rates ◽  
Tertiary Referral Centre ◽  
Actuarial Survival ◽  
Term Survival ◽  
Long Term Survival ◽  
Hemochromatosis Gene ◽  
Screening Study

PURPOSE: To study the clinical outcomes of subjects who are homozygous for the C282Y mutation of the hemochromatosis gene.SUBJECTS AND METHODS: All patients referred to a tertiary referral centre for hemochromatosis were included. The study also included 16 C282Y homozygotes detected in a population screening study.RESULTS: The study comprised 277 C282Y homozygotes, including 16 nonexpressing C282Y homozygotes. The mean follow-up period was 7.3 years (range zero to 44 years). The actuarial survival rates of C282Y homozygotes at five, 10 and 20 years were 95%, 93% and 66%, respectively. Life-threatening diseases (cirrhosis, hepatocellular carcinoma, diabetes, heart disease) were present in 36% of male C282Y homozygotes and 19% of female C282Y homozygotes. Cirrhosis of the liver and diabetes were the major clinical symptoms affecting long term survival. Only one nonexpressing homozygote required venesection therapy during the follow-up period.CONCLUSIONS: Long term survival is excellent in C282Y homozygotes diagnosed and treated before the development of cirrhosis and diabetes.

Survival investigation in patients with colorectal liver metastasis: A single-institution analysis.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 617-617
Author(s):  
Jianmin Xu ◽  
Dexiang Zhu ◽  
Li Ren ◽  
Ye Wei
Keyword(s):  
Liver Resection ◽  
Liver Metastasis ◽  
Liver Metastases ◽  
Median Survival ◽  
Colorectal Liver Metastasis ◽  
Survival Rates ◽  
Term Survival ◽  
Long Term Survival ◽  
Primary Colorectal Tumor

617 Background: To investigate survival in patients with colorectal liver metastasis (CRLM) and identify risk factors associated with survival. Methods: Clinical, pathologic, treatment and complete follow-up data were retrospectively collected from 1613 consecutive patients with CRLM in Zhongshan Hospital between 2000 and 2010. The prognostic value of different factors was studied through univariate and multivariate analyses. Results: The median survival was 22.0 mo and 5-yr survival rate was 16%. Survival of synchronous liver metastases (SLM) (21.2 mo and 16%) was lower than that of metachronous liver metastases (MLM) (30.1 mo and 23%, p<0.01). Survival after resection of liver metastases was 49.8 mo and 37%, higher than that after chemotherapy (22.2 mo and 0%), that after intervention(19.0 mo and 11%), that after chemotherapy combined with intervention(22.8 mo and 10%)and that after local regional treatment (28.5 mo and 0%). Expansion of the indications for liver resection (38.0 vs 48.0 mo, 32% vs 40%), simultaneous or staged resection of primary colorectal tumor and liver metastases (47.0 vs 44.0 mo, 33% vs 35%) and preoperative neoadjuvant therapy (44.0 vs 48.0 mo, 38% vs 36%) had no significant effect on survival. 64 initially irresectable patients could undergo surgery after convertible therapy, with the median survival 36.9 mo and 5-yr survival 30%, better than that of unresectable patients (18.2 mo and 8%). Five factors were found to be significant and independent predictors of poor survival by multivariate analysis: SLM, poorly differentiated primary, number of liver metastases >= 4, largest liver metastases >= 5 cm, and no surgical treatment of liver metastases. Giving one point to each above factor, the population was divided into six groups with 5-yr survival rates: 0 (64%), 1 (44%), 2 (29%), 3 (4%), 4 (4%) and 5 (1%) (p<0.01). Conclusions: Survival of SLM was lower than that of MLM. Resection of liver metastases provides good long-term survival benifit for patients with resectable and initially irresectable liver metastases. Expansion of the indications for liver resection is acceptable. Long-term survival outcome can be predicted from a risk factor scoring system.

Statistical analysis of clinicopathological features, radiotherapy, and survival in 170 cases of oligodendroglioma

1987 ◽  
Vol 67 (2) ◽  
pp. 224-230 ◽  
Author(s):  
Karl-Fredrik Lindegaard ◽  
Sverre J. Mørk ◽  
Geir E. Eide ◽  
Tore B. Halvorsen ◽  
Reidulv Hatlevoll ◽  
...  
Keyword(s):  
Survival Time ◽  
Median Survival ◽  
Postoperative Radiotherapy ◽  
Survival Rates ◽  
Tumor Resection ◽  
Survival Times ◽  
Term Survival ◽  
Content Type ◽  
Postoperative Irradiation

✓ The postoperative survival time of 170 nonrandomized patients treated for cerebral oligodendrogliomas in Norway from 1953 to 1977 was studied. Survival times were significantly prolonged if postoperative irradiation was performed in addition to surgery (median survival time 26.5 vs. 38 months, p = 0.039). In the group without postoperative radiotherapy, the 5-year rate of survival was 27% compared with 36% in the irradiated patients. The respective survival rates after 8 years were 14% versus 17%; thus, there was little effect on long-term survival. Irradiation appears not to be of benefit after “total” removal. Patients with partly resected lesions appeared to benefit from postoperative radiotherapy; the median survival period after subtotal tumor resection was 37 months with and 26 months without radiotherapy (p = 0.0089). The findings also indicate that irradiation doses between 40 and 50 Gy were as effective as doses between 50 and 60 Gy in increasing the patients' probability of surviving 5 years after subtotal tumor resection. Since the risk of radiation necrosis is proportional to the dose applied, the lower dose is recommended. These conclusions were also valid when adjustments were made for prognostically significant histological and clinical features.

Transapical versus Conventional Aortic Valve Replacement�A Propensity-Matched Comparison

2012 ◽  
Vol 15 (1) ◽  
pp. 4 ◽  
Author(s):  
David M. Holzhey ◽  
William Shi ◽  
A. Rastan ◽  
Michael A. Borger ◽  
Martin H�nsig ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Survival Rates ◽  
Long Term Results ◽  
Term Survival ◽  
Kaplan Meier ◽  
Risk Patients ◽  
Short And Long Term ◽  
Good Treatment Option ◽  
Matched Comparison

<p><b>Introduction:</b> The goal of this study was to compare the short- and long-term outcomes after aortic valve (AV) surgery carried out via standard sternotomy/partial sternotomy versus transapical transcatheter AV implantation (taTAVI).</p><p><b>Patients and Methods:</b> All 336 patients who underwent taTAVI between 2006 and 2010 were compared with 4533 patients who underwent conventional AV replacement (AVR) operations between 2001 and 2010. Using propensity score matching, we identified and consecutively compared 2 very similar groups of 167 patients each. The focus was on periprocedural complications and long-term survival.</p><p><b>Results:</b> The 30-day mortality rate was 10.8% and 8.4% (<i>P</i> = .56) for the conventional AVR patients and the TAVI patients, respectively. The percentages of postoperative pacemaker implantations (15.0% versus 6.0%, <i>P</i> = .017) and cases of renal failure requiring dialysis (25.7% versus 12.6%, <i>P</i> = .004) were higher in the TAVI group. Kaplan-Meier curves diverged after half a year in favor of conventional surgery. The estimated 3-year survival rates were 53.5% � 5.7% (TAVI) and 66.7% � 0.2% (conventional AVR).</p><p><b>Conclusion:</b> Our study shows that even with all the latest successes in catheter-based AV implantation, the conventional surgical approach is still a very good treatment option with excellent long-term results, even for older, high-risk patients.</p>

Új lehetőségek a refrakter és relabált Hodgkin-lymphomás betegek kezelésében

2015 ◽  
Vol 156 (45) ◽  
pp. 1824-1833 ◽  
Author(s):  
Árpád Illés ◽  
Ádám Jóna ◽  
Zsófia Simon ◽  
Miklós Udvardy ◽  
Zsófia Miltényi
Keyword(s):  
Stem Cell ◽  
Hodgkin Lymphoma ◽  
Treatment Options ◽  
Survival Rates ◽  
Relapse Free Survival ◽  
Term Survival ◽  
Free Survival ◽  
Novel Treatment ◽  
Refractory Hodgkin Lymphoma

Introduction: Hodgkin lymphoma is a curable lymphoma with an 80–90% long-term survival, however, 30% of the patients develop relapse. Only half of relapsed patients can be cured with autologous stem cell transplantation. Aim: The aim of the authors was to analyze survival rates and incidence of relapses among Hodgkin lymphoma patients who were treated between January 1, 1980 and December 31, 2014. Novel therapeutic options are also summarized. Method: Retrospective analysis of data was performed. Results: A total of 715 patients were treated (382 men and 333 women; median age at the time of diagnosis was 38 years). During the studied period the frequency of relapsed patients was reduced from 24.87% to 8.04%. The numbers of autologous stem cell transplantations was increased among refracter/relapsed patients, and 75% of the patients underwent transplantation since 2000. The 5-year overall survival improved significantly (between 1980 and 1989 64.4%, between 1990 and 1999 82.4%, between 2000 and 2009 88.4%, and between 2010 and 2014 87.1%). Relapse-free survival did not change significantly. Conclusions: During the study period treatment outcomes improved. For relapsed/refractory Hodgkin lymphoma patients novel treatment options may offer better chance for cure. Orv. Hetil., 2015, 156(45), 1824–1833.

scholarly journals Long-term survival with multiple metastasectomies for pulmonary osteosarcoma: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Satoshi Takamori ◽  
Hiroyuki Oizumi ◽  
Jun Suzuki ◽  
Katsuyuki Suzuki
Keyword(s):  
Case Report ◽  
Pulmonary Metastases ◽  
Multidisciplinary Treatment ◽  
Underlying Disease ◽  
Pulmonary Metastasectomy ◽  
Extensive Resection ◽  
Term Survival ◽  
Long Term Survival ◽  
Primary Surgery

Abstract Background Repeat pulmonary metastasectomy (PM) considerably improves the prognosis of patients with pulmonary metastases of osteosarcoma. Reports have demonstrated a significantly improved prognosis in patients who have undergone repeat metastasectomy for osteosarcoma; however, there have been no reports with more than six metastasectomies. Herein, we describe the long-term survival of a patient following resection of multiple tumors and other treatments for metastatic osteosarcoma. Case presentation A 28-year-old woman underwent extensive resection and postoperative adjuvant chemotherapy for right tibial sarcoma. Over the years, she developed repeated pulmonary metastases. First, 116 metastases were removed from the bilateral lungs. After that, multiple PMs of approximately 250 tumors and other treatments for deep metastatic lesions were performed. The patient died of the underlying disease 24 years after the primary surgery. Conclusions This case report demonstrates the long-term survival benefit of a multidisciplinary treatment centered on multiple metastasectomies.

Induction Therapy Prior to Surgical Resection for Patients Presenting with Locally Advanced Esthesioneuroblastoma

2020 ◽  
Author(s):  
Kevin C. Miller ◽  
John P. Marinelli ◽  
Jeffrey R. Janus ◽  
Ashish V. Chintakuntlawar ◽  
Robert L. Foote ◽  
...  
Keyword(s):  
Induction Therapy ◽  
Multidisciplinary Approach ◽  
Advanced Disease ◽  
Frozen Section ◽  
Locally Advanced ◽  
Patient Records ◽  
Term Survival ◽  
Positive Margins ◽  
Definitive Surgery

AbstractEsthesioneuroblastoma (ENB) is a rare olfactory malignancy that can present with locally advanced disease. At our institution, patients with ENB in whom the treating surgeon believes that a margin-negative resection is initially not achievable are selected to undergo induction with chemotherapy with or without radiotherapy prior to surgery. In a retrospective review of 61 patient records, we identified six patients (10%) treated with this approach. Five of six patients (83%) went on to definitive surgery. Prior to surgery, three of five patients (60%) had a partial response after induction therapy, whereas two of five (40%) had stable disease. Microscopically margin-negative resection was achieved in four of five (80%) of the patients who went on to surgery, while one patient had negative margins on frozen section but microscopically positive margins on permanent section. Three of five patients (60%) recurred after surgery; two of these patients died with recurrent/metastatic ENB. In summary, induction therapy may facilitate margin-negative resection in locally advanced ENB. Given the apparent sensitivity of ENB to chemotherapy and radiotherapy, future prospective studies should investigate the optimal multidisciplinary approach to improve long-term survival in this rare disease.

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