scholarly journals Pediatric Primary Alveolar Soft Part Sarcoma of the Bladder

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Kazuya Tanabe ◽  
Shigeru Nakamura ◽  
Taiju Hyuga ◽  
Shina Kawai ◽  
Masahiro Yamazaki ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Bladder Tumor ◽  
Clinical Course ◽  
Soft Part ◽  
Surgical Margin ◽  
Residual Tumor ◽  
Alveolar Soft Part Sarcoma ◽  
Positive Surgical Margin ◽  
Continent Urinary Reservoir ◽  
Urinary Reservoir

A 9-year-old girl was diagnosed with primary alveolar soft part sarcoma of the bladder after imaging examinations and transurethral resection (TUR) of the bladder tumor. As a positive surgical margin of the TUR indicated residual tumor cells, we performed a cystourethrectomy to remove the tumor. A continent urinary reservoir for self-catheterization was constructed using the Mainz pouch technique, and an abdominal (umbilical) continent catheterizable stoma using the appendix was performed. For 2.5 years postoperatively, the patient remained free of local recurrence and distant metastasis. The patient’s clinical course has been favorable, with good management of clean intermittent self-catheterization.

scholarly journals Postoperative radiotherapy of cervival carcinoma: Treatment results and analysis of prognostic factors

2009 ◽  
Vol 56 (4) ◽  
pp. 195-200
Author(s):  
V. Plesinac-Karapandzic ◽  
N. Borojevic ◽  
Z. Milosevic ◽  
B. Markovic ◽  
M. Nikitovic ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Prognostic Factors ◽  
Lymph Nodes ◽  
Cancer Patients ◽  
Early Stage ◽  
Postoperative Radiotherapy ◽  
Surgical Margin ◽  
Disease Free Survival ◽  
Residual Tumor ◽  
Positive Surgical Margin

The purpose of the study was to evaluate the efficacy of postoperative radiotherapy (RT) and to investigate prognostic factors for early-stage cervical cancer patients. We reviewed the medical records of 162 cervical cancer patients treated by RT during 2003 year. RT included 30- 45Gy of external photons to pelvis in 12-25 fractions. Brachytherapy with 192Ir was delivered in 3-5 fractions to a dose of 27-32 Gy. The mean age was 49 years (range 27-71). Majority of patients 130 had Stage Ib. Radical hysterectomy with lymphadenectomy was performed in 122pts. and simple hysterectomy in 40 pts. The 5-year actuarial overall survival (OS) for all patients was 92,6% and disease-free survival (DFS) was 90,9%.There was statistically significant differences in OS and DFS in pat. with positive vs. negative pelvic lymph nodes; tumor 4cm vs. tumor <4cm; positive vs. negative surgical margin/residual tumor (p<0,05). Late GIT complications were determined in 35,8% and UT in 12,3%. In conclusion, postoperative radiotherapy has achieved high-satisfactory survival with acceptable complications. The survival benefit was less evident among patients with positive lymph nodes, tumor > 4cm and positive surgical margin/ residual tumor.

scholarly journals Alveolar Soft Part Sarcoma of Urinary Bladder Occurring as a Second Primary Malignancy: A Case Report and Literature Review

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Manint Usawachintachit ◽  
Piyada Sitthideatphaiboon ◽  
Voranuch Thanakit ◽  
Sulada Pukiat ◽  
Kamol Panumatrassamee ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Soft Part ◽  
Lymphoblastic Leukemia ◽  
Surgical Margin ◽  
Alveolar Soft Part Sarcoma ◽  
Second Primary ◽  
Histopathological Diagnosis ◽  
Ureteral Orifice ◽  
Second Primary Malignancy ◽  
Primary Malignancy

We report a case of bladder alveolar soft part sarcoma in an 18-year-old Thai male patient who had been treated with testicular radiation and systemic chemotherapy for acute lymphoblastic leukemia with testicular relapse. He presented with recurrent dysuria and gross hematuria. Cystoscopy revealed a 2-centimeter irregular sessile mass at the bladder base adjacent to left ureteral orifice. Transurethral resection of the tumor was performed. The histopathological diagnosis was alveolar soft part sarcoma. Chest and abdominal computed tomography showed no evidence of metastasis. He was treated with partial cystectomy and left ureteral reimplantation with negative surgical margin. No evidence of recurrence was found during a 28-month follow-up period with surveillance cystoscopy and computed tomography of the chest and abdomen.

Predictive factor for residual tumor after lumpectomy for close margins

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11538-e11538
Author(s):  
V. Ozmen ◽  
S. Ozkan Gurdal ◽  
M. Muslumanoglu ◽  
A. Igci ◽  
S. S. Tuzlali ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Early Breast Cancer ◽  
Ductal Carcinoma ◽  
Residual Disease ◽  
Surgical Margin ◽  
Residual Tumor ◽  
Excisional Biopsy ◽  
Breast Conserving Surgery ◽  
Positive Surgical Margin ◽  
Breast Cancer Patients

e11538 Background: It is critical to obtain clear margins to minimize local recurrence after breast conserving surgery(BCS). When re-excisions are performed, there is often no residual disease in the new specimen, calling into question the need for re-excision(s) or mastectomy. The aim of the present study was to identify factors predicting a histologically positive re-excision specimen. Methods: Our prospective breast cancer database was queried for all invasive breast cancer patients who underwent a re-excision lumpectomy for either close or positive margins after an attempt at BCS. Close margins are defined as ≤ 2 mm for invasive carcinoma and presence of ductal carcinoma in situ(DCIS). Clinicopathologic features were correlated with the presence of residual disease in the re-excision specimen. Results: Between February 1997 and August 2008, 2054 patients with early breast cancer underwent surgical treatment in our breast unit. 939(45.7%) of them had BCS. In 543 patients(26.4%), re-excision required due to close margins on the permanent section analysis of their initial surgical specimens. 186 patients(34.3%) had previous excisional biopsy in other clinics. Median age of 543 patients was 50 years. In 290 patients(53.4%), mastectomy was performed due to positive surgical margin or poor cosmetic results. There were no residual tumors in re-excision(65.6 %) or mastectomy(42.4%) specimens of patients. The factors associated with tumor positive re-excision specimen were, age ≤50 years(p=0.044), lymphovascular invasion (p=0.029), multifocality(p<0.001), tumor size >2cm(p=0.008), presence of DCIS(p=0.018), focal margin positivity(p<0.001), DCIS at resection margin(p=0.008) and node positivity (p<0.001). Conclusions: Most of our patients with early breast cancer had unnecessary re-excisions or mastectomy to obtain clear surgical margins. In subset group of patients, re-excision or mastectomy may not be required. No significant financial relationships to disclose.

p53 Immunostaining of Surgical Margins as a Predictor of Local Recurrence in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx

1997 ◽  
Vol 76 (11) ◽  
pp. 818-823 ◽  
Author(s):  
Valerie A. Ball ◽  
Paul D. Righi ◽  
Eduardo Tejada ◽  
Shokri Radpour ◽  
Zlatko P. Pavelic ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Local Recurrence ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
P53 Protein ◽  
Surgical Margin ◽  
Surgical Margins ◽  
Positive Surgical Margin ◽  
Ratio Test

Local and regional recurrence is the principal reason for treatment failure in squamous cell carcinoma (SCC) of the head and neck. The conventional method of evaluating surgical margins for cellular atypia does not always predict risk of local recurrence accurately. Immunostaining of surgical margins for tumor markers may provide a more precise evaluation of risk of local recurrence. Paraffin-embedded tissue blocks of surgical margins from 24 patients with oral cavity and oropharyngeal squamous cell carcinoma were immunostained for p53 protein. Fifty-eight percent of the patients had at least one margin stain positive for p53, including eight often patients whose SCC recurred locally. The sample odds ratio test predicted a 5.333 times higher chance of local recurrence with at least one p53 positive surgical margin. The implications of these results for patient management and further investigations will be discussed.

scholarly journals RADI-04. Stereotactic radiosurgery in alveolar soft part sarcoma brain metastasis

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii18-iii18
Author(s):  
Jia Xu Lim ◽  
Bengt Karlsson ◽  
Angela Pang ◽  
Vellayappan Balamurugan ◽  
Vincent Nga
Keyword(s):  
Local Recurrence ◽  
Brain Metastasis ◽  
Stereotactic Radiosurgery ◽  
Radiation Effects ◽  
Low Dose ◽  
Soft Part ◽  
Tumour Volume ◽  
Alveolar Soft Part Sarcoma ◽  
High Dose ◽  
Dose Regime

Abstract Background Alveolar soft part sarcoma (ASPS), although rare, has the highest incidence of brain metastasis amongst all sarcomas. Stereotactic radiosurgery (SRS) has been shown to be a well tolerated and effective treatment of intracranial sarcomatous metastasis. However, there is a paucity of published literature that guides radiation therapy in this condition. Methods This is a single centre retrospective review of all ASPS patients with intraparenchymal brain metastasis in our centre treated with stereotactic radiosurgery (SRS). SRS dosing is dichotomised into high and low dose (≥25 Gy and &lt;25 Gy respectively) and outcomes such as local recurrence (LR) and radiation effects are noted. Successful treatment was defined as a lesion that regressed, is stable, or has less than 25% increase in tumour volume. Local recurrence (LR) was defined as increase in tumour volume by more than 25% during follow up. Results There were three patients with 11 ASPS metastatic brain lesions, one of which underwent retreatment. Each lesion was followed up for a mean duration of 12 months (range: 5 – 22 months). Five lesions treated with a high dose regime and six lesions were given low dose. Lesions treated with high dose SRS experienced significantly less LR (20% vs 83.3%, OR 20.0 [95%CI 0.93 – 430), p = 0.036) with no increase in undue symptomatic radiation effects. Retreatment of lesions with LR after initial SRS using a low dose regime was successful, albeit only in the single recurrent lesion. Conclusions We conclude that SRS can be used as a first line treatment for ASPS brain metastasis that are not surgically accessible and that using a high dose for treatment is effective and safe. Multicentre collaborative studies can be performed to validate this claim.

Risk Factors of Stomal Recurrence After Laryngectomy: A Systematic Review and Meta-analysis

2017 ◽  
Vol 126 (9) ◽  
pp. 654-668 ◽  
Author(s):  
Jinyu Mei ◽  
Zhaohui Huang ◽  
Kaile Wu ◽  
Yi Zhao ◽  
Jianming Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Local Recurrence ◽  
Recurrence Rate ◽  
Postoperative Radiotherapy ◽  
Meta Analysis ◽  
Surgical Margin ◽  
Epidemiological Studies ◽  
Cochrane Library ◽  
Positive Surgical Margin ◽  
T Classification

Objective: We wished to investigate the risk factors for stoma recurrence following laryngectomy. Methods: PubMed, Cochrane Library, and Embase were searched to identify primary research studies published between January 1, 1967, and October 31, 2016. We only included observational epidemiological studies and used risk ratios (RRs) and 95% confidence intervals (CI) to summarize the primary risk factors associated with recurrence following laryngectomy. Results: A total of 44 articles, including 11 928 patients, were included in the current meta-analysis. The pooled estimates of the stomal recurrence rate and the local recurrence rate following laryngectomy were 6.60% (95% CI, 5.40-7.90) and 19.40% (95% CI, 14.00%-24.80%), respectively. For stomal recurrence, we confirmed a series of earlier identified factors, including tumor site, prior tracheotomy, tracheotomy timing, T-classification, lymph node metastases, postoperative pharyngoperistomal fistula, and a positive surgical margin. For local recurrence, postoperative radiotherapy, overexpression of p53, and overexpression of p21 were significant, while preoperative tracheostomy and postoperative pharyngoperistomal fistula had an unexpectedly low impact on risk. Conclusion: This study has confirmed a series of earlier identified factors for stomal recurrence and local recurrence following laryngectomy. Our results will provide important insights for clinical practice.

scholarly journals Comparison of early experience laparoscopic versus open partial nephrectomy in terms of clinical, oncological and renal functional outcomes

2021 ◽  
pp. 116-123
Author(s):  
Mert Kılıç ◽  
Meftun Çulpan ◽  
Asıf Yıldırım ◽  
Turhan Çaşkurlu
Keyword(s):  
Local Recurrence ◽  
Partial Nephrectomy ◽  
Functional Outcomes ◽  
Surgical Margin ◽  
Renal Tumors ◽  
Positive Surgical Margin ◽  
Open Partial Nephrectomy ◽  
Renal Functions ◽  
Estimated Blood Loss ◽  
Zero Ischemia

Objective: Although laparoscopic partial nephrectomy (LPN) is minimally invasive, it is also a technically challenging procedure. Currently, open partial nephrectomy (OPN) remains the only alternative in many centers for T1 kidney tumors. We reported our initial experience of LPN compared to OPN regarding clinical, oncological findings and renal functions. Material and Methods: Between 2004-2013, 81 patients who underwent OPN (n=55) or LPN (n=26) for clinically T1 renal tumors were included. Perioperative and postoperative data were compared, retrospectively. Follow-up times for OPN and LPN groups were 72.9± 41.1 and 47.6± 32.4 months, respectively (p<0.05). Results: The mean tumor size and RENAL nephrometry scores were similar for both groups.  Zero-ischemia was performed in all of the LPN and 15% of the OPN procedures. Estimated blood loss and perioperative transfusion rates were higher in OPN group. Complications including grade < 3 and  ≥ 3 did not differ significantly between the groups. The decrease in creatinine-clearance at 6th month was statistically significant in OPN group, while stable in LPN. Positive surgical margin rates were 6.6% for OPN and 17.6% for LPN, p=0.19. One patient in LPN developed local recurrence and underwent nephrectomy. In OPN group,one local recurrence and one distant metastasis were observed in two independent patients. Both patients recieved tyrosine kinase inhibitor. Conclusion: Although LPN is accepted as a technically challenging procedure, LPN provided comparable outcomes to OPN including clinical, oncological findings and renal functions, even in the early learning phase. Zero-ischemia technique for LPN was feasible and safe with favorable perioperative and renal functional outcomes. Keywords: laparoscopy; learning curve; partial nephrectomy; renal cancer; surgical margins; zero-ischemia.

Mammary phyllodes tumour: a 15-year multicentre clinical review

2017 ◽  
Vol 71 (6) ◽  
pp. 493-497 ◽  
Author(s):  
Michael Co ◽  
Clement Chen ◽  
Julia Y Tsang ◽  
Gary Tse ◽  
Ava Kwong
Keyword(s):  
Risk Factors ◽  
Local Recurrence ◽  
Tumour Size ◽  
Significant Risk ◽  
Surgical Margin ◽  
Breast Conserving Surgery ◽  
Positive Surgical Margin ◽  
Biological Behaviour ◽  
Phyllodes Tumour ◽  
Long Term Prognosis

AimsPhyllodes tumour (PT) is an uncommon fibroepithelial tumour of the breast. It has a spectrum of aggressiveness in biological behaviour with chance of local recurrence and, occasionally, metastasis.MethodsA 15-year retrospective review from a multicentre database in Hong Kong was performed.ResultsClinical and pathological records of 465 patients with 469 PTs between 1998 and 2014 were reviewed. Median age of occurrence was 44 years (range 12–86 years). 281 (59.9%) PTs were benign, 124 (26.4%) were borderline and 64 (13.6%) were malignant. About half of all PTs (239, 51.5%) were between 2 and 5 cm while another 186 (40.1%) were >5 cm in size. Most PT (84.6%) were radiologically benign. Breast-conserving surgery (BCS) was feasible in 384 (82%) patients, whereas 84 (18%) patients had mastectomy. Multivariate analysis found that positive surgical margin (P<0.001) and BCS (P<0.001) were the only significant risk factors for local recurrence, while large tumour size (P=0.008) and malignant PT histotype (P<0.001) were the only significant risk factors for metastasis. Long-term prognosis of benign and borderline PT was excellent. After median follow-up interval of 85 months (range 12–180 months), the disease-specific survival of benign, borderline and malignant PT were 99.6%, 100% and 90.6%, respectively.ConclusionsLocal recurrence of PTs occurs irrespective of the tumour grade. Surgical margin is the only amendable factor to reduce the chance of recurrence.

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