scholarly journals Thymoma Metastasis to the Semimembranosus Muscle

2017 ◽  
Vol 10 (1) ◽  
pp. 21-26
Author(s):  
Kenta Taniguchi ◽  
Michiro Susa ◽  
Sho Ogata ◽  
Yuichi Ozeki ◽  
Kazuhiro Chiba
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Open Biopsy ◽  
Epithelial Tumor ◽  
Wide Margin ◽  
Thymic Epithelial Tumor ◽  
Semimembranosus Muscle ◽  
High Risk Tumor

Thymoma is the most common thymic epithelial tumor whose classification was first introduced in 1999. Type B2 thymoma is considered a moderate/high-risk tumor; however, extrathoracic metastases are extremely rare with limited reports to date. In this report, we present a rare thymoma metastasis to the semimembranosus muscle, which was resected with a wide margin after confirmation by open biopsy. At the final follow-up after 1 year, no local recurrence has been observed.

Impact of brachytherapy on local recurrence after sublobar resection: Results from ACOSOG Z4032 (Alliance), a phase III randomized trial for high-risk operable non-small cell lung cancer (NSCLC).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7502-7502 ◽  
Author(s):  
Hiran Chrishantha Fernando ◽  
Rodney Jerome Landreneau ◽  
Sumithra J. Mandrekar ◽  
Francis C Nichols ◽  
Shauna L Hillman ◽  
...  
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Staple Line ◽  
Randomized Study ◽  
Surgical Margin ◽  
Phase Iii ◽  
Oncologic Outcomes ◽  
Sublobar Resection ◽  
Local Progression

7502 Background: Prior studies suggest that adjuvant brachytherapy reduces local recurrence (LR) after sublobar resection (SR) for NSCLC. A multicenter randomized study was undertaken in patients (pts) with stage I NSCLC ≤3cm comparing SR to SR with brachytherapy (SRB). Methods: High-risk operable patients with NSCLC were randomized to SR or SRB. Brachytherapy involved placement of I125 seeds incorporated into Vicryl sutures or into Vicryl mesh placed over the staple line. Wedge or segmental resection was allowed. The primary endpoint was time to local recurrence (LR) defined as recurrence within the primary tumor lobe at the staple line (local progression), away from the staple line or within hilar nodes. The trial was designed to have 90% power to detect a hazard ratio (HR) of 0.315 in favor of the SRB arm using a one-sided α of 0.05 with a sample size of 100 eligible pts per arm. Follow-up CT scans were obtained serially for 36 months. Results: 224 pts were randomized; 213 (109 SR,104 SRB) were eligible. Median (range) age was 71 (49-87) yrs; 94 (44%) were male. No differences were found in baseline characteristics. Adverse events, previously reported, were not different between arms. Median (range) follow-up was 4.06 (0.04, 5.0) yrs. There was no difference between arms in time to LR (HR = 0.87; 5% CI: 0.41, 1.86, p=0.72) or to LR or death (LRD) (HR = 0.81, 95% CI: 0.50, 1.32, p=0.40). There was no difference between arms in pattern of LR (table). In subgroups of pts with potentially compromised surgical margin (margin < 1cm; margin:tumor ratio <1; positive staple line cytology) SRB did not reduce LR or LRD at 3-yrs. Overall 3-yr survival was similar for SR (71%) and SRB (72%) (p=0.81). Conclusions: LR remains a concern after sublobar resection. However, local progression at the staple line was low. This trial demonstrated that adjuvant brachytherapy does not impact oncologic outcomes. Clinical trial information: NCT00107172. [Table: see text]

Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma.

1991 ◽  
Vol 9 (10) ◽  
pp. 1757-1765 ◽  
Author(s):  
A Rydholm ◽  
P Gustafson ◽  
B Rööser ◽  
H Willén ◽  
M Akerman ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcoma ◽  
Soft Tissue Sarcomas ◽  
Deep Fascia ◽  
Open Biopsy ◽  
Radiographic Findings ◽  
Wide Margin ◽  
Anatomic Location ◽  
Local Surgery

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients--47 of whom had high-grade malignant tumors--had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.

Neoadjuvant denosumab

2019 ◽  
Vol 101-B (2) ◽  
pp. 170-177 ◽  
Author(s):  
A. Puri ◽  
A. Gulia ◽  
P. Hegde ◽  
V. Verma ◽  
B. Rekhi
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Local Control ◽  
Giant Cell Tumour ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
The Mean ◽  
Mean Time ◽  
Local Recurrence Free Survival

Aims The aims of this study were to evaluate the efficacy of preoperative denosumab in achieving prospectively decided intention of therapy in operable giant cell tumour of bone (GCTB) patients, and to document local recurrence-free survival (LRFS). Patients and Methods A total of 44 patients received preoperative denosumab: 22 to facilitate curettage, 16 to facilitate resection, and six with intent of converting resection to curettage. There were 26 male and 18 female patients. The mean age was 27 years (13 to 47). Results The mean number of denosumab treatments was five (2 to 7) per patient. In 42 of 44 patients (95%), denosumab helped to achieve prospectively decided intention. A total of 41 patients were available for follow-up at a mean follow-up of 34 months (24 to 48). There were 12 local recurrences (29%), in 11 patients (11/25, 44%) who had curettage and in one patient (1/16, 6%) who had resection. The mean time to local recurrence was 16 months (8 to 25). The LRFS was 76% at two years: 94% for cases with resection and 64% for cases with curettage (p = 0.013). Conclusion Although local control rates are unlikely to improve with use of preoperative denosumab, a short preoperative course of denosumab can facilitate surgery in certain cases of operable GCTB, with a high risk of local recurrence making curettage or resection technically easier. It may also help in converting a lesion requiring resection to a lesion that could possibly be treated with curettage.

The role of Denosumab in joint preservation for patients with giant cell tumour of bone

2021 ◽  
Vol 103-B (1) ◽  
pp. 184-191
Author(s):  
David Louis Perrin ◽  
Julia D. Visgauss ◽  
David A. Wilson ◽  
Anthony M. Griffin ◽  
Albiruni R. Abdul Razak ◽  
...  
Keyword(s):  
High Risk ◽  
Local Recurrence ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Lung Metastases ◽  
Cell Tumour ◽  
Joint Surface ◽  
Intralesional Curettage ◽  
Tissue Mass

Aims Local recurrence remains a challenging and common problem following curettage and joint-sparing surgery for giant cell tumour of bone (GCTB). We previously reported a 15% local recurrence rate at a median follow-up of 30 months in 20 patients with high-risk GCTB treated with neoadjuvant Denosumab. The aim of this study was to determine if this initial favourable outcome following the use of Denosumab was maintained with longer follow-up. Methods Patients with GCTB of the limb considered high-risk for unsuccessful joint salvage, due to minimal periarticular and subchondral bone, large soft tissue mass, or pathological fracture, were treated with Denosumab followed by extended intralesional curettage with the goal of preserving the joint surface. Patients were followed for local recurrence, metastasis, and secondary sarcoma. Results A total of 25 patients with a mean age of 33.8 years (18 to 67) with high-risk GCTB received median six cycles of Denosumab before surgery. Tumours occurred most commonly around the knee (17/25, 68%). The median follow-up was 57 months (interquartile range (IQR) 13 to 88). The joint was salvaged in 23 patients (92%). Two required knee arthroplasty due to intra-articular fracture and arthritis. Local recurrence developed in 11 patients (44%) at a mean of 32.5 months (3 to 75) following surgery, of whom four underwent repeat curettage and joint salvage. One patient developed secondary osteosarcoma and another benign GCT lung metastases. Conclusion The use of Denosumab for joint salvage was associated with a higher than expected rate of local recurrence at 44%. Neoadjuvant Denosumab for joint-sparing procedures should be considered with caution in light of these results. Cite this article: Bone Joint J 2021;103-B(1):184–191.

Long-term follow-up in high risk hypertensive patients with carotid dolicoarteriopathies

2020 ◽  
Vol 39 (1) ◽  
Author(s):  
Antonio Valvano ◽  
Giorgio Bosso ◽  
Valentina Apuzzi ◽  
Valentina Mercurio ◽  
Valeria Di Simone ◽  
...  
Keyword(s):  
High Risk ◽  
Hypertensive Patients ◽  
Long Term Follow Up
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