scholarly journals Therapeutic Concepts for Oligometastatic Gastrointestinal Tumours

2020 ◽  
Vol 36 (5) ◽  
pp. 359-363
Author(s):  
Jens Ricke ◽  
Christoph Benedikt Westphalen ◽  
Max Seidensticker
Keyword(s):  
Treatment Guidelines ◽  
Local Treatment ◽  
Disease Free Survival ◽  
Free Survival ◽  
Organ Systems ◽  
Therapeutic Concepts ◽  
Gastrointestinal Tumours ◽  
Definition Of ◽  
Disease Free ◽  
Systemic Therapies

<b><i>Background:</i></b> Clinical trials have proven a survival benefit from applying local therapies for oligometastatic cancers of various origin. <b><i>Summary:</i></b> Today, the definition of oligometa­static disease is based on limited lesion numbers and organ systems involved. Treatment guidelines by the European Organisation for Research and Treatment of Cancer (EORTC), European Society for Medical Oncology (ESMO) and several other groups suggest a threshold of up to 5 tumours. Established biological markers indicating the aggressiveness of a given tumour (and therefore suggesting local treatment only or the addition of or complete switch to systemic therapies) are missing, except for disease-free survival, the only recommended parameter for patient selection beyond lesion count. <b><i>Key Message:</i></b> The following article discusses clinical implications as well as local techniques established for the treatment of oligometastatic disease.

scholarly journals Definition of disease-free survival: this is my truth–show me yours

2005 ◽  
Vol 16 (11) ◽  
pp. 1719-1721 ◽  
Author(s):  
Y.J. Chua ◽  
D. Sargent ◽  
D. Cunningham
Keyword(s):  
Disease Free Survival ◽  
Free Survival ◽  
Definition Of ◽  
Disease Free

Endpoints in adjuvant trials: A systematic review of the literature in colon cancer and proposed definitions for future trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 4018-4018
Author(s):  
M. E. Buyse ◽  
K. J. Punt ◽  
C. H. Köhne ◽  
P. Hohenberger ◽  
R. Labianca ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colon Cancer ◽  
Overall Survival ◽  
Disease Free Survival ◽  
Review Of The Literature ◽  
Free Survival ◽  
Medical Oncologists ◽  
Starting Point ◽  
Definition Of ◽  
Disease Free

4018 Background: Disease-free survival (DFS) is the primary endpoint of most trials testing adjuvant treatments. However many other endpoints are used. There is much confusion about these endpoints since different definitions were used among trials, or no definitions were provided at all. Moreover there is no consensus on either the definition of each endpoint or on the most relevant among these endpoints. This creates difficulties when comparing the results of various trials. Methods: Adjuvant trials in colon cancer were used as a model. A systematic review was performed on published adjuvant studies in colon cancer from 1997–2006, and the definitions of endpoints other than overall survival (OS) were recorded. A panel of medical oncologists, surgical oncologists, and a statistician, all with expertise in randomised trials in colorectal cancer, aimed to reach consensus on the definition of the various endpoints as well as to select the most relevant among these. Results: A total of 52 studies were identified. In addition to overall survival 8 other endpoints were used, and both the definition of these endpoints as well as the starting point differed considerably among these studies. No definition was provided for the endpoint in 19 (37%) studies and for the starting point in 30 (58%) studies. The panel reached consensus on the definition of each endpoint ( table ), and agreed that DFS, defined as the time from randomisation to any event irrespective of cause was considered to be the most relevant endpoint for adjuvant studies. The date of randomisation was considered to be the most appropriate starting point. Conclusions: The proposed guideline will help in the design of future adjuvant studies in colon cancer, and will achieve the uniformity required to facilitate cross-study comparisons. It may serve as a model for adjuvant studies in other solid tumors. [Table: see text] No significant financial relationships to disclose.

Neoadjuvant Cisplatin Chemotherapy Before Chemoradiation: A Flawed Paradigm?

2007 ◽  
Vol 25 (33) ◽  
pp. 5281-5286 ◽  
Author(s):  
Rob Glynne-Jones ◽  
Peter Hoskin
Keyword(s):  
Local Treatment ◽  
Disease Free Survival ◽  
Distant Metastases ◽  
Free Survival ◽  
Palliative Intent ◽  
New Strategy ◽  
Meta Analyses ◽  
Disease Free ◽  
Selection Of Patients ◽  
Selection Of

Effective chemotherapy (CT) treatment of solid tumors emerged with the introduction of anthracyclines and platinum CT in the late 1970s, at first with palliative intent, and later extended into the adjuvant setting. High response rates led to the belief that systemic CT might improve locoregional control and also decrease the risk of distant metastases. A new strategy advocated cisplatin-based neoadjuvant CT (NACT) before definitive local treatment—either surgery or radiotherapy (RT). Response to NACT was viewed as a favorable prognostic sign, which allows the selection of patients most likely to benefit from RT or chemoradiotherapy (CRT). The aim of this discussion is to raise the debate regarding NACT in reducing metastases, improving local control and selecting out good responders for nonsurgical treatment in the following sites: head and neck, esophagus, cervix, anus, nasopharynx, and bladder; as well as non–small-cell lung cancer. NACT has almost invariably failed to deliver an improved outcome in terms of disease-free survival (DFS) or overall survival (OS) when delivered before RT or CRT in all solid tumor sites. The evidence that NACT may improve outcome in terms of DFS or OS is strongest when it is administered before surgical resection, but remains scant before RT or CRT. Taxane-containing regimens look more promising than does cisplatin NACT, but have not been shown to improve on concurrent CRT. Future meta-analyses should compare induction CT followed by RT and induction followed by CRT versus RT or CRT alone.

scholarly journals Moving the Target on the Optimal Adjuvant Strategy for Resected Pancreatic Cancers: A Systematic Review with Meta-Analysis

Cancers ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 534
Author(s):  
Antonio Galvano ◽  
Marta Castiglia ◽  
Sergio Rizzo ◽  
Nicola Silvestris ◽  
Oronzo Brunetti ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Indirect Comparison ◽  
Disease Free Survival ◽  
Efficacy And Safety ◽  
Free Survival ◽  
Pancreatic Cancers ◽  
Definition Of ◽  
Combination Regimens ◽  
Indirect Comparisons ◽  
Disease Free

Combination regimens have shown superiority over single agents in the adjuvant treatment of resected pancreatic cancer (PC), but there are no data supporting definition of the best regimen. This work aimed to compare the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel in PC patients. A meta-analysis was performed for direct comparison between trials comparing combination regimens and gemcitabine monotherapy. Subsequently, an indirect comparison was made between trials investigating the efficacy and safety of mFOLFIRINOX, gemcitabine+capecitabine, and gemcitabine+nab/paclitaxel because of the same control arm (gemcitabine). A total of three studies met the selection criteria and were included in our indirect comparison. Indirect comparisons for efficacy outcomes showed a benefit in terms of DFS (disease-free survival)/EFS (event-free survival)/RFS (relapse-free survival) for both mFOLFIRINOX versus gemcitabine+capecitabine (HR 0.69, 95% CI 0.52–0.91) and versus gemcitabine+nab/paclitaxel (HR 0.67, 95% CI 0.50–0.90). No significant advantage was registered for OS (overall survival). Indirect comparisons for safety showed an increase in terms of G3-5 AEs (with the exception of neutropenia) for mFOLFIRINOX versus gemcitabine+capecitabine (RR 1.24, 95% CI 1.03–1.50), while no significant differences were observed versus gemcitabine+nab/paclitaxel. According to our results, mFOLFIRINOX is feasible and manageable and could represent a first option for fit PC resected patients.

Systemic immune-inflammation index to predict survival in muscle-infiltrating urothelial carcinoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17022-e17022
Author(s):  
Jana Obertova ◽  
Patrik Palacka ◽  
Dalibor Gallik ◽  
Jan Slopovsky ◽  
Michal Chovanec ◽  
...  
Keyword(s):  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Urothelial Carcinoma ◽  
Urothelial Cancer ◽  
Local Treatment ◽  
Disease Free Survival ◽  
Free Survival ◽  
Metastatic Urothelial Cancer ◽  
Immune Inflammation ◽  
Disease Free

e17022 Background: Systemic immune-inflammation index (SII) is a prognostic factor in patients with metastatic urothelial cancer (MUC). The objective of this prospective study was to evaluate the prognostic value of the SII at baseline before neoadjuvant cisplatin-based chemotherapy start in patients with muscle-infiltrating urothelial cancer (MIUC). Methods: Seventy-two patients (49 men) with MIUC (71 bladder, 1 upper tract) were treated with cisplatin-based neoadjuvant chemotherapy (NACT). Thitrty-nine patients (pts.) underwent radical cystectomy (RC), 18 pts. external radiotherapy (EXRT) with concomitant cisplatin chemotherapy, and 15 pts. had no local treatment (NLT) afterwards. SII was defined as PxN/L, based on platelets (P), neutrophils (N) and lymphocytes (L) counts. This study population was dichotomized by median SII into low and high groups. Disease-free survival (DFS) and overall survival (OS) were estimated by Kaplan-Meier method and compared with logrank test. Results: At median follow-up of 13 months (range 2-40), 26 pts. relapsed and 24 of them died. Pts. with low SII at baseline had better DFS and OS compared to those with high SII (NR vs. 19 months, HR = 0.37, 95% CI 0.17-0.88, P = 0.0185 for DFS, 31 months vs. 20 months, HR = 0.43, 95% CI 0.19-0.98, P = 0.052 for OS, respectively). Subgroup analysis showed significant benefit for EXRT regarding of SII, however no differences were observed in both, RC and NL. Conclusions: The level of SII at baseline before neoadjuvant cisplatin-based chemotherapy initiation predicted survival in MIUC pts. Based on the level of SII, stratification of pts. into clinical trials could be possible. Pts. with high level of SII might be the candidates for the different therapeutic approaches. Key Words: Muscle-Infiltrating Urothelial Carcinoma. Systemic Immune-Inflammation Index. Neoadjuvant Chemotherapy. Disease-Free Survival. Overall Survival.

790: Ten-Year Disease Free Survival Rate Calculated with PSA Cutpoint 0.2 NG/ML in Men After Brachytherapy for T1C Prostate Cancer

2004 ◽  
Vol 171 (4S) ◽  
pp. 209-209
Author(s):  
James B. Benton ◽  
Frank A. Critz ◽  
W. Hamilton Williams ◽  
Clinton T. Holladay ◽  
Philip D. Shrake
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Disease Free Survival ◽  
Free Survival ◽  
Disease Free Survival Rate ◽  
Disease Free
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