scholarly journals Pembrolizumab-Induced Severe Neuropathy in a Patient with Metastatic Urothelial Carcinoma after Achieving Complete Response: Guillain-Barré Syndrome-Like Onset

2020 ◽  
Vol 13 (3) ◽  
pp. 1490-1494
Author(s):  
Shuntaro Aoki ◽  
Masato Yasui ◽  
Hironao Tajirika ◽  
Hideyuki Terao ◽  
Makoto Funahashi ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urothelial Carcinoma ◽  
Lung Metastases ◽  
Complete Response ◽  
Guillain Barre Syndrome ◽  
Node Metastasis ◽  
Aortic Lymph Node ◽  
Guillain Barré Syndrome ◽  
Guillain Barré

An 85-year-old female was admitted to our hospital for left ureteral cancer and para-aortic lymph node metastasis. To control hematuria, a laparoscopic retroperitoneal nephroureterectomy was performed, and papillary urothelial carcinoma (pT3b) was found. To treat para-aortic lymph node metastasis, she received chemotherapy with gemcitabine and nedaplatin. After 2 cycles, a computed tomography scan revealed its disappearance; however, bilateral lung metastases appeared. The patient was administered second-line therapy with pembrolizumab every 3 weeks. After 3 courses, lung metastases disappeared and she achieved a complete response. After the fifth administration of pembrolizumab, she was readmitted with right upper limb pain and weakness in both lower extremities. She was diagnosed with pembrolizumab-induced grade 3 peripheral neuropathy with Guillain-Barré syndrome-like onset. High-dose monocorticotherapy was initiated for treatment. Three weeks later, the pain and weakness of the limbs improved. After discharge, the dose of prednisolone was tapered and there was no relapse of adverse events. Pembrolizumab was discontinued at the onset of neuropathy, but she maintained a complete response.

scholarly journals A case of pathological complete response after chemotherapy by S-1 and gemcitabine for a pancreatic cancer with para-aortic lymph node metastasis

Suizo ◽  
2014 ◽  
Vol 29 (6) ◽  
pp. 898-904 ◽  
Author(s):  
Hiroshi KURAHARA ◽  
Kosei MAEMURA ◽  
Yuko MATAKI ◽  
Masahiko SAKODA ◽  
Satoshi IINO ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Pathological Complete Response ◽  
Complete Response ◽  
Node Metastasis ◽  
Aortic Lymph Node

scholarly journals A case of stage IV gastric cancer with para-aortic lymph node metastasis showing pathological complete response after neoadjuvant chemotherapy

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuki Katsura ◽  
Takehiro Okabayashi ◽  
Manabu Matsumoto ◽  
Kazuhide Ozaki ◽  
Yuichi Shibuya
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Pathological Complete Response ◽  
Stage Iv ◽  
Complete Response ◽  
Conversion Surgery ◽  
Stage Iv Gastric Cancer ◽  
Node Metastasis ◽  
Aortic Lymph Node

Abstract Background Stage IV advanced gastric cancer with para-aortic lymph node metastasis (PALM) is considered unresectable. Systemic chemotherapy is the treatment of choice for such tumors, while conversion surgery may be a treatment option in the case chemotherapy is effective but R0 resection is possible. We report a case of stage IV gastric cancer with PALM that showed pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) using S-1, oxaliplatin, and trastuzumab (SOX+HER). Case presentation A 69-year-old woman who was diagnosed with type 4 stage IV gastric cancer with PALM underwent five courses of NAC with the SOX+HER regimen. The primary tumor and the PALM shrank after treatment, suggesting that the NAC induced a partial response. We performed a total gastrectomy plus distal pancreaticosplenectomy with para-aortic lymph node dissection. Histological analysis revealed no remnant cancer cells in the primary tumor or the lymph nodes, confirming a pCR. The postoperative course was uneventful, and the patient was discharged on day 14 after the operation. S-1 was started as adjuvant chemotherapy, and the patient remains alive without recurrence 2 months after surgery. Conclusion This case shows the possibility of conversion surgery after SOX+HER therapy for stage IV advanced gastric cancer with PALM.

scholarly journals Significance of Concurrent Chemoradiotherapy as Primary Treatment in Patients with Metastatic Cervical Cancer

2021 ◽  
Vol 28 (3) ◽  
pp. 1663-1672
Author(s):  
Satomi Hattori ◽  
Nobuhisa Yoshikawa ◽  
Kazumasa Mogi ◽  
Kosuke Yoshida ◽  
Masato Yoshihara ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Tumor Size ◽  
Concurrent Chemoradiotherapy ◽  
Primary Treatment ◽  
Prognostic Impact ◽  
Primary Tumor Size ◽  
Node Metastasis ◽  
Aortic Lymph Node

(1) This study investigated the prognostic impact of tumor size in patients with metastatic cervical cancer. (2) Methods: Seventy-three cervical cancer patients in our institute were stratified into two groups based on distant metastasis: para-aortic lymph node metastasis alone (IIIC2) or spread to distant visceral organs with or without para-aortic lymph node metastasis (IVB) to identify primary tumor size and concurrent chemoradiotherapy. (3) Results: The overall survival (OS) for patients with a tumor >6.9 cm in size was significantly poorer than that for patients with a tumor ≤6.9 cm in the IVB group (p = 0.0028); the corresponding five-year OS rates in patients with a tumor ≤6.9 and >6.9 cm were 53.3% and 13.4%, respectively. In the multivariate analysis, tumor size and primary treatment were significantly associated with survival in metastatic cervical cancer. (4) Conclusions: Tumor size ≤6.9 cm and concurrent chemoradiotherapy as the primary treatment were favorable prognostic factors for patients with metastatic cervical cancer.

scholarly journals Risk stratification models for para-aortic lymph node metastasis and recurrence in stage IB–IIB cervical cancer

2018 ◽  
Vol 29 (1) ◽  
Author(s):  
Koji Matsuo ◽  
Muneaki Shimada ◽  
Tsuyoshi Saito ◽  
Kazuhiro Takehara ◽  
Hideki Tokunaga ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Risk Stratification ◽  
Node Metastasis ◽  
Stage Ib ◽  
Aortic Lymph Node

Cytokeratin 7 and Cytokeratin 20 in Primary Urinary Bladder Carcinoma and Matched Lymph Node Metastasis

2001 ◽  
Vol 125 (7) ◽  
pp. 921-923 ◽  
Author(s):  
Jiazhong Jiang ◽  
Thomas M. Ulbright ◽  
Cheryl Younger ◽  
Katya Sanchez ◽  
David G. Bostwick ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Urinary Bladder ◽  
Urothelial Carcinoma ◽  
Lymph Node Metastases ◽  
Primary Tumor ◽  
Cytokeratin 20 ◽  
Cytokeratin 7 ◽  
Node Metastasis ◽  
Node Metastases

Abstract Background.—Cytokeratin 7 (CK7) and cytokeratin 20 (CK20) are 2 types of intermediate filament protein. Expression of CK7 is seen in the majority of primary urinary bladder carcinomas. CK20 is restricted to superficial and occasional intermediate cells of the normal urothelium of the bladder. Aberrant CK20 expression has been documented in urothelial carcinoma and has proved useful as an ancillary diagnostic aid for urinary bladder tumor. Our hypothesis is that the pattern of CK7 and CK20 expression in metastatic urothelial carcinoma duplicates the expression of the same markers in the primary tumors. Therefore, immunohistochemical staining of metastatic tumors for these 2 markers may be helpful for differential diagnosis in ambiguous metastatic tumor deposits. Objective.—To determine the concordance of CK7 and CK20 expression in primary bladder urothelial carcinoma and the matched lymph node metastasis. Design.—We studied 26 patients with lymph node metastases who underwent radical cystectomy and bilateral lymphadenectomy for bladder carcinoma. Immunohistochemical staining for CK7 and CK20 was performed on formalin-fixed paraffin-embedded tissues containing primary cancers and lymph node metastases. Results.—In all cases, there was a concordant expression of CK20 in the primary cancer and its matched lymph node metastasis. Twelve cases (46%) showed positive CK20 immunoreactivity in the primary tumor and its matched lymph node metastases, whereas 14 cases (54%) were negative for CK20 in both the primary tumor and lymph node metastasis. All cases showed positive CK7 immunoreactivity in the primary cancers and matched lymph node metastases. Conclusions.—CK20 immunoreactivity is reliably observed in metastases from bladder cancer when the primary tumor expresses CK20.

CA19-9 level determines therapeutic modality in pancreatic cancer patients with para-aortic lymph node metastasis

2018 ◽  
Vol 17 (1) ◽  
pp. 75-80
Author(s):  
Tadafumi Asaoka ◽  
Atsushi Miyamoto ◽  
Sakae Maeda ◽  
Naoki Hama ◽  
Masanori Tsujie ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Cancer Patients ◽  
Therapeutic Modality ◽  
Node Metastasis ◽  
Aortic Lymph Node
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