scholarly journals Malignant lymphoma of the testis: a study of 12 cases

2013 ◽  
Vol 3 (5) ◽  
pp. 393 ◽  
Author(s):  
Andrea G. Lantz ◽  
Nicholas Power ◽  
Brian Hutton ◽  
Rekha Gupta
Keyword(s):  
Stage Iv ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Low Risk ◽  
Stage I ◽  
Advanced Stage ◽  
Testicular Lymphoma ◽  
Night Sweats ◽  
Cas A ◽  
Courbes De Survie

Introduction: Testicular lymphoma is a rare and deadly diseaserepresenting 1% to 2% of all non-Hodgkin lymphomas (NHLs)and approximately 5% of all testicular neoplasms. Our objectiveis this study was to identify the presenting signs and symptoms,treatment and outcome of patients with testicular lymphoma diagnosedat our institution from 1992 to 2005, and to identify anydifferences in survival based on Ann Arbor Stage and InternationalPrognostic Index (IPI).Methods: A retrospective chart review was performed to identifydemographic characteristics, presenting signs and symptoms, treatmentand outcomes. Survival was assessed using Kaplan-Meiersurvival curves and log-rank testing.Results: Thirteen cases were identified; 1 of these cases was ultimatelyexcluded due to a diagnosis of lymphoma a year beforehe presented with testicular involvement. Of the remaining 12cases, the mean age was 65 years. Most patients presented withtesticular and scrotal swelling or mass. B symptoms (weight loss,fever, night sweats) were present in 1 case. Of the 12 cases,7 cases were stage I, 1 stage II and 4 stage IV. InternationalPrognostic Index was low risk (≤1) in 7 cases and high risk (>1)in 4 cases. Orchiectomy was performed in all cases. Three patientsreceived no further treatment. Of the remaining 9 patients, overall7 received systemic chemotherapy, and 7 radiation therapy(prophylactic in 6). Three patients received intrathecal chemotheraphyprophylaxis. Seven patients achieved complete remission.Four patients (57%) relapsed following complete remission. Mediantime to relapse was 32 months (range 11 to 73 months). Six patientsdied. Median survival was 29 months, and was significantly differentbetween early versus advanced stage (stage I/II disease: 71months; stage IV: 5 months p = 0.007).Conclusion: Testicular lymphoma is a rare and deadly form of extranodallymphoma. Survival was significantly different in early stageI/II and IPI low-risk versus advanced stage IV and IPI high-riskdisease. Randomized, prospective treatment trials may help toestablish better treatment strategies.Introduction : Le lymphome testiculaire est une maladie rare etmeurtrière représentant de 1 à 2 % de tous les lymphomes nonhodgkiniens (LNH) et environ 5 % des cancers testiculaires.L’objectif de notre étude était de dégager les signes et symptômesinitiaux, le traitement et les résultats possibles liés au lymphometesticulaire chez les patients ayant reçu un tel diagnostic à notreétablissement entre 1992 et 2005, et de déterminer les différencesdans les taux de survie en fonction de la classification de AnnArbor et de l’Indice pronostique international (IPI).Méthodologie : Un examen rétrospectif de dossiers a été effectuéafin de dégager les caractéristiques démographiques, les signeset symptômes initiaux, les méthodes de traitement et les résultats.La survie a été évaluée à l’aide des courbes de survie deKaplan-Meier et de la méthode de Mantel-Haenzel.Résultats : Treize cas ont été cernés; un des cas a plus tard étéexclus de notre étude en raison d’un diagnostic de lymphomeétabli un an avant la découverte de l’atteinte testiculaire. Chezles 12 cas restants, l’âge moyen était de 65 ans. La plupart despatients présentaient une enflure ou une masse testiculaires ouscrotales. Des symptômes B (perte de poids, fièvre, sueurs nocturnes)ont été notés dans un cas. Sur les 12 cas, 7 étaient destade I, 1, de stade II et 4, de stade IV. L’IPI indiquait un faiblerisque (≤ 1) dans 7 cas, et un risque élevé (> 1) dans 4 cas. Tousles patients ont subi une orchidectomie. Trois patients n’ont reçuaucun autre traitement, tandis que chez les 9 autres patients, 7ont reçu une chimiothérapie systémique et 7, une radiothérapie(prophylactique dans 6 cas). Trois patients ont reçu un traitementprophylactique par chimiothérapie intrathécale. Sept patients ontobtenu une rémission complète, parmi lesquels quatre patients(57 %) ont présenté plus tard une récidive. Le délai médian avantla récidive était de 32 mois (écart : 11 à 73 mois). Six patientssont décédés. La survie médiane était de 29 mois; une différencesignificative a été notée sur le plan de la survie médiane entreles patients de stade précoce et les patients de stade avancé (stadesI ou II : 71 mois; stade IV : 5 mois; p = 0,007).Conclusion : Le lymphome testiculaire est une forme rare et meurtrièrede lymphome extraganglionnaire. La survie s’est révéléesignificativement différente entre les stades précoces (I/II) et unIPI associé à un faible risque d’une part et un stade avancé (IV)et un IPI associé à un risque élevé d’autre part. Des essais prospectifsavec répartition aléatoire pourraient aider à élaborer demeilleures stratégies thérapeutiques.

Limited-Stage Mantle Cell Lymphoma

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5330-5330 ◽  
Author(s):  
Ritsuro Suzuki ◽  
Dai Chihara ◽  
Naoko Asano ◽  
Ken Ohmachi ◽  
Tomohiro Kinoshita ◽  
...  
Keyword(s):  
Research Funding ◽  
Cell Lymphoma ◽  
Clinical Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Advanced Stage ◽  
Limited Stage ◽  
Stage Disease

Abstract [Background] Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma, characterized by the overexpression of cyclin D1 derived from t(11;14)(q13;q32) and poor prognosis. Most MCLs show nodal presentation, but also accompany extranodal involvement, such as bone marrow, peripheral blood or gastrointestinal tract. As a result, many MCLs present with advanced stage disease. Since only a small portion of patients show limited-stage disease, minimal data exist on treatment of patients diagnosed with limited stage disease. Nevertheless, the treatment strategy of MCL is recommended according to the clinical stage of limited- (stage I or non-bulky II) vs. advanced-stage, as well as other types of lymphoma. [Patients and methods] We recently collected 633 patient data of MCL (Chihara, et al. Ann Oncol 2015). Information of clinical stage was available in 626 patients. The patient data were retrospectively analyzed the by the clinical stage at initial presentation. [Results] The clinical stage was I in 24 patients (4%), II in 33 (5%), III in 70 (11%), and IV in 499 (80%). Only one patient presented with bulky stage II. Detailed demographic information by the clinical stage are listed in Table. Age and sex were not significantly different by clinical stage. Limited stage patients were associated with better performance status (PS), less B symptoms, no extranodal involvement, and lower lactate dehydrogenase (LDH) level and white blood cell (WBC) count. Most patients in any stage were treated with cytotoxic chemotherapy, but more patients in limited stage received radiotherapy. The proportion of high-dose cytarabine (HDCA)-containing regimen over CHOP/CHOP-like was higher in advanced stage patients. Complete and overall response rates were 92% and 96% in stage I, 58% and 94% in stage II, 66% and 86% in stage III, and 52% and 82% in stage IV, respectively (P = 0.02). However, the higher response rate in limited stage patients did not translate into better prognosis. The median survival was 11.0 years in stage I, 13.4 years in stage II, 11.5 years in stage III, and 5.6 years in stage IV (Figure). The prognosis was not significantly different among patients with stage I, II, and III (P = 0.33). [Conclusion] Prognosis of limited-stage MCL was almost similar to that of stage III MCL. Although the present study includes several limitations including a retrospective nature and limited number of patients, prognosis of patients with limited-stage MCL was not satisfactory. The significance of radiotherapy, as well as the optimal choice of chemotherapy, for limited-stage MCL needs re-evaluation. Table Table. Figure Figure. Disclosures Suzuki: Chugai: Honoraria; Kyowa Hakko kirin: Honoraria; Bristol-Myers Squibb: Honoraria. Asano:Jannsen: Honoraria; Chugai: Honoraria. Kinoshita:Ono: Research Funding; Gilead: Research Funding; Zenyaku: Honoraria, Research Funding; Takeda: Research Funding; Chugai: Honoraria, Research Funding; Eisai: Honoraria, Research Funding; Solasia: Research Funding; Janssen: Honoraria; Kyowa Kirin: Honoraria. Suzumiya:Chugai: Honoraria, Research Funding; Astellas: Research Funding; Eisai: Honoraria, Research Funding; Takeda: Honoraria; Toyama Chemical: Research Funding; Kyowa Hakko kirin: Research Funding. Ogura:SymBio Pharmaceuticals: Consultancy, Honoraria; Celltrion, Inc.: Consultancy, Honoraria.

The International Prognostic Factor Project Score (IPS) in Advanced Stage Hodgkin Lymphoma Has Limited Utility in Patients Treated in the Modern Era.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1554-1554 ◽  
Author(s):  
Moccia A. Moccia ◽  
Jane Donaldson ◽  
Mukesh Chhanabhai ◽  
Paul Hoskins ◽  
Richard Klasa ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Hodgkin Lymphoma ◽  
Lymphocyte Count ◽  
Standard Therapy ◽  
Stage Iv ◽  
Stage I ◽  
Stage Iii ◽  
Advanced Stage ◽  
Bulky Disease ◽  
Modern Era

Abstract Abstract 1554 Poster Board I-577 Introduction The International Prognostic Factor Project Score (IPS) is the most widely utilized risk stratification index for Hodgkin lymphoma (HL) (Hasenclever, N Engl J Med, 1998). Based on patients treated before 1992, it incorporates 7 adverse risk features (male gender, age ≥45 y, stage IV, hemoglobin <105 g/L, WBC ≥15 × 109/L, lymphocyte count <0.6 × 109/L or <8% of differential, albumin <40 g/L) and predicts for a 5-year freedom-from progression (FFP) ranging from 42-84%.The IPS has not been validated in a more recently treated population, where more accurate pathologic diagnosis, routine use of growth factors and enhanced supportive care may have improved outcomes compared with historic results. Methods This retrospective population-based analysis used the British Columbia Cancer Agency Lymphoid Cancer Database to identify all patients ages 15-65 y diagnosed from January 1st,1990 to June 30th, 2008 with advanced stage HL (stage III/IV, or stage I/II with B symptoms or bulky disease ≥10 cm), who were treated with curative intent with ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) or an ABVD-equivalent regimen and had complete information including all IPS variables. Primary endpoint was FFP, defined as the interval from diagnosis to first progression or relapse or death due to treatment toxicity; deaths from unrelated causes were censored. Results 579 patients were identified. Median age was 29 y (range 15-65); 11 (2%) stage I, 239 (41%) stage II, 202 (35%) stage III and 127 (22%) stage IV; 245 (42.3%) had bulky disease; and 359 (62%) had B symptoms. Histologies included: 455 (79%) nodular sclerosing, 35 (6%) mixed cellularity, 7 (1%) lymphocyte-rich, 11 (2%) lymphocyte depleted, 13 (2%) nodular lymphocyte predominant, 58 (10%) HL NOS. 161 (28%) patients received IFRT with primary treatment. Adverse prognostic factors were present as follows: 119 (21%) age≥45, 375 (65%) albumin <40 g/L, 88 (15%) WBC ≥15 × 109/L, 116 (20%) hemoglobin <105 g/L, 57 (10%) lymphocyte count <0.6 × 109/L or <8%, 302 (52%) male, 127(22%) stage IV. Only 37 (6.4%) patients had a prognostic score ≥5. With a median follow-up of 73 months (range, 1-222), 512 (88.4%) patients were alive and 67 (11.6%) had died (39 with HL, 7 due to toxicity and 21 from unrelated causes). Five year FFP and overall survival (OS) were 79% and 91%, respectively. The IPS was prognostic for both FFP (p=.0035) and OS (p<.0001), with 5-y FFP ranging from 66% to 86% and 5-y OS ranging from 74% to 98% (Table 1). In univariate analysis only stage IV (p=.003) and hemoglobin (P=.001) were prognostic for FFP. Albumin (p=.054), age (p=.082) and WBC (p=.094) were borderline significant, but gender (p=.329) and lymphocyte count (P=.496) appeared to have a weaker prognostic value for FFP. Only stage IV (HR=1.63, CI 1.10-2.40, p=.014) and hemoglobin (HR=1.73, CI 1.17-2.57, p=.006) were prognostic for FFP in a multivariate Cox regression. Conclusion The IPS remains prognostic for patients with advanced stage HL treated in a more modern era. However, it does not identify risk groups with sufficiently good or poor outcome to justify deviation from standard therapy. Identification of truly low or high risk populations will require supplementation with molecular markers and/or the use of early PET scanning. Caution should be used when comparing results from current clinical trials to historic controls, since more recent outcomes with standard therapy are clearly superior to those previously reported. Disclosures No relevant conflicts of interest to declare.

Outcome of Bone Marrow Biopsy in Patients with Diffuse Large B-Cell Lymphoma Patients Staged by Combined 18 FGD-PET/CT Scan

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4207-4207
Author(s):  
Rasha Abdel Tawab Hamed ◽  
Rami Kotp ◽  
Eric Turecotte ◽  
Baseem Sawan ◽  
Annie Morine
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Biopsy ◽  
Conflicts Of Interest ◽  
False Negative ◽  
Stage Iv ◽  
B Cell Lymphoma ◽  
Stage I ◽  
Stage Iii ◽  
Advanced Stage ◽  
Pet Ct

Abstract DLBCL represents 1/3 of non-Hodgkin lymphoma, in 60% of the cases the disease presented in advanced stage (III-IV). Extranodal organs are involved in 40% of cases; BM involvement in 11% to 27% of cases. BMB is an invasive procedure, & it also could represent false negative result in patients with patchy pattern of involvement or if involvement else where the routine biopsy site. Study included 102 patients, above the age of 18 years, confirmed to have newly diagnosed DLBCL with no any other malignancy. Every patient had a baseline PET-Ct, bone marrow biopsy. PET-CT detected BM infiltration in 23 patients, i.e 22.5%. BMB were positive in 20 patients, while PET-CT showed BM involvement in 23 patients.- 94 patients had concordant negative ( 75 patients ) or positive ( 19 patients), PET-CT & BMB results. One patient had positive BMB and negative PET-CT. All patients with stage I & II had concordant PET-CT & BMB results One patient graded stage III by PET-CT showed 1-2% BM infiltration & upstaged to stage IV. Of the 49 patients graded stage IV by PET-CT, 3 had positive BM involvement PET-CT and negative BMB. the sensitivity of PET-CT was 95%, the specificity of PET-CT was 96.2%. the PPV was 86.4% & the NPV was 98.7%. PET-CT showed 95.9% accuracy. Our results suggest PET-CT as a powerful tool to evaluate BM infiltration in patients with DLBCL, with overall concordance exceeding 94% (100%for stage I & II ). For patients with advanced stage IV disease, PET-CT was able to retrieve patients with BM involvement & false negative BMB. Disclosures No relevant conflicts of interest to declare.

Preoperative tumor markers at diagnosis in women with malignant mixed müllerian tumors/carcinosarcoma of the uterus

2008 ◽  
Vol 18 (6) ◽  
pp. 1200-1201 ◽  
Author(s):  
P. J. Hoskins ◽  
N. Le
Keyword(s):  
Endometrial Cancer ◽  
Tumor Markers ◽  
Chart Review ◽  
Stage Iv ◽  
Retrospective Chart Review ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Upper Limit ◽  
Stage Stage

CA125 is a well-recognized marker for endometrial cancer. Uterine malignant mixed müllerian tumors (MMMTs) are increasingly being recognized as an aggressive adenocarcinoma, not a sarcoma. There are no data in the literature regarding CA125 in this malignancy. One hundred twelve women with surgically staged MMMT, diagnosed between July 1990 and September 2005, had a retrospective chart review performed. Preoperative CA125 levels were available in 29 (26%) women. Seventeen (49%) women had levels above the upper limit of normal of 35 kμ/L. Mean levels increased with increasing surgical stage: stage I 53.4 kμ/L; stage II 122.5 kμ/L; stage III 147.1 kμ/L; and stage IV 428.4 kμ/L. Elevated levels of CA19-9, CEA, and CA15-3 were found in 8%, 12%, and 25%, respectively.

scholarly journals Real-World Treatment Patterns, Survival, and Costs for Ovarian Cancer in Canada: A Retrospective Cohort Study Using Provincial Administrative Data

2021 ◽  
Vol 8 (2) ◽  
pp. 114-121
Author(s):  
Manjusha Hurry ◽  
Shazia Hassan ◽  
Soo Jin Seung ◽  
Ryan Walton ◽  
Ashlie Elnoursi ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Health System ◽  
Advanced Disease ◽  
Stage Iv ◽  
Treatment Patterns ◽  
Stage I ◽  
Stage Iii ◽  
Advanced Stage ◽  
Poor Survival ◽  
Stage Disease

**Background:** In 2020, approximately 3100 Canadian women were diagnosed with ovarian cancer (OC), with 1950 women dying of this disease. Prognosis for OC remains poor, with 70% to 75% of cases diagnosed at an advanced stage and an overall 5-year survival of 46%. Current standard of care in Canada involves a combination of cytoreductive surgery and platinum-based chemotherapy. **Objective:** There are few studies reporting current OC costs. This study sought to determine patient characteristics and costs to the health system for OC in Ontario, Canada. **Methods:** Women diagnosed with OC in Ontario between 2010 and 2017 were identified. The cohort was linked to provincial administrative databases to capture treatment patterns, survival, and costs. Overall total and mean cost per patient (unadjusted) were reported in 2017 Canadian dollars, using a macro-based costing methodology called GETCOST. It is programmed to determine the costs of short-term and long-term episodes of health-care resources utilized. **Results:** Of the 2539 OC patients included in the study, the mean age at diagnosis was 60.4±11.35 years. The majority were diagnosed with stage III disease (n=1247). The only treatment required for 74% of stage I patients and 54% of stage II patients was first-line (1L) platinum chemotherapy; in advanced stages (III/IV) 24% and 20%, respectively, did not receive further treatment after 1L therapy. The median overall survival (mOS) for the whole cohort was 5.13 years. Survival was highest in earlier stage disease (mOS not reached in stage I/II), and dropped significantly in advanced stage patients (stage III: mOS=4.09 years; stage IV: mOS=3.47 years). Overall mean costs in patients stage I were CAD $58 099 compared to CAD $124 202 in stage IV. **Discussion:** The majority of OC patients continue to be diagnosed with advanced disease, which is associated with poor survival and increased treatment costs. Increased awareness and screening could facilitate diagnosis of earlier stage disease and reduce high downstream costs for advanced disease. **Conclusion:** Advanced OC is associated with poor survival and increased costs, mainly driven by hospitalizations or cancer clinic visits. The introduction of new targeted therapies such as olaparib could impact health system costs, by offsetting higher downstream costs while also improving survival.

scholarly journals Primary Testicular Non-Hodgkin Lymphoma: A Retrospective Single Centre Experience of 26 Cases with Long Follow Up

2021 ◽  
pp. 1-5
Author(s):  
Badereddin Mohamad Al-Ali ◽  
Badereddin Mohamad Al-Ali ◽  
Thamer Sliwa
Keyword(s):  
Clinical Characteristics ◽  
Testicular Tumor ◽  
Stage Iv ◽  
Intrathecal Chemotherapy ◽  
Stage I ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Non Hodgkin Lymphoma ◽  
Testicular Lymphoma ◽  
Primary Testicular Lymphoma

Introduction: Primary testicular lymphoma is a rare and aggressive malignancy representing 1% to 2% of all non-Hodgkin lymphomas (NHL) and accounts for approximately 5% of all testicular tumors. The aim of this study was to analyse clinical characteristics, therapy and survival outcomes of patients with primary testicular lymphoma diagnosed at our hospital from 1998 to 2017, and to compare differences in survival based on Ann Arbor Stages. Methods: A retrospective patient chart review was done to analyse the patient clinical characteristics, therapy and survival outcomes. Survival was calculated using Kaplan-Meier survival analysis. Results: Twenty-six patients were included; the mean age was 85±6.7 years. All patients presented with testicular tumor. Of the 26 patients, 17 patients were stage I, one stage III, and 8 stage IV. Orchiectomy was performed in all patients. 8 patients received no further treatment. Of the remaining 18 patients, overall, 18 received systemic chemotherapy and 5 radiation therapy. Six patients received intrathecal chemotherapy prophylaxis. Seventeen patients achieved complete remission. Four patients achieved partial remission; one patient had no response. Eleven patients died. Median survival was 144 months and was statistically significantly different between early versus advanced stage (stage I/II: 144 months; stage III-IV: 73 months, p=0.006). Conclusion: Primary testicular lymphomas are a rare and aggressive malignancy of extranodal lymphomas. Survival was different in early stages I/II versus advanced stages III- IV. Randomized, multi-center prospective studies could help to establish better prognostic and multi-modal therapy strategies.

Significance of CA 27.29 (MUC 1 glycoprotein) levels in patients with breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11579-e11579
Author(s):  
V. Ghai ◽  
H. A. Harvey ◽  
K. K. Abbi ◽  
A. Barochia ◽  
C. Bhardwaj ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Therapy ◽  
Locally Advanced ◽  
Metastatic Breast ◽  
Stage Iv ◽  
Retrospective Chart Review ◽  
Stage I ◽  
Clinical Progression ◽  
Stage Iv Breast Cancer ◽  
Progression Of Disease

e11579 Background: ASCO guidelines do not support the use of CA 15–3 and CA 27.29 for monitoring patients for recurrence after primary breast cancer therapy. However, several well-designed studies have shown that an increase in CA 15–3 or CA 27.29 after primary and/or adjuvant therapy can predict recurrence an average of 5 to 6 months before other symptoms or tests. We wanted to assess the significance of measuring the tumor marker (CA 27.29 levels) to monitor the clinical progress of breast cancer. Methods: After IRB approval, we conducted a retrospective chart review of 392 patients with breast cancer who had regular monitoring of CA 27.29 levels following the diagnosis of breast cancer. A total of 2671 values of CA 27.29 were evaluated from our institution over the past 5 years (2003–2008). Patient CA 27.29 levels were correlated with clinical progression of the disease (diagnostic imaging and history and physical examinations). Results: Out of 330 patients with Stage I, II, and III after treatment with adjuvant therapy, 316 had no evidence of disease (NED) and had normal levels(<38) of CA 27.29. Out of the14 patients with clinical evidence of disease recurrence, 3 had persistently elevated levels. Of the 62 patients with stage IV breast cancer following cheomotherapy, 29 patients had clinical progression of disease with 20 (69%) patients showing increasing levels. Out of the 33 patients with no evidence of progression of disease only 4(12%) had increasing levels. Conclusions: Our trend analysis concludes that a normal CA 27.29 level in patients with Stage I, II, and III, after adjuvant treatment, correlates well with clinically NED status and might be of reassuring benefit to the patients. However, increasing levels of CA27.29 in metastatic disease correlate well with clinical progression of the disease. A large multicenter prospective study is warranted to further assess the role of CA 27.29 for disease monitoring in locally advanced and metastatic breast cancer. No significant financial relationships to disclose.

Non-Hodgkin lymphoma in children: Is 1 g/m2 methotrexate as effective as 5 g/m2 in advanced-stage nonlymphoblastic non-Hodgkin lymphoma?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 10043-10043
Author(s):  
Rejin Kebudi ◽  
Bulent Zulfikar ◽  
F Betul Cakır ◽  
Omer Gorgun ◽  
Inci Ayan ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Demographic Data ◽  
Survival Rates ◽  
Stage Iv ◽  
Large Cell ◽  
Stage I ◽  
Advanced Stage ◽  
Non Hodgkin Lymphoma ◽  
Time Period ◽  
Stage Iv Disease

10043 Background: Survival rates in non-Hodgkin lymphoma (NHL) have increased significantly in the last decades. This study aims to assess the demographic data and treatment results of children with nonlymphoblastic NHL treated in a single institution. Methods: 106 children (74 male, 32 female), treated in Istanbul University, Oncology Institute, between 9/1989-12/2012 were evaluated retrospectively. Nonlymphoblastic NHL received COMP until 1991. After then, all received BFM protocols. They received BFM 90 protocol with 5 g/m2 methotrexate (MTX) until 1995 and modified BFM protocol with 1 g/m2 MTX thereafter. Results:The median age was 8(2-19) years. Histopathologic subtypes: 81 Burkitt, 25 large cell. The primary location was abdomen in 51, mediastinum 4, head/neck 31, 20 other (bone 8, breast 2, ovaries 2, skin 2, paravertebral 2, other 4). Bone marrow was involved in 10, CNS in 2. 40 patients had stage I+II, 44 stage III, and 22 stage IV disease. 23 patients died, 7 due to toxicity, 2 with second malignancies (AML,GBM). 10 year survival and EFS in the whole group was 76 and 76 % respectively. 10 year survival was 100, 94.3, 71.3 and 50% in stage I, II, III, and IV. In advanced stage nonlymphoblastic NHL patients, 10 year survival was significantly higher in patients receiving BFM regimen with 1 g/m2 MTX, than in ones receiving COMP or BFM protocol with 5 g/m2 MTX (10 year S, 81%, 46.7%, 44.4% respectively). These results were also compared with 47 advanced stage nonlymphoblastic NHL patients treated with 5 g/m2 BFM protocol in another center in the same university in the same time period (5 year S 78 %). Conclusions: Survival rates in the whole group are in parallel with advances attained in the world in NHL. The significantly higher survival rates achieved in patients with advanced stage non-lymphoblastic patients receiving modified BFM (1g/m2MTX) may be due to the decreased toxicity seen in this group and to the advances in supportive care in the last decade. In another major center in the same university that used the same protocol with 5 g/m2 MTX in the same time period, similar survival rates suggest that 1 g/m2 MTX which is cheaper and less toxic is also as effective as 5 gr/m2 in these patients.

scholarly journals Can Radiation Enhance Response to Checkpoint Inhibition in Advanced-Stage NSCLC? A Case Series and Review of the Literature

2018 ◽  
Vol 1 (1) ◽  
pp. 23-29
Author(s):  
Dalwadi Shraddha M ◽  
◽  
Preti Hector A ◽  
Chiang Stephen B ◽  
Butler E Brian ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Tumor Regression ◽  
Case Series ◽  
Stage Iv ◽  
Palliative Radiotherapy ◽  
Retrospective Chart Review ◽  
Response Rates ◽  
Abscopal Effect ◽  
Advanced Stage ◽  
Checkpoint Inhibition

Introduction: The abscopal effect is an elusive phenomenon first described by Mole in 1953 as tumor regression observed at sites distant to an irradiated area. Anti-PDL1 monoclonal antibodies (such as nivolumab) were recently approved as first and second-line treatment for advanced-stage NSCLC, but overall response rates remain low for these patients. Herein, we report two cases of stage IV lung adenocarcinoma that achieved complete response after the addition of radiation therapy to an existing anti-PD-1 regimen. Methods: Retrospective chart review of two patients was conducted, followed by systematic literature review using PubMed for abscopal effect observed in lung adenocarcinoma. Results: Two patients with widely metastastic lung adenocarcinoma and progression on multimodal therapy experienced complete resolution of radiographic disease after palliative radiotherapy administered in combination with maintenance anti-PD-1 therapy. Conclusion: Few studies describe the abscopal phenomenon in lung cancer. Adjunct radiotherapy may boost response rates in advanced-stage NSCLC managed with checkpoint inhibition via the abscopal effect. Investigative efforts are necessary to examine combined immunoradiotherapy in metastatic NSCLC.

scholarly journals A highly expressed mRNA signature for predicting survival in patients with stage I/II non-small-cell lung cancer after operation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nan Ma ◽  
Lu Si ◽  
Meiling Yang ◽  
Meihua Li ◽  
Zhiyi He
Keyword(s):  
High Risk ◽  
Roc Curve ◽  
Expression Profiles ◽  
Low Risk ◽  
Stage I ◽  
Risk Scores ◽  
Training Set ◽  
Cox Regression Analysis ◽  
Nsclc Patients ◽  
Rna Signature

AbstractThere is an urgent need to identify novel biomarkers that predict the prognosis of patients with NSCLC. In this study,we aim to find out mRNA signature closely related to the prognosis of NSCLC by new algorithm of bioinformatics. Identification of highly expressed mRNA in stage I/II patients with NSCLC was performed with the “Limma” package of R software. Survival analysis of patients with different mRNA expression levels was subsequently calculated by Cox regression analysis, and a multi-RNA signature was obtained by using the training set. Kaplan–Meier estimator, log-rank test and receiver operating characteristic (ROC) curves were used to analyse the predictive ability of the multi-RNA signature. RT-PCR used to verify the expression of the multi-RNA signature, and Westernblot used to verify the expression of proteins related to the multi-RNA signature. We identified fifteen survival-related mRNAs in the training set and classified the patients as high risk or low risk. NSCLC patients with low risk scores had longer disease-free survival than patients with high risk scores. The fifteen-mRNA signature was an independent prognostic factor, as shown by the ROC curve. ROC curve also showed that the combined model of the fifteen-mRNA signature and tumour stage had higher precision than stage alone. The expression of fifteen mRNAs and related proteins were higher in stage II NSCLC than in stage I NSCLC. Multi-gene expression profiles provide a moderate prognostic tool for NSCLC patients with stage I/II disease.

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