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Postoperative Adjuvant Therapy (postoperative + adjuvant_therapy)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Clinical features of renal cell carcinoma less than 25 millimeters in diameter

INTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2002
YOSHIAKI YAMADA
Abstract Background: We retrospectively investigated the clinicopathological features and prognosis of patients who underwent surgical treatment at our department for renal cell carcinoma (RCC) less than 25 mm in diameter. Methods: Of the 158 patients who underwent surgical treatment between April 1975 and April 1998, 16 (17 kidney, 10.1%) were included in this study. The study included 11 men and 5 women (ratio: 2.2). The age range was 35,76 years (average: age 53). The right kidney was involved in 9, left kidney in 6 and bilateral kidneys in 1 patient. The follow-up period was 26,157 months (mean: 86 months). Results: Thirteen tumors (81.2%) were incidental carcinomas. No patients had a tumor of rapid growing type. Radical nephrectomy was performed for 12 kidneys (70.6%), simple nephrectomy for 2 (11.8%) and partial nephrectomy for 3 (17.8%). Seven patients (43.7%) received interferon-, as postoperative adjuvant therapy. All tumors were pathologically classified as expansive type; 11 (64.8%) as clear cell carcinoma; 3 (17.6%) cyst-associated, and 3 (17.6%) papillary. Nine (52.9%) tumors were grade 1, and 8 (47.1%) were grade 2. Fourteen patients were pNo and V(,). The 5- and 10-year survival rates were excellent (100%). Conclusion: The features of small RCCs less than 25 mm were as follows: many tumors were incidental to clear cell carcinomas; all tumors were low grade, low stage and expansive type; no tumors showed acute phase reactants; and few tumors were of the solid type. Thus, the prognosis seemed to be excellent. [source]

Extent of mesorectal invasion is a prognostic indicator in T3 rectal carcinoma

ANZ JOURNAL OF SURGERY, Issue 7 2002
Malcolm C. A. Steel
Background: The aim of this study was to determine if local recurrence (LR) rates in patients with minimally invasive and advanced T3 rectal cancer are different. This may influence the use of adjuvant therapy. Methods: Consecutive patients with T3 rectal cancer undergoing curative surgery were classified into minimally invasive or advanced groups. Minimally invasive T3 was defined as a tumour that had invaded beyond the muscularis propria on microscopic examination only, whereas advanced T3 tumours had invasion beyond the muscularis propria that was obvious on macroscopic examination and confirmed histologically. Local recurrence rates of the two groups were compared by construction of Kaplan,Meier curves. The log-rank test was used to determine equivalence, and Cox regression to estimate the hazard ratio. The Grambsch, Therneau test and graphical comparison of predicted and observed Kaplan,Meier curves was used to test the proportional hazards assumption. Results: There were 222 patients in total, 74 in the minimally invasive group and 148 in the advanced. The overall LR rate was 11.2%. The LR rates in the minimally invasive and advanced groups were 5.4% and 14.2%, respectively. The log-rank test gives a P value of 0.042 for equivalence, with the minimally invasive patients doing significantly better. The hazard ratio estimated by Cox regression was 0.35 (early relative to advanced), 95% confidence intervals (0.12, 1.0). There was no evidence of confounding by age at surgery, pathology type, gender or postoperative adjuvant therapy. Conclusions: The extent of invasion into the mesorectum appears to be an independent prognostic variable. If oncologically sound surgical techniques are employed, the LR rate of patients with minimal invasion is low. Adjuvant therapy may not confer additional benefit in this group. [source]

Aggressive resection of the airway invaded by thyroid carcinoma

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 11 2005
Y.-F. Tsai
Background: The aim of this study was to investigate the hypothesis that outcome following concomitant airway resection is superior to that after shaving of the tumour in patients with airway invasion of thyroid carcinoma. Methods: The records of 34 patients with thyroid cancer with airway invasion were reviewed retrospectively. In addition to total thyroidectomy, airway resection was performed in 18 patients (group 1), whereas the tumour was shaved away from the airway in the other 16 patients (group 2). 131I was used as postoperative adjuvant therapy in all patients. Metastasis and recurrence of the primary lesion were determined by 131I whole-body scans, serum thyroglobulin levels, and computed tomography or ultrasonography of the neck. Results: In group 1, two anastomotic dehiscences resulted in one death. Patients in group 2 had a higher rate of local recurrence (relative risk 8·0, P = 0·013) and earlier recurrence (mean(s.e.m.) 2·6(0·8) versus 7·0(1·1) years; P = 0·026) than those in group 1. Median survival was 5·8 and 4·3 years in the 18 patients of group 1 and 16 patients of group 2 (P = 0·259), and the respective 5-year survival rates were 88 and 84 per cent (P = 0·783). Conclusion: Aggressive airway resection can minimize local recurrence of thyroid carcinoma with airway invasion. Copyright © 2005 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Skin-sparing mastectomy and immediate reconstruction is an acceptable treatment option for patients with high-risk breast carcinoma

CANCER, Issue 5 2005
Kevin J. Downes
Abstract BACKGROUND Skin-sparing mastectomy (SSM) followed by immediate reconstruction is an effective treatment option for patients with early-stage breast carcinoma, but its use in patients with more advanced disease is controversial. METHODS A retrospective review was performed that included 38 consecutive patients with high-risk breast carcinoma who underwent SSM and immediate reconstruction (between July 1996 and January 2002). Tumor characteristics, type of reconstruction, margin status, timing of adjuvant therapy, postoperative complications, and incidence of recurrence were evaluated. RESULTS High-risk patients (Stage IIA [n = 4 patients] Stage IIB [n = 23 patients] Stage IIIA [n = 8 patients] and Stage IIIB [n = 3 patients]) underwent immediate reconstruction after SSM with the use of a transverse rectus abdominis myocutaneous flap (n = 31 patients), a latissimus dorsi myocutaneous flap plus an implant (n = 3 patients), or tissue expanders with subsequent implant placement (n = 4 patients). The median follow-up was 52.9 months (range, 27.5,92.0 months), and the median time to recurrence has not yet been reached at the time of last follow-up. The median interval from surgery to the initiation of postoperative adjuvant therapy was 38 days (range, 25,238 days). Local recurrence was seen in 1 patient (2.6%), systemic recurrence in was seen in 10 patients (26.3%), and both local and distant metastases in were seen in 2 other patients (5.3%). CONCLUSIONS SSM with immediate reconstruction appeared to be an oncologically safe treatment option for high-risk patients with advanced stages of breast carcinoma. In addition to the aesthetic and psychological benefits of performing SSM with immediate reconstruction, local recurrence rates and disease-free survival were favorable when combined with the use of radiation therapy and adjuvant chemotherapy, as indicated. Cancer 2005. © 2005 American Cancer Society. [source]