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Residual Tumour (residual + tumour)
Selected AbstractsPercutaneous radiofrequency ablation of renal tumours: Case series of 11 tumours and review of published workJOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 5 2007TW Watkins Summary Detection of renal cell carcinoma (RCC) is increasing with the greater use of cross-sectional imaging and up to two-thirds of RCCs are discovered incidentally in asymptomatic patients. The traditional option of nephrectomy or partial nephrectomy may not always be appropriate. A minimally invasive treatment alternative is radiofrequency ablation (RFA). We retrospectively reviewed the RFA cases for renal tumours at our institution between January 2004 and June 2006. Thirteen RFA treatment sessions were conducted for 11 neoplasms in 11 patients. Mean patient age was 74.4 years (61,88 years). Imaging was carried out after ablation with a mean follow up of 8.0 months (2,26 months). No residual tumour was observed after the first RFA treatment in 82% of patients (nine of 11). Two patients required a second RFA treatment for residual (one) or recurrent tumour (one). RFA is emerging as a useful technique for treatment of small renal tumour. A number of short-term studies reflect this, however, long-term findings are still lacking. [source] GS13P OUTCOME OF TRANS-ANAL EXCISION FOR RECTAL CANCERANZ JOURNAL OF SURGERY, Issue 2007S. Banerjee Aims The aim of this study is to assess the outcome of trans-anal excision of rectal cancer in a single Surgeon's practice and determine possible selection criteria for this procedure. Methods Retrospective review of hospital records, specimen histopathology and imaging of consecutive patients with rectal cancer undergoing trans-anal excision as the primary treatment. Results 25 patients had trans-anal excision of rectal cancer including 3 cases of carcinoid tumour and 1 case of gastro-intestinal stromal tumour (GIST). 5/25 proceeded to radical rectal resection because of the presence of adverse features including lympho-vascular and peri-neural invasion and poorly differentiated cell type; residual tumour was present in 4/5 cases, nodal metastases in 3/5 patients each of whom received pre-operative chemotherapy and radiotherapy. 2/25 patients developed recurrence at 12 and 48 months from excision. One of these patients had distant recurrence at 12 months having proceeded to radical rectal resection and the other patient (aged 99), managed with trans-anal excision alone, recurred locally at 48 months. Both cases of recurrence were T3 tumours. Overall, 19/20 cases managed with trans-anal excision alone had no recurrence with a follow-up period of 12,48 months. 16 of these patients had T1 malignancy. Conclusion T1 tumours may be treated with trans-excision alone in the absence of adverse pathological features. It is unclear from our study whether T2 should be managed in this way due to their small number in this study and T3 tumours are clearly at high risk of recurrence with this treatment alone. [source] PERITONEAL CARCINOMATOSIS FROM COLORECTAL CANCER AND SMALL BOWEL CANCER TREATED WITH PERITONECTOMYANZ JOURNAL OF SURGERY, Issue 6 2006Mena Shehata Background: This study aims to assess the survival of patients who underwent peritonectomy, to assess the morbidity and mortality associated with the procedure and to review the published reports on the survival of patients with peritoneal spread of colorectal cancer (CRC). Methods: Peritonectomy involves resection of all visible peritoneal tumour and is followed by heated intraperitoneal chemotherapy. Peritonectomy with heated intraperitoneal chemotherapy is associated with a 3-year survival of 30,50% in patients with low peritoneal cancer index (PCI) with peritoneal carcinomatosis from CRC. There are approximately 1000 patients in phase 2 studies and a large survival advantage was shown in a randomized control trial. We have carried out over 100 peritonectomy procedures. This study describes 22 patients with peritoneal spread of gastrointestinal cancer treated with peritonectomy between 1996 and March 2005. Twenty of these patients had primary colorectal cancer and two patients had primary small bowel cancer. Results: Of the 22 patients who underwent peritonectomy, 8 patients are now deceased. The median follow up is now 16.1 months. At 12 months, the survival was 61.5% and at 24 months the survival was 46.1%, which are creditable results comparable with the world published reports. We found that those patients with all macroscopic residual tumour removed at the end of the procedure (completeness of cancer resection, CCR O) had improved 24-month survival compared with patients in whom there was incomplete tumour resection (53.3% survival vs 22.2%, respectively, P = 0.024). Patients with a PCI score less than 13 had better survival (P = 0.0003). Conclusions: Peritonectomy for peritoneal carcinomatosis from CRC offers patients improved survival. Our results are consistent with the published data with respect to improved survival in patients with low PCI and complete cytoreduction. [source] Effect of inflammation on positive margins of basal cell carcinomasAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 2 2010Neil Macpherson ABSTRACT Background/Objectives:, The use of preparations such as imiquimod in the treatment of basal cell carcinoma is well accepted. Imiquimod induces interferon-,, other cytokines, antigen-presenting cells and innate immunity, against tumour cells. The current study investigated whether the inflammation induced from a surgical procedure could have a similar effect on removing residual tumour after an excision. Method:, A retrospective audit was carried out on basal cell carcinoma removed in the Dermatology Clinic of the Royal Newcastle Centre in 2007. The end-point focussed on the features of those tumours which initially had a positive margin, but were found to have no remaining tumour on subsequent excision. Result:, A linear regression was carried out, revealing two significant predictors of outcome. These were the location of the basal cell carcinoma excision and the excision type. Punch biopsies and excisional biopsy had a greater number of histopathologically negative wider excisions despite initial positive margins. Facial lesions had a greater number of negative wider excisions. Conclusion:, The study has shown the majority of negative re-excisions were from lesions on the head which had had an initial surgical procedure. However, the evidence is not strong enough to advocate a protocol for dealing with positive margins. A larger sample size that encompassed all three factors that affect outcome, that is, the location of lesion, type of lesion and type of excision carried out, would be required in order to make a more definitive statement on protocol change for treatment of basal cell carcinoma. [source] Granulomatous mycosis fungoides with extensive chest wall involvementAUSTRALASIAN JOURNAL OF DERMATOLOGY, Issue 1 2004Jamie Von Nida SUMMARY A 40-year-old woman presented with a 5-year history of a mass overlying her right pectoralis major muscle. Histopathology of the lesion revealed a florid granulomatous infiltrate including an atypical lymphocytic component with marked epidermotropism consistent with granulomatous mycosis fungoides. Staging investigations demonstrated the tumour to be localized to the right chest. Consequently, the patient was treated with radiotherapy (50 Gy) to the lesion with good clinical effect. However, she soon developed a clinically palpable lesion on the left chest outside the radiotherapy field. Positron emission tomography scanning demonstrated an extensive left-sided chest wall tumour and also residual tumour on the right. This left-sided lesion failed to respond to systemic chemotherapy. Further radiotherapy (50 Gy) has recently been administered to the left chest lesion; the response is being monitored. While granulomatous inflammation has been previously described in cutaneous T-cell lymphomas, it is rare and is often associated with a delay in the diagnosis and difficulty with clinical staging. The clinical presentation can be extremely variable and consequently, diagnosis rests with histological features, immunohistochemical studies and gene rearrangement analysis. [source] Adult growth hormone replacement therapy and neuroimaging surveillance in brain tumour survivorsCLINICAL ENDOCRINOLOGY, Issue 6 2005Andreas Jostel Summary Objective, Systematic collections of neuroimaging data are nonexistent in brain tumour survivors treated with adult growth hormone replacement therapy (AGHRT). We present our surveillance data. Design, In 1993, our unit implemented a policy of performing brain scans on every brain tumour survivor before starting AGHRT, with repeat neuroimaging at least once after 12,18 months' treatment. Reports for baseline scans and most recent scans were analysed for this retrospective study. Patients, All brain tumour survivors who received AGHRT (60 patients) were included in the analysis. Measurements, Evidence and extent of residual tumour, tumour progression, tumour recurrence, and secondary neoplasms (SN) on baseline scan and latest follow-up scan. Results, All patients had baseline scans performed. Follow-up scans were available in 41/45 (91%) patients who received AGHRT for more than 1 year (mean duration ± SD of GHRT was 6·7 ± 3·6 years). Sixteen patients had residual tumours, and SNs (all meningiomas) were demonstrated in three patients on baseline scans. Appearances remained stable in 34 (83%) patients during follow-up (extending to 17·4 ± 8·3 years after tumour diagnosis). Of the 16 residual primary tumours, an incurable ependymoma continued to grow, and one meningioma progressed slightly in size over 7·7 years. Follow-up scans also revealed continued growth of the SNs detected at baseline, and five additional meningiomas (two in patients with a previous SN, confirming an excess risk in this subgroup, P = 0·02). All SNs occurred on average 22·8 (range 17,37) years after radiotherapy. Conclusions, Our data do not suggest an increased rate of recurrence or progression of childhood brain tumours during AGHRT. Nonetheless, vigilance and long-term surveillance are needed in these patients in order to detect and monitor SNs, in particular in patients with a previous history of a SN. We endorse a proactive neuroimaging policy, preferably as part of a larger, controlled trial in the future. [source] Treatment strategy after non-curative endoscopic resection of early gastric cancer,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 12 2008I. Oda Background: Endoscopic resection (ER) is indicated for patients with early gastric cancer who have a negligible risk of lymph node metastasis (LNM). Histological examination of the resected specimen may indicate a possible risk of LNM or a positive resection margin. These patients are considered to have undergone non-curative ER. The aim of this study was to determine the appropriate treatment strategy for such patients. Methods: A total of 298 patients who had non-curative ER were classified into those with a positive lateral margin only (group 1; 72 patients) and those with a possible risk of LNM (group 2; 226 patients). Results: Surgery was performed within 6 months of non-curative ER in 19 patients in group 1 and 144 in group 2. In group 1, nine patients were found to have local residual tumours, all limited to the mucosal layer without LNM. In Group 2, 13 patients had residual disease, including four local tumours without LNM, two local tumours with LNM and seven cases of LNM alone. The rate of LNM after surgery was 6·3 per cent in group 2. Conclusion: Surgery remains the standard treatment after non-curative ER in patients with a possible risk of LNM. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Adult growth hormone replacement therapy and neuroimaging surveillance in brain tumour survivorsCLINICAL ENDOCRINOLOGY, Issue 6 2005Andreas Jostel Summary Objective, Systematic collections of neuroimaging data are nonexistent in brain tumour survivors treated with adult growth hormone replacement therapy (AGHRT). We present our surveillance data. Design, In 1993, our unit implemented a policy of performing brain scans on every brain tumour survivor before starting AGHRT, with repeat neuroimaging at least once after 12,18 months' treatment. Reports for baseline scans and most recent scans were analysed for this retrospective study. Patients, All brain tumour survivors who received AGHRT (60 patients) were included in the analysis. Measurements, Evidence and extent of residual tumour, tumour progression, tumour recurrence, and secondary neoplasms (SN) on baseline scan and latest follow-up scan. Results, All patients had baseline scans performed. Follow-up scans were available in 41/45 (91%) patients who received AGHRT for more than 1 year (mean duration ± SD of GHRT was 6·7 ± 3·6 years). Sixteen patients had residual tumours, and SNs (all meningiomas) were demonstrated in three patients on baseline scans. Appearances remained stable in 34 (83%) patients during follow-up (extending to 17·4 ± 8·3 years after tumour diagnosis). Of the 16 residual primary tumours, an incurable ependymoma continued to grow, and one meningioma progressed slightly in size over 7·7 years. Follow-up scans also revealed continued growth of the SNs detected at baseline, and five additional meningiomas (two in patients with a previous SN, confirming an excess risk in this subgroup, P = 0·02). All SNs occurred on average 22·8 (range 17,37) years after radiotherapy. Conclusions, Our data do not suggest an increased rate of recurrence or progression of childhood brain tumours during AGHRT. Nonetheless, vigilance and long-term surveillance are needed in these patients in order to detect and monitor SNs, in particular in patients with a previous history of a SN. We endorse a proactive neuroimaging policy, preferably as part of a larger, controlled trial in the future. [source] | ||||||||||