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Node Group (node + group)

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Medical Sciences	100%

Selected Abstracts

Long-term outcomes for patients with limited stage follicular lymphoma,

CANCER, Issue 16 2010
Involved regional radiotherapy versus involved node radiotherapy
Abstract BACKGROUND: Given the indolent behavior of follicular lymphoma (FL), it is controversial whether limited stage FL can be cured using radiotherapy (RT). Furthermore, the optimal RT field size is unclear. The authors of this report investigated the long-term outcomes of patients with limited stage FL who received RT alone and studied the impact of reducing the RT field size from involved regional RT (IRRT) to involved node RT with margins up to 5 cm (INRT,5 cm). METHODS: Eligible patients had limited stage, grade 1 through 3A FL diagnosed between 1986 and 2006 and treated were with curative-intent RT alone. IRRT encompassed the involved lymph node group plus ,1 adjacent, uninvolved lymph node group(s). INRT,5 cm covered the involved lymph node(s) with margins ,5 cm. RESULTS: In total, 237 patients were identified (median follow-up, 7.3 years) and included 48% men, 54% aged >60 years, stage IA disease in 76% of patients, elevated lactate dehydrogenase (LDH) in 7% of patients, grade 3A tumors in 12% of patients, and lymph node size ,5 cm in 19% of patients. The 2 RT groups were IRRT (142 patients; 60%) and INRT,5 cm (95 patients; 40%). At 10 years, the progression-free survival (PFS) rate was 49%, and the overall survival (OS) rate was 66%. Only 2 patients developed recurrent disease beyond 10 years. The most common pattern of first failure was a distant recurrence only, which developed in 38% of patients who received IRRT and in 32% of patients who received INRT,5 cm. After INRT,5 cm, 1% of patients had a regional-only recurrence. Significant risk factors for PFS were lymph nodes ,5 cm (P = .008) and male gender (P = .042). Risk factors for OS were age >60 years (P < .001), elevated LDH (P = .007), lymph nodes ,5 cm (P = .016), and grade 3A tumors (P = .036). RT field size did not have an impact on PFS or OS. CONCLUSIONS: Disease recurrence after 10 years was uncommon in patients who had limited stage FL, suggesting that a cure is possible. Reducing RT fields to INRT,5 cm did not compromise long-term outcomes. Cancer 2010. © 2010 American Cancer Society. [source]

Diffuse large B-cell lymphoma

CANCER, Issue 21 2009
Clinical characterization, prognosis of Waldeyer ring versus lymph node presentation
Abstract BACKGROUND: The objective of this study was to compare the clinical features and prognosis of patients with diffuse large B-cell lymphoma (DLBCL) of Waldeyer ring (WR-DLBCL) and patients with lymph node DLBCL (N-DLBCL). METHODS: One hundred eighty-one patients with WR-DLBCL and N-DLBCL were reviewed. There were 57 patients with stage I disease, 83 patients with stage II disease, 26 patients with stage III disease, and 15 patients with stage IV disease. Among them, 101 patients had primary N-DLBCL, and 80 patients had primary WR-DLBCL. RESULTS: Patients with WR-DLBCL and N-DLBCL usually presented at an older age and had localized disease, a low frequency of B symptoms, a good performance status, and a low-risk International Prognostic Index (IPI) score. Compared with patients who had N-DLBCL, patients who had WR-DLBCL presented with more stage II disease and lower tumor burdens. The overall response rate after treatment was similar in both groups. The 5-year overall survival (OS) and progression-free survival (PFS) rates were 76% and 61% in patients with WR-DLBCL, respectively, and 56% and 50% in patients with N-DLBCL, respectively (P = .119 for OS; P = .052 for PFS). IPI scores and elevated ,2-microglobulin and LDH levels were associated with a poor prognosis for patients who had WR-DLBCL; whereas bulky tumor, elevated ,2-microglobulin levels, and IPI scores were associated with poor OS for patients who had N-DLBCL. CONCLUSIONS: The current results supported the continued inclusion of WR-DLBCL as a lymph node group in the staging of DLBCL. Patients with WR-DLBCL had clinical features and prognosis similar to those of patients with N-DLBCL. Cancer 2009. © 2009 American Cancer Society. [source]

Comparison of the accuracy of magnetic resonance imaging and positron emission tomography/computed tomography in the presurgical detection of lymph node metastases in patients with uterine cervical carcinoma

CANCER, Issue 4 2006
A prospective study
Abstract BACKGROUND The objective of the current study was to determine the accuracy of magnetic resonance imaging (MRI) and positron emission tomography/computed tomography (PET/CT) for detecting lymph node metastases in patients with uterine cervical carcinoma compared with thin-section histopathologic results from systemic lymphadenectomy. METHODS Twenty-two patients with International Federation of Obstetrics and Gynecology (FIGO) Stage IB,IVA cervical carcinoma who underwent both MRI and PET/CT before lymphadenectomy were included in this study. Lymphadenectomy involved removing all visible lymph nodes in the surgical fields. To enable region-specific comparisons, paraaortic and pelvic lymph nodes were divided into seven regions: the paraaortic area, both common iliac areas, both external iliac areas, and both internal iliac/obturator areas. Histopathologic evaluation of lymph nodes was the diagnostic standard. Chi-square analysis was used to compare the accuracy of MRI and PET/CT for the detection of metastatic lymph nodes. A P value , 0.05 was considered statistically significant. RESULTS With MRI, the sensitivity, specificity, and accuracy rates for detecting metastatic lymph nodes in each lymph node group were 30.3% (10 of 33 lymph node groups), 92.6% (112 of 121 lymph node groups), and 72.7% (122 of 154 lymph node groups), respectively; with PET/CT, those rates were 57.6% (19 of 33 lymph node groups), 92.6% (112 of 121 lymph node groups), and 85.1% (131 of 154 lymph node groups), respectively. Statistical analysis showed that PET/CT was more sensitive than MRI (P = 0.026) but that there were no statistical differences noted with regard to specificity (P = 1.000) or accuracy (P = 0.180). Power analysis demonstrated that a sample size of 685 lymph node groups (98 patients) would be necessary to demonstrate that PET/CT was more accurate than MRI (, = 0.05; , = 0.80). CONCLUSIONS PET/CT was more sensitive than MRI for detecting lymph node metastases in patients with uterine cervical carcinoma. Cancer 2006. © 2006 American Cancer Society. [source]

Integrated 18F-FDG PET/CT for the initial evaluation of cervical node level of patients with papillary thyroid carcinoma: comparison with ultrasound and contrast-enhanced CT

CLINICAL ENDOCRINOLOGY, Issue 3 2006
Han-Sin Jeong
Summary Objective, To compare the diagnostic accuracy of integrated 18F-fluorodeoxyglucose PET/CT with ultrasonography (US) and contrast enhanced CT (CECT) alone in the initial evaluation of cervical lymph node levels of patients with papillary thyroid carcinoma. Patients and measurements, From July 2004 to March 2005, 26 consecutive patients with papillary thyroid carcinoma, confirmed by aspiration cytology analysis, underwent US, CECT and PET/CT. The sensitivity, specificity and diagnostic accuracy of the US, CECT and PET/CT studies for the final status of 312 cervical node levels (levels I,V: 260, level VI: 52) were compared by employing a generalized estimating equation test. The final status of cervical node levels was determined by the surgical pathology and follow-up data. Results, At all lymph node levels (levels I,VI), PET/CT showed a sensitivity of 30·4%, a specificity of 96·2% and a diagnostic accuracy of 86·9%. The corresponding values for US and CECT were 41·3%, 97·4%, 89·1% (US) and 34·8%, 96·2%, 87·2% (CECT). Considering only the lateral cervical node group (levels I,V), PET/CT showed a sensitivity of 50·0%, a specificity of 97·0% and a diagnostic accuracy of 92·3%. The corresponding values for US and CECT were 53·9%, 97·9%, 93·5% (US) and 42·3%, 96·6%, 91·2% (CECT). The diagnostic results for US, CECT and PET/CT upon initial evaluation of the cervical lymph nodes did not differ significantly on a level-by-level basis. Conclusion, Our preliminary results suggest that integrated PET/CT does not provide any additional benefit when compared to US and CECT for the initial evaluation of cervical node levels in patients with papillary thyroid carcinoma. [source]