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1.
Ji Yoon Yoon Keith Sigel Jacob Martin Robyn Jordan Mary Beth Beasley Cardinale Smith Andrew Kaufman Juan Wisnivesky Michelle Kang Kim 《Journal of thoracic oncology》2019,14(2):184-192
Introduction
The TNM classification for lung cancer, originally designed for NSCLC, is applied to staging of bronchopulmonary carcinoid tumors. The validity of the eighth edition of the staging system for carcinoid tumors has not been assessed. In this study, we evaluated its prognostic accuracy by using data from a large national population-based cancer registry.Methods
Patients with typical and atypical bronchopulmonary carcinoids diagnosed between 2000 and 2013 were identified from the National Cancer Institute’s Surveillance, Epidemiology and End Results registry. We used competing risks analysis to compare 10-year disease-specific survival (DSS) across stages.Results
Overall, 4645 patients with bronchopulmonary carcinoid tumors were identified. Worsening DSS with increasing TNM status and stage was demonstrated across both typical and atypical carcinoids, with overlaps between adjacent subcategories. The combined stages (I versus II, II versus III, and III versus IV) showed greater separation in DSS despite persistent overlaps between groups. For typical carcinoids, we found decreased DSS for stages II, III, and IV, with hazard ratios of 3.8 (95% confidence interval [CI]: 2.6–5.6), 4.3 (95% CI: 3.0–6.1), and 9.0 (95% CI: 6.1–13.1), respectively, compared with stage I.Conclusion
The combined stage categories of the eighth edition of the TNM staging system provide useful information on outcomes for typical and atypical carcinoids. However, persistent overlaps in combined stage and subcategories of the staging system limit the usefulness of the TNM staging system, particularly in intermediate stages. These limitations suggest the need for future further study and refinement. 相似文献2.
Rati Chkheidze Mary Ann G. Sanders Barbara Haley A. Marilyn Leitch Sunati Sahoo 《Clinical breast cancer》2018,18(4):298-304
Background
Breast cancer metastases to an ipsilateral supraclavicular lymph node is assigned a N3 status in the TNM system and thus classified as stage III disease in the American Joint Commission on Cancer staging manual. Breast cancer metastatic to contralateral axillary lymph node (CAM) without metastases to any other distant organ is currently assigned M1 status (stage IV) instead of N3 (stage III).Patients and Methods
We retrospectively reviewed the medical records of breast cancer patients diagnosed with CAM for their clinical presentation, pathologic diagnoses, treatment, and follow-up data. Patients who had distant metastases at the time of CAM diagnosis were excluded from the study.Results
We report 12 breast cancer patients who developed CAM but no evidence of metastases in any other distant organ documented with extensive imaging workup. Imaging studies and thorough pathologic evaluation of the prophylactic total mastectomy specimen did not reveal a primary in the breast to account for the metastases in the axillary node.Conclusion
Findings of our study as well as previous studies support that lymph node metastases in the contralateral axilla represents a locoregional spread of the tumor from the index breast via lymphatics rather than hematogenous spread. Therefore, isolated CAM in breast cancer patients should not be classified as stage IV disease. 相似文献3.
D. Citterio S. Pusceddu A. Facciorusso J. Coppa M. Milione R. Buzzoni M. Bongini F. deBraud V. Mazzaferro 《European journal of surgical oncology》2017,43(2):380-387
Background
Functional well-differentiated neuroendocrine tumours (NET) with liver metastases represent a therapeutic challenge with few alternative options in guidelines. In these patients, the role of surgical resection of the primary tumour is controversial.Patients and methods
From a regional registry collecting somatostatin analogue (SSA)-treated tumours from 1979 to 2005, a series of 139 patients presenting with symptomatic, liver-metastatic, well-differentiated NET (G1–G2, mitoses: ≤20, Ki-67: ≤20%) was prospectively collected and retrospectively analysed. Surgery on either the primary tumour or liver metastases was chosen: 1) when low perioperative risk was predictable; 2) in presence of an impending risk of obstruction, bleeding, or perforation; or 3) if liver metastases were suitable of curative or subtotal (>90%) tumour removal. Impact of the most relevant clinico-pathological parameters on survival was studied.Results
Median follow-up was 127 months and median survival was 94 months, with 138 vs. 37 months in resected vs. non-resected primary NET (p < 0.001), respectively. In the univariate analysis, prolonged survival was significantly associated with primary tumour resection (p < 0.001), resection of liver metastases (p = 0.002), site of primary (carcinoid vs. pancreatic, p = 0.018), basal chromogranin-A (CgA) <200 ng/mL (p = 0.001), and absence of diarrhea (p = 0.012). Multivariate analysis showed that primary tumour resection was an independent positive prognostic factor (HR = 3.17; 95% CI: 1.77–5.69, p < 0.001), whereas diarrhea, basal CgA ≥200 ng/mL, and high tumour load were independent negative prognostic factors. Also, in 103 patients with non-resectable liver metastases, primary tumour resection was significantly associated with prolonged survival (median 137 vs. 32 months, p < 0.0001).Conclusions
Primary tumour resection may improve survival in functional well-differentiated NET with liver metastases. 相似文献4.
Kiyohiko Omichi Takashi Mizuno Masayuki Okuno Ching-Wei D. Tzeng Claudius Conrad Yun Shin Chun Thomas A. Aloia Jean-Nicolas Vauthey 《European journal of surgical oncology》2017,43(11):2129-2134
Background
Squamous cell carcinoma (SCC) liver metastases still remains a difficult challenge and the effectiveness of resection for SCC liver metastases is unclear. The aim of this study was to analyze long-term outcomes of surgically treated patients with SCC liver metastases.Methods
The clinicopathological characteristics, overall survival (OS), and recurrence free survival (RFS) of all patients with SCC liver metastases resected between 1998 and 2015, were analyzed.Results
Among 28 patients who met inclusion criteria, there were 19 patients with anal cancer metastases (68%), 2 (7%) with cervix cancer metastases, 2 (7%) with tonsil cancer metastases, 2 (7%) with lung cancer metastases, 2 (7%) with primary unknown cancer metastases and 1 (4%) with vulvar cancer metastases. Four (14%) patients underwent major hepatectomy. There were no liver insufficiency cases or 90-day mortality. Cumulative 3- and 5-year OS rates were 52% and 47%. Cumulative 1- and 3-year RFS rates were 50% and 25%.Conclusions
Long-term outcomes after resection of SCC liver metastases compare favorably with those of colorectal or neuroendocrine liver metastases. Liver resection can be an effective treatment option for SCC liver metastases in appropriately selected patients after systemic therapy. 相似文献5.
L.M. Almond J. Hodson S.J. Ford D. Gourevitch K.J. Roberts T. Shah J. Isaac A. Desai 《European journal of surgical oncology》2017,43(10):1808-1815
Purpose
This study aimed to evaluate the impact on overall survival following palliative surgery to remove the primary lesion in unresectable metastatic small intestinal (SI-NET) and pancreatic neuroendocrine tumours (P-NET).Methods
A systematic review of the literature and meta-analysis was performed. MEDLINE and Embase databases were searched to identify articles comparing patients undergoing palliative primary tumour resection without metastatectomy vs. no resection. Relevant articles were identified in accordance with PRISMA guidelines. The primary outcome was overall survival. Included studies were evaluated for heterogeneity and publication bias.Results
13 studies met the inclusion criteria, of which 6 presented data suitable for meta-analysis. No randomised controlled trials were identified. Analysis of pooled multivariate hazard ratios demonstrated significantly longer overall survival in patients undergoing resection of both P-NETs (HR 0.43; 95% CI: 0.34–0.57, p < 0.001) and SI-NETs (HR 0.47; 95% CI: 0.35–0.55, p = 0.007). The increase in median survival in patients treated surgically relative to non-surgically ranged from 14 to 46 months in P-NET, and 22–112 months in SI-NET. The number needed to treat in order that one additional patient was alive at five years, ranged from 3.0 to 4.2, and 1.7 to 7.7 respectively.Conclusions
Meta-analysis demonstrates that palliative resection of primary SI-NETs and P-NETs in the setting of unresectable metastatic disease can increase survival. Although these results should be interpreted with caution due to potential selection and publication bias, the data supports consideration of surgery, particularly in patients with low tumour burdens and good functional status. 相似文献6.
Jae Won Cho Yu-mi Lee Tae-Yon Sung Jong Ho Yoon Ki-Wook Chung Suck Joon Hong 《Surgical oncology》2018,27(1):18-22
Background
Surgery for metachronous adrenal metastases from solid primary carcinoma has increased with the development of technical skills. Here we analyzed the postoperative clinical outcomes of patients who underwent adrenalectomy for metachronous adrenal metastases from solid primary carcinomas.Methods
Patients who underwent adrenalectomy for metachronous adrenal metastases after initial treatment of primary carcinoma at Asan Medical Center from 2000 to 2010 were included. Clinicopathological parameters were analyzed to evaluate prognostic outcomes.Results
A total of 30 patients with 19 hepatocellular carcinomas and 11 lung carcinomas were included. The mean age was 54.3 years. The mean time until adrenalectomy was 23 months. The size of the metastatic adrenal tumor and the disease status of the primary carcinoma at the time of adrenalectomy were associated with second recurrence after adrenalectomy (P < 0.05). There was no significant difference in disease-specific recurrence-free survival between patients who underwent open adrenalectomy and laparoscopic adrenalectomy (P = 0.646).Conclusions
Surgical treatment should be recommended for metachronous adrenal metastases in patients with no evidence of primary carcinoma and/or in those having metastatic adrenal tumors ≤4.4 cm. This approach may increase the recurrence-free interval related to second recurrence. Further, laparoscopic adrenalectomy appears sufficient for the treatment of such patients. 相似文献7.
8.
Paul H. Sugarbaker 《European journal of surgical oncology》2018,44(6):805-809
Background
Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) may be of greatest benefit if all visible evidence of disease is resected. In some male patients the peritoneal metastases within the pelvis are invasive into the seminal vesicles and complete cytoreduction requires resection of these structures.Patients and methods
From a prospective database of colorectal and appendiceal cancer patients who had CT evidence of seminal vesicle involvement and then had cytoreduction including resection of the seminal vesicles were reviewed. Their clinical features were tabulated.Results
Five patients were identified between ages 52 and 60. Three of 5 were appendiceal mucinous neoplasms and 4 of 5 had complete cytoreduction. Two of the patients are long-term survivors of 120 and 28 months. All patients are impotent and reported no return of sexual function over time. All five patients report normal micturition.Conclusions
Resection of the seminal vesicles in a patient with invasion of these structures by peritoneal metastases is possible and should be considered in selected patients. This resection causes impotence but normal urination is to be expected. 相似文献9.
Florian Bösch Katharina Hofmann Michaela Coenen Sebastian Pratschke Michael Thomas Thomas Knösel Christiane J. Bruns Markus Guba Jens Werner Martin K. Angele 《Surgical oncology》2018,27(3):409-414
Background
Neuroendocrine tumors of the pancreas (pNETs) are a rare disease. Grading according to the Ki67-index is the most validated risk factor. Nevertheless, controversies exist concerning other prognostic factors. The aim of this study was to evaluate published risk factors.Methods
Patients with pancreatic NETs who underwent surgery at our department from 2000 to 2014 were analyzed. The patient and tumor characteristics were evaluated. Kaplan-Meier analyses, univariate calculations as well as multivariate analyses were performed.Results
In total, 98 patients underwent surgery due to a pNET. The final study population consisted of 88 patients. Univariate analysis demonstrated that overall survival is influenced by tumor grading, local resection margin and presence of distant metastases. However, in the multivariate analysis, only grading and the resection margin had prognostic significance. The size of the primary tumor directly correlated with the probability of metastases. Multivisceral operations had no influence on morbidity or mortality.Conclusions
Resection of pNETs is the only curative treatment and is safe. Since the incidence of pNETs is low, treatment should be performed at a high-volume center. 相似文献10.
Ryota Otsubo Hiroshi Hirakawa Masahiro Oikawa Masayuki Baba Eiko Inamasu Kenichiro Shibata Toshiko Hatachi Megumi Matsumoto Hiroshi Yano Kuniko Abe Hideki Taniguchi Masahiro Nakashima Takeshi Nagayasu 《Clinical breast cancer》2018,18(3):e345-e351
Background
The semidry dot-blot method is a diagnostic procedure for detecting lymph node (LN) metastases using the presence of cytokeratin (CK) in lavage fluid from sectioned LNs. We evaluated 2 novel kits that use newly developed anti-CK-19 antibodies to diagnose LN metastases in breast cancer.Patients and Methods
We examined 159 LNs dissected that we sliced at 2-mm intervals and washed with phosphate-buffered saline. The suspended cells in the lavage were centrifuged and lysed to extract protein. This extracted protein was used with a low-power and a high-power kit to diagnose LN metastasis. Diagnoses on the basis of the kits were compared with pathological diagnoses.Results
Of the 159 LNs, 68 were assessed as positive and 91 as negative in permanent section examination. Sensitivity, specificity, and accuracy of the low-power kit for detecting LN metastases was 83.8%, 100%, and 93.1%, respectively. Those of the high-power kit were 92.6%, 92.3%, and 92.5%, respectively. Combining the low- and high-power kit results, those for distinguishing macrometastases were 94.5%, 95.2%, and 95.0%, respectively. Diagnosis was achieved in approximately 20 minutes, at a cost of less than $30 USD.Conclusion
The kits were accurate, fast, and cost-effective in diagnosing LN metastases without the loss of LN tissue. 相似文献11.
Paul H. Sugarbaker 《European journal of surgical oncology》2018,44(7):1083-1086
Background
The hepatic bridge forms a tunnel of liver parenchyma that may obscure peritoneal metastases associated with the round ligament. Visualization and then resection of nodules associated with this structure is necessary.Materials and methods
The incidence of a hepatic bridge and the extent that it covered the round ligament was determined in consecutive patients. Extent of coverage of the round ligament by the hepatic bridge was determined: Class 1 indicates up to one-third of the round ligament obscured, Class 2 up to two-thirds and Class 3 more than two-thirds.Results
In 102 patients in whom the round ligament of the liver could be completely visualized, 50 had a hepatic bridge. Class 1 was 22 (44%) of the bridges, Class 2 was 16 (32%) and Class 3 was 12 (24%). A hepatic bridge was more frequently present in 28 of 45 male patients (62%) vs. 22 of 57 female patients (38%).Conclusions
Approximately one-half of our patients having cytoreductive surgery for peritoneal metastases were observed to have a hepatic bridge. Up to 56% of these patients have Class 2 or 3 hepatic bridge and may require division of the hepatic bridge to completely visualize the contents of the tunnel created by this structure. 相似文献12.
Paul H. Sugarbaker 《Surgical oncology》2018,27(2):154-157
Background
Mucinous appendiceal neoplasms have a pattern of metastases that is different from the other gastrointestinal cancers. The first site for cancer dissemination is the peritoneal space surrounding the primary tumor and this is followed by increasingly extensive peritoneal spread. Invasion of the psoas and iliacus muscle is an unusual phenomenon.Method
From a prospective database of appendiceal mucinous neoplasms treated by cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC), patients with psoas muscle invasion were reviewed. Their clinical features and treatments were tabulated.Results
Three patients with ages 33, 60, and 63 were identified. Two patients had disease progression into the psoas muscle 33 and 95 months after CRS plus HIPEC. One had dissecting mucinous tumor into psoas, iliacus and quadratus lumborum muscle at the time of diagnosis of the appendiceal mucinous neoplasm. All three survived at least five years from their initial treatment.Conclusion
Despite the fact that mucinous tumor invasion was outside the peritoneal cavity, long term benefit from psoas muscle resection with a mucinous appendiceal neoplasm is possible and resection possibly with HIPEC should be considered. 相似文献13.
Hiroyasu Furuki Takeshi Yamada Goro Takahashi Takuma Iwai Michihiro Koizumi Seiichi Shinji Yasuyuki Yokoyama Kohki Takeda Nobuhiko Taniai Eiji Uchida 《European journal of surgical oncology》2018,44(7):975-982
Background
Detection of gene mutations is important for planning molecular targeted therapy. Although most gene mutations are concordant between primary colon cancers and their liver metastases, new mutations can emerge in metastases. The liquid biopsy is a newly developed, gene analytic method to detect mutations in metastatic tumors. In this prospective study, we evaluated the applicability of liquid biopsies in the detection of mutations in primary and metastatic tumors.Methods
We included 22 patients with liver metastases from colorectal cancer and extracted DNA from primary colorectal tumors, metastatic liver tumors, and peripheral blood (liquid biopsy). Next-generation sequencing (NGS) and digital PCR were performed to detect mutations in these three sample types.Results
We found a total of 36 different mutations in samples from primary tumors, liver metastases, and liquid biopsies using NGS. Twenty-eight of these mutations were found in all three types of samples, whereas liquid biopsy did not identify four mutations that had been found in both primary tumors and liver metastases, but did identify four mutations that were found in liver tumors but not in primary tumors. The sensitivity of liquid biopsies for detecting mutations in liver metastases was 64% (23/36) using NGS and 89% (32/36, P = 0.02) using dPCR. The specificities of NGS and dPCR were 100% (23/23) and 100% (32/32), respectively.Conclusions
Emerging mutations, which are not found in primary tumors, can be detected in their metastases and liquid biopsies. 相似文献14.
T. Hackert W. Niesen U. Hinz C. Tjaden O. Strobel A. Ulrich C.W. Michalski M.W. Büchler 《European journal of surgical oncology》2017,43(2):358-363
Background
In metastatic disease (M1), chemotherapy (expected survival: 6–10 months) is considered the only treatment option. The aim of this study was to evaluate the outcome of curative M1 PDAC resections.Methods
Prospective data of all patients undergoing primary tumour and metastasis resection for stage IV PDAC during a 12-year period was analysed regarding localisation (liver or distant interaortocaval lymph nodes; ILN), morbidity and survival. Patients were stratified with regard to syn- or metachronous metastases resection.Results
Patients (n = 128) undergoing PDAC and metastases resection (intention-to-treat, oligometastatic stage; liver n = 85; ILN n = 43) were included. Surgical morbidity and 30-day mortality after synchronous resection of M1 tumours were 45% and 2.9%, respectively. Overall median survival after M1 resection was 12.3 months in both groups. Long-term outcome showed a 5-year survival of 8.1% after surgery for both liver metastases and 10.1% following ILN resection.Conclusions
The present collective is the largest series of resected metastatic PDAC and shows that resection of liver or ILN metastases can be done safely and should be considered as it may be superior to palliative treatment, and it is associated with long-term survival of 10% in selected patients. Further studies to stratify patients for these procedures are warranted. 相似文献15.
Vincenzo Abbate Giovanni Dell’Aversana Orabona Giovanni Salzano Paola Bonavolontà Fabio Maglitto Antonio Romano Filippo Tarabbia Mario Turri-Zanoni Federica Attanasi Alessandro Espedito Di Lauro Giorgio Iaconetta Luigi Califano 《Surgical oncology》2018,27(3):503-507
Background
Optimum management of clinically negative neck (cN0) remains controversial in early stage (T1-T2) squamous cell cancer of the oral tongue (OTSCC).The purpose of this study was to investigate the value of pre-treatment Neutrophil-to lymphocyte ratio (NLR) in predicting occult cervical metastasis in stage I and II OTSCC.Methods
We carried out a retrospective chart review on 110 patients suffering from early stage OTSCC who were surgically treated with tumour excision and elective neck dissection (END). Our cohort was divided in pN+ and pN0 groups basing on histopathological examination after elective neck dissection. For each patient pre-treatment NLR was calculated.Results
A statistically significant relationship between high levels of pre-treatment NLR and probability rate for neck occult metastases (0.000496 p-value) has been found. On our model the cut-off value was set for NLR >2.93. Above this level the probability to finding metastasis in a clinically negative neck increases exponentially.Conclusion
These preliminary results offer clinicians an easily obtainable tool to stratify patients based on risks of metastatic node in whom END could be indicated. 相似文献16.
Saiama N. Waqar Pamela P. Samson Cliff G. Robinson Jeffrey Bradley Siddhartha Devarakonda Lingling Du Ramaswamy Govindan Feng Gao Varun Puri Daniel Morgensztern 《Clinical lung cancer》2018,19(4):e373-e379
Background
Data on the prevalence of brain metastases at presentation in patients with non–small-cell lung cancer (NSCLC) are limited. We queried the National Cancer Data Base to determine prevalence, clinical risk factors, and outcomes of patients with NSCLC presenting with brain metastases.Patients and Methods
Patients with NSCLC diagnosed between 2010 and 2012 were identified using the National Cancer Data Base. The risk of brain metastases for individual variables was summarized by odds ratios and calculated using logistic regression analysis. The Kaplan-Meier product limit method was used to calculate the median and 1-, 2-, and 3-year overall survival (OS).Results
Brain metastases were observed in 47,546 (10.4%) of the 457,481 patients with NSCLC overall. The prevalence of brain metastases was much higher (26%) in patients with stage IV disease at presentation. On multivariate analysis, younger age, adenocarcinoma or large cell histology, tumor size > 3 cm, tumor grade ≥ II, and node-positive disease were associated with brain metastases. The prevalence of brain metastases ranged from as low as 0.57% in patients with only 1 risk factor to as high as 22% in patients with all 5 risk factors. The median and 1-, 2-, and 3-year OS for patients with brain metastases were 6 months and 29.9%, 14.3%, and 8.4%, respectively, with the 3-year OS increasing to 36.2% in those with T1/2 and N0/1 undergoing surgery for the primary site.Conclusions
In patients with NSCLC, the risk of brain metastases at presentation may be calculated based on 5 clinical variables. Selected patients with brain metastases at presentation may achieve prolonged benefit. 相似文献17.
In Seob Lee Sol Lee Young Soo Park Chung Sik Gong Jeong Hwan Yook Byung Sik Kim 《Surgical oncology》2017,26(1):8-12
Background
Endoscopic submucosal dissection (ESD) is not considered an appropriate treatment for undifferentiated early gastric cancer (UEGC) due to the higher risk of nodal metastases. We aimed to investigate predictive factors for nodal metastases in UEGCs, determine whether the tumor histology is an independent factor for it, and explore whether ESD is applicable for UEGC.Methods
We reviewed the medical records of 1837 patients who underwent curative gastrectomy for poorly differentiated adenocarcinoma, signet ring cell carcinoma, and a mixed type of both tumors between 2008 and 2012.Results
Nodal metastases were found in 208 (11.3%) patients. Multivariate analysis revealed that lymphovascular invasion and tumor histology were significantly associated with nodal metastases in mucosal cancers, the rates of which were higher in mixed type tumors (6.3%) than in the other two types (2.0–2.5%; p = 0.005). No nodal metastases were observed in poorly differentiated adenocarcinomas <2 cm and signet ring cell carcinomas <1 cm without lymphovascular invasion and confined to the mucosa.Conclusion
Mixed type tumors should not be considered for endoscopic resection. ESD might be applicable for mucosal tumors with poorly differentiated adenocarcinoma <2 cm and signet ring cell carcinoma <1 cm without lymphovascular invasion. 相似文献18.
Giulia Cossu Louis-Marie Terrier Lotfi Benboubker Christophe Destrieux Stéphane Velut Patrick François Ilyess Zemmoura Aymeric Amelot 《Surgical oncology》2018,27(2):321-326
Background
Patients with multiple myeloma (MM) have an extremely heterogeneous prognosis. The International Staging System (ISS) is actually the most reliable staging system and chromosomal abnormalities were integrated in the Revised-ISS. We wanted to evaluate the prognostic value of spinal secondary localization in patients with MM and its impact on the ISS.Methods
Epidemiological and biological data, as well as treatment protocols and secondary localization were analyzed for 650 consecutive patients diagnosed with MM from January 2006 to January 2017.Results
The overall survival (OS) was dependent on the WHO performance status, ISS and Salmon and Durie stage at diagnosis. Furthermore, presence of spinal metastases at diagnosis was predictive of a worse outcome (p?<?0.0001), while presence of peripheral bone metastases was not. Spinal metastases had a significant impact on OS for ISS III patients (p?<?0.0001). Also, a history of bone marrow graft was associated with a better OS (p?<?0.0001), while radiotherapy had no significant impact. The multivariate analysis confirmed that the spinal metastases at diagnosis determined a high-risk subgroup for ISS III patients with a very poor OS (p?<?0.0001).Conclusions
Spinal metastases are a negative prognostic factor for patients with MM, especially for ISS III patients, and are associated with a shorter OS. Spinal metastasis should be systemically searched for and should be included in a modified staging system to better manage these patients. 相似文献19.
Elio Mazzone Felix Preisser Sebastiano Nazzani Zhe Tian Marco Bandini Giorgio Gandaglia Nicola Fossati Denis Soulières Markus Graefen Francesco Montorsi Shahrokh F. Shariat Fred Saad Alberto Briganti Pierre I. Karakiewicz 《Clinical genitourinary cancer》2018,16(5):376-384.e1
Purpose
To quantify the prognostic effect of the location of prostate cancer (PCa) metastases on cancer-specific mortality (CSM) and the rate of other-cause mortality (OCM) in contemporary newly diagnosed metastatic PCa (mPCa) patients.Patients and Methods
Within the Surveillance Epidemiology and End Results database (2004-2014), we focused on newly diagnosed mPCa patients. Data were stratified according to the site of metastases and age group. Cumulative incidence smoothed plots were generated for CSM and OCM at 5 years after diagnosis, according to the competing-risks methods. Multivariable competing-risks analyses tested the effect of the location of PCa metastases on CSM.Results
Among 18,404 patients with mPCa, the majority had exclusively bone metastases (63.6%). At 5 years, CSM rate was 59.7% and OCM rate was 14%. According to the location of metastases, CSM rates were 44.5%, 57.9%, 67.1%, 62.7%, 66%, and 76.3% for exclusively lymph node (LN), exclusively bone, bone plus LN, exclusively visceral, visceral plus LN, and visceral plus LN and bone disease, respectively. In multivariable competing-risks models, PCa-specific mortality rate was 1.58-, 1.79-, 1.91-, 2.10-, and 2.47-fold higher in patients with exclusively bone, bone plus LN, exclusively visceral, visceral plus LN, and visceral plus bone and LN involvement compared to those with exclusively LN metastases (all P < .001).Conclusion
Patients with concomitant visceral, bone, and LN metastases have the worst prognosis. Similarly, when either bone or visceral metastases coexist with concomitant LN metastases, CSM rates are higher than when no concomitant LN metastases are present. 相似文献20.
Hiroaki Nozawa Soichiro Ishihara Kazushige Kawai Keisuke Hata Tomomichi Kiyomatsu Toshiaki Tanaka Takeshi Nishikawa Kensuke Otani Koji Yasuda Kazuhito Sasaki Manabu Kaneko Koji Murono 《Clinical colorectal cancer》2018,17(1):e91-e97