1,721,109 research outputs found
Treatment of brain metastases in uncommon tumors
No full textMelanoma spreads to the CNS with an incidence of 4 to 20%. Metastases from cancer of the colorectal and genitourinary tract, as well as sarcoma, are less frequent (1%). Surgery should be considered for single brain metastases in patients with controllable disease. Stereotactic needle biopsy may still be worthwhile to confirm diagnosis, and also in patients whose tumors are considered unresectable. Whole-brain radiotherapy is the treatment of choice for most brain metastases, since more than 70% of patients have multiple metastases at the time of diagnosis. Radiosurgery is particularly useful for patients unable to tolerate surgery and for patients with lesions inaccessible to surgery. Chemotherapy could be useful in patients with asymptomatic brain metastases and uncontrolled extracranial disease, depending on performance status and previous chemotherapy received
Relationship between hormone receptor rate, CEA, CA 15-3 and MIB-1 in patients with breast cancer recurrence
No full textBackground: Several tumor markers and risk factors have been investigated in patient with breast cancer (BC) for predicting recurrence and monitoring patients. The aim of this study was to analyze the correlation between estrogen (ER) and progesterone receptor (PgR) rate, serum tumor markers CEA and CA 15-3, MIB-1 proliferation index, and risk of BC relapse.
Patients and Methods: Data regarding a series of 363 consecutive women with pT1-2 BC who underwent curative surgery and were followed-up for 24-120 months were reviewed. The following parameters were recorded: age (years), greatest diameter of the tumor (size, mm), ER and PgR rate, MIB-1 index (%), CEA (ng/mL) and CA 15-3 (U/L) serum levels. Two Groups of patients were considered: (1) Group A cases (N=62, 17.1%, median age 55 years, range 35-83 years) with local or distant relapse, and (2) Group B controls (N=301, 82.9%, median age 61 years, range 28-88 years) without relapse.
Results: In univariate analysis CEA, CA 15-3, MIB-1 index, and PgR values did not differ (p=NS) between Groups, whilst ER rate (65.7±12.2 vs. 58.8±17.1; p=0.003) and size (24.3±7.1 vs. 20.7±10.2 mm; p=0.009) were significantly different.
Overall, a linear relationship between CEA and CA 15-3 (Group A: R=0.43, p=0.001; Group B: R=0.21, p=0.003), and between ER and PgR (Group A: R=0.38, p=0.002; Group B: R=0.54, p=<0.001) was found. In Group A patients there was a significant correlation between age and both CEA (R=-047, p=0.0003) and CA 15-3 (R=-0.46, p=0.0007), and between MIB-1 index and size (R=0.43, p=0.0005), age (R=0.36, p= 0.004) and CEA (R=-0.36, p=0.004). In Group B patients there was a week correlation between size and both age (R=0.18, p=0.001) and PgR (R=0.20, p=0.0004).
Conclusions: Preoperative serum tumor markers CEA and CA 15-3, ER and PgR rate, and MIB-1 index are not useful in predicting the clinical outcome of patients with BC who underwent surgery
Predictive value of different prognostic factors in breast cancer recurrence. Univariate and multivariate analysis
No full textPredictive value of different prognostic factors in breast cancer recurrences: multivariate analysis using a logistic regression model.
No full textThe aim of this study was to compare the sensitivity of different pre-operative parameters in patients with breast cancer (BC) recurrence using univariate and multivariate analysis. We retrospectively analyzed a series of 387 women (median age 60 years, range 35-83 years) who underwent curative surgery for pT1-2 BC. The patients were divided into two groups: Group 1: 325 (84.0%) patients with no evidence of disease during a median follow-up of 53 months (range 25-149 months) and Group 2: 62 (16.0%) patients who developed local or distant recurrences. Univariate analysis showed significant (p<0.01) differences between the two Groups in age, size and grading of the tumor and hormone receptor rate. MIB1 proliferation rate, serum markers CEA and CA 15-3, and lymph node status were not useful in predicting relapse. Multivariate analysis using a logistic regression model showed that only age, size of the tumor and hormone receptor rate independently correlate with the onset of recurrences. in conclusion, there is no clear correlation between BC recurrence and the majority of the prognostic factors available. Multivariate analysis of several pre-operative parameters may help to correctly select the high risk population
Sentinel node biopsy and axillary node sampling in women with breast cancer undergoing breast conserving surgery. Preliminary results of a prospective study
No full textBackground: Axillary dissection still represents the most accurate means of determining axillary lymph node status in patients with breast cancer (BC), but at the expense of significant morbidity. However, sentinel node biopsy (SNB) technique does not reach 100% sensitivity in detecting (or excluding) axillary node metastases, especially in the presence of unsuspected micrometastases. The aim of this study was to asses the accuracy of axillary node sampling (ALNS) in addition to SNB in patients with BC undergoing curative surgery.
Patients and Methods: Sixty-seven consecutive women (median age 54 years, range 28-68 years) with pT1 primary BC undergoing breast conserving surgery were enrolled in the study. Patients were prospectively randomizes to undergo SNB alone (Group A, 35 patients) or ALNS in addition to SNB (Group B, 32 patients), followed by level I-II axillary dissection. In all cases, a combined method using radioisotope and blue dye was used for SNB. Patients with positive SNB were excluded.
Results: The age of the patients (54.8±8.2 vs. 54.1±9.2, p=0.74) and the number of the removed nodes (median 19, range 16-25 in each Group) did not differ significantly (p=NS) between Groups. A median of 7 lymph nodes (range 6-9) was removed in Group B patients. In all patients intraoperative frozen section examination did not show positive nodes, whilst final histopathology showed micometastases in six (8.9%) patients. The sensitivity of SNB technique alone (false-negative rate: 14.3%) and SNB in addition to ALNS (false-negative rate: 3.1%) was 85.7% and 96.9%, respectively.
Conclusions: SNB alone in inaccurate in detecting axillary node micrometastases, and ALNS should be performed in all patients with macroscopically suspicious nodes and negative SNB
Usefulness of serum tumor markers CEA and CA 15-3 in patients with breast cancer. Long-term follow-up study
No full textQuality-of-life of breast cancer women who underwent axillary node dissection by using ultrasound scissors. A prospective clinical study
No full textBackground: In patients with early-stage breast cancer undergoing surgery axillary lymph node dissection (ALND) still represents the most accurate means of determining the axillary node status. Unfortunately, such procedure is usually associated with prolonged serous drainage that may result in an increased risk of lymphedema. The aim of this study was to analyze whether the use of ultrasound scissors (US) in performing ALND may reduce the risk of long-term morbidity, subsequently improving the quality of life of patients.
Methods: Ninety-seven women (median age 55 years, range 33-74) underwent modified radical mastectomy (N=40, 41.2 %) or breast-conserving surgery with ALND (N=57, 58.8%) for primary pT1-2 breast cancer. Patients were randomly assigned to undergo ALND by either using (Group A, N=51) or not using (Group B, N=46) US. Health-related quality-of-life was measured with the Medical Outcomes Study Short Form 36 (MOS-SF-36). Assessment of pain was observed using the short form of the McGill Pain Questionnaire. Data were collected 15-18 months after surgery.
Results: Age, BMI, tumor staging, number of removed and involved nodes, and type of surgery did not differ between Groups. Both total amount of drainage (449±152 vs. 384±131 mL; p=0.03), and the number of axillary seromas (19 of 51 vs. 24 of 46; p=0.14) were reduced in Group A patients. The results are shown in the table. Arm or shoulder pain was reported in 35% (Group A) and 52% (Group B) of patients (p=0.20).
Conclusions: In patients undergoing ALND for breast cancer the use of US is useful both in reducing the total amount of drainage and the risk of seroma formation. However, such advantages may have a limited impact on long-term quality-of-life since only few parameters in the MOS-SF-36 form improved significantly
Risk factors for breast cancer in the Northeast of Italy. Multivariate analysis usung a logistic regression model
No full textLong-term follow-up study in breast cancer patients using serum tumor markers CEA and CA 15-3.
No full textThe aim of this study was to evaluate CEA and CA 15-3 changes in patients surgically treated for breast cancer. One hundred and three women (median age 59 years, range 31-83 years) with pT1-2, pN0-1, M0 breast cancer were followed up for at least 5 years. CEA and CA 15-3 serum levels were measured before operation and every 6 months during follow-up. The diagnostic sensitivity of CEA and CA 15-3 was 22.3% and 33.3% respectively. There was a significant difference (p < 0.01) between pre- and post-operative (6 months and 5 years after surgery) mean CEA serum levels independent of TNM staging. During follow-up, 21 (20.4%) patients showed recurrence of cancer and overall CEA and CA 15-3 sensitivity was 38.1% and 61.1%, with 98.8% and 91.2% specificity, respectively. Tumor marker measurement may be useful in post-surgical follow-up, but at present they are neither sensitive nor specific enough for early diagnosis of malignancy
Sensitivity of serum tumor markers CEA and CA 15-3 in breast cancer recurrences and correlation with different prognostic factors
No full textThe aim of this study was to evaluate the correlation between serum tumor markers CEA and CA 15-3 in breast cancer (BC) patients with disease relapse and different prognostic parameters at first operation. Sixty-two women (median age 55 years, range 35-83 years) who had undergone curative surgery for pT1-2 pN0-1 M0 breast cancer developed local recurrences, distant metastases or contralateral BC during a median relapse time of 53 months (range 25-149 months). Sensitivity of CEA, CA 15-3, and CEA + CA 15-3 together was 40.3%, 41.9% and 59.7%, respectively. No correlation (p = NS) was found between tumor markers sensitivity and type of recurrence, surgical procedure, histologic subtypes and hormone receptors rate. CEA significantly (p < 0.01) correlated with the size of the tumor and axillary node status and CA 15-3 with the age of the patients. In conclusion, CEA and CA 15-3 should be considered complementary in detecting BC recurrences but their sensitivity is low and independent of the majority of the prognostic parameters that may be considered before relapse
- …
