Metastasectomy of Pulmonary Metastases from Osteosarcoma: Prognostic Factors and Indication for Repeat Metastasectomy
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Abstract:
Purpose . To identify prognostic factors for metastatic osteosarcoma patients and establish indication for repeat metastasectomy. Methods . Data from 37 patients with pulmonary metastasis from osteosarcoma who underwent metastasectomy in our institute from 1979 to 2013 were retrospectively reviewed. Results . Prognostic factors analyzed were age, sex, maximal diameter of the tumor at first pulmonary metastasectomy, total number of resected pulmonary metastases at first metastasectomy, number of surgeries, and disease free interval. In our analysis, characteristics associated with an increased overall survival were age > 15 years and fewer metastases (≤3). Of the 37 patients, 13 underwent repeat metastasectomy after the first metastasectomy. Of the 7 patients that underwent only two metastasectomies, three remained disease-free. In contrast, all six patients that underwent three or more metastasectomies died of relapse. Patients who had five or less lesions at second metastasectomy showed better survival compared to those who had six or more lesions. Conclusion . Age > 15 years and number of metastases at first metastasectomy were independent prognostic factors. Metastasectomy may provide curative treatment even in cases requiring repeat surgery. The number of metastases at second metastasectomy may be a potential predictor of the need for repeat surgery.Keywords:
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The latest results from the FLEX trial wag presented in ASCO annual meeting which was hold in June.2008 in Chicago.The study demonstrated that chemotherapy based on Cetuximab plus Cisplatin significantly increased the overall survival of NSCLC patients,including all histological subtypes.The new findings confirm that Erbitux is the first targeted thempy to show a significant survival benefit in NSCLC patients across all histological subtypes.
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Carcinoma,non-small-cell lung; Targeted therapy; Antibodies,monoelonal
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Background The most common site of metastasis for soft tissue sarcomas (STSs) is the lung. In patients who are candidates for resection, metastasectomy improves survival. Debate remains, however, on approach and patient selection for surgery. Methods We retrospectively analyzed demographics, tumor characteristics, peri- and postoperative factors for 53 patients who underwent lung metastasectomy for STS from 1989 to 2013. Disease-free intervals (DFIs) and survival were determined. Kaplan–Meier estimates and log-rank test were used for comparison and survival analyses. Results Median overall survival (diagnosis to death or last visit) was 59.9 months (IQR: 118.5), with mean follow-up of 85.3 months (SD: 69.5). Post-lung metastasectomy survival was 82.9%, 52.2%, 28.3%, and 13.3% at 1, 3, 5, and 10 years, respectively. Age at diagnosis of less than 50 years (p = 0.037), a low pathologic grade (p = 0.040), and a DFI until metastasis of greater than 13.5 months (p = 0.007) were significant predictors of improved survival. Conclusion Patients diagnosed at a younger age with low-grade tumors and those with a longer DFI prior to metastasis diagnosis gain the greatest survival advantage with surgery.
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With the advancement of surgical techniques and instruments, surgeries had been increasingly applied to patients with metastatic urothelial carcinoma. However, their survival benefits had not been carefully evaluated.Eligible articles were conducted by comprehensively searching three online databases (PubMed, EMBASE and Web of Science), published before May 1st, 2019. Overall survival (OS) and cancer-specific survival/progression-free survival (CSS/PFS) were analyzed to clarify their associations.Finally, eight out of 3,581 articles were enrolled in this meta-analysis. In terms of OS, our results indicated that OS was positively associated with the patients underwent radical cystectomy (RC) (pooled HR =0.72, 95% CI, 0.64-0.81, P=0.158, I2=39.4%), but it was not significantly associated with the patients underwent metastasectomy (MC) (pooled HR =0.78, 95% CI, 0.56-1.08, P=0.093, I2=49.7%). As for CSS/PFS, our results displayed that patients could benefit from surgery (RC or MC) (pooled HR =0.56, 95% CI, 0.42-0.75, P=0.213, I2=35.3%).Despite the positive role of the RC in treating metastatic urothelial carcinoma, MC did not suggest a survival benefit in terms of OS. More strictly designed randomized controlled trials (RCTs) were needed to validate our findings.
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Metastatic Urothelial Carcinoma
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Objective:To investigate the expression of ErbB2in patients with osteosarcoma and to determine the relation between ErbB2status and survival rate.Methods:Specimens were collected from 81osteosarcoma patients and immunohistochemical method was used to assay the expression of ErbB2.Results:Of the 81tumors examined,51(61%)demonstrated high levels of ErbB2expression.The presence of increased levels of ErbB2in osteosarcoma was significantly associated with the increased probability of event-free(P0.05)and overall survival(P0.05).Conclusion:In patients with osteosarcoma,ErbB2expression is associated with probability of event-free and overall survival.
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Correlations between treatment response and survival in patients with advanced non–small-cell lung cancer (NSCLC) have been unclear. Now, investigators have conducted a meta-analysis of 14 randomized, controlled trials of targeted and standard NSCLC therapies to examine associations between overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) in 12,567 NSCLC patients.
At the trial level, ORR was strongly correlated with PFS (R2 =0.89), but no …
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Background and Objectives The role of local surgical procedures in patients with metastatic soft tissue sarcoma is still undefined. Few retrospective studies have reported survival benefits for patients with pulmonary metastases after complete surgical resection. Treatment decisions are therefore mainly based on personal experiences rather than on reproducible knowledge. Method A total of 237 patients with metastatic sarcoma, treated between 1982 and 2015 at the University Hospital Tuebingen, Germany, were eligible for inclusion. Out of the 237 screened patients, 102 patients underwent at least one metastasectomy. Overall survival was defined as the primary endpoint in this study. For association of non‐linear relationship to the endpoint, significant prognostic factors were included into a recursive partitioning model. A subgroup analysis for long‐term survivors was also performed. Results The median overall survival was 64 months. The 3‐, 5‐, 10‐, and 20‐years overall survival rates were 70.7%, 50.3%, 24.7%, and 14.8%, respectively. The number of resections and the progression‐free intervals were independent prognostic factors in three statistical models. Conclusion Repeated resections of metastases from different localizations are a strong predictor for prolonged survival. We suggest that the progression‐free interval after metastasectomy should be considered as a predictive factor for benefit from further surgery.
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