Department of Surgery, Animal Medical Center, New York, NY 10021, USA.
Partial mandibulectomy was performed for the treatment of benign or malignant oral tumors in 142 dogs. Forty-two dogs with a benign tumor (ameloblastoma) had a 22.5 month (range, 6 to 74 months) median disease-free interval, with a 97% 1-year survival rate; there was local recurrence in one dog. Twenty-four dogs with squamous cell carcinoma had a disease-free interval of 26 months (range, 6 to 84 months), with a 91% 1-year survival rate; recurrence and metastasis developed in two dogs and metastatic disease in one dog. Based on survival curves, 37 dogs with a melanoma had a median survival time of 9.9 months (range, 1 to 36 months), with a 21% 1-year survival rate; 20 dogs died or were euthanatized for recurrent or metastatic disease. Twenty dogs with osteosarcoma had a median survival time of 13.6 months (range, 3 to 28 months), with a 35% 1-year survival rate; nine dogs died or were euthanatized for recurrent or metastatic disease. Nineteen dogs with fibrosarcoma had median survival time of 10.6 months (range, 3 to 32 months), with a 50% 1-year survival rate; 12 dogs died or were euthanatized for recurrent or metastatic disease. Results of this and previous studies demonstrated that partial mandibulectomy was effective in prolonging survival and decreasing recurrence for squamous cell carcinoma and ameloblastoma. Progressive disease and corresponding low survival times were common in dogs with melanoma, osteosarcoma, and fibrosarcoma. There were no differences in survival times or the progression of disease among five partial hemimandibulectomy procedures. The high rates of recurrence and metastasis in dogs with these tumors suggest a need for evaluation of ancillary chemotherapy and local radiation therapy to decrease the prevalence of progressive disease.
Dentistry and Oral Surgery Service, William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616, USA. firstname.lastname@example.org
Zygomatic salivary mucocoele as a postoperative complication following caudal hemimaxillectomy in a dog.
VRCC Veterinary Referrals, 1 Bramston Way, Laindon, Essex, SS15 6TP, UK.
Zygomatic mucocoele is reported as a postoperative complication occurring secondary to a caudal hemimaxillectomy in a two-year-old Labrador retriever. The dog was presented with a history of a rapidly growing oral mass, identified as a soft tissue sarcoma. A caudal hemimaxillectomy via an intraoral approach was performed as treatment for local control of the oral mass. Fifteen days postoperatively, periorbital swelling and exophthalmos developed on the ipsilateral side. The degree of swelling progressed and was identified by computed tomography, ultrasound and cytology as a salivary mucocoele. Zygomatic sialoadenectomy was performed via a modified lateral approach with zygomatic osteotomy. A small amount of discharge persisted from the surgical site but gradually resolved. Recurrence of the periorbital swelling and exophthalmos was noted 25 days later and further surgery was performed to excise residual salivary tissue. Adjuvant radiotherapy was performed, however local recurrence of the oral mass was identified 5 months postoperatively and the patient subsequently euthanased. Salivary mucocoele has been cited as a possible postoperative complication following maxillectomy and mandibulectomy procedures; however to the authors' knowledge, only one previous case report exists in the literature. The current case documents a zygomatic salivary mucocoele occurring subsequent to caudal hemimaxillectomy.
J Am Anim Hosp Assoc. ;46 (2):91-6 20194363
Veterinary Surgical Associates, 1410 Monument Boulevard, Suite 100, Concord, California 94520, USA.
This study reviews rim excision as a treatment for canine acanthomatous ameloblastomas (CAA) in dogs with <3 mm of bone involvement. Removal of a canine tooth was involved in 47% of the cases; 33% cases involved the caudal dentition. Follow-up ranged from 3 months to 5 years. No evidence of recurrence was seen. Client satisfaction with cosmesis and the animal's ability to masticate was judged to be good. With appropriate case selection, rim excision appears to be a viable option for CAA and results in improved dental occlusion, cosmesis, and no evidence of epulis recurrence.
Dentistry for Animals, 2651 Soquel Ave, Santa Cruz, CA 95076, USA. email@example.com
Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Veterinary Medical Teaching Hospital, Texas A&M University, College Station, Texas 77843, USA.
In a 10-year period, extramedullary plasmacytomas (EMP) represented 5.2% of all oral tumors found in the dog (16/302). These 16 oral EMP comprised 28.5% of all EMP within the same time period. Eleven dogs died with a median survival time of 474 days. Five dogs remain alive at the time of this writing. Dogs without complete surgical removal of the EMP and no adjuvant therapy had a median survival time of 138 days. Oral EMP have a clinical behavior consistent with EMP arising from other tissues. They have no obvious correlation with multiple myeloma, and complete surgical resection may be curative.
Can Vet J. 2007 Nov ;48 (11):1189-91 18050803
Donaldson-Atwood Cancer Clinic and Flaherty Comparative Oncology Laboratory, The Animal Medical Center, New York, New York, USA. Philip.Bergman@amcny.org
Melanoma is the most common oral malignancy in the dog. Oral and/or mucosal melanoma has been routinely considered an extremely malignant tumor with a high degree of local invasiveness and high metastatic propensity. Primary tumor size has been found to be extremely prognostic. The World Health Organization staging scheme for dogs with oral melanoma is based on size, with stage I =<2-cm-diameter tumor, stage II = 2- to <4-cm-diameter tumor, stage III => or = 4cm tumor and/or lymph node metastasis, and stage IV = distant metastasis. Median survival times for dogs with oral melanoma treated with surgery are approximately 17 to 18, 5 to 6, and 3 months with stage I, II, and III disease, respectively. Significant negative prognostic factors include stage, size, evidence of metastasis, and a variety of histologic criteria. Standardized treatments such as surgery, coarse-fractionation radiation therapy, and chemotherapy have afforded minimal to modest stage-dependent clinical benefits and death is usually due to systemic metastasis. Numerous immunotherapeutic strategies have been employed to date with limited clinical efficacy; however, the use of xenogeneic DNA vaccines may represent a leap forward in clinical efficacy. Oral melanoma is a spontaneous syngeneic cancer occurring in outbred, immunocompetent dogs and appears to be a more clinically faithful therapeutic model for human melanoma; further use of canine melanoma as a therapeutic model for human melanoma is strongly encouraged. In addition, the development of an expanded but clinically relevant staging system incorporating the aforementioned prognostic factors is also strongly encouraged.
Nicole C Northrup, Kimberly A Selting, Kenneth M Rassnick, Orna Kristal, Maura G O'Brien, Gillian Dank, Ravinder S Dhaliwal, Shyla Jagannatha, Karen K Cornell, Tracy L Gieger
Comparative Oncology Program, Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, Georgia 30602, USA.
Medical records of 42 cats treated with mandibulectomy for oral neoplasia at eight institutions were reviewed to determine morbidity, progression-free interval, and survival time. Progression-free and survival rates at 1 and 2 years were 56% and 49%, and 60% and 57%, respectively. Cats with squamous cell carcinoma had significantly shorter survival than cats with fibrosarcoma or osteosarcoma. Seventy-two percent of cats were dysphagic or inappetent immediately postoperatively, and 12% never regained the ability to eat. Despite acute morbidity in 98% and long-term morbidity in 76% of cats, 83% of the 30 owners providing information were satisfied with the outcome of mandibulectomy.
University of Wisconsin-Madison School of Veterinary Medicine, Madison, WI 53706, USA. firstname.lastname@example.org
Malignancies of the musculoskeletal system in dogs and cats can be categorized as either primary or metastatic within the bony or soft structures that comprise the musculoskeletal system. By far, the most common tumor that affects the musculoskeletal system in dogs is osteosarcoma. The most common tumors that affect the musculoskeletal system in cats are injection site sarcomas. These tumors are locally infiltrative; whereas up to 25% metastasize, most animals die from our inability to control local disease. The aim of this article is to provide a brief review of the biologic behavior of and treatment recommendations for common tumors of the musculoskeletal system, excluding the oral and nasal cavities.
Bilateral rostral maxillectomy and nasal planectomy for large rostral maxillofacial neoplasms in six dogs and one cat.
Animal Cancer Center, Department of Clinical Sciences, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado 80523, USA.
This paper describes in detail an aggressive rostral maxillectomy procedure in one cat and six dogs, and the postoperative complications and outcomes are reported. The surgeries were performed to attempt complete excision of large and extensive rostral maxillary fibrosarcomas (n=4), squamous cell carcinomas (n=2), or poorly differentiated mesenchymal neoplasia (n=1). The surgeries involved transection of the maxilla at the level of premolar (PM)1 and PM2 in a cat and two dogs, and between PM2 and PM3 in four dogs. There were no intraoperative complications. Complete margins of resection were obtained in all cases. The postoperative appearance was acceptable to owners. Local recurrence was only observed in one dog (10 months after surgery) during a follow-up period of 11 to 66 months (median, 21.5 months).
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Department of Surgery, Animal Medical Center, New York, NY 10021.
The medical records of 32 cats with small intestinal adenocarcinoma were reviewed. Common clinical signs included vomiting, dehydration, weight loss, cachexia, anorexia, and lethargy. In 50% of the cats, an abdominal mass was palpated, and in 38%, a mass was seen on radiographs. Biopsy of the tumor without resection was performed in 9 cats; 8 cats were euthanatized at the time of surgery, 7 because of metastases, and 1 cat died 1 day after surgery. In 23 cats, resection was performed. Eleven of these died within 2 weeks after surgery (mean survival time, 2.6 days); 8 had lymph node metastasis. Twelve cats survived greater than 2 weeks after surgery. The mean survival of 11 of these cats was 15 months. Six cats were euthanatized because of recurrent signs; 5 of the 6 had a recurrent abdominal mass. One cat was alive 2 years after surgery. Results of this study indicated that cats with adenocarcinoma, even those cats with advanced disease, can have long-term survival after surgery.
Department of Surgery, Animal Medical Center, New York, New York 10021.
The problems associated with perineal surgery depend on the surgical procedure performed. Problems are encountered before, during, and after surgery. Appropriate preoperative assessment, proper surgical technique, and thorough postoperative management are required for successful results. Immediate recognition and treatment of problems is essential.
Animal Medical Center, New York, New York 10021.
Prostatic abscessation in the dog is a disease process in which diagnostic, therapeutic, and postoperative problems are frequently encountered. Several surgical techniques for the treatment of prostatic abscessation in the dog have been reported. However, few studies have described the indications for use of a particular technique or associated postoperative complications.
Animal Medical Center, New York, New York 10021.
The management of animals with cystic hyperplasia-pyometra complex can be a challenge. Careful interpretation of the history and physical examination, radiographic, and clinicopathologic findings will lead to an accurate diagnosis. Appropriate and rapid stabilization of the animal before surgical removal of the uterus will greatly decrease morbidity and mortality. Precise surgical technique when performing ovariohysterectomy will decrease postoperative complications.
Department of Pathology, Animal Medical Center, New York, NY 10021.
Extra-adrenal pheochromocytoma (paraganglioma) arising from periadrenal tissue was diagnosed in an 18-year-old spayed domestic shorthair cat. The tumor was palpable on physical examination, but not apparent on plain radiographs. The cat developed temporary cardiac arrhythmia while the mass was being handled during excision, suggesting that the tumor was functional. The tumor was characterized histologically by nests and sheets of neoplastic cells separated by thin, vascular stroma. The cells had abundant eosinophilic granular cytoplasm and prominent nuclei. Diffuse, dark, intracytoplasmic granules were seen in sections stained with Grimelius stain. Ultrastructurally, the cells contained round and oblong, membrane-limited, dense core neurosecretory-type granules. Serotonin was detected in the cytoplasm of the neoplastic cells by use of immunocytochemical analysis.
Department of Surgery, Animal Medical Center, New York, NY 10021.
Single or multiple rib resection was performed in 40 dogs for the treatment of primary osteosarcoma or chondrosarcoma. The resulting thoracic wall defect was closed with polypropylene (12 dogs), primary muscle flap (16 dogs), diaphragmatic advancement (10 dogs), or a combination (2 dogs). Few immediate (less than 2 weeks) postoperative complications were observed. Twenty dogs with osteosarcoma had a median survival time of 3.3 months (range, 0.5 to 23 months), with a 20% 6-month survival time. Metastases occurred in all the dogs. Fourteen dogs with chondrosarcoma followed up longer than 2 weeks had a median survival time of 10.7 months (range, 0.5 to 36 months) with a 64% 6-month survival time. Eight dogs developed metastases, five died from concurrent disease, and one dog is alive. Dogs with chondrosarcoma survived significantly longer than dogs with osteosarcoma. Survival time was not related to tumor size or number of ribs resected.
Department of Surgery, Animal Medical Center, New York, NY 10021.
During a 5-year period, leiomyosarcoma was diagnosed in 57 dogs. Forty-four dogs were included in the study on the basis of completeness of medical records. All dogs underwent exploratory laparotomy, and dogs were allotted to 4 groups according to primary site of tumor: spleen (16 dogs, median age 10.3 years), stomach/small intestine (13 dogs, median age 10.3 years), cecum (10 dogs, median age 11.8 years), and liver (5 dogs, median age 9 years). All dogs with leiomyosarcoma of the liver had visible metastasis and were euthanatized at surgery. In the other 3 groups, 79% of the dogs had no gross evidence of metastasis at surgery, and 64% survived greater than 2 weeks. Median survival in these 3 groups was 10 months (range, 1 month to 7 years); 48% died of metastasis, 32% died of unrelated causes, and 16% died of unknown causes. The prognosis in dogs with leiomyosarcoma of the spleen, stomach, small intestine, and especially the cecum is good to excellent if surgery is performed. In dogs with leiomyosarcoma of the liver, the prognosis is poor.
Department of Surgery, Animal Medical Center, New York, New York 10021.
Hemimaxillectomy was performed in 69 dogs for the treatment of benign or malignant maxillary tumors. Eighteen dogs with ameloblastomas had a median disease-free interval of 21.5 months (range, 1 to 76 months), with a 72% 1-year survival time. There was recurrence in three dogs, with metastasis after malignant transformation in one of them. Based on calculated survival curves, seven dogs with squamous cell carcinoma had a median survival time of 19.2 months (range, 2 to 24 months), with a 57% 1-year survival time. There was local recurrence in two dogs. Twenty-three dogs with melanoma had a median survival time of 9.1 months (range, 1 to 46 months), and a 27% 1-year survival time. Twelve dogs died or were euthanatized because of recurrence or metastases. Fifteen dogs with fibrosarcoma had a median survival time of 12.2 months. Eight dogs died or were euthanatized because of recurrence or metastases. Six dogs with osteosarcoma had a median survival time of 4.6 months (range, 1 to 12.5 months), with a 17% 1-year survival time. Five dogs died or were euthanatized for recurrence or metastases. Tumor size or location and type of partial maxillectomy performed did not affect survival.
Vet Comp Oncol. 2004 Jun ;2 (2):98 19379190
Correlation of histologic grading of canine mast cell tumors with Ki67/PCNA/AgNOR/c-Kit scores: 38 cases (2002-2003).
P J Bergman, D M Craft, S J Newman, K Baer, M A Camps-Palau, J A McKnight, N F Leibman, S Brenn, K Finora, A E Hohenhaus, T Bartick, A K Patnaik, T Scase
DACC & Flaherty Comparative Oncology Laboratory or Dept. of Pathology, The Animal Medical Center, NYC, NY, USA.
Introduction: The Patnaik grading system for canine cutaneous MCT is currently one of the best determinants of prognosis; however, clinical outcome does not always correlate with histologic grade. The development of molecular markers offers a potential advantage and may complement subjective grading. The primary purpose of this study was to correlate histologic grading to Ki67/PCNA/AgNOR/c-Kit scores. Methods: Thirty-eight dogs with cutaneous MCT underwent surgical resection. Tumors were graded, with expansion of grade II MCT to low, medium (or II only) and high. For statistical purposes, MCT grade I, II (low, medium, high) and III were assigned a score of 1, 2, 3, 4, or 5, respectively. Sections were processed for AgNOR staining and expression of PCNA, Ki67 and c-Kit as previously described (modified biotin-strepavidin with DAB substrate). Paraffin-embedded canine tissue arrays were used as positive and negative controls (primary antibody replaced with pre-immune sera). Parametric statistical testing was performed using Statview statistical software with P </=.05 as significant. Results: There were 12, 20, 5 and 1 grade II low, grade II medium, grade II high and grade III MCT, respectively. The mean Ki67 score was 9.114 (median 8.0, range 1-28), mean PCNA score was 26.25 (median 24.0, range 5-65), mean AgNOR score was 1.499 (median 1.35, range 1.02-2.76) and c-Kit scores were +1 (9/37),+2 (19/37) and +3 (9/37). With parametric statistical testing, significantly positive correlations were found for Ki67/Grade, PCNA/Grade, AgNOR/Grade, Ki67/PCNA, Ki67/AgNOR and PCNA/AgNOR (all P <.0001). No significant correlation was found for c-Kit and grade; however,+3 c-Kit scores had statistically significantly higher grades than +2 c-Kit scores (P =.0458). Conclusions: Ki67/PCNA/AgNOR scores are positively correlated to grade in dogs with MCT. Further studies to correlate Ki67/PCNA/AgNOR/c-Kit scores with clinical variables are ongoing.
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Radiation Oncology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, Munich, Germany. email@example.com
PURPOSE The feasibility and effectiveness of radiotherapy in the management of recurrent esophageal carcinoma (REC) is reported. PATIENTS AND METHODS A consecutive cohort of 54 patients with rcT1-4, rcN0-1, or cM0 recurrent esophageal carcinoma (69% squamous cell carcinoma, 31% adenocarcinoma) was treated between 1988 and 2010. The initial treatment for these patients was definitive radiochemotherapy, surgery alone, or neoadjuvant radiochemotherapy + surgical resection in 8 (15%), 33 (61%), and 13 (24%) patients, respectively. The median time to recurrence from initial treatment was 19 months (range 4-79 months). The site of the recurrence was anastomotic or local, nodal, or both in 63%, 30%, and 7% of patients, respectively. Salvage radio(chemo)therapy was carried out with a median dose of 45 Gy (range 30-68 Gy). RESULTS Median follow-up time for surviving patients from the start of R(C)T was 38 months (range 10-105 months). Relief of symptoms was achieved in 19 of 28 symptomatic patients (68%). The median survival time was 12 months (95% confidence interval (CI) 7-17 months) and the median recurrence-free interval was 8 months (95% CI 4-12 months). The survival rates at 1, 2, and 3 years were 55 ± 7%, 29 ± 6%, and 19 ± 5%, respectively. The recurrence-free survival rates at 1, 2, and 3 years were 44 ± 7%, 22 ± 6%, and 15 ± 5%, respectively. A radiation dose ≥ 45 Gy and conformal RT were associated with a better prognosis. CONCLUSION RT is feasible and effective in the management of recurrent esophageal carcinoma, especially for relief of symptoms. Toxicity is in an acceptable range. The outcome of REC is poor; however, long-term survival of patients with recurrent esophageal carcinoma after radiochemotherapy might be possible, even with a previous history of radiotherapy in the initial treatment. If re-irradiation of esophageal carcinoma is contemplated, three-dimensional conformal techniques and a minimum total dose of 45 Gy are recommended.
Safety and efficacy of partial hepatectomy for huge (≥10 cm) hepatocellular carcinoma: a systematic review.
Department of Hepato-Biliary-Pancreato-Vascular Surgery, 1st affiliated Hospital of Xiamen University, Xiamen, China.
Huge (≥10 cm) hepatocellular carcinoma (HCC) is not uncommon at clinical presentation, and the surgical outcomes of such tumors are poor. This systematic review aimed to assess the safety and efficacy of partial hepatectomy for huge HCC. We performed a search on Medline and PubMed databases for all relevant studies published prior to December 2009. After exclusions, 21 studies remained for appraisal and data extraction. All studies were classified as level-4 evidence. The median overall perioperative morbidity and mortality rates were 29.2%(range: 13.6-72%) and 3.5%(range: 0-18.2%), respectively. The overall median survival since the partial hepatectomy was 20.7 months (range: 10.1-32 months), with median 1-, 3- and 5-year survival of 60.7%(range: 41-72.2%), 34%(range: 0-60.3%) and 28.6%(range: 0-54%), respectively. The median disease-free survival since the partial hepatectomy was 11.3 months (range: 5.5-32 months), with median 1-, 3- and 5-year disease-free survival rates of 48.7%(range: 32-65.4%), 27.5%(range: 14.1-49%) and 20.7%(range: 9.5-43%), respectively. Partial hepatectomy can be performed safely and is associated with long-term survival in a subset of patients with huge HCC, but the evidence of benefit is currently weak.
Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, PR China.
Department of Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA. firstname.lastname@example.org
Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, MO 65212, USA.
Oral squamous cell carcinoma (OSCC) is the most common malignancy of the oral cavity with a poor 5-year survival rate, due in large part to the presence of metastatic disease at initial diagnosis. In recent years, a number of studies have examined the oral tumor microenvironment to asses the potential dynamic balance between extracellular matrix deposition and proteolytic degradation as well as the cellular adhesion molecules that mediate adhesion to matrix and regulate tissue cohesion. The objective of this review is to provide a brief overview of the major matrix components, adhesion molecules and proteolytic enzymes in the oral tumor microenvironment and to summarize recent findings regarding the role of these complex molecular players in oral tumor progression.
*Division of Oncology, Tel-Aviv Sourasky Medical Center; daggerSackler School of Medicine, Tel Aviv University; and double daggerDepartment of Obstetrics & Gynecology, Lis Maternity Hospital, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
BACKGROUND:: Uterine leiomyosarcoma (LMS) is a rare disease and, when it recurs or metastasizes, can rarely be cured. In a retrospective study, we summarized our experience in treating a large cohort of patients with metastatic uterine LMS. MATERIALS AND METHODS:: Cases of recurrent or metastatic uterine LMS diagnosed between 2000 and 2008 were analyzed. Survival was determined from the time of initial diagnosis to last follow-up. RESULTS:: Thirty-three patients (median age, 55 years) were identified. Eighteen patients were initially diagnosed with localized disease. Median disease-free interval was 5.25 months, and overall survival (OS) is 43.7 months. Median OS of 15 patients with initially discovered metastatic disease is 31.4 months. Different chemotherapy regimens produced approximately 30% response rates. Twelve patients underwent at least 1 surgical resection of pulmonary or extrapulmonary metastases. In this group, median progression-free survival was 7.9 months (range, 0-33.9 months), median OS was 45.2 months (range,>8.1-78.8 months), 2-year survival rate was 83%, and 4-year survival rate was 25%. CONCLUSIONS:: Very few patients with recurrent or metastatic uterine LMS can be curatively treated. Our experience suggests that modern multimodal therapy or combining chemotherapy with aggressive surgery in selected patients may be significant in prolonging survival of women with this fatal disease.
Long-term survival in dogs with localized histiocytic sarcoma treated with CCNU as an adjuvant to local therapy.
Department of Surgical and Radiological Sciences, University of California, Davis, CA 95616, USA. email@example.com
Histiocytic sarcoma (HS) is associated with a poor prognosis owing to the presence of metastasis at the time of diagnosis in most dogs. Improved outcome has been reported in several dogs with localized HS following local therapy, however, distant metastasis occurs in 70-91% of dogs suggesting that adjuvant systemic therapy is necessary. The purpose of this retrospective study was to describe clinical characteristics and outcome in dogs with localized HS treated with aggressive local therapy plus adjuvant CCNU chemotherapy. Data from 16 dogs were evaluated. The median disease-free interval was 243 days. Two dogs had local recurrence and eight dogs developed metastatic disease with a median time to relapse of 201 days in these 10 dogs. The median survival time for all 16 dogs was 568 days. These results support the recommendation for aggressive local therapy combined with adjuvant CCNU chemotherapy in dogs with localized HS.
Department of Otolaryngology-Head and Neck Surgery, National Defense Medical Collage, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan. firstname.lastname@example.org
BACKGROUND This retrospective study evaluates the efficacy and safety of S-1 chemotherapy or S-1 followed by low-dose docetaxel chemotherapy for recurrent head and neck cancer. PATIENTS AND METHODS S-1 was administered to 21 patients with recurrent head and neck cancer, in outpatient settings. Of these 21 patients, 8 were additionally administered a low dose of docetaxel fortnightly. RESULTS The survival rate of patients with squamous cell carcinoma of the head and neck was 59.1% for 12 months and 17.5% for 24 months, with a median survival time of 18 months. Time to progression of more than 12 months was shown by 4 patients (22.2%). Most adverse events were mild (up to grade 2). CONCLUSION S-1 therapy is considered a safe and effective treatment option. From the viewpoint of tumour dormancy, S-1 therapy is a useful vigorous anticancer treatment that can be provided while maintaining patients' quality of life in recurrent cases.
Department of Oral Immunology,School of Stomatology,Shanghai No.9 Hospital,Shanghai Second Medical University.Shanghai 200011, China.
Malignant melanoma is a kind of tumor with higher malignant and lower therapeutic effect.it is demonstrated by experiment that melanoma cells have antigenicity and refer to immunology.BCG is a kind of biologic response modifier(BRM).it is able to promote physical antitumor ability.There were 42 patients with oral and maxillofacial malignant melanoma who received freezing therapy and surgery in this paper.11 cases of them added BCG immunotherapy.The result is that the median survival time of therapy plus BCG group is 4 years,and 3 years,5 years,7 years survival rate are 89%,72% and 32%,over 8 years survival rate is 18%.The median survival time of another group is 2 years,and 3 years,5 years,7 years survival rate are 55%,24% and 12%,over 8 years survival rate is 3%.There is a statistically significant difference between these two groups and BCG group has a longer survival time.This preliminary study demonstrated that BCG adjuvant therapy could decrease recurrence of metastases and increase patients survival time.
Brian D Crompton, Robert E Goldsby, Vivian K Weinberg, Robert Feren, Richard J O'Donnell, Arthur R Ablin
Department of Pediatrics, UCSF Children's Hospital, San Francisco, California 94143-0106, USA.
BACKGROUND Approximately one-third of patients with osteosarcoma who have a complete response to their initial treatment can be expected to relapse. It is important to define what host, tumor, or treatment characteristics determine outcome after relapse. We present findings in 59 patients treated at our institution from 1974 to 1996 who have relapsed one or more times after their initial response. METHODS Host and tumor characteristics at diagnosis and relapse, therapeutic interventions and survival outcomes were determined from examination of medical records and a follow-up questionnaire. RESULTS Of the 59 patients, 37 initially presented with localized disease of the extremity, 11 with localized non-extremity disease, and 11 with metastatic disease. This report focuses on those with localized disease of the extremity. For these patients, median time from original diagnosis to first recurrence was 14 months. Median survival after first recurrence was 31 months. The median post initial relapse survival was the same for patients whose first relapse occurred before or after 14 months from original diagnosis. Seventeen of 29 patients with systemic metastasis at first recurrence had complete removal of their disease and had a median post-op survival of 2.5 years, while the remaining 12 patients with no surgery, had a median survival of 2 years. Of the 37 patients who presented with primary disease only in the extremities and relapsed: 31 died (2 more than 6 years from first recurrence) and 6 are alive from 6 to 24 years from first recurrence (5 without disease and 1 with disease). Three of the five disease-free survivors had three or more relapses. CONCLUSION With a long follow-up time, we found 15% of patients with relapsed osteosarcoma who originally presented with localized disease in the extremity are alive with no evidence of disease at 10 years from first recurrence (Kaplan-Meier estimate). Even patients with multiple relapses may have long-term disease-free survival after salvage therapy. Chemotherapy and time to first recurrence were unrelated to survival after relapse in this study. Complete surgical removal of metastatic disease may be important for long-term survival.