• Title/Summary/Keyword: Local tumor recurrence

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Clinical Outcome of Treatment for Patients with Giant Cell Tumor in Spine

  • Kim, Seon Chun;Cho, Wonik;Chang, Ung-Kyu;Youn, Sang Min
    • Journal of Korean Neurosurgical Society
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    • v.58 no.3
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    • pp.248-253
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    • 2015
  • Objective : The treatment of giant cell tumor (GCT) is mainly performed surgically. However, GCT in spine seems difficult to treat because of the limited surgical accessibility and proximity. In this report, we analyzed the outcome of GCT treatment in spine. Methods : Between 2000 and 2012, 19 patients received treatment for GCT in spine. Median age at their first diagnosis was 31 years, 10 patients were male, and 9 female. Fourteen tumors were located in the sacrum, 1 in cervical, 1 in thoracic and 3 in lumbar spine. As primary treatment, gross total removal (GTR) was done in 6 patients, and subtotal removal (STR) in 13 patients. Radiation therapy (RT) as an adjuvant therapy was performed in 2 cases in GTR group and 10 cases in STR group. Results : During the follow-up, 7 patients had local recurrence (36.8%). The average period until recurrence after primary treatment was 14 months. No recurrence was detected in GTR group. Recurrence was noted in 7 out of 13 patients who underwent STR. These differences were statistically significant (p=0.024). A median of recurrence free period (RFP) was 84 months. Also average RFP of the RT group was 112 months, and non-RT group was 65 months. These differences were statistically significant (p=0.041). Conclusion : Treatment of choice for GCT in spine is a complete removal of tumor without neurological deficits. In case of incomplete removal, radiation therapy may be a useful adjuvant treatment modality.

Electrocautery as Adjuvant Treatment of Giant Cell Tumor (거대세포종의 보조 요법으로의 전기소작술)

  • Han, Chung-Soo;Kim, Se-Dong;Park, Sung-Hyuk;Kim, Jung-Rae;Shin, Duk-Seop
    • The Journal of the Korean bone and joint tumor society
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    • v.12 no.1
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    • pp.15-22
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    • 2006
  • Purpose: This study was designed to investigate the clinical and oncological results of giant cell tumor, treated with electrocautery as an adjuvant. Materials and Methods: We evaluated 47 giant cell tumors treated in both institution from 1989 to 2004, retrospectively. We treated all 47 cases with intralesional curettage and speed burring and followed electrocautery as an local adjuvant. Results: The mean follow up periods was 44 months and ranged from 12 to 180 months. The local recurrence occurred in 8 patients (17%) and one case lung metastasis was found. There was one case complication (septic knee) associated with electrocautery as an adjuvant. Conclusions: We thought electrocautery was feasible adjuvant treatment method of giant cell tumor, because it is very convenient technique, and the local recurrence rate was similar to any other methods.

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Clinical and Histo-Pathological Analysis for Recurrence after Curative Surgery of Esophageal Cancer (식도암의 근치적 절제술 후 재발에 대한 임상적 및 병리조직학적 분석)

  • 박재길;이재광;곽문섭
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.570-575
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    • 2000
  • Background; Surgical resection remains the mainstay of treatment for esophageal cancer. Despite recent advances in surgical therapy, i.e. en bloc resection and extended lymphadenectomy, the overall long-term prognosis of patients with esophageal carcinoma has not, however, improved during the last decades. One of the major reasons in its relatively high recurrence rate. Material and Method; A retrospective review of recurrent patte군 of cancer in 42 patients who underwent curative surgery for primary esophageal cancer was performed clinically and histo-phthologically. Result; Nineteen patients had developed recurrece during the 18 to 52 months(mean 34.2 nonths), 8 had local recurrences, 1 had both, and 11 had systemic recurrences. Twelve patients(63%) had developed recurrence within 1 year, 5 patients(26%) between 1 year to 2 patients(11%) after 2 years. The recurrence rate according to growth pattern of tumor or presence of microinvasive findings was not statistically significant, but it increased significantly in clinical tumor stage III than stage IIA, B and in patients with the number of metastatic lymph node over ten. Conclusion; Post-operative recurrences of esophageal cancer appear as a high rate even though curative wide resection was done. Several clinical and histo-pathological factors correlate with the recurrence.

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A Metastatic Giant Cell Tumor of the Soft Tissue of the Thoracic Wall - A case report - (흉벽 연부조직에 발생한 전이성 거대세포종 - 1예 보고 -)

  • Shin, Duk-Seop;Lee, Jang-Hoon;Choi, Jun-Hyuk;Chung, Tae-Eun
    • Journal of Chest Surgery
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    • v.40 no.7 s.276
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    • pp.526-528
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    • 2007
  • A giant cell tumor of bone is a benign bone tumor, but has very high local recurrence rate and, very rarely metastasizes to the lung or a distant area. We report a case of a 29-year-old male patient presenting with a metastatic giant cell tumor of the soft tissue of the chest wall, who underwent a total resection of the radius for recurrence of the giant cell tumor. The tumor was not related to any bony structure of the thorax. We resected the tumor with a wide surgical margin. No evidence of malignancy was seen in the frozen and permanent pathological report.

MR Imaging Findings of Recurred Dermatofibrosarcoma Protuberans of the Scalp: A Case Report (두피에서 재발한 융기성 피부섬유육종의 MR영상: 증례 보고)

  • Cho, Joon;Roh, Hong-Gee;Kim, Mi-Young
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.2
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    • pp.121-125
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    • 2006
  • A 48-year-old man presented with a dermatofibrosarcoma protuberans (DFSP) of the scalp associated with local recurrence. Axial T1- and T2-weighted images demonstrated a well-circumscribed hypointense and intermediate hyperintense mass in the skin and subcutaneous layer of the scalp, respectively. Contrast-enhanced T1-weighted images showed the strongly enhanced mass invasion to the skin, subcutaneous layer and adjacent galeal layer. Scalp DFSP is very uncommon but is an aggressive tumor, so MR imaging diagnosis of the extent of the lesion to underlying structures, and initial wide local resection is important to prevent recurrence.

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Local Recurrence of Osteosarcoma After Joint Sparing Wide Resection -A Case Report- (슬관절 보존형 광범위 절제를 시행한 골육종 환자에서 발생한 국소 재발 - 증례보고 -)

  • Cho, Sang-Hyun;Song, Won-Seok;Won, Ho-Hyun;Jeon, Dae-Geun
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.51-55
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    • 2008
  • As survival rate of patients in osteosarcoma improves, both patients and surgeons are increasingly interested in long-term functional outcome. For resection and reconstruction of tumors on either side of knee joint, if feasible, conservation of normal joint apparatus seems preferable method over use of tumor prosthesis. However, we should not trade off the sound surgical margin with expected functional gain. We report one case of osteosarcoma who was treated by wide, intercalary resection and reconstruction with autogenous pasteurized bone but, showed local recurrence at 44 months postoperatively.

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Prognostic Value of Osteopontin in Patients Treated with Primary Radiotherapy for Head and Neck Cancer

  • Etiz, Durmus;Ataizi, Fulya Colak;Bayman, Evrim;Akcay, Melek;Acikalin, Mustafa Fuat;Colak, Ertugrul;Ciftci, Evrim
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5175-5178
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    • 2013
  • Background: The prognostic value of tumor osteopontin (OPN) in patients with squamous-cell head and neck cancer (SCHNC) was investigated. Materials and Methods: OPN expression was assessed by immunohistochemical methods in 50 patients, who were treated with primary radiotherapy (RT) for locally advanced SCHNC. The effects of OPN on clinical parameters, local-regional control after RT and metastasis-free survival, was assessed. Results: The rate of OPN expression in tumor tissue was 76%. OPN positive cases had lower Hb levels (p=0.088). Mean time to local recurrence was 53.8 months (SE 3.9) in OPN-negative cases and 39.1 months (SE 4.7) in OPN-positive cases (p=0.047). OPN increased the risk of local recurrence 5.9 times (p=0.085). It had no effect on metastasis-free (p=0.116) or overall survival (p=0.123). OPN was positive in 12 of 19 cases that developed grade 3-4 acute radiation dermatitis (p=0.096). Conclusions: OPN expression is associated with an increase in local recurrence in patients who were treated with primary RT for locally advanced SCHNC.

Development and Validation of a Model Using Radiomics Features from an Apparent Diffusion Coefficient Map to Diagnose Local Tumor Recurrence in Patients Treated for Head and Neck Squamous Cell Carcinoma

  • Minjae Kim;Jeong Hyun Lee;Leehi Joo;Boryeong Jeong;Seonok Kim;Sungwon Ham;Jihye Yun;NamKug Kim;Sae Rom Chung;Young Jun Choi;Jung Hwan Baek;Ji Ye Lee;Ji-hoon Kim
    • Korean Journal of Radiology
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    • v.23 no.11
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    • pp.1078-1088
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    • 2022
  • Objective: To develop and validate a model using radiomics features from apparent diffusion coefficient (ADC) map to diagnose local tumor recurrence in head and neck squamous cell carcinoma (HNSCC). Materials and Methods: This retrospective study included 285 patients (mean age ± standard deviation, 62 ± 12 years; 220 male, 77.2%), including 215 for training (n = 161) and internal validation (n = 54) and 70 others for external validation, with newly developed contrast-enhancing lesions at the primary cancer site on the surveillance MRI following definitive treatment of HNSCC between January 2014 and October 2019. Of the 215 and 70 patients, 127 and 34, respectively, had local tumor recurrence. Radiomics models using radiomics scores were created separately for T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE-T1WI), and ADC maps using non-zero coefficients from the least absolute shrinkage and selection operator in the training set. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of each radiomics score and known clinical parameter (age, sex, and clinical stage) in the internal and external validation sets. Results: Five radiomics features from T2WI, six from CE-T1WI, and nine from ADC maps were selected and used to develop the respective radiomics models. The area under ROC curve (AUROC) of ADC radiomics score was 0.76 (95% confidence interval [CI], 0.62-0.89) and 0.77 (95% CI, 0.65-0.88) in the internal and external validation sets, respectively. These were significantly higher than the AUROC values of T2WI (0.53 [95% CI, 0.40-0.67], p = 0.006), CE-T1WI (0.53 [95% CI, 0.40-0.67], p = 0.012), and clinical parameters (0.53 [95% CI, 0.39-0.67], p = 0.021) in the external validation set. Conclusion: The radiomics model using ADC maps exhibited higher diagnostic performance than those of the radiomics models using T2WI or CE-T1WI and clinical parameters in the diagnosis of local tumor recurrence in HNSCC following definitive treatment.

Long-Term Outcomes in Stage I Lung Cancer After Segmentectomy with a Close Resection Margin

  • Kim, Dae Hyeon;Na, Kwon Joong;Park, In Kyu;Kang, Chang Hyun;Kim, Young Tae;Park, Samina
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.361-368
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    • 2021
  • Background: In general, a 2-cm surgical margin is recommended for limited resection to obtain equivalent oncologic outcomes to lobectomy for lung cancer. This study aimed to examine the patterns of recurrence and prognostic factors for recurrence in patients with a close parenchymal resection margin. Methods: From January 2009 to April 2017, 156 patients with stage I lung cancer who underwent segmentectomy with a close resection margin (<2 cm) were enrolled. Recurrence-free survival and overall survival were assessed. In addition, predisposing factors for recurrence were evaluated. Results: The mean tumor size was 1.7±0.8 cm and the parenchymal resection margin was 1.1±0.6 cm. Recurrence developed in 17 (10.7%) of the 156 patients, and the 5-year recurrence-free survival rate was 88.9%. Distant metastasis (7.7%) was the predominant recurrence pattern. The isolated local recurrence rate was 1.9%. Multivariate Cox regression analysis revealed that age, tumor size, mediastinal lymph node dissection, postoperative complications, and histologic type were significant predisposing factors for recurrence. However, parenchymal margin distance did not significantly affect the long-term prognosis. Conclusion: Segmentectomy with a close resection margin for early-stage lung cancer in selected patients resulted in acceptable recurrence and survival. However, patients with tumors larger than 2 cm, squamous cell carcinoma histology, and insufficient mediastinal evaluation should be carefully followed up for recurrence.

Osteochondroma in Cervical Spine - 1 Case Report - (경추에서 발생한 골연골종 - 1예 보고 -)

  • Na, Hwa-Yeop;Lee, Young-Sang;Choi, Joon-Cheol;Choi, Jun-Won;Kim, Woo-Sung;Song, Woo-Suk;Noh, Hyoun-Min
    • The Journal of the Korean bone and joint tumor society
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    • v.14 no.1
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    • pp.73-77
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    • 2008
  • Osteochondroma is the most common benign tumor in bone, consist of 40%, but, rare in spine area occupying only 2%. We report a case of osteochondroma that was in the 5th and 6th spinous process of cervical spine. We performed en bloc excisional biopsy of the bony mass. And the patient is doing well without evidence of local recurrence at 1 year after surgery. Further follow-up is necessary to observe local recurrence.

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