Joanna Langner, Frederick Millard, Vera Vavinskaya, Haiyan Zhang, Nuphat Yodkhunnatham, Aditya Bagrodia
A 41-year-old man presented to his primary care physician with a 1-month history of left neck adenopathy in the context of a history of nonseminomatous germ cell tumors (NSGCTs). In 2011, the patient was treated for stage IB (T2N0M0S0) right-sided NSGCTs of the testis, which were 95% embryonal and 5% yolk sac tumors. He underwent a right radical orchiectomy and was followed until 2022 without recurrence. In the work-up for his adenopathy, laboratory results for human chorionic gonadotropin, lactate dehydrogenase, and α-fetoprotein were normal. CT scans confirmed clustered enlarged lymph nodes in the left lower spinal accessory posterior triangle, enlarged left lower neck lymph nodes, and several foci of enlarged left retroperitoneal periaortic lymph nodes. Fine needle aspiration of a left neck lymph node identified malignant tumor cells. A left neck dissection showed embryonal carcinoma in 12 of 28 nodes. Immunostaining showed the tumor cells were positive for SALL4 and CD30 but negative for CD117. This patient likely had a contralateral late relapse of his original right NSGCT after 11 years of remission. The patient's original cancer was on the right side, with recurrence surrounding the aorta on the contralateral side, representing an atypical pattern of spread.
{"title":"Evaluation and Management of Testicular Cancer After Late Relapse.","authors":"Joanna Langner, Frederick Millard, Vera Vavinskaya, Haiyan Zhang, Nuphat Yodkhunnatham, Aditya Bagrodia","doi":"10.46883/2024.25921018","DOIUrl":"https://doi.org/10.46883/2024.25921018","url":null,"abstract":"A 41-year-old man presented to his primary care physician with a 1-month history of left neck adenopathy in the context of a history of nonseminomatous germ cell tumors (NSGCTs). In 2011, the patient was treated for stage IB (T2N0M0S0) right-sided NSGCTs of the testis, which were 95% embryonal and 5% yolk sac tumors. He underwent a right radical orchiectomy and was followed until 2022 without recurrence. In the work-up for his adenopathy, laboratory results for human chorionic gonadotropin, lactate dehydrogenase, and α-fetoprotein were normal. CT scans confirmed clustered enlarged lymph nodes in the left lower spinal accessory posterior triangle, enlarged left lower neck lymph nodes, and several foci of enlarged left retroperitoneal periaortic lymph nodes. Fine needle aspiration of a left neck lymph node identified malignant tumor cells. A left neck dissection showed embryonal carcinoma in 12 of 28 nodes. Immunostaining showed the tumor cells were positive for SALL4 and CD30 but negative for CD117. This patient likely had a contralateral late relapse of his original right NSGCT after 11 years of remission. The patient's original cancer was on the right side, with recurrence surrounding the aorta on the contralateral side, representing an atypical pattern of spread.","PeriodicalId":503486,"journal":{"name":"ONCOLOGY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140744080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hilary R Keller, Laura Fluke, Jared A Forrester, Ronald F Wolf
The recent Hot Topics section focuses on survival rates for patients with cholangiocarcinoma.
近期的热门话题版块重点关注胆管癌患者的生存率。
{"title":"Identifying Indications for Neoadjuvant Therapy in Cholangiocarcinoma.","authors":"Hilary R Keller, Laura Fluke, Jared A Forrester, Ronald F Wolf","doi":"10.46883/2024.25921017","DOIUrl":"https://doi.org/10.46883/2024.25921017","url":null,"abstract":"The recent Hot Topics section focuses on survival rates for patients with cholangiocarcinoma.","PeriodicalId":503486,"journal":{"name":"ONCOLOGY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140743515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.37766/inplasy2023.7.0120
Haixia Wu, Jun Li, J. Miao, Jia-wei Li
BACKGROUND Total neoadjuvant therapy (TNT) is a new strategy combining neoadjuvant therapy and chemotherapy to enhance tumor shrinkage and systemic control. Its effectiveness remains debated. OBJECTIVES This study conducts a meta-analysis of randomized controlled trials (RCTs) to assess TNT's impact and provide high-quality evidence for rectal cancer treatment decisions. METHOD We searched China National Knowledge Infrastructure, VIP Database, Wanfang Database, China biomedical literature database, PubMed database, Embase database, and The Cochrane Library for RCTs comparing TNT with neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer. The included trials were screened and assessed for quality based on inclusion and exclusion criteria, and meta-analysis was performed using RevMan 5.3 software. RESULTS A total of 11 RCTs reported in 14 articles, with 1624 cases in the TNT group and 1541 cases in the CRT group. The results of the meta-analysis showed that compared with the CRT group, the TNT group had a higher pathological complete response rate (RR=1.65, 95% CI [1.40, 1.94], P<0.00001), higher T0 downstaging rate (RR=1.51, 95% CI [1.29, 1.77], P<0.00001), higher 3-year overall survival (HR=0.81, 95% CI [0.67, 0.98], P=0.03), and higher 3-year disease-free survival (HR=0.82, 95% CI [0.70, 0.95], P=0.008). However, there was no statistically significant difference between the two groups in terms of R0 resection rate (RR=1.02, 95% CI [0.99, 1.05], P=0.14), sphincter preservation rate (RR=0.94, 95% CI [0.88, 1.01], P=0.12), anastomotic leakage rate (RR=1.42, 95% CI [0.85, 2.38], P=0.18), and grade 3 or higher adverse events (RR=1.21, 95% CI [0.95, 1.54], P=0.13). CONCLUSIONS In the treatment of locally advanced rectal cancer, TNT offers greater survival benefits compared to neoadjuvant CRT and does not significantly increase the incidence of adverse events. However, further data and studies with long-term outcomes are still required.
背景：全新辅助治疗（TNT）是一种将新辅助治疗和化疗相结合的新策略，旨在增强肿瘤的缩小和全身控制。其有效性仍存在争议。 目的 本研究对随机对照试验（RCT）进行荟萃分析，以评估 TNT 的影响，为直肠癌治疗决策提供高质量的证据。 方法 我们检索了中国国家知识基础设施、VIP 数据库、万方数据库、中国生物医学文献数据库、PubMed 数据库、Embase 数据库和 Cochrane 图书馆，以寻找在局部晚期直肠癌中比较 TNT 与新辅助化放疗（CRT）的 RCT。根据纳入和排除标准对纳入的试验进行筛选和质量评估，并使用 RevMan 5.3 软件进行荟萃分析。 结果 14篇文章共报告了11项RCT，其中TNT组1624例，CRT组1541例。荟萃分析结果显示，与 CRT 组相比，TNT 组病理完全反应率更高（RR=1.65，95% CI [1.40，1.94]，P<0.00001），T0 降期率更高（RR=1.51，95% CI [1.29，1.77]，P<0.00001）、更高的3年总生存率（HR=0.81，95% CI [0.67，0.98]，P=0.03）和更高的3年无病生存率（HR=0.82，95% CI [0.70，0.95]，P=0.008）。然而，两组在 R0 切除率（RR=1.02，95% CI [0.99，1.05]，P=0.14）、括约肌保留率（RR=0.94，95% CI [0.88，1.01]，P=0.12）、吻合口渗漏率（RR=1.42，95% CI [0.85，2.38]，P=0.18）和 3 级或以上不良事件（RR=1.21，95% CI [0.95，1.54]，P=0.13）。 结论 在局部晚期直肠癌的治疗中，与新辅助CRT相比，TNT能带来更大的生存获益，且不会显著增加不良事件的发生率。不过，仍需进一步的数据和长期结果研究。
{"title":"Is total neoadjuvant treatment beneficial for locally advanced rectal cancer? a meta-analysis of randomized controlled trials.","authors":"Haixia Wu, Jun Li, J. Miao, Jia-wei Li","doi":"10.37766/inplasy2023.7.0120","DOIUrl":"https://doi.org/10.37766/inplasy2023.7.0120","url":null,"abstract":"BACKGROUND Total neoadjuvant therapy (TNT) is a new strategy combining neoadjuvant therapy and chemotherapy to enhance tumor shrinkage and systemic control. Its effectiveness remains debated. OBJECTIVES This study conducts a meta-analysis of randomized controlled trials (RCTs) to assess TNT's impact and provide high-quality evidence for rectal cancer treatment decisions. METHOD We searched China National Knowledge Infrastructure, VIP Database, Wanfang Database, China biomedical literature database, PubMed database, Embase database, and The Cochrane Library for RCTs comparing TNT with neoadjuvant chemoradiotherapy (CRT) in locally advanced rectal cancer. The included trials were screened and assessed for quality based on inclusion and exclusion criteria, and meta-analysis was performed using RevMan 5.3 software. RESULTS A total of 11 RCTs reported in 14 articles, with 1624 cases in the TNT group and 1541 cases in the CRT group. The results of the meta-analysis showed that compared with the CRT group, the TNT group had a higher pathological complete response rate (RR=1.65, 95% CI [1.40, 1.94], P<0.00001), higher T0 downstaging rate (RR=1.51, 95% CI [1.29, 1.77], P<0.00001), higher 3-year overall survival (HR=0.81, 95% CI [0.67, 0.98], P=0.03), and higher 3-year disease-free survival (HR=0.82, 95% CI [0.70, 0.95], P=0.008). However, there was no statistically significant difference between the two groups in terms of R0 resection rate (RR=1.02, 95% CI [0.99, 1.05], P=0.14), sphincter preservation rate (RR=0.94, 95% CI [0.88, 1.01], P=0.12), anastomotic leakage rate (RR=1.42, 95% CI [0.85, 2.38], P=0.18), and grade 3 or higher adverse events (RR=1.21, 95% CI [0.95, 1.54], P=0.13). CONCLUSIONS In the treatment of locally advanced rectal cancer, TNT offers greater survival benefits compared to neoadjuvant CRT and does not significantly increase the incidence of adverse events. However, further data and studies with long-term outcomes are still required.","PeriodicalId":503486,"journal":{"name":"ONCOLOGY","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139353563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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