Late Tumor Recurrence Research Articles

Late deaths following radiotherapy for pediatric tumors.

From 1953 to 1975, 341 children received megavoltage radiation and survived at least 5 years. Chemotherapy was administered to 189 of these children. Although the expected age-adjusted 30-year survival was 97%, the observed survival was only 83%. Late recurrence of primary tumor was responsible for 24 of 37 deaths. Other causes of death included second neoplasm (4 patients), infection (4 patients), central nervous system complication (2 patients), inanition (1 patient), motor vehicle accident (1 patient), and miscellaneous (1 patient). Thus, 36 of the 37 late deaths were secondary to either the original cancer, a new cancer, or the effects of treatments. Brain tumors and Ewing's sarcoma have more late deaths while neuroblastomas have fewer late deaths than expected. Even after 25 years of follow-up, the survival of this cohort does not parallel that of the general population.

Second-Look Laparotomy for Wilms’ Tumor: Indications and Results in 19 Patients

Nineteen of 74 children with Wilms' tumor underwent second-look laparotomy. Transperitoneal operation was done in five cases referred after flank operation elsewhere. Four had a change in stage from I to II or III, while one considered inoperable was resected (4/5 survived). Reoperation was done in two late referrals after operations with tumor spill. One had recurrent flank disease; the other had a flank mass with unrecognized diaphragmatic and intracaval extension (1/2 survived). Three children with giant tumors initially considered unresectable were successfully resected after cytoreduction with chemotherapy (3/3 survived). Two of three patients with bilateral Wilms' tumor survived reoperative procedures (partial or total nephrectomy). Five children with late intraabdominal recurrence (3 liver: 2 flank) eventually died despite reoperation and adjunctive therapy. All five had unfavorable histology. One child with en bloc hepatic resection had successful reoperation for suprahepatic vena caval obstruction due to regeneration of liver, but subsequently died. Ten of the 19 patients survived (52.6%) following reoperation and adjunctive therapy. Second-look laparotomy is quite useful in patients inadequately staged with flank operations, in cases of bilateral Wilms' tumor, and in children with initially unresectable tumors following cytoreduction. Patients with extensive tumor spill at a previous procedure may benefit from early reoperation. Late recurrence of tumor (especially with unfavorable histology) and/or liver metastases carried an ominous prognosis.

Second-look laparotomy for Wilms' tumor: Indications and results in 19 patients

Nineteen of 74 children with Wilms' tumor underwent second-look laparotomy. Transperitoneal operation was done in five cases referred after flank operation elsewhere. Four had a change in stage from I to II or III, while one considered "inoperable" was resected (4/5 survived). Reoperation was done in two late referrals after operations with tumor spill. One had recurrent flank disease; the other had a flank mass with unrecognized diaphragmatic and intracaval extension (1/2 survived). Three children with giant tumors initially considered unresectable were successfully resected after cytoreduction with chemotherapy (3/3 survived). Two of three patients with bilateral Wilms' tumor survived reoperative procedures (partial or total nephrectomy). Five children with late intraabdominal recurrence (3 liver: 2 flank) eventually died despite reoperation and adjunctive therapy. All five had unfavorable histology. One child with en bloc hepatic resection had successful reoperation for suprahepatic vena caval obstruction due to regeneration of liver, but subsequently died. Ten of the 19 patients survived (52.6%) following reoperation and adjunctive therapy. Second-look laparotomy is quite useful in patients inadequately staged with flank operations, in cases of bilateral Wilms' tumor, and in children with initially unresectable tumors following cytoreduction. Patients with extensive tumor spill at a previous procedure may benefit from early reoperation. Late recurrence of tumor (especially with unfavorable histology) and/or liver metastases carried an ominous prognosis.

The role of second-look procedures in the management of retroperitoneal tumors in children.

Forty-two infants and children with retroperitoneal solid tumors underwent second operative procedures. Twenty-three children had stage III (4) or stage IV (19) neuroblastoma and 19 had Wilms' tumor. This report suggests that second-look procedures are quite beneficial in selected cases. In children with Wilms' tumor, second procedures are most useful in those patients inadequately staged with flank operations, in cases of bilateral tumors, and in children with initially unresectable tumors following cytoreduction. Patients with significant tumor spill at a previous procedure may also benefit from early reoperation. Late recurrence of tumor, especially in children with unfavorable histology and/or hematogenous liver metastases, carries an ominous prognosis. Ten of the 19 patients with Wilms' tumor are long-term survivors (52.6%). Patients with initially unresectable (stage III) neuroblastoma occurring in the pelvis respond well to second-look resection. Children with primary tumors surrounding the celiac axis eventually died despite subsequent resection. Although the efficacy of primary tumor resection in cases of metastatic neuroblastoma remains controversial, stage IV patients with tumor resection had a longer duration of survival. Our only long-term survivors had their primary tumors resected. Second-look or delayed abdominal operations in metastatic cases may be useful in assessing the effectiveness of treatment and for sampling of retroperitoneal lymph nodes as a prognostic indicator.

Late Recurrence of Wilms Tumor

Three patients with Wilms tumors recurring after nine years in an organized abdominal hematoma, after ten years in the lung, and after eleven years in the central nervous system, respectively, are presented. It is proposed that the nephroblastoma cells have survived in a latent or a very slowly growing state. The reactivation mechanisms are briefly discussed. A review of the literature indicates a rate of recurrence of nonmetastasizing Wilms tumors later than 24 months of 1.4--3.9%.

Liver transplantation for liver cancer.

AbstractResults in the first 100 orthotopic liver allografts performed in the Cambridge‐King's College Hospital series (1968–1980) are reported. Twenty‐two patients survived beyond a year (age range, 16–59 years). Of these, 12 were cirrhotics and 10 were primary malignancies. Of the cirrhotics, 10 are alive, with the 2 deaths resulting from cholangitis. Two patients who had primary hepatic carcinoma are alive at 1 and 5 years following transplantation; the 8 deaths in this group were attributed to tumor recurrence (5 patients), sepsis (2 patients), and secondary cirrhosis possibly due to non‐A non‐B hepatitis (1 patient). Patients who survive for 6 months have a greatly increased chance of surviving the second 6 months and subsequently. Of the last 14 liver allografts (12 for cirrhosis and 2 for primary malignancy), there are 9 survivors. This mortality (36%) probably represents the results of better selection of the cirrhotics before they were too sick to withstand the operation; better control of rejection; and refinements in surgical procedure and anesthesia. For those patients surviving the first year, there is a 40% chance of the tumor's being eliminated. The late tumor recurrence rate is unacceptably high at 60%, however, and our criteria for patient selection have become increasingly selective.

Recurrence of wilms tumor — twenty-three years later

A case of Wilms tumor recurrent twenty-three years after the initial nephrectomy and subsequent radiotherapy is presented. Late recurrence of Wilms tumor is rare, and one must postulate a breakdown in the host's immune surveillance system to explain such an unusual event.

Late recurrence of giant-cell tumor of bone: pharmacoangiographic evaluation.

Late recurrence (more than five years) of benign giant-cell tumor of bone is uncommon. Two patients were evaluated by angiography, including injection of vasoactive drugs, because of osteolytic lesions developing six and seven years after primary operation for benign giant-cell tumor. Angiography established a probable recurrence in both cases. Angiography also permitted accurate evaluation of tumor extension, facilitating pre-operative planning. Giant-cell tumors are predominantly hypervascular lesions. Angiographic evaluation is therefore recommended when a recurrent lesion is suspected.

Late recurrence of testicular tumor.

Late recurrence of testicular tumor.

Testicular tumors: 40 years' experience.

No AccessJournal of Urology1 Nov 1973Testicular Tumors: 40 Years’ Experience D.A. Culp, D.L. Boatman, and V.B. Wilson D.A. CulpD.A. Culp More articles by this author , D.L. BoatmanD.L. Boatman More articles by this author , and V.B. WilsonV.B. Wilson More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)60277-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail © 1973 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited BySmith R, Dekernion J and Skinner D (2018) Management of Advanced Testicular SeminomaJournal of Urology, VOL. 121, NO. 4, (429-431), Online publication date: 1-Apr-1979.Whitmore W (2018) Editorial CommentJournal of Urology, VOL. 121, NO. 4, (431-431), Online publication date: 1-Apr-1979.Geller R, Kuremsky D, Copeland J and Stept R (2018) Sarcoidosis and Testicular Neoplasm: An Unusual AssociationJournal of Urology, VOL. 118, NO. 3, (487-488), Online publication date: 1-Sep-1977.Dekernion J and Lupu A (2018) The Response of Metastatic Retroperitoneal Seminoma to ChemotherapyJournal of Urology, VOL. 117, NO. 6, (736-738), Online publication date: 1-Jun-1977.Waldbaum R, Katz R, Susin M and Perlmutter M (2018) Late Recurrence of Testicular Tumor (choriocarcinoma)Journal of Urology, VOL. 116, NO. 2, (261-262), Online publication date: 1-Aug-1976.Skinner D (2018) Non-Seminomatous Testis Tumors: a Plan of Management Based on 96 Patients to Improve Survival in All Stages by Combined Therapeutic ModalitiesJournal of Urology, VOL. 115, NO. 1, (65-69), Online publication date: 1-Jan-1976. Volume 110Issue 5November 1973Page: 548-553 Advertisement Copyright & Permissions© 1973 by The American Urological Association Education and Research, Inc.MetricsAuthor Information D.A. Culp More articles by this author D.L. Boatman More articles by this author V.B. Wilson More articles by this author Expand All Advertisement Loading ...

Late recurrence of testicular tumor.

Late recurrence of testicular tumor.

Carcinoma of the Rectum following Irradiation of Carcinoma of the Cervix

Three case histories are presented relating development of rectal cancer 20 yr after combined Ra and x-ray treatment of cancer of the uterine cervix. Radiation doses received by the three patients (Ra + x rays) were: 8687 mghr + 2400 r, 4900 mg-hr + 4000 r, and 8100 mg-hr + 1220 r. The rectal tumors were first observed 19, 12, and 20 yr after radiotherapy. It was relatively easy to differentiate between the second primary tumor and a late recurrence of the original tumor. In all three cases, the initial tumor was a squamous cell carcinoma and the subsequent one an adenocarcinoma. Histologically, these are separate primary tumors. Perirectal induration was noted in the patients, and in two it was thought to be due to extension of the carcinoma. Todd previously described the perirectal induration as the extrinsic reaction. Evidence of early damage by irradiation was shown by the development of a stricture in Case 1 and a vesicovaginal fistula in Case 3. It is difficult to be certain that these rectal tumors are related to irradiation and did not occur by coincidence. (BBB)