Lower 5-year Disease-specific Survival Research Articles

Sinonasal Mucoepidermoid Carcinoma: A Brief Review of Literature

Objective Review the clinical, histologic, and molecular features of sinonasal mucoepidermoid carcinoma (SN-MEC) with emphasis on the application and prognostic significance of MAML2 rearrangement. Main points Location of MEC in the sinonasal region accounts for less than 0.1% of primary sinonasal malignancies. Primary SN-MEC most commonly affects the maxillary sinuses, and the mean age at diagnosis is 57 years. MAML2 translocation status aids in diagnosis but has no bearing on prognosis. The most significant prognostic criteria for SN-MEC are older age, tumor size gerater than 4 cm, higher grade, and advanced American Joint Committee on Cancer stage. Conclusions SN-MEC is a rare entity that presents at a higher grade and has lower 5-year disease-specific survival when compared with MEC of the major salivary glands. Correct recognition is important because of the impact on clinical management and prognosis.

Clinical characteristics and survival outcomes of ascending, descending and mixed types of nasopharyngeal carcinoma in the non-endemic areas of china: A propensity score matching analysis.

PurposeTo compare the clinical characteristics and survival outcomes of patients with ascending type (type A), descending type (type D), and mixed type (type AD) of nasopharyngeal carcinoma (NPC) in non‐endemic areas.Materials and methodsThe cohort included 628 patients diagnosed with type A, type D, and type AD of NPC between January 2009 and December 2014. Type A was defined as T3‐4 N0‐1, type D as T0‐1 N2‐3, and type AD as T3‐4 N2‐3. Propensity score matching (PSM) was performed to balance clinical factors and match patients. Kaplan‐Meier methods and Cox proportional hazards models were used to evaluate the impact of different NPC types on survival outcomes.ResultsThere were 145 patients with type A, 194 with type D, and 289 with type AD. However, after PSM, there were only 130 patients with each type. Compared with patients with type A, those with type D had lower 5‐year disease‐specific survival (96.9% vs 91.5%) and distant metastasis‐free survival (92.3% vs 77.7%) and higher local relapse‐free survival (88.5% vs 96.9%) (p < 0.05 for all). Patients with type AD may have an increased risk of disease progression (progression‐free survival, 56.9% vs 74.6% and 66.2%) and death (overall survival [OS], 76.9% vs 85.4% and 85.4%) (p < 0.05 for all) compared to patients with the other two types of tumors.We further analyzed the metastasis trend. Similar metastasis patterns were observed in types AD and D, and types AD and A had similar recurrence trends. The mortality rate of patients with types AD and D in the first 3 years after metastasis was remarkably higher than that of patients with type A.ConclusionsIn non‐endemic areas of China, metastases and recurrence patterns differed across tumor types. Type AD has the worst OS, and the clinical process is more radical. Type D has a lower recurrence rate, higher metastasis, and disease‐related mortality rates, and poorer prognosis after metastasis than type A.

Laryngeal spindle cell carcinoma: A population-based analysis of incidence and survival

Laryngeal spindle cell carcinoma (LSpCC) is a rare variant of squamous cell carcinoma. Surgery is the reported mainstay of treatment, but previous analyses failed to demonstrate survival outcomes by therapeutic modality. This study aims to carry out the largest population-based analysis of this histology to determine tumor characteristics, incidence, survival, and prognostic indicators. The National Cancer Institute's Surveillance, Epidemiology, and End Results database was queried for cases of LSpCC diagnosed between 1973 and 2011. Data was analyzed for patient demographics, incidence, treatment, and survival. A total of 312 cases of LSpCC were identified. Males comprised 87.2% of the cases, representing a male-to-female ratio of nearly 7:1. Whites accounted for 83.7% of LSpCC cases, whereas blacks represented 13.1%. Most cases (72.1%) arose in the glottis. The incidence of LSpCC from 2000 to 2011 was 0.023 per 100,000, with an annual percent change of -0.115%. One-, 5-, and 10-year disease-specific survival (DSS) rates for LSpCC were 90.9%, 74.1%, and 57.9%; whereas 1-, 5-, and 10-year relative survival rates were 91.0%, 77.7%, and 64.5%, respectively. Tumors of the glottis had a 5-year DSS of 84.0% compared to 51.9% for nonglottic tumors (P < 0.0001). High-stage (III/IV) LpSCC had lower 5-year DSS than low-stage (I/II) (36.8% and 91.8%, respectively) (P < 0.0001). Surgery imparted favorable 5-year survival, whereas radiotherapy did not impact survival rates. Laryngeal spindle cell carcinoma most commonly affects males and has a strong predilection for the glottis. Survival is best for glottic LSpCC. Surgery imparts a favorable prognosis compared to radiotherapy. 4.

Results of Radiotherapy in 153 Primary Cutaneous B-Cell Lymphomas Classified According to the WHO-EORTC Classification

To evaluate the results of radiotherapy in patients with primary cutaneous B-cell lymphoma (CBCL) classified according to the criteria of the World Health Organization-European Organization for Research and Treatment of Cancer (WHO-EORTC) classification. Multicenter, 20-year, retrospective, cohort analysis. Eight dermatology departments collaborating in the Dutch Cutaneous Lymphoma Group. From 1985 until 2005, a total of 153 patients with CBCL were initially treated with radiotherapy with curative intent. These cases were classified according to the WHO-EORTC classification and consisted of 25 primary cutaneous marginal zone lymphomas (PCMZLs), 101 primary cutaneous follicle center lymphomas (PCFCLs), and 27 primary cutaneous large B-cell lymphomas, leg type (PCLBCLs, LT). Interventions Local radiotherapy with a median dose of 40 Gy (range, 20-46 Gy) applied to all visible skin lesions. Complete remission rate, relapse rate, 5-year relapse-free survival, 5-year overall survival, and 5-year disease-specific survival. Complete remission was reached in 151 of 153 patients (99%). Relapse rates for PCMZL, PCFCL, and PCLBCL, LT were 60%, 29%, and 64%, and the 5-year disease-specific survival was 95%, 97%, and 59%, respectively. The PCFCLs presenting on the legs had a higher relapse rate (63%) and a much lower 5-year disease-specific survival (44%) than PCFCLs at other sites (relapse rate, 25%; 5-year disease-specific survival, 99%). Radiotherapy is a suitable treatment for a large group of patients with CBCL. However, patients with PCFCL presenting with lesions on the leg and patients with PCLBCL, LT display a more unfavorable clinical course and should therefore be treated with more aggressive treatment modalities.

Clinical, pathological, and molecular correlations of necrosis in the primary tumor of patients with renal cell carcinoma

4643 Background: Presence of histologic necrosis in the primary tumor of patients with renal cell carcinoma (RCC) has been demonstrated to be an important predictor of survival. We investigated the relationship of necrosis to other histologic and clinical factors known to be important prognostic indicators for patients with RCC. Methods: The records of 300 patients undergoing treatment for RCC at UCLA were evaluated for basic clinical information including TNM stage, Eastern Cooperative Oncology Group performance status (ECOG-PS), nuclear grade, and survival. Pathologic slides of the primary tumors were reviewed by a single pathologist. Presence and amount of necrosis were correlated with clinical factors, carbonic anhydrase IX (CAIX) expression, and survival. Results: Patents with necrosis presented with higher T stage (p < 0.0001), metastases (p < 0.0001), greater mean tumor size (p < 0.001) and higher grade (p < 0.0001) compared to patients without necrosis. Extent of necrosis in the primary tumor significantly correlated with T stage, nodal status, metastasis, ECOG-PS, grade, tumor size, and UCLA Integrated Staging System (UISS) (p < 0.01). Patients with necrosis demonstrated a significantly lower 5-year disease specific survival compared to patients without necrosis (36% vs. 75%; p < 0.0001). Multivariate analysis demonstrated grade (p = 0.002), T stage (p < 0.0001), and ECOG-PS (p < 0.0001) to be independent predictors of disease specific survival, while necrosis approached significance (p = 0.07). Presence and extent of necrosis were independent predictors of survival in patients with localized (p < 0.05), but not metastatic (p > 0.05) disease. In patients with clear cell histology, necrosis was also an independent predictor of survival for localized (p = 0.04), but not metastatic (p = 0.49) disease. Conclusions: Presence of necrosis in the primary tumor of patients with RCC is associated with large size, high stage, high grade, and poor ECOG-PS, as well as the presence of distant metastases. The presence of this histologic variant is an independent predictor of poor survival in patients with localized, but not metastatic disease. No significant financial relationships to disclose.