PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Neoplasm Recurrence, Local”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1986

Local recurrence of colorectal cancer: effect of early detection and aggressive surgery.

A prospective study was undertaken of the incidence, symptoms, diagnostic measures and therapy of local recurrences of colorectal carcinoma following radical surgical management. Out of 715 patients, 156 (22 per cent) developed recurrence of the tumour, which was local in 90 patients. In addition, 36 patients with local recurrence from other hospitals were treated. Half of the patients were symptom-free at the time of diagnosis. Out of the 126 patients, 109 were treated by surgery, a radical operation being feasible in 53 cases. Fifty per cent of these have survived for at least 17 months. The operative mortality was very low (4.6 per cent), although extensive surgery was necessary in most of the cases. The preliminary results of this study support the hypothesis that a postoperative follow-up programme for patients with colorectal cancer leads to early detection of local recurrence and improves the chance of cure by surgical treatment.

Aged↗
PubMed1983

The implications of local recurrence of breast cancer as the first site of therapeutic failure.

Sixty patients who had ipsilateral chest wall recurrence of breast cancer and no detectable distant metastases were evaluated retrospectively to determine the implications of chest wall recurrence as the first site of therapeutic failure. Mean time intervals between treatment of the primary breast cancer and discovery of local recurrence, between treatment of local recurrence and distant metastases, and between treatment of local recurrence and death in order and, respectively, in years for pathologic Stages I, II, and III patients were 6.2, 4.3 and 2.1; 4.2, 3.5, and 1.2; and 7.2, 6.0, and 2.5. Surgical resection resulted in the best local control. All patients eventually died of metastatic breast cancer, one as late as 23 years after treatment of the local recurrence. No Stage I patients recurred before two years. An arbitrary delay of two years before recommending breast reconstruction to avoid masking local recurrence seems unjustified for pathologic Stage I patients.

Breast Neoplasms↗
PubMed1985

A method of reporting radial invasion and surgical clearance of rectal carcinoma.

Fifty rectal carcinomas resected during a 24-month period were examined by whole-mount giant sections. By light microscopy, the distance of maximal tumour invasion (penetration) into the bowel wall and the surgical clearance were measured by a new standardized method. The outer border of the muscularis propria and the line of surgical excision were used as the reference points. Preliminary results suggest that there is a significant inverse correlation between tumour penetration and radial surgical clearance. The adequacy of radial surgical clearance may affect the risk of local recurrence, and may prove useful as a prognostic indicator.

Humans↗
PubMed1995

Adequate locoregional treatment for early breast cancer may prevent secondary dissemination.

PURPOSE: To analyze different events that determine event-free survival (EFS) in a randomized trial on adjuvant radiotherapy in early breast cancer patients with more than 15 years of follow-up evaluation. PATIENTS AND METHODS: The trial included 960 patients with a unilateral, operable breast cancer. Surgery consisted of a modified radical mastectomy. The trial compared three arms, as follows: preoperative radiotherapy, postoperative radiotherapy, and no adjuvant treatment. Events were analyzed by a competing-risk approach. A proportional hazards multiple regression model was used to analyze the effects of radiotherapy on the risk of distant metastasis. Similar analyses were performed separately for node-negative [N(-)] and node-positive [N(+)] patients in the two groups that did not include preoperative radiotherapy. RESULTS: Radiotherapy produced a fivefold decrease of the risk of local recurrence (P < .0001). In N(+) patients, postoperative radiotherapy decreased the risk of distant dissemination (relative risk, 0.63). When local recurrence was introduced in the model as a time-dependent covariate, this factor was predictive of distant dissemination (P < .0001) and nullified the effect of postoperative radiotherapy. This finding suggests that the decrease of distant metastases was related to the prevention of local recurrence. A similar effect was found in models that used overall survival as an end point. CONCLUSION: This study shows that postmastectomy radiotherapy in N(+) breast cancer patients may decrease the distant metastasis rate by preventing local recurrences and thus avoiding secondary dissemination.

Breast Neoplasms↗
PubMed2004

Avoidance of adjuvant radiotherapy in selected patients with invasive breast cancer.

BACKGROUND: Current standard therapy for invasive breast carcinoma is mastectomy or breast conservation with adjuvant radiation. Data from randomized trials suggest no advantage for radiotherapy after lumpectomy in highly selected patients. Selective radiotherapy would make contemporary breast cancer therapy more rational with decreased morbidity and expense. METHODS: A total of 163 patients were treated by breast conservation without adjuvant radiation between 1978 and June 2003. They declined radiation after discussion or had medical contraindications. The great majority were postmenopausal and had lower-grade T1 tumors with resection margins > or = 1 cm and no nodal metastases. The goal was to identify patients with favorable prognostic features for omission of postsurgical irradiation without impaired local recurrence or survival. RESULTS: Twenty patients (12%) had local recurrences; 17 (10%) were invasive, and 3 (2%) were ductal carcinoma-in-situ. An ideal patient subgroup >50 years of age with grade 1 or 2 cancers < or =1.5 cm in diameter and with surgical margins > or = 1 cm was empirically defined. Of 80 such patients, 5 (6%) had local recurrence; 3 (3.5%) were invasive, and 2 (2.5%) were ductal carcinoma-in-situ. CONCLUSIONS: A defined ideal subset of older breast cancer patients with smaller, lower-grade cancers and adequate excision margins can be treated with lumpectomy without irradiation and with minimal local recurrence.

Adult↗
PubMed2005

Significance of survivin mRNA expression in prognosis of neuroblastoma.

Neuroblastoma (NB) is the most common malignant solid tumor in childhood, and among all childhood malignancies is second in prevalence only to leukemia. In NB we need to both make an accurate diagnosis and rapidly analyze the expression of genetic prognostic factors such as MYCN, H-ras, and trkA. Moreover, it has recently become important to analyze the expression of survivin mRNA, a member of the inhibitor of apoptosis protein family. Expression of the survivin gene is related to tumorigenesis and inhibition of apoptosis in some malignant tumors. We investigated its expression by reverse transcription-polymerase chain reaction (RT-PCR) in NB cell lines (SK-N-SH, NB-39, and IMR-32), two normal blood cell samples, and 13 clinical NB tumor samples. All three NB cell lines had high levels of mRNA expression for this gene, but normal blood cells had no expression. We detected expression of survivin mRNA in 7 of the 13 NB tumor samples (54%). Two NB patients were in stage I disease, 6 in stage II, and 5 in stage IV(A). Quantitative analysis by RT-PCR revealed that the ratio between survivin mRNA and human glyceraldehyde-3-phosphate dehydrogenase (h-GAPDH) mRNA was very low in stages I and II (0-0.017). In contrast, in advanced NBs (stage IV(A)) the ratio was much higher (0-0.050). The prognoses of the three patients in the advanced stage who had high ratios of expression were poor. A high level of expression of survivin mRNA indicates a high grade of malignancy, high likelihood of recurrence, and poor prognosis.

Cell Line, Tumor↗
PubMed2000

[Postoperative recurrence of T2 stage gastric cancer].

OBJECTIVE: To study the clinicopathological characteristics of T(2) gastric cancer and its postoperative recurrence. METHOD: 124 T(2) gastric cancer patients were divided into two groups: 42 patients with postoperative recurrence (Group 1) and 82 patients without recurrence (Group 2). RESULTS: The recurrence rate of local tumor was significantly lower in Group 1 (26.2%) than in Group 2 (45.1%). Deep invasion was highly different between the two groups. Circular muscle tumors were seen in Group 1 (4.8%) and in Group 2 (30.5%), whereas sub-serosa tumors were seen in Group 1 (61.8%) and in Group 2 (25.6%). The rate of lymph node metastasis was significantly higher in Group 1 (88.1%) than in Group 2 (57.3%). The mean number of positive nodes was (7.02 +/- 6.50) in Group 1 and (2.16 +/- 2.04) in Group 2(P < 0.01). Local recurrence rate and distant metastasis rate in Group 1 were 54.8% and 46.2% respectively. The median survival was 26.5 months in Group 1 and 57.0 months in Group 2 (P < 0.01). The 1-, 3-, 5-year survival rate in Group 1 and Group 2 were 61.4% vs 97.6%, 18.7% vs 95.9%, and 8.3% vs 95.9%, respectively. CONCLUSION: Poor prognosis is seen in T(2) gastric cancer patients with postoperative recurrence. Extended gastrectomy and multi-therapy are necessary for the patients with the risk factors so as to decrease local recurrence.

Adult↗
PubMed1980

[Gamma teletherapy in the combined treatment of breast cancer].

The results of combination treatment in 655 breast cancer patients, who underwent pre- and postoperative gammatherapy, are reported. Radiotherapy in 522 patients was performed prior to radical mastectomy, in 133--after it. 69.5% of patients showed cancer in stage II-b, III-a, III-b. A 5-year survival was noted in 54.6%, the clinical cure (without any signs of recurrence and metastases)--in 46.2%. A comparative analysis of the 5-year cure using pre- and postoperative irradiation indicated the rationale of preoperative gamma therapy in patients with regional metastases. Thus, the 5-year cure among patients irradiated preoperatively was 81.2% in stage II-b, 67.3%--in stage III-a, 31.4%--in stage III-b versus 38.9%, 60% and 25% respectively, while using postoperative gammatherapy. Preoperative irradiation is found to contribute to nearly 4 times less incidence of local recurrences compared with the postoperative one.

Adult↗
PubMed1990

Selection of patients with early-stage breast cancer for conservative surgery and radiation.

The great majority of patients with an early-stage breast cancer can be successfully treated with conservative surgery and radiotherapy (CS + RT). Careful clinical, radiologic, and pathologic assessment of the tumor's extent and characteristics is the key to appropriate patient selection. While disagreements remain, some guidelines for who should not be so treated have emerged. Patients with multiple palpable or radiologically detected lesions or widespread microcalcifications of the breast ordinarily should undergo mastectomy. Patients who present with a nipple discharge or subareolar mass are not suitable candidates for CS + RT unless nipple-areolar resection is acceptable to the patient. The role of pathologic margins in treatment selection remains controversial. The authors believe that margins have clinical meaning only when interpreted in relation to the histology of the primary tumor and that "negative" margins are not always needed to achieve a high rate of local tumor control.

Age Factors↗
PubMed2004

PET imaging in gynecologic malignancies.

FDG-PET has a definite role in detecting lymph node involvement and distant metastases. It has also shown encouraging results in assessing tumor recurrence and restaging, but further studies are required before FDG-PET can be incorporated in routine clinical practice for diagnosis of recurrence. In ovarian cancer, FDG-PET has high sensitivity and specificity in identifying patients with recurrent tumor, but lesion localization is difficult with PET. Normal FDG activity in the gastrointestinal tract and bladder may obscure some lesions. Combined PET/CT can help in localizing lesions and differentiating between pathologic and physiologic uptake in the pelvis and abdomen.

Female↗
PubMed1990

Predictors of local recurrence following conservative breast surgery and radiation therapy. The influence of tumor size.

Size of tumor has not been established as a predictor of tumor recurrence in the breast following conservative surgery and radiation therapy. We analyzed 783 patients with infiltrating carcinoma treated with simple excision and radiation therapy. Median follow-up was 91 months. Median age at diagnosis was 50 years. There was a 13% recurrence among patients with T1 lesions compared with a 12% recurrence among patients with T2 tumors. Size did not predict for local recurrence when the tumor was analyzed by 1-cm increments and whether the tumor was estrogen receptor protein positive or estrogen receptor protein negative. Patients with an extensive intraductal component had a significantly higher local recurrence rate for every tumor size compared with patients with extensive intraductal component-negative tumors. We concluded that size did not predict local recurrence.

Breast Neoplasms↗
PubMed1998

Recurrent primary pleomorphic adenomas of salivary gland origin: intrasurgical rupture, histopathologic features, and pseudopodia.

BACKGROUND: The rate of tumor recurrence after surgery for benign salivary gland pleomorphic adenoma varies considerably in different clinical settings and seems to depend to a great extent on the surgical technique used. The importance of tumor spillage for subsequent recurrence has recently been questioned. The current follow-up study was undertaken to ascertain whether intrasurgical rupture, tumor spillage, or any histopathologic feature might have had an impact on the rate of recurrence. METHODS: The medical records of all 255 patients operated on for benign salivary gland pleomorphic adenoma between the years 1974 and 1993 at the Department of Otorhinolaryngology, Huddinge University Hospital, were reviewed. All patients alive in April 1995 (n = 230) were sent a simple questionnaire. Two hundred thirteen of these patients received follow-up. All cases of tumor recurrence after surgery or intrasurgical rupture of the tumor capsule were reviewed histopathologically. RESULTS: Two (7.1%) of the 28 patients who had macroscopic capsule rupture during surgery experienced recurrence at a later stage. This was not a statistically higher rate than the 4.1% recurrence rate for the rest of the material. As many as 5 of the 9 primary tumors that subsequently recurred (56%) sent fingerlike tumor extensions or pseudopodia outside the pseudocapsule. The rate of occurrence of such structures was statistically higher than that of the tumors that ruptured during surgery (25%) and the examined uncomplicated cases (8%). CONCLUSIONS: Occurrence of pseudopodia--microscopic fingerlike formations of tumor tissue that extend beyond the main lump of the tumor--is a significant risk factor for local recurrence.

Adenoma, Pleomorphic↗