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Results for “M1 NED”

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PubMed2025

Long-term oncologic outcomes of metastatic clear-cell renal cell carcinoma after local therapy alone.

PURPOSE: Oligometastatic clear-cell renal cell carcinoma (ccRCC) represents a heterogeneous entity that can, in select cases, be managed with primary tumor resection and complete local treatment at all metastatic sites, rendering a patient metastatic with no evidence of disease (M1 NED). M1 NED patients have improved overall survival, although previous cohorts are relatively small and heterogeneous. We sought to identify the natural history of M1 NED ccRCC to clinical trial findings and to optimize management strategies. MATERIALS AND METHODS: Patients with synchronous metastatic ccRCC treated with local therapy alone and considered radiographically M1 NED at our institution between 1989 and 2023 were retrospectively evaluated. Survival probabilities used a combination of Kaplan-Meier estimator, log-rank test, and multivariable Cox proportional hazards regression. When available, limited genomic data obtained using the MSK-IMPACT targeted panel was correlated with outcomes. RESULTS: 85 patients met inclusion criteria. One-year disease free survival (DFS) was 53% (95% CI: 42 to 63%). Sarcomatoid features predicted shorter DFS (HR 2.62, CI: 1.08, 6.34, P = 0.03). Time from first disease recurrence to second recurrence was longer among patients with initial DFS ≥2 years (median 42 vs. 15 months, log-rank P = 0.005). A total of 18 patients (21%) underwent targeted genomic sequencing; higher fraction of genome altered and CDKN2A copy number loss were associated with shorter DFS. Findings were limited by cohort size. CONCLUSIONS: Most M1 NED ccRCC patients will experience disease recurrence, although certain baseline risk factors appear to predict earlier recurrence. Prognostic biomarkers are needed to predict outcomes and facilitate patient management.

Humans↗

PubMed1992

Lipid-associated sialic acid, squamous cell carcinoma antigen, carcinoembryonic antigen, and lactic dehydrogenase levels as tumor markers in squamous cell carcinoma of the head and neck.

BACKGROUND: Circulating tumor markers are valuable adjuncts in the management of several malignant lesions, including germ cell tumors and adenocarcinomas of the breast, colon, prostate, and ovary. However (to the authors' knowledge), currently, no serologic markers have been shown to have prognostic value for patients with squamous cell carcinomas of the head and neck (SCCHN). METHODS: Novel and existing markers were evaluated prospectively in patients with SCCHN: The levels of lipid-associated sialic acids (LASA), squamous cell carcinoma circulating antigen (SCC-Ag), carcinoembryonic antigen (CEA), and lactic dehydrogenase (LDH) were evaluated in 52 patients: 42 with active measurable SCCHN and 10 with no clinical evidence of active disease after treatment (NED). RESULTS: In patients with active disease, LASA, SCC-Ag, CEA, and LDH were elevated in 71%, 33%, 27%, and 18%, respectively, and in seven patients with distant metastasis (M1) in 100%, 86%, 57%, and 33%, respectively. None of the markers were elevated in the NED group. The incidence and magnitude of LASA and SCC-Ag elevations correlated with the extent of disease (active disease versus NED, Stage III versus IV, T0-3 versus T4 primary lesions, M0 versus M1). LDH and CEA elevations correlated primarily with the presence of distant metastases. CONCLUSIONS: LASA appears to be a promising sensitive marker of SCCHN, followed in decreasing order of sensitivity by SCC-Ag, CEA, and LDH. Additional study to evaluate the specificity of LASA and its correlation with tumor response to therapy is warranted.

Antigens, Neoplasm↗

PubMedDate not supplied

MCA in patients with breast cancer: correlation with CEA and CA15-3.

MCA serum levels were determined in 27 healthy subjects, 136 with benign pathology (42 breast) and in 289 patients with cancer (247 active). The last group includes 223 patients with breast cancer (96 without metastases, 89 with metastases and 38 no-evidence of disease). CEA and CA15-3 serum levels were determined in all the patients with breast diseases. The mean levels of MCA were 4.7 + 2.4 U/ml in the control group, considering less than 11 U/ml as normal. MCA values were abnormal in 15.4% of patients with benign pathology, mainly in those with liver cirrhosis (8/20) and lung diseases (4/20). In the majority of these cases, the rise was only moderate, lower than 15 U/ml in 97.5% of patients. In malignant diseases, important increments were found in breast cancer (19.8% Mo, 77.5% M1) and ovarian cancer stages III-IV (44.4%). When we compared MCA serum levels with CA15-3 and CEA in breast pathology, a similar specificity was observed: 92.3%, 92.3% and 100% in cases with benign pathology and 92.1%, 94.7%, and 97.4% in NED patients, respectively. MCA and CA15-3 sensitivity was similar in breast cancer without metastases (19.8%) and lower for CEA (16.7%). In patients with breast cancer without metastases, we found a relation between positivity of these tumor markers and prognostic factors (tumor size, nodal involvement). The disease free interval in patients with locoregional breast cancer was shorter in cases with abnormal presurgical levels of some of the tumor markers, but only the difference from MCA was significant (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Neoplasm↗