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Results for “Tumor recurrence”

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At least 19 recordsLinked to original sources

PubMed1997

Fibrotic focus in invasive ductal carcinoma of the breast: a histopathological prognostic parameter for tumor recurrence and tumor death within three years after the initial operation.

We investigated whether the presence of a fibrotic focus (FF) in the primary lesion and in lymph node metastasis is a good predictor of early tumor recurrence or death in patients with invasive ductal carcinoma (IDC). Multivariate relative risk (RR) of tumor recurrence and death according to the presence of FF in the primary tumor was estimated using the Cox proportional hazards regression model with adjustment for other prognostic factors (histologic grade, T classification, nodal status, tumor necrosis, DNA ploidy, c-erbB-2 protein expression, p53 protein expression, and labeling index of proliferating cell nuclear antigen). For the evaluation of the metastatic status in the axillary lymph nodes, RR of multivariate analysis was adjusted for the presence of FF in the metastatic tumor and the number of lymph nodes involved (1-3 and > 3). The presence of FF increased the RR of tumor recurrence significantly for the cases in all stages, and especially for those in stages I and II (RR = 6.9, P < 0.05 and RR = 25.0, P < 0.005, respectively). All cases that died of disease had FF. Among IDCs with FF, 24 cases had FF in lymph node metastasis. Significantly higher RRs of tumor recurrence and death were observed in cases with FF in lymph node metastasis than in those without it (RR = 2.0, P < 0.001 and RR = 5.9, P < 0.05, respectively). It was suggested that the presence of FF is an important predictor of early tumor recurrence or death in patients with IDCs. The presence of FF in lymph node metastatic lesions is also a significant prognostic parameter.

Adult↗

PubMedDate not supplied

Helical CT of postoperative patients with gastric carcinoma: value in evaluating surgical complications and tumor recurrence.

BACKGROUND: We assessed computed tomographic (CT) features of postoperative complications and recurrent tumors in gastric cancer patients who underwent radical surgery. METHODS: We performed a retrospective study of 397 patients who had undergone radical surgery for the treatment of gastric carcinoma and underwent postoperative CT in our institution over a 2-year period. Patients were assigned to one of two groups: group A consisted of 47 patients who underwent CT for complications in the early postoperative period, and group B consisted of 355 patients who underwent CT for evidence of tumor recurrence during the follow-up period. We classified recurrent tumors into four categories: local recurrence, lymph node metastasis, peritoneal seeding, and remote metastasis. RESULTS: In group A, localized fluid collections or abscesses in the surgical bed were found in 38 patients (81%) and usually involved the left subphrenic area (74%) or the superior recess of the lesser sac (47%). In group B, recurrent tumors were found in 196 patients (55%). Among these, lymph node metastasis was the most common pattern (52%), followed by peritoneal seeding (44%), local recurrence (40%), and remote metastasis (37%). CONCLUSION: CT after radical surgery for the treatment of gastric carcinoma frequently shows postoperative complications or tumor recurrence. Familiarity with the common postoperative complications and patterns of the tumor recurrence is a prerequisite to accurate interpretation of CT findings in these patients.

Adult↗

PubMed2000

Head and neck tumors: imaging recurrent tumor and post-therapeutic changes with CT and MRI.

OBJECTIVE: To evaluate criteria for detection of tumor recurrence and post-treatment changes in patients with head and neck malignancies in computed tomography (CT) and magnetic resonance imaging (MRI). METHODS AND MATERIALS: Thirty-nine patients with head and neck carcinoma receiving radiochemotherapy were examined before, during and after therapy with MRI. Changes in signal intensity were correlated to histology or clinical course. Three hundred and thirty-one patients with head and neck malignancies were examined with CT after therapy. CT diagnoses were correlated with histology or clinical course. RESULTS: Main criteria for recurrent/residual tumor in MRI was infiltrative mass with high signal intensity in T2-weighted images and enhancement after Gd-DTPA in T1-weighted images. Radiation-induced changes led to false positive diagnosis in 46% in the interval up to 3 months after therapy and in 58% in the interval 3-6 months after therapy. The combination of a circumscribed, infiltrative mass with contrast enhancement in CT had a sensitivity of 86% and a specificity of 80%. CONCLUSION: CT could accurately demonstrate postoperative changes and tumor recurrence. MRI had advantages in differentiation of tumor and scar, but edema after radiation therapy can spoil diagnosis.

Combined Modality Therapy↗

PubMed1989

Impact of the category of early tumor recurrence on tumor progression in bladder tumors treated by transurethral resection.

Forty-six newly diagnosed patients with T1 and T2 bladder tumors were treated with transurethral resection. During a 6-months period more than 50% of the tumors recurred. Subsequent progression of tumors was seen within 24 months in 35 and 28% of the patients with T1 and T2 tumors, respectively. Prognosis with regard to progression was significantly better in patients with Ta recurrence at first control than in patients with invasive recurrent tumors, irrespective of category of tumor at a later recurrence. It is concluded that the continued transurethral treatment of patients with early recurrent invasive tumors may have to be reconsidered.

Humans↗

PubMed1990

The use of molecular probes to distinguish new primary tumors from recurrent tumors in gynecologic malignancies.

This is the first report using DNA molecular probe technology to distinguish between recurrent tumor and a second primary malignancy in a patient. Tumor DNA was extracted from squamous cell carcinoma of the cervix at the time of radical hysterectomy. Eighteen months later a squamous cell cancer was found in a vaginal apex biopsy from which DNA was extracted. Tumor DNA from both lesions was subjected to restriction enzyme digestion and DNA molecular hybridization with human papillomavirus (HPV) probes. Although both lesions were positive for HPV 16, their respective restriction enzyme patterns had different HPV genetic arrangements, thereby demonstrating their distinctness.

Adult↗

PubMed1997

Patterns of mammographically detected calcifications after breast-conserving therapy associated with tumor recurrence.

BACKGROUND: Some authors have suggested that mammographically evident calcifications that would be considered benign in other situations can be due to carcinoma in women who have undergone breast conservation. This study was undertaken to determine if the pattern of calcifications associated with recurrent tumors detected mammographically differs from that observed in carcinomas developing de novo. METHODS: Mammograms of 22 cases of local tumor recurrence were retrospectively reviewed, and calcifications associated with recurrence were characterized according to the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) classification. RESULTS: Tumors were usually associated with > or = 10 calcifications (77%; 17 of 22 cases). Recurrences commonly contained very suspicious patterns of calcifications with linear forms present in 15 cases (68%) and pleomorphic calcifications present in 17 cases (77%). The distribution of calcifications was usually clustered (73%; 16 of 22 cases) or segmental (18%; 4 of 22 cases). Recurrences were usually obviously malignant (BI-RADS Category 5), and were characterized as such in 77% of cases. The remainder were indeterminate, requiring biopsy (BI-RADS Category 4). Recurrent tumors containing calcifications always contained some suspicious forms. Less worrisome types of calcifications were sometimes observed, including punctate calcifications in 36% and coarse calcifications in 14% of cases, but were always associated with more malignant patterns. CONCLUSIONS: Local tumor recurrences, when associated with mammographically evident calcifications, usually have a pattern highly suspicious for malignancy, although indeterminate forms can be the only calcifications present. Characteristically benign patterns of calcifications are not observed in recurrent tumors unless they are associated with more suspicious calcifications. Therefore, women without more worrisome patterns need not undergo biopsy because of the presence of these nonworrisome calcifications.

Breast Diseases↗

PubMed1992

[Immunohistochemical study of basement membrane in pleomorphic adenomas of the parotid gland: comparison between primary treated tumor and recurrent tumor].

We immunohistochemically investigated the distributions of components of the basement membrane (BM) (type IV collagen and laminin) and alpha smooth muscle actin in twelve primary pleomorphic adenomas of the parotid gland, as compared with six recurrent benign pleomorphic tumors (recurrent type). There were no differences between the two types of the tumor in the distributions of the BM components and actin, whereas the recurrent type of tumor have numerous myxochondroid areas histologically. The localization of type IV collagen in the tumor tissue was almost the same as that of laminin. Actin was identified in the occasional myoepithelial cell. In the tumor tissues, the components of BM were most densely localized in the areas surrounding solid clusters of epithelial cells, outer cells of glandular structures and occasional cells in the myxoid area, but the stroma of the myxochondroid areas did not take up stain. BM was densely defined between the tumor capsule and epithelial cells, but the tumor capsule was not bordered by myxochondroid areas with BM. These results suggest that loss of BM between the capsule and myxochondroid areas may be one of the causes of postoperative recurrence of pleomorphic adenomas.

Actins↗

PubMed1993

Tumor recurrence versus fibrosis in the irradiated breast: differentiation with dynamic gadolinium-enhanced MR imaging.

To assess the value of magnetic resonance (MR) imaging of the breast in the differentiation of late postirradiation fibrosis from recurrent carcinoma, 35 women with a history of breast carcinoma treated conservatively with radiation therapy underwent MR imaging. Nine patients had recurrent tumors confirmed at biopsy and surgery. Twenty-six patients had a localized fibrotic mass confirmed at biopsy and/or during long-term clinical and radiologic follow-up. In all cases, a localized hypointense area was present on plain spin-echo T1-weighted images. In all recurrent tumors, dynamic gadolinium-enhanced T1-weighted images demonstrated early increased signal intensity of the lesion within 3 minutes after bolus injection. The signal intensity over time in localized fibrosis differed from that in tumor recurrence, with no substantial enhancement on post-contrast T1-weighted images. Short inversion time inversion recovery and spin-echo T2-weighted images were not useful in the differential diagnosis of recurrent tumor versus radiation fibrosis.

Adult↗

PubMed1988

Tumor recurrence versus fibrosis in the female pelvis: differentiation with MR imaging at 1.5 T.

Twenty-two women with previous malignancies of the pelvis were examined with magnetic resonance (MR) imaging. In 21 of 22 patients, the MR imaging findings were confirmed with laparotomy on transvaginal biopsy. Twelve of the 22 patients had recurrent tumors; ten had a localized fibrotic mass, and two were found to have coexistent local fibrotic masses and distant recurrence. In 11 of the 12 patients with recurrence, MR imaging demonstrated the recurrent tumor as an area of increased signal intensity on long repetition time, long echo time spin-echo pulse sequences. Signal intensity of localized fibrosis varied with the time since initial treatment. Separate signal intensity measurements for T1- and T2-weighted images were obtained in regions of interest in recurrent tumors, early fibrosis (1-6 months after first treatment), and late fibrosis (more than 12 months). Ratios of signal intensity of muscle to that of fat were calculated, and a statistical analysis (Student t test) was performed. On heavily T2-weighted pulse sequences, the differences in signal intensity between late fibrosis and recurrent tumors were statistically significant (P less than .001). MR imaging is useful in identifying recurrent pelvic neoplasm and distinguishing it from posttreatment fibrosis.

Adult↗

PubMed1989

[The procedure in recurrent tumors of the liver].

From 1981 to 1988, 13 patients with liver metastasis and 7 patients with primary hepatic tumors underwent a second hepatic resection for tumor recurrence. A second resection was feasible even after an extensive first resection. Several patients experienced tumor recurrence shortly after the first resection, but lived a long time after the second resection. The actuarial survival after a second resection for colorectal metastasis was similar to that after the first resection. Therefore a second resection for tumor recurrence is reasonable and may prove especially important in individual situations.

Adenoma, Bile Duct↗

PubMed1994

Distinguishing tumor recurrence from irradiation sequelae with positron emission tomography in patients treated for larynx cancer.

PURPOSE: Distinguishing persistent or recurrent tumor from postradiation edema, or soft tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with 18F-2fluoro-2deoxyglucose (FDG) was studied for its ability to aid in this problem. METHODS AND MATERIALS: Positron emission tomography (18FDG) scans were performed on 11 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computerized tomography, and pathologic evaluation when indicated. Standard uptake values were used to quantitate the FDG uptake in the larynx. RESULTS: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 26 months with a median of 6 months. Ten patients underwent computed tomography (CT) of the larynx, which revealed edema of the larynx (six patients), glottic mass (four patients), and cervical nodes (one patient). Positron emission tomography scans revealed increased FDG uptake in the larynx in five patients and laryngectomy confirmed the presence of carcinoma in these patients. Five patients had positron emission tomography results consistent with normal tissue changes in the larynx, and one patient had increased FDG uptake in neck nodes. This patient underwent laryngectomy, and no cancer was found in the primary site, but nodes were pathologically positive. One patient had slightly elevated FDG uptake and negative biopsy results. The remaining patients have been followed for 11 to 14 months since their positron emission studies and their examinations have remained stable. In patients without tumor, average standard uptake values of the larynx ranged from 2.4 to 4.7, and in patients with tumor, the range was 4.9 to 10.7. CONCLUSION: Positron emission tomography with labeled FDG appears to be useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique may be preferable to biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis.

Deoxyglucose↗

PubMedDate not supplied

Can positron emission tomography distinguish tumor recurrence from irradiation sequelae in patients treated for larynx cancer?

PURPOSE: Distinguishing persistent or recurrent tumor from post-radiation edema or soft-tissue/cartilage necrosis in patients treated for carcinoma of the larynx can be difficult. Because recurrent tumor is often submucosal, multiple deep biopsies may be necessary before a diagnosis can be established. Positron emission tomography with F-18 fluorodeoxyglucose was studied for its ability to aid in this problem. PATIENTS AND METHODS: FDG PET scans were performed on 31 patients who were suspected of having persistent or recurrent tumor after radiation treatment for carcinoma of the larynx. Patients underwent thorough history and physical examinations, scans with computed tomography (23 patients), and pathological evaluation when indicated. PET scans were interpreted by each of the two radiologists, who were blinded to patient outcome and the other's report. RESULTS: The time between completion of radiation treatment and positron emission tomography examination ranged from 2 to 61 months with a median of 6 months. Fifteen patients had pathological evidence of tumor in the larynx, while 16 have remained without evidence of disease. The overall sensitivity and specificity of the positron emission tomography interpretations were 80% and 81%, respectively. The sensitivity and specificity of the computed tomography scan interpretations were 58% and 100%, respectively. Of the 23 patients with computed tomography scans, eight patients acquired useful information from the positron emission tomography, three patients had incorrect positron emission tomography interpretations and correct computed tomography interpretations, and one patient had positive tumor despite a negative positron emission tomography and computed tomography. DISCUSSION: Positron emission tomography is useful in distinguishing benign from malignant changes in the larynx after radiation treatment. This noninvasive technique can supplement information provided by computed tomography scans. It is reasonable to delay biopsy, which could traumatize radiation-damaged tissues and precipitate necrosis, for those patients with negative positron emission tomography scans who have clinical signs and symptoms associated with recurrence.

Diagnosis, Differential↗

PubMedDate not supplied

Intraoperative dynamic MRI: localization of sites of brain tumor recurrence after high-dose radiotherapy.

In patients with malignant astrocytomas or metastatic brain disease treated with high-dose radiotherapy, conventional imaging methods may not adequately distinguish recurrent tumor from radiation change. We used a fast spoiled gradient refocusing technique in the open-configuration intraoperative MR system to assess the rate of regional enhancement of the treated tumor bed and to localize specific sites for pathologic sampling to determine whether gadolinium uptake correlated with histologic data. Twenty-four patients were studied. Fourteen of 15 patients with areas of early enhancement had recurrent tumor present in histologic samples, and 8 of the remaining 9 patients had only reactive changes. Dynamic MRI was predictive of recurrent tumor (P < .0005, Fisher exact test and P < .002, Student t test). We conclude that dynamic MRI in the open-bore magnet is a promising method for localizing potential sites of active tumor growth in patients treated for malignant astrocytomas and metastatic brain lesions.

Brain↗

PubMed1986

Facial nerve sacrifice and tumor recurrence in primary and recurrent benign parotid tumors.

Three hundred eight patients underwent parotidectomy for a benign parotid tumor between 1948 and 1979. Two hundred seventy-four had operation for primary tumor, and 34, for recurrent tumor. Ninety-eight percent of those with primary tumors had superficial or total parotidectomy, and 2 percent had local excision with a wide margin of normal tissue. In those with recurrent tumor, 91 percent had superficial or total parotidectomy and 9 percent had local excision with a wide margin of normal tissue. There were nine recurrences in the primary group (3.2 percent) and 10 in the recurrent group (29 percent), at an average follow-up of 10 and 13 years, respectively. The time to recurrence in the primary group was between 5 and 20 years, whereas, second recurrences in the recurrent group generally took place within 5 years. Seven patients in the primary group (2.5 percent) and 9 in the recurrent group (26 percent) had sacrifice of the facial nerve. Most facial nerve sacrifices in the primary group were minor, involving a branch of the nerve only. Facial nerve sacrifice in the recurrent group, however, usually involved division of the nerve or the nerve trunk. These findings demonstrate that the major morbidity associated with managing benign parotid tumors occurs in dealing with recurrent tumors. Recurrence is uncommon if superficial or total parotidectomy is performed for a primary tumor.

Adenolymphoma↗

PubMed1990

CT of the abdomen after the Whipple procedure: value in depicting postoperative anatomy, surgical complications, and tumor recurrence.

We performed a retrospective study of CT scans in 29 patients who had undergone the Whipple procedure (radical pancreaticoduodenectomy) to study the CT appearance of the postsurgical anatomy and assess the use of CT in the evaluation of early postoperative complications and recurrent tumor. In the postoperative period, the scans from 15 patients revealed seven transient fluid collections; four deep abscesses, three of which were successfully drained under CT guidance; three superficial abscesses; and five cases of ascites. In 19 patients, CT scans were obtained up to 4 years after surgery to search for recurrent tumor. The most frequent site of recurrence was the liver. CT correctly identified liver metastases in six of seven patients and was falsely positive in one. Recurrence also was found twice in retroperitoneal lymph nodes; one time each in the mesenteric root, spleen, and lung base; and twice causing afferent loop blockage. Surgical proof of recurrence was obtained in eight cases. Our experience suggests that an understanding of the normal postoperative anatomy following the Whipple procedure is essential in evaluating postoperative CT scans. Scans obtained for detection of tumor recurrence should be optimized for imaging the liver because this was the most frequent site of recurrence.

Adult↗

PubMed2001

[Significance of radical recurrent tumor resection for recurrent gastric cancer as assessed by prognosis].

To evaluate the relationship between radical surgery of recurrent tumor and prognosis in cases of recurrent gastric cancer, we analyzed data on 202 patients with relapsed gastric cancer, focusing on surgical recurrent tumor removal. In our series, 18 of the 202 patients underwent radical recurrent tumor resection. Resected tumors were located in the ovarium (n = 4), colorectum (n = 3), liver (n = 3), lymph node (n = 2), locoregional stoma (n = 2), and peritoneum, adrenal gland, brain, and lung (n = 1 each). No surgery-related mortality occurred. One patient remains alive over 5 years after hepatectomy without recurrence, and 17 died within 3 years: 7 patients from primary recurrence and 10 from multiple modes of recurrence. Median survival after recurrence (MSTAR) in the 18 radical surgery patients was 14 months, against 5 months in those treated palliatively (p = 0.0001). MSTAR for the ovary and the liver were 30 months and 15 months in the radical surgery cases, and 2.5 months for the ovary and 5 months for the liver in the palliative cases. Significant differences were thus seen between radical and palliative cases in the ovary (p = 0.010) and in the liver (p = 0.036). Median survival after gastrectomy was 45 months in the radical surgery cases, and 28 months in the palliative cases (p = 0.024). In postoperative gastric cancer follow-up, early detection of recurrence and radical surgery may well benefit patients with relapse, especially in the liver and ovary, in terms of survival.

Colonic Neoplasms↗

PubMed1984

Effects of specific active immunization on tumor recurrence following primary tumor resection in WF rats with 1,2-dimethylhydrazine-induced bowel cancer.

Primary gastrointestinal tumors were induced in male WF rats by 16 weekly sc injections of 1,2-dimethylhydrazine [(DMH) CAS: 540-73-8; 20 mg/kg/wk]. Twenty-four to 28 weeks after the start of DMH injections, all rats were surgically explored and gastrointestinal tumors were resected. Rats with no remaining microscopic disease after operation were immunized with one of four tumor isografts. The first isograft, DMH-W163, is a poorly differentiated mucinous adenocarcinoma explanted from a colon cancer in a DMH-treated animal. It has been shown to possess antigens that cross-react with other DMH-induced bowel adenocarcinoma isografts. The second isograft, DMH-W49, is a carcinosarcoma explanted from a DMH-treated primary colon cancer. It has intermediate antigenic cross-reactivity with other colon adenocarcinoma isografts in the WF model. The third isograft, DMH-W15, is a sarcoma explanted from a DMH-induced colon cancer that does not possess antigens cross-reactive with other DMH-induced colon adenocarcinomas. The fourth isograft, SPK, is a spontaneous (non-DMH-induced) renal cell carcinoma that is immunogenic but should not contain tissue-type-specific antigens cross-reacting with the bowel cancers. Immunized rats received three sc weekly injections of 1 X 10(3) irradiated cells. Concomitant control rats received no immunization after resection of the primary tumor. Within 24 weeks of primary tumor resection, 12 of 16 (75%) rats not immunized had tumor recurrence. Only 8 of 24 (34%) rats immunized with DMH-W163 had tumor recurrence (P less than .025 compared to controls). Fifty percent of animals (10/20) immunized with the carcinosarcoma DMH-W49 had a recurrence. Animals immunized with the non-cross-reacting DMH-W15 sarcoma isograft had a recurrence rate similar to that of controls (16/20, 75%). The rats immunized with SPK were not protected from recurrence. Twelve of 19 (63%) had a recurrence at or near the suture line within 24 weeks following primary tumor resection. These results confirm that adjuvant immunotherapy can decrease the rate of recurrence following primary tumor resection in this model. In addition, immunogens that possessed tissue-type-specific antigens were more effective in preventing tumor recurrence than those that did not.

1,2-Dimethylhydrazine↗

PubMed1995

T-antigens in primary non-invasive and superficially invasive human urinary bladder tumors: the correlation to tumor recurrence and tumor progression. A mini-review.

As cellular carbohydrate structures are involved in multiple cellular functions, alterations in these structures have been studied in an effort to find markers and predictors of the clinical course of disease in human cancers. Special interest has been given to recurrence and progression of cancer disease. At present no such marker or predictor exists for the prediction of recurrence and progression of initially non-invasive (Ta) or superficially invasive (T1) human urinary bladder tumors. Over the years the T- (Thomsen-Friedenreich) antigen (the disaccharide Gal beta(1-3)GalNAc alpha(1-O)-R) has been investigated for its possible role as such a marker. An overview is given. It is concluded that there is a general, but not an individual correlation between T-antigen expression and recurrence or progression of initially non- or superficially invasive human bladder tumors.

Antigens, Tumor-Associated, Carbohydrate↗