OBJECTIVE: Aim of the study is to report the unique clinicopathologic feature, treatment outcome and prognostic factors of head and neck hemangiopericytoma (HNHPC). METHOD: A retrospective data collection of reported HNHPC cases, in which therapy, follow-up and outcome data were available, was performed from the electronic database of PubMed, Embase, Google scholar, China National Knowledge Infrastructure, Wan Fang and Wei Pu until on December 31, 2013. RESULT: A total of 213 HNHPC cases were identified from 122 peer-reviewed articles. The recurrence rate was 24.4% (51/209). The positive surgical margin (OR= 3. 977, P<0. 01) and poor pathologic differentiation (OR=l. 890, P<0. 01) were associated with increased local recurrence. The metastasis rate was 15.8% (22/139). The positive surgical margin (OR=13. 833, P<0. 01), poor pathologic differentiation (OR=4. 661, P<0. 01) and non-surgical treatment (OR=2. 000, P<0. 01) were associated with increased distant metastasis. The mortality rate was 15. 0% (32/213). The tumor size >5. 0 cm in diameter (OR= 2. 860, P<0. 05), positive surgical margin (OR=9. 833, P<0. 01), poor pathologic differentiation (OR=4. 061, P<0. 01) and non-surgical treatment (OR=2. 032, P<0. 01) were associated with worse mortality. The treatment included surgery alone 139 cases, multiple treatments 64 cases and non-surgical treatment 10 cases. The overall survival (OS) of the 213 cases was 85%, and the 3-year, 5-year and 10-year OS were 86%, 78% and 74%, respectively. The 3-year, 5-year and 10-year OS for surgery alone were 95%, 88% and 84%, respectively. The 3- year, 5-year and 10-year OS for surgery plus radiotherapy were 90%, 80% and 80%, respectively. The 3-year, 5- year and 10-year OS for surgery plus chemotherapy were 75%, 25% and 25%, respectively. The 3-year, 5-year and 10-year OS for surgery plus radio-chemotherapy were 67%, 58% and 46%, respectively. There were signifi- cant survival difference in recurrence-free survival (RFS), metastasis free survival (MFS) and OS depending on surgical margins (P<0. 01). RFS, MFS and OS difference were identified depending on pathologic differentiation (P<0. 01). MFS and OS differences were observed on the different treatment modality (P<0. 01). OS differences was observed on the different tumor sizes (P<0. 05). Positive surgical margins was correlated with disease recurrence (HR= 3. 680, P<0.01), while poor pathologic differentiation was correlated with metastasis and death (HR=2. 619, P<0. 05 and HR=3. 188, P<0. 05). The tumor size >5. 0 cm in diameter and non-surgical treatment was correlated with death (HR= 5. 461, P<0. 01 and HR= 8. 563, P<0. 01, respectively). CONCLUSION The surgical resection was the mainstream treatment and it was superior to multiple treatments. The tumor size, surgical margins, pathological differentiation and non-surgical treatment were independent prognostic factors.
Head and Neck Neoplasms ; mortality ; pathology ; therapy ; Hemangiopericytoma ; mortality ; pathology ; therapy ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo discuss the present status and progress of clinical research on recurrence of gastric cancer after surgery, including patterns, clinicopathologic factors, prognosis, detection, diagnosis, prevention, and treatment strategies.

DATA SOURCESThe data used in this review were mainly from PubMed articles published in English from 2000 to August 2011. The search terms were "gastric cancer" and "recurrence".

STUDY SELECTIONArticles were selected if they involved clinicopathologic factors, detection methods, and treatment strategies of recurrence of gastric cancer.

RESULTSPeritoneal recurrence is the most common pattern in recurrence of gastric cancer. The main risk factors for recurrence of gastric cancer are tumor stage, including depth of tumor invasion and lymph node metastasis, and Borrmann classification. The prognosis of patients with recurrence is very poor, especially patients with peritoneal recurrence. Systemic chemotherapy is still the main treatment method for patients with recurrent cancer. If complete resection can be accomplished, some benefits may be obtained from surgery for recurrence. However, standard treatment for patients with recurrence has not yet been established.

CONCLUSIONSEarly detection and diagnosis of recurrence is quite crucial for treatment and prognosis. The optimal therapeutic strategy for recurrence should be based on a multidisciplinary assessment and the patient's individual state and should involve combined therapy.

Biomarkers, Tumor ; analysis ; Humans ; Neoplasm Recurrence, Local ; diagnosis ; rehabilitation ; surgery ; therapy ; Neoplasm Staging ; Prognosis ; Stomach Neoplasms ; diagnosis ; mortality ; pathology ; surgery

OBJECTIVE: To review the pathological and clinical features and treatment of sinonasal malignant melanoma. METHOD: A retrospective analysis of 23 cases of sinonasal malignant melanoma. All the patients were conformed by histopathology, the most common symptoms were nasal obstruction and epistexis. Eight cases were treated with surgery, 8 with surgery and radiotherapy, 5 with surgery and chemotherapy, 2 with surgery and ra- diotherapy plus chemotherapy. RESULT: Twenty patients were followed up, the survival rates of 3 and 5 years were 50% (10/20) and 35% (7/20), respectively. CONCLUSION Sinonasal malignant melanoma has an aggressive behavior and easy recurrence and poor prognosis. Early diagnosis and reasonable treatment can increase the survival rate of the disease.
Humans ; Melanoma ; mortality ; pathology ; therapy ; Nasal Obstruction ; Neoplasm Recurrence, Local ; Nose Neoplasms ; mortality ; pathology ; therapy ; Paraganglioma ; Paranasal Sinus Neoplasms ; mortality ; pathology ; therapy ; Retrospective Studies ; Survival Rate

BACKGROUNDAnorectal malignant melanoma was a rare disease with extremely poor prognosis. The aim of this study was to explore the clinical characteristic, diagnosis and treatment strategies of anorectal malignant melanoma.

METHODSThe data of 57 patients with anorectal malignant melanoma was collected and retrospectively analyzed.

RESULTSRectal bleeding and anal mass were found to be common symptoms of anorectal malignant melanoma. The preoperative diagnosis rate of anorectal malignant melanoma was 48.6%. The overall 3-year and 5-year survival rate was 38.0% and 21.3% respectively. The 3-year survival rates of stage I and II patients were 63.0% and 16.7% respectively (P = 0.000), and the 5-year survival rates were 33.3% and 11.1% (P = 0.001), which both had significant statistic differences. The 3-year survival rate of patients undergone abdmoninoperineal resection and patients undergone wide local excision were 36.7% and 53.0% respectively (P = 0.280), while the 5-year survival rate were 24.1% and 23.1% (P = 0.642), which both had no significant statistic differences.

CONCLUSIONSThis study identified no survival advantage to abdominoperineal resection in treatment of anorectal malignant melanoma, and we propose that wide local excision could be considered as the initial treatment of choice.

Adult ; Aged ; Aged, 80 and over ; Anus Neoplasms ; diagnosis ; mortality ; pathology ; surgery ; Female ; Humans ; Male ; Melanoma ; diagnosis ; mortality ; pathology ; surgery ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Survival Rate

OBJECTIVETo investigate the clinicopathological characteristics and prognosis of patients with recurrent colorectal cancer.

METHODSClinicopathological characteristics and postoperative survival of 235 patients with recurrent colorectal cancer after radical resection were retrospectively analyzed, and was compared with that of 993 patients with radical resection.

RESULTSThe overall 5- and 10-year survival rates after radical resection were 67.7% and 55.8%, respectively. The 5- and 10-year survival rates in patients with recurrent colorectal cancer was 43.9% and 28.1% (P=0.000), respectively. Among patients with recurrent colorectal cancer, the 5- and 10-year survival rates of the patients underwent second radical resection were 50.2% and 32.7%, while the 5- and 10-year survival rates of the patients without second surgery were 25.8% and 0, respectively (P=0.000). On univariate analysis, postoperative recurrence was associated with age at diagnosis, cancerous ileus, ascites, lymphs nodes involvement, gross types, infiltration of tumor and Duke's stage. Multivariate analysis revealed that cancerous ileus, ascites, gross types and Duke's stage were independent predictive factors for postoperative recurrence.

CONCLUSIONCancerous ileus, ascites, gross types and Duke's stage were independent predictive factors for recurrence and metastasis of colorectal cancer after radical resection. The 5- and 10-year survival rates and quality of life could be improved by second radical resection.

Adult ; Aged ; Colorectal Neoplasms ; diagnosis ; mortality ; pathology ; Female ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; mortality ; pathology ; Neoplasm Staging ; Prognosis ; Survival Rate

OBJECTIVETo study the clinical characteristics, treatment and prognosis 24 cases of carcinoma in pleomorphic adenoma in salivary gland.

METHODSThe clinical data of 24 patients with carcinoma in pleomorphic adenoma treated in our hospital from September 1974 to July 1995 were analyzed.

RESULTSThe overall 5-year survival rate was 66.7%. The five-year survival rates of patients with carcinoma in pleomorphic adenoma in the major and minor salivary glands were 63.6% and 2/2, respectively.

CONCLUSIONOperation is the optimal treatment and extensive resection at the initial operation is suggested. For lumps in the submaxillary gland, preventive neck dissection should be considered. Postoperative radiotherapy can not improve the local-control rate.

Adenoma, Pleomorphic ; diagnosis ; mortality ; therapy ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Prognosis ; Salivary Gland Neoplasms ; mortality ; pathology ; therapy ; Survival Rate

OBJECTIVETo investigate the risk factors affecting neoplasm recurrence and metastasis following liver transplantation (LT) and liver resection (LR) in patients with hepatocellular carcinoma (HCC) meeting Milan criteria.

METHODSWe retrospectively analyzed the clinical data of 88 patients with HCC meeting Milan criteria undergoing LT or LR in Nanfang Hospital between January, 2006 and December, 2011 and compared the survival rate and recurrence-free survival rate between the two groups. Univariate analysis of 12 variables during peri-operative period was carried out to screen the risk factors affecting neoplasm recurrence and metastasis.

RESULTSThe LT group and HR group had similar 1-, 3-, and 5-year-survival rates (P>0.05), but the LT group showed significantly higher 1-, 3-, and 5-year recurrence-free survival rates (P<0.05). The recurrence rate was much lower in LT group than in LR group (P<0.05). Multivariate analysis identified gender, tumor size, degree of pathological differentiation, and microvascular tumor embolism as independent risk factors affecting the recurrence-free survival rate.

CONCLUSIONPatients with HCC meeting Milan criteria undergoing LT have longer long-term recurrence-free survival. A male patient with a greater tumor size, microvascular tumor embolism, and poorly differentiated carcinoma is more likely to develop neoplasm recurrence and metastasis following the surgery.

Carcinoma, Hepatocellular ; mortality ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; mortality ; pathology ; surgery ; Liver Transplantation ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

OBJECTIVETo investigate the clinicopathologic features of thymic carcinoma and assess its prognostic factors.

METHODSA retrospective analysis was performed in 54 patients with thymic carcinoma who underwent surgical resection. Eighteen patients were treated by total resection of the tumor, 17 partial resection and 10 exploratory thoracotomy. The clinical stage was determined according to Masaoka's classification. The survival time and prognostic factors were evaluated by the log-rank and Cox multivariate analysis model.

RESULTSThe overall 5-year survival rate was 44.4%. Being located in anterior mediastinum and noncalcification in the tumor pathognomonically played an important role in the differential diagnosis. According to the multivariate analysis, tumor maximum diameter (OR = 1.84), histological subtype (OR = 1.70), completeness of resection (OR = 1.37), tumor invasion of peritumoral organs (OR = 1.32) and postoperative recurrence (OR = 1.26) were significant prognostic factors. Compared with other subtypes, carcinoid tumor had the characteristics of earlier lesion, better resection rate and better prognosis.

CONCLUSIONThe most important prognostic variables for thymic carcinoma are tumor maximum diameter, histological subtype, completeness of resection, tumoral invasion and postoperative recurrence. Complete resection followed by chemoradiotherapy should be considered as favorable on the basis of a definitive pathologic diagnosis.

Adult ; Female ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Survival Rate ; Thymus Neoplasms ; mortality ; pathology ; surgery

OBJECTIVETo compare the 2004 and 1973 WHO classifications for predicting tumor recurrence for organ-confined (T stage ≤ pT2b) invasive urothelial carcinoma of the bladder treated with radical cystectomy.

METHODSFrom February 2000 to August 2011, the 173 consecutive cases of organ-confined invasive urothelial carcinoma of the bladder were treated with radical cystectomy. The data of clinical and follow-up information was collected. The Kaplan-Meier plots with Log-rank test were used to estimate recurrence-free survival (RFS). Univariate and multivariate analysis using the Cox proportional hazard regression model were performed to evaluate the impact of any clinicopathological prognostic factors (tumor grade, tumor stage, lymph node status, lymphovascular invasion, preoperative hydronephrosis, and non-pure urothelial carcinoma) on RFS.

RESULTSThe 5-year RFS was 84.7% for the entire cohort. Univariate and multivariate analysis demonstrated that when using the 2004 WHO classification, lymph node status (RR = 4.573, 95% CI: 1.469-14.237), tumor grade (RR = 9.993, 95% CI: 1.325-75.390) and preoperative hydronephrosis (RR = 3.207, 95% CI: 1.209-8.508) presented independent predictors for RFS; while using the 1973 WHO system, lymph node status (RR = 9.484, 95% CI: 3.450-26.074) and lymphovascular invasion (RR = 3.009, 95% CI: 1.062-8.526) were independent predictors.

CONCLUSIONSThe 2004 WHO classification, as an independent factor, is superior to the 1973 classification for predicting RFS in patients with organ-confined invasive bladder cancer treated with radical cystectomy. However, a further perspective study is needed to validate its role in prognosis.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Grading ; methods ; Neoplasm Recurrence, Local ; Urinary Bladder ; pathology ; Urinary Bladder Neoplasms ; classification ; mortality ; pathology

PURPOSE: To investigate the clinical features and course of conjunctival malignant melanoma in Korea. METHODS: The medical records of 15 patients, 5 males and 10 females, diagnosed with conjunctival malignant melanoma who had been treated at Severance Hospital from May 1991 to March 2004 were reviewed retrospectively. The clinical parameters of the patients, tumors, and treatment were analyzed for their relation to outcome measures. RESULTS: The mean age at the time of diagnosis was 53.4 years (+/-11.7 years). In all cases, the disease was unilateral and all patients had experienced at least one recurrence. Local lymph node metastasis was found in 3 patients (20%) and the mean time to metastasis was 3.5 years. Systemic metastasis was found in 6 patients (40%) and the mean time to metastasis was 9.3 years. There were 5 cases of tumor-related death (33.3%), 4 of which were attributed to systemic metastasis. The Kaplan-Meier estimates of cumulative survival rate were 90% at 30 months and 56.6% at 70 months. CONCLUSIONS: Although conjunctival malignant melanoma is a rare disease, it is life-threatening and complete tumor excision at an early stage is mandatory, as is additional therapy to prevent local recurrence and systemic metastasis.
Adult ; Conjunctival Neoplasms/mortality/*pathology/*physiopathology ; Female ; Humans ; *Lymphatic Metastasis ; Male ; Melanoma/mortality/*physiopathology/*secondary ; Middle Aged ; *Neoplasm Recurrence, Local ; Retrospective Studies ; Survival Analysis ; Time Factors