Adenocarcinoma ; drug therapy ; pathology ; surgery ; Adenoma, Villous ; drug therapy ; pathology ; surgery ; Adult ; Cell Transformation, Neoplastic ; Follow-Up Studies ; Humans ; Male ; Neoplasm Recurrence, Local ; Urinary Bladder Neoplasms ; drug therapy ; pathology ; surgery

Head and neck metastasis from glioblastoma is rare event usually seen in patients with previous and repeated surgery. We present the case of a 35 yr-old-female suffering from metastatic glioblastoma in cervical lymph node that was diagnosed by fine needle aspiration. During the last 4 yr, she had four separate craniotomies for the recurrent brain tumors. Cytological diagnosis was made by light microscopy with immunostaining with glial fibrillay acid protein. Chemotherapy with vincristine and procarbazine was performed. The cervical masses were decreased in size and some disappeared while the intracranial glioblastoma continued to grow during chemotherapy. We discuss possible explanations for these different courses after chemotherapy in extraneural metastatic glioblastoma and primary intracranial glioblastoma.
Adult ; Antineoplastic Agents/therapeutic use ; Brain Neoplasms/drug therapy/*surgery ; Craniotomy ; Female ; Glioblastoma/drug therapy/*pathology/*secondary ; Humans ; Lymph Nodes/*pathology ; Lymphatic Metastasis ; Neck ; Neoplasm Recurrence, Local/drug therapy/pathology/surgery

Breast ; surgery ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Female ; Humans ; Lymph Node Excision ; Mastectomy, Segmental ; Neoplasm Recurrence, Local ; Treatment Outcome

The aim of this study was to evaluate our experience using radical cystectomy to treat patients with bladder cancer and to describe the associations between pathologic features and clinical outcomes. All 701 patients who underwent radical cystectomy for bladder cancer were evaluated. The patient population consisted of 623 men and 78 women. The overall 5 and 10 yr recurrence-free survival (RFS) rates were 61.8% and 57.7%, respectively, and the 5 and 10 yr cancer-specific survival (CSS) rates were 70.8% and 65.1%, respectively. Multivariate analysis showed that factors significantly predictive of RFS and CSS included extravesical extension (P = 0.001), lymph node metastasis (P = 0.001), and lymphovascular invasion (P < 0.001 and P = 0.007). The 5 and 10 yr RFS rates for patients with lymph node metastasis were 25.6% and 20.8%, respectively, and the 5 and 10 yr CSS rates were 38.6% and 30.9%, respectively. Adjuvant chemotherapy significantly improved RFS (P = 0.002) and CSS (P = 0.001) in patients with lymph node metastasis. Radical cystectomy provides good survival results in patients with invasive bladder cancer. Pathologic features significantly associated with prognosis include extravesical extension, node metastasis, and lymphovascular invasion. Adjuvant chemotherapy improves survival in patients with advanced stage disease.
Chemotherapy, Adjuvant ; *Cystectomy ; Disease-Free Survival ; Female ; Humans ; Lymphatic Metastasis/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness/pathology ; Neoplasm Recurrence, Local/pathology ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Urinary Bladder/pathology/*surgery ; Urinary Bladder Neoplasms/drug therapy/pathology/*surgery

OBJECTIVETo investigate the histological criteria of breast cancer response to neoadjuvant therapy.

METHODSOne hundred and fifty-four cases of breast cancer receiving neoadjuvant therapy were collected from June, 2005 to June, 2007 and the clinical data were analyzed. All patients were operated on within 4 weeks after neoadjuvant therapy. All specimens were assessed by the standard method of Miller and Payne (MP) grading system. The response to neoadjuvant therapy were assessed by two pathologists independently, using MP grading system and common grading system separately.

RESULTSThe response rate using the MP grading system were grade 1 in 12 cases (7.8%), grade 2 in 33 cases (21.4%), grade 3 in 64 cases (41.6%), grade 4 in 31 cases (20.1%) and grade 5 in 14 cases (9.1%). Using the common grading system, the response were mild in 51 cases (33.1%), moderate in 71 cases (46.1%) and severe in 32 cases (20.8%). MP grading system may be related to common grading system (chi2 = 186.660, P < 0.01). Follow up information were available in 147 cases, with 14 cases showing recurrence, metastasis or death from the disease. The MP grading system may be related to the outcome (chi2 = 11.612, P = 0.020), but not the common grading system (chi2 = 0.881, P = 0.644).

CONCLUSIONMP grading system may be one of the prognostic factors in the neoadjuvant therapy of breast cancer.

Biopsy, Needle ; Breast ; pathology ; Breast Neoplasms ; drug therapy ; pathology ; surgery ; Carcinoma, Ductal, Breast ; drug therapy ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Preoperative Period

OBJECTIVETo analyze the clinical and pathologic risk factors of early recurrence in patients with pathological N1 (pN1) stage esophageal squamous cell carcinoma after radical esophagectomy.

METHODSA retrospective study was carried out on 95 consecutive pN1 stage esophageal squamous cell carcinoma patients undergoing esophagectomy with lymphadenectomy by the same surgical team from January 2004 to December 2010 was performed. The Cox proportional hazards model was used to determine the independent risk factors for recurrence and metastasis within 3 years after the operation.

RESULTSRecurrence was identified in 52 patients (54.7%) within 3 years after operation. Local recurrence was found in 42 patients (44.2%), and distant metastasis in 10 patients (10.5%). The Cox multivariate analysis showed that pT3-4a stage (RR=3.604, P=0.027), positive lymph node metastasis in two stations (RR=4.834, P=0.009) or two fields (RR=5.689, P=0.003), and postoperative adjuvant chemotherapy (RR=1.594, P=0.048) were independent risk factors for postoperative recurrence.

CONCLUSIONSPostoperative adjuvant chemotherapy can decrease the probability of postoperative recurrence and metastasis of pN1 esophageal squamous cell carcinoma. As for patients who are identified as multi-station or multi-field lymph node metastasis, preoperative induced therapy maybe further improve treatment outcomes.

Carcinoma, Squamous Cell ; drug therapy ; pathology ; surgery ; Chemotherapy, Adjuvant ; Esophageal Neoplasms ; drug therapy ; pathology ; surgery ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; etiology ; Postoperative Period ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors

Aged ; CD3 Complex ; metabolism ; Humans ; Immunohistochemistry ; Leukocyte Common Antigens ; metabolism ; Lymphoma, T-Cell, Peripheral ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Thyroid Neoplasms ; drug therapy ; metabolism ; pathology ; surgery

Adult ; Chemotherapy, Adjuvant ; Diagnosis, Differential ; Female ; Humans ; Lung Neoplasms ; secondary ; Mediastinal Neoplasms ; diagnostic imaging ; drug therapy ; pathology ; surgery ; Mediastinum ; diagnostic imaging ; pathology ; Neoplasm Recurrence, Local ; Osteosarcoma ; diagnostic imaging ; drug therapy ; pathology ; secondary ; surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the clinicopathologic features, diagnosis, treatment and prognosis of uterine mullerian adenosarcoma.

METHODSThe clinicopathological data of 9 cases of uterine mullerian adenosarcoma in PUMC hospital from January 2003 to February 2009 were retrospectively analyzed.

RESULTSThere were 6 uterine endometrial adenosarcomas and 3 cervical adenosarcomas. The main clinical manifestations were abnormal vaginal bleeding and pelvic pain. Physical examination showed cervical/vaginal mass, enlarged uterus or pelvic mass. The adenosarcoma was characterized by benign or atypical-appearing neoplastic glands within a sarcomatous stroma. This stroma could appear as periglandular cuffs or intraglandular polypoid projections of increased cellular structure. The primary diagnostic rate was 66.7% and the most common clinical stage was stage I (7/9). All patients received surgical treatment and seven had postoperative chemotherapy, radiotherapy or hormone therapy. Conservation of unilateral ovary or bilateral ovaries was performed in 5 cases. Three patients underwent local excision, which resulted in the preservation of reproductive function. During the follow-up, 2 cases of uterine endometrial adenosarcoma recurred. One patient of clinical stage III containing sarcomatous overgrowth died from recurrence 13 months after surgery. The other one recurred 2 years after local excision of the tumor in the uterine cavity and she remained healthy since hysterectomy.

CONCLUSIONUterine mullerian adenosarcoma is a rare tumor without specific clinical symptoms and signs. The diagnosis depends on pathomorphologic examination. The tumors show low malignant potential and the vast majority are at early stage. Surgical excision is the main treatment strategy with a good prognosis in the early stage disease with complete removal of tumors. The prognosis is poor in advanced adenosarcoma with sarcomatous overgrowth. Due to the relatively high rate of recurrence, long-term follow-up is recommended.

Adenosarcoma ; drug therapy ; pathology ; surgery ; Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Chemotherapy, Adjuvant ; Cisplatin ; therapeutic use ; Endometrial Neoplasms ; drug therapy ; pathology ; surgery ; Etoposide ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Ifosfamide ; therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies ; Uterine Cervical Neoplasms ; drug therapy ; pathology ; surgery ; Uterine Neoplasms ; drug therapy ; pathology ; surgery ; Young Adult

BACKGROUND/AIMS: Eradication of Helicobacter pylori reduces the incidence of gastric cancer, and may inhibit gastric dysplasia progression into gastric cancer. The aim of this study was to investigate the effect of eradication of Helicobacter on the incidence of subsequent gastric dysplasia development after endoscopic resection. METHODS: Medical records of patients who underwent endoscopic resection for gastric dysplasia were retrospectively reviewed. Presence of H. pylori was assessed by the Campylobacter-like organism test and histology. The rate of subsequent dysplasia development after endoscopic resection between the eradication group and non-eradication group was compared. RESULTS: Total of 129 patients positive for H. pylori infection were included for analysis. Of these, 85 patients received successful eradication therapy and 44 patients did not receive eradication therapy or failed to achieve successful eradication. Sex, mean age and pathologic grade of dysplasia did not differ between the two groups. In univariate analysis, the grade of intestinal metaplasia (p=0.013) significantly differed between metachronous dysplasia group and non-metachrounous dysplasia group. In multivariate analysis, eradication of H. pylori (p=0.014) was related to reduced incidence of subsequent gastric dysplasia development after endoscopic resection. CONCLUSIONS: Eradication of H. pylori likely has a beneficial effect in preventing the development of subsequent gastric dysplasia, a premalignant lesion of gastric cancer, after endoscopic resection.
Aged ; Anti-Bacterial Agents/*therapeutic use ; Female ; Gastric Mucosa/pathology/surgery ; Gastroscopy ; Helicobacter Infections/*drug therapy ; *Helicobacter pylori ; Humans ; Male ; Metaplasia/pathology ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Precancerous Conditions/*pathology ; Proportional Hazards Models ; Retrospective Studies ; Stomach Neoplasms/pathology/*surgery