The majority of patients with recurrent cervical cancer are incurable and treatment is based on the type of primary therapy delivered. Only a very small percentage of the patients with recurrent cervical cancer following primary radiotherapy will have central pelvic recurrences that are amenable to surgical resection and curable by pelvic exenteration. These procedures should be undertaken only after the completion of exhaustive attempts to exclude extrapelvic disease.
Cervix Neoplasms/drug therapy/mortality/*surgery ; Female ; Human ; Neoplasm Recurrence, Local/drug therapy/mortality/*surgery ; Pelvic Exenteration/adverse effects/methods

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

OBJECTIVETo analyze the complications and treatment results of intraoperative radiotherapy (IORT) for esophageal carcinoma.

METHODSSixty patients with thoracic esophageal carcinoma underwent esophagectomy through right thoractomy, 30 patients of whom received IORT of 15 - 25 Gy.

RESULTSIn patients who underwent IORT, 2 cases of pneumonitis, 1 case of anastomotic leak and 1 case of incisional wound infection were found. In patients underwent surgery only, 1 case of thoracic empyema and 1 case of anastomotic leak were found. All the complications ultimately healed. There was no operative mortality. During the follow-up of 3 years, in patients who underwent IORT, 2 of 3 died of radiation pneumonitis 24 and 26 months after IORT with one complicated with bronchoesophageal fistula. One of 3 died of multiple lung metastases. The 3-year survival rate was 88.0% (22/25) in IORT group and 76.0% (19/25) in surgery only group.

CONCLUSIONIntraoperative radiotherapy can reduce locoregional recurrence if performed to thoracic esophageal carcinoma patients without surgical contraindication or distant metastasis. Radiation pneumonitis, a common complication difficult to manage, implies a poor prognosis and, consequently, the lung and bronchus should be protected from the radiation.

Adult ; Aged ; Combined Modality Therapy ; Esophageal Neoplasms ; mortality ; therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiotherapy Dosage

OBJECTIVETo analyze the efficacy of recurrence prophylaxis using radiation and chemotherapy following bladder conservation surgery for muscle invasive bladder cancer.

METHODS23 patients with muscle invasive bladder cancer were treated with radiotherapy combined with bladder mitomycin infusion after bladder conservation surgery (study group). Radiotherapy was given using an external beam at an average dose of 5148 +/- 462 cGy with conventional fractionation. For comparison, 29 similar patients treated with postoperative bladder mitomycin infusion without radiation served as control (control group). All patients were followed up for more than 3 years, an average of 41.6 months (36 - 60 months).

RESULTSThe 3-year pelvic recurrent rate of muscle invasive bladder cancer was 17.4% in the study group and 44.8% (P = 0.036) in the control group. The 3-year distant metastasis rates were 17.4% and 24.1%, respectively (P = 0.554). The 3-year overall survival rates were 81.8% and 86.2%, respectively (P = 0.670). Two patients from the study group had their treatment interrupted, one for 3 days and the other for one week due to acute cystitis, while the rest of the patients were able to complete the treatment according to schedule.

CONCLUSIONRadiotherapy plus chemotherapy after bladder conservation surgery for muscle invasive bladder cancer can decrease the rate of pelvic recurrence effectively and be used as a realistic adjuvant treatment.

Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate ; Urinary Bladder Neoplasms ; mortality ; therapy

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

Most prostate cancer cases ultimately relapse after a period of initial response to castration therapy and progress to intractable castration-resistant prostate cancer (CRPC). Hardly any therapeutic options currently used can improve the 2- to 3-year survival of the patient. Recently, some new drugs for the treatment of CRPC through various action mechanisms have been approved, and others are in the advanced stage of clinical trial. This review provides an overview of these new therapeutic agents.
Antineoplastic Agents ; therapeutic use ; Humans ; Male ; Neoplasm Recurrence, Local ; Orchiectomy ; Prostatic Neoplasms ; surgery ; Prostatic Neoplasms, Castration-Resistant ; drug therapy ; mortality

OBJECTIVETo examine the benefit of restaging recurrent oral squamous cell carcinoma (R-OSCC) and the effect on salvage surgery.

METHODSAn analysis was performed on 30 patients with local only first failure (n = 13) or loca-regional only first failure (n = 9) or first recurrence in the neck (n = 8) after surgery and/or radiation treatment given for oral squamous cell carcinoma. All the 30 patients were restaged and treated with salvage surgery.

RESULTSThe overall survival time and disease-free survival time of patients with early staged R-OSCC was longer than that of patients with advanced staged R-OSCC. The 1-year survival and 1-year disease-free survival rates for early staged R-OSCC is also higher than that of advanced staged R-OSCC.

CONCLUSIONSThe re-stage of the recurrent tumor is significantly correlated with survival. The salvage surgery is an effective measure in patients with recurrent oral squamous cell carcinoma, especially in early staged patients of R-OSCC.

Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mouth Neoplasms ; mortality ; surgery ; Neoplasm Recurrence, Local ; mortality ; surgery ; Salvage Therapy ; Survival Rate

BACKGROUND/AIMS: The role of radiofrequency ablation (RFA) remains uncertain in patients with viable hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). METHODS: A total of 101 patients (April 2007 to August 2010) underwent RFA for residual or recurrent HCC after TACE. We analyzed their long-term outcomes and predictive factors. RESULTS: The overall survival rates after RFA were 93.1%, 65.4%, and 61.0% at 1, 3, and 5 years, respectively. Predictive factors for favorable overall survival were Child-Pugh class A (hazard ratio [HR], 3.45; p=0.001), serum alpha-fetoprotein (AFP) level <20 ng/mL (HR, 2.90; p=0.02), and recurrent tumors after the last TACE (HR, 3.14; p=0.007). The cumulative recurrence-free survival rate after RFA at 6 months was 50.1%. Predictive factors for early recurrence (within 6 months) were serum AFP level > or =20 ng/mL (HR, 3.02; p<0.001), tumor size > or =30 mm at RFA (HR, 2.90; p=0.005), and nonresponse to the last TACE (HR, 2.13; p=0.013). CONCLUSIONS: Patients with recurrent or residual HCC who undergo prior TACE show a favorable overall survival, although their tumors seem to recur early and frequently. While good liver function, a low serum AFP level, and recurrent tumors were independent predictive factors for a favorable overall survival, poor response to TACE, a high serum AFP level, and large tumors are associated with early recurrence.
Aged ; Carcinoma, Hepatocellular/*mortality/*therapy ; *Catheter Ablation ; Chemoembolization, Therapeutic/mortality ; Combined Modality Therapy/mortality ; Female ; Humans ; Liver Neoplasms/*mortality/*therapy ; Male ; Middle Aged ; Neoplasm Recurrence, Local/mortality ; Survival Rate ; Treatment Outcome ; alpha-Fetoproteins/analysis