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Lung and Tracheo-Bronchial Tumours - main types.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Primary bronchial tumours may sometimes become very large - even 10 cm or more in diameter. Some may have a smooth or lobulated outer border, whilst others are irregular. Such masses may occur with all types, but seem to be more common with squamous tumours, particularly those that are slowly growing. Those with a regular outer border seem to have a better prognosis than those with an irregular edge, presumably due to less permeation by the tumour. Both types may degenerate and cavitate. Sometimes the degenerate tumour material may be retained within the tumour 'capsule' and when aspirated appear identical to pus. It may indeed be full of pus cells, but be sterile and contain tumour cells. Large tumours may also be carcinosarcomas (see p. 24.18) with a very bad prognosis (lllus. CARCINOSARCOMA).
Clinical trial design
Published in Charles F. Levenback, Ate G.J. van der Zee, Robert L. Coleman, Clinical Lymphatic Mapping in Gynecologic Cancers, 2022
Scott Jordan, Brian M. Slomovitz
Initially, due to controversy surrounding the utility of comprehensive universal lymphadenectomy in the surgical management of early-stage endometrial cancer, SLN evaluation presented an attractive alternative due to decreased surgical intervention but equivalent detection rates.29 With increasing adoption of the technique, retrospective and prospective data were published demonstrating the utility of SLN in high-risk histologies. Schiavone et al. published the results of an analysis of a prospectively maintained database including 136 patients with carcinosarcoma. No difference in progression-free or overall survival was seen between patients who underwent complete lymphadenectomy or SLN biopsy alone.30 The rate of positive nodes was also equivalent between the two groups. Soliman et al. published a prospective trial of 123 patients with high-grade endometrial cancers, demonstrating 95% sensitivity and a false-negative rate of 4.3%.31
Uterine Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Claudia von Arx, Hani Gabra, Christina Fotopoulou
Regarding the management of uterine carcinosarcoma, when possible, surgery is recommended. Surgery should include TAH, BSO, omentectomy, pelvic LND, and possibly para-aortic LND. Even if the therapeutic benefit of lymphadenectomy remains unclear, the high risk of pelvic lymph node metastases shown in the GOG trial118 has justified the recommendation of pelvic lymphadenectomy in patients with uterine carcinomas.
Imaging-guided percutaneous radiofrequency ablation of retroperitoneal metastatic disease in uterine carcinosarcoma
Published in Journal of Obstetrics and Gynaecology, 2021
Min Jin Jeong, Dong Jin Chung, Jung Hyun Park, Seong Hye Park, Chan Joo Kim, Yong Seok Lee
A 62-year-old female underwent optimal debulking surgery for uterine carcinosarcoma. A total hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and a sigmoid colon anterior resection were performed. The final pathological report was carcinosarcoma, poorly differentiated, stage IV. After complete cytoreduction surgery, six cycles of combination of cisplatin and ifosfamide chemotherapy were administered, she had no specific problems. However, almost 5 months after adjuvant chemotherapy, a new retroperitoneal metastatic lesion at the left periureteral space was detected on CT scan. She did not want the surgery and hesitated to be treated. In 1 month, the tumour grew rapidly from 8 mm to 24 mm. Finally, she agreed to the treatment with percutaneous RFA procedure. Immediately after the procedure, an approximately 18 mm RF ablated mass without a remaining tumour portion in the left periureteral space was found on the CT. Seven months after the procedure, the lesion was subsequently treated with radiofrequency ablation (24 mm – >13 mm) (Figure 1G–I). One year later, the mass had disappeared, and she is living without recurrence.
Comparison of survival outcomes and effects of therapy between subtypes of high-grade endometrial cancer – a population-based study
Published in Acta Oncologica, 2021
Sophia Scharl, Michael Gerken, Tim Sprötge, Karin Kronberger, Anton Scharl, Atanas Ignatov, Olaf Ortmann, Oliver Kölbl, Monika Klinkhammer-Schalke, Thomas Papathemelis
Even though it has become clear that carcinosarcoma represents a subtype of endometrial cancer rather than sarcoma, few studies have been undertaken to compare its prognosis to other forms of high-grade endometrial cancer. Amant et al. reported a worse prognosis of carcinosarcoma compared to other high-grade histologies in a cohort comprised of 137 high-risk patients stages I-IV [19]. Felix et al, on the other hand, found no difference between carcinosarcoma patients and clear cell, serous or high-grade endometrioid cancer patients in terms of RFS and DSS [20]. In our cohort, we observed the lowest rates of OS and RFS and the highest recurrence rates in carcinosarcoma patients which were statistically significant compared to type I G3, not to type II tumors. All recurrences took place rather within 3 years from diagnosis. This might have implications on the schedule of aftercare and suggests that carcinosarcoma represents a subtype with a particularly poor prognosis and early recurrences.
Chemotherapy and targeted treatments of breast sarcoma by histologic subtype
Published in Expert Review of Anticancer Therapy, 2021
Stefania Kokkali, Athina Stravodimou, Jose Duran-Moreno, Nektarios Koufopoulos, Ioannis a Voutsadakis, Antonia Digklia
BS like soft tissue sarcomas found in other anatomical locations are a heterogeneous group of neoplasms consisting of several different subtypes including stromal sarcoma, angiosarcoma, liposarcoma, fibrosarcoma, osteosarcoma, chondrosarcoma, leiomyosarcoma, undifferentiated pleiomorphic sarcoma (UPS) and Kaposi sarcoma [5,19]. While some authors have excluded malignant PT, it is the first or second most common subtype in the remaining series that do include it [4,7,10,20]. Angiosarcoma, together with PT, constitutes the most frequent histopathologic subtypes that affect the breast. The frequencies of the other sarcoma histotypes vary in the different retrospective series reported in the literature, biased by the inherent problems of classification and nomenclature in older studies (as shown by the frequency of malignant fibrous histiocytoma, the term for UPS used in older studies). Carcinosarcoma is also inconsistently included in the different series.