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Hoveyan J, Asatryan E, Grigoryan H, Hovsepyan S, Avagyan A, Hakobyan L, Sargsyan L, Iskanyan S, Avagyan M, Hovhannisyan S, Melnichenko I, Minasyan M, Papyan R, Manukyan N, Lazaryan A, Danelyan S, Muradyan A, Arakelyan J, Qaddoumi I, Boop F, Mkhitharyan A, Harutyunyan M, Tamamyan G, Bardakhchyan S. Trends in pediatric CNS tumors in Armenia: a multicenter retrospective study. Childs Nerv Syst 2024; 40:435-444. [PMID: 37837453 DOI: 10.1007/s00381-023-06179-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 10/10/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Central nervous system (CNS) tumors are the most common solid malignancies in children worldwide, including in Armenia. The current study aims to analyze epidemiological data, treatment, and outcomes of children and young adults (≤25 years) with CNS tumors in Armenia during the last 26 years. METHODS We collected data from pediatric and young adult patients treated in selected sites in Armenia from 1st January 1995 to 31st December 2020. Incidence by sex, age at diagnosis, time from first complaints to diagnosis, histopathology results, treatment strategies, complications, and overall survival (OS) rates were calculated. RESULTS The multicenter data analysis revealed 149 patients with diagnosed primary CNS tumors over 26 years. Among them, 84 (56.4%) were male. The median age at diagnosis was 7 years (range, 3 months to 25 years), and the median time from the first complaints to diagnosis was 2 months (range, 1 week to 70 months). Medulloblastomas and other embryonal tumors (47), low-grade gliomas (32), and high-grade gliomas (22) were the most commonly diagnosed malignancies. Ependymomas, craniopharyngiomas, germ cell tumors, and other malignancies were observed in 22 patients. For 26 patients, no histopathological or radiological diagnosis was available. Follow-up information was available for 98 (65.8%) patients. The 5-year OS rate for the whole study group was 67.7%. CONCLUSION Consistent with international data, embryonal tumors, and gliomas were the most commonly diagnosed CNS malignancies in Armenia. Multimodal treatment was often not available in Armenia during the study period, especially for early cases.
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Affiliation(s)
- Julieta Hoveyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia.
- Immune Oncology Research Institute, Yerevan, Armenia.
| | - Eduard Asatryan
- Division of Neurosurgery, Department of Surgery, Wigmore Hospital for Children, Yerevan, Armenia
| | - Henrik Grigoryan
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Shushan Hovsepyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Anna Avagyan
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Lusine Hakobyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Lilit Sargsyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Samvel Iskanyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Manushak Avagyan
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Saten Hovhannisyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Irina Melnichenko
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Mariam Minasyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Ruzanna Papyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Narek Manukyan
- National Center of Oncology named after V. A. Fanarjyan, Yerevan, Armenia
| | - Armine Lazaryan
- Department of Radiation Oncology, National Center of Oncology named after V. A. Fanarjyan, Yerevan, Armenia
| | - Samvel Danelyan
- Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Armen Muradyan
- Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | | | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
- Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Frederick Boop
- Global Pediatric Medicine Department, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Armen Mkhitharyan
- HistoGen Pathology Center, Yerevan, Armenia
- Department of Pathology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Martin Harutyunyan
- Adult's Solid Tumor Chemotherapy Department, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
| | - Gevorg Tamamyan
- Department of Pediatric Oncology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Immune Oncology Research Institute, Yerevan, Armenia
- Department of Pediatric Hematology, Pediatric Cancer and Blood Disorders Center of Armenia, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
- Department of Hematology and Pediatric Oncology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Samvel Bardakhchyan
- Immune Oncology Research Institute, Yerevan, Armenia
- Adult's Solid Tumor Chemotherapy Department, Hematology Center after Prof. R. H. Yeolyan, Yerevan, Armenia
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Zohrabyan D, Karapetyan N, Danielyan S, Saghatelyan T, Safaryan L, Bardakhchyan S, Tamamyan G, Harutyunyan M, Rushanyan M, Mkrtchyan G, Badalyan S, Avagyan A, Harutyunyan L, Lazaryan A, Mkhitaryan S, Khanoyan A, Sargsyan A, Mailyan M, Mamunts D, Asadyan A, Khachatryan P, Mkhitaryan A, Kalemkerian GP. Lung Cancer in Armenia. J Thorac Oncol 2023; 18:402-409. [PMID: 36990573 DOI: 10.1016/j.jtho.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 03/29/2023]
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Figura N, Sim A, Chavez J, Shah B, Khimani F, Lazaryan A, Davila M, Bachmeier C, Nishihori T, Liu H, Christopherson K, Kim S, Locke F, Jain M, Robinson T. Patient-Level Disease Burden as a Predictor of In-Field Failures in Patients Undergoing Bridging Radiotherapy for CD19-Directed Chimeric Antigen Receptor (CAR) T-Cell Therapy for Recurrent/Refractory Large B-Cell Lymphomas. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sim A, Figura N, Dohm A, Chavez J, Shah B, Khimani F, Lazaryan A, Davila M, Bachmeier C, Nishihori T, Liu H, Kim S, Locke F, Jain M, Robinson T. In-Field Failures in Patients Undergoing Bridging Radiotherapy for CD19-Directed Chimeric Antigen Receptor (CAR) T-Cell Therapy for Recurrent/Refractory Large B-Cell Lymphomas. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Figura N, Sim A, Dahiya S, Lutfi F, Rapoport A, Mohindra P, Dohm A, Chavez J, Shah B, Khimani F, Lazaryan A, Davila M, Bachmeier C, Nishihori T, Liu H, Kim S, Locke F, Jain M, Robinson T. PO-1075 Bridging Radiotherapy prior to Brexucabtagene Autoleucel CAR T-Cell Therapy in Mantle Cell Lymphoma. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07526-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Lazaryan A, Rubin N, Goyal A. INCREASED RISK OF SECOND PRIMARY HEMATOLOGIC AND SOLID MALIGNANCIES IN PATIENTS WITH MYCOSIS FUNGOIDES: IMPACT ON OVERALL SURVIVAL IN SEER REGISTRY. Hematol Oncol 2019. [DOI: 10.1002/hon.94_2630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- A. Lazaryan
- BMT-Cellular Immunotherapy; Moffitt Cancer Center; Tampa United States
| | - N. Rubin
- Dermatology; University of Minnesota; Minneapolis United States
| | - A. Goyal
- Dermatology; University of Minnesota; Minneapolis United States
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Rivera S, Petit C, Martin AN, Cacicedo J, Leaman O, Rosselot MCA, Lazaryan A, Akperov K, Sinaika V, Monestel R, Fröbe A, Kevlishvili G, Stojkovski I, Magsar B, Corovic M, Mahmood H, Alauddin Z, Barriga O, Lucas M, Palmu M, Zubizarreta E, Hopkins K, Eriksen J. Long-term impact on contouring skills achieved by online learning. An ESTRO-FALCON-IAEA study. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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8
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Goyal A, Lazaryan A. 193 Increased risk of malignancy in mycosis fungoides: A single-center perspective. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Lazaryan A, Arora M. Evolving concepts in prognostic scoring of chronic GvHD. Bone Marrow Transplant 2017; 52:1361-1366. [PMID: 28346419 DOI: 10.1038/bmt.2017.50] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 01/03/2017] [Accepted: 02/16/2017] [Indexed: 01/27/2023]
Abstract
Chronic GvHD (cGvHD) remains one of the most complex and challenging complications after allogeneic hematopoietic cell transplantation. Emerging knowledge about the clinical manifestations and associated organ involvement of cGvHD has led to the establishment of prognostic parameters for post-transplant survival among affected allograft recipients. Studies employing the pre-National Institutes of Health (NIH) consensus data on cGvHD incidence and its risks have led to development of the CIBMTR's cGvHD risk stratification, which serves as the most refined and validated prognostic tool for estimating survival of patients with cGvHD. However, cGvHD global severity scoring has recently evolved as a powerful prognostic tool for patient survival in the post-NIH consensus era. Current use of the substantially redefined NIH criteria of cGvHD diagnosis and measurements of its severity makes it challenging to interpret prognostic scoring systems generated in the pre-NIH era. Some of the pre-NIH prognostic parameters, however, appear to retain their significance in predicting survival independently from the NIH global severity score. Thus, future analyses of prospective cohorts of patients with cGvHD defined by NIH consensus criteria will be critical in reconciling and integrating various prognostic scoring systems of cGvHD.
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Affiliation(s)
- A Lazaryan
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - M Arora
- Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota Medical Center, Minneapolis, MN, USA
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Chen YB, Wang T, Hemmer MT, Brady C, Couriel DR, Alousi A, Pidala J, Urbano-Ispizua A, Choi SW, Nishihori T, Teshima T, Inamoto Y, Wirk B, Marks DI, Abdel-Azim H, Lehmann L, Yu L, Bitan M, Cairo MS, Qayed M, Salit R, Gale RP, Martino R, Jaglowski S, Bajel A, Savani B, Frangoul H, Lewis ID, Storek J, Askar M, Kharfan-Dabaja MA, Aljurf M, Ringden O, Reshef R, Olsson RF, Hashmi S, Seo S, Spitzer TR, MacMillan ML, Lazaryan A, Spellman SR, Arora M, Cutler CS. GvHD after umbilical cord blood transplantation for acute leukemia: an analysis of risk factors and effect on outcomes. Bone Marrow Transplant 2016; 52:400-408. [PMID: 27941764 PMCID: PMC5332289 DOI: 10.1038/bmt.2016.265] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/12/2016] [Accepted: 08/28/2016] [Indexed: 11/15/2022]
Abstract
Using the Center for International Blood and Marrow Transplant Research (CIBMTR) registry, we analyzed 1,404 UCBT patients [single (< 18 years) = 810, double (≥ 18 years) = 594] with acute leukemia to define the incidence of acute and chronic graft-vs.-host disease (GVHD), analyze clinical risk factors and investigate outcomes. After single UCBT, 100-day incidence of grades II–IV aGVHD was 39% (95% CI, 36–43%), grades III–IV aGVHD was 18% (95% CI, 15–20%), and 1-year cGVHD was 27% (95% CI, 24–30%). After double UCBT, 100-day incidence of grades II–IV aGVHD was 45% (95% CI, 41%–49%), grades III–IV aGVHD was 22% (95% CI, 19–26%), and 1-year cGVHD was 26% (95% CI, 22–29%). For single UCBT, multivariate analysis showed that absence of anti-thymocyte globulin (ATG) was associated with aGVHD, whereas prior aGVHD was associated with cGVHD. For double UCBT, absence of ATG and myeloablative conditioning were associated with aGVHD, while prior aGVHD predicted for cGVHD. Grades III–IV aGVHD led to worse survival whereas cGVHD had no significant effect on disease-free or overall survival. GVHD is prevalent after UCBT with severe aGVHD leading to higher mortality. Future research in UCBT should prioritize prevention of GVHD.
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Affiliation(s)
- Y-B Chen
- Massachusetts General Hospital, Boston, MA, USA
| | - T Wang
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI, USA
| | - M T Hemmer
- Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - C Brady
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - D R Couriel
- Utah Blood and Marrow Transplant Program, Adults, Salt Lake City, UT, USA
| | - A Alousi
- Division of Cancer Medicine, Department of Stem Cell Transplantation, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - J Pidala
- H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - A Urbano-Ispizua
- Department of Hematology, Hospital Clinic, University of Barcelona, IDIBAPS and Institute of Research Josep Carreras, Barcelona, Spain
| | - S W Choi
- The University of Michigan, Ann Arbor, MI, USA
| | - T Nishihori
- Department of Blood and Marrow Transplantation, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - T Teshima
- Kyushu University Hospital, Fukuoka, Japan
| | - Y Inamoto
- Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - B Wirk
- Division of Bone Marrow Transplant, Seattle Cancer Care Alliance, Seattle, WA, USA
| | - D I Marks
- Adult Bone Marrow Transplant, University Hospitals Bristol NHS Trust, Bristol, UK
| | - H Abdel-Azim
- Division of Hematology, Oncology and Blood and Marrow Transplantation, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - L Lehmann
- Dana-Farber Cancer Institute/Boston Children's Hospital, Boston, MA, USA
| | - L Yu
- Division of Hematology/Oncology and HSCT, The Center for Cancer and Blood Disorders, Children's Hospital/Louisiana State University Medical Center, New Orleans, LA, USA
| | - M Bitan
- Department of Pediatric Hematology/Oncology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - M S Cairo
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Department of Pediatrics, New York Medical College, Valhalla, NY, USA
| | - M Qayed
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, Australia
| | - R Salit
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - R P Gale
- Hematology Research Centre, Division of Experimental Medicine, Department of Medicine, Imperial College London, London, UK
| | - R Martino
- Division of Clinical Hematology, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - S Jaglowski
- Division of Hematology, The Ohio State University Medical Center, Columbus, OH, USA
| | - A Bajel
- Royal Melbourne Hospital City Campus, Melbourne, Victoria, Australia
| | - B Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - H Frangoul
- Division of Hematology-Oncology, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - I D Lewis
- Haematology and Bone Marrow Transplant Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - J Storek
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - M Askar
- Baylor University Medical Center, Dallas, TX, USA
| | - M A Kharfan-Dabaja
- Department of Blood and Marrow Transplantation, H Lee Mofitt Cancer Center and Research Institute, Tampa, FL, USA
| | - M Aljurf
- Department of Oncology, King Faisal Specialist Hospital Center and Research, Riyadh, Saudi Arabia
| | - O Ringden
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - R Reshef
- Blood and Marrow Transplantation Program and Columbia Center for Translational Immunology, Columbia University Medical Center, New York, NY, USA
| | - R F Olsson
- Division of Therapeutic Immunology, Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Clinical Research Sormland, Uppsala University, Uppsala, Sweden
| | - S Hashmi
- Mayo Clinic Rochester, Rochester, MN, USA
| | - S Seo
- National Cancer Research Center, East Hospital, Kashiwa, Chiba, Japan
| | - T R Spitzer
- Massachusetts General Hospital, Boston, MA, USA
| | - M L MacMillan
- University of Minnesota Medical Center, Fairview, Minneapolis, MN, USA
| | - A Lazaryan
- University of Minnesota Medical Center, Fairview, Minneapolis, MN, USA
| | - S R Spellman
- Center for International Blood and Marrow Transplant Research, National Marrow Donor Program/Be The Match, Minneapolis, MN, USA
| | - M Arora
- Division of Hematology, Oncology, Transplantation, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA
| | - C S Cutler
- Center for Hematologic Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
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Hamilton B, Lazaryan A, McLellan L, Rybicki L, Foster L, Cooper M, Dabney J, Tench S, Sobecks R, Duong H, Kalaycio M, Bolwell B, Copelan E. Quality of Life and Psychosocial Functioning After Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) from Matched Sibling Compared to Unrelated Donors. Biol Blood Marrow Transplant 2012. [DOI: 10.1016/j.bbmt.2011.12.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Lazaryan A, Kalmadi S, Almhanna K, Pelley R, Kim R. Predictors of clinical outcomes of resected ampullary adenocarcinoma: a single-institution experience. Eur J Surg Oncol 2011; 37:791-7. [PMID: 21741199 DOI: 10.1016/j.ejso.2011.06.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 05/25/2011] [Accepted: 06/14/2011] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND In the absence of prospective data, the use of adjuvant therapy in ampullary adenocarcinoma is contingent upon the clinicopathological features which can correlate to 5-year post-operative survival and disease relapse. METHODS We investigated the factors associated with clinical outcomes among 72 patients who underwent pancreatoduodenectomy at the Cleveland Clinic from 1995 to 2007 for histologically confirmed adenocarcinoma of the ampulla of Vater. RESULTS R0 resection was achieved in 96% of patients (median age, 72 years; 58% males, 89% Caucasians). Nineteen patients experienced disease relapse after surgery and 61% were alive within 5 years of follow up. Thirty five percent of patients received some form of adjuvant therapy. Perineural tumor invasion (p < 0.01) and presence of ulcerated tumor on histopathology (p < 0.01) were associated with higher rates of tumor relapse and poor 5-year overall survival in multivariable analysis. Lymph node involvement (p = 0.02) also portended poor overall survival after adjustment for other covariates. Although adjuvant therapy was associated with poor clinical outcomes in univariate analysis, it demonstrated a favorable albeit non-significant trend in multivariable analysis. CONCLUSIONS Factors associated with poor clinical outcomes in this contemporary single-institution study, included perineural invasion, tumor ulceration, and lymph node involvement. No definite conclusion could be made in regards to adjuvant treatment.
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Affiliation(s)
- A Lazaryan
- Cleveland Clinic Taussig Cancer Institute, R35, Cleveland OH 44195, USA
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Bejanyan N, Lazaryan A, Rybicki L, Tench S, Andresen S, Sobecks R, Dean R, Pohlman B, Kalaycio M, Bolwell B, Copelan E. Sustained High-Dose Corticosteroid Use Does Not Independently Diminish Survival After Myeloablative Allogeneic Hematopoietic Stem Cell Transplantation. Biol Blood Marrow Transplant 2011. [DOI: 10.1016/j.bbmt.2010.12.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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14
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Almhanna K, Lazaryan A, Kalmadi S, Kim RD, Saxton JP, Lavery I, Foazio V, Kay E, Pelley R. Predictors of recurrence after definitive chemoradiation for anal cancer: The Cleveland Clinic experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lazaryan A, Almhanna K, Elson P, Kalmadi S, Vogt D, Walsh M, Henderson M, Pelley R, Kim RD. Factors associated with tumor recurrence and 5-year postoperative survival in ampullary carcinoma: Cleveland Clinic Experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Tsao RE, Almhanna K, Lazaryan A, Elson P, Pelley R, Kim RD, Walsh M, Henderson M, Vogt D. Is adjuvant radiation plus chemotherapy for resectable pancreatic adenocarcinoma associated with improved survival? The Cleveland Clinic experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Kim RD, Lazaryan A, Aucejo F, Eghtesad B, Pelley R, Fung J, Miller C, Yerian L. Vascular endothelial growth factor receptor 2 (VEGFr2) expression and recurrence of hepatocellular carcinoma following liver transplantation: The Cleveland Clinic experience. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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18
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Pamboukian S, Sanderson B, Lazaryan A, Bittner V. 284. J Heart Lung Transplant 2006. [DOI: 10.1016/j.healun.2005.11.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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