ABSTRACT
Objectives@#. To investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal cancers (NPCs) treated with concurrent chemoradiotherapy (C-CRT). @*Methods@#. The pre-C-CRT FDG PET-CT scans of 104 patients with NPC (cT1-4 N0-3 M0) were retrospectively examined to determine the presence of PP (PP+). Our primary endpoint was the influence of PP+ on overall survival (OS), while the progression-free survival (PFS) and locoregional PFS (LRPFS) constituted the secondary endpoints. @*Results@#. The PP+ was detected in 29 (27.9%): nine (8.7%), seven (6.7%), and 13 (12.5%) in the primary tumor alone, primary tumor plus neck nodes, and neck nodes alone, respectively. Because the PP+ cases were small by count per location, all comparative analyses were performed according to overall PP+/ PP– status instead of per detected site. At a median follow-up of 67.8 months (range, 9 to 130 months), the median survival times were not reached (NR) for the entire population, while 5-year OS, LRPFS, and PFS rates were 73.3%, 68.2%, and 63.4%, respectively. Comparatively the PP+ patients exhibited significantly poorer median OS (49.8 months vs. NR, P<0.001), LRPFS (40.7 months vs. NR, P=0.001), and PFS (31.8 months vs. NR, P=0.002) durations than their PP– counterparts. Furthermore, the PP+ retained its independent prognostic significance in multivariate analysis (P<0.001). @*Conclusion@#. Present results uncovered the pre-C-CRT PP as an independent predictor of poor prognosis for NPC patients, which underscore the requirement for the fortification of the local and systemic treatments in hypoxic NPCs.
ABSTRACT
Optimal management if male breast cancer [MBC] is not clearly established and treatment guidelines are scarce. We evaluated our own results in the treatment of male breast cancer patients with respect to local control [LC], overall survival [OS] and possible prognostic factors for survival. Thirty-nine patients with MBC were retrospectively studied to evaluate the results in this type of tumor; 94.8% had invasive ductal carcinoma [IDC], 2.6% invasive papillary carcinoma [IDC] and 2.6% invasive lobuler carcinoma [ILC]. The distribution according to stage was 12.8%, 46.2%, 30.7% and 10.3% in Stages I, II, III and IV, respectively; 7.7% underwent radiotherapy [RT] +/- hormonotherapy [HT], 22.8% had chemotherapy [CT], 61.8% had chemoradiotherapy [CRT] +/- HT and 7.7% had HT in addition to surgery. The distant metastases rate was 36% and the local recurrence rate was 5%. All the local recurrences and the distant metastases had occurred after the first two years. The 2-year disease free survival [DFS] and OS rates were 87.2% and 89.7%, respectively, and the 5-year DFS and OS rates were 65.8% and 80.1%, respectively. In a univariate analysis for OS, statistical significance was found for lymph node metastases [P=.00001], stage [P=.0098] and age [P=.03], while presence of RT in the treatment modality [P=.6849], and tumor size [P=.4439] demonstrated no significance. The presence of lymph node metastases significantly impaired OS [P=.004] and DPS [P=.014] in the multivariate analysis. Postoperative radiotherapy was important in the management of MBC to improve LC resulting in one local failure, but did not improve OS and DFS. The presence of lymph node metastases significantly impaired OS and DFS