A long-term survival pattern for breast cancer treated in a single institution.

AIM: This paper presents a 14-year retrospective study evaluating the survival rates and prognostic factors of breast carcinoma patients treated in private treatment center in the west coast of Turkey. MATERIALS AND METHODS: The survival rates of breast cancer patients (n = 1746) who have been treated from 1995 until 2008 were analyzed. The clinical data include age, menopausal stage, oestrogen (ER) and progesterone (PR) receptor status, and C-erbB-2 status as well as histopathological evaluation. AJCC (2002) was used for clinical tumor staging. Survival rates were computed using standard Kaplan-Meier methods, and the difference in survival curves was analyzed with the log-rank test. RESULTS: The 14-year overall survival, disease-free survival, local failure-free survival, and distant failure-free survival rates were 77%, 95%, 77%, and 94%, respectively. Early-stage patients had higher overall survival rates compared to advanced-stage patients (stage IIIb and IIIc, AJCC 2002), and early-stage patients had higher survival rates than advanced-stage patients for disease-free survival, local failure-free survival, and distant failure-free survival. The risk for cancer development increases significantly for advanced-stage patients with positive ER and PR receptor as well as C-erbB-2 receptor. CONCLUSIONS: The incidence of breast cancer in Turkey is smaller compared to other European countries. Low advanced-stage patient numbers compared to high early-stage patient numbers; and very high median survival times could possibly be the result of the improvement of detection and treatment of breast cancer over the years.

Evaluation of overall survival of nasopharyngeal carcinoma patients treated in ten years at a single institution.

PURPOSE: To evaluate the survival rates and prognostic factors of nasopharyngeal carcinoma (NPC) patients treated in Izmir Oncology Center (IOC). METHODS: The survival of 58 NPC patients (median age 52.5 years) treated from 1998 to 2008 were retrospectively analysed. Histological evaluation was based on WHO criteria. AJCC (1997), as well as the new proposed evaluation system by Liu (2008) for clinical staging were used. Most patients received concurrent chemoradiotherapy, some were given neoadjuvant chemotherapy (nCT). Radiotherapy (RT) was delivered by conventional technique to a total dose of 70Gy to the primary tumor and metastatic lymph nodes. RESULTS: The 5-year overall survival, disease-free survival, local failure-free survival, and distant failure-free survival rates were 55, 36, 58 and 59%, respectively. The median overall survival was 55.78 months. WHO type II disease was found in 55.2% of the patients. There was only 1 lymphoma patient. Concurrent chemoradiotherapy was given to 74.1% and nCT to 12.1% of the patients. Advanced-stage disease was determined in 81.1% of the patients; 27.6% of these had stage IV disease. Early-stage disease was infrequent (6 patients - T1N0 and T2N0) in both staging systems. No significant difference was found between disease-free survival vs. local failure-free survival, and distant failure-free survival vs. local failure-free survival for the different treatment groups (p=0.92). Male patients with WHO type II pathology had a greater risk for distant metastases. CONCLUSION: Both staging systems yielded similar results with no significant differences in survival rates but male patients and patients with type II pathology were at greater risk of distant metastases.

A case with three different synchronous primaries of the female genital system and their treatment.

Multiple carcinomas of the genital system are rare in the literature. We report a 43-year-old female patient who presented with 3 different synchronous primary genital system malignancies (cervix, endometrium and ovary). After Wertheim's hysterectomy there was a 4 x 2 cm residual mass for which systemic chemotherapy and radiotherapy were administered. The patient rapidly deteriorated and died due to disease progression. Registration of cases with multiple tumors in a single centre using a standardized investigation for predisposing parameters may contribute much to the management of such conditions.

Combined administration of ethodolac, ascorbic acid and radiotherapy as adjuvant therapies in an extrathoracic desmoid tumor with gross postoperative residual disease; case report and review of the literature.

A 37-year-old man was admitted with an extrathoracic desmoid tumor invading the brachial plexus. Magnetic resonance imaging (MRI) of the thorax demonstrated a 20 x 9 x 14 cm mass in the supraclavicular fossa, axillary fossa and the right side of the chest. It invaded the brachial plexus and circumscribed the subclavian and axillary arteries concentrically. Biopsy revealed desmoid tumor which was resected subtotally with the brachial plexus. The gross residual mass was treated postoperatively with radiotherapy (60 Gy) which resulted in major regression of the mass. Following radiotherapy, ethodolac with ascorbic acid were administered. The tumor was clinically indiscernible 35 months post-radiotherapy. This case shows the high effectiveness of radiotherapy along with less toxic medical treatment modalities in instances where local control is hard to achieve with surgery and highlights the importance of using multidisciplinary treatments to maintain good functional results.

Isolated inguinal lymph node metastasis from breast carcinoma--case report and review of the literature.

We report on a case of a premenopausal woman with breast cancer and unusual dissemination with isolated inguinal and iliac lymph node metastasis. The primary tumor was T2N0M0. After mastectomy the patient received adjuvant chemotherpy, hormonotherapy and radiotherapy (RT). Painful edema developed at the right leg 69 months after the operation. Diagnostic investigations revealed isolated right inguinal and iliac lymphadenopathy (LAP). Tru-cut aspiration biopsy was reported as negative. Four months later, abdominal magnetic resonance imaging (MRI) disclosed paraaortic and bilateral iliac and inguinal LAP. Pathological assessment of the right inguinal LAP confirmed a metastasis from breast cancer. After unsuccesful chemotherapy, palliative RT was performed to the inguinal, iliac and paraaortic lymph nodes, resulting in partial response. The patient ultimately died because of disease progression. Clinicians should maintain a high degree of suspicion when coming across with unusual complaints and findings in patients with breast cancer.