levoleucovorin and Peripheral-Nervous-System-Neoplasms

The prognostic significance of perineural and/or lymphovascular invasion (PLVI) and its relationship with tumor regression grade (TRG) in patients with locally advanced rectal cancer (LARC) treated with neoadjuvant chemoradiotherapy (CRT) and surgery.. A total of 324 patients with LARC were treated with CRT and operated on between January 1992 and June 2007. Tumors were graded using a quantitative 5-grade TRG classification and the presence of PLVI was histologically studied.. At a median follow-up of 79.0 months (range 3-250 months), a total of 80 patients (24.7%) relapsed. The observed 5- and 10-year overall survival (OS) was 83.2 and 74.9 %, respectively. The 5- and 10-year disease-free survival (DFS) was 75.1 and 71.4%, respectively. A significant correlation was found between the TRG and survival (log rank, p < 0.001). The 10-year OS was 32.7% for grade 1, 63.8% for grade 2, 75.0% for grade 3, 90.4% for grade 3+, and 96.0%,for grade 4. The 10-year DFS was 31.8% for grade 1, 58.6% for grade 2, 70.4% for grade 3, 88.4% for grade 3+, and 97.1% for grade 4. In patients with PLVI, the TRG had no impact on survival. When excluding patients with PLVI, the TRG was an independent prognostic factor for OS and DFS.. The presence of PLVI is a more powerful prognostic factor than TRG in LARC patients treated with neoadjuvant CRT followed by surgery. PLVI denotes an aggressive phenotype, suggesting that these patients may benefit from adjuvant systemic therapy.

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Chemoradiotherapy; Combined Modality Therapy; Female; Fluorouracil; Follow-Up Studies; Humans; Leucovorin; Lymphatic Metastasis; Male; Middle Aged; Neoadjuvant Therapy; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Organoplatinum Compounds; Oxaliplatin; Peripheral Nervous System Neoplasms; Postoperative Period; Prognosis; Rectal Neoplasms; Remission Induction; Survival Rate

Pelvic schwannomas are rare; it is even more rare for a pelvic schwannoma to occur concurrently with a colon cancer. The authors report the case of a 62-year-old woman with a cecal mass that was surgically removed and the histopathologic diagnosis was adenocarcinoma of the colon. Meanwhile, aretroperitonealpelvic nodalmasswas detected as questionable metastasis of the primary tumor. A subsequent computed tomography-guided fine-needle biopsy was carried out to establish the tumor stage. Surprisingly, the fine-needle biopsy revealed a benign schwannoma. This unusual case posed a dilemma in postoperative staging of the colon cancer.

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Biopsy, Fine-Needle; Carcinoembryonic Antigen; Cecum; Colonic Neoplasms; Combined Modality Therapy; Female; Fluorouracil; Humans; Leucovorin; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Neoplasms, Multiple Primary; Neurilemmoma; Organoplatinum Compounds; Oxaliplatin; Pelvic Neoplasms; Peripheral Nervous System Neoplasms; Tomography, X-Ray Computed