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Kazuhiro Kitajima - One of the best experts on this subject based on the ideXlab platform.
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accuracy of integrated fdg pet contrast enhanced ct in detecting pelvic and Paraaortic Lymph Node metastasis in patients with uterine cancer
European Radiology, 2009Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Yasushi Kaji, Kazuro SugimuraAbstract:The purpose is to evaluate the accuracy of integrated 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in detecting pelvic and Paraaortic Lymph Node metastasis in patients with uterine cancer, with surgical and histopathological findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after PET/CT. PET/CT findings were interpreted by two experienced radiologists in consensus. The criterion for malignancy on PET/CT images was increased tracer uptake by the Lymph Node, independent of Node size. The overall Node-based sensitivity, specificity, PPV, NPV and accuracy of PET/CT for detecting nodal metastases were 51.1% (23/45), 99.8% (1,927/1,931), 85.2% (23/27), 98.9% (1,927/1,949) and 98.7% (1,950/1,976), respectively. The sensitivity for detecting metastatic lesions 4 mm or less in short-axis diameter was 12.5% (2/16), that for between 5 and 9 mm was 66.7% (16/24), and that for 10 mm or larger was 100.0% (5/5). The overall patient-based sensitivity, specificity, positive predictive value ((PPV), negative predictive value (NPV), and accuracy were 50% (6/12), 90.9% (30/33), 66.7% (6/9), 83.3% (30/36) and 80.0% (36/45), respectively. Integrated FDG-PET/contrast-enhanced CT is superior to conventional imaging, but only moderately sensitive in predicting Lymph Node metastasis preoperatively in patients with uterine cancer.
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accuracy of 18f fdg pet ct in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer
American Journal of Roentgenology, 2008Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Ichio Fukasawa, Noriyuki Inaba, Yasushi Kaji, Kazuro SugimuraAbstract:OBJECTIVE. The objective of our study was to evaluate the accuracy of integrated PET and CT (PET/CT) using 18F-FDG in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer, using surgical and histopathologic findings as the reference standard.SUBJECTS AND METHODS. Forty patients with clinical stages IA to IIIC underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after FDG PET/CT. Lymphadenectomy involved removing all visible Lymph Nodes in the surgical fields. PET/CT findings were interpreted by two experienced radiologists in consensus and compared with histopathologic results. The criterion for malignancy on PET/CT images was increased radiotracer uptake by a Lymph Node independent of Node size.RESULTS. In total, 62 pathologically positive Nodes were found in 10 patients and 60 of 62 dissected metastatic Nodes were identified on the CT component. The overall Node-based sensitivity, specificity, and accuracy of PE...
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Accuracy of 18F-FDG PET/CT in Detecting Pelvic and Paraaortic Lymph Node Metastasis in Patients with Endometrial Cancer
American Journal of Roentgenology, 2008Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Ichio Fukasawa, Noriyuki Inaba, Yasushi Kaji, Kazuro SugimuraAbstract:OBJECTIVE. The objective of our study was to evaluate the accuracy of integrated PET and CT (PET/CT) using 18F-FDG in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer, using surgical and histopathologic findings as the reference standard.SUBJECTS AND METHODS. Forty patients with clinical stages IA to IIIC underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after FDG PET/CT. Lymphadenectomy involved removing all visible Lymph Nodes in the surgical fields. PET/CT findings were interpreted by two experienced radiologists in consensus and compared with histopathologic results. The criterion for malignancy on PET/CT images was increased radiotracer uptake by a Lymph Node independent of Node size.RESULTS. In total, 62 pathologically positive Nodes were found in 10 patients and 60 of 62 dissected metastatic Nodes were identified on the CT component. The overall Node-based sensitivity, specificity, and accuracy of PE...
Seung Hyuk Baik - One of the best experts on this subject based on the ideXlab platform.
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oncologic outcomes of colon cancer patients with extraregional Lymph Node metastasis comparison of isolated Paraaortic Lymph Node metastasis with resectable liver metastasis
Annals of Surgical Oncology, 2016Co-Authors: Seung Hyuk BaikAbstract:The treatment strategy and benefit of extended Lymph Node dissection among patients with preoperatively diagnosed Paraaortic Lymph Node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional Lymph Node dissection for colon cancer with isolated PALNM. From March 2000 to December 2009, the study group included 1082 patients who underwent curative surgery for colonic adenocarcinoma with pathological Lymph Node metastasis. Of 1082 patients who underwent curative surgery for colonic carcinoma, 953 (88.1 %) patients underwent regional Lymphadenectomy, and 129 (11.9 %) patients underwent Paraaortic Lymph Node dissection. Pathologic examination revealed N1 stage disease in 738 (68.2 %), N2 in 295 (27.3 %), and PALNM in 49 (4.5 %). Five-year overall survival (OS) and disease-free survival (DFS) rate were significantly better in the regional LNM group than in the PALNM group (OS 75.1 vs. 33.9 %, p < 0.001; DFS 66.2 vs. 26.5 %, p < 0.001). Five-year OS and DFS were not significantly different between the PALNM and resectable liver metastasis patients who underwent curative resection (OS 33.9 vs. 38.7 %, p = 0.080; DFS 26.5 vs. 27.6 %, p = 0.604). PALNM in colon cancer is associated with poorer survival than regional Lymph Node metastasis and showed comparable survival rates with metastasectomy for liver metastasis. Further studies evaluating the net benefit of upfront chemotherapy compared with initial resection for patients with potentially resectable PALNM are needed.
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Oncologic Outcomes of Colon Cancer Patients with Extraregional Lymph Node Metastasis: Comparison of Isolated Paraaortic Lymph Node Metastasis with Resectable Liver Metastasis
Annals of Surgical Oncology, 2015Co-Authors: Seung Hyuk BaikAbstract:Background The treatment strategy and benefit of extended Lymph Node dissection among patients with preoperatively diagnosed Paraaortic Lymph Node metastasis (PALNM) in colon cancer remains highly controversial. In the current study, we analyzed the oncologic outcomes of patients who underwent extraregional Lymph Node dissection for colon cancer with isolated PALNM.
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isolated Paraaortic Lymph Node recurrence after the curative resection of colorectal carcinoma
Journal of Surgical Oncology, 2008Co-Authors: Seung Kook Sohn, Seung Hyuk BaikAbstract:Background and objectives Isolated Paraaortic Lymph-Node recurrence (IPLR) after curative surgery for colorectal carcinoma is rare and no previous report has specifically addressed this type of recurrence. We investigated the clinical features of IPLR and analyzed prognostic factors. Methods Of 2,916 patients who underwent curative surgery for colorectal carcinoma, IPLR was identified in 38 patients (1.3%). The clinical features and prognostic factors of these patients were analyzed. Results IPLR was first detected by increased serum carcinoembryonic antigen (CEA) levels (63.2%) or by routine follow-up computed tomography (CT) (36.8%). Curative resection of IPLR was performed in six patients (15.8%). A total of 19 patients (50.0%) received chemoradiation therapy and 13 patients (34.2%) received chemotherapy only. The median survival from IPLR was 13 months (range: 5–60 months). The median survival time from IPLR for the resected patients was 34 months, whereas it was 12 months for those who did not undergo resection (P = 0.034). The factors associated with the prognosis were histological grade (P = 0.003), location (P = 0.032), and resection of IPLR (P = 0.034). Conclusions IPLR after curative surgery for colorectal carcinoma is rare. Although it is generally associated with poor prognosis, better survival might be achieved through curative resection in selected cases. J. Surg. Oncol. 2008;97:136–140. © 2007 Wiley-Liss, Inc.
Kazuro Sugimura - One of the best experts on this subject based on the ideXlab platform.
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accuracy of integrated fdg pet contrast enhanced ct in detecting pelvic and Paraaortic Lymph Node metastasis in patients with uterine cancer
European Radiology, 2009Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Yasushi Kaji, Kazuro SugimuraAbstract:The purpose is to evaluate the accuracy of integrated 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography ((CT) with intravenous contrast medium in detecting pelvic and Paraaortic Lymph Node metastasis in patients with uterine cancer, with surgical and histopathological findings used as the reference standard. Forty-five patients with endometrial or uterine cervical cancer underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after PET/CT. PET/CT findings were interpreted by two experienced radiologists in consensus. The criterion for malignancy on PET/CT images was increased tracer uptake by the Lymph Node, independent of Node size. The overall Node-based sensitivity, specificity, PPV, NPV and accuracy of PET/CT for detecting nodal metastases were 51.1% (23/45), 99.8% (1,927/1,931), 85.2% (23/27), 98.9% (1,927/1,949) and 98.7% (1,950/1,976), respectively. The sensitivity for detecting metastatic lesions 4 mm or less in short-axis diameter was 12.5% (2/16), that for between 5 and 9 mm was 66.7% (16/24), and that for 10 mm or larger was 100.0% (5/5). The overall patient-based sensitivity, specificity, positive predictive value ((PPV), negative predictive value (NPV), and accuracy were 50% (6/12), 90.9% (30/33), 66.7% (6/9), 83.3% (30/36) and 80.0% (36/45), respectively. Integrated FDG-PET/contrast-enhanced CT is superior to conventional imaging, but only moderately sensitive in predicting Lymph Node metastasis preoperatively in patients with uterine cancer.
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accuracy of 18f fdg pet ct in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer
American Journal of Roentgenology, 2008Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Ichio Fukasawa, Noriyuki Inaba, Yasushi Kaji, Kazuro SugimuraAbstract:OBJECTIVE. The objective of our study was to evaluate the accuracy of integrated PET and CT (PET/CT) using 18F-FDG in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer, using surgical and histopathologic findings as the reference standard.SUBJECTS AND METHODS. Forty patients with clinical stages IA to IIIC underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after FDG PET/CT. Lymphadenectomy involved removing all visible Lymph Nodes in the surgical fields. PET/CT findings were interpreted by two experienced radiologists in consensus and compared with histopathologic results. The criterion for malignancy on PET/CT images was increased radiotracer uptake by a Lymph Node independent of Node size.RESULTS. In total, 62 pathologically positive Nodes were found in 10 patients and 60 of 62 dissected metastatic Nodes were identified on the CT component. The overall Node-based sensitivity, specificity, and accuracy of PE...
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Accuracy of 18F-FDG PET/CT in Detecting Pelvic and Paraaortic Lymph Node Metastasis in Patients with Endometrial Cancer
American Journal of Roentgenology, 2008Co-Authors: Kazuhiro Kitajima, Koji Murakami, Erena Yamasaki, Ichio Fukasawa, Noriyuki Inaba, Yasushi Kaji, Kazuro SugimuraAbstract:OBJECTIVE. The objective of our study was to evaluate the accuracy of integrated PET and CT (PET/CT) using 18F-FDG in detecting pelvic and Paraaortic Lymph Node metastasis in patients with endometrial cancer, using surgical and histopathologic findings as the reference standard.SUBJECTS AND METHODS. Forty patients with clinical stages IA to IIIC underwent radical hysterectomy, including pelvic Lymphadenectomy with or without Paraaortic Lymphadenectomy, after FDG PET/CT. Lymphadenectomy involved removing all visible Lymph Nodes in the surgical fields. PET/CT findings were interpreted by two experienced radiologists in consensus and compared with histopathologic results. The criterion for malignancy on PET/CT images was increased radiotracer uptake by a Lymph Node independent of Node size.RESULTS. In total, 62 pathologically positive Nodes were found in 10 patients and 60 of 62 dissected metastatic Nodes were identified on the CT component. The overall Node-based sensitivity, specificity, and accuracy of PE...
Olaf Ortmann - One of the best experts on this subject based on the ideXlab platform.
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Long-term outcome of patients with intermediate- and high-risk endometrial cancer after pelvic and Paraaortic Lymph Node dissection: a comparison of laparoscopic vs. open procedure
Journal of Cancer Research and Clinical Oncology, 2020Co-Authors: Thomas Papathemelis, Helen Oppermann, Stella Grafl, Michael Gerken, Armin Pauer, Sophia Scharl, Anton Scharl, Elisabeth Inwald, Atanas Ignatov, Olaf OrtmannAbstract:Objective The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and Paraaortic Lymph Node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery. Methods This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan–Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250). Results We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable ( p = 0.002; PSM: p = 0.016) and multivariable analyses ( p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival ( p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding ( p = 0.108; PSM: p = 0.118). Conclusions Our study provides evidence that laparoscopic systematic Lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
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long term outcome of patients with intermediate and high risk endometrial cancer after pelvic and Paraaortic Lymph Node dissection a comparison of laparoscopic vs open procedure
Journal of Cancer Research and Clinical Oncology, 2020Co-Authors: Thomas Papathemelis, Helen Oppermann, Stella Grafl, Michael Gerken, Armin Pauer, Sophia Scharl, Anton Scharl, Elisabeth Inwald, Atanas Ignatov, Olaf OrtmannAbstract:The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and Paraaortic Lymph Node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery. This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan–Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250). We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable (p = 0.002; PSM: p = 0.016) and multivariable analyses (p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival (p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding (p = 0.108; PSM: p = 0.118). Our study provides evidence that laparoscopic systematic Lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
Thomas Papathemelis - One of the best experts on this subject based on the ideXlab platform.
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Long-term outcome of patients with intermediate- and high-risk endometrial cancer after pelvic and Paraaortic Lymph Node dissection: a comparison of laparoscopic vs. open procedure
Journal of Cancer Research and Clinical Oncology, 2020Co-Authors: Thomas Papathemelis, Helen Oppermann, Stella Grafl, Michael Gerken, Armin Pauer, Sophia Scharl, Anton Scharl, Elisabeth Inwald, Atanas Ignatov, Olaf OrtmannAbstract:Objective The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and Paraaortic Lymph Node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery. Methods This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan–Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250). Results We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable ( p = 0.002; PSM: p = 0.016) and multivariable analyses ( p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival ( p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding ( p = 0.108; PSM: p = 0.118). Conclusions Our study provides evidence that laparoscopic systematic Lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
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long term outcome of patients with intermediate and high risk endometrial cancer after pelvic and Paraaortic Lymph Node dissection a comparison of laparoscopic vs open procedure
Journal of Cancer Research and Clinical Oncology, 2020Co-Authors: Thomas Papathemelis, Helen Oppermann, Stella Grafl, Michael Gerken, Armin Pauer, Sophia Scharl, Anton Scharl, Elisabeth Inwald, Atanas Ignatov, Olaf OrtmannAbstract:The primary therapy for intermediate- and high-risk endometrial cancer includes pelvic and Paraaortic Lymph Node evaluation. Laparoscopic surgery is an increasingly popular intervention due to decreased risk and better short-term morbidity; however, a recent study casts doubt on the benefit of this approach in terms of oncological safety. In this cancer registry study, we sought to evaluate the benefit of laparoscopy versus laparotomy and retrospectively compared overall survival, recurrence rates, and recurrence-free survival among patients with intermediate- and high-risk endometrial cancer who underwent either laparoscopic or open surgery. This observational study included 419 patients who have been treated from 2011 to 2017. We employed Kaplan–Meier method, and univariable and multivariable Cox-regression to compare overall survival, recurrence rates, and recurrence-free survival in 110 patients, who underwent laparoscopic, with 309 patients, who underwent open surgery. To address the confounding bias in this retrospective study, we also performed a propensity score matching (PSM) analysis including 357 patients (laparoscopy: n = 107; open surgery: n = 250). We found a benefit for laparoscopic over open surgery in patients with intermediate- and high-risk endometrial cancer for overall survival in both univariable (p = 0.002; PSM: p = 0.016) and multivariable analyses (p = 0.019; PSM: p = 0.007). In contrast, there was no statistically significant difference between both patient groups regarding the cumulative recurrence rates. A univariable analysis identified a significant benefit for laparoscopy regarding recurrence-free survival (p = 0.003; PSM: p = 0.029) but a multivariable analysis failed to confirm this finding (p = 0.108; PSM: p = 0.118). Our study provides evidence that laparoscopic systematic Lymphadenectomy does not present a lower oncological efficacy than open surgery in the treatment of patients with endometrial cancer.
