Early salvageUsually neo-adjuvant chemotherapyChemotherapyRadiotherapy groupRecurrentRecurrenceRisk for all-cause mortaToxicityTherapyNivolumabTemozolomidePostprostatectomySurvivalMetastasesTreatmentUnderwentObservationPathologicRadicalBiochemicalOncologyFailureSurgeryTherapiesClinicalProstateLymphResults
Early salvage16
- In a retrospective cohort study reported in the Journal of Clinical Oncology , Tilki et al found that adjuvant radiotherapy was associated with reduced risk for all-cause mortality vs early salvage radiotherapy among men at high risk for disease recurrence following radical prostatectomy. (ascopost.com)
- As stated by the investigators, "Three randomized trials and an associated meta-analysis found no difference in progression-free survival when comparing adjuvant with early salvage radiotherapy, which can cause many physicians to not offer adjuvant radiotherapy, irrespective of the pathologic findings at radical prostatectomy. (ascopost.com)
- We provide evidence to support that adjuvant compared with early salvage radiotherapy may lower the risk of death in men with adverse pathology at radical prostatectomy. (ascopost.com)
- The study cohort consisted of 26,118 men with pT2-4N0 or N1M0 prostate cancer consecutively treated between June 1989 and July 2016 with radical prostatectomy and pelvic lymph node assessment and then followed for potential treatment with adjuvant or early salvage radiotherapy at three German and two U.S. centers. (ascopost.com)
- Analyses included use of a treatment propensity score to minimize potential treatment selection bias in estimating the causal association of adjuvant vs early salvage radiotherapy on all-cause mortality risk. (ascopost.com)
- Analyses were performed to assess the effect of different definitions of adverse pathology on all-cause mortality risk-eg, exclusion of pN1 disease and exclusion of early salvage radiotherapy patients with persistent postsurgery prostate-specific antigen level. (ascopost.com)
- Among the 933, 109 received adjuvant radiotherapy, 379 received no radiotherapy, and 445 received early salvage radiotherapy. (ascopost.com)
- On multivariate analysis, compared with early salvage radiotherapy, men receiving adjuvant radiotherapy had significantly lower risk of all-cause mortality both when patients with pN1 disease were included (adjusted hazard ratio [HR] = 0.61, 95% confidence interval [CI] = 0.41-0.89, P =.01) and when those with pN1 disease were excluded (HR = 0.31, 95% CI = 0.12-0.78, P = .01). (ascopost.com)
- Compared with early salvage radiotherapy, no significant differences in all-cause mortality risk were observed among patients receiving no radiotherapy when pN1 disease was included (HR = 1.09, 95% CI = 0.88-1.36, P = .42) or excluded (HR = 1.14, 95% CI = 0.83-1.57, P = .42). (ascopost.com)
- Compared with early salvage radiotherapy, no significant difference in risk for all-cause mortality was observed among men receiving adjuvant radiotherapy (HR = 0.78, 95% CI = 0.50-1.22, P = .28) or no radiotherapy (HR = 1.07, 95% CI = 0.93-1.23, P = .33). (ascopost.com)
- Nevertheless, the question of whether all patients with the aforementioned adverse features should undergo immediate adjuvant RT versus initial observation with more selective-but early-salvage RT in the event of biochemical failure remains the subject of heated controversy. (jnccn.org)
- Observation with early salvage radiotherapy in cases of biochemical failure should be the standard of care, concluded study co-author Noel Clarke, MBBS, who presented the results at the European Society for Medical Oncology (ESMO) Congress 2023 in Madrid on October 20. (medscape.com)
- The approach of early salvage radiotherapy spared morbidity [from] radiation in the vast majority of patients, and further bowel and bladder toxicity is reduced in the setting of salvage radiotherapy," said Sandhu, an associate professor and consultant medical oncologist at Peter MacCallum Cancer Centre, Victoria, Australia. (medscape.com)
- Overall, the trial results "support the use of early salvage radiotherapy for PSA failure after radical prostatectomy rather than early adjuvant intervention, " concluded Clarke, a professor and consultant urologist at The Christie Hospital and Salford Royal Hospital, Manchester, United Kingdom. (medscape.com)
- Among the 926 men, 538 (58%) received adjuvant radiation, 89 (10%) early salvage radiation therapy, and 299 (32%) observation alone for prostate cancer. (oncologynurseadvisor.com)
- Only the high-risk group benefited from adjuvant radiation therapy, which was significantly associated with a 57% improvement in 10-year overall survival compared with observation with or without early salvage radiation therapy (overall 10-year survival 76% vs 63%), the investigators reported. (oncologynurseadvisor.com)
Usually neo-adjuvant chemotherapy1
- Treatment is usually neo-adjuvant chemotherapy, limb salvage surgical resection, followed by adjuvant chemotherapy. (orthobullets.com)
Chemotherapy5
- Three patients additionally received salvage radiation therapy (sRT) including the prostatic lodge and docetaxel chemotherapy was started in one case. (frontiersin.org)
- Most patients with high grade tumors receive about three months of chemotherapy, known as neo-adjuvant therapy, before surgery. (sarcomahelp.org)
- Considering that adjuvant radiotherapy after surgical resection was effective to decrease loco-regional recurrence and most treatment failures were distant metastasis, multimodal therapy including surgery, radiotherapy, and chemotherapy might be an optimal treatment for uterine carcinosarcoma patients. (e-roj.org)
- ICIs can prolong overall survival (OS) in patients with aUC after platinum-based chemotherapy (either as switch maintenance or salvage therapy). (urotoday.com)
- Upon progression on platinum-based chemotherapy and ICI, there are other therapeutic options, such as enfortumab vedotin, sacituzumab govitecan, erdafitinib (for patients with FGFR2 or FGFR3 activating mutation or fusion), and even salvage chemotherapy. (urotoday.com)
Radiotherapy group1
- However, self-reported urinary and fecal incontinence rates at 1 year were significantly higher in the adjuvant radiotherapy group vs the observation group, 60% of whom had not received salvage radiotherapy at that time. (medscape.com)
Recurrent7
- Objectives: To determine the oncologic outcomes of patients undergoing salvage surgery for recurrent oral cavity squamous cell carcinoma (OCSCC) and oropharyngeal squamous cell carcinoma (OPSCC) after initial treatment with surgery and adjuvant therapy. (wustl.edu)
- The indication for salvage radiotherapy (RT) (SRT) in patients with biochemically-recurrent prostate cancer after surgery is based on prostate-specific antigen (PSA) levels at the time of biochemical recurrence. (wjgnet.com)
- Increasingly discussed salvage treatment of recurrent PCa also demands exact staging ( 4 , 10 , 12 , 13 ). (frontiersin.org)
- Therefore, a systematic review of the literature regarding treatment strategies employed in recurrent pediatric MB will evaluate previous salvage therapies in order to guide future clinical trials. (biomedcentral.com)
- The aim of this systematic review will be to investigate the efficacy and safety of salvage therapies for the management of children with progressive, treatment-refractory, or recurrent MB. (biomedcentral.com)
- In additional analyses, we will investigate the role of re-irradiation and mono- vs. poly-therapy in recurrent disease, and whether molecular subgrouping of MB influences salvage therapy. (biomedcentral.com)
- By reviewing the efficacy and toxicity of MB salvage therapies, this study will identify effective therapeutic strategies administered to recurrent MB patients and can inform future clinical trials aimed to improve patient survivorship and quality of life. (biomedcentral.com)
Recurrence5
- Subjects and Methods: Patients included those with OCSCC and OPSCC who were initially treated with surgery and adjuvant therapy between 2000 and 2015 and underwent salvage surgery for local and/or regional recurrence. (wustl.edu)
- Conclusion: Patients presenting with resectable recurrence after initial therapy with surgery and adjuvant therapy have a reasonable salvage rate when a negative margin resection can be attained. (wustl.edu)
- It should be especially useful in the early identification of men who would benefit from adjuvant postoperative radiation therapy and those who need postoperative salvage radiation therapy for recurrence. (northwestern.edu)
- 18 F-DCFPyL PET/CT has a significant impact on management intent in patients being considered for salvage radiotherapy after RP with PSA recurrence. (snmjournals.org)
- Postoperative radiotherapy adjuvant radiotherapy is controversial because not all patients with adverse pathological findings will have tumor recurrence. (szkitiarock.hu)
Risk for all-cause morta1
- Adjuvant radiation may reduce the risk for all-cause mortality in a subgroup of men with very high-risk adverse pathologic characteristics at the time of radical prostatectomy for prostate cancer, new findings suggest. (oncologynurseadvisor.com)
Toxicity2
- however, sexual toxicity is high with both, and urinary and rectal toxicity is high with salvage surgery. (prostatecancer.news)
- Zareba and Touijer did not report the toxicity of the salvage treatment, but with improved external beam radiation techniques and scrupulous image guidance, toxicity has been improving. (prostatecancer.news)
Therapy10
- Adjuvant radiation therapy should be considered in men with pN1 or [prostatectomy] Gleason score 8 to 10 and pT3/4 PC given the possibility that a significant reduction in all-cause mortality risk exists. (ascopost.com)
- Besides the known oncological benefits of ADT and sRT, in case of sole MLN metastases individualized therapy like salvage lymphadenectomy or RT with a defined radiation field could be options for these patients. (frontiersin.org)
- The application of this model in clinical practice could optimize the use of [adjuvant radiation therapy] by improving survival in selected individuals and avoiding the unnecessary adverse effects of [adjuvant radiation therapy] in others," Dr Mazzone's team concluded. (oncologynurseadvisor.com)
- Adjuvant therapy of ovarian germ cell tumors with cisplatin, etoposide, and bleomycin: a trial of the Gynecologic Oncology Group. (kaiserpermanente.org)
- Patients with nodal meastases, ECS, and poorly differentiated tumors are likely to succumb to their disease and should be selected for adjuvant therapy when possible. (edu.au)
- The patient has been disease-free for 1 year without adjuvant therapy. (bvsalud.org)
- Lenvatinib therapy is one of the promising therapeutic options for thymic carcinoma and may make salvage surgery increasingly useful for advanced thymic carcinoma. (bvsalud.org)
- This study aimed to evaluate the outcomes of salvage metastasectomy after failure of systemic therapy. (melanoma.org.au)
- 4. To prospectively evaluate the IPFSG scoring system as a predictor of outcome to initial salvage therapy in patients with relapsed or refractory GCT. (cincinnatichildrens.org)
- Nivolumab was FDA-approved in August 2021 as adjuvant therapy for patients with high-risk features (based on pathologic stage) after definitive surgery for urothelial cancer. (urotoday.com)
Nivolumab2
- Patients were then planned for treatment with adjuvant nivolumab for 3 months. (bmj.com)
- Another important question is regarding the efficacy of ICI in aUC patients who received ICI in localized settings (ie pembrolizumab in non-muscle invasive bladder cancer or adjuvant nivolumab in muscle-invasive bladder cancer setting). (urotoday.com)
Temozolomide1
- The current standard of care for GBM is maximal resection followed by postoperative radiation with concomitant and adjuvant temozolomide. (medscape.com)
Postprostatectomy1
- In 2010, the dilemma is not in the question of whether postprostatectomy adjuvant or salvage RT are effective among high-risk patients as a group, but rather which individual patients ought to receive it and when. (jnccn.org)
Survival3
- Adjuvant (chemo)reirradiation was not associated with disease control or survival regardless of margin status. (wustl.edu)
- Patients with postoperative positive margins have poor survival outcomes that are not significantly improved with adjuvant (chemo)reirradiation. (wustl.edu)
- The new findings showed no difference in the rate of 10-year freedom from distant metastases or overall survival in patients who received adjuvant radiotherapy vs those who underwent observation with salvage radiotherapy if their disease progressed and provided further confirmation of earlier results reported in The Lancet in 2020 . (medscape.com)
Metastases1
- Failure after salvage radiotherapy is most likely due to disease outside the prostate bed, which can include the pelvic lymph nodes, paraaortic lymph nodes, and distant metastases. (snmjournals.org)
Treatment5
- Although focal retreatment of the prostate using LDRBT has been used after failure of external beam radiation, there have been very few reports of salvage LDRBT after an initial treatment with LDRBT failed. (prostatecancer.news)
- The aim of the present study is to describe the disease-related and treatment-related outcomes of patients undergoing primary and salvage pharyngectomy for cancer of the hypopharynx and larynx over a 10-year period from a single institution. (edu.au)
- Salvage pharyngectomy for radiation failure was performed in 72 patients (52%), and in 66 patients (48%) pharyngectomy was performed as the primary treatment. (edu.au)
- Adjuvant radiotherapy is defined as treatment given directly after surgery in the presence of. (szkitiarock.hu)
- SAN ANTONIO-In the treatment of breast cancer, cardiomyopathy has represented a possible barrier to the use of trastuzumab (Herceptin) in the adjuvant setting. (cancernetwork.com)
Underwent1
- Twenty-five patients (25%) underwent a second salvage surgical procedure, of whom 8 achieved long-term disease control. (wustl.edu)
Observation4
- Adjuvant radiotherapy after radical prostatectomy provided no meaningful benefit in patients with prostate cancer but increased the risk for urinary and bowel morbidity compared with men followed with observation alone, according to the latest results from the phase 3 RADICALS-RT trial. (medscape.com)
- Invited discussant and session co-chair Shahneen Sandhu, MBBS, said that the findings definitively confirm the value of observation with salvage radiotherapy over adjuvant radiotherapy in this patient population. (medscape.com)
- In the study, 697 patients were randomly assigned to adjuvant radiotherapy and 699 to observation with salvage radiotherapy. (medscape.com)
- Patients in the observation arm received salvage radiotherapy if they experienced two consecutive PSA increases ≥ 0.1 ng/mL or three consecutive rises. (medscape.com)
Pathologic1
- Reflecting this, the most recent update of the NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer states "new evidence supports offering adjuvant/salvage RT in all men with adverse pathologic features or detectable PSA" 3 (to view the most recent version of these guidelines, visit the NCCN Web site at www.NCCN.org ). (jnccn.org)
Radical3
- Not all adverse pathology features are equal: Identifying optimal candidates for adjuvant radiotherapy among patients with adverse pathology at radical prostatectomy. (oncologynurseadvisor.com)
- Jun 26, · Simple open prostatectomy differs from radical prostatectomy in that the former consists of enucleation of a hyperplastic prostatic adenoma, and the latter involves removal en bloc of the entire prostate, the seminal vesicles, and the vas deferens. (szkitiarock.hu)
- After radical prostatectomy, two different strategies can be offered, adjuvant or salvage radiotherapy. (szkitiarock.hu)
Biochemical1
- Salvage radiotherapy, most commonly to the prostate bed, results in 5-y biochemical control of 56% ( 3 ). (snmjournals.org)
Oncology1
- Adjuvant and salvage radiotherapy after prostatectomy: American Society of Clinical Oncology clinical practice guideline endorsement. (nih.gov)
Failure1
- As far as other kinds of re-irradiation goes, there has only been a single case report of salvage SBRT after LDRBT failure. (prostatecancer.news)
Surgery3
- The functional consequences of salvage surgery and its effect on quality of life are critical in decision making and require further investigation. (wustl.edu)
- Surgery for squamous cell carcinoma (SCC) arising or extending to the hypopharynx is generally reserved for advanced disease or salvage. (edu.au)
- This study demonstrates that both salvage pharyngectomy and primary surgery for advanced disease are viable options with high locoregional control. (edu.au)
Therapies2
- This systematic review will provide an overview of the current literature regarding salvage therapies for relapsed MB patients. (biomedcentral.com)
- Salvage focal cryotherapy, as well as other focal ablative therapies may increasingly be used for this purpose. (prostatecancer.news)
Clinical1
- Although there are clear criteria (pT3-pT4 disease and/or positive margins) for the use of adjuvant radiotherapy, no specific clinical or tumour-related criteria have yet been defined for SRT. (wjgnet.com)
Prostate2
- Are all prostate cancer patients 'fit' for salvage radiotherapy? (wjgnet.com)
- González-San Segundo C, Gómez-Iturriaga A, Couñago F. Are all prostate cancer patients "fit" for salvage radiotherapy? (wjgnet.com)
Lymph1
- Is it still worthwhile to attempt salvage radiation (SRT) after positive pelvic lymph nodes ( PLN ) have been pathologically detected (stage pN1 )? (prostatecancer.news)
Results1
- Per ASCO guidelines , Decipher results should help to guide post-prostatectomy adjuvant or salvage radiation. (medscape.com)