Publications by authors named "Christopher Scally"
Article Synopsis
- Malignant peripheral nerve sheath tumors (MPNSTs) show altered DNA methylation patterns, suggesting these changes could be used as specific biomarkers for NF1 patient screening.
- Researchers conducted a study involving DNA methylation profiling from tumor and adjacent tissue samples of 13 MPNST patients, finding 73 candidate CpGs that could distinguish MPNSTs from neurofibromas.
- Five validated biomarkers demonstrated high sensitivity and specificity in tissue detection, and higher methylation levels were observed in plasma tests, indicating potential for early detection of MPNST in NF1 patients.
Background: The course of subclinical gastrointestinal stromal tumors (GISTs) is variable. The management of small GISTs is not well-defined.
Methods: Records of patients presenting with small GISTs with documented follow-up appointment at our institution between 2016 and 2022 were identified and reviewed.
Background: Moderately hypofractionated, preoperative radiotherapy in patients with soft tissue sarcomas (HYPORT-STS; ClinicalTrials.gov identifier NCT03819985) investigated a radiobiologically equivalent, moderately hypofractionated course of preoperative radiotherapy (RT) 15 × 2.85 Gy in patients with soft tissue sarcoma (STS).
View Article and Find Full Text PDFClinical Variables Influencing Outcomes in Patients with Atypical Intradermal Smooth Muscle Neoplasms (Formerly Cutaneous Leiomyosarcomas): Single-Institution Study of 95 Surgical Patients.
Ann Surg Oncol
November 2024
Article Synopsis
- Atypical intradermal smooth muscle neoplasm, or cutaneous leiomyosarcoma, is a rare skin tumor that grows slowly and usually isn't very aggressive.
- A study looked at 95 patients with this tumor from 2002 to 2021, mostly men around 58 years old, with most tumors appearing as painless lumps on the legs or arms.
- After treatment, the majority of patients (96%) stayed free of the disease for five years, showing that the outcomes were mostly good.
Importance: Serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125) have been useful in the management of gastrointestinal and gynecological cancers; however, there is limited information regarding their utility in patients with appendiceal adenocarcinoma.
Objective: To assess the association of serum tumor markers (CEA, CA19-9, and CA125) with clinical outcomes and pathologic and molecular features in patients with appendiceal adenocarcinoma.
Design, Setting, And Participants: This is a retrospective cohort study at a single tertiary care comprehensive cancer center.
Background: Although social vulnerability has been associated with worse postoperative and oncologic outcomes in other cancer types, these effects have not been characterized in patients with soft tissue sarcoma. This study evaluated the association of social vulnerability and oncologic outcomes.
Methods: The authors conducted a single-institution cohort study of adult patients with primary and locally recurrent extremity or truncal soft tissue sarcoma undergoing resection between January 2016 and December 2021.
A randomized, non-comparative phase 2 study of neoadjuvant immune-checkpoint blockade in retroperitoneal dedifferentiated liposarcoma and extremity/truncal undifferentiated pleomorphic sarcoma.
Nat Cancer
April 2024
Article Synopsis
- A randomized phase 2 trial was conducted to evaluate the effectiveness of neoadjuvant immune checkpoint blockade (ICB) therapies (nivolumab and nivolumab/ipilimumab) in patients with resectable retroperitoneal DDLPS and extremity/truncal UPS.
- The primary endpoint of pathologic response showed a median hyalinization of 8.8% in DDLPS and 89% in UPS, with secondary endpoints focusing on immune changes and survival rates over time.
- Results indicated that lower pre-treatment regulatory T cell densities correlated with better pathological outcomes, and that neoadjuvant ICB led to significant immune changes and benefits, particularly in patients with UPS when combined with radiation therapy
Purpose: The lungs are the most common site of metastasis for patients with soft tissue sarcoma. SABR is commonly employed to treat lung metastases among select patients with sarcoma with limited disease burden. We sought to evaluate outcomes and patterns of failure among patients with sarcoma treated with SABR for their lung metastases.
View Article and Find Full Text PDFIntroduction: Many patients with mucinous appendiceal adenocarcinoma experience peritoneal recurrence despite complete cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Prior work has demonstrated that repeat CRS/HIPEC can prolong survival in select patients. We sought to validate these findings using outcomes from a high-volume center.
View Article and Find Full Text PDFImportance: Serum tumor markers CEA, CA19-9, & CA125 have been useful in the management of gastrointestinal and gynecological cancers, however there is limited information regarding their utility in patients with appendiceal adenocarcinoma.
Objective: Assessing the association of serum tumor markers (CEA, CA19-9, and CA125) with clinical outcomes, pathologic, and molecular features in patients with appendiceal adenocarcinoma.
Design: This is a retrospective study with results reported in 2023.
Background: Heterogenous nomenclature describing appendiceal neoplasms has added to uncertainty around their appropriate treatment. Although a recent consensus has established the term low-grade appendiceal neoplasm (LAMN), we hypothesize that significant variation remains in the treatment of LAMNs.
Methods: We retrospectively reviewed our prospectively maintained appendiceal registry, identifying patients with LAMNs from 2009 to 2019.
Background: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) improves survival in select patients with peritoneal metastases (PM), but the impact of social determinants of health on CRS/HIPEC outcomes remains unclear.
Patients And Methods: A retrospective review was conducted of a multi-institutional database of patients with PM who underwent CRS/HIPEC in the USA between 2000 and 2017. The area deprivation index (ADI) was linked to the patient's residential address.
Importance: Appendiceal adenocarcinoma is a rare tumor, and given the inherent difficulties in performing prospective trials in such a rare disease, there are currently minimal high-quality data to guide treatment decisions, highlighting the need for more preclinical and clinical investigation for this disease.
Objective: To prospectively evaluate the effectiveness of fluoropyrimidine-based systemic chemotherapy in patients with inoperable low-grade mucinous appendiceal adenocarcinoma.
Design, Setting, And Participants: This open-label randomized crossover trial recruited patients at a single tertiary care comprehensive cancer center from September 2013 to January 2021.
Introduction: Appendiceal neoplasms have a propensity for peritoneal dissemination. The standard of care for select individuals is CRS/HIPEC. In the current 8 AJCC Staging system, a finding of only intraperitoneal acellular mucin (M1a) is classified as Stage IVa.
View Article and Find Full Text PDFBackground: Regional lymph node metastasis in extremity and trunk soft tissue sarcoma (ETSTS) is rare with no standardized management. We sought to determine management patterns for regional lymph node metastasis in ETSTS.
Methods: A survey regarding the management of ETSTS lymph node metastasis was distributed to the membership of the Musculoskeletal Tumor Society (MSTS) and the Society of Surgical Oncology (SSO) in January 2022.
Article Synopsis
- The study focuses on evaluating the safety of a shorter, moderately hypofractionated radiotherapy regimen (42.75 Gy over 15 fractions) for patients with non-metastatic soft tissue sarcomas, compared to the standard regimen of 50 Gy over 25 fractions.
- Conducted at MD Anderson Cancer Center, the trial aimed to determine if the new regimen would result in fewer major wound complications within 120 days post-surgery, which historically affect about 35% of patients.
- A total of 120 patients were enrolled from December 2018 to January 2021, and the trial has been registered for ongoing follow-up to assess safety and outcomes.
Article Synopsis
- Undifferentiated pleomorphic sarcoma (UPS) shows significant immune infiltration, with immune checkpoint inhibitors benefiting around 20% of patients, leading to an investigation of the tumor's immune microenvironment and its impact on patient outcomes.
- Researchers performed immunohistochemistry on 105 surgically removed UPS samples, assessing various immune markers and correlations related to overall and disease-free survival using statistical methods.
- Key findings revealed that certain immune markers (like CD39 and CD73) were linked to treatment responsiveness and survival rates, with significant variations seen in primary vs. recurrent and metastatic tumors, highlighting the complexity of immune interactions in UPS.
Introduction: EORTC-62092 (STRASS) was a phase 3, randomized study that compared surgery alone versus surgery plus neoadjuvant radiotherapy (RT) for retroperitoneal sarcomas. RT was not associated with improved abdominal recurrence-free survival, the primary outcome measure, although on subanalysis, there may have been benefit for well-differentiated (WD) liposarcoma. This study investigated the real-world use and outcomes of RT (neoadjuvant and adjuvant) for the management of retroperitoneal liposarcoma.
View Article and Find Full Text PDFBackground: Patients with unplanned excision (UPE) of trunk and extremity soft tissue sarcoma (STS) present a significant management challenge for sarcoma specialists. Oncologic re-resection has been considered standard practice after UPE with positive or uncertain margins. A strategy of active surveillance or "watch and wait" has been suggested as a safe alternative to routine re-excision.
View Article and Find Full Text PDFBackground: We designed a prospective feasibility study to assess the 5x-multiplier (5x) calculation (eg, 3 pills in last 24 hours × 5 = 15) to standardize discharge opioid prescriptions compared to usual care.
Methods: Faculty-based surgical teams volunteered for either 5x or usual care arms. Patients undergoing inpatient (≥ 48 hours) surgery and discharged by surgical teams were included.
Background: Lymph node metastases (LNMs) are rare in patients with soft tissue sarcoma (STS), and there is limited evidence to guide clinical management. We describe our experience with sentinel lymph node biopsy (SLNB) and lymphadenectomy in STS patients.
Methods: A single-center, retrospective review was performed for patients with STS treated with SLNB and/or lymphadenectomy from 1994 to 2018.