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Πέμπτη 2 Φεβρουαρίου 2023

Equivocal end‐of‐therapy imaging findings do not predict a higher risk of local relapse after definitive radiotherapy in pediatric Ewing sarcoma and rhabdomyosarcoma

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Posttherapy imaging studies can provide reassurance or induce anxiety regarding risk of recurrence for patients and their families. In some cases, it is difficult to determine if imaging findings represent posttreatment changes or residual disease. Equivocal radiographic findings can occur due to therapy-related inflammation or residual, inactive soft tissue masses, but it is unknown if such findings indicate an increased likelihood of local recurrence. The aim of this study was to assess the value of initial posttherapy scans for predicting local relapse in patients with Ewing sarcoma (EWS) or rhabdomyosarcoma (RMS) who received radiotherapy (RT) for local control. These findings are critical to inform clinicians' surveillance recommendations and ability to accurately counsel patients and their families.

Procedure

The primary endpoint was time to local progression (LP). Patients were classified as having posttherapy scans that were "positive" (residual disease within the RT field), "negative" (no evidence of residual disease within the RT field), or "equivocal" (no determination could be made). The value of initial posttreatment scans for predicting LP was assessed using positive predictive value (PPV) and negative predictive value (NPV).

Results

Negative imaging findings (n = 51) had an NPV of 88%, and positive imaging findings (n = 1) had a PPV of 100%. When equivocal findings (n = 16) were categorized with negative results (i.e., positive vs. equivocal/negative), the NPV was 90%. When equivocal findings were categorized with positive results (equivocal/positive vs. negative), the PPV was 12%.

Conclusion

Equivocal findings within the RT field on end-of-therapy imaging studies indicate no higher risk of local recurrence than negative findings. These results may contribute to appropriate surveillance schedules and accurate counseling of patients with RMS and EWS who have received RT for local control.

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Masseter muscle cross‐sectional area and late implant failure: A case–control study

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Introduction

Occlusal overload is considered to be one of the causes of late implant failure. However, it is unclear whether the magnitude of the patient's occlusal force is a risk factor for late implant failure.

Purpose

This case–control study aimed to clarify the association between the cross-sectional area (CSA) of the masseter muscle and late implant failure.

Methods

This case–control study was limited to implant-supported fixed prostheses. We compared cases with at least one late implant failure (n = 25 patients) to controls (n = 82 patients) without implant failure. Patients were matched by age, sex, year of surgery, jaw and tooth type, and bone graft. Log-rank and Cox proportional hazard regression analyses were used to identify possible risk factors for late implant failure.

Results

The incidence of late implant failure was significantly associated with masseter muscle CSA ≥504.5 mm2 (hazard ratio: 4.43; 95% CI: 1.82–10.79; p < 0.01).

Conclusion

Higher masseter muscle CSA increases the risk of late implant failure.

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Lip Squamous Cell Carcinoma With Spontaneous Eruption and Drainage

alexandrossfakianakis shared this article with you from Inoreader

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A 69-year-old woman with a newly diagnosed squamous cell carci noma of the lower lip mucosa presented 3 days after initiating neoadjuvant immune checkpoint blockade immunotherapy with redness and swelling of the tumor site. What is your diagnosis?
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