Erlinda Etcubanas
St. Jude Children's Research Hospital
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Featured researches published by Erlinda Etcubanas.
Cancer | 1989
Neyssa Marina; Erlinda Etcubanas; David M. Parham; Laura C. Bowman; Alexander A. Green
All patients diagnosed with primitive neuroectodermal tumor (PNET) and extraosseous Ewings sarcoma in one institution between 1962 and 1987 were reviewed. Of the 26 cases studied, 16 had been diagnosed originally as PNETs, seven tumors were rediagnosed as PNET or EOE by histologic review, and three tumors had an original diagnosis of extraosseous Ewings sarcoma. To determine whether these diagnoses determine a group of tumors with unique biologic behavior and identifiable pathologic characteristics, clinical and treatment response data were compiled, and electron microscopic and immunohistochemical studies were done for those patients with adequate samples. With combined modality therapy, this group achieved a substantially shorter disease control interval than patients with disseminated osseous Ewings sarcoma or disseminated neuroblastoma—10.8 months versus 17 months and 16 months, respectively. The pattern of relapse and distant spread also differed among these tumor types. Immunohistochemical studies (for example, neuron‐specific enolase and β2 microglobulin) were helpful in confirming the diagnosis but were not definitive in themselves. Tentative diagnostic criteria are proposed for use in studies designed to provide further information on the nature and treatment of PNET. Some of the controversies regarding diagnosis are discussed. The authors propose a uniform approach to treatment of extraosseous Ewings sarcoma and PNET in order to try to clarify their relation.
Journal of Clinical Oncology | 1986
Charles B. Pratt; Alexander A. Green; Marc E. Horowitz; William H. Meyer; Erlinda Etcubanas; Edwin C. Douglass; F A Hayes; E Thompson; Judith A. Wilimas; M Igarashi
Ifosfamide/mesna treatment of 50 patients with pediatric malignant solid tumors was associated with the development of neurotoxic signs and symptoms in 11 of these individuals who received 29 courses of treatment. Neurologic toxicity included changes in mental status, cerebellar function, cranial nerve, and cerebellar and motor system function, including seizures. All symptoms, signs, and EEG abnormalities were transient. Some of the affected individuals failed to develop acute neurotoxic signs of symptoms when retreated with ifosfamide. A grading system for scoring these neurologic abnormalities is presented for comparison of acute neurotoxic effects of other agents. Recommendations are made regarding early termination or delay of ifosfamide/mesna treatments in the presence of significant neurotoxicity.
Cancer | 1987
Marc E. Horowitz; Erlinda Etcubanas; Bruce L. Webber; Larry E. Kun; Bhaskar N. Rao; Ralph J. Vogel; Charles B. Pratt
From July 1972 through September 1984, 8 of 44 children diagnosed as having primary malignant hepatic tumors, who were treated at St. Jude Childrens Research Hospital, had undifferentiated (embryonal) sarcoma (five patients) or rhabdomyosarcoma (three patients). The natural history and response to multimodal therapy of these rare tumors are described. The pathologic material was reviewed and evidence for the differentiating potential of undifferentiated (embryonal) sarcoma is presented. At diagnosis, disease was restricted to the right lobe of the liver in three patients, was bilobar in four patients, and extended from the left lobe into the diaphragm in one patient. Lung metastases were present in two patients at diagnosis. All three patients with rhabdomyosarcoma had intrahepatic lesions without involvement of the biliary tree. Survival ranged from 6 to 73 months from diagnosis (median, 19.5 months); two patients are surviving disease‐free for 55+ and 73+ months, and one patient recently underwent resection of a recurrent pulmonary nodule 22 months from initial diagnosis. Three patients died of progressive intrahepatic and extrahepatic abdominal tumors, and two patients, who died of progressive pulmonary tumor, also had bone or brain metastasis but no recurrence of intra‐abdominal tumor. Six patients had objective evidence of response to chemotherapy. The authors suggest an aggressive multimodal approach to the treatment of these rare tumors in children.
Journal of Clinical Oncology | 1986
M E Horowitz; Charles B. Pratt; B L Webber; H O Hustu; Erlinda Etcubanas; J Miliauskas; Bhaskar N. Rao; Irvin D. Fleming; A P Mahesh Kumar; Alexandra Green
The rarity and diverse characteristics of the nonrhabdomyosarcomatous soft-tissue sarcomas (NRSTS) in children have hindered study of their clinical presentations and response to therapy. Here we describe the findings of a retrospective analysis of 62 cases of NRSTS seen in a single institution from 1962 through 1983. The most common histopathologic diagnosis was synovial sarcoma, occurring in 18 patients, followed by malignant schwannoma in 12. The median age at diagnosis was 11 years (range, 2 months to 20 years). Anatomic sites of primary tumors were the trunk (28), extremity (24), and head and neck (10). Of the 31 patients whose tumors were completely resected, 26 (84%) survive with no evidence of disease. Postoperative chemotherapy, administered to nearly one half of this group, did not produce any demonstrable gains in survival. Only one of the 26 patients with local or metastatic gross tumor after resection survives. We conclude that an aggressive surgical approach is imperative in patients with NRSTS and that the contribution of other treatment modalities needs to be defined in a collaborative group trial.
Annals of Surgery | 1984
Irvin D. Fleming; Erlinda Etcubanas; Richard Patterson; Bhaskar N. Rao; Charles B. Pratt; Omar Hustu; Mahesh Kumar
With the development of combined chemotherapy and radiation therapy for embryonal rhabdomyosarcoma, the role and extent of surgical resection of these pelvic tumors need to be defined. Thirty-six children with pelvic genitourinary rhabdomyosarcoma seen at St. Jude Childrens were managed on protocols combining surgical resection and radiation, and chemotherapy. Ten children presented with cervical—vaginal tumors, which were managed with combined therapy; the surgical resection was histovaginectomy in eight and pelvic exenteration in one. Eight of the ten are free of disease from 1 to 14 years. Twelve children presented with bladder and prostate tumors, which were resected with segmental cystectomy in four cases, biopsy in five, and pelvic exenteration in three. All received combination therapy and six of the twelve are surviving free of disease from 6 months to 16 years. Fourteen children presented with paratesticular rhabdomyosarcoma. Chemotherapy was combined with radical orchiectomy in all cases. Retroperitoneal node dissection was done in nine and five had inguinal node dissection. Nine of the 14 are surviving NED from 2 to 16 years. One patient died, free of disease, with complications of combination therapy. The results of this review supports the approach of combining chemotherapy, radiation, and complete surgical resection.
Journal of Pediatric Surgery | 1989
Eduardo T. Fernandes; Erlinda Etcubanas; Bhaskar N. Rao; A.P. Mahesh Kumar; Elizabeth I. Thompson; Jesse J. Jenkins
From 1968 to 1988, 24 children and adolescents with malignant testicular tumors were treated at St Jude Childrens Research Hospital. Pure yolk sac tumors (YST) were present in 13 cases; 11 patients had other types of nonseminomatous malignant germ cell tumors. Children with localized and totally resectable disease (stage I) were treated by orchiectomy alone; all others also received chemotherapy. Five of ten patients treated before the implementation of a multiagent chemotherapy protocol in 1979 have died. By contrast, all of the 14 patients treated on this protocol are alive. The improved survival during the past decade is attributable to better diagnostic imaging techniques, the availability of serum tumor markers to monitor disease activity, and more effective chemotherapy. Orchiectomy alone is sufficient treatment for patients with clinical stage I disease who show appropriate reductions in tumor marker levels after surgery. Modern platinum-based chemotherapy provides disease control in patients with higher stage disease.
Cancer Investigation | 1989
Bhaskar N. Rao; Erlinda Etcubanas; Alexander A. Green
1. NRSTS tumors represent 20-20% of all soft tissue sarcomas. In only the extremity primary are both RMS and NRSTS occurring with almost equal frequency. 2. Modern diagnostic imaging studies are invaluable to staging and preoperative planning. 3. The most important need is to standardize biopsy techniques, since an ill-conceived biopsy has an adverse effect on the definitive surgical procedure. 4. Standardization of surgical procedures is necessary to adequately define extent of local resection varying with site, type of tumor, and its biological behavior. Less radical procedures do not seem to have had an adverse effect in local control or survival as is evidenced in RMS of the orbit, vagina, and bladder. 5. Though complete surgical extirpation is the treatment of choice in RMS, incomplete surgical excision leaving microscopic disease can result in adequate local control following chemotherapy and radiation therapy. However, less than optimum responses to chemotherapy in the NRSTS makes it imperative that efforts be made to completely resect these lesions. 6. It is in the realm of initially unresectable primary lesion that the surgical oncologists role be refined. Consideration here includes: (a) use of newer surgical techniques such as laser, or free microvascular grafts, (b) protocols to define the optimum timing of delayed surgery following preoperative chemotherapy with or without radiation therapy.
Laryngoscope | 1989
Jeffrey A. Stephenson; Diane M. Mayland; Larry E. Kun; Erlinda Etcubanas; Elizabeth I. Thompson; Charles W. Gross
From 1962 through 1987, four children were diagnosed at our institution with primary germ cell malignancies of the extracranial head and neck regions. Ages of the children ranged from 2 to 44 months. Histologic findings included 2 yolk sac carcinoma (endodermal sinus tumor), 1 malignant teratoma with nephroblastoma (Wilms tumor), and 1 malignant teratoma with neuroblastoma (primitive neuroectodermal) components. Complete clinical and surgical staging was performed to rule out additional sites of disease. All patients initially underwent either biopsy or, when technically feasible, resection. Three patients received combination chemotherapy and two received irradiation. Three patients died of progressive disease. One patient who had yolk sac carcinoma of the temporomandibular region is alive and free of disease 40 months after therapy. Complete surgical resection is indicated for teratomatous tumors, if technically feasible. The malignant components of these tumors are sensitive to both chemotherapy and irradiation and combined therapy may be beneficial.
Cancer | 1991
Neyssa Marina; Erlinda Etcubanas; Elizabeth I. Thompson; Bhaskar N. Rao; Jesse J. Jenkins; Larry E. Kun
The need for second‐look surgery after chemotherapy in children with advanced germ cell tumors is controversial, particularly when levels of the tumor markers alpha‐fetoprotein (AFP) or beta‐human chorionic gonadotropin (βHCG) are elevated at diagnosis. The authors evaluated the outcome of second‐look surgery in relationship to tumor marker status in 27 patients with Stage III to IV disease who had completed four courses of chemotherapy. Markers were elevated at diagnosis in 19 patients. After chemotherapy, markers normalized in 12 of these patients. Second‐look surgery confirmed complete response (CR) in these 12 patients, two of whom had residual masses on computed tomography (CT) scan (mature teratoma and necrotic tumor). The AFP decreased but did not normalize in seven patients; five had residual disease at second look and the other two later developed measurable disease. Of the eight patients with normal AFP at diagnosis, second look confirmed clinical CR in four. The other four patients had CT evidence of residual masses: surgery showed necrotic tissue in two cases, mature glial elements in one, and mature teratoma with glial elements in one. Thus second‐look surgery added no information for treatment planning in children with elevated tumor markers at diagnosis and might best be reserved for patients without tumor markers at diagnosis and residual masses on CT scan, and those with persistent elevation of tumor markers and potentially resectable residual disease. Because of the possibility of small amount of residual tumor, second‐look surgery may also be useful in patients whose markers normalize but who have residual masses on CT scans.
Investigational New Drugs | 1986
Charles B. Pratt; Teresa J. Vietti; Erlinda Etcubanas; Charles Sexauer; R.A. Krance; Donald H. Mahoney; R.B. Patterson
SummaryOne hundred one patients with advanced pediatric malignant solid tumors, refractory to conventional chemotherapy, were given Novantrone in a Phase II study. A dosage of 18 mg/m2 was administered as a short intravenous infusion every 3 weeks. One complete and 2 partial responses were observed among 26 patients treated for rhabdomyosarcoma; one of 22 patients with neuroblastoma developed a partial response. Nausea and vomiting were uncommon. Leukopenia and/or granulocytopenia developed in 90 of 98 evaluable entries. Two patients developed fatal congestive heart failure, which may have been related to the fact that these patients previously had received doxorubicin; 3 other patients developed evidence of changes in cardiac function, without congestive heart failure. Evidence of activity of this agent in patients who had previously received doxorubicin suggests that Novantrone should be evaluated in pediatric subjects with malignant solid tumors who have had no prior exposure to anthracyclines.