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Pantelidou M, Challacombe B, McGrath A, Brown M, Ilyas S, Katsanos K, Adam A. Percutaneous Radiofrequency Ablation Versus Robotic-Assisted Partial Nephrectomy for the Treatment of Small Renal Cell Carcinoma. Cardiovasc Intervent Radiol 2016; 39:1595-1603. [PMID: 27435582 PMCID: PMC5052326 DOI: 10.1007/s00270-016-1417-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 06/19/2016] [Indexed: 01/20/2023]
Abstract
Introduction The authors compared the oncologic outcomes of radiofrequency ablation (RFA) with robotic-assisted partial nephrectomy (RPN) for the treatment of T1 stage renal cell carcinoma (RCC). Materials and methods This was a retrospective data analysis of a high-volume single tertiary centre. Patients were treated with RFA or RPN following multidisciplinary decision making. Only histologically proven RCCs were included. Baseline demographics were collected, and PADUA scores of tumour features were calculated to standardize baseline anatomy. Peri-operative complications, kidney function and oncological outcomes were compared. Results Sixty-three cases were included in each group. Baseline renal function was poorer in RFA, and 16/63 RFA patients had tumours in single kidneys compared to 1/63 RPN cases (p < 0.001). Length of stay was shorter in RFA (1 vs. 3 days, p < 0.0001). Post-procedure renal function decline at 30 days was significantly less in RFA [(−0.8) ± 9.6 vs. (−16.1) ± 19.5 mls/min/1.73 m2; p < 0.0001]. More minor complications were recorded in RPN (10/63 vs. 4/63, p = 0.15), but local recurrence was numerically higher in RFA (6/63 vs. 1/63, p = 0.11). Disease-free survival (DFS) was not significantly different (adjusted HR = 0.6, 95 % Cl 0.1–3.7; p = 0.60). Increasing tumour size was an independent predictor of local recurrence (adjusted HR = 1.7; 95 % Cl 1.1–2.6 per cm; p = 0.02). Conclusions Both RPN and RFA offer very good oncological outcomes for the treatment of T1 RCC with low peri-operative morbidity and similar oncologic outcomes. RFA demonstrated fewer peri-operative complications and better preservation of renal function, whereas RPN had an insignificantly lower local recurrence rate. RFA should be offered alongside RPN for selected cases.
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Affiliation(s)
- Maria Pantelidou
- Department of Interventional Radiology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK.,Department of Urology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
| | - Ben Challacombe
- Department of Urology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
| | - Andrew McGrath
- Department of Interventional Radiology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
| | - Matthew Brown
- Department of Urology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
| | - Shahzad Ilyas
- Department of Interventional Radiology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
| | - Konstantinos Katsanos
- Department of Interventional Radiology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK.
| | - Andreas Adam
- Department of Interventional Radiology, Guy's and St. Thomas' Hospitals, NHS Foundation Trust, King's Health Partners, London, SE1 7EH, UK
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502
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Jueckstock J, Rack B, Friedl TWP, Scholz C, Steidl J, Trapp E, Tesch H, Forstbauer H, Lorenz R, Rezai M, Häberle L, Alunni-Fabbroni M, Schneeweiss A, Beckmann MW, Lichtenegger W, Fasching PA, Pantel K, Janni W. Detection of circulating tumor cells using manually performed immunocytochemistry (MICC) does not correlate with outcome in patients with early breast cancer - Results of the German SUCCESS-A- trial. BMC Cancer 2016; 16:401. [PMID: 27387743 PMCID: PMC4936301 DOI: 10.1186/s12885-016-2454-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 06/28/2016] [Indexed: 12/15/2022] Open
Abstract
Background Recently, the prognostic significance of circulating tumor cells (CTCs) in primary breast cancer as assessed using the Food-and-Drug-Administration-approved CellSearch® system has been demonstrated. Here, we evaluated the prognostic relevance of CTCs, as determined using manually performed immunocytochemistry (MICC) in peripheral blood at primary diagnosis, in patients from the prospectively randomized multicenter SUCCESS-A trial (EudraCT2005000490-21). Methods We analyzed 23 ml of blood from 1221 patients with node-positive or high risk node-negative breast cancer before adjuvant taxane-based chemotherapy. Cells were separated using a density gradient followed by epithelial cell labeling with the anti-cytokeratin-antibody A45-B/B3, immunohistochemical staining with new fuchsin, and cytospin preparation. All cytospins were screened for CTCs, and the cutoff for positivity was at least one CTC. The prognostic value of CTCs with regard to disease-free survival (DFS), distant disease-free survival (DDFS), breast-cancer-specific survival (BCSS), and overall survival (OS) was assessed using both univariate analyses applying the Kaplan–Meier method and log-rank tests, and using multivariate Cox regressions adjusted for other predictive factors. Results In 20.6 % of all patients (n = 251) a median of 1 (range, 1–256) CTC was detected, while 79.4 % of the patients (n = 970) were negative for CTCs before adjuvant chemotherapy. A pT1 tumor was present in 40.0 % of patients, 4.8 % had G1 grading and 34.6 % were node-negative. There was no association between CTC positivity and tumor stage, nodal status, grading, histological type, hormone receptor status, Her2 status, menopausal status or treatment. Univariate survival analyses based on a median follow-up of 64 months revealed no significant differences between CTC-positive and CTC-negative patients with regard to DFS, DDFS, BCSS, or OS. This was confirmed by fully adjusted multivariate Cox regressions, showing that the presence of CTCs (yes/no) as assessed by MICC did not predict DFS, DDFS, BCSS or OS. Conclusions We could not demonstrate prognostic relevance regarding CTCs that were quantified using the MICC method at the time of primary diagnosis in our cohort of early breast cancer patients. Further studies are necessary to evaluate if the presence of CTCs assessed using MICC has prognostic relevance, or can be used for risk stratification and treatment monitoring in adjuvant breast cancer. Trial registration The ClinicalTrial.gov registration ID of this prospectively randomized trial is NCT02181101; the (retrospective) registration date was June 2014 (study start date September 2005).
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Affiliation(s)
- Julia Jueckstock
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University, Munich, Germany.
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University, Munich, Germany
| | - Thomas W P Friedl
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Christoph Scholz
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Julia Steidl
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University, Munich, Germany
| | - Elisabeth Trapp
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University, Munich, Germany
| | | | - Helmut Forstbauer
- Haemotologic-Oncologic Practice Dres, Forstbauer/Ziske, Troisdorf, Germany
| | - Ralf Lorenz
- Oncologic Practice Dres, Lorenz/Hecker/Wesche, Braunschweig, Germany
| | | | - Lothar Häberle
- Department of Gynecology and Obstetrics, University Erlangen, Erlangen, Germany
| | | | | | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Erlangen, Erlangen, Germany
| | | | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Erlangen, Erlangen, Germany
| | - Klaus Pantel
- Institute for Tumor Biology, Hamburg University, Hamburg, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
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503
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Abstract
Background CD44 has been reported to be involved with tumor growth and metastasis and has also been implicated as a CSC marker in hepatocellular carcinoma (HCC). However, the prognostic value of CD44 still remains controversial; hence, we investigated the correlation between CD44 and the clinicopathological features of HCC by meta-analysis. Methods Identification and review of publications assessing clinical or prognostic significance of CD44 expression in HCC until November 1, 2015. A meta-analysis was performed to clarify the association between CD44 expression and clinical outcomes. Results A total of 14 publications met the criteria and comprised 2235 cases. Analysis of these data showed that CD44 expression was not significantly associated with the tumor differentiation (OR 1.48, 95 % confidence interval [CI] 0.85–2.60, P = 0.17), AFP level of HCC patients (OR 0.83, 95 % CI 0.52–1.33, P = 0.45), or disease-free survival (relative risk [RR] 1.15, 95 % CI, 0.85–1.54; P = 0.36). However, in the identified studies, CD44 expression was highly correlated with tumor TNM classification (OR 2.38, 95 % CI 1.23–4.60; P = 0.01) and decreased overall survival (RR 1.49, 95 % CI, 1.26–1.76; P < 0.00001). Conclusions This meta-analysis shows CD44 expression in HCC is connected with decreased overall and thus marks a worse prognosis.
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Affiliation(s)
- Yangkun Luo
- Department of Radiation Oncology, Sichuan Cancer Hospital, No.55, Section 4, Renmin South Road, Chengdu, 610041 Sichuan China
| | - Yan Tan
- Department of Radiation Oncology, Sichuan Cancer Hospital, No.55, Section 4, Renmin South Road, Chengdu, 610041 Sichuan China
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504
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Sabatier R, Sabiani L, Zemmour C, Taix S, Chereau E, Gonçalves A, Jalaguier-Coudray A, Charafe-Jauffret E, Resbeut M, Extra JM, Viens P, Tallet A. Invasive ductal breast carcinoma with predominant intraductal component: Clinicopathological features and prognosis. Breast 2016; 27:8-14. [PMID: 27212694 DOI: 10.1016/j.breast.2015.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/14/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Invasive ductal carcinoma with predominant intraductal component (IDCPIC) represents almost 5% of breast cancers. Nevertheless few data exist concerning their characteristics and prognostic behaviour. Our objective was to describe IDCPIC's clinicopathological and prognostic features and compare them to that of invasive ductal carcinoma without predominant intraductal component (IDC). METHODS Retrospective single centre study including all the localized invasive ductal carcinoma listed in our institutional database. Clinical, radiological and pathological criteria were collected as well as disease-free survival (DFS) data. RESULTS From 1995 to 2008, 4109 invasive ductal breast cancers treated were included. Out of them 192 (4.7%) were IDCPIC. Most of IDCPIC (63%) were discovered by radiological screening whereas IDC suspicion was more often clinical (82.7% vs 49.5%, p < 0.001). Pathological lymph node involvement was less frequent in IDCPIC (35.8 vs 44.3%, p = 0.04). Invasive tumour median size was 2-fold smaller in IDCPIC (10 mm vs 20 mm, p<0.001). Hormone receptors expression was similar between both groups whereas HER2 overexpression was more frequent in IDCPIC (32% vs 14.3%, p<0.001). Mastectomy was more frequently performed for IDCPIC (67.7% vs 30.3%, p < 0.001) whereas chemotherapy and radiation therapy were less frequent (55.5% vs 68%, and 82.8% vs 95.5%, respectively, p < 0.001 for both). After matching for discriminant clinicopathological features (tumour size, lymph node involvement, vascular invasion, HER2), DFS was similar in both groups (5-year DFS of 87.4% vs 84.4%, p = 0.47). CONCLUSION IDCPIC and other IDC with invasive components showing similar clinicopathological features display a similar prognosis.
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Affiliation(s)
- Renaud Sabatier
- Department of Oncology, Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Université, Marseille, France
| | - Laura Sabiani
- Aix-Marseille Université, Marseille, France; Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France.
| | - Christophe Zemmour
- Department of Clinical Research and Innovation, Methodology and Biostatistics Unit, Institut Paoli-Calmettes, Marseille, France
| | - Sébastien Taix
- Aix-Marseille Université, Marseille, France; Department of Biopathology, Institut Paoli-Calmettes, Marseille, France
| | - Elisabeth Chereau
- Department of Surgical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Anthony Gonçalves
- Department of Oncology, Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Université, Marseille, France
| | | | - Emmanuelle Charafe-Jauffret
- Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Université, Marseille, France; Department of Biopathology, Institut Paoli-Calmettes, Marseille, France
| | - Michel Resbeut
- Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France
| | - Jean-Marc Extra
- Department of Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Patrice Viens
- Department of Oncology, Institut Paoli-Calmettes, Marseille, France; Centre de Recherche en Cancérologie de Marseille, INSERM U1068, CNRS U7258, Marseille, France; Aix-Marseille Université, Marseille, France
| | - Agnès Tallet
- Department of Radiotherapy, Institut Paoli-Calmettes, Marseille, France
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505
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Kim CS, Theeuwes A, Kwon DD, Choi YD, Chung BH, Lee HM, Lee KH, Lee SE. The PREVAIL trial of enzalutamide in men with chemotherapy-naïve, metastatic castration-resistant prostate cancer: Post hoc analysis of Korean patients. Investig Clin Urol 2016; 57:174-83. [PMID: 27195316 PMCID: PMC4869571 DOI: 10.4111/icu.2016.57.3.174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 05/01/2016] [Indexed: 12/01/2022] Open
Abstract
Purpose This post hoc analysis evaluated treatment effects, safety, and pharmacokinetics of enzalutamide in Korean patients in the phase 3, double-blind, placebo-controlled PREVAIL trial. Materials and Methods Asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer that progressed on androgen deprivation therapy received 160 mg/d oral enzalutamide or placebo (1:1) until death or discontinuation due to radiographic progression or skeletal-related event and initiation of subsequent therapy. Coprimary end points were centrally assessed radiographic progression-free survival (rPFS) and overall survival (OS). Secondary end points included investigator-assessed rPFS, time to initiation of chemotherapy, time to prostate-specific antigen (PSA) progression, PSA response (≥50% decline), and time to skeletal-related event. Results Of 1,717 total patients, 78 patients were enrolled in Korea (enzalutamide, n=40; placebo, n=38). Hazard ratios (95% confidence interval) for enzalutamide versus placebo were 0.23 (0.02–2.24) for centrally assessed rPFS, 0.77 (0.28–2.15) for OS, 0.21 (0.08–0.51) for time to chemotherapy, and 0.31 (0.17–0.56) for time to PSA progression. A PSA response was observed in 70.0% of enzalutamide-treated and 10.5% of placebo-treated Korean patients. Adverse events of grade ≥3 occurred in 33% of enzalutamide-treated and 11% of placebo-treated Korean patients, with median treatment durations of 13.0 and 5.1 months, respectively. At 13 weeks, the plasma concentration of enzalutamide plus N-desmethyl enzalutamide was similar in Korean and non-Korean patients (geometric mean ratio, 1.04; 90% confidence interval, 0.97–1.10). Conclusions In Korean patients, treatment effects and safety of enzalutamide were consistent with those observed in the overall PREVAIL study population (ClinicalTrials.gov Identifier: NCT01212991).
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Affiliation(s)
- Choung-Soo Kim
- Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ad Theeuwes
- Biostatistics, Astellas Pharma Europe B.V., Leiden, The Netherlands
| | - Dong Deuk Kwon
- Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea
| | - Young Deuk Choi
- Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Byung Ha Chung
- Department of Urology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun Moo Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kang Hyun Lee
- Department of Urology, Center for Prostate Cancer, National Cancer Center, Goyang, Korea
| | - Sang Eun Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
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506
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Jung SW, Kim DS, Yu YD, Han JH, Suh SO. Risk factors for cancer recurrence or death within 6 months after liver resection in patients with colorectal cancer liver metastasis. Ann Surg Treat Res 2016; 90:257-64. [PMID: 27186570 PMCID: PMC4865703 DOI: 10.4174/astr.2016.90.5.257] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Revised: 02/07/2016] [Accepted: 03/02/2016] [Indexed: 01/16/2023] Open
Abstract
Purpose The aim of this study was to find risk factors for early recurrence (ER) and early death (ED) after liver resection for colorectal cancer liver metastasis (CRCLM). Methods Between May 1990 and December 2011, 279 patients underwent liver resection for CRCLM at Korea University Medical Center. They were assigned to group ER (recurrence within 6 months after liver resection) or group NER (non-ER; no recurrence within 6 months after liver resection) and group ED (death within 6 months after liver resection) or group NED (alive > 6 months after liver resection). Results The ER group included 30 patients (10.8%) and the NER group included 247 patients (89.2%). The ED group included 18 patients (6.6%) and the NED group included 253 patients (93.4%). Prognostic factors for ER in a univariate analysis were poorly differentiated colorectal cancer (CRC), synchronous metastasis, ≥5 cm of liver mass, ≥50 ng/mL preoperative carcinoembryonic antigen level, positive liver resection margin, and surgery alone without perioperative chemotherapy. Prognostic factors for ED in a univariate analysis were poorly differentiated CRC, positive liver resection margin, and surgery alone without perioperative chemotherapy. Multivariate analysis showed that poorly differentiated CRC, ≥5-cm metastatic tumor size, positive liver resection margin, and surgery alone without perioperative chemotherapy were independent risk factors related to ER. For ED, poorly differentiated CRC, positive liver resection margin, and surgery alone without perioperative chemotherapy were risk factors in multivariate analysis. Conclusion Complete liver resection with clear resection margin and perioperative chemotherapy should be carefully considered when patients have the following preoperative risk factors: metastatic tumor size ≥ 5 cm and poorly differentiated CRC.
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Affiliation(s)
- Sung Won Jung
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Dong-Sik Kim
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Young Dong Yu
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Jae Hyun Han
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Sung-Ock Suh
- Division of HBP Surgery and Liver Transplantation, Department of Surgery, Korea University College of Medicine, Seoul, Korea
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507
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Jo S, Choi Y, Park SK, Kim JY, Kim HJ, Lee YH, Oh WY, Cho H, Ahn KJ. Efficacy of Dose-Escalated Radiotherapy for Recurrent Colorectal Cancer. Ann Coloproctol 2016; 32:66-72. [PMID: 27218097 PMCID: PMC4865467 DOI: 10.3393/ac.2016.32.2.66] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 12/23/2015] [Indexed: 11/14/2022] Open
Abstract
Purpose This study aimed to evaluate the effects of radiotherapy (RT) on progression-free survival (PFS) for patients with recurrent colorectal cancer. Methods We reviewed the records of 22 patients with recurrent colorectal cancer treated with RT between 2008 and 2014. The median radiation dose for recurrent disease was 57.6 Gy (range, 45–75.6 Gy). Patients were divided into 2 groups according to the type of RT: patients underwent RT without previous history of irradiation (n = 14) and those treated with secondary RT (reirradiation: n = 8) at the time of recurrence. Results The median follow-up period was 24.9 months (range, 4.5–66.6 months). Progression was observed in 14 patients (including 8 with loco-regional failure and 9 with distant metastases). Distant metastases were related to the RT dose (<70 Gy, P = 0.031). The 2-year loco-regional control (LRC), PFS, and overall survival (OS) rates were 74.6%, 45.1%, and 82.0%, respectively. The LRC rate was not different between the patients treated with RT for the first time and those treated with reirradiation (P = 0.101, 2-year LRC 79.5% vs. 41.7%). However, reirradiation was related to poor PFS (P = 0.022) and OS (P = 0.002). An escalated RT dose (≥70 Gy) was associated with a higher PFS (P = 0.014, 2-year PFS 63.5% vs. 20.8%). Conclusion Salvage RT for locally recurrent colorectal cancer can be offered when surgery is impossible. Dose-escalated RT shows a possible benefit in reducing the risk of progression.
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Affiliation(s)
- Sunmi Jo
- Department of Radiation Oncology, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Yunseon Choi
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Sung-Kwang Park
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Jin-Young Kim
- Department of Radiation Oncology, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Hyun Jung Kim
- Department of Radiation Oncology, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Yun-Han Lee
- Department of Radiation Oncology, Yonsei University Health System, Yonsei University College of Medicine, Seoul, Korea
| | - Won Yong Oh
- Department of Radiation Oncology, Inje University Haeundae Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Heunglae Cho
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
| | - Ki Jung Ahn
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea
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508
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Tsai HL, Huang CW, Yeh YS, Ma CJ, Chen CW, Lu CY, Huang MY, Yang IP, Wang JY. Factors affecting number of lymph nodes harvested and the impact of examining a minimum of 12 lymph nodes in stage I-III colorectal cancer patients: a retrospective single institution cohort study of 1167 consecutive patients. BMC Surg 2016; 16:17. [PMID: 27079509 PMCID: PMC4832538 DOI: 10.1186/s12893-016-0132-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/08/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To identify factors affecting the harvest of lymph nodes (LNs) and to investigate the association between examining a minimum of 12 LNs and clinical outcomes in stage I-III colorectal cancer (CRC) patients. METHODS The clinicopathologic features and the number of examined LNs for 1167 stage I-III CRC patients were analyzed to identify factors affecting the number of LNs harvested and the correlations between clinical outcomes and high harvests (≧12 LNs) and low harvests (<12 LNs). RESULTS A multivariate analysis showed that age (P = 0.007), tumor size (P = 0.030), and higher T stage (P = 0.001) were independent factors affecting the examinations of LNs in colon cancer and that tumor size (P = 0.015) was the only independent factor in rectal cancer. Patients with low harvests had poorer overall survival with stage II and stage III CRC (stage II: P < 0.0001; III: P = 0.001) and poorer disease-free survival for stages I-III (stage I: P = 0.023; II: P < 0.0001; III: P = 0.001). CONCLUSIONS The factors influencing nodal harvest are multifactorial, and an adequate number of examined LNs (≧12) is associated with a survival benefit. Removal of at least 12 LNs will determine the lymph node status reliably.
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Affiliation(s)
- Hsiang-Lin Tsai
- Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Wen Huang
- Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Colorectal Surgery, Department of Surgery, KaohsiungMedical University Hospital, Kaohsiung, Taiwan
| | - Yung-Sung Yeh
- Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Jen Ma
- Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Colorectal Surgery, Department of Surgery, KaohsiungMedical University Hospital, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chao-Wen Chen
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Emergency Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Yu Lu
- Division of Gastroenterology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Yii Huang
- Department of Radiation Oncology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Radiation Oncology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - I-Ping Yang
- Department of Nursing, Shu-Zen College of Medicine and Management, Kaohsiung, Taiwan
| | - Jaw-Yuan Wang
- Division of Gastroenterology and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Division of Colorectal Surgery, Department of Surgery, KaohsiungMedical University Hospital, Kaohsiung, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
- Center for Biomarkers and Biotech Drugs, Kaohsiung Medical University, Kaohsiung, Taiwan.
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509
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Amri R, Klos CL, Bordeianou L, Berger DL. The prognostic value of lymph node ratio in colon cancer is independent of resection length. Am J Surg. 2016;212:251-257. [PMID: 27156798 DOI: 10.1016/j.amjsurg.2015.10.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 10/11/2015] [Accepted: 10/28/2015] [Indexed: 12/16/2022]
Abstract
BACKGROUND Lymph node ratio (LNR), the ratio of tumor-positive lymph nodes (+LN) to the total number of resected lymph nodes (rLN), predicts recurrence and survival in colon cancer. Variations in colonic resection length (RL) may influence rLN, +LN, or both, thereby potentially impacting LNR and its prognostic value in colon cancer. METHODS All colon cancer patients treated surgically at our center from 2004 to 2011 were included in an institutional review board-approved data repository (n = 1,039). RESULTS Larger RL was associated with increased rLN (ρ = .22; P < .001) but not with +LN (P = .21). In node-positive patients (n = 411), RL-adjusted LNR had weaker correlations with death (ρ = .338 vs .373, both P < .001) or metastatic disease (ρ = .303 vs .345; both P < .001) and a smaller area under the curve (death: .695 vs .715, metastasis: .675 vs .699). Findings were similar in segmental, extended segmental, and total colectomy subgroups. CONCLUSIONS Provided that resections are performed following standard oncologic principles, our analysis shows that RL does not significantly impact the prognostic value of LNR in colon cancer. Correcting LNR for RL seems redundant and may even act as noise distorting LNR values.
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510
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García-Alfonso P, Feliú J, García-Carbonero R, Grávalos C, Guillén-Ponce C, Sastre J, García-Foncillas J. Is regorafenib providing clinically meaningful benefits to pretreated patients with metastatic colorectal cancer? Clin Transl Oncol 2016; 18:1072-1081. [PMID: 27037815 DOI: 10.1007/s12094-016-1499-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/03/2016] [Indexed: 01/26/2023]
Abstract
Treatment with regorafenib has demonstrated statistically significant improvements in terms of overall survival, progression-free survival and disease control when compared with placebo in pretreated patients with metastatic colorectal cancer in two placebo-controlled, randomized, phase III trials (CORRECT and CONCUR). Similar results were observed in two open-label, single-arm studies (REBECCA and CONSIGN) performed in the real-world setting. But several authors have suggested that the benefit provided by regorafenib may not be clinically meaningful for these patients. Moreover, it has been suggested that not all subgroups of patients might benefit from regorafenib. The intention of this review is to provide an overview of the existing evidence for regorafenib in terms of efficacy, tolerability and quality of life in different subpopulations according to clinical and biological characteristics. Additionally, the magnitude of the clinical benefit provided by regorafenib to these patients has been explored and whether there are poorer outcomes in certain subpopulations.
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Affiliation(s)
- P García-Alfonso
- Medical Oncology Department, Gregorio Marañón University Hospital (Center Affiliated to the Red Tematica de Investigacion Cooperativa en Cancer [RTICC], Instituto Carlos III, Spanish Ministry of Science and Innovation), Madrid, Spain.
| | - J Feliú
- Medical Oncology Department, La Paz University Hospital, Madrid, Spain
| | - R García-Carbonero
- Medical Oncology Department, Doce de Octubre University Hospital (Center Affiliated to the Red Tematica de Investigacion Cooperativa en Cancer [RTICC], Instituto Carlos III, Spanish Ministry of Science and Innovation), Madrid, Spain
| | - C Grávalos
- Medical Oncology Department, Doce de Octubre University Hospital (Center Affiliated to the Red Tematica de Investigacion Cooperativa en Cancer [RTICC], Instituto Carlos III, Spanish Ministry of Science and Innovation), Madrid, Spain
| | - C Guillén-Ponce
- Medical Oncology Department, Ramón y Cajal University Hospital (Center Affiliated to the Red Tematica de Investigacion Cooperativa en Cancer [RTICC], Instituto Carlos III, Spanish Ministry of Science and Innovation), Madrid, Spain
| | - J Sastre
- Medical Oncology Department, Clinic San Carlos University Hospital (Center Affiliated to the Red Tematica de Investigacion Cooperativa en Cancer [RTICC], Instituto Carlos III, Spanish Ministry of Science and Innovation), Madrid, Spain
| | - J García-Foncillas
- Oncology Department, Cancer Institute University Hospital (Fundacion Jimenez Diaz), Autonomous University of Madrid, Madrid, Spain
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511
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Kang HJ, Kay CS, Son SH, Kim M, Jo IY, Lee SJ, Lee DH, Suh HJ, Choi YS. Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study. Radiat Oncol J 2016; 34:45-51. [PMID: 27104166 PMCID: PMC4831968 DOI: 10.3857/roj.2016.34.1.45] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 02/06/2016] [Accepted: 03/10/2016] [Indexed: 12/04/2022] Open
Abstract
Purpose The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer. Materials and Methods Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the α/β ratio is 1.5 Gy. Results The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ≥3 acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed. Conclusion Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.
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Affiliation(s)
- Hye Jin Kang
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Chul-Seung Kay
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Seok Hyun Son
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Myungsoo Kim
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - In Young Jo
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - So Jung Lee
- Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Dong Hwan Lee
- Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Hong Jin Suh
- Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
| | - Yong Sun Choi
- Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea
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512
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Gupta K, Panda NK, Bakshi J, Das A. To evaluate disparity between clinical and pathological tumor-node-metastasis staging in oral cavity squamous cell carcinoma patients and its impact on overall survival: An institutional study. South Asian J Cancer 2016; 4:183-5. [PMID: 26981511 PMCID: PMC4772397 DOI: 10.4103/2278-330x.175957] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background: Accurate clinical staging is important for patient counseling, treatment planning, prognostication, and rational design of clinical trials. In head and neck squamous cell carcinoma, discrepancy between clinical and pathological staging has been reported. Objective: To evaluate any disparity between clinical and pathological tumor-node-metastasis (TNM) staging in oral cavity squamous cell carcinoma (OCSCC) patients and any impact of the same on survival. Materials and Methods: Retrospective chart review from year 2007 to 2013, at a tertiary care center. Statistical Analysis: All survival analyses were performed using SPSS for Windows version 15 (Chicago, IL, USA). Disease-free survival curves were generated using Kaplan–Meier algorithm. Results: One hundred and twenty-seven patients with OCSCC were analyzed. Seventy-nine (62.2%) were males and 48 (37.8%) females with a mean age at presentation 43.6 years (29–79 years). The highest congruence between clinical and pathological T-staging seen for clinical stage T1 and T4 at 76.9% and 73.4% with pathological T-stage. Similarly, the highest congruence between clinical and pathological N-stage seen for clinical N0 and N3 at 86.4% and 91.7% with pathological N-stage. Of clinically early stage patients, 67.5% remained early stage, and 32.5% were upstaged to advanced stage following pathological analysis. Of the clinically advanced stage patients, 75% remained advanced, and 25% were pathologically downstaged. This staging discrepancy did not significantly alter the survival. Conclusion: Some disparity exists in clinical and pathological TNM staging of OCSCC, which could affect treatment planning and survival of patients. Hence, more unified and even system of staging for the disease is required for proper decision-making.
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Affiliation(s)
- Karan Gupta
- Department of Otolaryngology and Head-Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh K Panda
- Department of Otolaryngology and Head-Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaimanti Bakshi
- Department of Otolaryngology and Head-Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashim Das
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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513
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Weixler B, Warschkow R, Ramser M, Droeser R, von Holzen U, Oertli D, Kettelhack C. Urgent surgery after emergency presentation for colorectal cancer has no impact on overall and disease-free survival: a propensity score analysis. BMC Cancer 2016; 16:208. [PMID: 26968526 PMCID: PMC4787247 DOI: 10.1186/s12885-016-2239-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 03/01/2016] [Indexed: 12/16/2022] Open
Abstract
Background It remains a matter of debate whether colorectal cancer resection in an emergency setting negatively impacts on survival. Our objective was therefore to assess the impact of urgent versus elective operation on overall and disease-free survival in patients undergoing resection for colorectal cancer by using propensity score adjusted analysis. Methods In a single-center study patients operated for colorectal cancer between 1989 and 2013 were identified from a prospectively maintained database. Median follow-up was 44 months. Patients with neoadjuvant treatment were excluded. The impact of urgent operation on overall and disease-free survival was assessed using both Cox regression and propensity score analyses. Results Of 747 patients with colorectal cancer, 84 (11 %) had urgent and 663 elective cancer resection. The propensity score revealed strongly biased patient characteristics (0.22 ± 0.16 vs. 0.10 ± 0.09; P < 0.001). In unadjusted analysis urgent operation was associated with a 35 % increased risk of overall mortality (hazard ratio(HR) of death = 1.35, 95 % confidence interval(CI):1.02–1.78, P = 0.045). In risk-adjusted Cox regression analysis urgent operation was not associated with poor overall (HR = 1.08, 95 %CI:0.79–1.48; P = 0.629) or disease-free survival (HR = 1.02, 95 %CI:0.76–1.38; P = 0.877). Similarly in propensity score analysis urgent operation did not influence overall (HR = 0.98, 95 % CI:0.74–1.29), P = 0.872) and disease-free survival (HR = 0.89, 95 %CI:0.68 to 1.16, P = 0.387). Conclusions This study provides evidence that worse oncologic outcomes after urgent operation for colorectal cancer are caused by clinical circumstances and not due to the urgent operation itself. Urgent operation is not a risk factor for colorectal cancer resection.
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Affiliation(s)
- Benjamin Weixler
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Rene Warschkow
- Department of Surgery, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.,Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Michaela Ramser
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Raoul Droeser
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Urs von Holzen
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.,Goshen Center for Cancer Care, Goshen, IN, 46507, USA
| | - Daniel Oertli
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Christoph Kettelhack
- Department of Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
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514
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Asayama N, Oka S, Tanaka S, Ninomiya Y, Tamaru Y, Shigita K, Hayashi N, Egi H, Hinoi T, Ohdan H, Arihiro K, Chayama K. Long-term outcomes after treatment for T1 colorectal carcinoma. Int J Colorectal Dis 2016; 31:571-8. [PMID: 26689400 DOI: 10.1007/s00384-015-2473-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE Long-term outcomes of patients with T1 colorectal carcinoma (CRC) treated by endoscopic resection (ER) or surgical resection are unclear in relation to the curative criteria in the Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines. The aim of this study was to retrospectively compare the long-term outcomes among patients with T1 CRC in relation to the treatment methods. METHODS We examined 322 T1 CRC cases treated between January 1992 and August 2008 at Hiroshima University Hospital. Patients who did not meet the curative criteria in the JSCCR guidelines were defined as "non-endoscopically curable" and classified into three groups: underwent ER alone (group A: 45 patients), underwent additional surgery after ER (group B: 106 patients), and underwent surgical resection alone (group C: 92 patients). RESULTS Of the 322 T1 CRC patients, 79 were categorized as endoscopically curable and 243 as non-endoscopically curable. Among the endoscopically curable T1 CRC patients, recurrence and 5-year OS rates were 0 and 94.2%, respectively. In groups A, B, and C, recurrence rates were 4.4, 6.6, and 4.3%, and OS rates were 85.6, 95.1, and 96.3%, respectively (p < 0.05). Local recurrence or distant/lymph node metastasis was observed in 13 patients (group A: 2; group B: 7; group C: 4). Death due to primary CRC occurred in six patients (group B: 4; group C: 2). CONCLUSION Long-term outcomes support the curative criteria according to the JSCCR guidelines. ER for T1 CRC did not worsen clinical outcomes in cases that required additional surgical resection.
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Affiliation(s)
- Naoki Asayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shiro Oka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
| | - Shinji Tanaka
- Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan
| | - Yuki Ninomiya
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuzuru Tamaru
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenjiro Shigita
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Nana Hayashi
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroyuki Egi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takao Hinoi
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Kazuaki Chayama
- Department of Gastroenterology and Metabolism, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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515
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Moreira DM, Gershman B, Lohse CM, Boorjian SA, Cheville JC, Leibovich BC, Thompson RH. Paraneoplastic syndromes are associated with adverse prognosis among patients with renal cell carcinoma undergoing nephrectomy. World J Urol 2016; 34:1465-72. [PMID: 26914818 DOI: 10.1007/s00345-016-1793-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 02/12/2016] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVES To analyze the association of paraneoplastic syndromes (PNS) with progression-free (PFS) and cancer-specific survival (CSS) among patients with renal cell carcinoma (RCC) undergoing nephrectomy. METHODS We performed a retrospective analysis of 2865 patients undergoing nephrectomy for localized RCC at Mayo Clinic from 1990 to 2010. PNS analyzed were anemia, polycythemia, hypercalcemia, recent-onset hypertension, and liver dysfunction. PFS and CSS were estimated using Kaplan-Meier method and compared with Cox proportional hazard models, unadjusted and adjusted for clinicopathologic features. RESULTS A total of 661 (23 %) patients had anemia, 37 (1 %) had polycythemia, 177 (9 %) had hypercalcemia, 51 (2 %) had recent-onset hypertension, and 224 (10 %) had liver dysfunction at time of nephrectomy. Patients with PNS were more likely to have high-grade tumors and advanced disease stages. A total of 675 (24 %) patients developed progression and 1171 (41 %) died of RCC, over a median follow-up of 8.2 years. On univariable analysis, the presence of any PNS was associated with inferior CSS [hazard ratio (HR) = 1.86, p = 0.007] and a trend toward shorter PFS (HR = 1.33, p = 0.07) compared with patients without PNS. Specifically, anemia, polycythemia, hypercalcemia, and liver dysfunction were each associated with inferior CSS and PFS (all p < 0.05). However, on multivariable analysis PNS (overall or each individual syndrome) did not remain independently associated with CSS or PFS. CONCLUSIONS Patients with RCC undergoing nephrectomy presenting with PNS have worse oncologic outcome than those with incidentally found tumors. However, the adverse outcome among PNS patients seems to be largely explained by adverse pathologic features of these tumors.
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Affiliation(s)
- Daniel M Moreira
- Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
| | - Boris Gershman
- Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Christine M Lohse
- Division of Biomedical Statistics and Informatics, Mayo Foundation for Medical Education and Research, Mayo Clinic, Rochester, MN, USA
| | - Stephen A Boorjian
- Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | | | - Bradley C Leibovich
- Department of Urology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
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516
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Cho SH, Chun JM, Kwon HJ, Han YS, Kim SG, Hwang YJ. Outcomes and recurrence pattern after non-anatomic liver resection for solitary hepatocellular carcinomas. Korean J Hepatobiliary Pancreat Surg 2016; 20:1-7. [PMID: 26925143 PMCID: PMC4767267 DOI: 10.14701/kjhbps.2016.20.1.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Revised: 09/26/2015] [Accepted: 09/30/2015] [Indexed: 12/11/2022]
Abstract
Backgrounds/Aims Anatomic resection (AR) is preferred for eradicating portal tributaries in patients with hepatocellular carcinoma (HCC). However, the extent of resection is influenced by underlying liver disease and tumor location. We compared the surgical outcomes and recurrence pattern between non-anatomic resection (NR) and AR. Methods From March 2009 to February 2012, 184 patients underwent surgical resection for HCC. Among these, 79 patients who were primarily treated for a single tumor without rupture or macroscopic vascular invasion were enrolled. The patients were divided into 2 groups based on the extent of resection: AR (n=31) or NR (n=48). We compared the clinical characteristics, overall survival, disease-free survival, pattern of recurrence, and biochemical liver functions during the perioperative period between the two groups. Results The extent of resection had no significant effect on overall or disease-free survival rates. The overall 1- and 3-year survival rates were 97% and 82% in the AR group, and 96% and 89% in the NR group, respectively (p=0.49). In addition, the respective 1- and 3-year disease-free survival rates for the AR and NR groups were 84% and 63%, and 85% and 65%, respectively (p=0.94). On the other hand, the presence of hepatic cirrhosis and a tumor size of >5 cm were significant risk factors for recurrence according to multivariate analysis (p<0.001 and p=0.003, respectively). The frequency of early recurrence, the first site of recurrence, and the pattern of intrahepatic recurrence were similar between the 2 groups (p=0.419, p=0.210, and p=0.734, respectively); in addition, the frequency of marginal recurrence did not differ between the 2 groups (1 patient in the AR group and 2 in the NR group). The NR group showed better postoperative liver function than the AR group. Conclusions Non-anatomic liver resection can be a safe and efficient treatment for patients with a solitary HCC without rupture or gross vascular invasion.
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Affiliation(s)
- Sung Hoon Cho
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jae Min Chun
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyung Jun Kwon
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Young Seok Han
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Sang Geol Kim
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Yoon Jin Hwang
- Department of Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
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517
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Jain MM, Gupte SU, Patil SG, Pathak AB, Deshmukh CD, Bhatt N, Haritha C, Govind Babu K, Bondarde SA, Digumarti R, Bajpai J, Kumar R, Bakshi AV, Bhattacharya GS, Patil P, Subramanian S, Vaid AK, Desai CJ, Khopade A, Chimote G, Bapsy PP, Bhowmik S. Paclitaxel injection concentrate for nanodispersion versus nab-paclitaxel in women with metastatic breast cancer: a multicenter, randomized, comparative phase II/III study. Breast Cancer Res Treat 2016; 156:125-34. [PMID: 26941199 PMCID: PMC4788678 DOI: 10.1007/s10549-016-3736-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 02/25/2016] [Indexed: 10/30/2022]
Abstract
Paclitaxel is widely used in the treatment of patients with metastatic breast cancer (MBC). Formulations of paclitaxel contain surfactants and solvents or albumin derived from human blood. The use of co-solvents such as polyoxyethylated castor oil is thought to contribute to toxicity profile and hypersensitivity reactions as well as leaching of plasticizers from polyvinyl chloride bags and infusion sets. Currently, nab-paclitaxel, an albumin-bound paclitaxel in nanometer range continues to be the preferred taxane formulation used in clinic. This study (CTRI/2010/091/001116) investigated the efficacy and tolerability of a polyoxyethylated castor oil- and albumin-free formulation of paclitaxel [paclitaxel injection concentrate for nanodispersion (PICN)] compared with nab-paclitaxel in women with refractory MBC. The current study was a multicenter, open-label, parallel-group, randomized, comparative phase II/III trial evaluating the efficacy and safety of PICN (260 mg/m(2) [n = 64] and 295 mg/m(2) [n = 58] every 3 weeks) compared with nab-paclitaxel (260 mg/m(2) every 3 weeks [n = 58]) in women 18 and 70 years old with confirmed MBC. Overall response rate (ORR) was assessed with imaging every 2 cycles. An independent analysis of radiologic data was performed for evaluable patients. Progression-free survival (PFS) was a secondary efficacy measure. Independent radiologist-assessed ORRs in the evaluable population of women aged ≥70 years were 35, 49, and 43 % in the PICN 260 mg/m(2), PICN 295 mg/m(2), and nab-paclitaxel 260 mg/m(2) arms, respectively. Median PFS in the evaluable population was 23, 35, and 34 weeks in the PICN 260 mg/m(2), PICN 295 mg/m(2), and nab-paclitaxel 260 mg/m(2) arms, respectively. Adverse events occurred in similar proportions of patients across treatment arms. Hypersensitivity reactions were not frequently observed with the clinical use of PICN across the treatment cohorts. In women with metastatic breast cancer, PICN at 260 and 295 mg/m(2) every 3 weeks was effective and well tolerated and showed similar tolerability compared with nab-paclitaxel 260 mg/m(2) every 3 weeks. Statistically, significant differences were not observed in the PICN and nab-paclitaxel treatment arms for radiologist-assessed ORR or median PFS. The novel paclitaxel formulation, PICN, offers apart from efficacy, potential safety advantage of decreased use of corticosteroid pretreatment and the absence of the risk of transmission of blood product-borne disease.
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Affiliation(s)
| | | | | | | | | | - Niraj Bhatt
- Kailash Cancer Hospital and Research Centre, Goraj, India
| | | | - K Govind Babu
- Kidwai Memorial Institute of Oncology, Bengaluru, India
| | | | | | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | | | | | | | - Poonam Patil
- Specialty Cancer Care Department, Manipal Hospital, Bengaluru, India
| | | | | | - Chirag J Desai
- Hemato-Oncology Clinic, Vedanta Institute of Medical Sciences, Ahmedabad, India
| | - Ajay Khopade
- Sun Pharma Advanced Research Co. Ltd., 17/B Mahal Industrial Estate, Mahakali Caves Road, Andheri (E), Mumbai, 400093, India
| | - Geetanjali Chimote
- Sun Pharma Advanced Research Co. Ltd., 17/B Mahal Industrial Estate, Mahakali Caves Road, Andheri (E), Mumbai, 400093, India
| | - Poonamalle P Bapsy
- Sun Pharma Advanced Research Co. Ltd., 17/B Mahal Industrial Estate, Mahakali Caves Road, Andheri (E), Mumbai, 400093, India
| | - Shravanti Bhowmik
- Sun Pharma Advanced Research Co. Ltd., 17/B Mahal Industrial Estate, Mahakali Caves Road, Andheri (E), Mumbai, 400093, India.
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518
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He J, Lv P, Yang X, Chen Y, Liu C, Qiu X. Pretreatment lymphocyte to monocyte ratio as a predictor of prognosis in patients with early-stage triple-negative breast cancer. Tumour Biol 2016; 37:9037-43. [PMID: 26762408 DOI: 10.1007/s13277-016-4793-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 01/06/2016] [Indexed: 01/04/2023] Open
Abstract
Recent studies have shown that the lymphocyte to monocyte ratio (LMR) is a useful prognostic factor in various cancers. The purpose of the current study was to investigate the association between pretreatment LMR, disease-free survival (DFS), and overall survival (OS) in patients with early-stage (I to III) triple-negative breast cancer (TNBC). Pretreatment LMR with corresponding clinical features from 230 TNBC patients was noted. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimal cutoff values for LMR, lymphocyte, and monocyte counts. The difference between variables was calculated using chi-square tests. The Kaplan-Meier method and univariate and multivariate Cox regression models were applied to assess OS and DFS. Based on the ROC analysis, the optimal cutoff point for LMR was 4.7. Associations between high LMR (≥4.7) and significantly small tumor size (P = 0.005) and TNM stage (P = 0.013) were found, although there was no significant association for other clinical pathological factors. In the multivariate analysis, LMR was a significant predictive factor for both OS (hazard ratio [HR] = 0.42; 95 % confidence interval [CI], 0.19-0.95; P < 0.001) and DFS (HR = 0.40; 95 % CI, 0.20-0.79; P < 0.001). In addition, the predictive values of the OS and DFS were also observed for absolute counts of lymphocytes (P < 0.001) and monocytes (P < 0.001). Our study suggests that pretreatment LMR may be a predictive factor for long-term survival in patients with early-stage TNBC.
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Affiliation(s)
- Juanjuan He
- Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Pengwei Lv
- Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xue Yang
- Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yanli Chen
- Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Chao Liu
- Department of Breast Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, China
| | - Xinguang Qiu
- Department of Thyroid Surgery, The First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China.
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519
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Metzger-Filho O, de Azambuja E, Procter M, Krieguer M, Smith I, Baselga J, Cameron D, Untch M, Jackisch C, Bell R, Gianni L, Goldhirsch A, Piccart M, Gelber RD. Trastuzumab re-treatment following adjuvant trastuzumab and the importance of distant disease-free interval: the HERA trial experience. Breast Cancer Res Treat 2015; 155:127-32. [PMID: 26708471 DOI: 10.1007/s10549-015-3656-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 12/08/2015] [Indexed: 01/03/2023]
Abstract
This retrospective analysis conducted using data from patients enrolled onto the Herceptin Adjuvant has two objectives: The first is to evaluate the impact of the time interval between the end of adjuvant trastuzumab and distant recurrence (TDRI) upon overall survival (OS). The second is to describe the duration of trastuzumab-based regimens in the metastatic setting for patients previously treated with adjuvant trastuzumab. The first objective included 187 patients treated with adjuvant trastuzumab and diagnosed with distant recurrence at 4-year median follow-up. The second objective included data from questionnaires sent to investigators retreating patients with trastuzumab upon distant recurrence: 144 of 156 questionnaires were returned (93 %), and 90 patients were selected based on available clinical information and consent for subsequent studies. There was no statistically significant relationship between TDRI following 1 year of adjuvant trastuzumab and OS from distant recurrence: hazard ratio 0.991, p = 0.46. The median OS from distant recurrence was numerically longer among patients with a TDRI of ≥12 months (n = 103) than <12 months (n = 84) but not statistically significant (23.7 vs. 17.8 months, p = 0.47). The median duration of first-line trastuzumab-based regimens for patients previously treated with adjuvant trastuzumab and diagnosed with distant disease recurrence was 8.8 months (n = 88). This retrospective, exploratory study suggests that TDRI did not impact on OS measured from distant recurrence. We argue that prospective collection of treatment information beyond disease progression should be included in future clinical studies.
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Affiliation(s)
- Otto Metzger-Filho
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue Yawkey, Boston, 1238, USA.
| | - Evandro de Azambuja
- Department of Medical Oncology and Breast European Adjuvant Study Team (BrEAST) Data Centre, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium.
| | - Marion Procter
- Frontier Science (Scotland) Ltd, Kincraig, Kingussie, UK.
| | - Magalie Krieguer
- Breast European Adjuvant Study Team (BrEAST) Data Centre, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium.
| | - Ian Smith
- Breast Unit, Royal Marsden Hospital, and Institute of Cancer Research, London, UK.
| | - Jose Baselga
- Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
| | - David Cameron
- Edinburgh Cancer Research Centre, Western general Hospital, University of Edinburgh, Crewe Road South, Edinburgh, UK.
| | - Michael Untch
- Department of Gynecology and Obstetrics and Multidisciplinary Breast Cancer Center, Helios Klinikum, Berlin-Buch, Germany.
| | - Christian Jackisch
- Department of Gynecology and Obstetrics, Klinikum Off enbach, Off Enbach, Germany.
| | - Richard Bell
- Department of Medical Oncology, The Andrew Love Cancer Centre, Deakin University, Geelong, Australia.
| | - Luca Gianni
- Department of Medical Oncology, San Raffaele Institute, Milan, Italy.
| | - Aron Goldhirsch
- European Institute of Oncology, Milan, Italy. .,Swiss Center for Breast Health, Sant'Anna Clinic, Lugano-Sorengo, Switzerland.
| | - Martine Piccart
- Department of Medicine, Institut Jules Bordet and Université Libre de Bruxelles, Brussels, Belgium.
| | - Richard D Gelber
- Department of Biostatistics and Computational Biology, International Breast Cancer Study Group (IBCSG) Statistical Center, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School, Boston, USA.
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520
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Zhu YY, Si W, Ji TF, Guo XQ, Hu Y, Yang JL. The variation and clinical significance of hormone receptors and Her-2 status from primary to metastatic lesions in breast cancer patients. Tumour Biol 2016; 37:7675-84. [PMID: 26687919 DOI: 10.1007/s13277-015-4649-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 12/14/2015] [Indexed: 12/13/2022] Open
Abstract
The objective of this study is to investigate how the change of hormone receptor (HR) and human epidermal growth factor receptor-2 (Her-2) status is related to patients' clinical features. One hundred ninety-three cases of patients treated at general hospital of PLA from 2000 to 2015 with advanced breast cancer were included. All patients developed recurrence that were re-biopsied and had complete pathological profile both at initial diagnosis and at relapse. HR status before and after relapse were available for all patients, while only 143 cases had Her-2 status at the two stages. The changes of ER, PR, and Her-2 status and their association with clincopathological factors and DFS were analyzed. The discordant rates of ER, PR, and Her-2 status between primary breast cancer and recurrent tumor were 34.2, 38.3, and 16.8 %, respectively. At relapse, the rates of gain of ER and PR positivity were 10.9 and 13.5 %, respectively; the rates of loss of ER and PR positivity were 23.3 and 24.9 %. Loss of positivity was more frequent than gain of positivity (p ER < 0.000, p PR = 0.001). Among patients with Her-2 negative primary tumors, 15.4 % acquired Her-2 positivity at relapse; and among Her-2 positive patients at initial diagnosis, 1.4 % turned to Her-2 negative at relapse; gain of positivity was more frequent than loss of positivity (p < 0.000). Patients with tumor larger than 2 cm in diameter were more likely to experience change of Her-2 status (25.0 vs 5.8 %, p = 0.005). Yet, the change of ER/PR was not significantly associated with the size of primary tumor. Patients with ER positive recurrent disease and PR positive primary tumor had a DFS of more than 40 months. Compared to patients who maintained PR negative, patients who gained PR positivity at relapse had significantly longer DFS by 8.5 % (35.2 vs 26.7 months, p = 0.024). Patients losing ER positivity at relapse had shorter DFS by 7.8 months compared to those with stable ER positive tumors; patients gaining ER positivity experienced longer DFS by 8.3 months; but both differences were not statistically significant. Loss of Her-2 positivity was associated with longer DFS by 13.8 months as opposed to stable Her-2 status, without statistical significance. For patients with Her-2 negative primary tumor, the changes of Her-2 status were not associated with DFS. 34.2, 38.3, and 16.8 % of breast cancer patients had their ER, PR, and Her-2 status changed after recurrence, and these changes of receptor status were associated with DFS to some degree. Gain of PR positivity at relapse was significantly correlated with longer DFS.
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521
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Liang Y, Lü B, Chen X, Qin J, Cheng X, Xie X, Lü W. Prognostic value of pathological response to neoadjuvant chemotherapy in bulky stage Ib2 and IIa cervical squamous cell cancer patients. Virchows Arch 2016; 468:329-36. [PMID: 26637198 DOI: 10.1007/s00428-015-1888-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 10/22/2015] [Accepted: 11/22/2015] [Indexed: 12/20/2022]
Abstract
Neoadjuvant chemotherapy (NAC) is widely used to treat patients with locally advanced cervical cancer. Optimal pathological response to neoadjuvant therapy has proven to be a good prognostic indicator for patient survival, but the prognostic significance of a partial response remains unclear. The aim of this study was to identify prognostic predictors for patients with partial response. We included in the study 190 patients with bulky stage Ib2 or IIa cervical squamous cell cancer, who underwent neoadjuvant chemotherapy followed by surgery. A novel pathological grading system, including optimal response (complete disappearance of tumor, grade 1), viable tumor cells occupying <(2)/3 (grade 2) or >(2)/3 (grade 3) of the tumor bed area and extra-cervical tumor deposits (grade 4), was developed and associations with disease-free survival and overall survival were studied. Survival analysis was conducted using log-rank testing and Cox regression analysis. We found statistically significant differences between 4 different pathological response groups both in terms of disease-free survival (p = 0.001) and overall survival (p = 0.003). Combining adjacent survival curves in the pathological grading system allowed us to identify response grade 2 patients with disease-free and overall survival similar to those of optimal response patients (p = 0.000, p = 0.002). Multivariate analyses showed that the pathological response grading system is the only independent predictor for progression-free survival and overall survival (p = 0.001 and p = 0.007). A response grading system based on pathological parameters may be useful to predict both progression-free and overall survival in bulky stage Ib2 and IIa cervical squamous cell cancer patients treated with NAC.
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522
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Asteria CR, Pucciarelli S, Gerard L, Mantovani N, Pagani M, Boccia L, Ricci P, Troiano L, Lucchini G, Pulica C. The impact of colorectal screening program on the detection of right-sided colorectal cancer. A 5-year cohort study in the Mantua District. Int J Colorectal Dis 2015; 30:1627-37. [PMID: 26255258 DOI: 10.1007/s00384-015-2352-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND High rates of advanced colorectal cancer (CRC) are still diagnosed in the right side of the colon. This study aimed to investigate whether screening programs increase CRC detection and whether tumor location is associated with survival outcome. METHODS Patients affected by CRC, aged from 50 to 69 years and operated on from 2005 to 2009 were reviewed. Other than patient-, disease-, and treatment-related factors, detection mode and tumor location were recorded. Overall (OS) and disease-free survival (DFS) were investigated, using univariate and multivariate analyses. RESULTS Mean age of 386 patients included was 62.0 years, 59 % were males. CRC was detected by screening in 17 % of cases, and diagnosis was made from symptoms in 67 % and emergency surgery for 16 %. Screen-detected CRCs were located in the left colon (59 %), then in rectum (25 %) and in proximal colon (16 %) (p = 0.02). Most of CRC patients urgently operated on had cancer located in proximal colon (45 %), then in the left colon (36 %) and in rectum (18 %) (p = 0.001). Right-sided CRC demonstrated higher pTNM stage (p = 0.001), adequate harvest count nodes (p = 0.0001), metastatic nodes (p = 0.02), and poor differentiation grading (p = 0.0001). With multivariate analysis, poor differentiation grade was independently associated with both worse OS (HR 3.6, p = 0.05) and worse DFS (HR 8.1, p = 0.0001), while distant recurrence was associated with worse OS (HR 20.1, p = 0.0001). CONCLUSION Low rates of right-sided CRC are diagnosed following screening program. Proximal CRC demonstrates aggressive behavior without impact on outcome. These findings prompt concern about population awareness for CRC screening.
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Affiliation(s)
- Corrado R Asteria
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy.
| | - Salvatore Pucciarelli
- Department of Surgery Oncology and Gastroenterology, Surgical Clinic I, School of Medicine, University of Padua, Padua, Italy
| | - Leonardo Gerard
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
| | - Nicola Mantovani
- Department of Surgery and Orthopaedics, Digestive Endoscopy Unit, Carlo Poma Hospital, Mantua, Italy
| | - Mauro Pagani
- Department of Medicine, Medicine Unit, Pieve Coriano, Carlo Poma Hospital Mantua, Mantua, Italy
| | - Luigi Boccia
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
| | - Paolo Ricci
- Epidemiological Observatory Local Health-care Authority (LHCA), Mantua, Italy
| | - Luigi Troiano
- Department of Surgery and Orthopaedics, Digestive Endoscopy Unit, Carlo Poma Hospital, Mantua, Italy
| | - Giuseppe Lucchini
- Department of Healthcare Medical Management, Biostatistic Service, Carlo Poma Hospital, Mantua, Italy
| | - Coriolano Pulica
- Department of Surgery and Orthopaedics, General Surgery Units of Asola, Mantua and Pieve C., Carlo Poma Hospital, 80° Fanteria Place, 1-46041, Asola, Mantua, Italy
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523
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Chung SY, Jung YY, Park IA, Kim H, Chung YR, Kim JY, Park SY, Im SA, Lee KH, Moon HG, Noh DY, Han W, Lee C, Kim TY, Ryu HS. Oncogenic role of SIRT1 associated with tumor invasion, lymph node metastasis, and poor disease-free survival in triple negative breast cancer. Clin Exp Metastasis 2015; 33:179-85. [PMID: 26585892 DOI: 10.1007/s10585-015-9767-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/09/2015] [Indexed: 12/31/2022]
Abstract
The aim of this study is to evaluate the biological role and clinical implications of silent mating type information regulation 2 homolog 1 (SIRT1) as a novel candidate for target therapy in triple negative breast cancer (TNBC) for which there is no specific agent. 344 patients who received surgical resection for TNBC from January 2003 to December 2006 at Seoul National University Hospital were enrolled, and the role of SIRT1 protein was evaluated via immunohistochemistry on tissue samples. In vivo experiments to evaluate tumor invasiveness were carried out with three human TNBC cell lines following SIRT1-siRNA transfection. Expression of SIRT1 significantly correlated with lymph node metastasis (p = 0.008). In multivariate analysis, SIRT1 expression (p = 0.011), T stage (p = 0.014), and lymphatic invasion (p < 0.001) were revealed to be independent predictive factors for lymph node metastasis. Combination of these three parameters revealed predictive performance for lymph node metastasis with an area under the curve (AUC) of 0.689 on receiver operating characteristics (ROC) curves analysis. SIRT1 expression correlated with shorter disease-free survival (P = 0.003) but not with overall survival. Inhibition of SIRT1 with small interfering RNA (siRNA) conspicuously suppressed the invasiveness of TNBC cell lines. This study reveals the role of SIRT1 on tumor invasiveness and unfavorable clinical outcomes, and we suggest its potential role as a prognostic indicator as well as a novel therapeutic target in TNBC.
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Affiliation(s)
- Soo Young Chung
- Department of Pathology, Cancer Center, Dongnam Institute of Radiological and Medical Sciences (DIRAMS), Busan, South Korea
| | - Yoon Yang Jung
- Department of Pathology, Yonsei University College of Medicine, Severance Hospital, Seoul, Korea
| | - In Ae Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Hyojin Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Yul Ri Chung
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Young Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Soo Young Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyeong-Gon Moon
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University Hospital, Seoul, Korea
| | - Chul Lee
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
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524
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Cho KM, Keam B, Kim TM, Lee SH, Kim DW, Heo DS. Clinical efficacy of erlotinib, a salvage treatment for non-small cell lung cancer patients following gefitinib failure. Korean J Intern Med 2015; 30:891-8. [PMID: 26552465 PMCID: PMC4642019 DOI: 10.3904/kjim.2015.30.6.891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 09/29/2014] [Accepted: 12/05/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND/AIMS The purpose of this study was to identify predictive factors for erlotinib treatment in non-small cell lung cancer (NSCLC) patients following gefitinib failure. METHODS Forty-five patients with NSCLC who were treated with erlotinib following gefitinib failure at Seoul National University Hospital between August 2005 and November 2011 were enrolled. Epidermal growth factor receptor (EGFR) mutation status, pathologic findings and other clinical factors, including response to tyrosine kinase inhibitors (TKIs) and progression-free survival (PFS), were evaluated. RESULTS Of the 45 patients, 40 patients (88.8%) had adenocarcinoma. The following EGFR mutations were observed: five patients with a deletion of exon 19, six patients with an L858R mutation, three patients with wild-type EGFR, and 31 patients with unknown mutations. The response rate of erlotinib was 4.4%, and stable disease was 42.2%. The median PFS for erlotinib was 2.6 months (95% confidence interval, 1.4 to 3.7). Patients with a PFS ≥ 4 months during previous gefitinib treatment had a significantly longer PFS with erlotinib (3.3 months vs. 1.6 months, respectively; p < 0.01) than patients with PFS < 4 months with gefitinib. According to multivariate analyses, PFS ≥ 4 months for previous gefitinib treatment was significantly associated with prolonged PFS with erlotinib (p = 0.04). However, the response rate of gefitinib and treatment sequence were not associated with prolonged PFS with erlotinib (p = 0.28 and p = 0.67, respectively). CONCLUSIONS Following rechallenge with the EGFR TKI erlotinib following gefitinib failure, patients who showed prolonged PFS with gefitinib benefit from erlotinib. However, further prospective studies are needed to confirm these findings.
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Affiliation(s)
- Kyoung Min Cho
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Correspondence to Bhumsuk Keam, M.D. Department of Internal Medicine, Seoul National University Hospital, 101 Daehak-ro, Jongno- gu, Seoul 03080, Korea Tel: +82-2-2072-7215 Fax: +82-2-762-9662 E-mail:
| | - Tae Min Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Se-Hoon Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Wan Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Seog Heo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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525
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Jin MS, Hyun CL, Park IA, Kim JY, Chung YR, Im SA, Lee KH, Moon HG, Ryu HS. SIRT1 induces tumor invasion by targeting epithelial mesenchymal transition-related pathway and is a prognostic marker in triple negative breast cancer. Tumour Biol 2015; 37:4743-53. [PMID: 26515337 DOI: 10.1007/s13277-015-4231-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 10/12/2015] [Indexed: 12/17/2022] Open
Abstract
Absence of therapeutic targets poses a critical hurdle in improving prognosis for patients with triple negative breast cancer (TNBC). We evaluated interaction between SIRT1 and epithelial mesenchymal transition (EMT)-associated proteins as well as the role of combined protein expression as a predictor of lymph node metastasis and clinical outcome in TNBC through in vivo and vitro studies. Three hundred nineteen patients diagnosed with TNBC were chosen, immunohistochemical staining for SIRT1 and EMT-related markers' expression was performed on tissue microarrays, and in vitro experiments with each of the three human TNBC cell lines were carried out. The cohort was reclassified according to the use of adjuvant chemotherapy, tumor size, and AJCC stage to analyze the prognostic role of SIRT1 and EMT-related proteins' expression considering different therapeutic modalities and AJCC stages. Combination of four proteins including SIRT1 and three EMT-related proteins was revealed to be a statistically significant independent predictor of lymph node metastasis in the tumor size cohort as well as in the total patient population. Upon Cox regression analysis, increased expression level of the combined proteins correlated with decreased disease-free survival in the total patients as well as those who received adjuvant chemotherapy and those who had early stage breast cancer. In additional in vitro experiments, inhibition of SIRT1 expression with small interfering RNA (siRNA) suppressed tumor invasion in three different TNBC cell lines, and altered expression levels of EMT-related proteins following SIRT1 gene inhibition were identified on western blotting and fluorescence activated cell sorting (FACS) analysis; on the other hand, no change in expression levels of the cell cycle-related factors was observed. Our analysis showed the potential role of SIRT1 in association with EMT-related factors on tumor invasion, metastasis, and disease-free survival in TNBC, SIRT1, and associated EMT-related markers may offer a new prognostic indicator as well as a novel therapeutic candidate.
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Affiliation(s)
- Min-Sun Jin
- Department of Pathology, Buchen St. Mary's Hospital, Catholic university, Gyeonggi-do, South Korea
| | - Chang Lim Hyun
- Department of Pathology, Jeju National University Hospital, Jeju, South Korea
| | - In Ae Park
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Ji Young Kim
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Yul Ri Chung
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hyeong-Gon Moon
- Department of Surgery, Seoul National University Hospital, Seoul, South Korea
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
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526
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Lee SG, Lee J, Kim MJ, Choi JB, Kim TH, Ban EJ, Lee CR, Kang SW, Jeong JJ, Nam KH, Jo YS, Chung WY. Long-term oncologic outcome of robotic versus open total thyroidectomy in PTC: a case-matched retrospective study. Surg Endosc 2015; 30:3474-9. [PMID: 26514137 DOI: 10.1007/s00464-015-4632-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 10/17/2015] [Indexed: 12/12/2022]
Abstract
PURPOSE The role of the robot in thyroid surgery remains uncertain, and it is unclear whether robotic total thyroidectomy (R-TT) can be justified as a standard treatment for patients with thyroid cancer. This study compared the long-term operative results and oncologic outcomes of R-TT and conventional open TT (O-TT) after propensity score matching of the cohorts. METHODS This study retrospectively evaluated patients with papillary thyroid cancer (PTC) who underwent TT with central compartment node dissection (CCND) by a single surgeon in tertiary medical center. Of the 833 patients, 94 (11.3 %) were lost to follow-up. 245 (33.2 %) underwent R-TT, and 494 (66.8 %) underwent O-TT. The mean follow-up duration was 74 (range 61-91) months. Propensity score matching in age, gender, tumor size, extrathyroidal invasion, multiplicity, bilaterality, and TNM stage identified 206 pairs of patients. The long-term oncologic outcomes were assessed in the R-TT and O-TT groups before and after adjustment for baseline covariates. RESULTS After adjustment for baseline covariates, serum thyroglobulin (Tg) (p = 0.746) and anti-thyroglobulin antibody (TgAb) (p = 0.394) concentrations were similar in the two groups 5 years after surgery. Nine patients experienced locoregional recurrence, six in the O-TT and three in the R-TT group, with all recurrences in regional LNs. Disease-free survival (DFS) was similar in the R-TT and O-TT groups before matching (p = 0.890) and after adjustment for baseline covariates (p = 0.882). CONCLUSION This represents the first report of 5-year surgical outcomes in patients who underwent R-TT for thyroid cancer. Long-term oncologic quality was similar after R-TT and O-TT.
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Affiliation(s)
- Seul Gi Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Jandee Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Min Jhi Kim
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Jung Bum Choi
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Tae Hyung Kim
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Eun Jeong Ban
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Cho Rok Lee
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Sang Wook Kang
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Jong Ju Jeong
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Kee Hyun Nam
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea
| | - Young Suk Jo
- Department of Internal Medicine, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Woong Youn Chung
- Department of Surgery, Open NBI Convergence Technology Research Laboratory, Severance Hospital, Yonsei Cancer Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
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Hong J, Mao Y, Chen X, Zhu L, He J, Chen W, Li Y, Lin L, Fei X, Shen K. Elevated preoperative neutrophil-to-lymphocyte ratio predicts poor disease-free survival in Chinese women with breast cancer. Tumour Biol 2015; 37:4135-42. [PMID: 26490984 DOI: 10.1007/s13277-015-4233-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 10/12/2015] [Indexed: 02/06/2023] Open
Abstract
Inflammation and tumor immune microenviroment are critical factors for prognosis in numerous cancers. The aim of this study was to determine the prognostic value of preoperative neutrophil-to-lymphocyte ratio (NLR) in breast cancer. We performed a retrospective analysis of 487 patients diagnosed with primary breast cancer at Shanghai Ruijin hospital from January 2009 to December 2010. Hematological parameters before surgery, clinicopathological data, and survival status were obtained. Survival analysis was used to evaluate the prognostic value of NLR. The optimal cutoff value was determined as 1.93 for NLR and the median follow-up time was 55.0 months. On univariate analysis, patients with high NLR (>1.93) had worse 5-year disease-free survival (DFS) compared to those with low NLR (77.9 vs 88.0 %, p = 0.002). Regarding overall survival, there was no significant difference between patients with high NLR and low NLR, with 5-year overall survival of 90.8 and 91.7 % (p = 0.707). In triple-negative breast cancer, patients with high NLR was associated with worse 5-year DFS compared with patients with low NLR (63.4 vs 84.9 %, p = 0.040). Mutivariate analysis revealed that NLR was an independent prognostic factor for DFS in breast cancer (HR = 1.867, 95 % confidence interval; (95%CI) = 1.155-3.017, p = 0.011). Preoperative NLR is an independent predictor of DFS in breast cancer patients, especially in triple-negative subtype. Further studies are required to validate the prognostic value of NLR before clinical application.
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Affiliation(s)
- Jin Hong
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Yan Mao
- Center of Diagnosis and Treatment for Breast Disease, Affiliated hospital of Qingdao University, 59 Haier Road, Qingdao, 266061, China
| | - Xiaosong Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Li Zhu
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Jianrong He
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Weiguo Chen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Yafen Li
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Lin Lin
- Department of Clinical Laboratory, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Xiaochun Fei
- Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China
| | - Kunwei Shen
- Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Second Road, Shanghai, 200025, China.
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Xia Y, Liu L, Long Q, Bai Q, Wang J, Xu J, Guo J. Decreased expression of CTR2 predicts poor prognosis of patients with clear cell renal cell carcinoma. Urol Oncol 2016; 34:5.e1-9. [PMID: 26411550 DOI: 10.1016/j.urolonc.2015.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Revised: 07/28/2015] [Accepted: 08/24/2015] [Indexed: 11/21/2022]
Abstract
PURPOSE Clear cell renal cell carcinoma (ccRCC) is well known for its hypervascularity due to the Von Hippel-Lindau/hypoxia-inducible factor dysregulation. Recent findings suggested that copper transporter 2 (CTR2) is also associated with angiogenesis through copper׳s modulation of the hypoxia-inducible factor pathway. Our group thus explored the prognostic role of CTR2 in patients with ccRCC. MATERIALS AND METHODS A total of 331 patients with ccRCC who underwent nephrectomy were enrolled between February 2005 and June 2007 at a single institution. The median follow-up was 98.97 months (2.63-120.47mo). Patients׳ samples were collected and stained for CTR2 by immunohistochemistry. The staining intensity was analyzed quantitatively and defined as high/low expression using X-tile software. Stage, Size, Grade, and Necrosis score and University of California Los Angeles Integrated Staging System score were applied to stratify patients׳ risks. Survival analyses were performed through the Kaplan-Meier method and Cox proportional hazard model. After integrating tumoral CTR2 expression with other clinical parameters, 2 nomograms were generated for overall survival (OS) and disease-free survival (DFS) prediction. RESULTS CTR2 expression in ccRCC was decreased compared with that in the peritumoral tissue (P<0.001) and negatively correlated with many other clinical parameters. In survival analyses using the Kaplan-Meier method, low tumoral CTR2 expression displayed a dismal prognostic effect both in OS and DFS prediction (P<0.001). Multivariate analyses also revealed the same result after adjusted with other clinical parameters (P<0.001). Stratifying patients into 3 risk levels using the Stage, Size, Grade, and Necrosis score and University of California Los Angeles Integrated Staging System score, decreased CTR2 expression associated with shorter OS and DFS in the low- and intermediate-risk groups. Moreover, the generated nomogram integrating tumoral CTR2 expression performed better in predicting patients׳ OS than using TNM stages alone (c-index = 0.799; 95% CI: 0.752-0.846 vs. 0.691; 95% CI: 0.637-0.745). CONCLUSIONS CTR2 is a novel prognostic marker for patients with ccRCC both in OS and DFS prediction, and could be incorporated with other clinical parameters for better patient risk stratification.
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529
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Abstract
Background Cyclin D3, which induces progression through the G1 phase of the cell cycle, is a regulator of Cyclin-dependent kinases 4 and 6. Previous studies revealed that abnormal expression of Cyclin D3 was found in many different cancers. However, the role of Cyclin D3 in breast cancer (BC) remains unknown. The aim of this study is to examine the expression pattern of Cyclin D3 in BC and to evaluate its biological role and clinical significance in prognosis prediction. The mechanism involved is also evaluated. Methods Immunohistochemical staining was used to detect the expression of Cyclin D3. qRT-PCR was used to detect the mRNA level of Cyclin D3 in BC tissues and BC cell lines. Transwell assay was used to examine the role of Cyclin D3 in the migration and invasion of BC cells. Mass Spectrometry was used to search for the interacting protein with Cyclin D3. Co-Immunoprecipitation assay and GST-Pull Down assay were used to validate the interaction of Cyclin D3 and its interaction protein. Results Through detecting Cyclin D3 expression in 243 breast cancer patients’ tissue array, we found Cyclin D3 expression was correlated with ER status (p = 0.000), PR status (p = 0.001), HER2 status (p = 0.002) and tumor differentiation (p = 0.045). The Kaplan–Meier survival curves indicated that the disease free survival (DFS) was significantly poor in high Cyclin D3 expression BC patients (p = 0.004). Furthermore, expression of Cyclin D3 was significantly associated with BC prognosis and was shown to be an independent prognostic marker in breast cancer (p = 0.028). By IHC staining and qPCR detection, Cyclin D3 expression was found to be down-regulated both in BC tissues and in BC cell lines compared with the corresponding normal controls. Further investigation showed Cyclin D3 was involved in the metastasis of BC cells and physically interacted with actin in vivo and in vitro. Conclusion Our studies revealed that Cyclin D3 was upregulated in breast cancer and represented a novel predictor of BC prognosis. Electronic supplementary material The online version of this article (doi:10.1186/s12935-015-0245-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yayun Chi
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Building 7, No. 270 Dong An Road, Shanghai, 200032 China
| | - Sheng Huang
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Building 7, No. 270 Dong An Road, Shanghai, 200032 China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
| | - Mengying Liu
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Building 7, No. 270 Dong An Road, Shanghai, 200032 China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
| | - Liang Guo
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Building 7, No. 270 Dong An Road, Shanghai, 200032 China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
| | - Xuxia Shen
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032 China
| | - Jiong Wu
- Department of Breast Surgery, Breast Cancer Institute, Fudan University Shanghai Cancer Center, Building 7, No. 270 Dong An Road, Shanghai, 200032 China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032 China
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530
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Park Y, Lee KS, Park SY, Kim JH, Kang EY, Kim SW, Eom KY, Kim JS, Kim IA. Potential Prognostic Value of Histone Deacetylase 6 and Acetylated Heat-Shock Protein 90 in Early-Stage Breast Cancer. J Breast Cancer 2015; 18:249-55. [PMID: 26472975 PMCID: PMC4600689 DOI: 10.4048/jbc.2015.18.3.249] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 06/25/2015] [Indexed: 12/25/2022] Open
Abstract
Purpose Histone deacetylase 6 (HDAC6) is an enzyme that deacetylates heat-shock protein 90 (HSP90). Many studies have investigated the role of HDAC6 and HSP90 in tumorigenesis and in the prognosis of cancer patients. This study aimed to evaluate the prognostic value of HDAC6 and acetylated HSP90 (acetyl-HSP90) in a cohort of breast cancer patients. Methods Immunohistochemical analysis of 314 surgical specimens obtained from patients with invasive breast cancer was carried out to assess standard pathologic factors and the expression of HDAC6 and acetyl-HSP90. Statistical analyses were performed to determine the association between HDAC6, acetyl-HSP90, and conventional clinicopathological factors, and the prognostic values of these factors were evaluated. Results HDAC6 expression did not show any correlation with other clinicopathological factors, but acetyl-HSP90 was significantly correlated with histologic grade (p=0.001) and the Ki-67 index (p=0.015). HDAC6 and acetyl-HSP90 expression were significantly associated with each other (p=0.047). Although HDAC6 was not prognostic for disease-free survival (DFS), some patients with high expression of HDAC6 experienced recurrence 5 years after diagnosis, while there was no recurrent disease after 5 years in those with low expression. Acetyl-HSP90 was significantly associated with the DFS of all patients (p=0.016) and with high HDAC6 expression (p=0.017), but not with low expression. Conclusion Expression of HDAC6 and acetyl-HSP90 are correlated. HDAC6 is proposed to be a possible predictive marker of late recurrence, and acetyl-HSP90 has prognostic value in predicting the DFS of breast cancer patients.
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Affiliation(s)
- Younghee Park
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyu Sang Lee
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - So Yeon Park
- Department of Pathology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jee Hyun Kim
- Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Young Kang
- Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Won Kim
- Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Keon Young Eom
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Sung Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea
| | - In Ah Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. ; Breast Care Center, Seoul National University Bundang Hospital, Seongnam, Korea
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Ryu HK, Baek JS, Kang WD, Kim SM. The prognostic value of squamous cell carcinoma antigen for predicting tumor recurrence in cervical squamous cell carcinoma patients. Obstet Gynecol Sci 2015; 58:368-76. [PMID: 26430661 DOI: 10.5468/ogs.2015.58.5.368] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 04/26/2015] [Accepted: 04/29/2015] [Indexed: 11/08/2022] Open
Abstract
Objective The aim of this study was to evaluate the prognostic value of squamous cell carcinoma antigen (SCC-Ag) and the optimal cut-off value for predicting recurrence in cervical squamous cell carcinoma patients with complete remission after primary treatment. Methods We reviewed the records of 783 cervical squamous cell cancer patients who underwent primary therapy and showed complete remission at our institution between January 2000 and April 2014. A receiver operating characteristic curve was used to determine the optimal SCC-Ag threshold to predict recurrence. Cox regression model for disease free survival was used to assess differences in outcome. Results The median follow-up period was 41.2 months, and 154 patients (19.7%) had recurrent disease. The median pretreatment and posttreatment SCC-Ag level was 2.6 ng/mL (range, 0.1 to 532.0 ng/mL) and 0.7 ng/mL (range, 0.0 to 46.8 ng/mL), respectively. Both pretreatment and posttreatment SCC-Ag levels were higher in the recurrence group (P=0.017 and P=0.039). Optimal cut-off value of pretreatment and posttreatment SCC-Ag for predicting recurrence was 1.86 ng/mL (area under the curve, 0.663; P=0.000), and 0.9 ng/mL (area under the curve, 0.581; P=0.002), respectively. In the multivariate Cox regression model, pretreatment SCC-Ag >1.86 ng/mL (odds ratio, 2.11; 95% confidence interval, 1.38 to 3.22; P=0.001) and posttreatment SCC-Ag >0.9 ng/mL (odds ratio, 1.64; 95% confidence interval, 1.18 to 2.28; P=0.003) were significantly associated with poor disease free survival. Conclusion Patients with pretreatment SCC-Ag >1.86 ng/mL or posttreatment SCC-Ag >0.9 ng/mL should be considered at high risk for cancer recurrence after complete remission, and therefore, closer surveillance is needed.
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532
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El Majdoub F, Neudorfer C, Blau T, Hellmich M, Bührle C, Deckert M, Sturm V, Maarouf M. Stereotactic interstitial brachytherapy for the treatment of oligodendroglial brain tumors. Strahlenther Onkol 2015; 191:936-44. [PMID: 26307628 DOI: 10.1007/s00066-015-0887-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Accepted: 08/07/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE We evaluated the treatment of oligodendroglial brain tumors with interstitial brachytherapy (IBT) using (125)iodine seeds ((125)I) and analyzed prognostic factors. PATIENTS AND METHODS Between January 1991 and December 2010, 63 patients (median age 43.3 years, range 20.8-63.4 years) suffering from oligodendroglial brain tumors were treated with (125)I IBT either as primary, adjuvantly after incomplete resection, or as salvage therapy after tumor recurrence. Possible prognostic factors influencing disease progression and survival were retrospectively investigated. RESULTS The actuarial 2-, 5-, and 10-year overall and progression-free survival rates after IBT for WHO II tumors were 96.9, 96.9, 89.8 % and 96.9, 93.8, 47.3 %; for WHO III tumors 90.3, 77, 54.9 % and 80.6, 58.4, 45.9 %, respectively. Magnetic resonance imaging demonstrated complete remission in 2 patients, partial remission in 13 patients, stable disease in 17 patients and tumor progression in 31 patients. Median time to progression for WHO II tumors was 87.6 months and for WHO III tumors 27.8 months. Neurological status improved in 10 patients and remained stable in 20 patients, while 9 patients deteriorated. There was no treatment-related mortality. Treatment-related morbidity was transient in 11 patients. WHO II, KPS ≥ 90 %, frontal location, and tumor surface dose > 50 Gy were associated with increased overall survival (p ≤ 0.05). Oligodendroglioma and frontal location were associated with a prolonged progression-free survival (p ≤ 0.05). CONCLUSION Our study indicates that IBT achieves local control rates comparable to surgery and radio-/chemotherapy treatment, is minimally invasive, and safe. Due to the low rate of side effects, IBT may represent an attractive option as part of a multimodal treatment schedule, being supplementary to microsurgery or as a salvage therapy after chemotherapy and conventional irradiation.
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533
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Meng Q, Sun W, Li M, Zhao Y, Chen X, Sun L, Cai L. Increased Expression of Eps15 Homology Domain 1 is Associated with Poor Prognosis in Resected Small Cell Lung Cancer. J Cancer 2015; 6:990-5. [PMID: 26366212 PMCID: PMC4565848 DOI: 10.7150/jca.11650] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/13/2015] [Indexed: 12/20/2022] Open
Abstract
One of the great challenges of small cell lung cancer (SCLC) treatment is identifying patients at high risk for recurrence after surgical resection and chemotherapy. We examined Eps15 homology domain 1 (EHD1) protein expression in paraffin sections of 85 resected SCLC tissues, metastatic lymph nodes and normal bronchial epithelial tissues using immunohistochemistry to study the correlation between EHD1 expression and patient clinicopathological features. Within these variables, disease free survival (DFS) analyzed by the log-rank test was constructed using the multivariate Cox proportional hazards regression model and Kaplan-Meier analysis. Immunohistochemistry results showed that EHD1 protein was significantly increased in SCLC tissues compared with normal tissues (P < 0.001). Moreover, EHD1 expression was positively correlated with tumor size (P = 0.019). Multivariate Cox proportional hazards model analysis showed that EHD1 expression (P = 0.047; HR, 1.869; 95% CI, 1.008-3.466) and American Joint Committee on Cancer (AJCC) status (P < 0.001; HR, 1.412; 95% CI, 1.165-1.711) were independent prognostic indicators of DFS. In conclusion, these data demonstrated a remarkable correlation between the cytoplasmic expression of EHD1 protein and adverse prognosis in patients receiving early-stage cisplatin treatment for resected SCLC.
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Affiliation(s)
- Qingwei Meng
- 1. The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Weiling Sun
- 2. The Department of Endoscopy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Man Li
- 2. The Department of Endoscopy, Harbin Medical University Cancer Hospital, Harbin, China
| | - Yanbin Zhao
- 1. The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xuesong Chen
- 1. The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Lichun Sun
- 1. The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Li Cai
- 1. The Fourth Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
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Huang L, Li G, Fang ZY, Huang J. Predictive and prognostic roles of ribonucleotide reductase M1 in pancreatic cancer: A Meta-analysis. Shijie Huaren Xiaohua Zazhi 2015; 23:3789-3796. [DOI: 10.11569/wcjd.v23.i23.3789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the role of ribonucleotide reductase M1 (RRM1) in predicting the survival of patients with resectable pancreatic cancer who receive gemcitabine adjuvant therapy.
METHODS: Cochrane Library, Medline, Science Direct, Springer link, CBM, Cnki, Wan fang and VIP database were searched before December 31, 2014 to collect the articles regarding RRM1 in the treatment of pancreatic cancer. The quality of the included trials was assessed according to the inclusive and exclusive criteria, and the data were extracted and analyzed using Stata12.0 and RevMan 5.2.10 software.
RESULTS: A total of eight clinical studies involving 556 pancreatic cancer patients treated with adjuvant gemcitabine-based chemotherapy were included, including 373 patients with high RRM1 expression and 293 patients with low RRM1 expression. Meta-analysis showed that high RRM1 expression was associated with improved overall survival (OS) of pancreatic cancer patients (HR = 1.56, 95%CI: 1.17-2.07, P < 0.05). High RRM1 expression also was linked to longer disease-free survival (DFS) than low RRM1 expression (HR = 1.47, 95%CI: 0.83-2.62, P < 0.05).
CONCLUSION: This Meta-analysis shows that high RRM1 expression may be associated with improved OS and DFS of pancreatic cancer patients treated with adjuvant gemcitabine-based chemotherapy. The detection of RRM1 expression may be a promising biomarker for predicting the prognosis of pancreatic cancer patients treated with gemcitabine.
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Abstract
BACKGROUND We investigated the factors associated with post-recurrence survival and the treatment for non-small-cell lung cancer patients with postoperative distant recurrence, especially oligometastasis. METHODS We reviewed the data of 272 patients with distant recurrence who underwent resection of non-small-cell lung cancer from January 2000 through December 2011. RESULTS The type of distant recurrence was classified as oligometastasis (n = 76, 28%) or polymetastasis (n = 196, 72%). Forty-seven (62%) patients with oligometastasis received local therapy (surgery 5, radiotherapy 9, sequential local and systemic therapy 28, chemoradiotherapy 5). Multivariate analysis revealed older age, non-adenocarcinoma, shorter disease-free interval, no pulmonary metastasis, liver metastases, bone metastases, and polymetastasis had significant associations with unfavorable post-recurrence survival. Subgroup analysis of patients with oligometastasis showed histology and disease-free interval had a great impact on survival. Smoking history and histology were associated with survival in patients with lung oligometastasis, whereas systemic treatment and longer disease-free interval were related to increased post-recurrence survival in those with brain oligometastasis. CONCLUSIONS This study showed that an oligometastatic state per se was a significant favorable factor. Optimization of personalized systemic treatment and adding local treatment are important in the management of patients with non-small-cell lung cancer and oligometastasis.
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Affiliation(s)
- Yoshihisa Shimada
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hisashi Saji
- Department of Chest Surgery, St. Marianna University School of Medicine, Tokyo, Japan
| | - Masatoshi Kakihana
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Naohiro Kajiwara
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Tatsuo Ohira
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Norihiko Ikeda
- Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan
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536
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Le Du F, Gonzalez-Angulo AM, Park M, Liu DD, Hortobagyi GN, Ueno NT. Effect of 21-Gene RT-PCR Assay on Adjuvant Therapy and Outcomes in Patients With Stage I Breast Cancer. Clin Breast Cancer 2015; 15:458-66. [PMID: 26233757 DOI: 10.1016/j.clbc.2015.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 06/11/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Recurrence score (RS) derived from a 21-gene reverse transcriptase-polymerase chain reaction assay is used to stratify patients with early-stage estrogen receptor-positive, HER2-normal breast cancer into 3 groups on the basis of 10-year distant metastasis risk: low, intermediate, and high. Published data are limited regarding the effect of RS on choice of adjuvant therapy for T1 breast cancer. We investigated the relationship between RS and choice of adjuvant therapy, prognosis, and benefit of chemotherapy (CT) in stage I breast cancer. MATERIALS AND METHODS We reviewed the records of 1030 patients with estrogen receptor-positive, HER2-normal stage I breast cancer and RS available. RSs were correlated with clinicopathologic characteristics, treatment, and outcome. RESULTS Patients with pathologic (p)T1a, pT1b, and pT1c disease did not differ in distribution of low, intermediate, and high RS (P = .673). Overall, fewer than 10% of patients had a high RS. Histologic grade 1, nuclear grade 1, and low Ki-67 expression had only 1%, 0%, and 6% of high RSs, respectively. Among patients with intermediate RSs, 41% with pT1b and 46% with pT1c disease received CT. Among patients with intermediate RSs, for pT1b disease, distant disease-free survival (DDFS) did not differ between hormonal therapy (HT) alone and CT with HT (P = .752); for pT1c, DDFS was superior for CT with HT (P = .020). Histologic grade was the only independent prognostic factor of DDFS (P = .0007, 1 vs. 3; P = .035, 2 vs. 3); RS did not predict DDFS (P = .083, high vs. low; P = .066, intermediate vs. low). CONCLUSION The added value of RS to known prognostic factors appears limited to patients with pT1b breast cancer. However, this study lacked long-term follow-up.
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Affiliation(s)
- Fanny Le Du
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Medical Oncology, Eugène Marquis Cancer Center, Rennes, France
| | - Ana M Gonzalez-Angulo
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Minjeong Park
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Diane D Liu
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Gabriel N Hortobagyi
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Naoto T Ueno
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.
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Kim Y, Jae E, Yoon M. Influence of Androgen Receptor Expression on the Survival Outcomes in Breast Cancer: A Meta-Analysis. J Breast Cancer 2015; 18:134-42. [PMID: 26155289 PMCID: PMC4490262 DOI: 10.4048/jbc.2015.18.2.134] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 04/15/2015] [Indexed: 12/26/2022] Open
Abstract
PURPOSE Despite the fact that the androgen receptor (AR) is known to be involved in the pathogenesis of breast cancer, its prognostic effect remains controversial. In this meta-analysis, we explored AR expression and its impact on survival outcomes in breast cancer. METHODS We searched PubMed, EMBASE, Cochrane Library, ScienceDirect, SpringerLink, and Ovid databases and references of articles to identify studies reporting data until December 2013. Disease-free survival (DFS) and overall survival (OS) were analyzed by extracting the number of patients with recurrence and survival according to AR expression. RESULTS There were 16 articles that met the criteria for inclusion in our meta-analysis. DFS and OS were significantly longer in patients with AR expression compared with patients without AR expression (odds ratio [OR], 0.60; 95% confidence interval [CI], 0.40-0.90; OR, 0.53; 95% CI, 0.38-0.73, respectively). In addition, hormone receptor (HR) positive patients had a longer DFS when AR was also expressed (OR, 0.63; 95% CI, 0.41-0.98). For patients with triple negative breast cancer (TNBC), AR expression was also associated with longer DFS and OS (OR, 0.44, 95% CI, 0.26-0.75; OR, 0.26, 95% CI, 0.12-0.55, respectively). Furthermore, AR expression was associated with a longer DFS and OS in women (OR, 0.42, 95% CI, 0.27-0.64; OR, 0.47, 95% CI, 0.38-0.59, respectively). However, in men, AR expression was associated with a worse DFS (OR, 6.00; 95% CI, 1.46-24.73). CONCLUSION Expression of AR in breast cancer might be associated with better survival outcomes, especially in patients with HR-positive tumors and TNBC, and women. Based on this meta-analysis, we propose that AR expression might be related to prognostic features and contribute to clinical outcomes.
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Affiliation(s)
- Yoonseok Kim
- Department of Surgery, Kosin University Gospel Hospital, Busan, Korea
| | - Eunae Jae
- Department of Obstetrics and Gynecology, Mirae Woman's Hospital, Busan, Korea
| | - Myunghee Yoon
- Department of Surgery, Kosin University Gospel Hospital, Busan, Korea
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538
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Chen JH, Wei CK, Lee CH, Chang CM, Hsu TW, Yin WY. The safety and adequacy of resection on hepatocellular carcinoma larger than 10 cm: A retrospective study over 10 years. Ann Med Surg (Lond) 2015; 4:193-9. [PMID: 26052436 PMCID: PMC4454785 DOI: 10.1016/j.amsu.2015.05.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND/PURPOSE Current treatment options for HCC≥10 cm (huge HCC) are limited. Otherwise, the margin status is known as a prognostic factor. Our aim was to determine the safety, effectiveness, and risk factors for overall survival and disease-free survival for these patients. METHODS A total of 211 consecutive patients from 2000/08 to 2010/12 were enrolled. Characteristics of patients, tumors, and treatment were compared between the huge group (HCCs; ≥10 cm, n = 23; 11%) and those with smaller group (HCC; <10 cm n = 188; 89%). Disease-free survival (DFS), overall survival (OS), and risk factors were analyzed. RESULTS Median follow up was 37 months. Patients with huge HCC were more likely to be symptomatic, positive for preoperative portal vein thrombosis, longer surgical time, more blood loss and transfusions, and significantly shorter median OS and DFS. Both groups had similar postoperative mortality and morbidity rates. In the huge HCC, multivariate analysis identified two significant determinants of DFS (preoperative portal vein thrombosis on imaging and tumor-free margin less than 1 mm) and two significant determinants of OS (age over 80 and preoperative portal vein thrombosis). Even with positive margins, it still had no impact on OS. For DFS, 1 mm free margins appeared to be adequate. CONCLUSION Tumor-free margin is an independent risk factor for recurrence but has no impact on OS. Surgical margin >1 mm is adequate in patients with tumors ≥10 cm. Postoperative close follow up, especially of distant metastasis, and appropriate treatment of recurrence by a multidisciplinary approach may improve prognosis.
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Affiliation(s)
- Jian-Han Chen
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC
| | - Chang-Kuo Wei
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC
| | - Cheng-Hung Lee
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC
| | - Chun-Ming Chang
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC
| | - Ta-Wen Hsu
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC ; Department of Surgery, College of Medicine, Tzu Chi University, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Hualien, Taiwan, ROC
| | - Wen-Yao Yin
- Department of Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Taiwan, ROC ; Department of Surgery, College of Medicine, Tzu Chi University, No.2, Minsheng Rd., Dalin Township, Chiayi County 622, Hualien, Taiwan, ROC
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539
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Cingeetham A, Vuree S, Dunna NR, Gorre M, Nanchari SR, Edathara PM, Meka P, Annamaneni S, Digumarthi R, Sinha S, Satti V. Influence of BCL2-938C>A and BAX-248G>A promoter polymorphisms in the development of AML: case-control study from South India. Tumour Biol 2015; 36:7967-76. [PMID: 25957891 DOI: 10.1007/s13277-015-3457-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
B-cell lymphoma 2 (BCL2) and BCL2-associated X protein (BAX) proteins are anti-apoptotic and pro-apoptotic determinants of mitochondrial-mediated apoptosis, and their relative expression determines the cell fate. The promoter polymorphisms in these genes were shown to alter the protein function or expression and exert an impact on apoptosis regulation. Deregulation in the expression of any of these genes leads to disruption of cellular homeostasis and malignant transformation. The present study was aimed to determine the association of BCL2-938C>A and BAX-248G>A promoter polymorphisms with origin and progression of acute myeloid leukemia (AML). We also have performed combined genotype analysis to evaluate the cumulative effect of risk genotypes in the AML development. These polymorphisms were genotyped by polymerase chain reaction- restriction fragment length polymorphism (PCR-RFLP) in 221 AML patients and 305 age- and sex-matched healthy controls. Our study revealed that BCL2-938CA (p = 0.018) and BAX-248GG (0.043) genotypes were significantly associated with increased risk for AML occurrence. BAX-248A allele had shown decreased risk for AML. The combined analysis had shown that BCL2-938CA+AA-BAX-248GG group had a 1.63-fold (95 % CI: 1.08-2.45, p = 0.02) increased risk for AML. None of the clinical variables had shown any significant association with both polymorphisms. With respect to complete remission (CR) rate, BAX-248GG genotype (p = 0.002) and G allele (p = 0.009) had conferred significant risk for complete remission failure. Although the log rank test was not significant, survival analysis had shown a trend where BCL2-938CA genotype, and BAX-248GG had reduced median disease-free survival (DFS) of 9 and 10 months, respectively. In conclusion, BCL2-938C>A and BAX-248G>A gene polymorphisms might contribute to the origin of AML. Moreover, influence of BAX-248GG genotype on CR and DFS rate suggests that the BAX-248G>A polymorphism can serve as marker for poor prognosis in AML.
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Affiliation(s)
| | - Sugunakar Vuree
- Department of Genetics, Osmania University, Hyderabad, 500007, India
| | | | - Manjula Gorre
- Department of Genetics, Osmania University, Hyderabad, 500007, India
| | | | | | | | | | | | - Sudha Sinha
- MNJ Institute of Oncology Regional Cancer Center, Hyderabad, India
| | - Vishnupriya Satti
- Department of Genetics, Osmania University, Hyderabad, 500007, India.
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540
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Koloff ZB, Hamstra DA, Wei JT, Montgomery JS, Tomlins SA, Wu AJ, Morgan TM, Siddiqui J, Paich K, Chinnaiyan AM, Feng FY, Weizer AZ, Kunju LP, Hollenbeck BK, Miller DC, Palapattu GS, Mehra R. Impact of tertiary Gleason pattern 5 on prostate cancer aggressiveness: Lessons from a contemporary single institution radical prostatectomy series. Asian J Urol 2015; 2:53-58. [PMID: 29264120 PMCID: PMC5730694 DOI: 10.1016/j.ajur.2015.04.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 08/15/2014] [Accepted: 08/26/2014] [Indexed: 11/20/2022] Open
Abstract
Objective To better evaluate tertiary Gleason pattern reporting and to evaluate the impact of tertiary Gleason pattern 5 (TP5) on prostate cancer pathological features and biochemical recurrence at our large single institution. Methods We retrospectively reviewed 1962 patients who underwent radical prostatectomy (RP) for prostate cancer; TP5 was reported in 159 cases (8.1%). Men with Gleason score (GS) 7 and GS 8 disease were divided into subgroups with and without TP5, and histopathological features were compared. Multivariate analyses were conducted to assess the impact on TP5 on biochemical-free survival (BFS). Results Tumors possessing GS 3 + 4 with TP5 were more likely to exhibit extraprostatic extension (EPE) and had a larger tumor diameter (TD) than GS 3 + 4 alone. GS 3 + 4 with TP5 was also associated with positive surgical margins (SM), seminal vesicle involvement (SVI), and higher pre-operative prostate-specific antigen (PSA) values, but without statistical significance. GS 4 + 3 with TP5 more commonly presented with EPE, positive SM, SVI, and greater TD and pre-operative PSA level than GS 4 + 3 alone. In multivariate analysis, Gleason score, EPE, and TP5 were overall independent risk factors for PSA recurrence in this cohort. Additionally, GS 4 + 3 with TP5 was associated with shorter time to recurrence versus GS 4 + 3 alone. Conclusion Our results emphasize the importance of TP5 and suggest that criteria for tertiary pattern reporting in prostate cancer should be standardized. Further studies are needed to evaluate the role of tertiary patterns in prognostic models.
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Affiliation(s)
- Zachary B Koloff
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Daniel A Hamstra
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - John T Wei
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jeffrey S Montgomery
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Scott A Tomlins
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Angela J Wu
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Todd M Morgan
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Javed Siddiqui
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Kellie Paich
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Arul M Chinnaiyan
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Felix Y Feng
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Alon Z Weizer
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Lakshmi P Kunju
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Brent K Hollenbeck
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - David C Miller
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ganesh S Palapattu
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Rohit Mehra
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
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541
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Wei D, Peng JJ, Gao H, Zhang T, Tan Y, Hu YH. ALDH1 Expression and the Prognosis of Lung Cancer: A Systematic Review and Meta-Analysis. Heart Lung Circ 2015; 24:780-8. [PMID: 25921687 DOI: 10.1016/j.hlc.2015.03.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 03/16/2015] [Accepted: 03/26/2015] [Indexed: 12/16/2022]
Abstract
PURPOSE Aldehyde dehydrogenase 1 (ALDH1) has been identified as a putative cancer stem cell (CSC) marker in lung cancer. However, the clinicopathological and prognostic value of this protein in lung cancer patients remains controversial. Thus, we performed a systematic review and meta-analysis of studies assessing the clinical and prognostic significance of ALDH1 expression in lung cancer. METHODS An identification and review of publications assessing clinical or prognostic significance of ALDH1 expression in lung cancer until September 1, 2014 was undertaken. A meta-analysis was performed to clarify the association between ALDH1 expression and clinical outcomes. RESULTS A total of 14 publications met the criteria and comprised 1926 cases. Analysis of these data showed that ALDH1 expression was not significantly associated with the patient age (OR = 0.82, 95% confidence interval [CI]: 0.45-1.50, P=0.52), tumour size (OR=0.68, 95% CI: 0.22-2.06, P=0.49), smoking status (OR=1.37, 95% CI: 0.85-2.22, P=0.19), or tumour grade (OR=1.65, 95% CI: 0.83-3.26, P=0.15). However, in the identified studies, ALDH1 expression was highly correlated with lymph node metastasis (OR=1.97, 95% CI: 1.16-3.34, P=0.01), tumour TNM staging (OR=1.68, 95% CI 1.28-2.22, P=0.0002), decreased overall survival (relative risk [RR]: 1.97,95% CI: 1.16-3.34, P =0.01) and decreased disease free survival (RR: 1.63, 95% CI: 1.01-2.64, P=0.05). CONCLUSIONS This meta-analysis shows ALDH1 expression in lung cancer is connected with decreased overall and disease free survival and thus marks a worse prognosis.
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Affiliation(s)
- Dong Wei
- Department of Oncology, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China
| | - Jing-Jing Peng
- Department of Oncology, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China
| | - Hui Gao
- Department of Oncology, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China
| | - Tao Zhang
- Department of Oncology, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China
| | - Yong Tan
- Department of Oncology, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China
| | - Yong-He Hu
- Department of Traditional Chinese Medicine, Chengdu Military General Hospital, Chengdu, Sichuan, 610083, P.R. China.
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542
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Srivastava P, Kingsley PA, Srivastava H, Sachdeva J, Kaur P. Persistent Post-radiotherapy Pain and Locoregional Recurrence in Head and Neck Cancer-Is There a Hidden Link? Korean J Pain 2015; 28:116-21. [PMID: 25852833 PMCID: PMC4387456 DOI: 10.3344/kjp.2015.28.2.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 01/10/2015] [Accepted: 01/12/2015] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To explore the relationship between persistent post-radiotherapy pain and locoregional recurrence in head and neck cancer patients. METHODS Five year retrospective data was reviewed of 86 patients of head and neck cancer treated with radiotherapy who continued to have pain at 6 weeks after completion of treatment. At follow-up after 3 months, these patients were stratified into: Group A (n = 39) constituted of patients whose pain subsided and Group B (n = 47) were patients who continued to have persistent pain. RESULTS At median follow-up time of 25 months (range: 8-47), one patient (2.6%) and 18 (38.3%) patients in group A and group B had locoregional recurrence respectively (P < 0.0001). Furthermore, group B patients had higher mean pain score levels as compared to group A (P = 0.03). Patients in whom pain subsided within 3 months had statistically much greater disease-free survival in comparison to those with persistent pain (P < 0.0001). CONCLUSIONS Pain in head and neck cancer is an important symptom and should be considered a poor prognostic factor. In the current study, the majority of the patients with persistent pain had recurrent disease as compared to those in whom pain subsided within 3 months of post-treatment. It is suggested that patients with persistent pain need more intense follow-up and should be investigated thoroughly to detect recurrence at an early stage to provide a better quality of life.
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Affiliation(s)
- Preety Srivastava
- Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Pamela Alice Kingsley
- Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Himanshu Srivastava
- Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Jaineet Sachdeva
- Department of Radiotherapy, Christian Medical College and Hospital, Ludhiana, Punjab, India
| | - Paramdeep Kaur
- Department of Community Medicine, Christian Medical College and Hospital, Ludhiana, Punjab, India
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543
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Jung HY, Cho H, Oh MH, Lee JH, Lee HJ, Jang SH, Lee MS. Loss of FAT Atypical Cadherin 4 Expression Is Associated with High Pathologic T Stage in Radically Resected Gastric Cancer. J Gastric Cancer 2015; 15:39-45. [PMID: 25861521 PMCID: PMC4389095 DOI: 10.5230/jgc.2015.15.1.39] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 02/08/2015] [Accepted: 02/08/2015] [Indexed: 12/12/2022] Open
Abstract
Purpose Recent studies have revealed recurrent alterations in the cell adhesion gene FAT4, a candidate tumor suppressor gene, in cancer. FAT atypical cadherin 4 (FAT4) is a transmembrane receptor involved in the Hippo signaling pathway, which is involved in the control of organ size. Here, we investigated the loss of FAT4 expression and its association with clinicopathological risk factors in gastric cancer. Materials and Methods We assessed the expression of FAT4 by using immunohistochemistry on three tissue microarrays containing samples from 136 gastric cancer cases, radically resected in the Soonchunhyang University Cheonan Hospital between July 2006 and June 2008. Cytoplasmic immunoexpression of FAT4 was semi-quantitatively scored using the H-score system. An H-score of ≥10 was considered positive for FAT4 expression. Results Variable cytoplasmic expressions of FAT4 were observed in gastric cancers, with 33 cases (24.3%) showing loss of expression (H-score <10). Loss of FAT4 expression was associated with an increased rate of perineural invasion (H-score <10 vs. ≥10, 36.4% vs. 16.5%, P=0.015), high pathologic T stage (P=0.015), high tumor-node-metastasis stage (P=0.017), and reduced disease-free survival time (H-score <10 vs. ≥10, mean survival 62.7±7.3 months vs. 79.1±3.1 months, P=0.025). However, no association was found between the loss of FAT4 expression and tumor size, gross type, histologic subtype, Lauren classification, lymphovascular invasion, or overall survival. Conclusions Loss of FAT4 expression appears to be associated with invasiveness in gastric cancer.
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Affiliation(s)
- Hae Yoen Jung
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyundeuk Cho
- Department of Pathology, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Mee-Hye Oh
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Ji-Hye Lee
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Hyun Ju Lee
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Si-Hyong Jang
- Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Moon Soo Lee
- Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
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544
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Rezende PC, Scudeler TL, da Costa LMA, Hueb W. Conservative strategy for treatment of stable coronary artery disease. World J Clin Cases 2015; 3:163-170. [PMID: 25685763 PMCID: PMC4317610 DOI: 10.12998/wjcc.v3.i2.163] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/25/2014] [Indexed: 02/05/2023] Open
Abstract
Patients with coronary artery disease vary widely in terms of prognosis, which is mainly dependent on ventricular function. In relation to the major outcomes of death and myocardial infarction, it is not clear in the literature if an invasive strategy of myocardial revascularization is superior to a conservative strategy of optimized medical therapy. Moreover, with the exception of patients with left main coronary disease, this similarity in prognosis also occurs in different subgroups of patients.
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545
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Wang L, Yao L, Zheng YZ, Xu Q, Liu XP, Hu X, Wang P, Shao ZM. Expression of autophagy-related proteins ATG5 and FIP200 predicts favorable disease-free survival in patients with breast cancer. Biochem Biophys Res Commun 2015; 458:816-22. [PMID: 25689718 DOI: 10.1016/j.bbrc.2015.02.037] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 02/06/2015] [Indexed: 11/28/2022]
Abstract
Autophagy is a self-digesting process that is primarily responsible for the removal and recycling of long-lived proteins and damaged organelles to maintain the homeostasis of the cell. Recent studies have indicated dual roles for autophagy in cancer: suppression of tumor progression and promotion of survival. In this study, we sought to investigate the prognostic value of two autophagy-related proteins, autophagy-related gene 5 (ATG5) and FAK family kinase-interacting protein of 200 kDa (FIP200), in patients with operable breast cancer. More specifically, the expression of ATG5 and FIP200 was evaluated by immunohistochemistry (IHC) in surgical specimens collected from 200 patients who were diagnosed with histologically proven invasive ductal breast cancer. A stepwise Cox multivariate analysis was then performed to construct a risk prediction model. In this retrospective cohort study, both ATG5 (HR = 0.465, 95% CI 0.247-0.872, P = 0.017) and FIP200 (HR = 0.521, 95% CI 0.278-0.979, P = 0.043) correlated with prolonged disease-free survival (DFS). In a receiver operating characteristic (ROC) analysis, the addition of ATG5 and FIP200 expression led to a significantly improved area under the time-dependent ROC curve (AUC) at 3 years (0.748 versus 0.680, P < 0.001) and 5 years (0.756 versus 0.699, P < 0.001). Collectively, our findings established the prognostic significance of ATG5 and FIP200 in patients with breast cancer.
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Affiliation(s)
- Lei Wang
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ling Yao
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Zi Zheng
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qing Xu
- Department of Finance and Control Sciences, School of Mathematical Sciences, Fudan University, Shanghai, China
| | - Xiu-Ping Liu
- Department of Pathology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Xin Hu
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
| | - Peng Wang
- Key Laboratory of Systems Biology, Shanghai Advanced Research Institute, Chinese Academy of Sciences, Shanghai, China; School of Life Science and Technology, ShanghaiTech University, Shanghai, China.
| | - Zhi-Ming Shao
- Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
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546
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Peng YF, Yu WD, Pan HD, Wang L, Li M, Yao YF, Zhao J, Gu J. Tumor regression grades: Potential outcome predictor of locally advanced rectal adenocarcinoma after preoperative radiotherapy. World J Gastroenterol 2015; 21:1851-1856. [PMID: 25684951 PMCID: PMC4323462 DOI: 10.3748/wjg.v21.i6.1851] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 09/29/2014] [Accepted: 12/08/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To analyze tumor regression grade (TRG) for prognosis of locally advanced rectal adenocarcinoma (LARA) treated with preoperative radiotherapy.
METHODS: One hundred and ninety patients with clinical stage II/III LARA were studied. All patients underwent radical surgery (between 2004 and 2010) after 30-Gy/10-fraction preoperative radiotherapy (pre-RT). All 190 patients received a short course of pre-RT and were reassessed for disease recurrence and survival; the slides of surgical specimens were reviewed and classified according to Mandard TRG. We compared patients with good response (Mandard TRG1 or TRG2) vs patients with bad/poor response (Mandard TRG3-5). Outcomes evaluated were 5-year overall survival (OS), 5-year disease-free survival (DFS), and local, distant and mixed recurrence. Fisher’s exact test or χ2 test, log-rank test and proportional hazards regression analysis were used to calculate the probability that Mandard TRG was associated with patient outcomes.
RESULTS: One hundred and sixty-six of 190 patients (87.4%) were identified as Mandard bad responders (TRG3-5). High Mandard grade was correlated with tumor height (41.7% < 6 cm vs 58.3% ≥ 6 cm, P = 0.050), ypT stage (75% ypT0-2 vs 25% ypT3-4, P = 0.000), and ypN stage (75% ypN0 vs 25% ypN1, P = 0.031). In univariate survival analysis, Mandard grade bad responders had significantly worse OS and DFS than good responders (TRG1/2) (OS, 83.1% vs 96.4%, P = 0.000; DFS, 72.3% vs 92.0%, P = 0.002). In multivariate survival analysis, Mandard bad responders had significantly worse DFS than Mandard good responders (DFS 3.8 years (95%CI: 1.2-12.2 years, P = 0.026).
CONCLUSION: Mandard grade good responders had a favorable prognosis. TRG may be a potential predictor for DFS in LARA after pre-RT.
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547
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Rizk J, Ouzzane A, Flamand V, Fantoni JC, Puech P, Leroy X, Villers A. [Long term biochemical recurrence free survival after radical prostatectomy for cancer: comparative analysis according to surgical approach and clinicopathological stage]. Prog Urol 2015; 25:157-68. [PMID: 25614075 DOI: 10.1016/j.purol.2014.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/19/2014] [Accepted: 12/18/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess long term biochemical recurrence free survival after radical prostatectomy according to open, laparoscopic and robot-assisted surgical approach and clinicopathological stage. MATERIAL AND METHODS A cohort study of 1313 consecutive patients treated by radical prostatectomy for localized or locally advanced prostate cancer between 2000 and 2013. Open surgery (63.7%), laparoscopy (10%) and robot-assisted laparoscopy (26.4%) were performed. Biochemical recurrence was defined by PSA>0,1ng/mL. The biochemical recurrence free survival was described by Kaplan Meier method and prognostic factors were analysed by multivariable Cox regression. RESULTS Median follow-up was 57 months (IQR: 31-90). Ten years biochemical recurrence free survival was 88.5%, 71.6% and 53.5% respectively for low, intermediate and high-risk D'Amico groups. On multivariable analysis, the worse prognostic factor was Gleason score (P<0.001). Positive surgical margins rate was 53% in pT3 tumours and 24% in pT2 tumours (P<0.001). Biochemical recurrence free survival (P=0.06) and positive surgical margins rate (P=0.87) were not statistically different between the three surgical approaches. CONCLUSION Biochemical recurrence free survival in our study does not differ according to surgical approach and is similar to published series. Ten years biochemical recurrence free survival for high-risk tumours without hormone therapy is 54% justifying the role of surgery in the therapeutic conversations in this group of tumours. LEVEL OF EVIDENCE 3.
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548
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Baek JH, Lee GJ, Lee WS. Comparison of long-term oncologic outcomes of stage III colorectal cancer following laparoscopic versus open surgery. Ann Surg Treat Res 2014; 88:8-14. [PMID: 25553319 PMCID: PMC4279992 DOI: 10.4174/astr.2015.88.1.8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/13/2014] [Accepted: 07/30/2014] [Indexed: 02/04/2023] Open
Abstract
Purpose The oncologic outcomes after performing laparoscopic surgery (LS) compared to open surgery (OS) are still under debate and a concern when treating patients with colon cancer. The aim of this study was to compare the long-term oncologic outcomes of LS and OS as treatment for stage III colorectal cancer patients. Methods From January 2001 to December 2007, 230 patients with stage III colorectal cancer who had undergone LS or OS in this single center were assessed. Data were analyzed according to intention-to-treat. The primary endpoints were disease-free survival and overall survival. Results A total of 230 patients were entered into the study (114 patients had colon cancer-33 underwent LS and 81 underwent OS; 116 patients had rectal cancer-44 underwent LS and 72 underwent OS). The median follow-up periods for the colon and rectal cancer groups were 54 and 53 months, respectively. The overall conversion rate was 12.1% (n = 4) for colon cancer, and 4.5% (n = 2) for rectal cancer. Disease-free 5-year survival of colon cancer was 84.3% and 90% in LS group (LG) and OS group (OG), respectively, and that of rectal cancer was 83% and 74.6%, respectively (P > 0.05). Overall 5-year survival for colon cancer was 72.2% and 71.3% for LG and OG, respectively, and that for rectal cancer was 67.6% and 59.2%, respectively (P > 0.05). Conclusion The long-term analyses for oncologic aspects of our study may confirm the safety of LS compared to OS in stage III colorectal cancer patients.
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Affiliation(s)
- Jeong-Heum Baek
- Division of Colon and Rectal Surgery, Department of Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine,Incheon, Korea
| | - Gil-Jae Lee
- Division of Colon and Rectal Surgery, Department of Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine,Incheon, Korea
| | - Won-Suk Lee
- Division of Colon and Rectal Surgery, Department of Surgery, Gachon University Gil Medical Center, Gachon University School of Medicine,Incheon, Korea
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549
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Yu WD, Peng YF, Pan HD, Wang L, Li K, Gu J. Phosphatidylinositol 3-kinase CB association with preoperative radiotherapy response in rectal adenocarcinoma. World J Gastroenterol 2014; 20:16258-16267. [PMID: 25473181 PMCID: PMC4239515 DOI: 10.3748/wjg.v20.i43.16258] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 07/09/2014] [Accepted: 08/28/2014] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the correlation of phosphatidylinositol 3-kinase (PIK3) CB expression with preoperative radiotherapy response in patients with stage II/III rectal adenocarcinoma.
METHODS: PIK3CB immunoexpression was retrospectively assessed in pretreatment biopsies from 208 patients with clinical stage II/III rectal adenocarcinoma, who underwent radical surgery after 30-Gy/10-fraction preoperative radiotherapy. The relation between PIK3CB expression and tumor regression grade, clinicopathological characteristics, and survival time was statistically analyzed. Western blotting and in vitro clonogenic formation assay were used to detect PIK3CB expression in four colorectal cancer cell lines (HCT116, HT29, LoVo, and LS174T) treated with 6-Gy ionizing radiation. Pharmacological assays were used to evaluate the therapeutic relevance of TGX-221 (a PIK3CB-specific inhibitor) in the four colorectal cancer cell lines.
RESULTS: Immunohistochemical staining indicated that PIK3CB was more abundant in rectal adenocarcinoma tissues with poor response to preoperative radiotherapy. High expression of PIK3CB was closely correlated with tumor height (P < 0.05), ypT stage (P < 0.05), and high-degree tumor regression grade (P < 0.001). High expression of PIK3CB was a potential prognostic factor for local recurrence-free survival (P < 0.05) and metastasis-free survival (P < 0.05). High expression of PIK3CB was also associated with poor therapeutic response and adverse outcomes in rectal adenocarcinoma patients treated with 30-Gy/10-fraction preoperative radiotherapy. In vitro, PIK3CB expression was upregulated in all four colorectal cancer cell lines concurrently treated with 6-Gy ionizing radiation, and the PIK3CB-specific inhibitor TGX-221 effectively inhibited the clonogenic formation of these four colorectal cancer cell lines.
CONCLUSION: PIK3CB is critically involved in response to preoperative radiotherapy and may serve as a novel target for therapeutic intervention.
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550
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Nakamura H, Saji H, Shinmyo T, Tagaya R, Kurimoto N, Koizumi H, Takagi M. Association of IASLC/ATS/ERS Histologic Subtypes of Lung Adenocarcinoma With Epidermal Growth Factor Receptor Mutations in 320 Resected Cases. Clin Lung Cancer 2015; 16:209-15. [PMID: 25467929 DOI: 10.1016/j.cllc.2014.10.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 10/18/2014] [Accepted: 10/21/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND The relationships between the subtypes defined by the new international histologic classification of lung adenocarcinoma (IASLC/ATS/ERS) and epidermal growth factor receptor (EGFR) mutations were studied. PATIENTS AND METHODS We retrospectively reviewed 320 patients with lung adenocarcinoma (162 women, 158 men; mean age, 69 years) who had undergone complete resection, focusing on the new histologic subtypes and EGFR mutations. The clinical stage was IA in 196 patients, IB in 95, IIA in 10, IIB in 10, IIIA in 6, and IV in 3. RESULTS The most prevalent subtype was papillary (35.0%), followed by acinar (29.4%), lepidic (13.1%), solid (7.2%), adenocarcinoma in situ (6.6%), minimally invasive adenocarcinoma (6.3%), micropapillary (1.6%), and invasive mucinous adenocarcinoma (1.0%). These subtypes were predictive for both postoperative disease-free and overall survival. EGFR mutations, detected in 40.6% of all cases, were most frequent in acinar (48.4%), followed by minimally invasive adenocarcinoma (45.0%) and papillary (43.8%). They were least frequent in the solid subtype (17.4%). EGFR mutation status did not affect postoperative disease-free or overall survival. CONCLUSION The outcome after complete resection for lung adenocarcinoma was predicted by the proposed subtype classification. Because EGFR mutations were found in all subtypes, mutation analyses are essential to identify patients with postoperative relapse who would benefit from EGFR-tyrosine kinase inhibitor therapy.
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