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Gu Y, Lai S, Wang Y, Yang J, Zhou P, Chen T. A population study comparing tracheal and lung adenoid cystic carcinoma. Cancer Med 2024; 13:e7158. [PMID: 38572933 PMCID: PMC10993707 DOI: 10.1002/cam4.7158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Thoracic adenoid cystic carcinoma (ACC) is rare, and the differences between tracheal and lung lesions have not been fully understood. METHODS Patients were identified from a Chinese cancer center (FUSCC) (2005-2022) and the Surveillance, Epidemiology, and End Results (SEER) database (2000-2019). Incidence was calculated and trends were quantified. Clinicopathological features and overall survival (OS) were analyzed. Nomograms predicting OS were constructed. RESULTS Totally, 55 tracheal adenoid cystic carcinoma (TACC) and 25 lung and bronchus adenoid cystic carcinoma (LACC) were included in a Chinese cohort, 121 TACC and 162 LACC included in the SEER cohort. There were larger tumor sizes, more lymph nodes and distant metastases for LACC than TACC patients. TACC patients are more likely to get local treatments. Patients with LACC had significantly worse median OS than patients with TACC (SEER cohort: 68.0 months vs. 109.0 months, p = 0.001, Chinese cohort: 62.9 months vs. 124.8 months, p = 0.061). Age, lymph node metastasis, distant metastasis and local treatment were identified as independent prognostic factors for OS of TACC. Distant metastasis and local treatment were identified for LACC. Specifically, surgery alone or in combination with radiotherapy is crucial for improving survival in both TACC and LACC. Only TACC benefits from radiotherapy alone, while chemotherapy does not improve survival for either. The nomograms constructed using these factors revealed good prognostic accuracy. CONCLUSIONS LACC is more aggressive and has a worse prognosis than TACC. TACC patients have more opportunities for local treatment, which is important for the prognosis of both TACC and LACC. Nomograms were created for TACC and LACC to aid in personalized survival predictions and clinical decisions.
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Affiliation(s)
- Yu Gu
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Songtao Lai
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
- Department of Oncology, Shanghai Medical CollegeFudan UniversityShanghaiChina
- Shanghai Clinical Research Center for Radiation OncologyShanghaiChina
- Shanghai Key Laboratory of Radiation OncologyShanghaiChina
| | - Yang Wang
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
| | - Juan Yang
- Xiaogan Hospital Affiliated to Wuhan University of Science and TechnologyXiaoganChina
| | - Ping Zhou
- Department of RadiotherapyThe First Affiliated Hospital of Hainan Medical UniversityHaikouChina
| | - Tianxiang Chen
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of MedicineShanghai Jiao Tong UniversityShanghaiChina
- Department of Thoracic SurgeryThe First Affiliated Hospital of Wenzhou Medical UniversityWenzhouChina
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2
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Takamori S, Yatabe Y, Osoegawa A, Aokage K, Yoshioka H, Miyoshi T, Mimae T, Endo M, Hattori A, Yotsukura M, Isaka T, Isaka M, Maniwa T, Nakajima R, Watanabe SI. Rare but clinically important salivary gland-type tumor of the lung: A review. Jpn J Clin Oncol 2024; 54:121-128. [PMID: 37952098 DOI: 10.1093/jjco/hyad154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Salivary gland-type tumor (SGT) of the lung, which arises from the bronchial glands of the tracheobronchial tree, was first recognized in the 1950s. SGT represents less than 1% of all lung tumors and is generally reported to have a good prognosis. Mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC) are the two most common subtypes, comprising more than 90% of all SGTs. The reported 5-year survival rate of patients with SGT is 63.4%. Because this type of tumor develops in major bronchi, patients with SGT commonly present with symptoms of bronchial obstruction, including dyspnea, shortness of breath, wheezing, and coughing; thus, the tumor is usually identified at an early stage. Most patients are treated by lobectomy and pneumonectomy, but bronchoplasty or tracheoplasty is often needed to preserve respiratory function. Lymphadenectomy in the surgical resection of SGT is recommended, given that clinical benefit from lymphadenectomy has been reported in patients with MEC. For advanced tumors, appropriate therapy should be considered according to the subtype because of the varying clinicopathologic features. MEC, but not ACC, is less likely to be treated with radiation therapy because of its low response rate. Although previous researchers have learned much from studying SGT over the years, the diagnosis and treatment of SGT remains a complex and challenging problem for thoracic surgeons. In this article, we review the diagnosis, prognosis, and treatment (surgery, chemotherapy, and radiotherapy) of SGT, mainly focusing on MEC and ACC. We also summarize reports of adjuvant and definitive radiation therapy for ACC in the literature.
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Affiliation(s)
- Shinkichi Takamori
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Yasushi Yatabe
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
| | - Atsushi Osoegawa
- Department of Thoracic and Breast Surgery, Oita University Faculty of Medicine, Oita, Japan
| | - Keiju Aokage
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Hiroshige Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Osaka, Japan
| | - Tomohiro Miyoshi
- Division of Thoracic Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Takahiro Mimae
- Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan
| | - Makoto Endo
- Department of Thoracic Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Aritoshi Hattori
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
| | - Masaya Yotsukura
- Department of Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Tetsuya Isaka
- Department of Thoracic Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Mitsuhiro Isaka
- Division of Thoracic Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tomohiro Maniwa
- Department of General Thoracic Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Ryu Nakajima
- Division of Thoracic Surgery, Osaka City General Hospital, Osaka, Japan
| | - Shun-Ichi Watanabe
- Division of General Thoracic Surgery, Juntendo University Hospital, Tokyo, Japan
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3
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Naso JR, Roden AC. Recent developments in the pathology of primary pulmonary salivary gland-type tumours. Histopathology 2024; 84:102-123. [PMID: 37694812 DOI: 10.1111/his.15039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
Primary pulmonary salivary gland-type tumours are rare neoplasms that are thought to arise from seromucinous glands that are located in the submucosa of large airways. These neoplasms have clinical and pathologic features that are distinct from other pulmonary neoplasms. The majority of primary pulmonary salivary gland-type tumours are malignant, with the most common entities being mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma. Less commonly seen are myoepithelial carcinoma, hyalinizing clear cell carcinoma, acinic cell carcinoma, secretory carcinoma, salivary duct carcinoma, intraductal carcinoma, and polymorphous adenocarcinoma. Benign salivary gland-type tumours of the lung include pleomorphic adenoma and sialadenoma papilliferum. Morphologic, immunophenotypic, and molecular features of these neoplasms are largely similar to salivary gland tumours elsewhere, and therefore the exclusion of metastatic disease requires clinical and radiologic correlation. However, the differential diagnostic considerations are different in the lung. The distinction of salivary gland-type tumours from their histologic mimics is important for both prognostication and treatment decisions. Overall, salivary gland type-tumours tend to have a more favourable outcome than other pulmonary carcinomas, although high-grade variants exist for many of these tumour types. Recent advances in our understanding of the spectrum of salivary gland-type tumours reported in the lung and their diversity of molecular and immunohistochemical features have helped to refine the classification of these tumours and have highlighted a few differences between salivary gland-type tumours of the lung and those primary to other sites.
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Affiliation(s)
- Julia R Naso
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
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4
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Gyulai M, Harko T, Fabian K, Karsko L, Agocs L, Szigeti B, Fillinger J, Szallasi Z, Pipek O, Moldvay J. Claudin expression in pulmonary adenoid cystic carcinoma and mucoepidermoid carcinoma. Pathol Oncol Res 2023; 29:1611328. [PMID: 37621953 PMCID: PMC10444951 DOI: 10.3389/pore.2023.1611328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/27/2023] [Indexed: 08/26/2023]
Abstract
Background: Although the expression of tight junction protein claudins (CLDNs) is well known in common histological subtypes of lung cancer, it has not been investigated in rare lung cancers. The aim of our study was to examine the expression of different CLDNs in pulmonary salivary gland tumors. Methods: 35 rare lung cancers including pathologically confirmed 12 adenoid cystic carcinomas (ACCs) and 23 mucoepidermoid carcinomas (MECs) were collected retrospectively. Immunohistochemical (IHC) staining was performed on formalin fixed paraffin embedded (FFPE) tumor tissues, and CLDN1, -2, -3, -4, -5, -7, and -18 protein expressions were analyzed. The levels of immunopositivity were determined with H-score. Certain pathological characteristics of ACC and MEC samples (tumor grade, presence of necrosis, presence of blood vessel infiltration, and degree of lymphoid infiltration) were also analyzed. Results: CLDN overexpression was observed in both tumor types, especially in CLDN2, -7, and -18 IHC. Markedly different patterns of CLDN expression were found for ACC and MEC tumors, especially for CLDN1, -2, -4, and -7, although none of these trends remained significant after correction for multiple testing. Positive correlations between expressions of CLDN2 and -5, CLDN3 and -4, and CLDN5 and -18 were also demonstrated. Tumors of never-smokers presented lower levels of CLDN18 than tumors of current smokers (p-value: 0.003). Conclusion: This is the first study to comprehensively describe the expression of different CLDNs in lung ACC and MEC. Overexpression of certain CLDNs may pave the way for targeted anti-claudin therapy in these rare histological subtypes of lung cancer.
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Affiliation(s)
- Marton Gyulai
- County Institute of Pulmonology, Torokbalint, Hungary
- Karoly Racz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary
| | - Tunde Harko
- Department of Pathology, National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Katalin Fabian
- Department of Pathology, South-Buda Center Hospital St. Imre University Teaching Hospital, Budapest, Hungary
| | - Luca Karsko
- Department of Thoracic Surgery, National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Laszlo Agocs
- Department of Thoracic Surgery, National Koranyi Institute of Pulmonology, Budapest, Hungary
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
| | - Balazs Szigeti
- Department of Pathology, National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Janos Fillinger
- Department of Pathology, National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Zoltan Szallasi
- National Koranyi Institute of Pulmonology, Budapest, Hungary
- Department of Bioinformatics, Semmelweis University, Budapest, Hungary
- Computational Health Informatics Program, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Orsolya Pipek
- Department of Physics of Complex Systems, ELTE Eotvos Lorand University, Budapest, Hungary
| | - Judit Moldvay
- Ist Department of Pulmonology, National Koranyi Institute of Pulmonology, Budapest, Hungary
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5
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Tamura K, Uchimura K, Furuse H, Imabayashi T, Matsumoto Y, Tsuchida T. Mucoepidermoid carcinoma cured by a combination of high-frequency snare and photodynamic therapy: A case report. Thorac Cancer 2023; 14:1306-1310. [PMID: 36929314 PMCID: PMC10175029 DOI: 10.1111/1759-7714.14861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is a rare salivary gland tumor, accounting for 0.2% of all lung tumors. The standard treatment for MEC of the primary bronchus is surgery, although intraluminal bronchoscopic treatment has recently become an option. A 68-year-old man presented with an asymptomatic bronchial tumor in the right intermediate bronchus. The tumor was resected using a high-frequency snare (HFS) during bronchoscopy, and the specimen was pathologically diagnosed as low-grade MEC. A residual lesion was detected in the resected area by autofluorescence imaging. The tumor appeared to be localized within the subepithelial layer without metastases, and photodynamic therapy (PDT) was performed as a local treatment. The patient had no recurrence for 18 months. PDT is effective and safe for patients with centrally located early-stage lung cancer, but there are few reports of its use for rare tumors, such as MEC. In this case, PDT allowed for local control and avoided surgery, including bronchoplasty, for MEC. Combined treatment of tumor reduction by HFS and PDT of the residual lesion may be an optimal treatment for MEC of the bronchus.
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Affiliation(s)
- Kentaro Tamura
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan.,Division of Respiratory Diseases, Department of Internal Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Keigo Uchimura
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hideaki Furuse
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Imabayashi
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Yuji Matsumoto
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.,Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takaaki Tsuchida
- Department of Endoscopy, Respiratory Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
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6
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Ding YM, Wang Q. Endoscopic resection of bronchial mucoepidermoid carcinoma in a young adult man: A case report and review of literature. World J Clin Cases 2022; 10:11921-11928. [PMID: 36405259 PMCID: PMC9669874 DOI: 10.12998/wjcc.v10.i32.11921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/22/2022] [Accepted: 10/17/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Primary tracheobronchial mucoepidermoid carcinoma (MEC), derived from salivary mucus glands, is an uncommon neoplasm in adults. At present, surgery is still the preferred treatment for adult bronchial MEC, although it may cause significant trauma and loss of lung function. Here, we report a patient with endobronchial MEC who received the interventional bronchoscopic therapy to remove the neoplasm and no recurrence occurred during follow-up.
CASE SUMMARY A 28-year-old man was admitted to our unit with mild hemoptysis for 3 d. Physical examination did not show any abnormal signs, and the serological indexes were all in the normal range. Chest computed tomography (CT) indicated an intraluminal nodule in the bronchus intermedius with homogeneous density and a well-defined margin. Upon fiberoptic bronchoscopy, an endobronchial pedunculated polypoid was discovered without submucosal involvement. As the neoplasm was confined to the bronchus, interventional bronchoscopy was performed to remove the mass by high-frequency electric knife and laser resection. Tissue was sampled and histopathological examination confirmed the diagnosis of low-grade MEC. As the proliferation index was low, no further treatment was given. During 2 years of follow-up, the patient’s condition was good and no relapse was discovered under fluorescence bronchoscopy or CT scan.
CONCLUSION Interventional bronchoscopy can be considered for treatment of low-grade bronchial MEC, with few complications and preserved lung function.
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Affiliation(s)
- Yong-Min Ding
- Department of Respiratory and Critical Care Medicine, Shengzhou People’s Hospital, Shengzhou 312499, Zhejiang Province, China
| | - Qing Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China
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7
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Pulmonary Salivary Gland Tumor, Mucoepidermoid Carcinoma: A Literature Review. JOURNAL OF ONCOLOGY 2022; 2022:9742091. [PMID: 36385961 PMCID: PMC9646301 DOI: 10.1155/2022/9742091] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Revised: 05/10/2022] [Accepted: 08/31/2022] [Indexed: 01/25/2023]
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is the most common malignant salivary gland tumor in the lungs and accounts for 0.1-0.2% of all lung malignancies in adults. It has no specific epidemiological or clinical characteristics. Correct diagnosis requires the combined examinations of images, laboratories, pathology, and immunohistochemistry (IHC) as well as molecular characteristics. PMEC tumors are characterized by squamous, intermediate, and mucus-secreting cells. Currently, histological appearance, mitotic frequency, cellular atypia, and necrocytosis allow the classification of PMEC into low grade or high grade. Molecular changes are crucial to pathological diagnosis. The driver of PMEC seems to be the fusion protein MECT1-MAML2 that is generated from a genetic mutation in t (11; 19) (q21; p13), while other gene mutations are also reported. However, no treatment of PMEC exists so far; surgical excision is still the primary treatment, while the efficacies of chemotherapy or radiotherapy are undefined. Tyrosine kinase inhibitor (TKI) therapy and immunotherapy showed to have significant therapeutic effects but require more investigation and better understanding. This review focuses on the clinical characteristics, imaging and pathologic features, immunohistochemical examination, mutation analysis, differential diagnosis, prognosis, and treatment of PMEC.
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8
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Clinical, laboratory, pathological, and radiological characteristics and prognosis of patients with pulmonary salivary gland-type tumors. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04295-5. [PMID: 36038675 DOI: 10.1007/s00432-022-04295-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/14/2022] [Indexed: 10/15/2022]
Abstract
PURPOSE Primary pulmonary salivary gland-type tumor (PSGT) included two main subtypes, pulmonary adenoid cystic carcinoma (PACC) and pulmonary mucoepidermoid carcinoma (PMEC). The purpose of this study was to compare the similarities and differences between these two subtypes and to identify independent risk factors for the prognosis of PSGT patients. METHODS This study screened patients with a pathological diagnosis of PSGT in Beijing Chaoyang Hospital between 2010 and 2021. The clinical, pathological, radiological, laboratory test, and other characteristics were collected, and t, nonparametric and chi-squared tests were used to compare the differences in clinical characteristics of the two subtypes. COX univariate and multivariate analyses were used to explore prognostic-related risk factors. RESULTS A total of 62 patients with PSGT were included in our center over a 12-year period. There were 26 PMEC patients and 36 PACC patients. There were differences in the clinical, pathological, and radiological features of the two tumor subtypes. Univariate analysis showed that weight loss, chemotherapy, white blood cells, lymphocytes, red blood cells, total protein, and total bilirubin might be related to the prognosis in PSGT patients. Multivariate results showed that lymphocytes (p = 0.031), red blood cells (p = 0.047), total protein (p = 0.032), and total bilirubin (p = 0.010) were independent prognostic risk factors. Chemotherapy (HR 4.452; 95% CI 1.723-11.503; p = 0.002) might be associated with progression-free survival (PFS). CONCLUSION The two subtypes of PSGT had significantly different clinical, laboratory, pathological, and radiological features. However, there was no significant difference in the prognosis of patients with PMEC and PACC subtypes. Cox univariate and multivariate analyses showed that levels of lymphocytes, erythrocytes, total protein and total bilirubin in the peripheral blood of PSGT patients might be related to patient overall survival. Chemotherapy might also be associated with PFS.
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9
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Zheng BH, Zhang C, Wan WZ, Sun WT, Cheng X, Ni XJ, Ni XL, Suo T, Liu H, Shen S, Liu HB. The clinical and prognostic factors for biliary neuroendocrine neoplasm: a study based on the SEER database. BMC Surg 2022; 22:253. [PMID: 35768809 PMCID: PMC9245279 DOI: 10.1186/s12893-022-01689-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 06/06/2022] [Indexed: 12/15/2022] Open
Abstract
Background In this study, we aimed at elucidating the postoperative survival and prognostic factors in patients with biliary neuroendocrine neoplasm (NEN). Methods Cases of biliary system NEN and adenocarcinoma from 1975 to 2016 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A propensity score matching (PSM) method was used to adjust baseline differences in clinicopathological characteristics in our analysis. The Kaplan–Meier analysis was carried out for survival analysis. Results A total of 233 patients with biliary system NEN were enrolled in this study, of which 119 patients’ lesions located in gallbladder, while the others’ located in bile duct. The postoperative overall survival of bile duct NEN is significantly longer than that of gallbladder NEN (P < 0.001). For gallbladder NENs, surgery method (P = 0.020) and lymph node metastasis (P = 0.018) were identified as independent prognostic factors. In terms of ampulla of vater (AOV) NENs, age (P = 0.017) and lymph node metastasis (P = 0.006) were identified as independent prognostic factors, while grade (P = 0.002) and lymph node metastasis (P = 0.036) were identified as independent prognostic factors for extrahepatic bile duct (EBD) NENs. PSM analysis indicated that patients with biliary duct NENs have a better postoperative prognosis than biliary duct adenocarcinoma. Conclusions Patients with NEN have better overall survival than patients with adenocarcinoma. Gallbladder NEN has an adverse prognosis than that of biliary tract NEN. The pathological subtype, differentiation, lymph node metastasis, surgery method, and lymph node resection could affect the postoperative prognosis of the gallbladder and biliary tract NEN. Supplementary Information The online version contains supplementary material available at 10.1186/s12893-022-01689-7.
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Affiliation(s)
- Bo-Hao Zheng
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Cheng Zhang
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Wen-Ze Wan
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Wen-Tao Sun
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Xi Cheng
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Xiao-Jian Ni
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Xiao-Ling Ni
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Tao Suo
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Han Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China.,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China
| | - Sheng Shen
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China. .,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China.
| | - Hou-Bao Liu
- Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Biliary Tract Disease Center, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Biliary Tract Disease Institute, Fudan University, 180 Fenglin Road, Shanghai, 200032, China. .,Cancer Center, Zhongshan Hospital, 180 Fenglin Road, 200032, Shanghai, China. .,Shanghai Engineering Research Center of Biliary Tract Minimal Invasive Surgery and Materials, Shanghai, China. .,Department of General Surgery, Biliary Tract Disease Institute, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China.
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10
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Wang M, Gilani S, Xu H, Cai G. Salivary Gland-type Tumors of the Lung. Arch Pathol Lab Med 2021; 145:1379-1386. [PMID: 34673911 DOI: 10.5858/arpa.2021-0093-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Salivary gland-type tumors (SGTs) of the lung represent a distinct group of lung neoplasms. Pulmonary SGTs often pose diagnostic challenges, especially in small biopsy and cytology samples because of limited sample volume and overlapping morphology among pulmonary SGTs, metastatic SGTs of head and neck origin, and other lung tumors. OBJECTIVE.— To identify the clinical characteristics, histomorphology, immunophenotypic features, and molecular alterations that are crucial for the diagnosis and differential diagnosis of pulmonary SGTs, especially in small biopsy and cytology specimens. DATA SOURCES.— Literature review and authors' personal practice experience. CONCLUSIONS.— An accurate diagnosis of pulmonary SGTs can be achieved by careful evaluation of clinical findings and histomorphology in conjunction with immunohistochemical studies and molecular analysis.
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Affiliation(s)
- Minhua Wang
- From the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Wang, Gilani, Cai)
| | - Syed Gilani
- From the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Wang, Gilani, Cai)
| | - Haodong Xu
- The Department of Laboratory Medicine & Pathology, University of Washington, Seattle (Xu)
| | - Guoping Cai
- From the Department of Pathology, Yale University School of Medicine, New Haven, Connecticut (Wang, Gilani, Cai)
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11
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Kawakado K, Tamura T, Nakanishi M, Makimoto G, Sato Y, Kuyama S. Carboplatin, pemetrexed, and pembrolizumab was effective for primary salivary gland-type lung adenocarcinoma diagnosed due to esophageal stricture: A case report. Thorac Cancer 2021; 12:2513-2516. [PMID: 34369074 PMCID: PMC8447908 DOI: 10.1111/1759-7714.14100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022] Open
Abstract
Primary salivary gland‐type tumors of the lung are rare, accounting for <1% of all lung tumors. There are few reports on chemotherapy for the treatment of primary salivary gland‐type tumors of the lung. The patient in this report was a 71‐year‐old woman who presented with a chief complaint of dysphagia. Upper gastrointestinal endoscopy revealed an esophageal stricture, but biopsy showed no malignancy. Chest computed tomography (CT) showed carcinomatous lymphangiomatosis and a nodule in the right lung. Bronchoscopy showed a rough mucous membrane of the central bronchi, while biopsy showed adenocarcinoma. The patient was diagnosed with bronchogenic adenocarcinoma and received carboplatin, pemetrexed, and pembrolizumab, which alleviated the esophageal stricture and cancerous lymphangiopathy. However, the adenocarcinoma progressed, and she subsequently received several rounds of chemotherapy. One year after diagnosis, the patient died, and pathological autopsy revealed primary salivary gland‐type tumors of the lung.
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Affiliation(s)
- Keita Kawakado
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan.,Department of Internal Medicine, Division of Medical Oncology and Respiratory Medicine, Shimane University Faculty of Medicine, Izumo, Japan
| | - Tomoki Tamura
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan
| | - Masamoto Nakanishi
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan
| | - Go Makimoto
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan
| | - Yumiko Sato
- Department of Pathology, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan
| | - Shoichi Kuyama
- Department of Respiratory Medicine, National Hospital Organization Iwakuni Clinical Center, Iawkuni-City, Japan
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12
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Wang F, Xi SY, Hao WW, Yang XH, Deng L, Xu YX, Wu XY, Zeng L, Guo KH, Wang HY. Mutational landscape of primary pulmonary salivary gland-type tumors through targeted next-generation sequencing. Lung Cancer 2021; 160:1-7. [PMID: 34364112 DOI: 10.1016/j.lungcan.2021.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/19/2021] [Accepted: 07/01/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Primary pulmonary salivary gland-type tumors (PSGTs) mainly comprise of mucoepidermoid carcinoma (MEC) and adenoid cystic carcinoma (ACC), which are rare and molecularly poorly understood. This study aimed to profile the molecular alterations of PSGTs via targeted next-generation sequencing (NGS). MATERIAL AND METHODS Immunohistochemistry was used to screen PSGTs in 32 patients and MAML2 and MYB rearrangements were detected using fluorescence in situ hybridization. 1021-Genepanel of targeted NGS was conducted to profile genomic mutations in all the PSGT patients. RESULTS Among the 32 patients, 25 had MEC and 7 had ACC. MAML2 and MYB rearrangements were detected in 80.0% (20/25) of the MEC and 71.4% (5/7) of the ACC patients. Among the MEC patients, 10 (40.0%) had ≥1 mutation, and 6 of them had 11 isolated mutations with abundance >5%, namely NFE2L2, MYOD1, INPP4B, CCND2, SNTG1, HSPD1, TGFBR1, RBM10, NOTCH4, ASXL1, and PTPRD mutations. The remaining 4 patients had 9 mutations with abundance <5%, namely KMT2A, PDCD11, FLT1, BRCA2, APC, SLX4, FOXP1, FGFR1, and HRAS mutations. All the ACC patients had mutations, which were enriched in 5 pathways including the PI3K and NOTCH pathways, chromatin and cytoskeleton remodeling, and DNA damage. These results explain PSGTs harbor distinct driver features of MAML2 or MYB rearrangement, accompanied with wide mutational diversity with very low rate of somatic mutation. Several important pathways, including the NOTCH and PI3K pathways, and chromatin remodeling could be targeted to improve the survival in patients with ACC.
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Affiliation(s)
- Fang Wang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China; Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Shao-Yan Xi
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China; Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Wen-Wen Hao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangdong Key Laboratory Of Nasopharyngeal Carcinoma Diagnosis And Therapy, Guangzhou 510060, PR China.
| | - Xin-Hua Yang
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Ling Deng
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Yu-Xia Xu
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Xiao-Yan Wu
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, Guangzhou 510060, PR China.
| | - Liang Zeng
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, PR China.
| | - Kai-Hua Guo
- Department of Anatomy and Neurobiology, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou 510080, PR China.
| | - Hai-Yun Wang
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou 510623, PR China; Guangzhou Institute of Pediatrics, Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623 Guangdong, PR China.
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13
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Wang SC, Yin LK, Zhang Y, Xue LM, Ye JD, Tao GY, Yu H, Qiang JW. Contrast-enhanced CT longitudinal tail sign as a marker of positive resection margins in adenoid cystic carcinoma of the central airway. J Thorac Dis 2021; 13:2803-2811. [PMID: 34164172 PMCID: PMC8182504 DOI: 10.21037/jtd-20-2929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background Due to submucosal infiltration’s biological nature along the airway, adenoid cystic carcinoma (ACC) frequently leaves positive surgical margins. This study evaluated the clinicopathologic, and computed tomography (CT) features for predicting surgical margin status in central airway ACC. Methods We retrospectively analyzed the files of 71 patients with ACC of the central airway proven by histopathology and surgery who had presented between January 2010 and December 2018. All patients were classified into positive and negative surgical margin groups according to margin status. Univariate analysis and multivariable logistic regression models were then performed to compare demography, histopathology, and CT characteristics between ACC patients with positive and negative margins. Results After surgical resection, 59 (83.1%) patients had positive margins, and 12 (16.9%) had negative margins. The contrast-enhanced CT (CECT) longitudinal tail sign (LTS) was identified in 55 of 59 (93.2%) patients with positive margins and was the only feature that had a significant association with positive margins (odds ratio 41.250, 95% CI: 7.886–215.767; P<0.001). Moreover, positive margins in upper or/and lower directions were associated with the LTS in corresponding directions (P<0.001). Conclusions Most central airway ACC patients exhibited positive margins following surgery. The appearance of the LTS on CECT was significantly associated with positive margins and could help preoperatively predict the submucosal invasion of ACC.
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Affiliation(s)
- Shu-Chao Wang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Le-Kang Yin
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Zhang
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Min Xue
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China.,Shanghai Institute of Imaging Medicine, Fudan University, Shanghai, China
| | - Jian-Ding Ye
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guang-Yu Tao
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin-Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
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14
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Wang SC, Yin LK, Zhang Y, Xue LM, Ye JD, Tao GY, Yu H, Qiang JW. CT diagnosis and prognosis prediction of tracheal adenoid cystic carcinoma. Eur J Radiol 2021; 140:109746. [PMID: 33992979 DOI: 10.1016/j.ejrad.2021.109746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/08/2021] [Accepted: 04/26/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE To evaluate computed tomography (CT) features and establish a predictive model for the clinical diagnosis and prognosis of tracheal adenoid cystic carcinoma (ACC). METHOD From January 2010 to December 2018, 82 patients with tracheal tumors, including 46 patients with ACC confirmed by surgery and histopathology, were enrolled in this study. These patients' clinicopathologic information, CT features and survival outcomes were recorded and analyzed. Independent predictors of diagnosis and prognosis of tracheal ACC were determined by both univariate and multivariate analyses. RESULTS Compared with tracheal non-ACC patients, univariate analysis showed that ACC patients were more likely to have extensive longitudinal length (p < 0.001) and to appear as annular wall thickening (p = 0.001), transmural growth (p = 0.036), poorly defined border (p = 0.003) and mild enhancement (p = 0.001). Multivariate logistic analysis showed that longitudinal length and enhancement degree were independent predictors of tracheal ACC. The 3-year and 5-year disease-free survival (DFS) were 75.7 % and 64.5 %, respectively. Longitudinal length (≥ 34 mm), transverse length (≥ 20 mm) and transmural growth were associated with poor DFS in univariate analysis. After multivariate adjustment, only transverse length (≥ 20 mm) was an adverse prognostic factor for DFS (hazard ratio = 4.594, 95 % confidence interval = 1.240-17.017; p = 0.022). CONCLUSIONS CT longitudinal length and enhancement degree of tumors showed satisfactory discrimination for tracheal ACC. Excessive CT transverse length might be an unfavorable indicator for ACC recurrence and could be helpful for predicting the survival outcomes of ACC at the initial diagnosis.
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Affiliation(s)
- Shu Chao Wang
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China
| | - Le Kang Yin
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Yu Zhang
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Li Min Xue
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China; Shanghai Institute of Imaging Medicine, Fudan University, 180 Fenglin Road, Shanghai, 200030, China
| | - Jian Ding Ye
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Guang Yu Tao
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China
| | - Hong Yu
- Department of Radiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, 241 West Huaihai Road, Shanghai, 200030, China.
| | - Jin Wei Qiang
- Department of Radiology, Jinshan Hospital, Fudan University, 1508 Longhang Road, Shanghai, 201508, China.
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15
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Roden AC. Recent updates in salivary gland tumors of the lung. Semin Diagn Pathol 2021; 38:98-108. [PMID: 33744018 DOI: 10.1053/j.semdp.2021.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/03/2021] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Salivary gland tumors are uncommon primary lesions in the lung. Their morphologic, immunophenotypic, and molecular characteristics resemble those of their counterparts in the head and neck or elsewhere. Most common primary pulmonary salivary gland tumors include mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma. The study of these neoplasms is hampered by their paucity. Therefore, studies are in general small or restricted to individual cases. Despite this challenge recent advances have been made specifically at the molecular level. Molecular alterations such as MAML2 rearrangements in mucoepidermoid carcinoma, MYB rearrangements in adenoid cystic carcinomas, and EWSR1 rearrangements in hyalinizing clear cell carcinomas and myoepithelial tumors have been identified. These molecular alterations might be helpful in the distinction of these salivary gland tumors from other neoplasms in the lung. However, the distinction from metastatic disease remains challenging. Awareness of these tumors and knowledge of available ancillary studies to confirm the diagnosis is important to avoid misdiagnosis which might lead to differences in treatment, management, and prognosis. Further studies are needed to identify biomarkers to better predict patient's outcome and for individual management and treatment of patients.
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Affiliation(s)
- Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, MN, United States.
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16
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Qiu L, Song P, Chen P, Wang H, Li F, Shu M, Gong GC, Song X, Huang C, Jia H, Li N, Zhang G. Clinical Characteristics and Prognosis of Patients With Pulmonary Mucoepidermoid Carcinoma: A SEER-Based Analysis. Front Oncol 2021; 11:601185. [PMID: 33747918 PMCID: PMC7973275 DOI: 10.3389/fonc.2021.601185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 01/07/2021] [Indexed: 02/05/2023] Open
Abstract
Background Primary pulmonary mucoepidermoid carcinoma (PMEC) is an extremely rare malignancy. Its clinical characteristics and prognosis are not fully understood. This study evaluated clinical characteristics and prognostic factors of PMEC and established a nomogram to predict its 1-, 3-, 5- and 10-year cancer-specific survival (CSS) rates. Methods In the Surveillance, Epidemiology, and End Results database from January 1, 2016 to December 31, 2016, patients pathologically diagnosed with PMEC were identified. Kaplan-Meier analysis and Cox regression were performed to evaluate the CSS stratified by different covariates. A predictive nomogram model was built and validated by the concordance index (C-index) and calibration curves. Results A total of 585 PMEC patients were identified. A total of 408 (70%) of patients were placed into the training cohort, and 177 (30%) patients were placed into the validation cohort. The 5- and 10-year CSS rates of stage I-II PMEC patients were 91.4 and 88.9, respectively. The 1-, 3- and 5-year CSS rates of stage III-IV PMEC were 56.5, 39.45, and 32.1%, respectively. Survival curves showed that older age, large tumor size, poor differentiation, and high TNM stage were associated with a significantly worse prognosis. CSS outcomes were significantly better in patients who received surgical treatments (surgical alone, surgery plus radiation and/or chemotherapy). Patients who received radiation and/or chemotherapy had the worst prognosis. Multivariate Cox results revealed that covariates, including age, tumor laterality, tumor sizes, pathological differentiation, lymph node metastasis, distant metastasis, TNM stage and therapy, were independent prognostic factors for PMEC. These factors were used to construct a nomogram. The C-index of the nomogram was 0.921. The calibration curve presented favorable consistency between the predicted CSS and actual observations. This nomogram was validated by the validation cohort. The C-index of the validation cohort was 0.968. Conclusion Age, bilateral tumors, tumor size, pathological differentiation grade, lymph node metastasis, distant metastasis, TNM stage and therapy were independent prognostic factors of PMEC patients. The first nomogram for predicting the CSS of PMEC was built and validated, showing its potential value in practice.
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Affiliation(s)
- Lingxiao Qiu
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Pan Song
- Department of Urology, West China Hospital of Sichuan University, Chengdu, China
| | - Pingmei Chen
- Department of Neonatology, West China Guang'an Hospital, Sichuan University, Guang'an, China
| | - Huaqi Wang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Zhengzhou Key Laboratory for Chronic Respiratory Disease, Zhengzhou, China.,Henan Provincial Respiratory Medicine Center, Zhengzhou, China
| | - Fangfang Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengxuan Shu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Gen-Cheng Gong
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiangjin Song
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chun Huang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongxia Jia
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Nana Li
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guojun Zhang
- Department of Respiratory Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Zhengzhou Key Laboratory for Chronic Respiratory Disease, Zhengzhou, China.,Henan Provincial Respiratory Medicine Center, Zhengzhou, China
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17
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Kim BG, Lee K, Um SW, Han J, Cho JH, Kim J, Kim H, Jeong BH. Clinical outcomes and the role of bronchoscopic intervention in patients with primary pulmonary salivary gland-type tumors. Lung Cancer 2020; 146:58-65. [PMID: 32512274 DOI: 10.1016/j.lungcan.2020.05.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Primary pulmonary salivary gland-type tumors (PSGT) are rare among all types of lung cancer. The purpose of this study was not only to evaluate the clinical outcomes and prognostic factors after treatment, but also to assess the role for bronchoscopic intervention in PSGT. METHODS We analyzed the medical data of 181 PSGT patients who were treated between 1995 and 2018. Patients were divided into three groups according to the initial treatment, as follows: surgical resection with/without adjuvant therapy including bronchoscopic intervention (surgery group, n = 116); bronchoscopic intervention without surgical resection (bronchoscopic intervention group, n = 51); and other treatments group (n = 14). A multivariable Cox proportional hazard regression analysis was used to identify the independent prognostic factors associated with overall survival (OS) and progression free survival (PFS) after the first treatment. In addition, subgroup analysis was performed according to the clinical stage. RESULTS Among the 181 patients, 104 (57.5%) patients were diagnosed with adenoid cystic carcinoma (ACC), 71 (39.2%) with mucoepidermoid carcinoma, and 6 (3.3%) with epithelial-myoepithelial carcinoma. In the surgery group, 21 patients underwent bronchoscopic intervention as a bridge therapy before surgery because of respiratory distress. Poor OS was associated with older age, the existence of other malignancy, higher clinical stages, larger tumor size, and non-surgical treatments. Lower PFS was associated with ACC, larger tumor size, and non-surgical treatments. The surgery group had the best OS and PFS among all treatment groups. However, there was no significant difference in the OS between the surgery and bronchoscopic intervention groups (p = 0.66) in patients at high clinical stages. CONCLUSIONS Surgical resection was the best initial treatment choice. However, bronchoscopic intervention may be useful as the initial treatment in patients at high clinical stage and as a bridge therapy prior to surgery.
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Affiliation(s)
- Bo-Guen Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungjong Lee
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sang-Won Um
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Joungho Han
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jong Ho Cho
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jhingook Kim
- Department of Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hojoong Kim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Byeong-Ho Jeong
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Diagnostic Significance of HRAS Mutations in Epithelial-Myoepithelial Carcinomas Exhibiting a Broad Histopathologic Spectrum. Am J Surg Pathol 2020; 43:984-994. [PMID: 30994537 DOI: 10.1097/pas.0000000000001258] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland tumor that is histologically characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells. Because of its histologic variety, it is sometimes challenging to make an accurate diagnosis, and useful ancillary tests are essential for this purpose. We investigated 87 cases of EMC arising in the major and minor salivary glands and seromucinous glands in the nasal cavity or bronchus to describe the histologic features and mutation status of selected key oncogenes. Classic EMC accounted for 40.2% of all cases. Other cases showed various growth patterns and cytologic features in addition to the typical histology; cribriform patterns, a basaloid appearance, and sebaceous differentiation were relatively common (17.2% to 18.4%), whereas oncocytic/apocrine, papillary-cystic, double-clear, squamous, psammomatous, Verocay-like, and high-grade transformation were rare. HRAS mutations were found in 82.7% of EMCs and were concentrated in codon 61. There was no significant correlation between the HRAS mutation status and the histology. No EMC ex pleomorphic adenoma cases had HRAS mutations. PIK3CA and/or AKT1 mutations were the second most frequent mutations (20.7%, 6.5%, respectively) and almost always cooccurred with HRAS mutations. It is noteworthy that the HRAS mutation was not identified in any salivary gland tumor entities manifesting EMC-like features, including adenoid cystic carcinoma, pleomorphic adenoma, basal cell adenoma/adenocarcinoma, and myoepithelial carcinoma. We conclude that HRAS mutations are a frequent tumorigenic gene alteration in EMC, despite its histologic diversity. This study provides further insight into strategies for diagnosing EMC and discriminating it from its mimics.
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19
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Liang X, Cheng Y, Yuan Z, Yan Z, Li Q, Huang Y, Feng G. Clinical, pathological and treatment factors associated with the survival of patients with pulmonary sarcomatoid carcinoma. Oncol Lett 2020; 19:4031-4039. [PMID: 32382345 PMCID: PMC7202303 DOI: 10.3892/ol.2020.11472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 02/19/2020] [Indexed: 12/29/2022] Open
Abstract
Pulmonary sarcomatoid carcinoma (PSC) is a group of five rare non-small cell lung cancer subtypes. In the present study, the clinical characteristics and outcomes of patients with PSC registered in the Surveillance, Epidemiology and End Results (SEER) database were investigated. For this purpose, data for patients with PSC (n=1,723) who received their initial diagnosis between 1988 and 2016 were collected from the SEER database. Survival analysis was performed using the Kaplan-Meier curves and the log-rank test. Subsequently, multivariate analyses with the Cox proportional hazards model were used to identify significant independent predictors. A nomogram model was established to predict survival performance using the concordance index (C-index). From the total cohort, patients with pulmonary blastoma demonstrated improved 1-year overall survival (OS) rate compared with other pathological types (P<0.001). The 2-year overall survival rates of the ‘only radiotherapy’ cohort and the ‘no specific treatment’ cohort were 9.1 and 5.4% (P<0.001), respectively. Radiotherapy significantly improved the OS rate in stage I–III patients with PSC (P<0.001) when stratified by stage. After matching the propensity scores, the ‘surgery combined with radiotherapy’ group comprised 156 patients and the ‘surgery-only’ group had 247 patients (1:1.6). However, no significant differences in prognosis were found between the 2 subgroups (P=0.052). The multivariate Cox analysis demonstrated that older age (≥76 years old), male, unmarried, pathological type, larger tumor size (≥56 mm), later tumor node metastasis stages and treatment modalities were independent prognostic factors. A nomogram model was established to predict the survival of patients with PSC. This model incorporated the seven aforementioned independent prognostic factors (C-index for survival, 0.75; 95% confidence interval, 0.74–0.76). Radiotherapy needs to considered for stage I–III patients with PSC who undergo radiation therapy without surgical resection.
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Affiliation(s)
- Xiaohong Liang
- Department of Pulmonary and Critical Care Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Yinan Cheng
- Department of Pulmonary and Critical Care Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Zijiang Yuan
- Department of Ear, Nose and Throat, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Zhengping Yan
- Department of Pulmonary and Critical Care Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Quqing Li
- Department of Pulmonary and Critical Care Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Yuan Huang
- Department of Cardiovascular Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
| | - Gaohua Feng
- Department of Pulmonary and Critical Care Medicine, Zhangjiagang Traditional Chinese Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Zhangjiagang, Jiangsu 215600, P.R. China
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Zhang Z, Xie H, Chen P, Cao P. Development and Identification of a Nomogram Prognostic Model for Patients with Primary Clear Cell Carcinoma of the Liver. Med Sci Monit 2020; 26:e919789. [PMID: 31969554 PMCID: PMC6996864 DOI: 10.12659/msm.919789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Primary clear cell carcinoma of the liver (PCCCL) is an infrequent variant of primary hepatocellular carcinoma (HCC), we retrospectively performed a large population-based cohort study to elucidate the relationships between demographic, carcinoma- and therapy-specific variables and overall survival (OS). MATERIAL AND METHODS The Surveillance, Epidemiology and End Results (SEER) database was queried to extract data on 419 patients with pathologically confirmed PCCCL from 1988 to 2015. A nomogram with good accuracy was formulated to predict long-term survival of PCCCL patients. RESULTS The OS for PCCCL patients was 25.6 months (95% confidence interval [CI]: 22.2-29 months), the overall 1-year, 3-year, and 5-year survival rates were 59.5%, 39.3%, and 29.9%, respectively. Log-rank analysis revealed that there was no statistically significant discrepancy in clinical outcome between PCCCL and common-type HCC after propensity-matched analysis. Multivariate Cox analysis confirmed that larger lesions (>96 mm), distant metastases and elevated alpha-fetoprotein (AFP) levels were independent prognostic factors for undesirable outcome. Conversely, surgery was an independent protective factor (hazard ratio [HR]=0.23, 95% CI 0.17-0.31), which significantly boosted OS by virtually 35 months (47.3 months versus 12.7 months, P<0.001). Radiotherapy or chemotherapy was not associated with OS for PCCCL patients (both P>0.05). The nomogram incorporated 4 independent prognostic factors and its concordance index for predicting survival was 0.761. CONCLUSIONS The prognosis of PCCCL resembled that of common-type HCC. Larger lesions, distant metastases, and enhanced AFP levels were associated with unsatisfactory prognosis. Surgery fulfill favorable prognosis while radiotherapy or chemotherapy exerted no significant effects on survival.
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Affiliation(s)
- Ziying Zhang
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Hui Xie
- Department of Thoracic and Cardiovascular Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China (mainland)
| | - Peng Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
| | - Peiguo Cao
- Department of Oncology, Third Xiangya Hospital, Central South University, Changsha, Hunan, China (mainland)
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Qin BD, Jiao XD, Liu K, Wu Y, He X, Liu J, Qin WX, Wang Z, Zang YS. Basket Trials for Intractable Cancer. Front Oncol 2019; 9:229. [PMID: 31032221 PMCID: PMC6473081 DOI: 10.3389/fonc.2019.00229] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/14/2019] [Indexed: 12/13/2022] Open
Abstract
Currently, genomic characterization has become standard of care for tumor types such as non-small cell lung cancer, breast cancer, melanoma, and colorectal cancer. A deep understanding of genomic alterations in different tumor types would help identify potentially actionable genomic changes which occur across a wide variety of tumor types. A basket trial is a new type of clinical trial for which eligibility is based on the presence of a specific genomic alteration, irrespective of histology. Basket trials are phase II screening trials for the off-label use of a targeted drug in patients with the same genomic alterations for which it was approved. Intractable cancer refers to a type or condition of cancer which is unresponsive or resistant to treatment; intractable cancers may be classified into five subtypes as follows: hard-to-treat condition of common advanced cancer after multiple-line therapy, rare cancer in which no standard of care has been recommended, advanced cancer in which standard of care does not work well, cancer accompanied with organ dysfunction, and cancers in older or younger cancer patients. Previous studies have demonstrated that in basket trials, genomic-guided therapy yields clinical benefits in intractable cancer, thereby providing novel insights into the optimal clinical management of such cancers. In this review, we describe a novel way to classify intractable cancer, and summarize the current knowledge on such cancers. We additionally provide information on the role of basket trials in intractable cancer.
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Affiliation(s)
- Bao-Dong Qin
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xiao-Dong Jiao
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Ke Liu
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Ying Wu
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Xi He
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jun Liu
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Wen-Xing Qin
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Zhan Wang
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yuan-Sheng Zang
- Department of Medical Oncology, Changzheng Hospital, Naval Medical University, Shanghai, China
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