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Botta FP, Rocha LA, de Souza VDGP, Dos Reis PP, Lima EDO, Ferrasi AC, Fernandes AY, Zanini MA, Hamamoto Filho PT. Survival in patients undergoing surgical resection for brain metastasis from lung cancer and utility of different prognostic scales. Neurosurg Rev 2023; 46:184. [PMID: 37493965 DOI: 10.1007/s10143-023-02092-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/19/2023] [Accepted: 07/15/2023] [Indexed: 07/27/2023]
Abstract
Brain metastases (BM) from lung cancer are among the most common intracranial tumors. Several studies have published scales to estimate the survival of patients with BM. Routine access to molecular diagnostics and modern oncologic treatments, including targeted therapy and immunotherapy, is limited in low- and middle-income countries (LMICs); therefore, incorporating them into recent prognostic scales may diminish the reliability of the scales in LMICs. This retrospective study aimed to determine the survival of 55 patients who were surgically treated for BM from lung cancer at a Brazilian public tertiary teaching hospital between 2012 and 2022. We determined clinical factors associated with survival, and compared observed survival rates with the estimated survival on prognostic scales. The mean overall survival (OS) was 9.3 months (range:0.2-76.5). At univariate analysis, female sex and improved postoperative Karnofsky performance status (KPS) score were associated with longer survival. The median survival did not differ between groups when classified using the Graded Prognostic Assessment (GPA)-2008, Lung-molecular GPA-2017, and Lung-GPA-2021 scales. According to the Diagnosis-Specific (DS)-GPA-2012 scale, there was a significant difference between the groups. In the multivariate Cox regression survival analysis, a higher DS-GPA-2012 and improved postoperative KPS score remained significantly associated with longer survival. In conclusion, this cohort showed a mean OS of < 1 year. Improved KPS score after surgery was associated with increased survival. This cohort DS-GPA scale demonstrated the highest concordance with observed survival, indicating its potential as a valuable tool for patient stratification in surgical treatment decision-making in LMICs.
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Affiliation(s)
- Fábio Pires Botta
- Department of Neurology, Psychology and Psychiatry, UNESP - São Paulo State University. Botucatu Medical School, Botucatu, Brazil
| | | | | | - Patrícia Pintor Dos Reis
- Department of Surgery and Orthopedics, UNESP - São Paulo State University. Botucatu Medical School, Botucatu, Brazil
| | - Estela de Oliveira Lima
- Department of Internal Medicine, UNESP - São Paulo State University, Botucatu Medical School, Botucatu, Brazil
| | - Adriana Camargo Ferrasi
- Department of Internal Medicine, UNESP - São Paulo State University, Botucatu Medical School, Botucatu, Brazil
| | - Adriano Yacubian Fernandes
- Department of Neurology, Psychology and Psychiatry, UNESP - São Paulo State University. Botucatu Medical School, Botucatu, Brazil
| | - Marco Antônio Zanini
- Department of Neurology, Psychology and Psychiatry, UNESP - São Paulo State University. Botucatu Medical School, Botucatu, Brazil
| | - Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, UNESP - São Paulo State University. Botucatu Medical School, Botucatu, Brazil.
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Freire PP, Fernandez GJ, de Moraes D, Cury SS, Dal Pai‐Silva M, Dos Reis PP, Rogatto SR, Carvalho RF. The authors reply: Comment on "The expression landscape of cachexia-inducing factors in human cancers" by Freire et al. J Cachexia Sarcopenia Muscle 2020; 11:1854-1857. [PMID: 32996709 PMCID: PMC7749551 DOI: 10.1002/jcsm.12635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Paula Paccielli Freire
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
| | - Geysson Javier Fernandez
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
- Faculty of MedicineUniversity of Antioquia, UdeAMedellínColombia
| | - Diogo de Moraes
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
| | - Sarah Santiloni Cury
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
| | - Maeli Dal Pai‐Silva
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
| | - Patrícia Pintor Dos Reis
- Department of Surgery and Orthopedics, Faculty of MedicineSão Paulo State University, UNESPBotucatuBrazil
- Experimental Research Unity, Faculty of MedicineSão Paulo State University, UNESPBotucatuBrazil
| | - Silvia Regina Rogatto
- Department of Clinical Genetics, University Hospital, Institute of Regional Health ResearchUniversity of Southern DenmarkVejleDenmark
- Danish Colorectal Cancer Center SouthVejleDenmark
| | - Robson Francisco Carvalho
- Department of Structural and Functional Biology, Institute of BiosciencesSão Paulo State University, UNESPBotucatuBrazil
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Freire PP, Fernandez GJ, Cury SS, de Moraes D, Oliveira JS, de Oliveira G, Dal-Pai-Silva M, Dos Reis PP, Carvalho RF. The Pathway to Cancer Cachexia: MicroRNA-Regulated Networks in Muscle Wasting Based on Integrative Meta-Analysis. Int J Mol Sci 2019; 20:ijms20081962. [PMID: 31013615 PMCID: PMC6515458 DOI: 10.3390/ijms20081962] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 03/12/2019] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 12/15/2022] Open
Abstract
Cancer cachexia is a multifactorial syndrome that leads to significant weight loss. Cachexia affects 50%-80% of cancer patients, depending on the tumor type, and is associated with 20%-40% of cancer patient deaths. Besides the efforts to identify molecular mechanisms of skeletal muscle atrophy-a key feature in cancer cachexia-no effective therapy for the syndrome is currently available. MicroRNAs are regulators of gene expression, with therapeutic potential in several muscle wasting disorders. We performed a meta-analysis of previously published gene expression data to reveal new potential microRNA-mRNA networks associated with muscle atrophy in cancer cachexia. We retrieved 52 differentially expressed genes in nine studies of muscle tissue from patients and rodent models of cancer cachexia. Next, we predicted microRNAs targeting these differentially expressed genes. We also include global microRNA expression data surveyed in atrophying skeletal muscles from previous studies as background information. We identified deregulated genes involved in the regulation of apoptosis, muscle hypertrophy, catabolism, and acute phase response. We further predicted new microRNA-mRNA interactions, such as miR-27a/Foxo1, miR-27a/Mef2c, miR-27b/Cxcl12, miR-27b/Mef2c, miR-140/Cxcl12, miR-199a/Cav1, and miR-199a/Junb, which may contribute to muscle wasting in cancer cachexia. Finally, we found drugs targeting MSTN, CXCL12, and CAMK2B, which may be considered for the development of novel therapeutic strategies for cancer cachexia. Our study has broadened the knowledge of microRNA-regulated networks that are likely associated with muscle atrophy in cancer cachexia, pointing to their involvement as potential targets for novel therapeutic strategies.
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Affiliation(s)
- Paula Paccielli Freire
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Geysson Javier Fernandez
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Sarah Santiloni Cury
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Diogo de Moraes
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Jakeline Santos Oliveira
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Grasieli de Oliveira
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Maeli Dal-Pai-Silva
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
| | - Patrícia Pintor Dos Reis
- Department of Surgery and Orthopedics, Faculty of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-687, Brazil.
- Experimental Research Unity, Faculty of Medicine, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-687, Brazil.
| | - Robson Francisco Carvalho
- Department of Morphology, Institute of Biosciences, São Paulo State University (UNESP), Botucatu, São Paulo 18.618-619, Brazil.
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