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Jiang MQ, Qian LQ, Shen YJ, Fu YY, Feng W, Ding ZP, Han YC, Fu XL. Who benefit from adjuvant chemotherapy in stage I lung adenocarcinoma? A multi-dimensional model for candidate selection. Neoplasia 2024; 50:100979. [PMID: 38387107 PMCID: PMC10899011 DOI: 10.1016/j.neo.2024.100979] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Despite promising overall survival of stage I lung adenocarcinoma (LUAD) patients, 10-25 % of them still went through recurrence after surgery. [1] While it is still disputable whether adjuvant chemotherapy is necessary for stage I patients. [2] IASLC grading system for non-mucinous LUAD shows that minor high-grade patterns are significant indicator of poor prognosis. [3] Other risk factors, such as, pleura invasion, lympho-vascular invasion, STAS, etc. are also related to poor prognosis. [4-6] There still lack evidence whether IASLC grade itself or together with other risk factors can guide the use of adjuvant therapy in stage I patients. In this article, we tried to establish a multi-variable recurrence prediction model for stage I LUAD patients that is able to identify candidates of adjuvant chemotherapy. METHODS We retrospectively collected patients who underwent lung surgery from 2018.8.1 to 2018.12.31 at our institution and diagnosed with lung adenocarcinoma pT1-2aN0M0 (stage I). Clinical data, manifestation on CT scan, pathologic features, driver gene mutations and follow-up information were collected. Cox proportional hazards regression analyses were performed utilizing the non-adjuvant cohort to predict disease free survival (DFS) and a nomogram was constructed and applied to the total cohort. Kaplan-Meier method was used to compare DFS between groups. Statistical analysis was conducted by R version 3.6.3. FINDINGS A total of 913 stage I LUAD patients were included in this study. Median follow-up time is 48.1 months.4-year and 5-year DFS are 92.9 % and 89.6 % for the total cohort. 65 patient experienced recurrence or death. 4-year DFS are 97.0 %,94.6 % and 76.2 %, and 5-year DFS are 95.5 %, 90.0 % and 74.1 % in IASLC Grade1, 2 and 3, respectively(p < 0.0001). High-risk patients defined by single risk factors, such as, IASLC grade 3, pleura invasion, STAS, less LN resected could not benefit from adjuvant therapy. A LASSO-COX regression model was built and patients are divided into high-risk and low-risk groups. In the high-risk group, patients underwent adjuvant chemotherapy have longer DFS than those who did not (p = 0.024), while in the low-risk group, patients underwent adjuvant chemotherapy have inferior DFS than those who did not (p < 0.001). INTERPRETATION IASLC grading is a significant indicator of DFS, however it could not guide adjuvant therapy in our stage I LUAD cohort. Growth patterns and T indicators together with other risk factors could identify high-risk patients that are potential candidate of adjuvant therapy, including some stage IA LUAD patients.
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Affiliation(s)
- Meng-Qi Jiang
- Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Li-Qiang Qian
- Department of Thoracic Surgery, Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Jia Shen
- Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuan-Yuan Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wen Feng
- Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng-Ping Ding
- Department of Thoracic Surgery, Shanghai Lung Cancer Center, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu-Chen Han
- Department of Pathology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Xiao-Long Fu
- Department of Radiation Oncology, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Ang A, Michaelides A, Chelala C, Ullah D, Kocher HM. Prognostication for recurrence patterns after curative resection for pancreatic ductal adenocarcinoma. Ann Hepatobiliary Pancreat Surg 2024:ahbps.23-149. [PMID: 38556877 DOI: 10.14701/ahbps.23-149] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 02/02/2024] [Accepted: 02/10/2024] [Indexed: 04/02/2024] Open
Abstract
Backgrounds/Aims This study aimed to investigate patterns and factors affecting recurrence after curative resection for pancreatic ductal adenocarcinoma (PDAC). Methods Consecutive patients who underwent curative resection for PDAC (2011-21) and consented to data and tissue collection (Barts Pancreas Tissue Bank) were followed up until May 2023. Clinico-pathological variables were analysed using Cox proportional hazards model. Results Of 91 people (42 males [46%]; median age, 71 years [range, 43-86 years]) with a median follow-up of 51 months (95% confidence intervals [CIs], 40-61 months), the recurrence rate was 72.5% (n = 66; 12 loco-regional alone, 11 liver alone, 5 lung alone, 3 peritoneal alone, 29 simultaneous loco-regional and distant metastases, and 6 multi-focal distant metastases at first recurrence diagnosis). The median time to recurrence was 8.5 months (95% CI, 6.6-10.5 months). Median survival after recurrence was 5.8 months (95% CI, 4.2-7.3 months). Stratification by recurrence location revealed significant differences in time to recurrence between loco-regional only recurrence (median, 13.6 months; 95% CI, 11.7-15.5 months) and simultaneous loco-regional with distant recurrence (median, 7.5 months; 95% CI, 4.6-10.4 months; p = 0.02, pairwise log-rank test). Significant predictors for recurrence were systemic inflammation index (SII) ≥ 500 (hazard ratio [HR], 4.5; 95% CI, 1.4-14.3), lymph node ratio ≥ 0.33 (HR, 2.8; 95% CI, 1.4-5.8), and adjuvant chemotherapy (HR, 0.4; 95% CI, 0.2-0.7). Conclusions Timing to loco-regional only recurrence was significantly longer than simultaneous loco-regional with distant recurrence. Significant predictors for recurrence were SII, lymph node ration, and adjuvant chemotherapy.
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Affiliation(s)
- Andrew Ang
- The Royal London Hospital, Barts Health NHS Trust, London, UK
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - Athena Michaelides
- The Royal London Hospital, Barts Health NHS Trust, London, UK
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - Claude Chelala
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - Dayem Ullah
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
| | - Hemant M Kocher
- The Royal London Hospital, Barts Health NHS Trust, London, UK
- Barts Cancer Institute, Queen Mary University of London, John Vane Science Centre, Charterhouse Square, London, UK
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Nozzoli F, Catalano M, Messerini L, Cianchi F, Nassini R, De Logu F, Iannone LF, Ugolini F, Simi S, Massi D, Geppetti P, Roviello G. Perineural invasion score system and clinical outcomes in resected pancreatic cancer patients. Pancreatology 2024:S1424-3903(24)00065-6. [PMID: 38514359 DOI: 10.1016/j.pan.2024.03.004] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 02/21/2024] [Accepted: 03/06/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND/OBJECTIVES Perineural invasion (PNI), classified according to its presence or absence in tumor specimens, is recognized as a poor prognostic factor in pancreatic ductal adenocarcinoma (PDAC) patients. Herein, we identified five histological features of PNI and investigated their impact on survival outcomes of PDAC resected patients. METHODS Five histopathological features of PNI (diameter, number, site, sheath involvement, and mitotic figures within perineural invasion) were combined in an additional final score (ranging from 0 to 8), and clinical data of PDAC patients were retrospectively analyzed. PNI + patients were stratified in two categories according to the median score value (<6 and ≥ 6, respectively). Impact of PNI on disease-free survival (DFS) and overall survival (OS) were analyzed. RESULTS Forty-five patients were enrolled, of whom 34 with PNI (PNI+) and 11 without PNI (PNI-). The DFS was 11 months vs. not reached (NR) (p = 0.258), while the OS was 19 months vs. NR (p = 0.040) in PNI+ and PNI- patients, respectively. A ≥6 PNI was identified as an independent predictor of worse OS vs. <6 PNI + patients (29 vs. 11 months, p < 0.001) and <6 PNI+ and PNI- patients (43 vs. 11 months, p < 0.001). PNI ≥6 was an independent negative prognostic factor of DFS vs. <6 PNI+ and PNI- patients (13 vs. 6 months, p = 0.022). CONCLUSIONS We report a PNI scoring system that stratifies surgically-treated PDAC patients in a graded manner that correlates with patient prognosis better than the current dichotomous (presence/absence) definition. However, further and larger studies are needed to support this PNI scoring system.
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Affiliation(s)
- Filippo Nozzoli
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy.
| | - Martina Catalano
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luca Messerini
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Fabio Cianchi
- Section of Surgery, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Romina Nassini
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Francesco De Logu
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luigi Francesco Iannone
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Filippo Ugolini
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Sara Simi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Daniela Massi
- Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Pierangelo Geppetti
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Giandomenico Roviello
- Section of Clinical Pharmacology & Oncology, Department of Health Sciences, University of Florence, Florence, Italy
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Tortorella L, Cappuccio S, Giannarelli D, Nero C, Marchetti C, Gallotta V, Costantini B, Pasciuto T, Minucci A, Fagotti A, Scambia G. Distribution and prognostic role of BRCA status in elderly ovarian cancer patients. Gynecol Oncol 2024; 182:57-62. [PMID: 38262239 DOI: 10.1016/j.ygyno.2023.12.022] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 12/17/2023] [Accepted: 12/22/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVE In the era of target therapy and personalized medicine, BRCA mutational status has a major influence on survival in ovarian cancer patients. Our aim is to verify if the poorer prognosis of elderly ovarian cancer patients can be related to the biology of the tumor beyond their own morbidities and/or suboptimal treatments. METHODS This is a retrospective single-institution study evaluating prognosis of patients with a diagnosis of ovarian cancer and known BRCA status. We collected clinical and surgical characteristics and the distribution of BRCA mutational status according to age groups. RESULTS 1840 patients were included in the analysis. The rate of BRCA mutated decreased over age-range from 49.7% in patients aged <50 years to 18.8% in ≥80 years old women. The prognostic role of BRCA status on survival is maintained when focusing on the elderly population, with improved Disease Free Survival (27.2 months vs 16.5 months for BRCA mutated and wild type respectively, p = 0.001) and Cancer Specific Survival (117.6 months vs 43.1 months for BRCA mutated and wild type respectively, p = 0.001) for BRCAmut compared to BRCAwt patients. In the multivariable analysis, among elderly women, upfront surgery and BRCA mutation are independent factors affecting survival. CONCLUSIONS Elderly patients experiment a poorer prognosis due to multiple factors that include both their medical condition and comorbidities, under-treatment and most importantly disease characteristics. We found that beyond disparities, BRCA mutation is still the strongest independent prognostic factor affecting both the risk of recurrence and death due to disease.
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Affiliation(s)
- Lucia Tortorella
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Serena Cappuccio
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Diana Giannarelli
- Epidemiology and Biostatistics Facility G-STeP Generator Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Camilla Nero
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy; Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Claudia Marchetti
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Valerio Gallotta
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Barbara Costantini
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy; Unicamillus, International Medical University, Via di Sant'Alessandro 8, 00131 Rome, Italy
| | - Tina Pasciuto
- Epidemiology and Biostatistics Facility G-STeP Generator Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy
| | - Angelo Minucci
- Genomics Core Facility, Gemelli Science and Technology Park (G-STeP), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, L.go A. Gemelli, 00167 Roma, Italy
| | - Anna Fagotti
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy; Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00167 Rome, Italy.
| | - Giovanni Scambia
- Department of Woman and Child Health and Public Health Sciences, Gynercologic Oncology Unit Fondazione Policlinico Universitario A. Gemelli, IRCCS, L.go A. Gemelli 8, 00167 Rome, Italy; Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, 00167 Rome, Italy
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Martí-Obiol R, Martí-Fernández R, Fernández-Moreno MC, Barrios-Carvajal ME, López-Mozos F. Characteristics of gastrointestinal stromal tumors associated to other tumors: Características de los tumores del estroma gastrointestinal asociados a otras neoplasias. Cir Esp 2024; 102:135-141. [PMID: 38135151 DOI: 10.1016/j.cireng.2023.11.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/02/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION Our aim is to analyze the differences between sporadic gastrointestinal stromal tumors and those associated with other tumors. METHODS Retrospective cohort study including patients with diagnosis of gastrointestinal stromal tumors operated at our center. Patients were divided into two groups, according to whether or not they had associated other tumors, both synchronously and metachronously. Disease free survival and overall survival were calculated for both groups. RESULTS 96 patients were included, 60 (62.5%) were male, with a median age of 66.8 (35-84). An association with other tumors was found in 33 cases (34.3%); 12 were synchronous (36.3%) and 21 metachronous (63.7%). The presence of mutations in associated tumors was 70% and in non-associated tumors 75%. Associated tumors were classified as low risk tumors based on Fletcher's stratification scale (p = 0.001) as they usually were smaller in size and had less than ≤5 mitosis per 50 HPF compared to non-associated tumors. When analyzing overall survival, there were statistically significant differences (p = 0,035) between both groups. CONCLUSION The relatively high proportion of gastrointestinal stromal tumors cases with associated tumors suggests the need to carry out a study to rule out presence of a second neoplasm and a long-term follow-up should be carried out in order to diagnose a possible second neoplasm. Gastrointestinal stromal tumors associated with other tumors have usually low risk of recurrence with a good long-term prognosis.
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Affiliation(s)
- Roberto Martí-Obiol
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain
| | - Rosa Martí-Fernández
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain.
| | | | | | - Fernando López-Mozos
- Upper Gastrointestinal Surgery Unit, Hospital Clínico Universitario, Valencia, Spain; Department of Surgery, Universidad de Valencia, Valencia, Spain
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Akdag G, Alan Ö, Dogan A, Yildirim S, Kinikoglu O, Batu A, Kudu E, Geçmen GG, Isik D, Sever ON, Odabas H, Yildirim ME, Turan N. Prognostic scores in pulmonary large cell neuroendocrine carcinoma: A retrospective cohort study. Heliyon 2024; 10:e25029. [PMID: 38317875 PMCID: PMC10839983 DOI: 10.1016/j.heliyon.2024.e25029] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 02/07/2024] Open
Abstract
Introduction Pulmonary large cell neuroendocrine carcinoma (PLCNEC) is a rare but aggressive subtype of lung cancer with an incidence of approximately 3 %. Identifying effective prognostic indicators is crucial for guiding treatments. This study examined the relationship between inflammatory markers and PLCNEC patient overall survival (OS) and sought to determine their prognostic significance in PLCNEC. Methods Patients diagnosed with PLCNEC between 2007 and 2022 at the oncology center, were retrospectively included. Patients who underwent surgery were pathologically re-staged post-surgery. Potential prognostic parameters (neutrophil/lymphocyte ratio, platelet/lymphocyte ratio [PLR], panimmune inflammatory value, prognostic nutritional index and modified Glasgow prognostic score [mGPS]) were calculated at that time of diagnosis. Results Sixty patients were included. The median follow-up was 23 months. Thirty-eight patients initially diagnosed with early or locally advanced. The mGPS was identified as a poor prognostic factor that influenced disease free survival (DFS) fourfold (p = 0.03). All patients' median OS was 45 months. Evaluating factors affecting OS in all patients, statistically significant relationships were observed between OS and the prognostic nutritional index (p = 0.001), neutrophil/lymphocyte ratio (p = 0.03), platelet/lymphocyte ratio (p = 0.002), and pan-immunoinflammatory value (p = 0.005). Upon multivariate analysis, the platelet/lymphocyte ratio was identified as an independent poor prognostic factor for OS, increasing the mortality risk by 5.4 times (p = 0.002). Conclusion mGPS was significantly linked with prognosis in non-metastatic PLCNEC, with patients with higher mGPS exhibiting poorer long-term DFS. This finding contributes to the evolving understanding of PLCNEC. The multivariable predictive model we employed suggests that PLR is an independent predictor of OS at all stages. A lower PLR was correlated with worse overall survival. Thus, PLR can be a readily accessible and cost-effective prognostic factor in PLCNEC patients.
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Affiliation(s)
- Goncagul Akdag
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Özkan Alan
- Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey
| | - Akif Dogan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Sedat Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Oguzcan Kinikoglu
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Aziz Batu
- Division of Medical Oncology, Department of Internal Medicine, Ümraniye Research and Training Hospital, Istanbul, Turkey
| | - Emre Kudu
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Gonca Gül Geçmen
- Department of Pathology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Deniz Isik
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Ozlem Nuray Sever
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Hatice Odabas
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Mahmut Emre Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
| | - Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Istanbul, Turkey
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Forcada C, Gómez-Hernández MT, Rivas C, Fuentes M, Novoa N, Varela G, Jiménez M. Operative outcomes and middle-term survival of robotic-assisted lung resection for clinical stage IA lung cancer compared with video-assisted thoracoscopic surgery. Cir Esp 2024; 102:90-98. [PMID: 37967649 DOI: 10.1016/j.cireng.2023.10.003] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Despite limited published evidence, robotic-assisted thoracoscopic surgery (RATS) for anatomic lung resection in early-stage lung cancer continues growing. The aim of this study is to evaluate its safety and oncologic efficacy compared to video-assisted thoracoscopic surgery (VATS). METHODS Single-centre retrospective study of all patients with resected clinical stage IA NSCLC who underwent RATS or VATS anatomic lung resection from June 2018 to January 2022. RATS and VATS cases were matched by propensity scoring (PSM) according to age, sex, histology, and type of resection. Short-term outcomes were compared, and the Kaplan-Meier method and log-rank test were used to evaluate the overall survival (OS) and disease-free survival (DFS). RESULTS 321 patients (94 RATS and 227 VATS cases) were included. After PSM, 94 VATS and 94 RATS cases were compared. Demographics, pulmonary function, and comorbidity were similar in both groups. Overall postoperative morbidity was comparable for RATS and VATS cases (20.2% vs 25.5%, P = 0.385, respectively). Pathological nodal upstaging was similar in both groups (10.6% in RATS and 12.8% in VATS). During the 3.5-year follow-up period (median: 29 months; IQR: 18-39), recurrence rate was 6.4% in RATS group and 18.1% in the VATS group (P = 0.014). OS and DFS were similar in RATS and VATS groups (log rank P = 0.848 and P = 0.117, respectively). CONCLUSION RATS can be performed safely in patients with early-stage NSCLC. For clinical stage IA disease, robotic anatomic lung resection offers better oncologic outcomes in terms of recurrence, although there are no differences in OS and DFS compared with VATS.
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Affiliation(s)
- Clara Forcada
- Service of Thoracic Surgery, Salamanca University Hospital. Salamanca, Spain
| | | | - Cristina Rivas
- Service of Thoracic Surgery, Salamanca University Hospital. Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - Marta Fuentes
- Service of Thoracic Surgery, Salamanca University Hospital. Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - Nuria Novoa
- Service of Thoracic Surgery, Salamanca University Hospital. Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
| | - Gonzalo Varela
- Salamanca Institute of Biomedical Research, Salamanca, Spain
| | - Marcelo Jiménez
- Service of Thoracic Surgery, Salamanca University Hospital. Salamanca, Spain; Salamanca Institute of Biomedical Research, Salamanca, Spain; University of Salamanca, Salamanca, Spain
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Varshney J, Debnath S, Sharma A, Rawal S, Jain V. Single Institute Experience with Neo-Adjuvant Chemotherapy and Interval Debulking Surgery in Advanced Endometrial Cancer. Indian J Surg Oncol 2023; 14:800-808. [PMID: 38187853 PMCID: PMC10767180 DOI: 10.1007/s13193-023-01781-1] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/06/2023] [Indexed: 01/09/2024] Open
Abstract
Our study aims to review the role of neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS) in patients with advanced endometrial cancer. Patients with advanced endometrial cancer treated with NACT followed by IDS at our institute from January 2010 to January 2020 were recruited. Data pertaining to baseline patient characteristics, surgical details, histopathology/imaging reports, treatment and follow up details including the development of recurrence and death were collected from institutional database. Disease free survival (DFS) and overall survival (OS) were calculated using Kaplan Meier survival curves. We recruited 31 patients for our study. About 83.9% patients showed partial response and 6.4% patients responded completely to NACT with none of the patients developing disease progression. Complete cytoreduction was achieved in 90.3% patients, optimal cytoreduction in 3.2% patients while 6.5% patients had suboptimal surgery. On completion of primary treatment, complete remission was achieved by 80.6% patients while 16.1% patients had progressive disease. Median follow up period was 21 months (range 1- 61 months). During follow up period, 51.6% patients developed recurrent disease after achieving complete remission and 61.3% patients died of disease progression/recurrence. The median DFS and median OS of the cohort was 15 months and 21 months respectively. The 2 year DFS for the cohort was 34.1% and the 3 year OS was 30.5%. NACT followed by IDS is a reasonably good option for advanced stage endometrial cancer not amenable to primary surgery. Innovative treatments are warranted in this cluster of patients.
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Affiliation(s)
- Jahnvi Varshney
- Department of Gynae Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Subrata Debnath
- Department of Gynae Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Anila Sharma
- Department of Histopathology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Sudhir Rawal
- Department of Uro-Gynae Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| | - Vandana Jain
- Department of Gynae Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
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Uccella S, Bosco M, Mezzetto L, Garzon S, Maggi V, Giacopuzzi S, Antonelli A, Pinali L, Zorzato PC, Festi A, Polati E, Montemezzi S, De Manzoni G, Franchi MP, Veraldi GF. Major vessel resection for complete cytoreduction in primary advanced and recurrent ovarian malignancies: A case series and systematic review of the literature - pushing the boundaries in oncovascular surgery. Gynecol Oncol 2023; 179:42-51. [PMID: 37922861 DOI: 10.1016/j.ygyno.2023.10.021] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 10/21/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Oncovascular surgery (the removal of major blood vessels infiltrated by cancer) is challenging but can be key to achieve complete cytoreduction in patient with advanced ovarian cancer. The aim of this study was to review the literature on oncovascular surgery in ovarian cancer and to report the details of all the cases performed at our institution. METHODS We retrospectively reviewed the database of ovarian cancer patients who underwent debulking surgery at the Department of Obstetrics and Gynecology of Verona University between January 2021 and 2023. Patients with at least one major vessel resection during cytoreduction were identified. We then systematically review the literature searching Pubmed and Embase from inception to January 2023 to report all cases of surgery for ovarian cancer with concomitant major vessel resection. RESULTS Five patients with advanced/recurrent ovarian cancer underwent major vascular resection at our institution. Vascular involvement was preoperatively identified in all cases and no case of vascular resection was performed after accidental injury. The major vessels removed were the inferior vena cava (n = 2), the common iliac veins (n = 2), the external iliac arteries (n = 2), the left common iliac artery (n = 1), and the left external iliac vein (n = 1). All patients underwent other non-gynecological cytoreductive procedures prior to vessel removal and had R0 obtained. Three (60%) patients experienced one or more postoperative complications. The literature search identified a total of seven cases of major vessels resection in ovarian cancer surgery. A single or multiple major vessels were removed in two (28.6%) and five (72.4%) cases, respectively. All the seven patients underwent vascular reconstruction. Four (57.1%) patients reported postoperative complications. Overall, 66.7% of the 12 total identified patients were free from disease at the last follow-up [median 15.5 months (range 5-25)]. CONCLUSIONS Oncovascular surgery is feasible in selected patients with ovarian cancer, provided that a multidisciplinary approach with customized care is available.
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Affiliation(s)
- Stefano Uccella
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy.
| | - Mariachiara Bosco
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Luca Mezzetto
- Unit of Vascular Surgery, Azienda Ospedaliera Universitaria Integrata, University of Verona, Italy
| | - Simone Garzon
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Veronica Maggi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Simone Giacopuzzi
- Department of General and Upper G.I. Surgery, University of Verona, Verona, Italy
| | - Alessandro Antonelli
- Department of Urology, Azienda Ospedaliera Universitaria Integrata, University of Verona, Verona, Italy
| | - Lucia Pinali
- Radiology Department, Verona University Hospital, Verona, Italy
| | - Pier Carlo Zorzato
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Anna Festi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Enrico Polati
- Department of Anaesthesia and Intensive Care B, University of Verona, DAI Emergenza e Terapie Intensive, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy
| | | | - Giovanni De Manzoni
- Department of General and Upper G.I. Surgery, University of Verona, Verona, Italy
| | - Massimo P Franchi
- Department of Obstetrics and Gynecology, AOUI Verona, University of Verona, Verona, Italy
| | - Gian Franco Veraldi
- Unit of Vascular Surgery, Azienda Ospedaliera Universitaria Integrata, University of Verona, Italy
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Jiang XF, Jiang WJ. The construction and validation of ECM-related prognosis model in laryngeal squamous cell carcinoma. Heliyon 2023; 9:e19907. [PMID: 37809868 PMCID: PMC10559327 DOI: 10.1016/j.heliyon.2023.e19907] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/23/2023] [Accepted: 09/05/2023] [Indexed: 10/10/2023] Open
Abstract
Background Laryngeal squamous cell carcinoma (LSCC) is a kind of common and aggressive tumor with high mortality. The application of molecular biomarkers is useful for the early diagnosis and treatment of LSCC. Methods The expression and clinical information were obtained from The Cancer Genome Atlas (TCGA) database. Principal components analysis (PCA) was used to discriminate between LSCC and normal samples. The hub genes were screened out through univariate and multivariate cox analyses. The Kaplan-Meier (K-M) and receiver operating characteristic (ROC) curve was used to validate the predictive performance. The single sample gene set enrichment analysis (ssGSEA), Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis were used to determine the enrichment function. Protein-Protein Interaction (PPI) network was constructed in STRING. The immune analysis was performed by ESTIMATE, IPS and xCELL. The drug sensitivity was identified with GSCA database. Results We identified that 47 extracellular matrix (ECM) genes were differentially expressed in LSCC compared with normal group. Univariate and multivariate cox analysis determined that leucine-rich glioma-inactivated 4 (LGI4), matrilin 4 (MATN4), microfibrillar-associated protein 2 (MFAP2) and fibrinogen like 2 (FGL2) were closely related to the disease free survival (DSS) of LSCC. ROC curve determined that the risk model has a good predictive performance. PPI network showed the top 100 genes with high correlation of hub genes. The ssGSEA, GO and KEGG enrichment analyses determined that immune response was significantly involved in the development of LSCC. Immune infiltration analysis showed that most immune cells and immune checkpoints were inhibited in high risk score group. Drug sensitivity analysis showed that MATN4, FGL2 and LGI4 were negatively related to various drugs, while MFAP2 was positively related to many drugs. Conclusion We established a risk model constructed with four ECM-related genes, which could effectively predict the prognosis of LSCC.
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Affiliation(s)
- Xue-Fan Jiang
- Department of Otolaryngology, Center of Otolaryngology-head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Wen-Jing Jiang
- Department of Otolaryngology, Center of Otolaryngology-head and Neck Surgery, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
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11
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Chen M, Wang J, Xiao Y. Leucine zipper protein 1 (LUZP1) serves as a prognostic biomarker for patients with renal papillary cell carcinoma. Asian J Surg 2023; 46:4011-4013. [PMID: 37105814 DOI: 10.1016/j.asjsur.2023.04.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 04/07/2023] [Indexed: 04/29/2023] Open
Affiliation(s)
- Mei Chen
- Department of Urology, Yaan People's Hospital, Yaan, China.
| | - Jie Wang
- Department of Urology, West China School of Medicine, West China Hospital, Sichuan University, China
| | - Yuhan Xiao
- Department of Urology, West China School of Medicine, West China Hospital, Sichuan University, China
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12
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Akdag G, Alan O, Dogan A, Yuksel Z, Yildirim S, Kinikoglu O, Kudu E, Surmeli H, Odabas H, Yildirim ME, Turan N. Outcomes of surveillance versus adjuvant treatment for patients with stage-I seminoma: a single-center experience. World J Urol 2023; 41:2201-2207. [PMID: 37351618 DOI: 10.1007/s00345-023-04482-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/04/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Testicular germ cell tumors (seminoma/non-seminoma) are the most common carcinomas in young males, comprising approximately 1% of all carcinomas. In stage-I disease, orchiectomy can cure approximately 85% of patients. Post-surgical options are adjuvant therapy and active surveillance. Our study examined the effects of management options on stage-I seminoma patients followed in our center. METHODS We evaluated the patients with stage-I testicular seminoma who underwent radical orchiectomy and followed up in the oncology center between 2001 and 2022. The outcomes of management options, survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated. RESULTS Of the 140 patients with stage-I seminoma, 49 (35%) were treated with adjuvant therapy, and 91 (65%) underwent surveillance. The median follow-up duration was 37 months. During the follow-up period, nine patients in the active surveillance group and four in the adjuvant therapy group had a recurrence. There was no statistically significant difference between the two groups (p = 0.67). In the surveillance group, the univariate and multivariate analyzes identified the presence of lymphovascular invasion (p = 0.005, HR: 0.13) as significant prognostic factor for disease-free survival (DFS). In the surveillance cohort, the 5-year DFS rate was 60% for patients with lymphovascular invasion and 93% for those without. There was statistical significance between the two groups (p = 0.003). CONCLUSION Our study shows that adjuvant therapy does not significantly improve DFS compared to surveillance in patients. In addition, it has been shown that lymphovascular invasion is an important prognostic indicator for DFS in determining the treatment strategy.
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Affiliation(s)
- Goncagul Akdag
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
| | - Ozkan Alan
- Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey
| | - Akif Dogan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Zeynep Yuksel
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Sedat Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Oguzcan Kinikoglu
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Emre Kudu
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Heves Surmeli
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Hatice Odabas
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Mahmut Emre Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
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An N, Yang X. Prediction of disease-free survival of N1/2 non-small cell lung cancer after adjuvant chemotherapy by the biomarker RPMB. Heliyon 2023; 9:e18266. [PMID: 37501955 PMCID: PMC10368914 DOI: 10.1016/j.heliyon.2023.e18266] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/06/2023] [Accepted: 07/12/2023] [Indexed: 07/29/2023] Open
Abstract
No molecular biomarkers have been proven applicable in clinical practice to identify patients who can benefit from adjuvant chemotherapy in non-small cell lung cancer (NSCLC). In this study, we established a biomarker, RPMB, short for promotor methylation burden of DNA repair genes (DRGs), to identify the subgroup of patients who might benefit from adjuvant chemotherapy in NSCLC. Methylation profiles of 828 NSCLC primary tumors and their clinical information were downloaded from The Cancer Genome Atlas (TCGA) database. The RPMB for each patient after radical resection was calculated and its correlation with the prognosis of NSCLC was extensively investigated. DRGs of NSCLC were much more hypomethylated than the other genes (all p<0.001). RPMB was defined as the ratio of methylated DRGs to the total number of all the DRGs. Patients with higher RPMB values tended to be nonsmokers, had adenocarcinoma, were female and had peripheral tumors. Subgroup analysis of forest plot among different clinical factors showed that high RPMB was significantly correlated to better disease-free survival (DFS) in pathologic N-positive patients after adjuvant chemotherapy (HR = 0.404, n = 62, p = 0.034). Notably, more superior DFS was exhibited in high RPMB NSCLCs with N1 nodal stage compared with those with low RPMB values (HR = 0.348, n = 47, p = 0.043). High RPMB might be used as a potential predictor to identify suitable N-positive NSCLC patients who can benefit from adjuvant chemotherapy after radical surgery.
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Affiliation(s)
- Ning An
- Department of Radiation Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
| | - Xue Yang
- Department of Medical Oncology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, China
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Strous MTA, van der Linden RLA, Gubbels ALHM, Faes TKE, Bosscha K, Bronkhorst CM, Janssen-Heijnen MLG, de Bruïne AP, Vogelaar FJ. Node-negative colon cancer: histological, molecular, and stromal features predicting disease recurrence. Mol Med 2023; 29:77. [PMID: 37344790 DOI: 10.1186/s10020-023-00677-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 06/05/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Within the group of node-negative colon cancer patients, presumed to have a good prognosis, a significant percentage of patients develops cancer-recurrence. Current high-risk features prove inadequate to select these particular high-risk patients. In the process of tailor-made care and shared decision-making the need to identify these patients grows. In this study we investigate the value of adding molecular markers and the tumour-stroma ratio (TSR) to conventional histological tumour staging methods to improve the selection of high risk patients. METHODS We retrospectively analysed 201 patients diagnosed with TNM-stage I-II colon cancer and treated by complete oncological resection between November 1st 2002 and December 31st 2012 at the Jeroen Bosch Hospital. Conventional histological tumour staging, BRAF mutations, KRAS mutations, MSI status and TSR were determined. Differences between groups based on TSR and mutation status, in disease free survival were analysed using Cox-Regression analyses. RESULTS Poorly differentiated histology (p = 0.002), high-TSR (p = 0.033), BRAF-mutation (p = 0.008) and MSI (p = 0.011) were identified as significant risk factors for cancer recurrence. The risk of recurrence increased in the presence of both a BRAF-mutation and high-TSR compared to the absence of both factors or presence of only one factor (HR = 3.66 BRAF-mt/TSR-low (p = 0.006), HR 2.82 BRAF-wt/TSR-high (p = 0.015), HR = 4.39 BRAF-mt/TSR-high (p = 0.023)). This was also seen in tumours with MSI and high-TSR (HR = 2.46 MSS/TSR-high (p = 0.041), HR = 3.31 MSI/TSR-high (p = 0.045). CONCLUSION Judging by the higher HR for the combination of the prognostic factors TSR and BRAF compared to the HRs of these prognostic factors individually, the prognostication for disease free survival can be improved by determining both TSR and BRAF instead of BRAF alone, as is done in current daily practise. In this study MSI also shows additional value to TSR in the prognostication of disease free survival. Adopting TSR into daily diagnostics will be of additional value next to currently used molecular markers in risk stratification of patients with node negative colon cancer and is therefore advised.
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Affiliation(s)
- Maud T A Strous
- Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands.
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands.
| | - Ragna L A van der Linden
- Department of Surgery, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's Hertogenbosch, The Netherlands
| | - Audrey L H M Gubbels
- Department of Pathology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Timothy K E Faes
- Department of Pathology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - Koop Bosscha
- Department of Surgery, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's Hertogenbosch, The Netherlands
| | - Carolien M Bronkhorst
- Department of Pathology, Jeroen Bosch Hospital, Henri Dunantstraat 1, 5223 GZ, 's Hertogenbosch, The Netherlands
| | - Maryska L G Janssen-Heijnen
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
- Department of Clinical Epidemiology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, the Netherlands
| | - Adriaan P de Bruïne
- Department of Pathology, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
| | - F Jeroen Vogelaar
- Department of Surgery, VieCuri Medical Centre, Tegelseweg 210, 5912 BL, Venlo, The Netherlands
- Department of Epidemiology, GROW School for Oncology and Developmental Biology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 40, 6229 ER, Maastricht, The Netherlands
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Rathod R, Panda NK, Bakshi J, Nayak G, Ramavat A. Hemithyroidectomy in Papillary Thyroid Cancers: A Prospective, Single Institutional Surgical Audit and Contemplating on the Clinical Implications of 2015 American Thyroid Association Guidelines. Indian J Otolaryngol Head Neck Surg 2023; 75:508-516. [PMID: 37275097 PMCID: PMC10234917 DOI: 10.1007/s12070-022-03312-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) contributes to 88% of thyroid malignancies and its extent of surgical management has been a topic of debate in the past 2 decades. American thyroid association (ATA) recommendations have been periodically updated for its robust and evidence-based management. We present our experience in implementing 2015 ATA guidelines, assessment of surgical outcomes of hemithyroidectomy in PTC ≤ 4 cm and contemplating on the potential clinical implications of 2015 ATA guidelines. A prospective study in a cohort of Bethesda class V and VI PTC with nodule ≤ 4 cm who underwent Hemithyroidectomy between 2012 and 2020. Data on thyroid nodule evaluation, management, histopathology and follow up were used for risk stratification. Of 37 patients, 27 (72.9%) were low risk and 10 (37%) were intermediate risk ATA group. 4 (40%) intermediate risk patients had structural incomplete response and underwent completion thyroidectomy. 1 (2.7%) out of 4 completion surgery patients required adjuvant radio-ablation iodine (RAI) and 3 patients were under surveillance. Overall, 2 (5.4%) of 37 patients, 1 each from low and intermediate groups were given remnant RAI in view of aggressive histology, old age and unwillingness for a completion surgery. During follow up of 4.94 ± 2.4 years, 35 (94.5%) showed excellent response and 2 (5.4%) showed biochemical incomplete response. The difference in RFS between two groups was statistically significant with p < 0.001. Thyroid preserving surgery combined with real time risk stratification seems appropriate for low and intermediate risk PTC ≤ 4 cm.
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Affiliation(s)
- Ramya Rathod
- Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Naresh K. Panda
- Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Jaimanti Bakshi
- Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Gyanaranjan Nayak
- Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Anurag Ramavat
- Department of Otolaryngology, Head and Neck Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Ye H, Wang Y, Yao S, Liu Z, Liang C, Zhu Y, Cui Y, Zhao K. Necrosis score as a prognostic factor in stage I-III colorectal cancer: a retrospective multicenter study. Discov Oncol 2023; 14:61. [PMID: 37155090 PMCID: PMC10167085 DOI: 10.1007/s12672-023-00655-w] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/12/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Tumor necrosis results from failure to meet the requirement for rapid proliferation of tumor, related to unfavorable prognosis in colorectal cancer (CRC). However, previous studies used traditional microscopes to evaluate necrosis on slides, lacking a simultaneous phase and panoramic view for assessment. Therefore, we proposed a whole-slide images (WSIs)-based method to develop a necrosis score and validated its prognostic value in multicenter cohorts. METHODS Necrosis score was defined as the proportion of necrosis in the tumor area, semi-quantitatively classified into 3-level score groups by the cut-off of 10% and 30% on HE-stained WSIs. 768 patients from two centers were enrolled in this study, divided into a discovery (N = 445) and a validation (N = 323) cohort. The prognostic value of necrosis score was evaluated by Kaplan-Meier curves and the Cox model. RESULT Necrosis score was associated with overall survival, with hazard ratio for high vs. low in discovery and validation cohorts being 2.62 (95% confidence interval 1.59-4.32) and 2.51 (1.39-4.52), respectively. The 3-year disease free survival rates of necrosis-low, middle, and high were 83.6%, 80.2%, and 59.8% in discovery cohort, and 86.5%, 84.2%, and 66.5% in validation cohort. In necrosis middle plus high subgroup, there was a trend but no significant difference in overall survival between surgery alone and adjuvant chemotherapy group in stage II CRC (P = .075). CONCLUSION As a stable prognostic factor, high-level necrosis evaluated by the proposed method on WSIs was associated with unfavorable outcomes. Additionally, adjuvant chemotherapy provide survival benefits for patients with high necrosis in stage II CRC.
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Affiliation(s)
- Huifen Ye
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yiting Wang
- Department of Pathology, The Sixth Affiliated Hospital of Sun Yat-Sen University, 26 Yuan Cun 2 Cross Road, TianHe District, Guangzhou, 510655, China
| | - Su Yao
- Department of Pathology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zaiyi Liu
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Changhong Liang
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, 106 Zhongshan Er Road, Guangzhou, 510080, China
| | - Yaxi Zhu
- Department of Pathology, The Sixth Affiliated Hospital of Sun Yat-Sen University, 26 Yuan Cun 2 Cross Road, TianHe District, Guangzhou, 510655, China.
| | - Yanfen Cui
- Department of Radiology, Shanxi Cancer Hospital, Shanxi Medical University, No.3, Xinjie West Alley, Taiyuan, 030013, China.
| | - Ke Zhao
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Artificial Intelligence in Medical Image Analysis and Application, 106 Zhongshan Er Road, Guangzhou, 510080, China.
- Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
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Shi Z, Liu Y, Zhang S, Cai S, Liu X, Meng J, Zhang J. Evaluation of predictive and prognostic value of androgen receptor expression in breast cancer subtypes treated with neoadjuvant chemotherapy. Discov Oncol 2023; 14:49. [PMID: 37099044 PMCID: PMC10133426 DOI: 10.1007/s12672-023-00660-z] [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] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/17/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Neoadjuvant chemotherapy is the standard treatment for local advanced breast cancer administered to shrink tumors and destroy undetected metastatic cells, thereby facilitating subsequent surgery. Previous studies have shown that AR may be used as a prognostic predictor in breast cancers, but its role in neoadjuvant therapy and the relationship with prognosis of different molecular subtypes of breast cancer need to be further explored. METHODS We retrospectively evaluated 1231 breast cancer patients with complete medical records at Tianjin Medical University Cancer Institute and Hospital who were treated with neoadjuvant chemotherapy between January 2018 to December 2021. All the patients were selected for prognostic analysis. The follow-up time ranged from 12 to 60 months. We first analyzed the AR expression in different subtypes of breast cancer and its correlation with clinicopathological features. Meanwhile, the association of AR expression and pCR of different breast cancer subtypes was investigated. Finally, the effect of AR status on the prognosis of different subtypes of breast cancer after neoadjuvant therapy was analyzed. RESULTS The positive rates of AR expression in HR + /HER2-, HR + /HER2 +, HR-/HER2 + and TNBC subtypes were 82.5%, 86.9%, 72.2% and 34.6%, respectively. Histological grade III (P = 0.014, OR = 1.862, 95% CI 1.137 to 2.562), ER positive expression (P = 0.002, OR = 0.381, 95% CI 0.102 to 0.754) and HER2 positive expression (P = 0.006, OR = 0.542, 95% CI 0.227 to 0.836) were independent related factors for AR positive expression. AR expression status was associated with pCR rate after neoadjuvant therapy only in subtype of TNBC. AR positive expression was independent protective factor for recurrence and metastasis in HR + /HER2- (P = 0.033, HR = 0.653, 95% CI 0.237 to 0.986) and HR + /HER2 + breast cancer (P = 0.012, HR = 0.803, 95% CI 0.167 to 0.959), but was independent risk factors for recurrence and metastasis in TNBC (P = 0.015, HR = 4.551, 95% CI 2.668 to 8.063). AR positive expression is not an independent predictor of HR-/HER2 + breast cancer. CONCLUSIONS AR expressed the lowest in TNBC, but it could be a potential marker for the prediction of pCR in neoadjuvant therapy. AR negative patients had a higher pCR rate. AR positive expression was an independent risk factor for pCR in TNBC after neoadjuvant therapy (P = 0.017, OR = 2.758, 95% CI 1.564 to 4.013). In HR + /HER2- subtype and in HR + /HER2 + subtype, the DFS rate in AR positive patients and AR negative patients was 96.2% vs 89.0% (P = 0.001, HR = 0.330, 95% CI 0.106 to 1.034) and was 96.0% vs 85.7% (P = 0.002, HR = 0.278, 95% CI 0.082 to 0.940), respectively. However, in HR-/HER2 + and TNBC subtypes, the DFS rate in AR positive patients and AR negative patients was 89.0% vs 95.9% (P = 0.102, HR = 3.211, 95% CI 1.117 to 9.224) and 75.0% vs 93.4% (P < 0.001, HR = 3.706, 95% CI 1.681 to 8.171), respectively. In HR + /HER2- and HR + /HER2 + breast cancer, AR positive patients had a better prognosis, however in TNBC, AR-positive patients have a poor prognosis.
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Affiliation(s)
- Zhendong Shi
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Yingxue Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Shichao Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Shuanglong Cai
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Xu Liu
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Jie Meng
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China
| | - Jin Zhang
- The Third Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China.
- Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
- Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
- Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin, China.
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Slater S, Bryant A, Chen HC, Begum R, Rana I, Aresu M, Peckitt C, Zhitkov O, Lazaro-Alcausi R, Borja V, Powell R, Lowery D, Hubank M, Rich T, Anandappa G, Chau I, Starling N, Cunningham D. ctDNA guided adjuvant chemotherapy versus standard of care adjuvant chemotherapy after curative surgery in patients with high risk stage II or stage III colorectal cancer: a multi-centre, prospective, randomised control trial (TRACC Part C). BMC Cancer 2023; 23:257. [PMID: 36941575 PMCID: PMC10026439 DOI: 10.1186/s12885-023-10699-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 01/26/2023] [Accepted: 03/02/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Circulating tumour DNA (ctDNA) to detect minimal residual disease (MRD) is emerging as a biomarker to predict recurrence in patients with curatively treated early stage colorectal cancer (CRC). ctDNA risk stratifies patients to guide adjuvant treatment decisions. We are conducting the UK's first multi-centre, prospective, randomised study to determine whether a de-escalation strategy using ctDNA to guide adjuvant chemotherapy (ACT) decisions is non-inferior to standard of care (SOC) chemotherapy, as measured by 3-year disease free survival (DFS) in patients with resected CRC with no evidence of MRD (ctDNA negative post-operatively). In doing so we may be able to spare patients unnecessary chemotherapy and associated toxicity and achieve significant cost savings for the National Health Service (NHS). METHODS We are recruiting patients with fully resected high risk stage II and stage III CRC who are being considered for ACT into the study which uses results from a plasma-only ctDNA assay to guide treatment decisions. Eligible patients are randomised 1:1 to receive ctDNA-guided chemotherapy versus SOC chemotherapy. The primary endpoint is the difference in DFS at 3 years between the trial arms. Secondary endpoints include the proportion of patients in the ctDNA-guided arm who are ctDNA negative post-operatively and receive de-escalated ACT compared to the standard arm, the difference in overall survival (OS), neurotoxicity and quality of life between the arms, and the cost-effectiveness of ctDNA-guided therapy compared to SOC treatment. We hypothesise that using a ctDNA-guided approach to ACT decisions is non-inferior to SOC. Target accrual is 1621 patients over 4 years, which will provide a power of 80% with an alpha of 0.1 to demonstrate non-inferiority with a margin of 1.25 in survival of the ctDNA-guided approach compared to SOC. We anticipate approximately 50 UK centres will participate. The study opened with the Guardant Reveal plasma-only ctDNA assay in August 2022. DISCUSSION The trial will determine whether ctDNA guided ACT is non-inferior to SOC ACT in patients with fully resected high risk stage II and stage III resected CRC, with the potential to significantly reduce unnecessary ACT and the toxicity associated with it. TRIAL REGISTRATION NCT04050345.
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Affiliation(s)
| | | | | | - Ruwaida Begum
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Isma Rana
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Maria Aresu
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Clare Peckitt
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - Oleg Zhitkov
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | | | | | - Rachel Powell
- Royal Marsden Hospital NHS Foundation Trust, London, UK
| | - David Lowery
- Biomedical Research Centre at the Royal Marsden and the Institute of Cancer Research, London, UK
| | - Michael Hubank
- Centre for Molecular Pathology at the The Royal Marsden Hospital and Institute of Cancer Research, Sutton, UK
| | | | | | - Ian Chau
- Royal Marsden Hospital NHS Foundation Trust, London, UK
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Zagalaz-Anula N, Mora-Rubio MJ, Obrero-Gaitán E, Del-Pino-Casado R. Recreational physical activity reduces breast cancer recurrence in female survivors of breast cancer: A meta-analysis. Eur J Oncol Nurs 2022; 59:102162. [PMID: 35716452 DOI: 10.1016/j.ejon.2022.102162] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/30/2022] [Accepted: 06/08/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE The aim of this review was to systematically collect the published evidence to assess the effect of recreational physical activity (PA) in reducing breast cancer (BC) recurrence in female survivors. METHODS A bibliographic search was carried out in PubMed Medline, CINAHL Complete, Scopus and Lilacs until June 2021. We selected observational studies or clinical trials comprising women diagnosed with BC, in which the risk of recurrence of BC was measured before or after performing recreational PA. As a secondary outcome, we analyzed disease free survival for recurrence/disease-specific mortality. The methodological quality of observational studies was assessed with the Newcastle-Ottawa Scale and clinical trials with the PEDro scale. A random effects model was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) to infer the results for any female survivor of BC. We performed separate meta-analyses for prediagnosis and postdiagnosis recreational PA. RESULTS Eleven studies were included, providing data from 29,677 surviving women with BC with an age range of 18-79 years old. Postdiagnosis recreational PA reduced the risk of BC recurrence by 16% (RR, 0.84; 95% CI: 0.78 to 0.91) and the risk of recurrence/disease-specific mortality by 23% (RR, 0.77; 95% CI: 0.66 to 0.93). Prediagnosis PA reduced the risk of BC by 18% (RR, 0.82; 95% CI: 0.74 to 0.91). CONCLUSION This systematic review with meta-analysis shows that recreational PA can be an interesting therapeutic tool to protect against recurrence of BC in female survivors.
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Waqas K, Lima Ferreira J, Tsourdi E, Body JJ, Hadji P, Zillikens M. Updated guidance on the management of cancer treatment-induced bone loss (CTIBL) in pre- and postmenopausal women with early-stage breast cancer. J Bone Oncol 2021; 28:100355. [PMID: 33948427 PMCID: PMC8080519 DOI: 10.1016/j.jbo.2021.100355] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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: 12/03/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Adjuvant endocrine therapy induces bone loss and increases fracture risk in women with hormone-receptor positive, early-stage breast cancer (EBC). We aimed to update a previous position statement on the management of aromatase inhibitors (AIs) induced bone loss and now included premenopausal women. METHODS We conducted a systematic literature search of the medical databases from January 2017 to May 2020 and assessed 144 new studies. RESULTS Extended use of AIs beyond 5 years leads to persistent bone loss in breast cancer extended adjuvant trials and meta-analyses. In addition to bone mineral density (BMD), vertebral fracture assessment (VFA) and trabecular bone score (TBS) were shown to independently predict fracture risk in real life prospective studies. FRAX® tool does not seem to be reliable for assessing fracture risk in CTIBL. In premenopausal women, there is strong evidence that intravenous zoledronate prevents bone loss but weak conflicting evidence on reducing disease recurrence from independent randomised controlled trials (RCTs). In postmenopausal women, the strongest evidence for fracture prevention is for denosumab based on a well-powered RCT while there is strong evidence for bisphosphonates (BPs) to prevent and reduce CTIBL but no convincing data on fractures. Adjuvant denosumab has failed to show anticancer benefits in a large, well-designed RCT. DISCUSSION AND CONCLUSIONS Extended use of AIs and persistent bone loss from recent data reinforce the need to evaluate fracture risk in EBC women initiated on AIs. Fracture risk should be assessed with clinical risk factors and BMD along with VFA, but FRAX is not adapted to CTIBL. Anti-resorptive therapy should be considered in those with a BMD T-score < -2.0 SD or with ≥ 2 clinical risk factors including a BMD T-score < -1.0 SD. In premenopausal women, intravenous zoledronate is the only drug reported to prevent bone loss and may have additional anticancer benefits. In postmenopausal women, either denosumab or BPs can be prescribed for fracture prevention with pertinent attention to the rebound phenomenon after stopping denosumab. Adjuvant BPs, in contrast to denosumab, have shown high level evidence for reducing breast cancer recurrence in high-risk post-MP women which should be taken into account when choosing between these two.
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Affiliation(s)
- Komal Waqas
- Bone Centre, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - Joana Lima Ferreira
- Department of Endocrinology, Hospital Pedro Hispano, Matosinhos Local Health Unit, Matosinhos, Portugal
| | - Elena Tsourdi
- Department of Medicine III and 4. Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Jean-Jacques Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Peyman Hadji
- Frankfurt Center of Bone Health, Goethestrasse 23, Frankfurt, Germany and Philipps-University of Marburg, Germany
| | - M.C. Zillikens
- Bone Centre, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Matly A, Quinn JA, McMillan DC, Park JH, Edwards J. The relationship between β-catenin and patient survival in colorectal cancer systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 163:103337. [PMID: 33992802 DOI: 10.1016/j.critrevonc.2021.103337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 12/08/2020] [Revised: 03/23/2021] [Accepted: 03/31/2021] [Indexed: 01/11/2023] Open
Abstract
β-catenin is a key component of Wnt signalling, which plays a crucial role in CRC progression. Therefore, a meta-analysis was performed to assess the prognostic value of β-catenin expression in CRC patients. PubMed and Web of Science were searched for relevant publications referring to the association between β-catenin expression and outcome of CRC patients. Review Manager version 5.4 was employed to analysis data from 28 eligible studies (containing 5475 patients). Of these, 6 provided data on DFS, 6 provided data on CSS and 18 reports provided data on OS. High nuclear β-catenin expression was significantly associated with poorer DFS, CSS and OS in patients with CRC whereas, low membranous β-catenin expression was associated to poor OS. In conclusion, β-catenin has prognostic value and potential as a biomarker to stratify patients with CRC. However, further work with high quantity tissue cohorts and patient data is required to confirm this conclusion.
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Affiliation(s)
- Amna Matly
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Garscube Estate, Glasgow, G61 1QH, United Kingdom.
| | - Jean A Quinn
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Garscube Estate, Glasgow, G61 1QH, United Kingdom.
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Alexandria Parade, Glasgow, G31 2ER, United Kingdom.
| | - James H Park
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Alexandria Parade, Glasgow, G31 2ER, United Kingdom.
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, University of Glasgow, Wolfson Wohl Cancer Research Centre, Garscube Estate, Glasgow, G61 1QH, United Kingdom.
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22
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Zhang Z, He T, Huang L, Li J, Wang P. Immune gene prognostic signature for disease free survival of gastric cancer: Translational research of an artificial intelligence survival predictive system. Comput Struct Biotechnol J 2021; 19:2329-2346. [PMID: 34025929 PMCID: PMC8111455 DOI: 10.1016/j.csbj.2021.04.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/30/2021] [Revised: 04/09/2021] [Accepted: 04/09/2021] [Indexed: 12/13/2022] Open
Abstract
The progress of artificial intelligence algorithms and massive data provide new ideas and choices for individual mortality risk prediction for cancer patients. The current research focused on depict immune gene related regulatory network and develop an artificial intelligence survival predictive system for disease free survival of gastric cancer. Multi-task logistic regression algorithm, Cox survival regression algorithm, and Random survival forest algorithm were used to develop the artificial intelligence survival predictive system. Nineteen transcription factors and seventy immune genes were identified to construct a transcription factor regulatory network of immune genes. Multivariate Cox regression identified fourteen immune genes as prognostic markers. These immune genes were used to construct a prognostic signature for gastric cancer. Concordance indexes were 0.800, 0.809, and 0.856 for 1-, 3- and 5- year survival. An interesting artificial intelligence survival predictive system was developed based on three artificial intelligence algorithms for gastric cancer. Gastric cancer patients with high risk score have poor survival than patients with low risk score. The current study constructed a transcription factor regulatory network and developed two artificial intelligence survival prediction tools for disease free survival of gastric cancer patients. These artificial intelligence survival prediction tools are helpful for individualized treatment decision.
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Key Words
- AJCC, the American Joint Committee on Cancer
- CI, confidence interval
- DCA, decision curve analysis
- DFS, disease free survival
- Disease free survival
- GC, gastric cancer
- GEO, the Gene Expression Omnibus
- Gastric cancer
- HR, hazard ratio
- Immune gene
- Prognostic signature
- ROC, receiver operating characteristic
- SD, standard deviation
- TCGA, The Cancer Genome Atlas
- Transcription factor
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Affiliation(s)
- Zhiqiao Zhang
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
| | - Tingshan He
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
| | - Liwen Huang
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
| | - Jing Li
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
| | - Peng Wang
- Department of Infectious Diseases, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
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Hegab HM, El-Ghammaz AMS, El-Razzaz MK, Helal RAA. Prognostic Impact of Serum Growth Differentiation Factor 15 Level in Acute Myeloid Leukemia Patients. Indian J Hematol Blood Transfus 2021; 37:37-44. [PMID: 33707833 DOI: 10.1007/s12288-020-01315-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 06/25/2020] [Indexed: 10/24/2022] Open
Abstract
Growth differentiation factor 15 (GDF15) plays an important role in cancer pathophysiology and prognosis. However, limited studies analyzed its level and prognostic value in acute myeloid leukemia (AML) patients. This study included 56 adult AML patients. Serum GDF15 level was measured at diagnosis in all patients by enzyme-linked immunosorbent assay. Remission and survival statuses were assessed at 90 days following treatment. GDF15 level was significantly higher in patients than in controls (P < 0.001). GDF15 level correlated positively with age (P < 0.001), hemoglobin level (P = 0.027), and platelet count (P = 0.024). High GDF15 above the median level was associated with inferior OS (P = 0.044) together with high platelet count (P = 0.006) and high bone marrow blast percent (P = 0.038). There was no statistically significant difference between patients with GDF15 above and below the median level regarding DFS (P = 0.881). On multivariate analysis for OS, GDF15 level was an independent risk factor (P = 0.047). In conclusion, serum GDF15 level is significantly elevated in AML patients and high GDF15 level is associated with inferior OS.
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Shamis SAK, McMillan DC, Edwards J. The relationship between hypoxia-inducible factor 1α (HIF-1α) and patient survival in breast cancer: Systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 159:103231. [PMID: 33482350 DOI: 10.1016/j.critrevonc.2021.103231] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/06/2021] [Accepted: 01/16/2021] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION Hypoxia is a characteristic of many solid tumours and results in an increase in expression of HIF-1α. Many studies have investigated the prognostic value of HIF-1α expression in breast cancer (BC), however, the prognostic value remains unclear. Therefore, a systematic review and meta-analysis was undertaken to determine the prognostic value of HIF-1α in BC patients. METHODS The electronic databases PubMed and Web of science were systematically searched to identify relevant papers. The clinical outcomes included disease-free survival (DFS), recurrence-free survival (RFS) and overall survival (OS) in BC patients. Review Manager version 5.4 was employed to analysis data from 30 eligible studies (containing 6201patients). RESULTS High expression of HIF-1α was associated with poorer DFS and OS. There was an effect of survival analysis, study region, antibodies used, scoring and threshold methods on HIF-1α expression. CONCLUSION HIF-1α overexpression was significantly associated with poorer DFS and OS in breast cancer patients.
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Affiliation(s)
- Suad A K Shamis
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences- University of Glasgow, Royal Infirmary, Glasgow, UK; Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK.
| | - Donald C McMillan
- Academic Unit of Surgery, College of Medical, Veterinary and Life Sciences- University of Glasgow, Royal Infirmary, Glasgow, UK
| | - Joanne Edwards
- Unit of Experimental Therapeutics, Institute of Cancer Sciences, College of Medical, Veterinary and Life Sciences-University of Glasgow, Glasgow, UK
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Line PD, Dueland S. Liver transplantation for secondary liver tumours: The difficult balance between survival and recurrence. J Hepatol 2020; 73:1557-1562. [PMID: 32896581 DOI: 10.1016/j.jhep.2020.08.015] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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] [Received: 06/16/2020] [Revised: 08/05/2020] [Accepted: 08/07/2020] [Indexed: 12/13/2022]
Abstract
Assessing the balance between survival and recurrence after transplantation for secondary liver tumours should be based on the type of cancer in question. For neuroendocrine liver metastases, high recurrence rates are clearly related to reduced long-term survival. For colorectal liver metastases, experience to date indicates that pulmonary recurrence alone has a modest impact on survival outcomes. Further studies focusing on this group of patients will be important for the development of this field of transplant oncology. Liver transplantation for secondary liver tumours should be implemented in accordance with stringent transplant criteria and preferably in the context of prospective trials. Expansion of the donor pool by utilising extended criteria donors and partial liver transplantation could be considered for this indication.
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Affiliation(s)
- Pål-Dag Line
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway; Experimental Transplantation and Malignancy Research Group, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Svein Dueland
- Experimental Transplantation and Malignancy Research Group, Division of Surgery, Inflammatory Diseases and Transplantation, Oslo University Hospital, Oslo, Norway
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Combariza JF, Arango M, Díaz L, Agudelo C, Hernandez S, Madera AM, León G, Avila V, Bautista L, Valdés J, Orduz R, Mejía F, Moreno L, Ramirez C. Measurable Residual Disease Assessment and Allogeneic Transplantation as Consolidation Therapy in Adult Acute Lymphoblastic Leukemia in Colombia. Clin Lymphoma Myeloma Leuk 2020; 21:e365-e372. [PMID: 33277225 DOI: 10.1016/j.clml.2020.11.010] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/05/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Detectable minimal residual disease (MRD) after therapy for acute lymphoblastic leukemia (ALL) is the strongest predictor of hematologic relapse. The objective of the study was to assess disease-free survival (DFS) and overall survival (OS) of patients with ALL according with MRD status at the end of induction therapy in a Colombian population. PATIENTS AND METHODS We assessed a retrospective cohort to compare DFS and OS in adults with de novo ALL according to MRD status at the end of induction chemotherapy, and the type of postinduction consolidation strategy used. RESULTS A total of 165 adults with ALL were included in the MRD part of the study, 73 patients in the MRD-negative group and 92 in the MRD-positive group. Median DFS for the MRD-positive group was 11 months (95% confidence interval, 11.7-22.2) and was not reached for the MRD-negative group (P < .001). At 3 years, DFS was 18% and 55%, respectively (P < .001). The median OS for MRD-positive patients was 16 months (95% confidence interval, 8.8-23.15) and was not reached in the MRD-negative group. At 3 years, OS was 26% and 51% for the former and latter group, respectively. Among subjects who did not receive a transplant, median DFS was 21 months for MRD-negative patients and 9 months for MRD-positive patients (P < .001). The median DFS was not reached in either group, whereas 3-year DFS was 64% for MRD-negative and 70% for MRD-positive patients who underwent transplantation in first remission (P = .861). CONCLUSION MRD status at the end of induction is an independent prognostic factor for DFS and OS in adult ALL. Allogeneic transplantation in first remission could overcome the adverse prognostic impact of MRD.
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Affiliation(s)
| | - Marcos Arango
- Department of Hematology, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Laura Díaz
- Department of Hematology, Hospital Pablo Tobón Uribe, Medellín, Colombia
| | - Claudia Agudelo
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Sonia Hernandez
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Ana María Madera
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Guillermo León
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Vladimir Avila
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Leonardo Bautista
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Jaime Valdés
- Department of Hematology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Rocio Orduz
- Department of Pathology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Fabian Mejía
- Department of Pathology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Liliana Moreno
- Department of Pathology, Clínica Universitaria Colombia, Bogotá, Colombia
| | - Carlos Ramirez
- Department of Hematology, Clínica Reina Sofía, Bogotá, Colombia
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Lund CM, Dyhl-Polk A, Nielsen DL, Riis LB. Wnt5a expression and prognosis in stage II-III colon cancer. Transl Oncol 2020; 14:100892. [PMID: 33045677 PMCID: PMC7553443 DOI: 10.1016/j.tranon.2020.100892] [Citation(s) in RCA: 4] [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: 06/21/2020] [Revised: 09/07/2020] [Accepted: 09/08/2020] [Indexed: 02/08/2023] Open
Abstract
Cancer metastases accounts for most cancer deaths. The secreting glycoprotein Wnt5a impairs tumor cell migration and reduces invasiveness and metastasis. High Wnt5a expression in tumor cells is correlated to better outcomes in patients with breast, prostate and epithelial ovarian cancer. We aimed to investigate the association between the Wnt5a expression and outcomes in patients with colon cancer (CC) stage II/III. We performed a retrospective single-center study evaluating 345 patients with radical resection for primary CC, stage II/III, who started 6 months of adjuvant chemotherapy with 5-FU or capecitabine ± oxaliplatin between 2001 and 2015. Archived formalin-fixed paraffin embedded tumor tissue from resection specimens were stained with Wnt5a antibody using immunohistochemistry. Cytoplasmatic Wnt5a staining was assessed according to intensity and percentage of stained cells. Patients were divided in groups depending on high (n = 230) or low (n = 115) Wnt5a expression. Disease free survival (DFS) and overall survival (OS) were analyzed for the two groups using Kaplan-Meier plots and Long rank test. Patients with Wnt5a-negative tumors had significantly poorer performance status (PS) than patients with high Wnt5a expression (p = 0.046). No significant difference was seen between patients with low and high Wnt5a expression in terms of 5-year DFS (p = 0.517) or 5-year OS (p = 0.415). Poor PS was associated with lower DFS (p = 0.002) and OS (p < 0.001). In conclusion, we found no significant difference in prognosis for patients with stage II/III CC depending on their Wnt5a expression. Patients with Wnt5a-negative tumors had significant poorer PS than patients with higher levels. Poor PS was associated with lower DFS and OS. High expression of Wnt5a in tumor cells are correlated to significantly better outcomes in patients with different cancers. We found no difference in survival among patients with colon cancer stage II-III depending on their Wnt5a expression. Patients with low Wnt5a expression had significantly poor performance status than patients with high levels. Poor performance status was shown to predict poorer outcomes.
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Affiliation(s)
- Cecilia Margareta Lund
- Department of Medicine, Copenhagen University Hospital, Herlev and Gentofte, Denmark; Copenage, Copenhagen Center for Clinical Age Research, University of Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark.
| | - Anne Dyhl-Polk
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Denmark
| | - Dorte Lisbeth Nielsen
- Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark
| | - Lene Buhl Riis
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Copenhagen University, Denmark; Department of Pathology, Copenhagen University Hospital, Herlev and Gentofte, Denmark
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Liu D, Wu Y. Association of an anaplastic lymphoma kinase pathway signature with cell de-differentiation, neoadjuvant chemotherapy response, and recurrence risk in breast cancer. Cancer Commun (Lond) 2020; 40:422-434. [PMID: 32822101 PMCID: PMC7494065 DOI: 10.1002/cac2.12038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/04/2019] [Revised: 01/01/2019] [Accepted: 05/14/2020] [Indexed: 02/06/2023] Open
Abstract
Background Aberrant activation of anaplastic lymphoma kinase (ALK) signaling has been found to be involved in the tumorigenesis of multiple types of cancer. The aim of this study was to determine the role of this pathway in the pathogenesis of breast cancer. Methods An ALK pathway signature that we generated previously was used to compute the ALK pathway activity in 6381 breast cancer samples from 42 microarray datasets, and the associations between ALK pathway signature score and clinical variables were examined using logistic regression and survival analyses. Results Our results indicated that high ALK pathway activity was a significant risk factor for hormone receptor‐negative, high‐grade breast cancer in the 42 datasets. ALK pathway activity was positively associated with pathological complete response (pCR) in 15 datasets annotated with patient's neoadjuvant chemotherapy response information (overall odds ratio = 1.67, P < 0.01), and this association was more significant in HER2‐negative and grade 1&2 tumors than in HER2‐positive and grade 3 tumors. ALK pathway activity was also positively associated with recurrence risk in breast cancer patients from 30 datasets annotated with survival information (overall hazard ratio = 1.21, P < 0.01), particularly in patients with age > 50 years old, with positive lymph nodes, or with residual disease after neoadjuvant chemotherapy. Conclusions ALK may be involved in breast cancer tumorigenesis, and ALK pathway signature score may serve as a prognostic biomarker for breast cancer.
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Affiliation(s)
- Dingxie Liu
- Bluewater Biotech LLC, New Providence, Mandaluyong, NJ, 07974, USA
| | - Yong Wu
- Division of Cancer Research and Training, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, 90059, USA.,David Geffen UCLA School of Medicine, and UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90059, USA
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Katna R, Bhosale B, Sharma R, Singh S, Deshpande A, Kalyani N. Oncological outcomes in patients undergoing major glossectomy for advanced carcinoma of the oral tongue. Ann R Coll Surg Engl 2020; 102:514-518. [PMID: 32436723 DOI: 10.1308/rcsann.2020.0100] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Major glossectomy is the treatment of choice in locally advanced tongue cancer. It remains the only option in the presence of recurrent or residual disease. The long-term outcomes for patients undergoing major glossectomy have traditionally been poor, with significant morbidity and poor oncological outcomes. The aim of this study was to report on oncological outcomes in patients undergoing major glossectomy. METHODS All patients undergoing major glossectomy between 2014 and 2018 were included in the study. The data of 85 patients with advanced carcinoma of the oral tongue were evaluated. All were under the care of a single surgical and reconstructive team at two hospitals in Mumbai. RESULTS The median patient age was 45 years. At the most recent follow-up, 55 patients (65%) were alive, 47 of whom were disease free. Twenty-nine patients (34%) had locoregional recurrence and twenty-five (29%) had distant metastasis. At a median follow-up of 19 months, rates for 2-year locoregional control, disease free survival (DFS) and overall survival (OS) were 69%, 61% and 62% respectively. Perinodal extension demonstrated a trend towards poor DFS (p=0.060), as did perineural invasion (p=0.055). Node positivity was a significant factor for poor OS, DFS and locoregional control. Multiple node involvement was significantly associated with poor OS on multivariate analysis (p=0.002). CONCLUSIONS Node positivity and multiple node involvement were associated with poor outcomes. Major glossectomy may be offered as a curative option for selected patients with advanced carcinoma of the oral tongue with node negative or limited neck nodal disease (N1).
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Affiliation(s)
- R Katna
- Jaslok Hospital and Research Centre, Mumbai, India.,Bombay Hospital and Medical Research Centre, Mumbai, India
| | - B Bhosale
- Jaslok Hospital and Research Centre, Mumbai, India.,Bombay Hospital and Medical Research Centre, Mumbai, India
| | - R Sharma
- Bombay Hospital and Medical Research Centre, Mumbai, India
| | - S Singh
- Bombay Hospital and Medical Research Centre, Mumbai, India
| | - A Deshpande
- Jaslok Hospital and Research Centre, Mumbai, India.,Bombay Hospital and Medical Research Centre, Mumbai, India
| | - N Kalyani
- Jaslok Hospital and Research Centre, Mumbai, India
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Van Mechelen M, Van Herck A, Punie K, Nevelsteen I, Smeets A, Neven P, Weltens C, Han S, Vanderstichele A, Floris G, Lobelle JP, Wildiers H. Behavior of metastatic breast cancer according to subtype. Breast Cancer Res Treat 2020; 181:115-125. [PMID: 32193802 DOI: 10.1007/s10549-020-05597-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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: 10/23/2019] [Accepted: 03/12/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE To explore the impact of breast cancer subtype on metastatic behavior and long-term outcome defined as breast cancer specific survival (BCSS). METHODS Retrospective single centre cross-sectional study of 5972 patients with newly diagnosed, unilateral first diagnosis of breast cancer, diagnosed 2000-2010. Patients had either early breast cancer (EBC) treated primarily by surgery (SURG n = 5072), neoadjuvant systemic therapy (NEO n = 592), or upfront metastatic disease (META n = 308). Surrogate breast cancer subtypes were defined according to classical pathological criteria. Analysis was performed using Kaplan-Meier method and logistic/Cox regression. RESULTS After median follow-up time of 103.6 months (IQR 73.4-139.2 months), 817 patients with EBC at diagnosis (14.4%) developed distant metastases of which 621 (12.2%) SURG and 196 (33.1%) NEO. Metastasis rate after EBC was: LuminalA 8.1%, LuminalB1(HER2-) 20.4%, LuminalB2(HER2+) without (neo)adjuvant trastuzumab 21.7%, LuminalB2(HER2+) with trastuzumab 9.0%, HER2Positive(ER-) without trastuzumab 30.0%, HER2Positive(ER-) with trastuzumab 19.9% and TripleNegative 25.3%. There were major differences in site of first metastases according to subtype. For single site first metastases, median BCSS assessed from time of metastases was worst for brain localization (13.9 months) and best for bone (48.4 months). Multiple sites of first metastases had worse BCSS from date of metastases than single site first metastases (median BCSS for 1 site 40.0, 2 sites 27.1, ≥ 3 sites 20.5 months). Median BCSS from date of metastases is longer in upfront metastases compared to secondary metastases after EBC (43.4 vs. 27.9 months). CONCLUSIONS Tumor subtype influences the metastatic behavior and survival after development of distant metastases.
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Affiliation(s)
- Margot Van Mechelen
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Anke Van Herck
- Department of Internal Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Kevin Punie
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium.,Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Department of Oncology, KU Leuven, Leuven, Belgium
| | - Ines Nevelsteen
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Patrick Neven
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Caroline Weltens
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | - Sileny Han
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium
| | | | - Giuseppe Floris
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium.,Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research and University Hospitals Leuven, Leuven, Belgium.,Department of Pathology, KU Leuven, Leuven, Belgium
| | | | - Hans Wildiers
- Multidisciplinary Breast Centre, University Hospitals Leuven, Leuven, Belgium. .,Department of General Medical Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium. .,Department of Oncology, KU Leuven, Leuven, Belgium.
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Tečić Vuger A, Šeparović R, Vazdar L, Pavlović M, Lepetić P, Šitić S, Bajić Ž, Šarčević B, Vrbanec D. CHARACTERISTICS AND PROGNOSIS OF TRIPLE-NEGATIVE BREAST CANCER PATIENTS: A CROATIAN SINGLE INstitution RETROSPECTIVE COHORT STUDY. Acta Clin Croat 2020; 59:97-108. [PMID: 32724280 PMCID: PMC7382886 DOI: 10.20471/acc.2020.59.01.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 12/20/2022] Open
Abstract
Triple-negative breast cancer (TNBC) occurs in around one-sixth of all breast cancer (BC) patients, with the most aggressive behavior and worst prognosis of all BC subtypes. It is a heterogeneous disease, with specific molecular characteristics and natural dynamics of early recurrence and fast progression. Due to the lack of biomarkers or any valid treatment targets, it can only be treated with classic cytotoxic chemotherapy. We analyzed a cohort of 152 patients, median age 58 years, diagnosed with and treated for early stage TNBC at the University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia, during the 2009-2012 period. Patients were treated with primary surgical approach, adjuvant chemotherapy and adjuvant irradiation. We observed a relatively large proportion of locally advanced TNBC at diagnosis, with large tumor size and nodal involvement, with high grade and high proliferation index Ki67. Patient age, tumor size and lymph node involvement, as expected, were significant and clinically most important prognostic factors for 5-year disease-free survival (67%; 95% CI 60%-75%) and overall absolute survival rate (74%; 95% CI 66%-81%).
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Affiliation(s)
| | - Robert Šeparović
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Ljubica Vazdar
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Mirjana Pavlović
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Petra Lepetić
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Sanda Šitić
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Žarko Bajić
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Božena Šarčević
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
| | - Damir Vrbanec
- 1Department of Medical Oncology, Division of Radiotherapy and Medical Oncology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 2Department of Oncologic Cytology and Pathology, University Hospital for Tumors, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 3Dr. Mirko Grmek Scientific Unit, Sveti Ivan Psychiatric Hospital, Zagreb, Croatia; 4School of Medicine, University of Zagreb, Zagreb, Croatia; 5School of Medicine, Juraj Dobrila University, Pula, Croatia
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Wasmann KATGM, Klaver CEL, van der Bilt JDW, Nagtegaal ID, Wolthuis AM, van Santvoort HC, Ramshorst B, D’Hoore A, de Wilt JHW, Tanis PJ. Subclassification of Multivisceral Resections for T4b Colon Cancer with Relevance for Postoperative Complications and Oncological Risks. J Gastrointest Surg 2020; 24:2113-2120. [PMID: 31749095 PMCID: PMC7441085 DOI: 10.1007/s11605-019-04426-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 06/24/2019] [Accepted: 09/30/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Multivisceral resection for T4b colon cancer constitutes a heterogeneous group of surgical procedures. The purpose of this study was to explore clinically distinct categories of multivisceral resection, with subsequent correlation to postoperative complications and oncological outcomes. METHODS In this multicenter cohort study, all consecutive patients without metastases who underwent multivisceral resection for pT4bN0-2M0 colon cancer between 2000 and 2014 were included. Multivisceral resection was divided into four categories: (i) gastrointestinal (including the stomach), (ii) urologic ((partial) bladder and ureter), (iii) solid organ (spleen, kidney, liver, pancreas, and uterus), and (iv) abdominal wall/omentum/ovaries. The primary outcome was surgical complications and secondary outcomes were 5-year intra-abdominal recurrence, disease-free survival, and overall survival. RESULTS In total, 130 patients who underwent curative intent resection of pT4 colon cancer were included. Patients who underwent multivisceral resection within multiple categories were assigned to one of the categories based on hierarchy of clinical impact after exploratory analysis. For the primary endpoint, 55 patients were assigned to gastrointestinal, 14 to urologic, 14 to solid organ, and 47 to abdominal wall/omentum/ovaries multivisceral resection. Gastrointestinal multivisceral resection was independently associated with surgical complications (HR 3.9, 95% CI 1.4-10.6). Abdominal wall/omentum/ovaries multivisceral resection was significantly related with intra-abdominal recurrence (HR 7.8, 95% CI 1.0-57.8). The 5-year disease-free survival and overall survival showed no significant differences per multivisceral resection category. CONCLUSIONS Multivisceral resections for T4b colon cancer are heterogeneous procedures considering risk profiles. The proposed multivisceral resection subclassification needs validation, but might improve comparability between studies and hospitals (auditing).
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Affiliation(s)
- Karin A. T. G. M. Wasmann
- grid.7177.60000000084992262Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Charlotte E. L. Klaver
- grid.7177.60000000084992262Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Jarmila D. W. van der Bilt
- grid.7177.60000000084992262Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands ,grid.410569.f0000 0004 0626 3338Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - Iris D. Nagtegaal
- grid.10417.330000 0004 0444 9382Department of Pathology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Albert M. Wolthuis
- grid.410569.f0000 0004 0626 3338Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - Hjalmar C. van Santvoort
- grid.415960.f0000 0004 0622 1269Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - Bert Ramshorst
- grid.415960.f0000 0004 0622 1269Department of Surgery, St. Antonius Hospital, Nieuwegein, the Netherlands
| | - André D’Hoore
- grid.410569.f0000 0004 0626 3338Department of Abdominal Surgery, University Hospital Leuven, Leuven, Belgium
| | - Johannes H. W. de Wilt
- grid.10417.330000 0004 0444 9382Department of Surgery, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Pieter J. Tanis
- grid.7177.60000000084992262Department of Surgery, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
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Kim WJ, Lim TW, Kang SH, Park PJ, Choi SB, Lee SI, Min BW, Kim WB. Development and validation of novel scoring system for the prediction of disease recurrence following resection of colorectal liver metastasis. Asian J Surg 2019; 43:438-446. [PMID: 31439461 DOI: 10.1016/j.asjsur.2019.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 01/08/2019] [Revised: 02/27/2019] [Accepted: 06/03/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The aim of this study was to identify predictive factors for the recurrence of colorectal cancer liver metastasis (CRLM) and then to develop a corresponding novel scoring system that should improve the sensitivity of predicting recurrence in patients with CRLM. METHODS A total of 295 consecutive CRLM patients were enrolled in our institution between January 2002 and December 2015. Multivariate analyses were performed to identify the variables associated with disease recurrence and established the novel scoring system based on it. RESULTS The scoring system considered seven variables: synchronosity, CA19-9 level, number of liver metastasis, largest size of liver metastasis, resection margin of hepatic lesion, neutrophil-to-lymphocyte ratio and prognostic nutritional index. The area under the curve of ROC was 0.824 (95% confidence interval 0.767-0.882); the sensitivity of our scoring system was 87.9%, specificity was 66.7%, positive predictive value was 20.6%, and negative predictive value was 20.9%. CONCLUSION For patients with CRLM undergoing curative hepatic resection, our novel scoring system would improve the sensitivity for prediction of disease recurrence in Case of CRLM patients.
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Affiliation(s)
- Wan-Joon Kim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Tae-Wan Lim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sang-Hee Kang
- Division of Colorectal Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Pyoung-Jae Park
- Division of Transplantation Vascular Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sae-Byeol Choi
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Sun-Il Lee
- Division of Colorectal Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Byung-Wook Min
- Division of Colorectal Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea
| | - Wan-Bae Kim
- Division of Hepatobiliary Pancreas Surgery, Department of Surgery, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
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Liu W, Wang K, Han Y, Liang JY, Li YH, Xing BC. Nomogram predicted disease free survival for colorectal liver metastasis patients with preoperative chemotherapy followed by hepatic resection. Eur J Surg Oncol 2019; 45:2070-7. [PMID: 31279595 DOI: 10.1016/j.ejso.2019.06.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/09/2019] [Accepted: 06/24/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Hepatic resection is regarded to as a potentially curative option for colorectal cancer liver metastases (CRLM), but it is associated with a high rate of recurrence. The present study intended to establish an effective nomogram to predict disease free survival (DFS) and select candidates of hepatic resection. METHODS The nomogram was based on a retrospective study on 447 CRLM patients treated with preoperative chemotherapy followed by hepatic resection using a multicentric database between January 1st, 2010 and December 31st, 2017. Results were validated using bootstrap resampling on 117 patients. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve. Overall survival, disease free survival, and local recurrence rate for patients with colorectal cancer were measured. RESULTS Based on multivariate analysis of the primary cohort, independent factors for DFS included tumor size larger than 5 cm, multiple liver metastases(>1), RAS mutation, primary lymph node metastasis and tumor size increase after preoperative chemotherapy. These five factors were all considered in the nomogram. The C-index of the nomogram for predicting survival was 0.675. With external validation, the C-index of the nomogram for the prediction of the DFS was 0.77, which demonstrated that this model has a good level of discriminative ability. For the 382 patients (66.7%) who developed recurrence, the optimal cutoff point for early recurrence was determined to be 12 months after hepatic resection. CONCLUSIONS The proposed nomogram demonstrated accurate prognostic prediction of DFS for CRLM patients with preoperative chemotherapy followed by hepatic resection.
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Jin X, Lin B, Chen D, Li L, Han C, Zhou Y, Zheng X, Gong C, Chen M, Xie C. Safety and outcomes of volumetric modulated arc therapy in the treatment of patients with inoperable lung cancer. J Cancer 2019; 10:2868-2873. [PMID: 31281463 PMCID: PMC6590029 DOI: 10.7150/jca.31260] [Citation(s) in RCA: 4] [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: 11/05/2018] [Accepted: 04/14/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Published data on the effects and toxicities of volumetric modulated arc therapy (VMAT) in the management of inoperable lung cancer are scarce. Materials and methods: The clinical outcomes and pulmonary toxicities of 134 patients with consecutive inoperable lung cancer who underwent VMAT from March 2011 to September 2016 were retrospectively reviewed. The dosimetric and characteristic factors associated with acute radiation pneumonitis (RP) and pulmonary fibrosis were evaluated with univariate and multivariate analysis. Results: The average prescription doses to these 134 patients were 57.07±6.27 Gy (range 52-64 Gy). The overall median follow-up time was 18.6 months (range, 2-45 mo), with a median follow-up time for the surviving patients of 20 months (range, 7-45 mo). The 2-year progression-free survival (PFS) and overall survival (OS) for all patients were 18.2% and 38.4%, with a median PFS and OS of 7.6 months and 18.6 months, respectively. The percent of patients with grade III/higher RP and pulmonary fibrosis were 10.5% and 9.0%, respectively. V13 (p=0.02) and age (p=0.02) were independently associated with acute RP according to multivariate analysis. The constraints for lung dosimetric metrics V10,V13,V20 and V30 were approximately 49%,41%,26% and 17% in VMAT treatment of lung cancer to limit the RP rate < 10%. Conclusion: VMAT can be delivered safely with acceptable acute and late toxicities for lung cancer patients. Lung dosimetric metrics were valuable in predicting acute RP. A lung V13 constraint of 40% was helpful to limit the RP rate < 10% in VMAT treatment of lung cancer patients.
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Affiliation(s)
- Xiance Jin
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Baochai Lin
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Didi Chen
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Lili Li
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Ce Han
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Yongqiang Zhou
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Xiaomin Zheng
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Changfei Gong
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
| | - Mengfeng Chen
- Respiratory Department, Third People's Hospital of Yueqing, Wenzhou, China, 325600
| | - Congying Xie
- Radiation and Medical Oncology, the first Affiliated Hospital of Wenzhou Medical University, Wenzhou, China,325000
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Cheng C, Wang Q, Zhu M, Liu K, Zhang Z. Integrated analysis reveals potential long non-coding RNA biomarkers and their potential biological functions for disease free survival in gastric cancer patients. Cancer Cell Int 2019; 19:123. [PMID: 31080364 PMCID: PMC6505118 DOI: 10.1186/s12935-019-0846-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 02/19/2019] [Accepted: 05/02/2019] [Indexed: 12/24/2022] Open
Abstract
Background Increasing evidences supported the association between long non-coding RNA (lncRNA) and disease free survival in gastric cancer (GC) patients. The purpose of the current study was to construct and verify a noninvasive preoperative predictive tool for disease free survival in GC patients. Methods There were 265 and 300 GC patients in model dataset and validation dataset respectively. The associations between the lncRNA biomarkers and disease free survival were evaluated by univariate and multivariate Cox regression. Results Thirteen lncRNA biomarkers (GAS5-AS1, AL109615.3, KDM7A-DT, AP000866.2, KCNJ2-AS1, LINC00656, LINC01777, AC046185.3, TTTY14, LINC01526, LINC02523, LINC00592, and C5orf66) were identified as prognostic biomarkers with disease free survival. These thirteen lncRNA biomarkers were combined to construct a prognostic signature for disease free survival. The C-indexes of the current predictive signature in model cohort were 0.849 (95% CI 0.803–0.895), 0.859 (95% CI 0.813–0.905) and 0.888 (95% CI 0.842–0.934) for 1-year, 3-year and 5-year disease free survival respectively. Based on thirteen-lncRNA prognostic signature, patients in model cohort could be stratified into high risk group and low risk group with significant different disease free survival rate (hazard ratio [HR] = 7.355, 95% confidence interval [CI] 4.378–12.356). Good reproducibility of thirteen-lncRNA prognostic signature was confirmed in an external validation cohort (GSE62254) with HR 3.919 and 95% CI 2.817–5.453. Further analysis demonstrated that the prognostic significance of thirteen-lncRNA prognostic signature was independent of other clinical characteristics. Conclusions In conclusion, a simple noninvasive prognostic signature was established for preoperative prediction of disease free survival in GC patients. This prognostic signature might predict the individual mortality risk of disease free survival without pathological information and facilitate individual treatment decision-making. Electronic supplementary material The online version of this article (10.1186/s12935-019-0846-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Canchang Cheng
- 1Department of Internal Medicine, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Shunde District, Guangdong China
| | - Qicai Wang
- 2Department of General Surgery, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Shunde District, Guangdong China
| | - Minggu Zhu
- 1Department of Internal Medicine, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Shunde District, Guangdong China
| | - Kelong Liu
- 2Department of General Surgery, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Shunde District, Guangdong China
| | - Zhiqiao Zhang
- 1Department of Internal Medicine, The Affiliated Chencun Hospital of Shunde Hospital, Southern Medical University, Shunde District, Guangdong China
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Li X, Zhang C, Sun Z, Yang F, Xiao R, Sui X, Jiang G, Zhong W, Wang J. Propensity-matched analysis of adjuvant chemotherapy for completely resected Stage IB non-small-cell lung cancer patients. Lung Cancer 2019; 133:75-82. [PMID: 31200832 DOI: 10.1016/j.lungcan.2019.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/18/2019] [Accepted: 04/23/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The use of adjuvant chemotherapy (ACT) in completely resected stage IB non-small cell lung cancer (NSCLC) is still controversial. The divergent outcomes of prospective trials have created uncertainty as to the utility of ACT in stage IB NSCLC. This study assesses the effect of postoperative adjuvant chemotherapy in stage IB patients in clinical practice. METHODS Patients with pT2aN0M0 stage IB NSCLC who underwent complete resection from 2004 to 2015 were identified from prospectively collected databases in two medical centers. The log-rank test was used to compare overall survival (OS) and disease free survival (DFS). Fine and Gray's competing risks regression model was built to identify predictors of cancer-specific survival. One to one propensity-score matching (PSM) was performed to reduce the selection bias and additional analyses were performed on these subgroups. RESULTS Of 1005 patients identified for the study, 202 (20.1%) received ACT and 803 (79.9%) underwent surgery alone (observation group). Compared with the observation group, patients who underwent ACT were younger (p < 0.001), had larger tumors (p = 0.004), and had higher rates of squamous cell carcinoma (p < 0.001) and lymphovascular invasion (p = 0.017). After propensity score matching, 196 pairs of patients were 1:1 matched in the two groups and all baseline characteristics were well balanced. ACT was not associated with improved survival (including OS, DFS; all log-rank p > 0.05) in both unmatched and matched (196 pairs) cohorts. In subgroup analysis of the matched population, ACT was not associated with survival benefits for patients regardless of whether their tumors measured <4 cm or ≥4 cm (both log-rank p > 0.05). CONCLUSIONS In patients with completely resected stage IB (T2aN0M0) NSCLC, ACT is not associated with improved prognosis. Further large multicenter studies are needed to confirm these findings.
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Matuschek C, Haussmann J, Bölke E, Tamaskovics B, Djiepmo Njanang FJ, Orth K, Peiper M, Gerber PA, Anooshar B, Kammers K, Budach W. Adjuvant radiochemotherapy vs. chemotherapy alone in gastric cancer: a meta-analysis. Strahlenther Onkol 2019; 195:695-706. [PMID: 30796495 DOI: 10.1007/s00066-019-01431-y] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 01/11/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND As an adjuvant therapeutic strategy in advanced gastric cancer, both adjuvant chemotherapy (CTx) and postoperative radiochemotherapy (RCTx) can be considered. Both approaches have been shown to improve overall survival compared to resection alone. Several prospective randomized trials have compared the two postoperative concepts. METHODS We performed a literature search to identify prospective randomized trials which compared adjuvant chemotherapy to adjuvant radiochemotherapy in patients with advanced gastric cancer. As effect sizes, we extracted hazard ratios (HR) as well as event rates from the included trials for the endpoints overall survival, disease-free survival and locoregional control. RESULTS We identified seven studies that enrolled 1807 patients overall. Combined radiochemotherapy showed no significant improvement of overall survival in comparison to chemotherapy alone (HR = 0.93; 95%CI: 0.82-1.06; p = 0.28). For disease-free survival (HR = 0.86; 95%CI: 0.76-0.98; p = 0.023) and locoregional control (odds ratio [OR] = 0.56; 95%CI: 0.42-0.75; p = <0.001) we detected significant advantages from the addition of radiation to chemotherapy. A subgroup analysis demonstrated an improvement in survival when the radiochemotherapy protocol was not de-intensified. CONCLUSIONS Adjuvant chemotherapy or radiochemotherapy demonstrate similar oncologic efficacy and therapy-associated toxicity. Individual patient characteristics should therefore determine the therapeutic approach in a multidisciplinary discussion. Irradiation added to standard-dose chemotherapy possibly results in a survival benefit.
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Affiliation(s)
- Christiane Matuschek
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Jan Haussmann
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Bálint Tamaskovics
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | | | - Klaus Orth
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Matthias Peiper
- Department of Surgery, St. Marien Krankenhaus Ratingen, Ratingen, Germany
| | - Peter Arne Gerber
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | | | - Kai Kammers
- Division of Biostatistics and Bioinformatics, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Wilfried Budach
- Department of Radiation Oncology, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
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Überall I, Gachechiladze M, Joerger M, Anděl J, Smičková P, Kolek V, Grygárková I, Škarda J. Tumor autophagy is associated with survival outcomes in patients with resected non-small cell lung cancer. Lung Cancer 2019; 129:85-91. [PMID: 30797498 DOI: 10.1016/j.lungcan.2019.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 07/26/2018] [Revised: 12/31/2018] [Accepted: 01/07/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES LC3A protein is associated with autophagosomes, and LC3A immunohistochemistry (IHC) is used for the detection of autophagy activity. The aim of this study was to assess the prognostic value of LC3A expression in patients with resected non-small cell lung cancer (NSCLC). MATERIALS AND METHODS We used tissue microarrays (TMAs) constructed from 116 resected stage IB-III NSCLC patients. Standard immunohistochemistry was performed on formalin-fixed paraffin-embedded tissue sections using antibody against LC3A autophagic potein. Stained slides were scanned by Olympus dotSlide Digital Virtual Microscopy System (Japan) and the LC3A staining was evaluated digitally. Groups were compared using the Mann Whitney U test, and correlations were assessed using Spearman's rank test. Survival was calculated using Kaplan-Meier analysis. Primary study endpoint was overall survival (OS), secondardy study endpoint disease-free survival (DFS). Cut-off optimization for LC3A prognostic value was performed using the "cut-off finder' 'software (Charite, Berlin, Germany). In addition, the Kaplan Meier plotter (KmPlot) was used to assess the relationship between LC3A mRNA expression and clinical outcome (OS and DFS) in patients with NSCLC. RESULTS From 116 patients, 88 tissue samples were available for final examination. No significant association was found between LC3A staining and other clinicopathological variables, including tumor grade, stage and histological subtype. A higher number of LC3A stone-like structures (SLSs) (>20), was significanly associated with poor OS (HR = 2.27, p = 0.011) and DFS (HR = 2.27, p = 0.003). A significant association between high LC3A mRNA and both a worse OS and worse DFS was found by KMPlot analysis in patients with stage I-III NSCLC. CONSLUSION This retrospective study suggests that SLSs as assessed by LC3A IHC as well as LC3A mRNA expression has a clinically relevant negative prognostic value in patients with resected NSCLC, and should be further investigated.
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Affiliation(s)
- Ivo Überall
- Laboratory of Molecular Pathology, Department of Clinical and Molecular Pathology, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic.
| | - Mariam Gachechiladze
- Laboratory of Molecular Pathology, Department of Clinical and Molecular Pathology, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic.
| | - Markus Joerger
- Department of Medical Oncology and Hematology, Cantonal Hospital, CH-9007, St. Gallen, Switzerland
| | - Josef Anděl
- Department of Oncology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic
| | - Petra Smičková
- Department of Tuberculosis and Respiratory Diseases, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Vítězslav Kolek
- Department of Tuberculosis and Respiratory Diseases, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Ivona Grygárková
- Department of Tuberculosis and Respiratory Diseases, Faculty of Medicine and Dentistry, Palacký University and University Hospital, Olomouc, Czech Republic
| | - Josef Škarda
- Laboratory of Molecular Pathology, Department of Clinical and Molecular Pathology, Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic; Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentristy, Palacký University, Olomouc, Czech Republic.
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Liu X, Xu S, Liu B, Xu W, Ding R, Wang T, Li B, Wang X, Wu Q, Teng H, Wang S. [Survival Analysis of Stage I Non-small Cell Lung Cancer Patients Treated with
Da Vinci Robot-assisted Thoracic Surgery]. Zhongguo Fei Ai Za Zhi 2018; 21:849-856. [PMID: 30454547 PMCID: PMC6247004 DOI: 10.3779/j.issn.1009-3419.2018.11.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
背景与目的 达芬奇机器人手术系统在胸外科的应用日益广泛,本研究旨在探讨经达芬奇机器人手术治疗Ⅰ期非小细胞肺癌(non-small cell lung cancer, NSCLC)患者的疗效。 方法 回顾2012年1月-2017年12月于我科行手术治疗的Ⅰ期NSCLC患者347例,依据手术方式分为机器人(robot-assisted thoracic surgery, RATS)组134例及腔镜(video-assisted thoracic surgery, VATS)组213例。比较两组患者围术期一般指标(术中出血量、术后引流量、术后带管时间、术后住院时间、淋巴结清扫状况),分析患者生存状况(overall survival, OS)、无进展生存状况(disease free survival, DFS)及相关影响因子。 结果 机器人组与腔镜组术中出血量[(49±39) mL vs (202±239) mL]、术后引流量[Day 1: (248±123) mL vs (350±213) mL; Day 2: (288±189) mL vs (338±189) mL]比较,机器人组均少于腔镜组(P < 0.05);术后带管时间[(10±5) d vs (11±8) d]及住院时间[(13±6) d vs (14±9) d]两组患者无明显差异(P > 0.05)。机器人组与腔镜组的淋巴结清扫组数[(5±2)组vs(4±2)组]及淋巴清扫数量[(18±9)枚vs(11±8)枚]比较,机器人组均优于腔镜组(P < 0.05)。机器人组与腔镜组生存状况比较[1年生存率:97.3% vs 96%、3年生存率:89.8% vs 83.1%、5年生存率:87.5 % vs 70.3%,平均生存时间(month):61 vs 59],两组无统计学差异(P > 0.05)。无进展生存状况:机器人组与腔镜组比较[1年无进展生存率:93.7% vs 91.3%、3年无进展生存率:87.7% vs 68.4%、5年无进展生存率:87.7% vs 52.5%,平均无进展生存时间(month):61 vs 50],机器人组明显优于腔镜组(P < 0.05)。单因素分析显示,淋巴结清扫数量是患者生存状况的影响因子;肿瘤直径、手术方式、淋巴结清扫组数、淋巴结清扫数量为患者无进展生存状况的影响因子。多因素分析显示生存状况无独立影响因子,肿瘤直径及手术方式为无进展生存状况的独立影响因子。 结论 达芬奇机器人Ⅰ期非小细胞肺癌患者术后生存状况与腔镜手术无差异,但无进展生存状况优于腔镜手术;达芬奇机器人手术淋巴结清扫更彻底,同时术中出血量更少。
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Affiliation(s)
- Xingchi Liu
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Shiguang Xu
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Bo Liu
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Wei Xu
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Renquan Ding
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Tong Wang
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Bo Li
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Xilong Wang
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Qiong Wu
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Hong Teng
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
| | - Shumin Wang
- Department of Thoracic Surgery, General Hospital of Shenyang Military Command, Shenyang 110016, China
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Xia Y, Wei X, Gong H, Ni Y. Aldehyde dehydrogenase serves as a biomarker for worse survival profiles in ovarian cancer patients: an updated meta-analysis. BMC Womens Health 2018; 18:199. [PMID: 30522488 PMCID: PMC6284301 DOI: 10.1186/s12905-018-0686-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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: 08/07/2018] [Accepted: 11/20/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The purpose of this comprehensive meta-analysis was to assess the association of aldehyde dehydrogenase (ALDH) expression with overall survival (OS) and disease-free survival (DFS)/progression-free survival (PFS) in ovarian cancer patients. METHODS Systematic searches of Pubmed databases was performed to identify relevant literature published before February 28, 2018. A total of 14 studies (13 articles) with 2210 ovarian cancer patients were pooled. All included studies were performed by using Immunohistochemistry (IHC) for detection of ALDH expression. Hazard ratio (HR) and 95% confidence interval (CI) were extracted from included studies to evaluate the correlation of ALDH expression with OS and DFS/PFS. RESULTS High expression of ALDH was associated with worse OS (HR: 1.43; 95% CI: 1.18-1.73) and poor DFS/PFS (HR: 1.55, 95% CI: 1.12-2.14). No evidence of publication bias was observed in OS (Begg's test, P = 0.113; Egger's test, P = 0.355) and DFS/PFS (Begg's test, P = 0.655; Egger's test, P = 0.189) in ovarian cancer patients. The subgroup of studies with cut-off value of low expression showed that high expression of ALDH was correlated with poor OS (HR: 1.36; 95% CI: 1.14-1.62) and DFS/PFS (HR: 1.79; 95% CI: 1.45-2.20) in ovarian cancer patients, with no observed heterogeneity (OS: I2 = 0%, P = 0.45; DFS/PFS: I2 = 0%, P = 0.55). CONCLUSION In conclusion, high expression of ALDH is correlated with worse survival profiles in ovarian cancer patients, indicating that ALDH might act as a potential molecular biomarker for prognosis of ovarian cancer.
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Affiliation(s)
- Yan Xia
- Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China
| | - Xuemin Wei
- Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China
| | - Hui Gong
- Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China.
| | - Yunxiang Ni
- Department of Obstetrics and Gynecology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 Xianxia Road, Shanghai, 200336, China.
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Sakin A, Arici S, Secmeler S, Can O, Geredeli C, Yasar N, Demir C, Demir OG, Cihan S. Prognostic significance of primary tumor localization in stage II and III colon cancer. World J Gastrointest Oncol 2018; 10:410-420. [PMID: 30487952 PMCID: PMC6247106 DOI: 10.4251/wjgo.v10.i11.410] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/14/2018] [Accepted: 10/17/2018] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate the effects of tumor localization on disease free survival (DFS) and overall survival (OS) in patients with stage II-III colon cancer.
METHODS This retrospective study included 942 patients with stage II and III colon cancer, which were followed up in our clinics between 1995 and 2017. The tumors from the caecum to splenic flexure were defined as right colon cancer (RCC) and those from splenic flexure to the sigmoid colon as left colon cancer (LCC).
RESULTS The median age of the patients was 58 years (range: 19-94 years). Male patients constituted 54.2%. The rates of RCC and LCC were 48.4% (n = 456) and 51.6% (n = 486), respectively. During the median follow-up of 90 mo (range: 6-252 mo), 14.6% of patients developed recurrence and 9.1% of patients died. In patients with stage II and III disease with or without adjuvant therapy, DFS was similar in terms of primary tumor localization (stage II; P = 0.547 and P = 0.481, respectively; stage III; P = 0.976 and P = 0.978, respectively). In patients with stage II and III disease with or without adjuvant therapy, OS was not statistically significant with respect to primary tumor localization (stage II; P = 0.381 and P = 0.947, respectively; stage III; P = 0.378 and P = 0.904, respectively). The difference between median OS of recurrent RCC (26 ± 6.2 mo) and LCC (34 ± 4.9 mo) cases was eight months (P = 0.092).
CONCLUSION Our study showed no association of tumor localization with either DFS or OS in patients with stage II or III colon cancer managed with or without adjuvant therapy. However, post-recurrence OS appeared to be worse in RCC patients.
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Affiliation(s)
- Abdullah Sakin
- Department of Medical Oncology, Yuzuncu Yil University Medical School, Van 65090, Turkey
| | - Serdar Arici
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Saban Secmeler
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Orcun Can
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Caglayan Geredeli
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Nurgul Yasar
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Cumhur Demir
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
| | - Osman Gokhan Demir
- Department of Medical Oncology, Acıbadem University, Istanbul 34396, Turkey
| | - Sener Cihan
- Department of Medical Oncology, University of Health Sciences, Okmeydani Training and Research Hospital, Istanbul 34384, Turkey
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Umer M, Saeed J, Zahid N. Aggressive fibromatosis in pediatric population-A case series. Int J Surg Case Rep 2018; 52:45-8. [PMID: 30316134 DOI: 10.1016/j.ijscr.2018.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 05/19/2018] [Revised: 09/20/2018] [Accepted: 09/20/2018] [Indexed: 11/21/2022] Open
Abstract
Desmoid tumor or aggressive fibromatosis (AF) is a benign tumor of borderline malignant condition, it is infiltrative, deep-seated and muscoloapo neurotic in nature. AF is commonly found among children below 15 years of age, affecting males more as compared to females. Primary surgery is not the treatment choice among patients with positive margins as the risk of recurrence is higher after surgery. However, radiation and chemotherapy may assist in maintaining local control of these tumors in such patients. Primary surgery with negative margins is the treatment choice for children with AF.
Introduction Aggressive fibromatosis or Desmoid fibromatosis is a benign tumor which originated form mesenchymal tissues of the body. This tumor has strong potential of recurrence and infiltration but it does not metastasize to other organs of the body. This case series is focused to determine the treatment outcomes for pediatric patients of aggressive fibromatosis. Methodology It is a retrospective case series conducted on 7 patients presented to section of Orthopedics, department of surgery of our institute in Karachi. We included all the cases of pediatric patients from 1 to 16 years, with biopsy proven fibromatosis from January 2000 to December 2015. Presentation of Cases Out of 7 pediatric patients, there were 6 (85.7%) males and 1 (14.3%) female patient. The median age was 6 years IQR (5–11) years. Gluteal region was the most common site of disease. Four patients (57.1%) had positive tumor margins while three (42.9%) had negative margins. Out of 7 patients, 4 patients (57.1%) had recurrent disease and they had positive margins. The median Disease Free survival time was 14 months and there was no expiry of patients. Conclusion & recommendation The conclusion of our study was that aggressive fibromatosis is more prevalent in children below 15 years of age and disease burden is higher in male gender. Positive margins after surgery indicate a high risk for disease recurrence therefore; primary surgery with negative margins is the treatment of choice for children with AF. However, we recommend that multicenter trials should be conducted in the future to clarify the role of adjuvant treatment for patients with pediatric AF.
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Hofmann HS, Doblinger C, Szöke T, Grosser C, Potzger T, Ried M, Neu R. [Influence of primary lymph node status of colorectal cancer on the development of pulmonary metastases and thoracic lymph node metastases]. Chirurg 2018; 90:403-410. [PMID: 30276427 DOI: 10.1007/s00104-018-0742-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND The lungs are the second most common organ site for metastases in patients with colorectal cancer (CRC). Lymph node metastasis of CRC represents a prognostic factor for survival. OBJECTIVE The present study investigated the influence of CRC lymph node metastasis on lung metastasis, in particular thoracic lymph node metastasis. MATERIAL AND METHODS A retrospective analysis of 88 patients (n = 56 male) with curative resection of lung metastases of CRC was performed. Primary endpoint: influence of lymph node status of CRC on lung metastases. Secondary endpoints: disease-free survival and overall survival. Statistical evaluation was carried out with SPSS. RESULTS In 48 patients a positive lymph node status of CRC and in 9 patients an N+ status of lung metastases were determined. The lymph node status of the CRC significantly affected the incidence of synchronous metastases (p = 0.03), disease-free interval until formation of metachronous lung metastases (p = 0.012) and the overall survival of patients with CRC (p = 0.048). The 5‑year survival rate for CRC patients with lung metastases was 48.7% after pulmonary metastasectomy. Thoracic lymph node involvement also significantly affected survival (p = 0.001). CONCLUSION Screening for pulmonary metastases should be included in the staging and follow-up of all patients with CRC, especially in patients with a positive lymph node status of the CRC.
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Affiliation(s)
- H-S Hofmann
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. .,Klinik für Thoraxchirurgie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland.
| | - C Doblinger
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - T Szöke
- Klinik für Thoraxchirurgie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland
| | - C Grosser
- Klinik für Thoraxchirurgie, Krankenhaus Barmherzige Brüder Regensburg, Prüfeninger Str. 86, 93049, Regensburg, Deutschland
| | - T Potzger
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - M Ried
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - R Neu
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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Wang Y, Liu B, Cao P, Wang W, Wang W, Chang H, Li D, Li X, Zhao X, Li Y. Comparison between computed tomography-guided percutaneous microwave ablation and thoracoscopic lobectomy for stage I non-small cell lung cancer. Thorac Cancer 2018; 9:1376-1382. [PMID: 30152596 PMCID: PMC6209786 DOI: 10.1111/1759-7714.12842] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [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: 06/25/2018] [Revised: 07/21/2018] [Accepted: 07/21/2018] [Indexed: 12/12/2022] Open
Abstract
Background The study was conducted to investigate the effectiveness and cost of computed tomography (CT)‐guided percutaneous microwave ablation (MWA) and thoracoscopic lobectomy for stage I non‐small cell lung cancer (NSCLC). Methods We retrospectively analyzed the data of 46 and 85 patients with stage I NSCLC treated with CT‐guided percutaneous MWA or thoracoscopic lobectomy, respectively, at our center from July 2013 to June 2015. Overall survival (OS), disease‐free survival (DFS), local control rate, hospital stay, and cost were evaluated. Survival curves were constructed using the Kaplan–Meier method and compared using the log‐rank test. Results The one and two‐year OS rates were 97.82% and 91.30% and 97.65% and 90.59% in the MWA and lobectomy groups, respectively. The one and two‐year DFS rates were 95.65% and 76.09% and 95.29% and 75.29%, respectively. No significant differences were observed in log‐rank analysis between the groups (P = 0.169). The hospital stays in the MWA and lobectomy groups were 6.62 ± 2.31 and 9.57 ± 3.19 days, respectively. The costs of MWA and lobectomy were US$3274.50 ± US$233.91 and US$4678.87 ± US$155.96, respectively. The differences were all significant (P = 0.003). Conclusion MWA and thoracoscopic lobectomy for stage I NSCLC demonstrate similar one and two‐year OS and DFS, with no significant differences between the two groups. MWA involved a shorter hospital stay and lower cost, thus should be considered a better option for patients with severe cardiopulmonary comorbidity and patients unwilling to undergo surgery.
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Affiliation(s)
- Yongzheng Wang
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
| | - Bin Liu
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
| | - Pikun Cao
- School of Medicine, Shandong University, Jinan, China
| | - Wujie Wang
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
| | - Wei Wang
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
| | - Haiyang Chang
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
| | - Dong Li
- School of Medicine, Shandong University, Jinan, China
| | - Xiao Li
- School of Medicine, Shandong University, Jinan, China
| | - Xiaogang Zhao
- Department of Thoracic Surgery, The Second Hospital of Shandong University, Jinan, China
| | - Yuliang Li
- Department of Interventional Medicine, The Second Hospital of Shandong University, Jinan, China.,Interventional Oncology Institute of Shandong University, Jinan, China
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Ibis K, Saglam S, Saglam EK, Firat P, Yilmazbayhan D, Toker A, Ozkan B, Hancer VS, Buyukdogan M, Disci R, Pilanci KN. Prognostic significance of carbonic anhydrase IX overexpression in stage III non-small cell lung cancer patients after neoadjuvant treatment. Pathol Res Pract 2018; 214:1291-1296. [PMID: 30029935 DOI: 10.1016/j.prp.2018.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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] [Received: 04/19/2018] [Revised: 06/18/2018] [Accepted: 07/05/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND To assess the prognostic importance of carbonic anhydrase IX (CA IX), a hypoxic biomarker, after neoadjuvant treatment in Stage III non-small cell lung cancer (NSCLC) patients. METHODS Tissue CA IX expression was examined after surgical resection in 77 patients who had undergone neoadjuvant treatment. The effects of CA IX overexpression and other clinical factors on disease-free survival and overall survival were investigated. RESULTS In multivariate analysis, number of neoadjuvant chemotherapy (CT) courses and gender emerged as significant independent predictors for disease-free survival, where administration of 2-3 courses of neoadjuvant chemotherapy (CT) (HR, 3.2 [95% CI 1.3-7.6], p = 0.009) and female gender were associated with poor survival (HR, 3.2 [95% CI 1.3-7.7], p = 0.009). The only significant independent predictor for overall survival was recurrence (HR, 5.6 [95% CI 2.4-12.8], p < 0.001). On the other hand, CA IX overexpression was not associated with disease free survival (p = 0.560) or overall survival (p = 0.799). DISCUSSION Our results do not suggest a prognostic role for CA IX overexpression in stage III NSCLC patients who received neoadjuvant treatment.
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Affiliation(s)
- Kamuran Ibis
- Department of Radiation Oncology, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Sezer Saglam
- Department of Medical Oncology, Istanbul Bilim University, Istanbul, Turkey.
| | - Esra Kaytan Saglam
- Department of Radiation Oncology, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Pinar Firat
- Department of Pathology, Koc University School of Medicine, Istanbul, Turkey
| | | | - Alper Toker
- Department of Thoracic Surgery, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Berker Ozkan
- Department of Thoracic Surgery, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Veysel S Hancer
- Istinye University, Department of Medical Genetics, Istanbul, Turkey
| | | | - Rian Disci
- Department of Biostatistics, Basic Medical Sciences, Istanbul University Medical Faculty, Istanbul, Turkey
| | - Kezban Nur Pilanci
- Department of Medical Oncology, Istanbul Haseki Egitim Arastirma Hospital, Istanbul, Turkey
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Zhang J, Wu Y, Lin YH, Guo S, Ning PF, Zheng ZC, Wang Y, Zhao Y. Prognostic value of hypoxia-inducible factor-1 alpha and prolyl 4-hydroxylase beta polypeptide overexpression in gastric cancer. World J Gastroenterol 2018; 24:2381-2391. [PMID: 29904245 PMCID: PMC6000295 DOI: 10.3748/wjg.v24.i22.2381] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 03/08/2018] [Accepted: 04/15/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To investigate the relationship between hypoxia-inducible factor-1α (HIF-1α), prolyl 4-hydroxylase beta (P4HB) expression, and clinicopathologic parameters, as well as the prognostic value of these genes for patients with gastric cancer (GC).
METHODS Hypoxia is a critical factor that shapes the GC microenvironment. In previous reports, we have demonstrated that P4HB is a potential target of HIF-1α. In the present study, gene expression profiling interactive analysis (GEPIA) was used to analyze the relationship between P4HB and hypoxia-associated genes. To this end, 428 GC tissue samples were used to analyze the expression of HIF-1α and P4HB via immunohistochemical staining. Patient samples were classified as having weak-expression or over-expression both in terms of HIF-1α and P4HB. Correlations between biomarkers and clinicopathological factors were analyzed to predict survival.
RESULTS P4HB demonstrated a positive correlation with hypoxia-associated genes (P < 0.05). HIF-1α and P4HB overexpression have a significant correlation with TNM staging (χ2 = 23.32, P = 0.00; χ2 = 65.64, P = 0.00) and peritoneum cavity metastasis (χ2 = 12.67, P = 0.00; χ2 = 39.29, P = 0.00). In univariate analysis, patients with a high HIF-1α expression trend had a shorter disease-free survival (DFS: 44.80 mo vs 22.06 mo) and overall survival (OS: 49.58 mo vs 39.92 mo). P4HB overexpression reflected similar results: patients with over-expression of P4HB had a shorter survival time than those with weak-expression (DFS: 48.03 mo vs 29.64 mo, OS: 52.48 mo vs 36.87 mo). Furthermore, HIF-1α is also a clinicopathological predictor of dismal prognosis according to multivariate analysis (DFS, 95%CI: 0.52-0.88, P < 0.00; OS, 95%CI: 0.50-0.85, P < 0.00). However, P4HB was meaningful in DFS (95%CI: 0.58-1.00, P < 0.05) but not in OS (95%CI: 0.72-1.23, P > 0.05).
CONCLUSION Overexpression of HIF-1α and P4HB is associated with poor prognosis in patients with GC. Thus, these genes may be potential prognostic biomarker candidates in GC.
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Affiliation(s)
- Jun Zhang
- Department of Gastric Cancer, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
| | - Yue Wu
- Department of Emergency, ShengJing Hospital of China Medical University, Shenyang 110042, Liaoning Province, China
| | - Yu-Hang Lin
- Department of Pancreatic and Thyroid Surgery, ShengJing Hospital of China Medical University, Shenyang 110042, Liaoning Province, China
| | - Shuai Guo
- Department of Gastric Cancer, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
| | - Pei-Fang Ning
- Department of Pathology, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
| | - Zhi-Chao Zheng
- Department of Gastric Cancer, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
| | - Yue Wang
- Department of Gastric Cancer, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
| | - Yan Zhao
- Department of Gastric Cancer, Liaoning Cancer Hospital and Institute (Cancer Hospital of China Medical University), Shenyang 110042, Liaoning Province, China
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Kim CW, Kang BM, Kim IY, Kim JY, Park SJ, Park WC, Bae KB, Bae BN, Baek SK, Baik SH, Son GM, Lee YS, Lee SH. Korean Society of Coloproctology (KSCP) trial of cONsolidation Chemotherapy for Locally advanced mid or low rectal cancer after neoadjUvant concurrent chemoraDiothErapy: a multicenter, randomized controlled trial (KONCLUDE). BMC Cancer 2018; 18:538. [PMID: 29739356 PMCID: PMC5941462 DOI: 10.1186/s12885-018-4466-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 06/21/2017] [Accepted: 04/30/2018] [Indexed: 12/18/2022] Open
Abstract
Background Neoadjuvant chemoradiotherapy (CRT) followed by total mesorectal excision (TME) has been a standard treatment option for locally advanced rectal cancer with improved local control. However, systemic recurrence despite neoadjuvant CRT remained unchanged. The only significant prognostic factor proven to be important was pathologic complete response (pCR) after neoadjuvant CRT. Several efforts have been tried to improve survival of patients who treated with neoadjuvant CRT and to achieve more pCR including adding cytotoxic chemotherapeutic agents, chronologic modification of chemotherapy schedule or adding chemotherapy during the perioperative period. Consolidation chemotherapy is adding several cycles of chemotherapy between neoadjuvant CRT and TME. It could increase pCR rate, subsequently could show better oncologic outcomes. Methods Patients with advanced mid or low rectal cancer who received neoadjuvant CRT will be included after screening. They will be randomized and assigned to undergo TME followed by 8 cycles of adjuvant chemotherapy (control arm) or receive 3 cycles of consolidation chemotherapy before TME, and receive 5 cycles of adjuvant chemotherapy (experimental arm). The primary endpoints are pCR and 3-year disease-free survival (DFS), and the secondary endpoints are radiotherapy-related complications, R0 resection rate, tumor response rate, surgery-related morbidity, and peripheral neuropathy at 3 year after the surgery. The authors hypothesize that the experimental arm would show a 15% improvement in pCR (15 to 30%) and in 3-year DFS (65 to 80%), compared with the control arm. The accrual period is 2 years and the follow-up period is 3 years. Based on the superiority design, one-sided log-rank test with α-error of 0.025 and a power of 80% was conducted. Allowing for a drop-out rate of 10%, 358 patients (179 per arm) will need to be recruited. Patients will be followed up at every 3 months for 2 years and then every 6 months for 3 years after the last patient has been randomized. Discussion KONCLUDE trial aims to investigate whether consolidation chemotherapy shows better pCR and 3-year DFS than adjuvant chemotherapy alone for the patients who received neoadjuvant CRT for locally advanced rectal cancer. This trial is expected to provide evidence to support clear treatment guidelines for patients with locally advanced rectal cancer. Trial registration Clinicaltrials.gov NCT02843191 (First posted on July 25, 2016).
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Affiliation(s)
- Chang Woo Kim
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, South Korea.,Department of Medicine, the Graduate School of Yonsei University, 50-1 Yonsei-ro, Seoul, South Korea
| | - Byung Mo Kang
- Department of Surgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, South Korea
| | - Ik Yong Kim
- Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, South Korea
| | - Ji Yeon Kim
- Department of Surgery, Chungnam National University Hospital, Chungnam National University College of Medicine, 282 Munhwa-ro, Daejeon, South Korea
| | - Sun Jin Park
- Department of Surgery, Kyung Hee Medical Center, Kyung Hee University School of Medicine, 23 Kyung Hee dae-ro, Seoul, South Korea
| | - Won Cheol Park
- Department of Surgery, Wonkwang University Hospital, Wonkwang University School of Medicine, 895 Muwang-ro, Iksan, South Korea
| | - Ki Beom Bae
- Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busan, South Korea
| | - Byung-Noe Bae
- Department of Surgery, Inje University Sanggye Paik Hospital, Inje University College of Medicine, 1342 Dongil-ro, Seoul, South Korea
| | - Seong Kyu Baek
- Department of Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, 56 Dalseong-ro, Daegu, South Korea
| | - Seung Hyuk Baik
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Seoul, South Korea
| | - Gyung Mo Son
- Department of Surgery, Pusan National University Yangsan Hospital, Pusan University College of Medicine, 20 Geumo-ro, Yangsan-si, South Korea
| | - Yoon Suk Lee
- Department of Surgery, Seoul St. Mary's Hospital, The Catholic University College of Medicine, 222 Banpodae-ro, Seoul, South Korea
| | - Suk-Hwan Lee
- Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, 892 Dongnam-ro, Gangdong-gu, Seoul, 05278, South Korea.
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Kuo SH, Lo C, Chen YH, Lien HC, Kuo WH, Wang MY, Lee YH, Huang CS. Prognostic Significance of Clinicopathologic Features in Patients With Breast Ductal Carcinoma-in-Situ Who Received Breast-Conserving Surgery. Clin Breast Cancer 2018; 18:441-450.e2. [PMID: 29709458 DOI: 10.1016/j.clbc.2018.04.002] [Citation(s) in RCA: 5] [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: 08/01/2017] [Revised: 03/23/2018] [Accepted: 04/02/2018] [Indexed: 11/22/2022]
Abstract
PURPOSE To identify whether a certain group of breast ductal carcinoma-in-situ (DCIS) patients can be treated with breast-conserving surgery (BCS) alone; to analyze the clinicopathologic features of DCIS and tamoxifen administration in patients treated with BCS who developed ipsilateral breast tumor recurrence (IBTR). PATIENTS AND METHODS Data for 375 women with breast DCIS who underwent BCS at our institute between June 2003 and October 2010 were analyzed. The patients were divided into different categories according to the recurrence risk predicted using the California/Van Nuys Prognostic Index (USC/VNPI) score (4-6, 7-9, and 10-12), Eastern Cooperative Oncology Group (ECOG) E5194 criteria, or combined risk features with USC/VNPI score and ECOG E5194 criteria. The IBTR and disease-free survival (DFS) rates were calculated by the Kaplan-Meier method. The prognostic effects of age, tumor size, tumor grade, margin width, estrogen receptor status, USC/VNPI score, low-risk characteristics, and tamoxifen use were evaluated by log-rank tests. RESULTS Of the patients, 168 were treated with breast irradiation after BCS and 207 were not. The patients who were treated with radiotherapy (RT) tended to be younger (< 40 years), to have higher USC/VNPI scores (7-9), and to meet the ECOG E5194 non-cohort 1 criteria. The 7-year risk of IBTR was 6.2% (n = 11) in the patients who received irradiation and 9.0% (n = 22) in those who did not. DFS rates were better in the patients who underwent RT than in those who did not (93.3% vs. 88.5%, P = .056). Among the patients who underwent BCS alone, age ≥ 40 years, margin width > 10 mm, USC/VNPI scores 4-6, ECOG E5194 cohort 1 criteria, estrogen receptor-positive status, and tamoxifen use predicted lower IBTR and better DFS rates. In the multivariate analysis, combined low-risk characteristics (USC/VNPI scores 4-6 and meeting the ECOG E5194 cohort 1 criteria) were identified as an independent prognostic factor of lower IBTR (P = .028) and better DFS (P = .005). CONCLUSION RT reduces the risk of IBTR after BCS for DCIS of the breast. Patients with combined low-risk characteristics (USC/VNPI scores 4-6 and meeting the ECOG E5194 cohort 1 criteria) may be adequately treated with BCS alone.
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Ibrahim S, Li G, Hu F, Hou Z, Chen Q, Li G, Luo X, Hu J, Feng Y. PIK3R3 promotes chemotherapeutic sensitivity of colorectal cancer through PIK3R3/NF-kB/TP pathway. Cancer Biol Ther 2018; 19:222-229. [PMID: 29370570 DOI: 10.1080/15384047.2017.1416936] [Citation(s) in RCA: 7] [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] [Indexed: 12/19/2022] Open
Abstract
Phosphoinositide-3-kinase regulatory subunit 3(PIK3R3) is overexpressed in different types of human cancer. We previously reported the important role of PIK3R3 in colorectal cancer (CRC). However, the prognosis effect of PIK3R3 in CRC is still remaining unclear. In this study, we explored online clinical databases to analyze the prognosis differences between higher and lower expression of PIK3R3 in CRC patients. Interestingly, we found that better disease-free survival (DFS) were occurred in patients with higher expression of PIK3R3, but there is no significant difference in overall survival (OS). For further, we showed that PIK3R3 could enhance 5-FU induced apoptosis by regulating the expression of thymmidine phosphorylase (TP). In conclusion, PIK3R3 could be considered as a predictor of 5-FU sensitivity for personalized treatment, and a therapeutic target for colorectal cancer.
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Affiliation(s)
- Sidikjan Ibrahim
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Guodong Li
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Fuqing Hu
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Zhenlin Hou
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Qianzhi Chen
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Geng Li
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Xuelai Luo
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Junbo Hu
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
| | - Yongdong Feng
- a Cancer Research Institute, Tongji Hospital, Huazhong University of Science and Technology , Wuhan , China
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