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Chen Y, Guo L, Li X, Liu R, Ren C, Du S. Reduced-dose bevacizumab vs. standard-dose bevacizumab in recurrent high-grade glioma: Which one is better? A meta-analysis. Clin Neurol Neurosurg 2020; 198:106239. [PMID: 33007724 DOI: 10.1016/j.clineuro.2020.106239] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/02/2020] [Accepted: 09/12/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Based on the effective radiological responses, bevacizumab (BEV) has been widely used in the treatment of recurrent high-grade glioma. Although the current standard dose is 5 mg/kg/week, the optimal dosage of BEV is controversial, as few dose-response studies have been performed in recent years. Therefore, we conducted a meta-analysis to explore the value of reduced-dose bevacizumab versus standard-dose bevacizumab in recurrent high-grade glioma treatment. METHODS Three major electronic databases (PubMed, EMBASE and the Cochrane Library) were searched for eligible documents published before February 2020. Literature on low-dose bevacizumab versus conventional dose in progressive high-grade glioma was included, and the endpoints of eligible researches should be progression-free survival (PFS) and overall survival (OS). All available data were collected and then analyzed with Stata software. RESULTS Four cohort studies were evaluated, including 552 patients (reduced-dose BEV group: 257, standard-dose BEV group: 295). Low dose BEV seems to slightly improve survival compared to conventional dose as HR < 1 indicates a protective effect, but no significant differences in OS (HR 0.77; 95 % CI 0.53-1.10; P = 0.151) and PFS (HR 0.66; 95 % CI 0.37-1.20; P = 0.175) were found between the two groups in this study. CONCLUSION Reduced-dose bevacizumab schedule resulted in similar OS and PFS to standard-dose bevacizumab in recurrent high-grade glioma, with less side effects and less cost of treatment. Therefore, low-dose bevacizumab represents a promising therapeutic option for recurrent high-grade glioma patients. Further prospective randomized trials are needed to confirm our results.
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Affiliation(s)
- Yulei Chen
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Longbin Guo
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xuanzi Li
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Rongping Liu
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Chen Ren
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Shasha Du
- Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
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Casey RT, Valk GD, Schalin-Jäntti C, Grossman AB, Thakker RV. ENDOCRINOLOGY IN THE TIME OF COVID-19: Clinical management of neuroendocrine neoplasms (NENs). Eur J Endocrinol 2020; 183:G79-G88. [PMID: 32554825 PMCID: PMC7938008 DOI: 10.1530/eje-20-0424] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
In viral pandemics, most specifically Covid-19, many patients with neuroendocrine neoplasms (NENs), including phaeochromocytomas, paragangliomas and medullary thyroid carcinoma, may develop Covid-19 in a mild or severe form, or be concerned about the influence of viral infection relative to their anti-tumoral therapy. In general, newly presenting patients should be assessed, and patients recently receiving chemotherapy, targeted therapy or radionuclide therapy, or showing tumour growth, should be closely followed. For previously diagnosed patients, who have indolent disease, some delay in routine follow-up or treatment may not be problematic. However, patients developing acute secretory syndromes due to functional neuroendocrine neoplasms (such as of the pancreas, intestine or lung), phaeochromocytomas and paragangliomas, will require prompt treatment. Patients with life-threatening Covid-19-related symptoms should be urgently treated and long-term anti-tumoral treatments may be temporarily delayed. In patients with especially aggressive NENs, a careful judgement should be made regarding the severity of any Covid-19 illness, tumour grade, and the immunosuppressant effects of any planned chemotherapy, immunotherapy (e.g. interferon-alpha), targeted therapy or related treatment. In other cases, especially patients with completely resected NENs, or who are under surveillance for a genetic disorder, a telephone or delayed consultation may be in order, balancing the risk of a delay against that of the possible development of Covid-19.
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Affiliation(s)
- Ruth T Casey
- Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospital NHS Foundation Trust, Cambridge, UK
- Department of Medical Genetics, Cambridge University, Cambridge, UK
| | - Gerlof D Valk
- Department of Endocrine Oncology, University Medical Centre Utrecht, ENETS Centre of Excellence, Utrecht, Netherlands
| | - Camilla Schalin-Jäntti
- Division of Endocrinology, Abdominal Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Ashley B Grossman
- Royal Free Hospital ENETs Centre of Excellence, London, UK
- Centre for Endocrinology, Barts and the London School of Medicine, London, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
- Correspondence should be addressed to R V Thakker;
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Sehn JK. Prostate Cancer Pathology: Recent Updates and Controversies. Mo Med 2018; 115:151-155. [PMID: 30228708 PMCID: PMC6139855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Prostate cancer is common, and recent efforts in clinical management have focused on identifying patients who could be candidates from less aggressive management or who could benefit from more aggressive therapy. As prostate cancer histology, especially Gleason score, plays a critical role in predicting patient outcomes, attempts have been made to refine histologic classification and reporting in prostate cancer to facilitate patient risk stratification. This review discusses recent updates in prostate cancer grading and reporting.
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Affiliation(s)
- Jennifer K Sehn
- Jennifer K. Sehn, MD, is Assistant Professor, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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Rindi G, Klersy C, Albarello L, Baudin E, Bianchi A, Buchler MW, Caplin M, Couvelard A, Cros J, de Herder WW, Delle Fave G, Doglioni C, Federspiel B, Fischer L, Fusai G, Gavazzi F, Hansen CP, Inzani F, Jann H, Komminoth P, Knigge UP, Landoni L, La Rosa S, Lawlor RT, Luong TV, Marinoni I, Panzuto F, Pape UF, Partelli S, Perren A, Rinzivillo M, Rubini C, Ruszniewski P, Scarpa A, Schmitt A, Schinzari G, Scoazec JY, Sessa F, Solcia E, Spaggiari P, Toumpanakis C, Vanoli A, Wiedenmann B, Zamboni G, Zandee WT, Zerbi A, Falconi M. Competitive Testing of the WHO 2010 versus the WHO 2017 Grading of Pancreatic Neuroendocrine Neoplasms: Data from a Large International Cohort Study. Neuroendocrinology 2018; 107:375-386. [PMID: 30300897 DOI: 10.1159/000494355] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 10/03/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the American Joint Cancer Committee (AJCC) modified the grading of pancreatic neuroendocrine neoplasms from a three-tier (WHO-AJCC 2010) to a four-tier system by introducing the novel category of NET G3 (WHO-AJCC 2017). OBJECTIVES This study aims at validating the WHO-AJCC 2017 and identifying the most effective grading system. METHOD A total of 2,102 patients were enrolled; entry criteria were: (i) patient underwent surgery; (ii) at least 2 years of follow-up; (iii) observation time up to 2015. Data from 34 variables were collected; grading was assessed and compared for efficacy by statistical means including Kaplan-Meier method, Cox regression analysis, Harrell's C statistics, and Royston's explained variation in univariable and multivariable analyses. RESULTS In descriptive analysis, the two grading systems demonstrated statistically significant differences for the major category sex but not for age groups. In Cox regression analysis, both grading systems showed statistically significant differences between grades for OS and EFS; however, no statistically significant difference was observed between the two G3 classes of WHO-AJCC 2017. In multivariable analysis for the two models fitted to compare efficacy, the two grading systems performed equally well with substantially similar optimal discrimination and well-explained variation for both OS and EFS. The WHO-AJCC 2017 grading system retained statistically significant difference between the two G3 classes for OS but not for EFS. CONCLUSIONS The WHO-AJCC 2017 grading system is at least equally performing as the WHO-AJCC 2010 but allows the successful identification of the most aggressive PanNET subgroup. Grading is confirmed as probably the most powerful tool for predicting patient survival.
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Affiliation(s)
- Guido Rindi
- Institute of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Roma ENETS Center of Excellence, Rome,
| | - Catherine Klersy
- Service of Biometry and Clinical Epidemiology, Research Department, and IRCCS Fondazione Policlinico San Matteo, Pavia, Italy
| | - Luca Albarello
- Pathology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Eric Baudin
- Department of Oncology, Cancer Campus, Villejuif, France
| | - Antonio Bianchi
- Department of Endocrinology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Roma ENETS Center of Excellence, Rome, Italy
| | - Markus W Buchler
- Department of Surgery, University Hospital Heidelberg, Neu Heidelberg, Germany
| | - Martyn Caplin
- Neuroendocrine Tumour Unit, Centre for Gastroenterology, London, United Kingdom
| | - Anne Couvelard
- Department of Pathology, Hopital Beaujon, Paris ENETS Center of Excellence, Clichy, France
| | - Jérôme Cros
- Department of Pathology, Hopital Beaujon, Paris ENETS Center of Excellence, Clichy, France
| | - Wouter W de Herder
- Section Endocrinology, Department of Internal Medicine, Erasmus University Medical Center and and Erasmus MC Cancer Institute Rotterdam, Rotterdam ENETS Center of Excellence, Rotterdam, The Netherlands
| | - Gianfranco Delle Fave
- Digestive and Liver Disease Unit, Sant'Andrea University Hospital, Roma ENETS Center of Excellence, Rome, Italy
| | | | - Birgitte Federspiel
- Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen ENETS Center of Excellence, Copenhagen, Denmark
| | - Lars Fischer
- Department of Surgery, University Hospital Heidelberg, Neu Heidelberg, Germany
| | - Giuseppe Fusai
- Department of Surgery, University College, Royal Free Hospital, London ENETS Center of Excellence, London, United Kingdom
| | - Francesca Gavazzi
- Pancreatic Surgery, Humanitas Clinical and Research Center, Humanitas Milan ENETS Center of Excellence, Milan, Italy
| | - Carsten P Hansen
- Department of Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen ENETS Center of Excellence, Copenhagen, Denmark
| | - Frediano Inzani
- Institute of Pathology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Roma ENETS Center of Excellence, Rome, Italy
| | - Henning Jann
- Department of Hepatology and Gastroenterology, Charité, Campus Virchow Klinikum and Charite Mitte, University Medicine Berlin, Berlin ENETS Center of Excellence, Berlin, Germany
| | - Paul Komminoth
- Institute of Pathology, Stadtspital Triemli, Zurich, Switzerland
| | - Ulrich P Knigge
- Department of Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen ENETS Center of Excellence, Copenhagen, Denmark
| | - Luca Landoni
- Department of Surgery and Oncology, General and Pancreatic Surgery, The Pancreas Institute, Verona ENETS Center of Excellence, Verona, Italy
| | - Stefano La Rosa
- Department of Pathology, Ospedale di Circolo, Università dell'Insubria, Varese, Italy
| | - Rita T Lawlor
- Section of Pathology and ARC-Net Research Centre, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona ENETS Center of Excellence, Verona, Italy
| | - Tu V Luong
- Department of Pathology, University College, Royal Free Hospital, London ENETS Center of Excellence, London, United Kingdom
| | - Ilaria Marinoni
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - F Panzuto
- Digestive and Liver Disease Unit, Sant'Andrea University Hospital, Roma ENETS Center of Excellence, Rome, Italy
| | - Ulrich-Frank Pape
- Department of Hepatology and Gastroenterology, Charité, Campus Virchow Klinikum and Charite Mitte, University Medicine Berlin, Berlin ENETS Center of Excellence, Berlin, Germany
| | - Stefano Partelli
- Pancreatic Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Aurel Perren
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Maria Rinzivillo
- Digestive and Liver Disease Unit, Sant'Andrea University Hospital, Roma ENETS Center of Excellence, Rome, Italy
| | - Corrado Rubini
- Department of Pathology, Marche Polytechnic University, Ancona, Italy
| | - Philippe Ruszniewski
- Department of Gastroenterology and Pancreatology, Hopital Beaujon, Paris ENETS Center of Excellence, Clichy, France
| | - Aldo Scarpa
- Section of Pathology and ARC-Net Research Centre, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona ENETS Center of Excellence, Verona, Italy
| | - Anja Schmitt
- Institute of Pathology, University of Bern, Bern, Switzerland
| | - Giovanni Schinzari
- Department of Medical Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma-Università Cattolica del Sacro Cuore, Roma ENETS Center of Excellence, Rome, Italy
| | - Jean-Yves Scoazec
- Department of Medical Biology and Pathology, Cancer Campus, Villejuif, France
| | - Fausto Sessa
- Department of Pathology, Ospedale di Circolo, Università dell'Insubria, Varese, Italy
| | - Enrico Solcia
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Paola Spaggiari
- Pathology Department, Humanitas Clinical and Research Center, Humanitas Milan ENETS Center of Excellence, Milan, Italy
| | | | | | - Bertram Wiedenmann
- Department of Hepatology and Gastroenterology, Charité, Campus Virchow Klinikum and Charite Mitte, University Medicine Berlin, Berlin ENETS Center of Excellence, Berlin, Germany
| | - Giuseppe Zamboni
- Department of Pathology, Sacro Cuore-Don Calabria Hospital, Negrar, Italy
| | - Wouter T Zandee
- Section Endocrinology, Department of Internal Medicine, Erasmus University Medical Center and and Erasmus MC Cancer Institute Rotterdam, Rotterdam ENETS Center of Excellence, Rotterdam, The Netherlands
| | - Alessandro Zerbi
- Pancreatic Surgery, Humanitas Clinical and Research Center, Humanitas Milan ENETS Center of Excellence, Milan, Italy
| | - Massimo Falconi
- Pancreatic Surgery Unit, San Raffaele Scientific Institute, Milan, Italy
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Kane CJ, Eggener SE, Shindel AW, Andriole GL. Variability in Outcomes for Patients with Intermediate-risk Prostate Cancer (Gleason Score 7, International Society of Urological Pathology Gleason Group 2-3) and Implications for Risk Stratification: A Systematic Review. Eur Urol Focus 2017; 3:487-497. [PMID: 28753804 DOI: 10.1016/j.euf.2016.10.010] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/03/2016] [Accepted: 10/18/2016] [Indexed: 12/22/2022]
Abstract
CONTEXT Optimal management for patients with intermediate-risk (IR) prostate cancer (PCa) remains controversial. Clinical metrics provide guidance on appropriate management options. OBJECTIVE To report estimates for clinically relevant outcomes in men with IR PCa based on clinical and pathological features. EVIDENCE ACQUISITION PubMed and programs from key 2015 uro-oncology congresses were searched using the terms "intermediate", "Gleason 3 + 4", "Gleason 4 + 3", "active surveillance", "treatment", "adverse pathology", AND "prostate cancer." Articles meeting prespecified criteria were retrieved. Bibliographies were scanned for additional relevant references. EVIDENCE SYNTHESIS Men with IR PCa have a wide range of predicted clinically relevant outcomes. Within the IR category, estimate ranges for adverse surgical pathology and 5-yr disease progression are 15-64% and 21-91%, respectively. Clinical parameters and predictive nomograms refine these estimates, but do not uniformly differentiate favorable and unfavorable IR PCa. Variations in study design and data quality in source manuscripts mandate caution in interpreting results. CONCLUSIONS Outcomes in IR PCa are heterogeneous. Refinements in personalized risk assessment are needed to better select IR PCa patients for surveillance. PATIENT SUMMARY Current and future risk stratification tools may provide additional information to identify men with intermediate-risk prostate cancer who may consider active surveillance.
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Affiliation(s)
- Christopher J Kane
- Department of Urology, University of California San Diego Health System, San Diego, CA, USA.
| | - Scott E Eggener
- Department of Urology, University of Chicago, Chicago, IL, USA
| | | | - Gerald L Andriole
- Division of Urologic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA
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6
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Capogrosso P, Ventimiglia E, Moschini M, Boeri L, Farina E, Finocchio N, Gandaglia G, Fossati N, Briganti A, Montorsi F, Salonia A. Testosterone Levels Correlate With Grade Group 5 Prostate Cancer: Another Step Toward Personalized Medicine. Prostate 2017; 77:234-241. [PMID: 27775173 DOI: 10.1002/pros.23266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Accepted: 09/20/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Controversial results have shown a significant association with either low or high total testosterone (tT) levels and high risk prostate cancer (PCa). We tested the relationship between circulating tT and grade group 5 (G5) PCa at radical prostatectomy (RP) in patients with preoperative low- to intermediate-risk disease. METHODS Serum sex hormones were assessed the day before RP in a cohort of 846 patients with low- to intermediate-risk PCa. Patients were segregated using the new 5-tiered Gleason grade groups. Restricted cubic spline functions and logistic regression analyses tested the association between sex hormones and G5 PCa. Differences in potential predictive accuracy (PA) were assessed for tT and prostate-specific antigen (PSA) levels. RESULTS Overall, 27 men (3.2%) had G5 PCa at RP, and this group had higher PSA values than patients with G1-G4 PCa (P = 0.02). The groups did not differ in terms of preoperative mean hormonal values. Both low and high circulating tT values depicted a nonlinear U-shaped correlation with G5 PCa at RP. The lowest and highest (10th and 90th percentiles) tT values and biopsy PCa grade emerged as multivariable independent predictors of G5 PCa at RP (all P < 0.05). PA for G5 PCa did not differ between tT (area under the curve [AUC] 0.631) and PSA (AUC 0.636). CONCLUSIONS Circulating tT was a significant predictor of G5 PCa at RP in patients with preoperative low- to intermediate-risk disease. Preoperative tT and PSA values showed similar PA for the most aggressive disease, confirming a potential role for circulating androgens in preoperative risk assessment of PCa patients. Prostate 77:234-241, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Marco Moschini
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Elena Farina
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Nadia Finocchio
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Giorgio Gandaglia
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Nicola Fossati
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Franscesco Montorsi
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy
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7
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Wang GW, Shen DH, Zhang WY, Xu KX, Xu T, Hu H. [Trends in Gleason scores of Chinese prostate carcinoma from 1995 to 2014]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:801-805. [PMID: 27752159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To assess the changing trends in Gleason score (GS) of Chinese prostate carcinoma (PCa) from January 1995 to December 2014. METHODS In the study, 875 patients admitted to hospital from January 1995 to December 2004 (1995-2004) and from January 2005 to December 2014 (2005-2014) were divided into two groups. The mean levels and proportions of GS, primary and secondary grades were studied. The patients were divided into four groups according to age: <60, 60-69, 70-79 and ≥80 years. Types of specimen included needle biopsy (NB), transurethral resection of the prostate (TURP) and radical prostatectomy (RP). Histological types were made up by acinar carcinoma and other types (including atrophic, pseudohyperplastic, foam, signet ring cell and ductal carcinoma, and so on). The total prostate-specific antigen (tPSA) involved groups of <20.0 μg/L and ≥20.0 μg/L. We observed the mean levels and proportions of GS in age, types of specimen, histological types and total prostate-specific antigen in different periods, and used SPSS 17.0 software for statistical analysis. RESULTS Compared with 1995-2004, the mean levels of GS, primary and secondary grades decreased 0.32 (P=0.003), 0.19 (P=0.001) and 0.12 (P=0.016) in 2005-2014, respectively. The proportions of ≤6 in GS increased 10.9% (P=0.003), and ≥8 decreased 14.0% (P<0.001). The difference of GS 7 was not statistically significant. In the primary grade, the ratio of grades≤3 increased 12.8% (P=0.001), and grade 4 decreased 7.4% (P=0.037), grade 5 decreased 5.5% (P=0.007). The ratio of secondary grades ≤3 increased 7.6% (P=0.037). The difference of grades 4 and 5 was not statistically significant. CONCLUSION GS in Chinese patients with PCa showed a downward trend, which is one of the notable features in the past 20 years in China. The types of specimen and age are important factors in GS, while the histological types and tPSA have less impact on the GS.
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Affiliation(s)
- G W Wang
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - D H Shen
- Department of Pathology, Peking University People's Hospital, Beijing 100044, China
| | - W Y Zhang
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - K X Xu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - T Xu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
| | - H Hu
- Department of Urology, Peking University People's Hospital, Beijing 100044, China
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8
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Lococo F, Cafarotti S, Cesario A, Dall'Armi V, Cusumano G, Lauriola L, Frederic M, Evoli A, Margaritora S, Granone P. Prognostic grading after complete resection for thymic malignancies. Eur Rev Med Pharmacol Sci 2015; 19:2882-2891. [PMID: 26241544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Despite the World Health Organization (WHO) and Masaoka classifications have been widely accepted as the main describers of prognosis determinants in thymic malignancies, so far, these have been considered independently from one another. We have reviewed our single-centre 40-year results after surgical treatment of thymic malignancies evaluating the inter-relationships between the clinical, surgical and pathological variables and investigating their prognostic impact in completely resected patients. PATIENTS AND METHODS A surgical series of 347 patients was reviewed and, of these, 305 with complete resection enrolled. Long-term and disease-free survival (LTS, DFS) analyses were performed. Kaplan-Meir curves for WHO histotypes and Masaoka-stages were inspected and matched with the log-rank test; the Cox regression analysis was adopted in a multivariable approach. RESULTS Considered independently, the WHO-histotypes did not differentiate clearly from one to another in terms of LTS and DFS; however, types A-AB-B1-B2 and B3-C clustered in 2, statistically different, malignancy groups (LTS, DFS: Cox-p < 0.001). Masaoka staging was confirmed to be a relevant prognostic determinant, even if no evident difference between stages I vs II and stages III vs IV emerged when the Masaoka-classification was factored in. Thus, when investigating 13 surgical and pathological factors of invasiveness, these showed a clustering in 2 groups according to the presence/absence of pathological proven infiltration in the peri-thymic structures (LTS, DFS: Cox-p < 0.001). By matching the WHO-malignancy clusters and infiltration clusters, 4 classes may be identified, which proved to have a distinct prognostic significance: (LTS-Cox: stage-I vs stage-II, p = 0.003; III: p < 0.001, IV: p < 0.001; DFS-Cox: stage-I vs stage-II, p < 0.001; III: p < 0.001; IV: p < 0.001). CONCLUSIONS When analyzing the long-term outcome of patients underwent complete resection for thymic malignancies, the combination between pathological and surgical variables showed accurate prognosis predictability.
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Affiliation(s)
- F Lococo
- Unit of Thoracic Surgery, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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9
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Nixon IJ, Ganly I, Patel SG, Palmer FL, Whitcher MM, Ghossein R, Michael Tuttle R, Shaha AR, Shah JP. Changing trends in well differentiated thyroid carcinoma over eight decades. Int J Surg 2012; 10:618-23. [PMID: 23128246 DOI: 10.1016/j.ijsu.2012.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 10/21/2012] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The incidence of well differentiated thyroid cancer (WDTC) is rising in the USA. The objective of this study is to present the changes in incidence, presentation, management and outcomes of WDTC within our institution over the past 8 decades. METHODS 2797 patients managed between 1932 and 2005 at Memorial Sloan Kettering Cancer Center were identified from our institutional database. RESULTS There has been an increase in the number of patients managed per decade. Although the median age was 45 years, patients managed post-1985 were more likely to be over 45 years (53% versus 44%, p < 0.001). The percentage of women increased from 68% to 72% (p = 0.026), and the percentage of papillary carcinomas also increased, from 78% to 92%, p < 0.001. An increase in early stage tumors was observed with pT1 lesions increasing from 19% to 48%. Patients in the latter cohort were less likely to have thyroid lobectomy (29% versus 72%, p < 0.001). There was a significant change in the use of RRA, with 8% of the early versus 44% of the latter group receiving post-operative RRA (p < 0.001). Since the introduction of risk group stratification disease specific survival (DSS) has not changed significantly. With a median follow up of 90 months, 10 year DSS rates were below 90% in the cohort managed prior to the 1970s, which rose to >95% thereafter (p < 0.001). CONCLUSIONS Older patients with earlier stage disease present an increasing workload for surgical oncologists. Excellent outcomes remain unchanged despite increasingly aggressive surgical and medical management.
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Affiliation(s)
- Iain J Nixon
- Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY 10021, USA.
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Taranenko AV, Batoroev IK, Leliavin KB. [Comparative assessment of the grading system for prostate cancer in a historical perspective]. Vopr Onkol 2012; 58:582-585. [PMID: 23607221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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