Background
The development of brain metastases (BMs) was associated with poor prognosis in melanoma patients. Patients with BMs have a median survival of <6 months. Melanoma is the third most common ...tumor to metastasize to the brain with a reported incidence of 10–40 %. Our aim was to identify factors predicting development of BMs and survival.
Patients and methods
We performed a retrospective analysis of 470 melanoma patients between 2000 and 2012. The logistic regression analyses were used to identify the clinicopathological features of primary melanoma that are predictive of BMs development and survival after a diagnosis of brain metastases.
Results
There were 52 patients (11.1 %) who developed melanoma BMs during the study period. The analysis of post-BMs with Kaplan–Meier curves has resulted in a median survival rate of 4.1 months (range 2.9–5.1 months). On logistic regression analysis site of the primary tumor on the head and neck (
p
= 0.002), primary tumor thickness (Breslow >4 mm) (
p
= 0.008), ulceration (
p
= 0.007), and pathologically N2 and N3 diseases (
p
= 0.001) were found to be significantly associated with the development of BMs. In univariate analysis, tumor thickness and performance status had a significant influence on post-BMs survival. In multivariate analysis, these clinicopathologic factors were not remained as significant predictive factors.
Conclusions
Our results revealed the importance of primary tumor characteristics associated with the development of BMs. Ulceration, primary tumor thickness, anatomic site, and pathologic ≥N2 disease were found to be significant predictors of BMs development.
Background: Pazopanib (PZP) may induce prolonged cardiac repolarization and proarrhythmic effects, similarly to other tyrosine kinase inhibitors. Objectives: To demonstrate PZP-induced prolonged ...cardiac repolarization and proarrhythmic electrophysiological effects and to investigate possible preventive effects of metoprolol and diltiazem on ECG changes (prolonged QT) in an experimental rat model. Methods: Twenty-four Sprague-Dawley adult male rats were randomly assigned to 4 groups (n = 6). The first group (normal group) received 4 mL of tap water and the other groups received 100 mg/kg of PZP (Votrient® tablet) perorally, via orogastric tubes. After 3 hours, the following solutions were intraperitoneally administered to the animals: physiological saline solution (SP), to the normal group and to the second group (control-PZP+SP group); 1 mg/kg metoprolol (Beloc, Ampule, AstraZeneca), to the third group (PZP+metoprolol group); and 1mg/kg diltiazem (Diltiazem, Mustafa Nevzat), to the fourth group (PZP+diltiazem group). One hour after, and under anesthesia, QTc was calculated by recording ECG on lead I. Results: The mean QTc interval values were as follows: normal group, 99.93 ± 3.62 ms; control-PZP+SP group, 131.23 ± 12.21 ms; PZP+metoprolol group, 89.36 ± 3.61 ms; and PZP+diltiazem group, 88.86 ± 4.04 ms. Both PZP+metoprolol and PZP+diltiazem groups had significantly shorter QTc intervals compared to the control-PZP+SP group (p < 0.001). Conclusion: Both metoprolol and diltiazem prevented PZP-induced QT interval prolongation. These drugs may provide a promising prophylactic strategy for the prolonged QTc interval associated with tyrosine kinase inhibitor use.
M30 ve M65 ölçümleri anti kanser ilaçların farklı tümör tiplerinde kullanımında yanıt değerlendirmede gün geçerek daha fazla kullanılmaktadır. Bu çalışmada metastatik kolorektal kanserde serum M30 ve ...M65 düzeylerinin kemoterapiye erken yanıtı değerlendirmede kullanılabilirliği ve bu belirteçlerin klinikte rutin kullanımda olan CEA ve CA19–9 tümör belirteçleri ile korelasyonun incelenmesi hedeflenmiştir. Çalışmamızda 28 metastatik kolorektal kanser hastası olup hastaların tümüne ilk sırada FOLFOX (Flouraurasil + Ca folinik Asit + okzaliplatin) ve bevasuzimab tedavisi verilmiştir. Hastalarımızda 6 kür kemoterapi sırasında her kürde 0. ve 2. Günlerde M30, M65 ELISA ile bakılması için serumlar ayrılmıştır. 24 hastada kısmı yanıt/stabil yanıt ve 4 hastada progresyon saptanmıştır. M30 değerlerinde her kürde (1,3,6) 0. Gün ile 2. Gün arasında istatiksel anlamlı artış saptanmıştır. M65 değerlerinde her üç kürde 0. Gün ile ikinci gün arasında istatiksel anlamlı artış saptanmıştır. CEA ve CA 19–9 ilerleyen kürlerde (1, 3, 6) düşmekte olduğu saptanmıştır. M30 ve M65 değerlerinin ilk kürden itibaren 0. gün ile 2. gün arasında karşılaştırıldığında anlamlı artış, M65 değerlerinde ise karşılaştırıldığında her 3 kür için 0. Ve 2. gün arasında istatiksel anlamlı artış saptanmıştır. M30 ve M65 değerlerine bakılarak metastatik kolorektal kanserde erken dönemde kemoterapi yanıtınıı öngörmemizi ve tedavi devamını daha doğru şekilde yönetmemizi sağlayabilir.
Each year, 12.7 million people learn that they have cancer and 8.2 million people die of cancer worldwide. Cancer is a major public health issue which causes fundamental changes in the lives of ...patients and their families. The purpose of this study was to evaluate the lives of patients after diagnosis and determine the changes in their lifestyles.
Between September 2013 to December 2013, a questionnaire consisting of 22 questions was administered during a face to face interview to patients at 13 different Oncology Units in Turkey. Each patient was queried during the administration of his/her chemotherapy. Eight of the questions featured independent choices, and 14 had dependent (multiple) choices.
A total of 1300 patients were included in the study. Of patients 9.5% were 71 years of age and older which was the oldest age group. The mean patient age was 54.6±13.8 years. Of the whole group of patients 58.5% were female and 41.5% male. After diagnosis, 64% of the patients reported that they were complying with guidelines for a healthy lifestyle and 80% said that they were eating healthier food. At the time they filled in the questionnaire, more than half of the patients (57.3%) felt optimistic about their disease.
Diagnosis of cancer may change the patients' dietary and reading habits, social relationships, activities and more importantly, their point of life view.
Classic Kaposi's sarcoma: A review of 156 cases Cetin, Bulent; Aktas, Bilge; Bal, Oznur ...
Dermatologica Sinica,
December 2018, 2018-12-00, 2018-12-01, Letnik:
36, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Kaposi's sarcoma (KS) is a reactive, multifocal, multicentric, angiogenic neoplastic proliferation that is thought to originate from endothelial cells that are infected with human herpesvirus-8 ...(HHV-8). This report examines a cohort of patients with classic Kaposi's sarcoma (KS) evaluated at the national institute of oncology over the 13-year period.
A retrospective analysis of 156 patients with classic KS, between January 2000 and November 2013, was performed. This study focused on the clinical presentation, staging, diagnosis, and treatment of classic KS.
One hundred fifty-six patients (median age 69 and 115 male) were enrolled into the study. Median age at diagnosis was 69 (range: 32–95 years). Male/female ratio was 2.80. The most common location was the lower limbs. There were 75 stage I patients (48.1%), 8 stage II patients (22.4%), 31 stage III patients (19.9%) and 15 stage IV patients (9.6%). Surgery was the most common local treatment method (43%). 44 patients (28.2%) received radiotherapy (RT) at diagnosis. Cytotoxic treatment with chemotherapy or interferon-α was administered in 57 patients. Visceral involvement was observed in 10 patients (lung: nine patients, liver: one patient) and bone metastasis occurred in two patients at relapse.
This study is one of the largest reported series. Further studies are required and it will be important to standardize the assessment of disease activity and clinical response.
Purpose
In this study, we investigated the effect of lapatinib plus capecitabine treatment in HER2-positive breast cancer patients with brain metastasis.
Methods
Of 405 metastatic breast cancer ...patients with brain metastases at referral centers in Turkey, 46 were treated with lapatinib plus capecitabine only after the development of brain metastasis. Patients who only received trastuzumab-based therapy after the development of brain metastases were accepted as the historic control group for survival analyses (
n
= 65). Patients who received both drugs consecutively or sequentially were excluded from the analyses (
n
= 34).
Results
Median age among 46 patients who received lapatinib plus capecitabine therapy was 45 years (27–76), and median time for development of brain metastases was 11.9 months (0–69 months). Twenty-six out of 38 patients who received lapatinib plus capecitabine and had extracranial metastasis showed partial response or stable diseases (68.4 %). Grade 3-4 toxicity was observed in eight patients (17.3 %). Median overall survival (OS) in patients treated with lapatinib plus capecitabine was significantly increased compared to that in patients treated with trastuzumab-based therapy (19.1 vs. 12 months, respectively,
p
= 0.039). The incidence of cerebral death was slightly decreased in patients who received lapatinib plus capecitabine compared to those who received trastuzumab-based therapy (32 vs. 43.4 %,
p
= 0.332). In the multivariate analysis, lapatinib plus capecitabine therapy remained an independent positive predictor for survival odds ratio (OR), 0.57;
p
= 0.02.
Discussion
Although this retrospective multicenter study had several limitations, the results suggest that undergoing lapatinib plus capecitabine therapy after the diagnosis of brain metastasis may further improve survival compared to undergoing only trastuzumab-based therapy.
This study aimed to assess the diagnostic performance of 18F-FDG PET/CT for detecting recurrence in gastric cancer patients with radiologic or clinical suspicion of recurrence and its clinical impact ...on making decision. The authors evaluated the diagnostic accuracy of PET/CT for detecting the recurrence in terms of whether or not histology had been SRC/musinous adenocarcinoma. Of all 130 patients, 91 patients were confirmed to have true recurrence. The sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of PET/CT for diagnosing true recurrence on a per-person basis were 91.2%, 61.5%, 84.6%, 75.0% and 82.3%, respectively. Final diagnoses were confirmed histopathologically in 59 of 130 patients and by clinical and radiological follow-up in the remaining 71 patients. In the subgroup with SRC/mucinous adenocarcinoma differentiation of the primary tumor, there was no statistically significant difference in terms of diagnostic accuracy of PET/CT on a per-person basis.
Purpose. To determine the values of prognostic nutritional and inflammatory markers in chemotherapy outcomes and survival in the patients with advanced nonsmall cell lung cancer (NSCLC) and also in ...the secondary malnutrition and cachexia. Methods. Twenty-five patients with diagnosis of aNSCLC were registered for the prospective study. Malnutrition was determined by the Subjective Global Assessment (SGA) and performance status by criteria of the Eastern Cooperative Oncology Group (ECOG). Before treatment, serum levels of albumin, prealbumin, vitamin D, zinc (Zn), C-reactive protein (CRP), IL-6, IL-1 β, TNF-α, lipoprotein lipase (LPL), and the Glasgow Prognostic Score (GPS) were recorded. Patients were followed prospectively for treatment outcomes and survival. Results. Due to the deaths of 18 patients during the 4-month follow-up period, no adequate measurements of inflammatory and nutritional markers could be performed. However, seven patients completed the treatment period and evaluations of these markers could be performed during the three periods. Eighty-four percent of patients were male with a mean age of 63.3 ± 8.7 years. Evaluation of the malnutrition by SGA showed that 5 (20%) patients were well nourished (A), 12(48%) were moderately malnourished (B), and 8(32%) were severely malnourished (C). Low levels of serum albumin (<3.5g/dl), prealbumin (<20 mg/ml), 25-hydroxycholecalciferol (<30 ng/ml), and Zn (<70mg/ml) were detected in 15(60%), 17(68%), 24 (96%), and 22 (88%) patients, respectively. Elevated levels of CRP (≥10 mg/L), IL6 (≥18pg/ml), TNF-α (≥24pg/ml), IL-1β (≥10pg/ml), and LPL (<12pg/ml) were found in 24 (96%), 11(44%), 9(36), 13(52%), and 11(44%) patients, respectively. Moderate and severe malnutrition, acute phase response, and reduced survival were determined in patients with NCSLC. In 7 patients that completed the treatment period, there was an association between elevated serum levels of IL-6, IL-1β, TNF-α, CRP, and LPL and also the reduced serum levels of albumin, prealbumin, Zn, vitamin D, and GPS, respectively. Similarly, Friedman analysis indicated that prealbumin significantly increased (p=0.007) in the follow-up period. But the serum levels of CRP (mean 37.3±22.3; Wilcoxon test P=0.368) in the seven patients were lower than those of the 18 patients that expired (mean 75.82±56.2). Conclusion. Malnutrition and cachexia negatively influence oncological outcomes in patients with NSCLC. These nutritional/inflammatory markers may be useful for selection of high risk and reduced survival in patients with aNSCLC undergoing adjuvant chemotherapy.
This study aimed to identify the risk factors related in recurrence with isolated intra-abdominal lymph node metastasis in patients with colorectal cancer.
This is a retrospective, cross-sectional ...study of 21 colorectal cancer patients with isolated intra-abdominal lymph node metastases. Preoperative demographic and laboratory/postoperative histological features of these patients were been analyzed.
Lymphovascular and perineural invasion and mutant-type K-ras status were more common in the study patients. In addition, a significant correlation was been detected between lymphovascular and perineural invasion, preoperative serum CEA level, preoperative thrombocyte count, mutant-type K-ras status, and pathological N3 disease. Mutant-type K-ras status and the presence of lymphovascular invasion were independent prognostic risk factors for isolated intra-abdominal lymph node metastasis.
The presence of lymphovascular invasion and mutant-type K-ras status may be poor prognostic risk factors for isolated intra-abdominal lymph node metastasis in patients with colorectal cancer. However, studies involving larger patient series, molecular indicators, and cohorts with metastasis in other areas are been needed to verify this study.
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