Abstract Background Nutritional status and body composition parameters such as sarcopenia are important risk factors for impaired outcome in patients with esophageal cancer. This study was conducted ...to evaluate the effect of sarcopenia on long-term outcome after esophageal resection following neoadjuvant treatment. Methods Skeletal muscle index (SMI) and body composition parameters were measured in patients receiving neoadjuvant treatment for locally advanced esophageal cancer. Endpoints included relapse-free survival (RFS) and overall survival (OS). Results The study included 130 patients. Sarcopenia was found in 80 patients (61.5%). Patients with squamous-cell cancer (SCC) showed a decreased median SMI of 48 (range 28.4–60.8) cm/m2 compared with that of patients with adenocarcinoma (AC) of 52 (range 34.4–74.2) cm/m2 , P < 0.001. The presence of sarcopenia had a significant impact on patient outcome: HR 1.69 (1.04–2.75), P = 0.036. Median OS was 20.5 (7.36–33.64) versus 52.1 (13.55–90.65) months in sarcopenic and non-sarcopenic patients, respectively. Sarcopenia was identified as an independent risk factor: HR 1.72 (1.049–2.83), P = 0.032. Conclusion Our data provide evidence that sarcopenia impacts long-term outcome after esophageal resection in patients who have undergone neoadjuvant therapy. Assessment of the body composition parameter can be a reasonable part of patient selection and may influence treatment methods.
Background Fluorouracil and cisplatin have been used most frequently as neoadjuvant therapy for esophageal cancer. Both drugs are believed to act via a p53-dependent apoptosis pathway. The TP53 gene ...is frequently mutated in esophageal cancer. Objective To test the value of TP53 as a biomarker prognosing outcome in patients with neoadjuvantly treated esophageal cancer. Patients and Methods The investigation included 36 patients with primary operable esophageal cancer who were treated neoadjuvantly with cisplatin and fluorouracil. The TP53 genotype was assessed from paraffin-embedded diagnostic tumor biopsies using a standardized gene-specific TP53 sequencing protocol (mark53 kit; mark53 Ltd, Vienna, Austria). Results Mutations in the TP53 gene were present in 50% of tumors. Two-year overall survival rates were 55.6% in patients with a normal TP53 marker status, compared with 16.7% in those with a mutant TP53 gene. In patients with normal TP53 , neoadjuvant treatment resulted in significant advantages in terms of tumor-associated survival ( P = .0049) and overall survival ( P = .0304) compared with those with mutant TP53 . The median tumor-associated survival was 34.2 months for patients with normal TP53 , compared with 8.9 months for those with mutant TP53 . The latter had a 3-fold higher risk of dying (hazard ratio, 3.01; 95% confidence interval, 1.359-6.86). Conclusions The biomarker TP53 divides esophageal cancer patients into 2 categories with markedly different outcomes: patients with a normal TP53 marker status may experience notable benefits from neoadjuvant chemotherapy with cisplatin/fluorouracil, whereas those with a mutant TP53 marker status appear to be at risk for lack of response.
MR imaging of benign focal liver lesions Ba-Ssalamah, Ahmed; Baroud, Susanne; Bastati, Nina ...
Magnetic resonance imaging clinics of North America,
08/2010, Letnik:
18, Številka:
3
Journal Article
Recenzirano
MRI has become the most important imaging modality for detecting and characterizing focal liver lesions. The introduction of high-field-strengths, such as 3 Tesla MR imaging, in combination with the ...parallel imaging technique, has led to significant improvements in spatial and temporal resolution and has established this technique as a valuable asset in daily clinical practice. New techniques, such as diffusion-weighted imaging, may improve MR imaging sensitivity and specificity in the diagnostic workup of focal liver lesions. The tailored administration of various nonspecific and liver-specific contrast agents enables clinicians to increase the detection rate and improve the characterization of the different focal liver lesions. This article describes the usefulness of these imaging techniques in detecting and characterizing the most common benign focal liver lesions.
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