We aimed to investigate whether Computed Tomography (CT) attenuation change is predictive of poor pathological response in patients with gastric cancer (GC) and gastroesophageal junction (GEJ) ...adenocarcinoma who received perioperative fluorouracil (FU), leucovorin (LV), oxaliplatin, and docetaxel (FLOT) regimen.
This trial was planned as a retrospective single-center study. In the neoadjuvant setting, patients received a regimen that includes docetaxel (50 mg/m
), oxaliplatin (85 mg/m
), and LV (200 mg/m
) with short-term infusional FU (2600 mg/m
as a 24-hour infusion), on day 1 and administered every two weeks for four cycles. Patients were classified as response rates according to the CAP-TRG system (0-1 response or 2-3 response) after completing four cycles of the FLOT regimen.
In total, 108 patients with GC and GEJ adenocarcinoma were included in the study. In a univariate analysis, age, histologic grade, T stage, N stage, and change in attenuation were found to be the statistically significant factors (p = 0.034, p =0.038, p = 0.001, p =0.029, and p = 0.022, respectively). In a multivariate analysis, T4 tumors and a higher change in attenuation were found to be important factors associated with poor pathologic response (p = 0.027 and p = 0.038, respectively).
Our results demonstrate that a higher decrease in CT attenuation and T4 tumors is associated with a poor response to perioperative FLOT chemotherapy in patients with GC and GEJ adenocarcinoma.
To investigate the effect of body mass index(BMI) on treatment outcomes and side-effect profile in metastatic non-small cell lung cancer(NSCLC) patients receiving platinum-based chemotherapy(ChT) in ...the first-line setting. This was a retrospective analysis of 233 NSCLC patients who were treated and followed up from 2008 through 2018. NSCLC patients who had metastatic disease at the time of diagnosis and were treated with platinum-based ChT in the first-line setting were included. The patients were divided into 2 groups based on the BMI as follows; BMI < 25 kg/m
2
and BMI ≥ 25 kg/m
2
. This retrospective analysis enrolled 233 patients, 35 (15.0%) of whom were female. The BMI in 132 patients (56.2%) was < 25 kg/m
2
. The median age was 58 years (range, 21-90). Median progression-free survival(PFS) was 7 mo, in the patients with BMI ≥ 25 kg/m
2
compared to 5.0 mo, in those with BMI < 25 kg/m
2
(p = 0.032), with corresponding median overall survival(OS) durations of 12 vs. 9 mo, (p = 0.003). In multivariate analysis, ECOG PS 2, grade III histology, and brain or bone metastasis negatively affected OS, whereas BMI ≥ 25 kg/m
2
positively affected OS. A high BMI prior to therapy in patients with NSCLC treated with platinum-based ChT in the first-line setting was associated with more favorable PFS and OS.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Mean platelet volume (MPV), the most commonly used measure of platelet size, and is altered in patients with malignancies. The aim of this study was to investigate the effect of MPV on overall ...survival (OS) of patients with locally advanced (Stage IIIA/B) inoperable non-small cell lung cancer (NSCLC). This retrospective study included patients who received concomitant chemoradiotherapy (CCRT) with cisplatin + etoposide regimen due to locally advanced stage IIIA/B NSCLC. The study included a total of 115 cases, consisting of 110 (95.7%) male and 5 (4.2%) female patients. The mean age of the patients was 61.3 ± 10.4 (22-82) years. ROC curve generated by MPV for OS yielded an AUC of 0.746 (95% CI 0.659-0.833), (p < 0.001). MPV was detected as >9 fL with a sensitivity of 74.4% and a specificity of 72.0%. In patients with stage IIIA, median OS was 45.0 months (95% CI 17.3-74.1) and 21 months (95% CI 10.6-31.3) in groups with MPV > 9.0 fL and ≤9.0 fL, respectively (p = 0.013). In patients with stage IIIB, median OS was 44.0 months (95% CI 13.8-60.6) and 16 months (95% CI 9.5-22.4) in groups with MPV > 9.0 fL and ≤9.0 fL, respectively (p = 0.036). ECOG performance score, total platelet count, and MPV were found as the most significant independent factors affecting survival (p < 0.001, p = 0.008, and, p = 0.034, respectively). In this study, we showed that decreased pre-treatment MPV was an independent risk factor for survival in NSCLC patients who were administered CCRT. As part of routine complete blood count panel, MPV may represent one of the easiest measuring tools as an independent prognostic marker for survival in locally advanced NSCLC.
Aim
The aim was to investigate the RAS discordance between initial and recurrent metastasectomy specimens in metastatic colorectal cancer (mCRC) patients treated with chemotherapy (CT) plus ...biological agents in a first‐line setting.
Methods
Patients who had been treated with CT plus bevacizumab or cetuximab or panitumumab followed by R0 resection for potentially resectable colorectal cancer liver metastases were scanned. Among these, patients who developed resectable new metastases after a disease‐free interval longer than 6 months were included in the study. We compared the RAS mutation status between the first biopsy and the second metastasectomy specimen.
Results
A total of 82 mCRC patients treated with CT plus biological agents in a first‐line setting were included in the study. The first biopsy assessment showed wild‐type RAS tumours in 39 (47.6%) patients and mutant RAS tumours in 43 (52.4%) patients. The mean time for new operable liver metastasis after R0 resection was 15.5 months. In the second metastasectomy specimens, the numbers of wild‐type and mutant RAS tumours were 30 (36.6%) and 52 (63.4%), respectively. The comparison with the first biopsy specimens showed RAS status conversions in 17 (20.7%) patients. Univariate comparison between patients with and without RAS status conversion revealed that grade, pathological T stage, wild‐type RAS tumour and longer biological agent use time in the first‐line treatment were significant factors for RAS conversion.
Conclusion
Our results suggest that re‐biopsy is needed for an optimal second‐line treatment decision in mCRC patients regardless of backbone biological agent, especially in patients with wild‐type RAS mCRC.
Obesity has become one of the major public health problems in many countries. Controversial results were reported in publications on the relationship between obesity and mortality in patients ...diagnosed with colorectal cancer (CRC) and that receive curative treatment. In this study, we evaluated the effects of body mass index (BMI) on the location of recurrence and disease-free survival (DFS) in patients with early-stage CRC.
Patients that were followed up and treated in the Department of Medical Oncology between 1999 and 2016 were retrospectively included in the study. Patients with operated Stage I, II, and III CRC were included in the study. Patients were divided into three groups based on their BMI (kg/m
) of below 25, between 25 and 30, and above 30.
A total of 950 patients, of which 527 (55.5%) were male and 423 (44.5%) were female, were included in the study. The median age of the patients was 56 years. Of the patients, 408 (42.4%) had BMI of <25, 370 (38.9%) had BMI between 25 and 30, and 172 (18.2%) had BMI of ≥30. Local recurrence rate was significantly higher in the group with BMI ≥30 compared to the other groups (P <0.01). When compared with DFS, there was a statistically significant difference between groups with BMI of <25 and ≥30 (P = 0.02) and that difference was more evidently observed in Stage III (P = 0.02). There was no statistically significant difference of overall survival in the BMI groups (P = 0.87). In multivariate analysis, the BMI ≥30 (hazard ratio HR, 1.49, 95% confidence interval CI, 1.02-2.17), rectal tumor (HR, 1.70, 95% CI, 1.15-2.51), Stage III (HR, 3.91, 95% CI, 1.86-8.25), number of positive lymph nodes (HR, 1.05, 95% CI, 1.03-1.07), and R1 resection (HR, 3.47, 95% CI, 1.71-7.05) were identified as independent risk factors negatively affecting DFS.
In this study, we observed that the high BMI increased the risk of recurrence, especially in Stage III CRC patients, and that the recurrence frequently occurred locally.
Background
This study aimed to retrospectively investigate the efficacy and tolerability of adjuvant chemotherapy in ≥70-year-old patients with stage IIA (T3N0M0) colorectal cancer.
Methods
...Lymphovascular invasion, perineural invasion, margin positivity, dissected lymph node count of <12, and presence of perforation/obstruction were accepted as risk factors. Those patients with at least one risk factor were regarded as having high risk.
Results
The study included 168 patients, among which 95 (56.5%) were male and 73 (43.5%) were female. The median age of patients was 73 years (range: 70–94). One hundred one (60.1%) patients were identified to have high risk. Eighty-one (87%) patients received 5-flourouracil+leucovorin and 12 (13%) patients received capecitabine regimens as adjuvant chemotherapy. The patients receiving capecitabine regimen had significantly higher rates of dose reduction at initiation and during the treatment. Among low-risk group, there was no statistically significant difference between patients with and without adjuvant chemotherapy in terms of disease-free survival or overall survival (p = 0.528 and p = 0.217, respectively). In high-risk group, patients receiving adjuvant chemotherapy significantly differed from those not receiving adjuvant chemotherapy in terms of median disease-free survival and overall survival (p = 0.009 and p < 0.001, respectively). While the grade, lymph node status, and adjuvant chemotherapy were identified as the most significant independent factors for disease-free survival, the most significant factors for overall survival were the age, Eastern Cooperative Oncology Group performance status, adjuvant chemotherapy, and recurrence.
Conclusion
The findings of our study showed improved disease-free survival and overall survival in high-risk ≥70-year-old patients who received adjuvant chemotherapy due to T3N0M0 colorectal cancer. We believe that 5-flourouracil+leucovorin or capecitabine regimens should be recommended for these older high-risk patients who could receive adjuvant chemotherapy regardless of age.
Purpose
The aim of this study is to investigate the prognostic effect of tumor regression grade (TRG) on long-term survival in locally advanced rectal cancer treated with preoperative ...chemoradiotherapy.
Methods
Medical records of 182 patients with locally advanced rectal cancer, who were treated with preoperative chemoradiotherapy followed by surgery between 2002 and 2016, were retrospectively reviewed. TRG was classified into five categories based on the pathological response as follows – TRG1: no viable cancer cell, TRG2: single cancer cell or small groups of cancer cells, TRG3: residual tumor outgrown by fibrosis, TRG4: residual tumor outgrowing fibrosis, TRG5: diffuse residual tumor without regression. TRG1, (TRG2+TRG3), and (TRG4+TRG5) were grouped as complete response, intermediate response, and no response, respectively.
Results
Of the 182 patients with locally advanced rectal cancer, 112 (61.5%) were male. The mean age was 54.4 (range, 25–87) years. The total number of patients in complete response, intermediate response, and no response group was 24 (13.2%), 105 (57.7%), and 53 (29.1%), respectively. The corresponding five-year relapse-free survival and overall survival rates were 79.8%–92.3%, 74.7%–79.4%, and 55.7%–55.8%, respectively (p < 0.05 for relapse-free survival, p < 0.05 for overall survival). According to ypTNM stage, there was no significant difference in relapse-free survival among TRG groups in ypStage I and II patients (p > 0.05). In ypStage III patients, relapse-free survival was 62 months in no response group vs. not reached in intermediate response group (p < 0.05). According to the ypTNM, there was no significant difference in overall survival among TRG groups in ypStage I, II, and III patients (p > 0.05). In the multivariate analysis, pathological complete response was found to be an independent variable for relapse-free survival and overall survival (hazard ratio (95% confidence interval), 0.34 (0.17–6.77), 0.39 (0.18–0.83), respectively).
Conclusion
This study showed that patients with pathological complete response to preoperative chemoradiotherapy had longer relapse-free survival and overall survival rates than those with residual disease.
To examine predictive markers for high detection rates of 68Ga PSMA-PET/CT in biochemical recurrence (BR) prostate cancer (PCa) patients with low PSA levels.
This trial was planned as a retrospective ...single center study. Patients with BR prostat cancer were included. PSA levels of all patients were lower 2 μg/l.
Totally thirty-two men patients with BR PCa were included in this study. 18 (56.3%) patients underwent radical prostatectomy and 14 (43.7%) patients curative intense radiotherapy. The number of patients received adjuvant maximal androgen blokage (MAB) treatment was 15 (46.9%). Median PSA levels was calculated 1.03 μg/l 17 (53.1%) of patients had <1 μg/l PSA levels and 7 (21.8%) of patients <0.5 μg/l. The patients number was 16 in unfavorable intermediate risk group (50.0%), 12 (37.5%) in high group and 4 (12.5%) in very high group. The median PSA doubling time was 6.2 months. The number of patients received adjuvant MAB treatment was 15 and in 14 (93.3%) of patients were found positive lesion in 68Ga PSMA-PET/CT. The number of patients with at least one lesion detected on 68Ga PSMA-PET/CT was 19 (59.4%). In univariate analysis to detect the factors affecting 68Ga PSMA-PET/CT positivity, there was only the presence of adjuvant MAB treatment as statistically significant importance (p < 0.001) and in multivariate analysis, the presence of adjuvant MAB treatment was found to be as statistically significant factor in terms of affecting 68Ga PSMA-PET/CT positivity (p = 0.003). The cut-off value was calculated as 1.12 μg/l in patients with no adjuvant MAB treatment (sensitivity 80% and specificity 83.3%).
Clinicians may perform 68Ga PSMA PET/CT in low PSA levels to detect lesions in biochemical recurrent prostate cancer patients who had received MAB treatment and in patients with higher PSA levels who had no received MAB treatment.
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