Summary Objectives To evaluate photodynamic therapy (PDT) using 5-ALA-induced protoporphyrin IX (PPIX) in an in vivo hypoxic tumor model and its monitoring using MRI. Materiel and methods Dunning ...R3327-AT2 tumors were grafted in the neck of Copenhagen rats. PDT using 150 mg 5-ALA/kg i.v. was performed by focal interstitial illumination of the photosensitized tumor ( λ = 633 nm; fluence = 100 J/cm2 ). MRI at baseline and 2 days after treatment (T1, T2 and dynamic gadolinium enhanced sequences) were performed. Necrosis volumes were determined on post-procedure MRI. Tumors were resected 2 days post-PDT and obtained necrosis was determined histopathologically. Intra-tumoral PPIX distribution was evaluated using confocal microscopy and tissue porphyrin quantification. Results Twenty rats were treated divided into three groups: continuous ( n = 7), fractionated illumination ( n = 7), and a control group receiving only light or only ALA or neither ( n = 6). Baseline MRI confirmed the hypoxic character of tumors. Necrosis volumes determined on posttreatment MRI were not reproducible and presented with important geometric and volumetric variability. Average necrosis volumes of 0.39 cc (0–0.874 cc) in the continuous group, 0.24 cc (0.107–0.436 cc) in the fractionated group and 0.012 cc (0–0.071 cc) in the control group were observed. Intra-tumoral PPIX distribution was heterogeneous and PPIX quantification revealed low intra-tumoral concentration. Conclusion Necrosis volumes induced by 5-ALA-mediated PDT were highly variable and non reproducible, probably because of lack of intra-tissular oxygen. Photosensitizer was poorly represented inside the tumor and its distribution was heterogeneous. Our study suggests that 5-ALA-mediated PDT might not be the best management option for hypoxic prostatic adenocarcinoma.
To determine potential prognostic factors for survival in patients with mucosal malignant melanoma of the sinonasal tract.
Patients managed between 1991 and 2008 were assessed retrospectively. The ...seventh edition Union for International Cancer Control (7th UICC) tumour-node-metastasis classification was used for tumour staging. Kaplan-Meier and log rank tests were used for survival analysis.
Twenty-five patients were studied (six were tumour stage three, eight tumour stage four(a) and 11 tumour stage four(b)). Surgery was performed on 23 patients (92 per cent). Fifteen received post-operative radiotherapy. Mean follow up was 31.3 months (range, two to 99 months). Three-year disease-free survival was improved in patients with stage four tumour arising from the nasal fossa, versus other sites, and in those with stage four tumour treated with surgery plus adjuvant radiotherapy, versus other treatments.
Patients with melanoma of the nasal cavity have very poor survival rates. Treatment is still based on adequate surgical resection with safe margins. In this study, post-operative radiotherapy improved local control only for stage four tumours.
Aims: To examine the level of expression of the pleiotropic regulators galectins‐1 and ‐7 in relation to neoplastic progression of hypopharyngeal (HSCCs) and laryngeal (LSCCs) squamous cell ...carcinomas.
Methods and results: The presence of galectins‐1 and ‐7 was investigated using quantitative immunohistochemistry in (i) a series of 78 HSCCs by comparison with 17 normal epithelia (N_E), 26 low‐grade dysplasia (low_D) and 27 high‐grade dysplasia (high_D) and (ii) a series of 56 LSCCs by comparison with 50 N_E, 23 low_D and 29 high_D. Galectin‐1 positivity expressed as a percentage of cells was significantly higher in carcinomas (HSCCs and LSCCs) than in N_E, low_D or high_D (P < 10−6). Galectin‐7 expression was elevated in low_D (P = 0.0004) compared with N_E and in carcinomas (HSCC) compared with high_D (P = 0.0002). Tumour progression from high_D to carcinomas was associated with a shift of galectin‐1 localization from the nucleus towards the cytoplasm. Increased expression of galectin‐7 in dysplasias was accompanied by a shift from the cytoplasmic compartment (N_E) to the nucleus (low_D and high_D).
Conclusions: Our data reveal an association between the level of presence of galectins‐1 and ‐7 and neoplastic progression of HSCCs and LSCCs. Moreover, inverse shifts between nuclear and cytoplasmic positivity intimating functional divergence were detected.
Objectives:
To determine the value of frozen section examination for the management of small incidental testis tumors.
Methods:
We reviewed all cases of incidental nonpalpable testis tumors that have ...been examined in frozen section during the period 1996–2002. For each case, frozen section and definitive histological slides were available and were reviewed.
Results:
Fifteen cases were retrieved in the files of the Department of Pathology. Nine cases were discovered by ultrasonography examination in patients presenting with infertility. Six cases were discovered incidentally by sonography for testis trauma or scrotal pain. The patients were aged from 18 to 43 years. The tumors measured from 4 to 16
mm. Frozen section examination concluded in 9 cases to a benign lesion “Leydig cell nodule”, in four cases a diagnosis of malignancy was retained and the last two cases were inconclusive. The standard microscopic examination confirmed the 9 cases of Leydig cell tumors; malignancy was confirmed in the 4 cases (3 seminomas and one teratoma) and the uncertain cases were benign Sertoli cells tumors. Benign lesions were treated by a conservative approach.
Conclusion:
Frozen section examination is a useful method for the management of small incidental masses of the testis.
To analyze, in patients with prostate cancer (PC) potentially eligible for active surveillance (AS), whether multiparametric-MRI (mp-MRI) predicts presence of clinically significant cancer on radical ...prostatectomy (RP) specimen.
We identified 77 men with PC eligible for AS (PSA≤15ng/mL, stage≤T2a, Gleason score≤6, up to 3 positive cores, maximal cancer core length≤5mm) who underwent RP between 01/2008 and 08/2015. All patients had prebiopsy mp-MRI followed by systematic±targeted biopsies. For each patient, the likelihood of the presence of cancer on mp-MRI was assigned using Likert scale (1 to 5). The predictive factors for the presence of significant cancer on RP specimen (Gleason score≥7 and/or tumoral maximal diameter>10mm) were evaluated using logistic regression.
Median age was 61 and median PSA was 6.7ng/mL. Overall, 49 (64%) patients had a positive mp-MRI (score≥3). Clinically significant cancer on RP specimen was found in 45 (58%) patients (69% in MRI-positive patients vs 39% in MRI-negative patients). In multivariate analysis, a positive MRI was a predictive factor for the presence of significant cancer on the surgical specimen (OR=3.0; CI95% 1.01-8.88; P=0.04), as was age (OR=1.17; CI95% 1.05-1.31; P=0.004) and PSAD (OR=1.10; CI95% 1.01-1.20; P=0.02).
Mp-MRI is a useful exam for selecting patients eligible for AS even if the situation remains unclear after prostate biopsies including targeted biopsies. Upon confirmation by further studies, mp-MRI should be considered as an independent criterion before entering an AS program.
4.
PDF
