In general, neoadjuvant treatment is the standard for clinical stage II/III esophageal cancer (EC), whereas the effect of adjuvant treatment on survival still remains controversial. The aim of this ...study was to investigate the efficacy of adjuvant treatment modalities on the survival of EC patients.
A total of 63 patients with stage II-IVA EC who had undergone curative surgery between the years 2002 and 2020 were included in the study. Patients' data were retrospectively collected from oncologic follow-up files. Various treatment regimens were administered during this period, including chemotherapy and chemoradiotherapy.
The median age was 56 years (24-73), and the number of males was slightly higher than females (male/female: 33/30). While 32 (51%) patients received postoperative adjuvant treatment, the remaining 31 (49%) patients underwent surgery alone. The median overall survival (OS) was 45.9 months (95% confidence interval CI: 25.1-66.8) in patients receiving adjuvant therapy and 37.6 months (95% CI: 20.9-54.4) in patients not receiving adjuvant therapy. The 8.3-month survival difference was statistically insignificant (P = 0.54). The 1-, 3-, and 5-year OS rates were 87.5% versus 77.4%, 58.4% versus 51.6%, and 40.8% versus 27.6% for patients with and without adjuvant therapy, respectively. Pathological stage (P = 0.028) and lymph node status (P = 0.044) were significant prognostic factors for survival.
This study did not support the benefit of adjuvant treatment compared with surgery alone in completely resected EC patients. The reason for this result may be related to the small sample size and different treatment regimens due to the change in treatment options over time.
The identification of prognostic factors in patients with glioblastoma multiforme (GBM) represents an area of increasing interest. Carbonic anhydrase IX (CA‐IX), a hypoxia marker, correlates with ...tumor progression in a variety of human cancers. However, the role of CA‐IX in GBM remains largely unknown. In the present study, we evaluated the prognostic role of CA‐IX in GBM patients. In total, 66 consecutive patients with GBM who received concomitant chemoradiotherapy and adjuvant chemotherapy with temozolomide were retrospectively reviewed, and all patients received temozolomide chemotherapy for at least 3 months. Kaplan–Meier curves and log‐rank tests were used for analysis of progression‐free survival (PFS) and overall survival (OS), and a multivariate Cox proportional hazard model was employed to identify factors with an independent effect on survival. The median OS was longer in patients with low levels of CA‐IX expression (18 months) compared to patients overexpressing CA‐IX (9 months) (P = 0.004). There was not a statistically significant difference in median PFS (3.5 vs. 8 months, P = 0.054) between patients with high or low levels of CA‐IX expression. In multivariate analysis, the variables that were identified as significant prognostic factors for OS were preoperative Karnofsky performance scale score (KPS) (hazard ratio (HR), 3.703; P = 0.001), CA‐IX overexpression (HR, 1.967; P = 0.019), and incomplete adjuvant temozolomide treatment (HR, 2.241; P = 0.003) and gross‐total resection (HR, 1.956; P = 0.034). Our findings indicated that CA‐IX may be a potential prognostic biomarker in the treatment of GBM.
Background: Inflammation markers are the new point of view in cancer due to increasing data on the interaction of immune system with tumor cells and their prognostic and predictive importance were ...found in many different types of solid tumors. Therefore, we aimed to evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR), neutrophil-platelet score (NPS), and systemic inflammation index (SII) in Ewing sarcoma patients in which risk groups are still not clearly defined.
Methods and Results: A total of 64 patients were evaluated retrospectively. Receiver operating characteristic analysis was performed to find cut-off values for NLR and SII. Survival analysis was calculated by using Kaplan-Meier method. Cox regression analysis was performed to determine prognostic factors such as age, stage, and neoadjuvant chemotherapy were statistically significant prognostic factors for OS in multivariate analysis. While patients with low NLR and SII had longer OS (P = 0.003 and P = 0.018), patients with high NPS score had shorter OS (67.7 vs 21.7 months, P = 0.001).
Conclusion: Patients with lower NLR, NPS, and SII score have a better prognosis compared with those with higher NLR, NPS, and SII score and these simple parameters may be monitoring tools of the tumor microenvironment.
Helicobacter pylori(HP) is a significant causative agent of gastric cancer (GC). However, the underlying mechanisms involved in its pathogenesis and association with oncoproteins are unclear. The aim ...of the present study was to evaluate the relationship between HP infection and human epidermal growth factor receptor 2 (HER2) expression in GC patients.
Surgery (173) or endoscopic biopsy (35) specimen of 208 patients diagnosed with GC was evaluated for the presence of HER2 and HP. HER2 expression was assessed by fluorescence in situ hybridization (FISH) method, whereas HP status was evaluated histologically. Giemsa stain was used to identify HP status, in case HP could not be recognized in routine H and E-stained sections despite careful examination.
The median age was 63 years (27-91), and most patients were male (male/female: 149/59). Of all the 208 patients, HP was positive in 87 (41.8%) and negative in 121 (58.2%) patients. FISH positivity for HER2 was observed in 41 (19.7%) patients, whereas FISH negativity was observed in 167 (80.3%) patients. According to the Chi-square test, patient distribution was 21 in HER2-positive HP-negative group, 20 in HER2-positive HP-positive group, 100 in HER2-negative HP-negative group, and 67 in HER2-negative HP-positive group. No correlation was found between HP and HER2 status (P = 0.314). HP positivity had significant effect on median overall survival (27.4 vs. 12.9 months, P = 0.046).
Our results suggest that there is no relationship between HP infection and HER2 status in patients with GC.
Teratomas are types of germ cell tumor which can arise from gonads or extragonadal tissues and can show malignant transformation. . In this article,We presented a patient with enteric adenocarcinoma ...on the basis of teratoma with a mediastinal mass invading the sternum .
Bowel perforation is a rare but well-described complication of bevacizumab, a VEGF monoclonal antibody. However, bevacizumab associated abdominal wall perforation is a more serious complication. In ...here, a patient with recurrent epithelial ovarian cancer developing both bowel and abdominal wall perforation after bevacizumab treatment is reported with review of the literature to point out the clinical significance of this rare complication. To our knowledge, this is the first case with bevacizumab associated abdominal wall perforation.
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.
The aim of the present study was to evaluate the prevalence of thyroid lesions detected by 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) incidentally, ...determine malignancy risk and its relationship with maximal standardized uptake value (SUVmax) and FDG uptake pattern.
Between February 2009 and February 2014, a total of 12713 patients underwent 18F-FDG PET/CT. Incidental thyroid uptake was seen in 710 patients and further diagnostic evaluation was performed on 147 patients with focal or diffuse FDG uptake. The 18F-FDG PET/CT findings of these patients and their association with malignancy were retrospectively reviewed.
The prevalence of thyroid incidentalomas detected by 18F-FDG PET/CT was 5.6% (710/12713). Of the 147 patients who underwent biopsy or thyroid surgery, histology was benign in 99 and malign in 48 patients. The malignancy risk of incidental thyroid lesions was calculated as 32.7% (48/147). The median SUVmax was 2.9 (0.6–27.4) in benign group, whereas 11.8 (2.4–72.9) in malign group and the difference between these groups was statistically significant (p < 0.001). According to the ROC analysis, a SUVmax above 6 was more likely to be malign with statistical significance (p < 0.001). The sensitivity, specificity, positive predictive value and negative predictive value were 87.4%, 81.7%, 70.1% and 93% respectively.
The malignancy risk of incidental thyroid lesions on 18F-FDG PET/CT is high. Although it is obvious that higher SUVmax values are tended to be malign, an overlap between benign and malign groups is still remaining. In case of absence of clinical contraindications, further examination should be recommended.
To evaluate the usage of duplex power Doppler ultrasound (PDUS) for the differentiation of benign and malignant thyroid nodules.
We prospectively examined 77 thyroid nodules in 60 patients undergoing ...ultrasound-guided fine needle aspiration biopsy (FNAB). Each nodule was described according to size, inner structure, borders, parenchymal echogenicity, peripheral halo formation, and the presence of calcification (B-mode ultrasound findings). Vascularity as determined by PDUS imaging was defined as non-vascular, peripheral, central, or of mixed type. For each nodule, the pulsatility index (PI) and resistive index (RI) values were obtained. Results of FNAB and surgical pathological examination (if available) were used as a proof of final diagnosis to categorize all nodules as benign or malignant. A receiver operating characteristic (ROC) curve analysis was performed to establish cut-off, sensitivity, and specificity values associated with RI-PI values.
A significant relationship was observed between malignancy and irregular margins, microcalcifications, and hypoechogenicity on ultrasound examination (p < 0.05). The pattern of vascularity as determined by PDUS analysis was not a statistically significant criterion to suggest benign or malignant disease in this study (p > 0.05). The central, peripheral, and mean RI-PI values were higher in malignant nodules when compared to the other cytologies (p < 0.05).
Vascularity is not a useful parameter for distinguishing malignant from benign thyroid nodules. However, RI and PI values are useful in distinguishing malignant from benign thyroid nodules.
Objective
The objective of this retrospective study is to investigate the association between survival and maximum standardized uptake values (SUV
max
) of liver metastases detected by pre-treatment ...positron emission tomography-computed tomography (PET-CT) in patients with adenocarcinoma of unknown primary origin (ACUP).
Methods
A total of 58 patients with ACUP and liver metastases confirmed histopathologically by liver biopsy and pre-treatment PET-CT were included in this study. SUV
max
values of the liver lesions were measured and their association with survival was investigated.
Results
The median age was 62 years; 63.8 % of the patients were males and 36.2 % were females. The median overall survival was calculated as 10.7 months (OS). The median SUV
max
of the liver metastases was 8.6. Accordingly, two groups were established: one with values <8.6 and the other with ones ≥8.6. No differences were detected between the two groups with respect to general characteristics. Median OS was 13.2 months in the group with SUV
max
<8.6 compared to 7.4 months in the group with SUV
max
≥8.6. This difference was statistically significant (
p
= 0.033). SUV
max
(HR 1.104, 95 % CI 1.013–1.204,
p
= 0.025), age (HR 1.033, 95 % CI 1.002–1.064,
p
= 0.034), presence of chemotherapy (HR 2.296, 95 % CI 1.136–4.641,
p
= 0.021) and LDH level (HR 1.002, 95 % CI 1.001–1.003,
p
= 0.007) were identified as independent prognostic factors affecting survival in the multivariable analysis. This is the first report evaluating the impact of SUV
max
for liver metastases on ACUP patient survival.
Conclusion
The SUV
max
of liver metastases evaluated by PET-CT is a prognostic factor influencing survival of patients with ACUP.
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