Purpose: Germ cell tumors (GCTs) are rare and highly curable malignancies. However, salvage treatments for relapsed or refractory disease are needed in approximately 20-60% of the patients. As ...salvage therapy, autologous stem cell transplantation (ASCT) administered after high-dose chemotherapy (HDCT) may be a feasible option as well as standard dose chemotherapy (SDCT). This study aimed to evaluate the efficacy and toxicity of ASCT in salvage therapy of GCTs retrospectively. Materials and Methods: Male patients older than 18 years of age who underwent ASCT due to a relapsed/refractory GCT were included in the study. Results: The median age of 18 patients included in the study was 28 (19-46). The majority of patients (n:16, 88.8%) had non-seminomatous GCT histology. All of the patients had relapsed or refractory GCTs and received bleomycin, etoposide, cisplatin (BEP) combination therapy previously. Half of the patients were in the poor risk group. ASCT was administered as a second-line therapy in 14 (77.7%) patients and third-line therapy in four (22.2%) patients. There is no ASCT-related exitus. Febrile neutropenia (FN) developed in almost all patients. Complete response (CR) was obtained in 7 (38.8%) patients, partial response (PR) in four (22.2%) patients after ASCT. The 2-year PFS was 44.4% and the median PFS was 8.7 (2.7-12.6) months. Median OS was 22.7 (3.9-41.7) months and 3 years OS was 50.0%. Conclusion: In conclusion, ASCT was found to be an effective and safe treatment option in salvage therapy of GCT patients in our study.
Breast cancer (BC) is the most common cancer among women and a major cause of death. Signal Peptide-Cub-Epidermal growth factor domain-containing protein-1 (SCUBE1) is secreted under hypoxia and ...inflammatory conditions from platelet alpha granules. Its biological function is uncertain, although it may be a procoagulant substance in cancer patients. SCUBE1 is useful for identifying thrombotic diseases, including cancers and acute coronary syndromes. D-dimer reflects the relationship between coagulation activation and fibrinolysis; namely, thrombosis and D-dimer levels are closely linked. This is the first investigation of the potential diagnostic and prognostic value of SCUBE1 levels in patients with BC. Fifty patients and 33 age-matched and body mass index-matched healthy controls were enrolled. Blood samples were collected before chemotherapy regimens commenced. Serum SCUBE1 and D-dimer levels were measured before adjuvant chemotherapy and were compared to the healthy controls. SCUBE1 levels were determined using an enzyme-linked immunosorbent assay (ELISA) method. SCUBE1 and D-dimer levels were significantly higher in patients than in the controls (p = 0.03 and p < 0.001, respectively). A cut-off value of 1.55 ng/mL for SCUBE1 was associated with 62% sensitivity and 72.7% specificity and with positive predictive value of 77.5% and negative predictive value of 55.8%. Two patients with high SCUBE1 and D-dimer levels also developed pulmonary embolism. SCUBE1 may indicate hypercoagulability in patients with BC and thus help identify patients at greater risk of thrombosis and requiring anti-thrombosis treatment. SCUBE1 may also be used as an assistant test for identifying patients at risk of BC.
Purpose: To investigate the importance of mucinous histopathology on the assessment of tumor response in patients with metastatic colorectal cancer (mCRC) receiving regorafenib. Materials and method: ...All patients diagnosed with histologically confirmed mCRC in 2 oncology centers between 2013 and 2018 were retrospectively analyzed. Among 678 patients diagnosed with mCRC, 103 patients were treated with regorafenib. Ninety-four of these patients who had used at least 2 cycles of regorafenib and evaluable for treatment response were included in the analysis. Histopathologically, 18 patients with mucinous adenocarcinoma and 76 patients with nonmucinous adenocarcinoma were compared in terms of response rate and survival durations. Results: Median follow-up duration of 6 months, median age of the patients was 61 (34-77) years. While 19.1% of the patients had mucinous histology, 80.9% had nonmucinous histology. The overall response rate was significantly lower in the mucinous subgroup than the nonmucinous subgroup (5.6% vs 43.4%, respectively, P = 0.003). Similarly, both progression-free survival (3.0 vs 4.0 months, respectively, P = 0.011) and overall survival duration were shorter in the mucinous subgroup (3.0 vs 7.0 months, P = 0.016, respectively) compared with the nonmucinous subgroup. Conclusion: The histological subgroup may predict tumor response in mCRC patients receiving regorafenib. Its efficacy on nonmucinous histology had significantly more favorable than mucinous subtype.
Merkel cell carcinoma in Turkey: A multicentric study Yildiz, Fatih; Demirci, Umut; Küçükarda, Ahmet ...
Journal of Cancer Research and Therapeutics/Journal of cancer research and therapeutics,
10/2021, Letnik:
17, Številka:
6
Journal Article
Recenzirano
Odprti dostop
Background: Merkel cell carcinoma (MCC) is a rare but highly aggressive neuroendocrine carcinoma of the skin. In this study, we aimed to evaluate the clinicopathologic characteristics, treatment ...outcomes, and survival of MCC cases in Turkey.
Materials and Methods: The patients diagnosed with MCC between 1999 and 2018 at twenty different centers in Turkey were included in the study. Patient and tumor characteristics and adjuvant and metastatis treatment outcomes were analyzed retrospectively.
Results: The median age of totally 89 patients was 70 (26-93). The most common primary location was lower limbs (n = 29, 32.5%). Immunohistochemically, CK20 positivity was present in 59 patients (66.3%). Only two patients had secondary malignancy. The majority of the patients (n = 76, 85.4%) were diagnosed at the localized stage. Surgery was performed for all patients in the early stage, and adjuvant radiotherapy or/and chemotherapy was applied to 52.6% (n = 40) of nonmetastatic patients. The median follow-up was 29 months. Recurrence developed in 21 (27.6%) of the 76 patients who presented with local or regional disease. Two-year disease-free survival (DFS) was 68.1% and 5-year DFS was 62.0% for localized stage. The 5-year DFS was similar for patients receiving adjuvant treatment (chemotherapy, radiotherapy, or sequential chemoradiotherapy) and without adjuvant therapy (P > 0.05). Two-year overall survival in patients who presented with localized disease was 71.3% and 18.5% in metastatic patients (P < 0.001). In the metastatic stage, platinum/etoposide combination was the most preferred combination regimen. Median progression-free survival (PFS) in first-line chemotherapy was 7 months (95% confidence interval: 3.5-10.5 months; standart error: 1.78).
Conclusions: Although MCC is rare in Turkey, the incidence is increasing. Gender, CK20 status, tumor size, lymph node involvement, and adjuvant treatment were not associated with recurrence.
Advanced pancreatic cancer (APC) is a highly lethal malignancy which has one of the worst treatment outcomes. Modified (m)FOLFIRINOX is an intense but a proven treatment approach with a survival ...benefit for APC. Although mFOLFIRINOX demonstrated survival benefit compared with gemcitabine monotherapy, the standard treatment in previous years, toxicity is a difficult aspect of this treatment.
A retrospective analysis of patients referred to Medical Oncology Clinics of Ankara Oncology Research and Training Hospital with the diagnosis of inoperable locally advanced or metastatic pancreatic cancer and treated with mFOLFIRINOX or gemcitabine monotheraphy from March 2013 to April 2018 was performed.
Forty three patients and 37 patients were included in mFOLFIRINOX and gemcitabine groups, respectively. The mean age of the patients was 53.74 years (range: 32–69) and 65,7 years (range: 47–82) for mFOLFIRINOX and gemcitabine, respectively (95% CI, p < 0.001). All patients, except one, had ECOG performance status of 0 or 1 in mFOLFIRINOX group. In contrast, nine patients had ECOG performance status of 2 in the gemcitabine group (95% CI, p = 0.002). When the patients were evaluated for response, 11 (25.6%) and 6 (16.2%) had partial remission with mFOLFIRINOX and gemcitabine, respectively. Median PFS and OS was 5,73 (95% CI, 2,57-8,90) months and 8.77 (95% CI, 6.54–10.99) months with mFOLFIRINOX and 2,77 (95% CI, 2,29-3,24) months and 5.80 (95% CI, 3.08–7.92) months with gemcitabine, respectively. mFOLFIRINOX regimen was more toxic than gemcitabine regimen. The incidences of all-grade neutropenia, neuropathy, and emesis were more prominent in the mFOLFIRINOX group.
mFOLFIRINOX is a difficult regimen for both patients and physicians with significant toxicity with a greater survival benefit. The survival benefit was modest in this real-life experience. Patient selection bias and small sample size of this retrospective study should be considered.
Surgical resection of asymptomatic primary colorectal cancer in patients presenting with synchronous unresectable metastatic disease is controversial. Concerns and controversies remain over combining ...cytotoxic chemotherapy with bevacizumab in this patient population.
We identified medical records of 99 patients with synchronous metastatic primary colorectal cancer who received chemotherapy with bevacizumab as their initial treatment. The incidence of subsequent use of surgery and surgical outcomes were recorded. Patients were also assessed for overall survival.
Patients who received bevacizumab-containing chemotherapy for synchronous metastatic primary colorectal cancer were divided into the non-surgery and surgery groups according to the resection status of their asymptomatic primary tumor. In the non-surgery group, two patients (4.4%) underwent additional surgery, while three patients (5.7%) required surgery for rectovesical fistula in the surgery group. The median overall survival was 17 months for the non-surgery group (95% CI: 10.6-23.3 months) and 23 months for the surgery group (95% CI: 21.3-24.6 months; P = 0.322).
This study utilizing chemotherapy with bevacizumab did not result in an increased rate of morbidity related to the unresected primary tumor. Survival is not compromised by leaving the primary colon tumor intact.
Background
Clinical care of patients with cancer mostly focuses on medical management with less attention on disease‐related malnutrition. The Global Leadership Initiative on Malnutrition (GLIM) ...released new criteria for diagnosing malnutrition, but the validation of these criteria in treatment‐naïve patients with cancer is not well documented. This study aimed to investigate the application of the GLIM criteria in nutrition assessment and mortality prediction in treatment‐naïve patients with cancer.
Methods
A total of 267 patients newly diagnosed with different types of cancer were enrolled. Nutrition status was assessed with the Patient‐Generated Subjective Global Assessment (PG‐SGA) at outpatient clinic admission during the data collection period. Furthermore, after the GLIM criteria publication, nutrition status was assessed retrospectively using the GLIM criteria in the same cohort to assess validity. The agreement between the tools was calculated using kappa statistics, and the association of malnutrition according to each tool and mortality was analyzed using logistic regression analysis.
Results
The mean age of the patients was 58.06 ± 12.6 years, and 42.7% were women. The prevalence of malnutrition was 60.3% with GLIM criteria and 53.6% with PG‐SGA. Agreement between tools was moderate (κ = 0.483, P < 0.001). During a median follow‐up period of 23.6 months, 99 deaths occurred. Both GLIM‐defined and PG‐SGA–defined malnutrition was independently associated with 2‐year mortality after adjusting for age, sex, presence of comorbidities, and stage of cancer.
Conclusions
Our findings support the validation of GLIM in diagnosing malnutrition and predicting 2‐year mortality among treatment‐naïve patients with cancer.
Small cell neuroendocrine carcinoma of the posterior tongue Gumusay, Ozge; Yilmaz, Guldal; Aydil, Utku ...
Journal of Cancer Research and Therapeutics/Journal of cancer research and therapeutics,
07/2015, Letnik:
11, Številka:
3
Journal Article
Recenzirano
Odprti dostop
In the head and neck mucosa, neuroendocrine carcinomas of the oral cavity is rare. Herein, we present the first report of a small cell neuroendocrine carcinoma in a 54-year-old man on the right ...lateral posterior tongue. It is important to remember that although neuroendocrine small cell carcinomas (SCCs) are most commonly seen in the lung, they rarely may arise in the extrapulmonary sites, including salivary glands, as well. As there is not any standard therapeutic regimen already existing, it is important to be aware of and to know how to deal with such rare cases.
Increased early diagnosis and improved treatment options have decreased the mortality rate of breast cancer and increased the survival rate. Healthy lifestyle behaviors are very important in breast ...cancer survivors as they reduce mortality and morbidity rates, cancer recurrence frequency, and side effects of treatment and improve health. This study was conducted to evaluate the effectiveness of a health promotion training intervention in breast cancer survival.
The study is a quasi-experimental, pre-test-post-test and single-group study. It was conducted with 43 women breast cancer survivors. The "Healthy Lifestyle Behaviors Scale II" was used to collect the data. Four sessions of training were given to the women once a week, and a 3-month post-training follow-up was performed. The
-test, Wilcoxon analysis, and Spearmen correlation analysis were used to evaluate the data.
Pre-training and post-training scores in the sub-dimensions and total scores of the healthy lifestyle behavior scale showed that the training was highly effective. There was a significant increase in all sub-dimensions and total scale post-training scores (
< 0.05). In the correlation analysis, a negative correlation was found between age and physical activity, between elapsed time after diagnosis and nutrition, and between elapsed time after diagnosis and spiritual development (
< 0,05). However, there was a positive correlation between educational status and nutrition (
< 0.05).
The results show that a health promotion training program covering physical activity/exercise, healthy nutrition, effective communication, coping with stress, and increasing health responsibility had positive effects on healthy lifestyle behaviors in this population, and age, educational status, and elapsed time after diagnosis influence healthy lifestyle behaviors in survival.
Diabetes insipidus in pregnancy has different causes. The association of diabetes insipidus with disturbances of liver function has been reported, however, diabetes insipidus has rarely been reported ...in HELLP syndrome. We present a 23‐year‐old primigravida with a singleton gestation complicated by HELLP syndrome who developed postpartum diabetes insipidus. Labor was induced promptly to terminate pregnancy because of intrauterine fetal death and liver dysfunction. 1‐deamino‐8‐D‐arginine‐vasopressin was administered. Diabetes insipidus and liver dysfunction resolved within 2 weeks. Development of diabetes insipidus may result from increased vasopressinase activity mainly caused by deterioration of liver functions caused by HELLP syndrome. In pregnant women with liver disease as a result of any cause, the development of diabetes insipidus should be assessed with particular attention.
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