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Yang J, Peng H, Tu SK, Li M, Song K. Extramedullary plasmacytoma with the uvula as first affected site: A case report. World J Clin Oncol 2025; 16:96131. [DOI: 10.5306/wjco.v16.i1.96131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 09/03/2024] [Accepted: 09/23/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Extramedullary plasmacytoma (EMP) represents one of the rarer forms of plasma cell malignancies, capable of impacting a variety of tissues and organs throughout the body. The majority of EMP cases are predominantly found in the head and neck region, especially within the laryngopharynx, as well as in the gastrointestinal tract. While there have been documented instances of oropharyngeal involvement in EMP cases in the academic literature, it is important to note that EMP specifically affecting the uvula is exceedingly uncommon. Furthermore, it is noteworthy that over 60% of epithelial carcinomas in the upper respiratory tract and oropharynx tend to metastasize to the cervical lymph nodes, indicating a propensity for regional spread in these types of cancers. In this context, we present a rare case of extramedullary plasmacytoma where the uvula served as the initially affected site. This case emphasizes the need for heightened awareness among clinicians regarding such unusual comorbidities, as early recognition and diagnosis can significantly influence patient management and treatment outcomes. In addition, a review of the relevant literature is included to further educate and inform healthcare professionals about this rare presentation, ultimately aiming to enhance clinical understanding and improve patient care in similar situations.
CASE SUMMARY A 51-year-old man was admitted to our hospital because of a slowly enlarging neck mass. A physical examination revealed a palpable left lymph node, and magnetic resonance imaging (MRI) of the oropharynx and the neck showed a soft tissue mass in the oropharynx and enlargement of multiple lymph nodes in the neck. The soft tissue mass was diagnosed as plasmacytoma by immunohistochemical analysis. Monoclonal immunoglobulins and bone marrow biopsy showed normal results. Therefore, we diagnosed that as EMP of the uvula. After four cycles of adjuvant chemotherapy dominated by bortezomib, MRI reexamination showed a significant reduction of the mass in the oropharynx and the cervical lymph nodes. Afterwards, the λ light chain returned to normal levels. There was no evidence of evolution to multiple myeloma.
CONCLUSION We have reported a rare case of extramedullary plasmacytoma with the uvula as the first affected site and the relevant literature is reviewed to improve clinicians' awareness of such rare comorbidities.
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Qayed E. Optimizing care for gastric cancer with overt bleeding: Is systemic therapy a valid option? World J Clin Oncol 2025; 16:100943. [DOI: 10.5306/wjco.v16.i1.100943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2024] [Revised: 09/26/2024] [Accepted: 10/22/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
Gastric cancer (GC) and gastroesophageal junction cancer (GEJC) represent a significant burden globally, with complications such as overt bleeding (OB) further exacerbating patient outcomes. A recent study by Yao et al evaluated the effectiveness and safety of systematic treatment in GC/GEJC patients presenting with OB. Using propensity score matching, the study balanced the comparison groups to investigate overall survival and treatment-related adverse events. The study's findings emphasize that systematic therapy can be safe and effective and contribute to the ongoing debate about the management of advanced GC/GEJC with OB, highlighting the complexities of treatment decisions in these high-risk patients.
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Cheng CH, Hao WR, Cheng TH. Improving postoperative outcomes in patients with pancreatic cancer: Inflammatory and nutritional biomarkers. World J Clin Oncol 2025; 16:99651. [DOI: 10.5306/wjco.v16.i1.99651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 10/02/2024] [Accepted: 10/20/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
This editorial assesses the prognostic value of preoperative inflammatory and nutritional biomarkers in patients undergoing surgical resection for pancreatic cancer. Lu et al evaluated the ability of seven biomarkers to predict postoperative recovery and long-term outcomes. These biomarkers were albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, nutritional risk index, and geriatric nutritional risk index. The PNI was found to be a strong predictor of both overall and recurrence-free survival, underscoring its clinical relevance in managing patients with pancreatic cancer.
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Tang ZJ, Pan YM, Li W, Ma RQ, Wang JL. Unlocking the future: Mitochondrial genes and neural networks in predicting ovarian cancer prognosis and immunotherapy response. World J Clin Oncol 2025; 16:94813. [DOI: 10.5306/wjco.v16.i1.94813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/17/2024] [Accepted: 06/05/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Mitochondrial genes are involved in tumor metabolism in ovarian cancer (OC) and affect immune cell infiltration and treatment responses.
AIM To predict prognosis and immunotherapy response in patients diagnosed with OC using mitochondrial genes and neural networks.
METHODS Prognosis, immunotherapy efficacy, and next-generation sequencing data of patients with OC were downloaded from The Cancer Genome Atlas and Gene Expression Omnibus. Mitochondrial genes were sourced from the MitoCarta3.0 database. The discovery cohort for model construction was created from 70% of the patients, whereas the remaining 30% constituted the validation cohort. Using the expression of mitochondrial genes as the predictor variable and based on neural network algorithm, the overall survival time and immunotherapy efficacy (complete or partial response) of patients were predicted.
RESULTS In total, 375 patients with OC were included to construct the prognostic model, and 26 patients were included to construct the immune efficacy model. The average area under the receiver operating characteristic curve of the prognostic model was 0.7268 [95% confidence interval (CI): 0.7258-0.7278] in the discovery cohort and 0.6475 (95%CI: 0.6466-0.6484) in the validation cohort. The average area under the receiver operating characteristic curve of the immunotherapy efficacy model was 0.9444 (95%CI: 0.8333-1.0000) in the discovery cohort and 0.9167 (95%CI: 0.6667-1.0000) in the validation cohort.
CONCLUSION The application of mitochondrial genes and neural networks has the potential to predict prognosis and immunotherapy response in patients with OC, providing valuable insights into personalized treatment strategies.
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Krishnan A, Schneider CV, Walsh D. Proton pump inhibitors and all-cause mortality risk among cancer patients. World J Clin Oncol 2025; 16:99240. [DOI: 10.5306/wjco.v16.i1.99240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 09/09/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Proton pump inhibitors (PPIs) are widely used, including among cancer patients, to manage gastroesophageal reflux and other gastric acid-related disorders. Recent evidence suggests associations between long-term PPI use and higher risks for various adverse health outcomes, including greater mortality.
AIM To investigate the association between PPI use and all-cause mortality among cancer patients by a comprehensive analysis after adjustment for various confounders and a robust methodological approach to minimize bias.
METHODS This retrospective cohort study used data from the TriNetX research network, with electronic health records from multiple healthcare organizations. The study employed a new-user, active comparator design, which compared newly treated PPI users with non-users and newly treated histamine2 receptor antagonists (H2RA) users among adult cancer patients. Newly prescribed PPIs (esomeprazole, lansoprazole, omeprazole, pantoprazole, or rabeprazole) users were compared to non-users or newly prescribed H2RAs (cimetidine, famotidine, nizatidine, or ranitidine) users. The primary outcome was all-cause mortality. Each patient in the main group was matched to a patient in the control group using 1:1 propensity score matching to reduce confounding effects. Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence interval (CI).
RESULTS During the follow-up period (median 5.4 ± 1.8 years for PPI users and 6.5 ± 1.0 years for non-users), PPI users demonstrated a higher all-cause mortality rate than non-users after 1 year, 2 years, and at the end of follow up (HRs: 2.34-2.72). Compared with H2RA users, PPI users demonstrated a higher rate of all-cause mortality HR: 1.51 (95%CI: 1.41-1.69). Similar results were observed across sensitivity analyses by excluding deaths from the first 9 months and 1-year post-exposure, confirming the robustness of these findings. In a sensitivity analysis, we analyzed all-cause mortality outcomes between former PPI users and individuals who have never used PPIs, providing insights into the long-term effects of past PPI use. In addition, at 1-year follow-up, the analysis revealed a significant difference in mortality rates between former PPI users and non-users (HR: 1.84; 95%CI: 1.82-1.96).
CONCLUSION PPI use among cancer patients was associated with a higher risk of all-cause mortality compared to non-users or H2RA users. These findings emphasize the need for cautious use of PPIs in cancer patients and suggest that alternative treatments should be considered when clinically feasible. However, further studies are needed to corroborate our findings, given the significant adverse outcomes in cancer patients.
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Teja M, Garrido MI, Ocanto A, Couñago F. Prognostic impact of inflammatory and nutritional biomarkers in pancreatic cancer. World J Clin Oncol 2025; 16:101191. [DOI: 10.5306/wjco.v16.i1.101191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2024] [Revised: 09/28/2024] [Accepted: 10/10/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
Pancreatic cancer is usually associated with a poor prognosis. Surgery is the main curative treatment but pancreatic operations are aggressive and new tools that help clinicians to predict surgical and prognostic outcomes are necessary. Lu et al recently published a retrospective, single centre cohort study evaluating the impact of seven nutritional and inflammatory markers in pancreatic cancer surgical patients: The albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), nutritional risk index, and the geriatric nutritional risk index. A significant correlation was found between the PNI, SII, NLR, and PLR and a hospital discharge of less than 15 days. In a univariable analysis, PNI, SII, NLR and PLR were significantly related to recurrence-free survival and, in a multivariable analysis PNI was associated with overall survival. Various meta-analyses corroborate the results in terms of prognosis but individual studies are discordant on their usefulness. Besides, the cut-off values for these markers vary significantly between studies and there are no clinical trials comparing them to identify the most relevant ones. These are limitations when implementing nutritional and inflammatory biomarkers into clinical practice and further studies are needed in order to answer these questions.
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Lan YZ, Wu Z, Chen WJ, Yu XN, Wu HT, Liu J. Sine oculis homeobox homolog family function in gastrointestinal cancer: Progression and comprehensive analysis. World J Clin Oncol 2025; 16:97163. [DOI: 10.5306/wjco.v16.i1.97163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Revised: 09/20/2024] [Accepted: 10/20/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
The sine oculis homeobox homolog (SIX) family, a group of transcription factors characterized by a conserved DNA-binding homology domain, plays a critical role in orchestrating embryonic development and organogenesis across various organisms, including humans. Comprising six distinct members, from SIX1 to SIX6, each member contributes uniquely to the development and differentiation of diverse tissues and organs, underscoring the versatility of the SIX family. Dysregulation or mutations in SIX genes have been implicated in a spectrum of developmental disorders, as well as in tumor initiation and progression, highlighting their pivotal role in maintaining normal developmental trajectories and cellular functions. Efforts to target the transcriptional complex of the SIX gene family have emerged as a promising strategy to inhibit tumor development. While the development of inhibitors targeting this gene family is still in its early stages, the significant potential of such interventions holds promise for future therapeutic advances. Therefore, this review aimed to comprehensively explore the advancements in understanding the SIX family within gastrointestinal cancers, focusing on its critical role in normal organ development and its implications in gastrointestinal cancers, including gastric, pancreatic, colorectal cancer, and hepatocellular carcinomas. In conclusion, this review deepened the understanding of the functional roles of the SIX family and explored the potential of utilizing this gene family for the diagnosis, prognosis, and treatment of gastrointestinal cancers.
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Bian JY, Feng YF, He WT, Zhang T. Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine. World J Clin Oncol 2025; 16:93670. [DOI: 10.5306/wjco.v16.i1.93670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 09/04/2024] [Accepted: 10/11/2024] [Indexed: 10/30/2024] [Imported: 10/30/2024] Open
Abstract
BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer (mCRC) have a low incidence rate, poor biological activity, suboptimal response to conventional treatments, and a poor prognosis. In the previous cohort study on mCRC conducted by our team, it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival (OS) of patients with colorectal cancer. Therefore, we further explored the survival benefits in the population with BRAF V600E mutant mCRC.
AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.
METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022. The patients were divided into two cohorts.
RESULTS A total of 34 cases were included, with 23 in Chinese-Western medicine cohort (cohort A) and 11 in Western medicine cohort (cohort B). The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B, with a statistically significant difference (P = 0.038, hazard ratio = 0.46). The 1-3-year survival rates were 95.65% (22/23), 39.13% (9/23), and 26.09% (6/23) in cohort A, and 63.64% (7/11), 18.18% (2/11), and 9.09% (1/11) in cohort B, respectively. Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon, liver metastasis, chemotherapy, and first-line treatment subgroups (P < 0.05).
CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer, with more pronounced benefits observed in patients with right colon involvement, liver metastasis, combined chemotherapy, and first-line treatment.
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Christodoulidis G, Agko SE, Koumarelas KE, Kouliou MN, Zacharoulis D. Advancements and challenges in the treatment of esophageal cancer: A comprehensive review. World J Clin Oncol 2024; 15:1463-1467. [DOI: 10.5306/wjco.v15.i12.1463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Revised: 07/23/2024] [Accepted: 10/15/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
Esophageal cancer (EC) is an aggressive malignancy with a poor prognosis, ranking seventh in incidence and sixth cancer-related deaths globally. EC is classified in two main types, the esophageal squamous cell carcinoma (ESCC) and esophageal adenocarcinoma (EAC), with ESCC being more common in Eastern Europe, South Asia, and Africa, while EAC is prevalent in Western Europe and North America. Molecular analysis identifies three subgroups of ESCC, each with distinct genetic mutations and treatment responses. Early-stage EC is often difficult to detect, leading to late-stage diagnoses that necessitate systemic drug therapies, including molecular-targeted therapies and immunotherapies. Immunotherapy, particularly immune checkpoint inhibitor, has shown promising results in improving survival rates for metastatic or persistent EC. It is particularly important to target to multidisciplinary combination therapies, integrating surgery, chemoradiotherapy, targeted therapy and immunotherapy. Additionally, radioimmunotherapy is being explored for its potential to enhance treatment efficacy, especially in advanced and metastatic tumors. However, the pathological complete response rate to neoadjuvant chemoradiotherapy remains suboptimal, highlighting the need for novel treatment strategies. Future research should focus on optimizing treatment combinations and identifying predictive biomarkers to improve clinical outcomes for EC patients.
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Moukadem HA, Fakhreddine MA, Assaf N, Safi N, Al Masry A, Al Darazi M, Mahfouz R, El Saghir NS. Germline pathogenic variants among high hereditary risk patients with breast and ovarian cancer and unaffected subjects in Lebanese Arab women. World J Clin Oncol 2024; 15:1481-1490. [DOI: 10.5306/wjco.v15.i12.1481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/23/2024] [Accepted: 10/11/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND The prevalence of germline pathogenic variants in high hereditary risk breast and/or ovarian cancer patients and unaffected subjects referred for testing is an unmet need in low and middle-income countries.
AIM To determine the prevalence of germline pathogenic variants in high hereditary risk patients with breast and/or ovarian cancer and unaffected individuals.
METHODS We retrospectively reviewed records of patients and unaffected subjects referred for germline pathogenic variant testing due to high hereditary risk between 2010-2020. Data was collected and analyzed on Excel sheet.
RESULTS In total, 358 individuals were included, including 257 patients and 101 unaffected individuals with relatives with breast or ovarian cancer. The prevalence of breast cancer susceptibility gene (BRCA) 1/2 pathogenic variants was 8.63% (19/220) in patients with breast cancer, and 15.1% (5/33) in those with ovarian cancer. Among the 25 of 220 patients with breast cancer tested by next-generation sequencing, 3 patients had pathogenic variants other than BRCA1/2. The highest risk was observed in those aged 40 years with breast cancer and a positive family history, where the BRCA1/2 prevalence was 20.1% (9/43). Among the unaffected subjects, 31.1% (14/45) had the same BRCA1/2 pathogenic variants in their corresponding relatives. Among the subjects referred because of a positive family history of cancer without known hereditary factors, 5.35% (3/56) had pathogenic variants of BRCA1 and BRCA2. The c.131G>T nucleotide change was noted in one patient and two unrelated unaffected subjects with a BRCA1 pathogenic variant.
CONCLUSION This study showed a 8.63% prevalence of pathogenic variants in patients with breast cancer and a 15.1% prevalence in patients with ovarian cancer. Among the relatives of patients with BRCA1/2 pathogenic variants, 31% tested positive for the same variant, while 5.3% of subjects who tested positive due to a family history of breast cancer had a BRCA pathogenic variant.
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Du H, Chen HB, Zhao Y. Exploring a new chapter in traditional Chinese medicine: The potential of Calculus bovis in liver cancer treatment. World J Clin Oncol 2024; 15:1520-1527. [DOI: 10.5306/wjco.v15.i12.1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/19/2024] [Accepted: 10/15/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
In the ongoing quest for new treatments in medicine, traditional Chinese medicine offers unique insights and potential. Recently, studies on the ability of Calculus bovis to inhibit M2-type tumour-associated macrophage polarisation by modulating the Wnt/β-catenin signalling pathway to suppress liver cancer have undoubtedly revealed new benefits and hope for this field of research. The purpose of this article is to comment on this study and explore its strengths and weaknesses, thereby providing ideas for the future treatment of liver cancer.
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Sun YW, Zhou Y, Liu XY, Shen DH. DEK::AFF2 fusion-associated middle ear non-keratinizing squamous cell carcinoma: A case report. World J Clin Oncol 2024; 15:1501-1506. [DOI: 10.5306/wjco.v15.i12.1501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 09/19/2024] [Accepted: 09/30/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND Primary squamous cell carcinoma (SCC) of the middle ear is rare, with non-keratinizing basaloid types being exceptionally uncommon. Distinguishing these cancers, often caused by viral factors (e.g., human papillomavirus or Epstein-Barr virus), or specific genetic alterations (e.g., bromodomain-containing protein 4-nuclear protein in testis fusion gene or Ewing sarcoma breakpoint region 1 gene fused with FLI chromosomal rearrangement), from other cranial conditions, is difficult. The recently identified DEK::AFF2 non-keratinizing SCC (NKSCC) is a novel subtype, fitting the World Health Organization classification of head and neck neoplasms. Less than 30 cases have been reported, highlighting the need for further studies.
CASE SUMMARY A 55-year-old female patient first exhibited signs of illness over 10 years ago with persistent discomfort in the left external auditory canal, accompanied by skin irritation and bleeding. One month prior to seeking professional help, she experienced hearing loss and a sensation of obstruction in the affected ear, intermittently accompanied by ringing sounds, but no dizziness. An unusual mass was detected in the left auditory canal, confirmed through biopsy as moderately differentiated epithelial squamous cancer cells. This led to her admission to our hospital, where the final diagnosis confirmed as “NKSCC linked to a positive DEK::AFF2 fusion”. The patient underwent surgical excision, followed by three cycles of local radiation therapy. Yet, metastasis to the lumbar vertebrae occurred 19 months post-treatment, followed by neck lymph node swelling detected three months after a physical examination. The patient died nine months later despite surgical removal of the metastatic lesion.
CONCLUSION DEK::AFF2 gene fusion-associated NKSCC of the middle ear carries a grim prognosis and presents an emerging challenge.
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Fasano M, Pirozzi M, Vitale P, Damiano V, Ronzino G, Farese S, Carfora V, Ciccarelli G, Di Giovanni I, Facchini S, Cennamo G, Caraglia M, Ciardiello F, Addeo R. Paclitaxel for second-line treatment of squamous cell carcinoma of the head and neck: A multicenter retrospective Italian study. World J Clin Oncol 2024; 15:1468-1480. [DOI: 10.5306/wjco.v15.i12.1468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 08/02/2024] [Accepted: 08/26/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND Squamous cell carcinoma of the head and neck (SCCHN) accounts for 3% of all malignant tumors in Italy. Immune checkpoint inhibitors combined with chemotherapy is first-line treatment for SCCHN; however, second-line treatment options are limited. Taxanes are widely used for combination therapy of SCCHN, as clinical trials have shown their efficacy in patients with this disease, particularly in patients with prior therapy.
AIM To perform a multicenter retrospective study on the efficacy and safety of weekly paclitaxel for SCCHN.
METHODS All patients were previously treated with at least one systemic therapy regimen, which included platinum-based therapy in the vast majority. No patient received prior immunotherapy.
RESULTS Median progression-free survival (mPFS) was 3.4 months and median overall survival (mOS) was 6.5 months. Subgroup analysis was performed according to three principal prognostic factors: Smoking, alcohol consumption, and body mass index. Analysis demonstrated reduced survival, both mOS and mPFS, in the unfavorable prognostic groups, with the biggest deltas observed in mOS.
CONCLUSION Weekly paclitaxel provided favorable survival and disease control rates, with low severe adverse events. Paclitaxel is a safe and valid therapeutic option for patients with SCCHN who received prior therapy.
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Ma Y, Jia B, He XJ, Cai YX, Chen JY, Zhong JX. Orbital and sinus rhabdomyosarcoma with concurrent central retinal artery occlusion: A case report. World J Clin Oncol 2024; 15:1507-1513. [DOI: 10.5306/wjco.v15.i12.1507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2024] [Revised: 09/05/2024] [Accepted: 09/30/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND Both rhabdomyosarcoma (RMS) and central retinal artery occlusion (CRAO) are rare medical diseases, and their simultaneous occurrence in the same patient is extraordinarily uncommon. This study presents a comprehensive overview of the clinical manifestations, diagnostic imaging results, and therapeutic interventions of a patient with both conditions.
CASE SUMMARY In this report, we present a 30-year-old male who presented with significant protrusion, pain and vision loss and was diagnosed with RMS in the orbit and sinus with CRAO. Following resection of the sinus and orbital mass and enucleation of the right eye, the patient experienced symptom improvement.
CONCLUSION This article provides an in-depth analysis of the patient’s clinical manifestations, the tumor’s anatomical origin, and the etiology of CRAO. The concurrent manifestation of both RMS and CRAO is exceedingly uncommon in clinical practice.
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Das A, Bararia A, Mukherjee S, Sikdar N. Chronic pancreatitis as a driving factor for pancreatic cancer: An epidemiological understanding. World J Clin Oncol 2024; 15:1459-1462. [DOI: 10.5306/wjco.v15.i12.1459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 09/21/2024] [Accepted: 10/08/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
The retrospective study by Lew et al (2022) examined the rising hospitalization rates for chronic pancreatitis (CP) and its association with pancreatic ductal adenocarcinoma (PDAC), revealing significant ethno-racial disparities and risk factors. Overweight black men aged 40-59 years and white men over 40 years with higher incomes showed an elevated risk of PDAC among CP patients. The study, which included 14.2 million admissions from 2016-2017, found that 2.6% of adult patients were diagnosed with CP, with white males being the majority. Multivariate regression analysis identified men, black individuals, those aged 40-59 years, and individuals with a body mass index (BMI) between 25 and 29.9 as having an increased risk for CP. Moreover, 0.78% of CP patients also had PDAC, with older age and BMI being significant risk factors for developing PDAC in CP patients. The study also highlighted disparities in healthcare access and utilization among different socioeconomic and ethno-racial groups, which may impact the risk and outcomes of CP and PDAC.
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Zu YE, Wang SF, Peng XX, Wen YC, Shen XX, Wang XL, Liao WB, Jia D, Liu JY, Peng XW. New cheaper human papilloma virus mass screening strategy reduces cervical cancer incidence in Changsha city: A clinical trial. World J Clin Oncol 2024; 15:1491-1500. [DOI: 10.5306/wjco.v15.i12.1491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/05/2024] [Accepted: 10/14/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND Cervical cancer is the second leading cause of death in women worldwide, second only to breast cancer. Around 80% of women have been infected with human papillomavirus (HPV) in their lifetime. Early screening and treatment are effective means of preventing cervical cancer, but due to economic reasons, many parts of the world do not have free screening programs to protect women’s health.
AIM To increase HPV cervical cancer screening in Changsha and reduce the incidence of cervical cancer.
METHODS Cervical cancer screening included gynecological examination, vaginal secretion examination and HPV high-risk typing testing. Cervical cytology examination (ThinPrep cytology test) was performed for individuals who test positive for HPV types other than 16 and 18. Vaginal colposcopy examination was performed for HPV16 and 18 positive individuals, as well as for those who were positive for ThinPrep cytology test. If the results of vaginal colposcopy examination were abnormal, histopathological examination was performed. We conducted a cost-benefit analysis after 4 years.
RESULTS From 2019 to 2022, 523437 women aged 35-64 years in Changsha city were screened and 73313 were positive, with a 14% positive rate. The detection rate of precancerous lesions of cervical cancer was 0.6% and the detection rate of cervical cancer was 0.037%. Among 311212 patients who underwent two cancers examinations, the incidence rate was reduced by more than half in the second examination. The average screening cost per woman was 120 RMB. The average cost of detecting early cases was 10619 RMB, with an early detection cost coefficient of 0.083.
CONCLUSION Our screening strategy was effective and cost-effective, making it valuable for early diagnosis and treatment of cervical cancer. It is worth promoting in economically limited areas.
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Luo Y, Li CY, Wang YQ, Xiang SM, Zhao C. Diabetic ulcer with cutaneous squamous cell carcinoma: A case report. World J Clin Oncol 2024; 15:1514-1519. [DOI: 10.5306/wjco.v15.i12.1514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 09/02/2024] [Accepted: 09/10/2024] [Indexed: 10/22/2024] [Imported: 10/22/2024] Open
Abstract
BACKGROUND Chronic skin ulcers are a risk factor for the development of skin tumors. In patients with diabetes, chronic refractory ulcers may also contribute to higher susceptibility to skin tumors. Timely surgical removal of chronic and nonhealing diabetic foot ulcers can effectively prevent progression to squamous cell carcinoma. Such cases may be misdiagnosed owing to currently insufficient clinical evidence. However, in cases of chronic ulcer wounds, it is crucial to enhance clinical awareness regarding their potential progression into malignant lesions.
CASE SUMMARY An 84-year-old male patient with diabetes presented with a significantly ulcerated area on his foot. The ulcer had been present to varying degrees since 1996. Between 2012 and July 2019, even after receiving treatments such as herbal medicines or heat clearance and detoxification complete healing of the wound was not achieved. In July 2020, histopathological analysis confirmed a well-differentiated cutaneous squamous cell carcinoma. After the treatments, the ulcer wound healed slowly and did not expand.
CONCLUSION Potentially malignant lesions in chronic ulcer wounds should be identified and treated in a timely manner to prevent their progression.
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Stojanovic MM, Brzacki V, Marjanovic G, Nestorovic M, Zivadinovic J, Krstic M, Gmijovic M, Golubovic I, Jovanovic S, Stojanovic MP, Terzic K. Primary pancreatic lymphoma: A case report and review of literature. World J Clin Oncol 2024; 15:1444-1453. [DOI: 10.5306/wjco.v15.i11.1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 08/21/2024] [Accepted: 09/23/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
BACKGROUND Primary pancreatic lymphoma (PPL) is a rare tumor that mimics pancreatic adenocarcinoma, leading to diagnostic and therapeutic challenges. PPL accounts for 0.2% of all pancreatic tumors and is typically treated with chemotherapy. However, the long-term survival rates for PPL with chemotherapy and radiotherapy alone are unsatisfactory. Due to the improvements in pancreatic surgery, there is a need to reevaluate the treatment strategies for PPL.
CASE SUMMARY A 62-year-old male presented to our clinic. A biopsy was unsuccessful, and the imaging was suggestive of pancreatic adenocarcinoma. Therefore, subtotal splenopancreatectomy was performed and histopathology was performed. He was then diagnosed with primary pancreatic diffuse large B-cell lymphoma. He received adjuvant chemotherapy and radiotherapy. Currently, the patient is alive with no evidence of disease 36 months after surgery.
CONCLUSION The potential role of surgery in the treatment of PPL should be emphasized and added in the management protocol of early stage lymphoma.
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Gafton B, Morarasu S, Dimofte G. Role of immunotherapy in gastric cancer with liver metastasis. World J Clin Oncol 2024; 15:1383-1389. [DOI: 10.5306/wjco.v15.i11.1383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 09/08/2024] [Accepted: 09/23/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
Gastric cancer continues to be a significant issue for public health, marked by its widespread occurrence and high mortality rates, even as the incidence of the disease shows a declining trend. The liver is the primary site for metastatic spread, with the peritoneum, lungs, and bones also being common targets. With the advent of biologic treatments and the introduction of immunotherapy for patients with metastatic conditions, the options to treat metastatic gastric cancer have expanded. This diversified therapeutic approach is designed to enhance patient quality of life and prolong survival, showcasing the progress in treatment modalities for individuals with gastric cancer and liver metastases.
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Tang JE, Wang RJ, Fang ZH, Zhu PY, Yao JX, Yang H. Treatment of fat-poor renal angiomyolipoma with ectopic blood supply by fluorescent laparoscopy: A case report and review of literature. World J Clin Oncol 2024; 15:1435-1443. [DOI: 10.5306/wjco.v15.i11.1435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 09/05/2024] [Accepted: 09/27/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
BACKGROUND Renal angiomyolipoma and renal cell carcinoma are the most common benign and malignant tumors of the kidney respectively, and the preoperative differential diagnosis is crucial due to the wide difference in treatment methods. Fat-poor renal angiomyolipoma is a relatively rare type of in renal angiomyolipoma. Its fat imaging features are not obvious, and it is easily misdiagnosed as renal cell carcinoma.
CASE SUMMARY We report the case of a 41-year-old man who complained of osphyalgia. Subsequent abdominal computed tomography scans revealed that a heterogeneous mass was seen in the lower pole of the right kidney, with the size of about 53 mm × 47 mm. And showed two right renal arteries, with the mass supplied by an ectopic vessel from the abdominal aorta. Fluorescent laparoscopic blockade of the right renal heterotopic artery and partial nephrectomy was performed. Based on histological and immunohistochemical findings, the tumor was diagnosed as fat-poor renal angiomyolipoma.
CONCLUSION The use of fluorescent laparoscopy can effectively help intraoperative management, and the fluorescence pattern provided by intravenous indocyanine green can help suggest the final diagnosis, effectively guide the surgical decision-making, and avoid preoperative imaging diagnosis leading to nephrectomy for benign renal tumors, through fluorescent navigation of tumor supply vessel precise block, minimize the loss of renal function.
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Rzeniewicz K, Sharma R. Systemic treatment of hepatocellular carcinoma secondary to non-alcoholic fatty liver disease. World J Clin Oncol 2024; 15:1394-1403. [DOI: 10.5306/wjco.v15.i11.1394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/29/2024] [Accepted: 08/05/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
Hepatocellular carcinoma (HCC) is the third leading cause of cancer death globally, with 15% of cases arising on a background of non-alcoholic fatty liver disease (NAFLD). NAFLD is a heterogenous condition ranging from fatty liver to cirrhosis and is itself a growing global problem, with estimated worldwide prevalence of 50% in 2040. Pathophysiology of NAFLD-HCC is not well understood, there are no dedicated screening programs, and there have been no clinical studies of anti-cancer treatments in this population specifically. However, the NAFLD-HCC population appears different than other aetiologies - patients tend to be older, diagnosed at more advanced stages, have more comorbidities, and overall worse prognosis. Understanding of best treatment options for this group of patients is an urgent unmet clinical need. This narrative review discusses NAFLD-HCC pathophysiology and systemic treatment, and offers suggestions for future directions in this therapy area.
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Song ZN, Cheng Y, Wang DD, Li MJ, Zhao XR, Li FW, Liu Z, Zhu XR, Jia XD, Wang YF, Liang FF. Whole exome sequencing identifies risk variants associated with intracranial epidermoid cyst deterioration: A case report. World J Clin Oncol 2024; 15:1428-1434. [DOI: 10.5306/wjco.v15.i11.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 09/11/2024] [Accepted: 09/25/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
BACKGROUND Intracranial epidermoid cyst (IEC) transformation to malignant squamous cell carcinoma (SCC) is extremely rare, and its etiology is yet unknown. Currently, SCC is treated by performing surgery, followed by a combination of radiotherapy and chemotherapy. It is crucial to identify efficient and trustworthy therapeutic targets for SCC to improve its diagnosis, prognosis, and treatment.
CASE SUMMARY In this study, we report the case of a 47-year-old female patient with SCC, which progressed from IEC in the left internal capsule region. The patient was sought treatment at our hospital for severe diplopic vision, accompanied with speech disorder and memory loss. Based on the clinical and postoperative pathology, this patient was finally diagnosed with SCC. To identify disease-causing variants, whole exome sequencing (WES) was performed on the proband. WES revealed two pathogenic missense mutations on Gap junction protein beta 2 (GJB2) (c.257C>T) and Toll-like receptor 2 (TLR2) (c.1039A>G), respectively.
CONCLUSION This study provided the first clinical evidence for demonstrating the role of GJB2 and TLR2 in IEC development and treatment. We further confirmed WES as a robust and reliable technique for underlying rare and complex disease-related genetic factor identification.
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Ono T, Koto M. Radical radiotherapy without surgical tumor resection for rectal cancer. World J Clin Oncol 2024; 15:1390-1393. [DOI: 10.5306/wjco.v15.i11.1390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2024] [Revised: 09/19/2024] [Accepted: 09/27/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
In this editorial, I would like to comment on the article, recently published in the World Journal of Clinical Oncology. The article focuses on non-surgical treatments for locally recurrent rectal cancer, including the watch-and-wait (WW) strategy after total neoadjuvant therapy (TNT) and particle beam therapy. As treatment options for rectal cancer continue to evolve, the high complete response rate achieved with TNT has led to the development of a new non-surgical approach: WW. Chemoradiotherapy followed by consolidation chemotherapy, in particular, has a low rate of tumor growth and is a treatment aimed at achieving a cure without surgery. However, the risk of recurrence within two years is significant, necessitating careful follow-up. Establishing standardized follow-up methods that can be implemented by many physicians is essential. Carbon ion radiotherapy has demonstrated high local control with a low incidence of severe late toxicities, even after previous pelvic radiotherapy. While these new non-surgical curative treatments for rectal cancer require further investigation, future advancements in this field are anticipated.
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Li H, Huang HQ, Huang ZG, He RQ, Fang YY, Song R, Luo JY, Zeng DT, Qin K, Wei DM, Chen G. Potential regulatory mechanism and clinical significance of synaptotagmin binding cytoplasmic RNA interacting protein in colorectal cancer. World J Clin Oncol 2024; 15:1412-1427. [DOI: 10.5306/wjco.v15.i11.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 08/17/2024] [Accepted: 09/09/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
BACKGROUND Colorectal cancer (CRC) causes many deaths worldwide. Synaptotagmin binding cytoplasmic RNA interacting protein (SYNCRIP) is an RNA-binding protein that plays an important role in multiple cancers by epigenetically targeting some genes. Our study will examine the expression, potential effect, biological function and clinical value of SYNCRIP in CRC.
AIM To examine the expression, potential effect, biological function and clinical value of SYNCRIP in CRC.
METHODS The expression of SYNCRIP was examined by immunohistochemistry arrays and high-throughput data. The effect of SYNCRIP gene in CRC cell growth was evaluated by CRISPR-Cas9 technology. The target genes of SYNCRIP were calculated using various algorithms, and the molecular mechanism of SYNCRIP in CRC was explored by mutation analysis and pathway analysis. The clinical value of SYNCRIP in prognosis and radiotherapy was revealed via evidence-based medicine methods.
RESULTS The protein and mRNA levels of SYNCRIP were both highly expressed in CRC samples compared to nontumorous tissue based on 330 immunohistochemistry arrays and 3640 CRC samples. Cells grew more slowly in eleven CRC cell lines after knocking out the SYNCRIP gene. SYNCRIP could epigenetically target genes to promote the occurrence and development of CRC by boosting the cell cycle and affecting the tumor microenvironment. In addition, CRC patients with high SYNCRIP expression are more sensitive to radiotherapy.
CONCLUSION SYNCRIP is upregulated in CRC, and highly expressed SYNCRIP can accelerate CRC cell division by exerting its epigenetic regulatory effects. In addition, SYNCRIP is expected to become a potential biomarker to predict the effect of radiotherapy.
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Li GY, Jiang J. Recent efficacy and long-term survival of Astragalus polysaccharide combined with gemcitabine and S-1 in pancreatic cancer. World J Clin Oncol 2024; 15:1404-1411. [DOI: 10.5306/wjco.v15.i11.1404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 08/28/2024] [Accepted: 09/12/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
BACKGROUND Pancreatic cancer is a highly malignant tumor with a rapid progression rate and a high susceptibility to infiltration and metastasis. Astragalus polysaccharide (APS), a pure Chinese medicine preparation primarily made from the traditional Chinese herb Astragalus, plays a positive role in the treatment of many malignant tumors.
AIM To explore the recent efficacy of APS combined with gemcitabine plus tegafur gimeracil oteracil potassium capsule (S-1) (GS) regimen in the treatment of pancreatic cancer and assess its effect on the immune function and long-term survival of patients.
METHODS A total of 97 patients who were diagnosed with pancreatic cancer and received GS chemotherapy at The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine) from March 2021 to December 2021 were included in the retrospective analysis. Among them, 41 patients received APS combined with GS chemotherapy, and 56 patients received GS chemotherapy only. The recent efficacy, immune function, adverse reactions, and long-term survival were compared among these patients.
RESULTS After 4 cycles of treatment, the objective response rate of patients receiving the combined therapy of APS and GS was 51.22%, and the disease control rate (DCR) was 56.10%, higher than those of patients receiving the monotherapy with GS alone (30.36% and 35.71%, respectively). Besides, the percentages of CD3+ T cells (50.18% ± 9.57%) and CD4+ T cells (31.52% ± 5.33%) in the peripheral blood of patients receiving the combined therapy of APS and GS were higher compared with those treated with GS regimen alone [(44.06% ± 8.55%) and (26.01% ± 7.83%), respectively]. Additionally, the incidences of leukopenia, thrombocytopenia, and fatigue in patients receiving the combined therapy of APS and GS were significantly lower than those in patients receiving the monotherapy of GS alone (17.07%, 9.76%, 31.71% vs 37.50%, 28.57%, 60.71%). Moreover, the median survival time of patients receiving the combined therapy of APS and GS was 394 days, significantly longer than that of patients receiving the monotherapy of GS alone (339 days) (hazard ratio: 0.66; 95%CI: 0.45-0.99; P = 0.036). All these differences were statistically significant (P < 0.05).
CONCLUSION The combined therapy of APS and GS improved the recent efficacy and long-term survival of patients with pancreatic cancer and alleviated chemotherapy-induced immune suppression and adverse reactions.
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