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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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Lyon-Colbert AD, Basson MD, Klug MG, Schwartz GG. Well water contaminants and colorectal cancer in North Dakota. World J Clin Oncol 2024; 15:1454-1458. [DOI: 10.5306/wjco.v15.i11.1454] [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: 05/23/2024] [Revised: 09/16/2024] [Accepted: 09/25/2024] [Indexed: 10/14/2024] [Imported: 10/14/2024] Open
Abstract
This study aims to identify common contaminants in well water linked to an increase in colorectal cancer (CRC) incidence rates in North Dakota (ND) counties. County-specific incidence rates for CRC were obtained from the ND Statewide Cancer Registry. Corresponding demographic, agricultural, and geophysical data were obtained from population-based sources. Associations between well water contaminants and CRC incidence were examined for 16 counties in ND with complete well water profiles between 1997-2019. Data were analyzed by multiple linear regression. Iron in well water exhibited a significant positive association with CRC incidence (4.75, P = 0.001), and barium exhibited a small, but significant negative association (-0.06907, P = 0.01). Residents in counties in ND with prevalent well water usage contaminated with iron may be at higher risk for CRC.
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Tez M. Inflammatory and nutritional markers in colorectal cancer: Implications for prognosis and treatment. World J Clin Oncol 2024; 15:1264-1268. [DOI: 10.5306/wjco.v15.i10.1264] [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: 07/25/2024] [Revised: 08/25/2024] [Accepted: 08/28/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
The prognosis of colorectal cancer (CRC) patients with peritoneal metastasis remains poor despite advancements in detection and treatment. Preoperative inflammatory and nutritional markers have emerged as significant predictors of prognosis in CRC, potentially guiding treatment decisions and improving patient outcomes. This editorial explores the prognostic value of markers such as the neutrophil-to-lymphocyte ratio, hemoglobin, and serum albumin levels. By integrating these markers into prognostic models, clinicians can better stratify patients, personalize treatment strategies, and ultimately enhance clinical outcomes. This review highlights the importance of these markers in providing a comprehensive assessment of patient condition and underscores the need for further research to validate their clinical utility and uncover underlying mechanisms.
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Liu D, Li SC. Nursing of a patient with multiple primary cancers: A case report and review of literature. World J Clin Oncol 2024; 15:1315-1323. [DOI: 10.5306/wjco.v15.i10.1315] [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: 03/19/2024] [Revised: 08/15/2024] [Accepted: 08/23/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Although the occurrence of multiple primary cancers (MPC) is not exceedingly common, it is not rare in clinical practice. In recent years, there has been a notable increase in its incidence. The frequent confusion between MPC and tumor metastasis or recurrence often leads to delays in diagnosis and treatment. This study aimed to enhance understanding of MPC, improve diagnostic accuracy, guide precise clinical treatment, and implement a case management nursing model (CMNM) to facilitate quick patient recovery.
CASE SUMMARY A 61-year-old female patient presented with persistent upper abdominal pain lasting over 2 months. Gastroscopy revealed the presence of both gastric and duodenal cancers. Following a thorough evaluation, the patient underwent pancreaticoduodenectomy, cholecystectomy, and total gastrectomy. Post-surgery, an individualized case management nursing approach was applied, leading to a successful recovery. Three months after the surgery, follow-up examinations showed no signs of recurrence.
CONCLUSION The CMNM effectively promoted rapid patient recovery, enhanced the quality of orthopedic nursing services, and accelerated postoperative recovery, ultimately leading to increased patient satisfaction with nursing care.
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Dursun CU, Tugcu AO, Dogru GD. Gastric metastasis of small cell lung carcinoma: A rare but noteworthy entity to consider. World J Clin Oncol 2024; 15:1379-1382. [DOI: 10.5306/wjco.v15.i10.1379] [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: 08/13/2024] [Revised: 09/12/2024] [Accepted: 09/19/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
Small cell lung carcinoma (SCLC) is an aggressive malignancy known for its propensity for early and extensive metastatic spread. Gastric metastasis, where cancer cells disseminate from the lung to the stomach, is a rare but increasingly recognized complication of SCLC. This review provides a comprehensive overview of gastric metastasis in SCLC, addressing its clinical significance, diagnostic challenges, management strategies, and prognosis. Additionally, it examines the broader metastatic patterns of SCLC and compares them with other malignancies known for gastric metastasis. Gastric metastasis in SCLC, though infrequent, is clinically significant and often indicates advanced disease with a poor prognosis. SCLC typically metastasizes to the liver, brain, bones, and adrenal glands, with the stomach being an unusual site. The incidence of gastric metastasis ranges from 1% to 5% in autopsy studies, although this may be underestimated due to diagnostic difficulties and asymptomatic early lesions. Diagnosing gastric metastasis presents several challenges, including the asymptomatic nature of many cases, limitations of conventional imaging techniques, and difficulties in distinguishing metastatic lesions from primary gastric cancer via endoscopy. Histopathological diagnosis requires careful examination to identify SCLC cells through their characteristic small cell morphology and neuroendocrine markers. Management of gastric metastasis in SCLC typically involves a multidisciplinary approach. Systemic therapy, primarily chemotherapy, remains the cornerstone of treatment, with palliative care addressing symptoms and complications. Surgical intervention is usually reserved for specific cases requiring symptomatic relief. The prognosis for patients with gastric metastasis from SCLC is generally poor, reflecting the advanced stage of the disease. Median survival is significantly reduced compared to patients without gastric metastasis. This review emphasizes the need for enhanced awareness and early detection to improve patient outcomes and highlights the importance of ongoing research into better diagnostic and therapeutic strategies.
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Lei XG, Zhang H. Vaginal clear cell adenocarcinoma in Herlyn-Werner-Wunderlich syndrome: A case report. World J Clin Oncol 2024; 15:1359-1365. [DOI: 10.5306/wjco.v15.i10.1359] [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: 04/26/2024] [Revised: 09/14/2024] [Accepted: 09/19/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Herlyn-Werner-Wunderlich (HWW) syndrome is a rare Müllerian duct anomaly, characterized by a combination of urogenital abnormalities. The occurrence of primary cervico-vaginal carcinomas in patients with HWW syndrome is exceptionally rare, posing significant challenges for screening, early diagnosis, and effective management.
CASE SUMMARY We report a rare case of primary clear cell carcinoma of the vagina complicated in a 40-year-old woman with HWW syndrome. The patient presented with irregular vaginal bleeding for 4 years. On gynecological examination, an oblique vaginal septum was suspected. Surgical resection of the vaginal septum revealed a communicating fistula and a tumor on the left vagina and the left side of the septum, which was confirmed as clear cell carcinoma. One month later, she underwent a radical hysterectomy, vaginectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Due to significant side effects, she completed only one course of chemotherapy. A year later, lung metastasis was detected and continued to grow. A thoracoscopic wedge resection of the right upper lobe was performed 4 years after the initial surgery. We also conducted a systemic review of the literature on primary cervical or vaginal carcinoma in HWW syndrome to explore this rare entity.
CONCLUSION Cervico-vaginal adenocarcinomas in patients with HWW syndrome are occult, and require early surgical intervention and regular imaging surveillance.
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Li XQ, Yang J, Liu B, Han SM. Disitamab vedotin combined with apatinib in gastric cancer: A case report and review of literature. World J Clin Oncol 2024; 15:1351-1358. [DOI: 10.5306/wjco.v15.i10.1351] [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: 04/15/2024] [Revised: 08/18/2024] [Accepted: 08/29/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND In patients with human epidermal growth factor receptor 2 (HER2)-overexpressing gastric cancer (GC), the combination of HER2 targeting and a standard first-line chemotherapy regimen has been demonstrated to significantly improve their prognosis. However, in a proportion of patients, cancer progresses within a short period of time, and there is currently no standard treatment after disease progression.
CASE SUMMARY This study presents a case of a 51-year-old male with advanced GC who underwent radical resection (Billroth type II subtotal gastrectomy and gastrojejunostomy) and resection of liver metastases. Immunohistochemical staining revealed a HER2 score of 2+, a dMMR status, and a Ki67 proliferation index of 30% to 40%. The gene test results indicated the presence of ERBB2 amplification and a PD-L1 expression level of less than 5%. Since December 2021, the patient has experienced disease progression during both first-line (two cycles of KN026 combined with KN046) and second-line (five cycles of nivolumab combined with trastuzumab and SOX chemotherapy) treatment regimens. The patient's prognosis following the first and second lines of treatment was unfavorable, with progression occurring in a relatively short time. For third-line therapy, disitamab vedotin (RC48) plus apatinib was used. At the time of this report, the patient had achieved a progression-free survival (PFS) of 25.8 months, which exceeded the median survival time for patients with advanced GC.
CONCLUSION Despite the unfavorable prognosis associated with advanced GC, the implementation of personalized treatment approaches may still prove beneficial for select patients. In patients with HER2-positive GC with extensive metastatic involvement, the use of the HER2-targeted combination with apatinib has demonstrated the potential to prolong both PFS and overall survival.
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Chen QQ, Chen CQ, Liu JK, Huang MY, Pan M, Huang H. Hypofractionated and intensity-modulated radiotherapy combined with systemic therapy in metastatic hepatocellular carcinoma: A case report. World J Clin Oncol 2024; 15:1342-1350. [DOI: 10.5306/wjco.v15.i10.1342] [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: 04/08/2024] [Revised: 08/16/2024] [Accepted: 08/21/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Liver cancer treatment is characterized by multidisciplinary participation and coexistence of multiple treatment methods. Hypofractionated and intensity-modulated radiotherapy is a new precise radiotherapy technique applied to the treatment of systemic malignant tumors. There is a lack of understanding of hypofractionated and intensity-modulated radiotherapy combined with systemic therapy in metastatic hepatocellular carcinoma (HCC).
CASE SUMMARY We report a case of metastatic HCC treated with hypofractionated and intensity-modulated radiotherapy combined with systemic therapy. A 41-year-old man was diagnosed with metastatic HCC (T3N1M1 stage IVB). Because it was found to be in the late stage of cancer and had already metastasized, it was impossible to undergo surgical treatment. In addition to aggressive comprehensive treatment for the primary lesion, local treatment for metastatic cancer can improve the patient's survival potential. Hypofractionated and intensity-modulated radiotherapy can provide a larger single treatment dose within a shorter overall treatment time, and improve the local control rate of the tumor. Follow-up examination demonstrated that the tumor and metastatic lesions had shrunk after therapy. The treatment has showed good efficacy. The patient survived for 18 months without disease progression and stable disease persisted for > 38 months.
CONCLUSION Targeted therapy and immunotherapy followed by hypofractionated and intensity-modulated radiotherapy are also effective for advanced metastatic HCC.
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Zhu YL, Li R, Cheng YG, Wang YF. Perioperative management of postoperative sigmoid colon cancer complicated by a large abdominal wall defect: A case report. World J Clin Oncol 2024; 15:1333-1341. [DOI: 10.5306/wjco.v15.i10.1333] [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: 03/25/2024] [Revised: 08/25/2024] [Accepted: 08/29/2024] [Indexed: 09/29/2024] [Imported: 09/29/2024] Open
Abstract
BACKGROUND Large abdominal wall defect (LAWD) measures > 20 cm in width. LAWD can easily lead to intestinal necrosis, peritonitis, other complications, and even multiple organ dysfunction syndrome. Multiple intestinal fistulas are high-flow fistulas that can cause severe water–electrolyte imbalance and malnutrition, as well as inflammation, high metabolic status, and chronic intestinal failure caused by intestinal fluid corrosion in tissues around the orifice fistulas.
CASE SUMMARY This article summarizes the nursing experience of a patient with sigmoid carcinoma who has LAWD with multiple intestinal fistula due to repeated operations for postoperative complications. The key points of care: Scientific assessment of nutritional status, dynamic adjustment of nutritional support programmes, comprehensive adoption of enteral nutrition, parenteral nutrition and combined nutrition of enteral and parenteral; taking good care of abdominal wall defects and intestinal fistulas; continuous flushing of the abdominal drainage tube and low negative pressure drainage; prevention of venous thrombosis; strengthening of physical exercise; implementation of positive psychological interventions.
CONCLUSION After more than 7 months of careful care, the patient's physical fitness has been well recovered, local inflammation is well controlled, which wins the opportunity for the operation, and the postoperative recovery is good.
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