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Moschetta M, Telegrafo M, Introna T, Coi L, Rella L, Ranieri V, Cirili A, Stabile Ianora AA, Angelelli G. Role of specimen US for predicting resection margin status in breast conserving therapy. G Chir 2016; 36:201-4. [PMID: 26712255 DOI: 10.11138/gchir/2015.36.5.201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM To assess the diagnostic accuracy of specimen ultrasound (US) for predicting resection margin status in women undergoing breast conserving therapy for US-detected cancer, having the histological findings as the reference standard. PATIENTS AND METHODS A total of 132 consecutive patients (age range, 34-87 years; mean, 51 years) underwent breast-conserving surgery for US-detected invasive breast cancer. All surgical specimens underwent US examination. The presence of lesion within the specimen and its distance from the specimen margins were assessed considering a threshold distance between the lesion and specimen margins of 10 mm. US findings were then compared with the pathological ones and specimen US. Sensitivity, specificity, diagnostic accuracy, positive (PPV) and negative predictive values (NPV) for predicting histological margin status were evaluated, having the histological findings as the reference standard. RESULTS The histological examination detected invasive ductal carcinoma in 96/132 (73%) cases, invasive lobular carcinoma in 32/132 (24%), mucinous carcinoma in 4/132 (3%). The pathological margin analysis revealed 96/132 (73%) negative margins and 36 (27%) close/positive margins. US examination detected all 132 breast lesions within the surgical specimens. 110 (83%) negative margins and 22 (17%) positive margins were found on US. Sensitivity, specificity, diagnostic accuracy, PPV and NPV of 44%, 94%, 80%, 73% and 82%, respectively, were found for specimen US. CONCLUSIONS Specimen US represents a time and cost saving imaging tool for evaluating the presence of US detected-breast lesion within surgical specimen and for predicting the histological margin status.
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MESH Headings
- Adenocarcinoma, Mucinous/diagnostic imaging
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/surgery
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/epidemiology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Lobular/diagnostic imaging
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/surgery
- Female
- Humans
- Italy/epidemiology
- Mastectomy, Segmental/methods
- Middle Aged
- Predictive Value of Tests
- Sensitivity and Specificity
- Treatment Outcome
- Ultrasonography
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Peres LC, Camacho F, Abbott SE, Alberg AJ, Bandera EV, Barnholtz-Sloan J, Bondy M, Cote ML, Crankshaw S, Funkhouser E, Moorman PG, Peters ES, Schwartz AG, Terry P, Wang F, Schildkraut JM. Analgesic medication use and risk of epithelial ovarian cancer in African American women. Br J Cancer 2016; 114:819-25. [PMID: 26908324 PMCID: PMC4984862 DOI: 10.1038/bjc.2016.39] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 01/21/2016] [Accepted: 01/28/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Existing literature examining analgesic medication use and epithelial ovarian cancer (EOC) risk has been inconsistent, with the majority of studies reporting an inverse association. Race-specific effects of this relationship have not been adequately addressed. METHODS Utilising data from the largest population-based case-control study of EOC in African Americans, the African American Cancer Epidemiology Study, the relationship between analgesic use (aspirin, non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs), and acetaminophen) and risk of EOC was estimated by multivariate logistic regression. The association of frequency, duration, and indication of analgesic use on EOC risk was also assessed. RESULTS Aspirin use, overall, was associated with a 44% lower EOC risk (OR=0.56; 95% CI=0.35-0.92) and a 26% lower EOC risk was observed for non-aspirin NSAID use (OR=0.74; 95% CI=0.52-1.05). The inverse association was strongest for women taking aspirin to prevent cardiovascular disease and women taking non-aspirin NSAIDs for arthritis. Significantly decreased EOC risks were observed for low-dose aspirin use, daily aspirin use, aspirin use for <5 years, and occasional non-aspirin NSAID use for a duration of ⩾5 years. No association was observed for acetaminophen use. CONCLUSIONS Collectively, these findings support previous evidence that any NSAID use is inversely associated with EOC risk.
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Gansmo LB, Bjørnslett M, Halle MK, Salvesen HB, Dørum A, Birkeland E, Hveem K, Romundstad P, Vatten L, Lønning PE, Knappskog S. The MDM4 SNP34091 (rs4245739) C-allele is associated with increased risk of ovarian-but not endometrial cancer. Tumour Biol 2016; 37:10697-702. [PMID: 26867771 PMCID: PMC4999457 DOI: 10.1007/s13277-016-4940-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/29/2016] [Indexed: 12/17/2022] Open
Abstract
The MDM4 protein (also known as MDMX or HDMX) is a negative regulator of p53, not only by direct interaction but also through its interaction with MDM2. Further, MDM4 overexpression and amplification have been observed in several cancer forms. Recently, a single nucleotide polymorphism (SNP) in the 3’ untranslated region of the MDM4 gene, SNP34091A > C (rs4245739) was reported to alter MDM4 messenger RNA (mRNA) stability by modulating a microRNA binding site, thereby leading to decreased MDM4 levels. In this case-control study, we aimed to evaluate the possible association between MDM4 SNP34091 status and cancer risk by comparing the genotype frequencies in large hospital-based cohorts of endometrial- (n = 1404) and ovarian (n = 1385) cancer patients with healthy female controls (n = 1870). Genotype frequencies were compared by odds ratio (OR) estimates and Fisher exact tests. We found that individuals harboring the MDM4 SNP34091AC/CC genotypes had a significantly elevated risk for serous ovarian cancer (SOC) in general and high-grade serous ovarian cancer (HGSOC) in particular (SOC: OR = 1.18., 95 % CI = 1.01–1.39; HGSOC: OR = 1.25, CI = 1.02–1.53). No association between SNP34091 genotypes and endometrial cancer risk was observed. Our data indicate the MDM4 SNP34091AC/CC genotypes to be associated with an elevated risk for SOC and in particular the HGSOC type.
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MESH Headings
- 3' Untranslated Regions/genetics
- Adenocarcinoma, Clear Cell/epidemiology
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/genetics
- Alleles
- Carcinoma, Endometrioid/epidemiology
- Carcinoma, Endometrioid/genetics
- Case-Control Studies
- Cell Cycle Proteins
- Cystadenocarcinoma, Serous/epidemiology
- Cystadenocarcinoma, Serous/genetics
- Endometrial Neoplasms/epidemiology
- Endometrial Neoplasms/genetics
- Female
- Gene Frequency
- Genes, Neoplasm
- Genetic Predisposition to Disease
- Genotype
- Humans
- Neoplasm Proteins/genetics
- Norway/epidemiology
- Nuclear Proteins/genetics
- Odds Ratio
- Ovarian Neoplasms/epidemiology
- Ovarian Neoplasms/genetics
- Polymorphism, Single Nucleotide
- Proto-Oncogene Proteins/genetics
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Hussain M, Waqas O, Hassan U, Loya A, Akhtar N, Mushtaq S, Yusuf MA, Syed AA. Right-Sided and Left-Sided Colon Cancers are Two Distinct Disease Entities: an Analysis of 200 Cases in Pakistan. Asian Pac J Cancer Prev 2016; 17:2545-2548. [PMID: 27268627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND There is growing evidence that there are differences in histological and genetic characteristics along with clinical behavior between right- and left-sided colon carcinomas. We have compared various parameters of the two types and assessed associations of the results with prognosis in patients in Pakistan. MATERIALS AND METHODS We reviewed 200 cases from our institutional database; 100 cases of right-sided and 100 cases of left-sided colon cancer. Parameters including age, gender, TNM stage, histological features and clinical outcome were analyzed. RESULTS The patients with right-sided colon cancer were significantly older as compared to their counterparts with left-sided cancer. They presented with a lumbar mass rather than symptoms of obstruction and perforation as seen in left-sided colon cancers, and the histology showed higher percentage of poorly differentiated tumors with advanced pT stage. Moreover, Crohn's-like reactions, intra tumoral lymphocyte responses and other poor prognostic factors like lymph vascular invasion and perineural invasion were more common in right-sided cancers. CONCLUSIONS We found that right- and left-sided colon cancers are different from each other in terms of clinical presentation, histology and clinical behavior. Right-sided colon cancers are more aggressive and are associated with poorer clinical outcome as compared to left sided colon cancers in our population.
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Pugliese L, Keskin M, Maisonneuve P, D'Haese JG, Marchegiani G, Wenzel P, Del Chiaro M, Ceyhan GO. Increased incidence of extrapancreatic neoplasms in patients with IPMN: Fact or fiction? A critical systematic review. Pancreatology 2015; 15:209-16. [PMID: 25841270 DOI: 10.1016/j.pan.2015.03.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Revised: 03/07/2015] [Accepted: 03/10/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND To identify potential associations between intraductal papillary mucinous neoplasm of the pancreas (IPMN) and extrapancreatic neoplasms (EPN), a systematic review of the literature has been performed. METHODS A systematic search of Medline/Pubmed was performed according to the PRISMA guidelines for reporting systematic reviews and meta-analysis for the following search terms: "extrapancreatic", "non pancreatic", "additional pancreatic", "additional primary" and alternatively matched with "neoplasms/tumours/cancers/malignancies/lesions". The results obtained specifically for IPMN were examined one by one by two independent investigators for further data selection and extraction. RESULTS Fifteen studies were identified to be suitable and included for systematic review. Fourteen reported an elevated risk for extrapancreatic malignancy, particularly gastric and colon cancer, while the largest and only prospective study did not find any association. Most studies were retrospective with a weak level of evidence that was not substantially enhanced even by a recent multicentre case series. CONCLUSIONS The available data on this clinically relevant question remain inconclusive. Due to lacking evidence on extrapancreatic neoplasms in IPMN patients, only a standard surveillance can be advised.
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Suzuki Y, Nakazato T, Yokoyama M, Mori T, Sugiyama M. [Epidemiology of intraductal papillary mucinous neoplasm of the pancreas]. NIHON RINSHO. JAPANESE JOURNAL OF CLINICAL MEDICINE 2015; 73 Suppl 3:203-205. [PMID: 25857016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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32
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Kono H, Ueda J, Ide T, Noshiro H. [Differential diagnosis of mucinous cystic neoplasm of the pancreas]. NIHON RINSHO. JAPANESE JOURNAL OF CLINICAL MEDICINE 2015; 73 Suppl 3:287-290. [PMID: 25857034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Yokoyama M, Nakazato T, Suzuki Y, Sugiyama M. [Epidemiology of mucinous cystic neoplasm (MCN)]. NIHON RINSHO. JAPANESE JOURNAL OF CLINICAL MEDICINE 2015; 73 Suppl 3:264-266. [PMID: 25857029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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34
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Matsumoto T, Inokuma T. [Mucinous adenocarcinoma, signet-ring cell carcinoma]. NIHON RINSHO. JAPANESE JOURNAL OF CLINICAL MEDICINE 2015; 73 Suppl 3:754-757. [PMID: 25857129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Ieni A, Branca G, Parisi A, Fedele F, Irato E, Venuti A, Caruso RA. Neutrophil-rich gastric carcinoma in the integrated cancer registry of eastern Sicily, Italy. Anticancer Res 2015; 35:487-492. [PMID: 25550592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND/AIM Neutrophil-rich carcinoma is a variant of gastric carcinoma that has not been well-studied or characterized. The purpose of the present study was to reveal the incidence and clinicopathological findings compared to ordinary gastric carcinoma. PATIENTS AND METHODS A population-based series of 430 gastric cancers, identified between 2003 and 2006 from the province of Messina (insular Italy; population, 662,450), was used. The number of tumor-infiltrating neutrophils was assessed in a semi-quantitative manner using the mean value of 20 non-overlapping high-power fields (magnification, 400; 0.08 mm(2)). Tumors with >10 neutrophils per 20 high-power fields were arbitrarily considered as neutrophil-rich gastric carcinomas. Moreover, MUC1 immunohistochemical expression was investigated to show possible correlation with neutrophil infiltration in gastric carcinomas. RESULTS Among 193 gastric cancers resected for curative purposes, 30 (15.54%) were represented by neutrophil-rich gastric carcinomas. These tumors occurred more frequently in patients aged more than 72 years (p<0.05), showing an inverse correlation with mucinous subtype according to the WHO classification (p<0.001) and expressed MUC1. However, intensity and distribution of MUC1 was heterogeneous, and independent of neutrophil infiltration within the tumor stroma. CONCLUSION Neutrophil-rich carcinoma seems to represent a distinctive morphological variant of gastric carcinoma, although the true mechanism for the infiltration of neutrophils is still unclear.
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Ruterbusch JJ, Ali-Fehmi R, Olson SH, Sealy-Jefferson S, Rybicki BA, Hensley-Alford S, Elshaikh MA, Gaba AR, Schultz D, Munkarah AR, Cote ML. The influence of comorbid conditions on racial disparities in endometrial cancer survival. Am J Obstet Gynecol 2014; 211:627.e1-9. [PMID: 24954655 DOI: 10.1016/j.ajog.2014.06.036] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/21/2014] [Accepted: 06/17/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE There are known disparities in endometrial cancer survival with black women who experience a greater risk of death compared with white women. The purpose of this investigation was to evaluate the role of comorbid conditions as modifiers of endometrial cancer survival by race. STUDY DESIGN Two hundred seventy-one black women and 356 white women who had been diagnosed with endometrial cancer from 1990-2005 were identified from a large urban integrated health center. A retrospective chart review was conducted to gather information on comorbid conditions and other known demographic and clinical predictors of survival. RESULTS Black women experienced a higher hazard of death from any cause (hazard ratio [HR] 1.51; 95% confidence interval [CI], 1.22-1.87) and from endometrial cancer (HR, 2.42; 95% CI, 1.63-3.60). After adjustment for known clinical prognostic factors and comorbid conditions, the hazard of death for black women was elevated but no longer statistically significant for overall survival (HR, 1.22; 95% CI, 0.94-1.57), and the hazard of death from endometrial cancer remained significantly increased (HR, 2.27; 95% CI, 1.39-3.68). Both black and white women with a history of hypertension experienced a lower hazard of death from endometrial cancer (HR, 0.47; 95% CI, 0.23-0.98; and HR, 0.35; 95% CI, 0.19-0.67, respectively). CONCLUSION The higher prevalence of comorbid conditions among black women does not explain fully the racial disparities that are seen in endometrial cancer survival. The association between hypertension and a lower hazard of death from endometrial cancer is intriguing, and further investigation into the underlying mechanism is needed.
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Araki K, Kidokoro Y, Hosoya K, Wakahara M, Matsuoka Y, Takagi Y, Haruki T, Miwa K, Taniguchi Y, Horie S, Nakamura H. Excellent prognosis of lepidic-predominant lung adenocarcinoma: low incidence of lymphatic vessel invasion as a key factor. Anticancer Res 2014; 34:3153-3156. [PMID: 24922687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM To clarify the prognostic value of predominant histological subtypes for small-sized lung adenocarcinoma. MATERIALS AND METHODS Sixty-four specimens of resected invasive lung adenocarcinoma less than 20 mm in diameter with no lymph node metastasis were studied. These specimens were microscopically classified into predominant histological subtypes (21 lepidic, 16 acinar, 24 papillary, and three solid) according to the International association for the study of lung cancer/American thoracic society/European respiratory society adenocarcinoma classification. The relationships between tumor relapse and predominant histological subtypes were statistically analyzed. In addition the relationships between several pathological factors and predominant histological subtypes were statistically assessed. RESULTS Kaplan-Meier relapse-free curves showed a five-year relapse-free rate of 100% in 64 patients with lepidic-predominant adenocarcinoma, compared with a rate of 73.7% (p=0.035 by log rank test) in patients with non-lepidic-predominant adenocarcinoma (papillary, acinar, and solid). The only statistically significant pathological factor between lepidic-predominant and non-lepidic-predominant histological subtypes was lymphatic vessel invasion as assessed by logistic regression analysis. CONCLUSION In small-sized lung adenocarcinoma, lepidic-predominant histological subtype is the best prognostic factor, and a low incidence of lymphatic vessel invasion in the histological subtype is a key factor for an excellent prognosis.
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Rotimi O, Abdulkareem FB. Fifty-three years of reporting colorectal cancer in Nigerians--a systematic review of the published literature. Niger Postgrad Med J 2014; 21:68-73. [PMID: 24956622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIMS AND OBJECTIVES This study aimed to perform a systematic review of all the available published data on CRC in Nigerians over a period of 53 years as a proximate indication of the burden of the disease. MATERIALS & METHODS The data were sourced from PubMed, MEDLINE, EMBASE and Google Scholar search engines as well as direct contact with some authors. All published studies on histologically confirmed CRC in Nigerians constitute the materials. Selected papers were independently reviewed by the authors. RESULTS Of 35 papers found, 19 met the criteria and a total of 2497 cases reported in these 19 publications constituted the materials utilised for the review. There is increasing incidence as evident by increase in annual frequency increased from 18.2/annum in the early years (1954-1969) to 86.8/annum in the latter years (1991-2007). The average age incidence was 46 years (peak=41-50 age group); 674 (32%) of all the cases were aged below 40 years. The male to female ratio was 1.3:1. Of the 2238 cases in which site was reported, rectum 1349 (60%) was the commonest site followed by caecum 260 (17%). All the cases were adenocarcinomas and 1043 (56%) were well differentiated. Mucinous carcinoma and signet ring type accounted for 309 (17%) and 32 (2%) respectively. Of 1061 cases in which Duke's staging was reported, 622 (59%) presented in stage B disease followed by stage C 266 (25%). CONCLUSIONS The incidence is of CRC is increasing in Nigeria. The mean age is low and incidence appears to be increasing in younger patients.
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Iachetta F, Reggiani Bonetti L, Marcheselli L, Di Gregorio C, Cirilli C, Messinese S, Cervo GL, Postiglione R, Di Emidio K, Pedroni M, Longinotti E, Federico M, Ponz de Leon M. Lymph node evaluation in stage IIA colorectal cancer and its impact on patient prognosis: a population-based study. Acta Oncol 2013; 52:1682-90. [PMID: 23786176 DOI: 10.3109/0284186x.2013.808376] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The analysis of regional lymph nodes is particularly relevant in patients with stage II colorectal cancer, in whom the role of adjuvant chemotherapy remains unclear. The aim of this study was to assess the relationship between number of examined lymph nodes and survival in patients with stage IIA (pT3N0M0) colorectal cancer, and to determine the optimal number of lymph nodes that should be examined. METHODS The study group included all the surgically-treated colorectal cancer patients in stage IIA (n = 657) who were identified through the population-based Cancer Registry of the Province of Modena (Northern Italy), during the period 2002-2006. RESULTS The median number of harvested lymph nodes was 19 (range 1-68). Considering, as a reference point, patients with 12 or less lymph nodes, subjects with n ≥ 20 lymph nodes examined showed, in univariate analysis, a significantly higher cancer specific (p = 0.01) and relapse-free survival (p = 0.003). The results were confirmed by multivariate analysis (Cox model). CONCLUSION The result suggests that colorectal cancer patients in stage IIA with n ≥ 20 lymph nodes examined exhibit better survival when compared with subjects in whom fewer lymph nodes were examined. The number of 20 lymph nodes is the essential requirement for an oncologic resection of the large bowel.
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Furman MJ, Cahan M, Cohen P, Lambert LA. Increased risk of mucinous neoplasm of the appendix in adults undergoing interval appendectomy. JAMA Surg 2013; 148:703-706. [PMID: 23740174 DOI: 10.1001/jamasurg.2013.1212] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
Abstract
IMPORTANCE The role of interval appendectomy after conservative management of perforated appendicitis remains controversial. Determining the etiology of perforated appendicitis is one reason to perform interval appendectomies. OBJECTIVE To determine whether adult patients undergoing interval appendectomy experience an increased rate of neoplasms. DESIGN Retrospective study. SETTING A single tertiary care institution. PARTICIPANTS All patients 18 years or older who underwent appendectomy for presumed appendicitis from January 1, 2006, through December 31, 2010. EXPOSURES Appendectomy for presumed appendicitis. MAIN OUTCOMES AND MEASURES Underlying neoplasm as the cause of presentation for presumed appendicitis. Demographic data, clinicopathologic characteristics, interval resection rate, and complication data were collected and analyzed. RESULTS During the study period, 376 patients underwent appendectomies. Interval appendectomy was performed in 17 patients (4.5%). Neoplasms were identified in 14 patients (3.7%); 5 of those tumors occurred in patients who had undergone interval appendectomy (29.4%). Nine neoplasms were mucinous tumors (64.3%), including all neoplasms associated with interval appendectomies. The mean age of all patients with appendiceal tumors was 49 years (range, 35-74 years). CONCLUSIONS AND RELEVANCE Mucinous neoplasms of the appendix were found in 5 of 17 patients (29.4%) undergoing interval appendectomy. Interval appendectomies should be considered in all adult patients, especially those 40 years or older, to determine the underlying cause of appendicitis. A multi-institutional study to determine the generalizability of these findings is warranted.
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Nyante SJ, Dallal CM, Gierach GL, Park Y, Hollenbeck AR, Brinton LA. Risk factors for specific histopathological types of postmenopausal breast cancer in the NIH-AARP Diet and Health Study. Am J Epidemiol 2013; 178:359-71. [PMID: 23899816 DOI: 10.1093/aje/kws471] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Risk factor associations for rare breast cancer variants are often imprecise, obscuring differences between tumor types. To clarify differences, we examined risk factors for 5 histological types of breast cancer in the National Institutes of Health-AARP Diet and Health Study. Risk factor information was self-reported. We followed 192,076 postmenopausal women aged 50-71 years from 1995-1996 through 2006. During that time period, 5,334 ductal, 836 lobular, 639 mixed ductal-lobular, 216 mucinous, and 132 tubular breast cancers were diagnosed. Hazard ratios and 95% confidence intervals were estimated using Cox proportional hazards regression. Heterogeneity was evaluated using case-only logistic regression. The strongest differences were for menopausal hormone therapy (Pheterogeneity < 0.01) and age at first birth (Pheterogeneity < 0.01). Risk of tubular cancer in relation to current menopausal hormone therapy (for current use vs. never use, hazard ratio (HR) = 4.39, 95% confidence interval (CI): 2.77, 6.96) was several times stronger than risk of other histological types (range of HRs, 1.39-1.75). Older age at first birth was unassociated with risk of mucinous (for ≥30 years vs. 20-24 years, HR = 0.62, 95% CI: 0.27, 1.42) or tubular (HR = 1.08, 95% CI: 0.51, 2.29) tumors, in contrast to clear positive associations with lobular (HR = 1.82, 95% CI: 1.39, 2.37) and mixed ductal-lobular (HR = 1.87, 95% CI: 1.39, 2.51) tumors. Differing associations for hormonal factors and mucinous and tubular cancers suggest etiologies distinct from those of common breast cancers.
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MESH Headings
- Adenocarcinoma/epidemiology
- Adenocarcinoma/pathology
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/pathology
- Aged
- Anthropometry
- Breast Neoplasms/epidemiology
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/epidemiology
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Lobular/epidemiology
- Carcinoma, Lobular/pathology
- Cohort Studies
- Confidence Intervals
- Contraceptives, Oral
- Female
- Follow-Up Studies
- Hormone Replacement Therapy/statistics & numerical data
- Humans
- Logistic Models
- Maternal Age
- Middle Aged
- National Institutes of Health (U.S.)
- Neoplasm Grading
- Neoplasm Staging
- Postmenopause/physiology
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Risk Factors
- Surveys and Questionnaires
- United States/epidemiology
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Larghi A, Panic N, Capurso G, Leoncini E, Arzani D, Salvia R, Del Chiaro M, Frulloni L, Arcidiacono PG, Zerbi A, Manta R, Fabbri C, Ventrucci M, Tarantino I, Piciucchi M, Carnuccio A, Boggi U, Costamagna G, Delle Fave G, Pezzilli R, Bassi C, Bulajic M, Ricciardi W, Boccia S. Prevalence and risk factors of extrapancreatic malignancies in a large cohort of patients with intraductal papillary mucinous neoplasm (IPMN) of the pancreas. Ann Oncol 2013; 24:1907-1911. [PMID: 23676419 DOI: 10.1093/annonc/mdt184] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The objectives of this study are to estimate prevalence and incidence of extrapancreatic malignancies (EPMs) among intraductal papillary mucinous neoplasms (IPMNs) of the pancreas, and to identify risk factors for their occurrence. PATIENTS AND METHODS We conducted multicentric cohort study in Italy from January 2010 to January 2011 including 390 IPMN cases. EPMs were grouped as previous, synchronous (both prevalent) and metachronous (incident). We calculated the observed/expected (O/E) ratio of prevalent EPMs, and compared the distribution of demographic, medical history and lifestyle habits. RESULTS Ninety-seven EPMs were diagnosed in 92 patients (23.6%), among them 78 (80.4%) were previous, 14 (14.4%) were synchronous and 5 (5.2%) were metachronous. O/E ratios for prevalent EPMs were significantly increased for colorectal carcinoma (2.26; CI 95% 1.17-3.96), renal cell carcinoma (6.00; CI 95% 2.74-11.39) and thyroid carcinoma (5.56; CI 95% 1.80-12.96). Increased age, heavy cigarette smoking, alcohol consumption and first-degree family history of gastric cancer are significant risk factors for EPMs, while first-degree family history of colorectal carcinoma was borderline. CONCLUSION We report an increased prevalence of EPMs in Italian patients with IPMN, especially for colorectal carcinoma, renal cell and thyroid cancers. A systematic surveillance of IPMN cases for such cancer types would be advised.
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Vargas-Hernández VM. [Endometriosis as a risk factor for ovarian cancer]. CIR CIR 2013; 81:163-168. [PMID: 23522320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
A history of endometriosis is a risk factor for some subtypes of epithelial ovarian cancer. Endometriosis is associated with increased risk of ovarian clear cell, serous low-grade endometrioid cancer, but it is unclear what the role of endometriosis is in the development of other histopathological subtypes of ovarian cancer, such as high-grade serous borderline tumors subtypes or borderline serous and mucinous cancers. An understanding of the mechanisms leading to malignant transformation of endometriosis will be needed to identify subgroups of women at increased risk of ovarian cancer. This is important because of their high prevalence and cause of infertility in Mexico and the world. All factors must be considered during the decision-making process for the treatment of endometriosis, including the rare malignant transformation.
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Jain A, Seiden MV. Rare epithelial tumors arising in or near the ovary: a review of the risk factors, presentation, and future treatment direction for ovarian clear cell and mucinous carcinoma. Am Soc Clin Oncol Educ Book 2013:0011300200. [PMID: 23714502 DOI: 10.14694/edbook_am.2013.33.e200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Currently all advanced-stage epithelial ovarian cancers are treated with a total abdominal hysterectomy, bilateral oophorectomy, and complete tumor debulking surgery, followed by carboplatin and paclitaxel. This treatment recommendation is based on clinical trials that are mostly populated with women with high-grade serous carcinomas. Patients with mucinous or clear cell carcinomas of the ovary tend to present with earlier-stage disease, and may not require adjuvant chemotherapy; those with advanced-stage disease tend to have carboplatin-resistant disease. Patients with mucinous ovarian carcinoma have presentations and tumor biology that are similar to colorectal carcinomas and may benefit from colorectal regimens containing fluorouracil (FU) and oxaliplatin. Their tumors may also be KRAS wild-type or have HER2 amplification, and could benefit from drugs like cetuximab or trastuzumab. Patients with clear cell carcinoma of the ovary often harbor AIRD1a mutations, an early event in oncogenesis that is not a currently drugable target. Anecdotal cases and our biologic understanding of these malignancies suggest they might be preferentially sensitive to antiangiogenesis inhibitors. Focused international trials will be needed in both of these rare epithelial ovarian cancers to better define optimal treatment regimens.
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MESH Headings
- Adenocarcinoma, Mucinous/chemistry
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/therapy
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Carcinoma, Ovarian Epithelial
- Female
- Genetic Predisposition to Disease
- Humans
- Neoplasm Staging
- Neoplasms, Glandular and Epithelial/chemistry
- Neoplasms, Glandular and Epithelial/diagnosis
- Neoplasms, Glandular and Epithelial/epidemiology
- Neoplasms, Glandular and Epithelial/genetics
- Neoplasms, Glandular and Epithelial/therapy
- Ovarian Neoplasms/chemistry
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/epidemiology
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/therapy
- Predictive Value of Tests
- Risk Factors
- Treatment Outcome
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Ovarian cancer and smoking: individual participant meta-analysis including 28,114 women with ovarian cancer from 51 epidemiological studies. Lancet Oncol 2012; 13:946-56. [PMID: 22863523 PMCID: PMC3431503 DOI: 10.1016/s1470-2045(12)70322-4] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Smoking has been linked to mucinous ovarian cancer, but its effects on other ovarian cancer subtypes and on overall ovarian cancer risk are unclear, and the findings from most studies with relevant data are unpublished. To assess these associations, we review the published and unpublished evidence. Methods Eligible epidemiological studies were identified by electronic searches, review articles, and discussions with colleagues. Individual participant data for 28 114 women with and 94 942 without ovarian cancer from 51 epidemiological studies were analysed centrally, yielding adjusted relative risks (RRs) of ovarian cancer in smokers compared with never smokers. Findings After exclusion of studies with hospital controls, in which smoking could have affected recruitment, overall ovarian cancer incidence was only slightly increased in current smokers compared with women who had never smoked (RR 1·06, 95% CI 1·01–1·11, p=0·01). Of 17 641 epithelial cancers with specified histology, 2314 (13%) were mucinous, 2360 (13%) endometrioid, 969 (5%) clear-cell, and 9086 (52%) serous. Smoking-related risks varied substantially across these subtypes (pheterogeneity<0·0001). For mucinous cancers, incidence was increased in current versus never smokers (1·79, 95% CI 1·60–2·00, p<0·0001), but the increase was mainly in borderline malignant rather than in fully malignant tumours (2·25, 95% CI 1·91–2·65 vs 1·49, 1·28–1·73; pheterogeneity=0·01; almost half the mucinous tumours were only borderline malignant). Both endometrioid (0·81, 95% CI 0·72–0·92, p=0·001) and clear-cell ovarian cancer risks (0·80, 95% CI 0·65–0·97, p=0·03) were reduced in current smokers, and there was no significant association for serous ovarian cancers (0·99, 95% CI 0·93–1·06, p=0·8). These associations did not vary significantly by 13 sociodemographic and personal characteristics of women including their body-mass index, parity, and use of alcohol, oral contraceptives, and menopausal hormone therapy. Interpretation The excess of mucinous ovarian cancers in smokers, which is mainly of tumours of borderline malignancy, is roughly counterbalanced by the deficit of endometrioid and clear-cell ovarian cancers. The substantial variation in smoking-related risks by tumour subtype is important for understanding ovarian carcinogenesis. Funding Cancer Research UK and MRC.
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Giurgea NL, Pitrop M, Mihailovici MS. [Serous and mucinous epithelial ovarian tumors--a clinicopathologic study of 116 cases]. REVISTA MEDICO-CHIRURGICALA A SOCIETATII DE MEDICI SI NATURALISTI DIN IASI 2012; 116:389-394. [PMID: 23077925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Surface epithelial tumors are the most important group of neoplasm of the ovary. These tumors are classified according to the following parameters: cell type, pattern of growth, amount of fibrous stroma, atypia and invasiveness. AIM This study aimed to identify ovarian tumours, especially borderline type, by applying last parameters of criteria for histologic diagnostic of ovarian neoplasms. MATERIAL AND METHODS The retrospective study included 116 patients with ovarian tumors diagnosed, investigated, surgically treated at the Obstetrical and Gynecological Hospital Botoşani in the past 9 years (2002-2010). In this interval were recorded 116 cases of epithelial ovarian tumors. In sample processing, we used formalin for fixation, paraffin for specimen embedding and hematoxilin-eosin for staining. The age of the patients ranged between 19-86 years. RESULTS From 116 cases, 57 (49,1%) were benign, 40 (34,5%) malignant and 19 (16,4%) borderline. In our study of benign neoplasms, we included 37 cases of serous tumours (64,9%) and 20 cases of mucinous types (35%). In the group of borderline tumours, the serous type was the most frequent (13 cases), followed by mucinous types (6), including 5 cases of intestinal type and 1 of endocervical pattern. The malignant tumors, according with decreasing order of frequency, were the following: 19 serous (47,5%), 8 mucinous (20%), 11 endometroid type (27,5%) and one of each cases of clear cell and small cell tumors (2,5%). CONCLUSIONS Of great interest in our research was to identify ovarian borderline tumours, still representing a controversial group, in the same time corresponding with a scientiphic progress. Because the spectrum of epithelial tumors is very large, extensive sampling is essential to carry out all these important determinations, because benign, borderline and malignant patterns can be found in the same tumor.
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MESH Headings
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/epidemiology
- Adenocarcinoma, Mucinous/pathology
- Adenocarcinoma, Mucinous/surgery
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Carcinoma, Ovarian Epithelial
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/epidemiology
- Cystadenocarcinoma, Serous/pathology
- Cystadenocarcinoma, Serous/surgery
- Female
- Humans
- Incidence
- Middle Aged
- Neoplasms, Glandular and Epithelial/pathology
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/epidemiology
- Ovarian Neoplasms/pathology
- Ovarian Neoplasms/surgery
- Retrospective Studies
- Romania/epidemiology
- Treatment Outcome
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Oberaigner W, Minicozzi P, Bielska-Lasota M, Allemani C, de Angelis R, Mangone L, Sant M. Survival for ovarian cancer in Europe: the across-country variation did not shrink in the past decade. Acta Oncol 2012; 51:441-53. [PMID: 22313338 DOI: 10.3109/0284186x.2011.653437] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Survival for ovarian cancer is the poorest of all gynaecological cancer sites. Our aim was to present the most up-to-date survival estimate for ovarian cancer by age and morphology and to answer the question whether survival for ovarian cancer improved in Europe during the 1990s. MATERIAL AND METHODS This analysis was performed with data from the EUROCARE database. We considered all adult women diagnosed with ovarian cancer between 1995 and 2002 and life status followed up until the end of 2003. A total of 97 691 cases were contributed by 72 European cancer registries in 24 countries. We estimated the most up-to-date relative survival for a mean of 23 661 patients followed up in 2000-2003 using the period hybrid approach and described the relative survival trends from the beginning of 1990s. RESULTS AND CONCLUSION Overall, the European age-standardised one-year, five-year and five-year conditional on surviving one-year relative survival were 67.2% (95% CI 66.6-67.8), 36.1% (95% CI 35.4-36.8) and 53.7% (95% CI 52.8-54.7), respectively. Five-year relative survival was 58.6% (95% CI 57.4-59.8), 37.1% (95% CI 36.1-38.1) and 20.5% (95% CI 19.1-21.9) in women aged 15-54, 55-74 and 75-99 years, respectively. The age-standardised five-year relative survival was 38.1% (95% CI 36.9-39.3) for serous tumours and 51.9% (95% CI 49.0-54.9) for mucinous cancers and the crude five-year relative survival was 85.6% (95% CI 81.2-90.0) for germ cell cancers. Overall, the age-standardised five-year relative survival increased from 32.4% (95% CI 31.7-33.2) in 1991-1993 to 36.3% (95% CI 35.5-37.0) in 2000-2003. There is a need to better understand the reasons for the wide variation in survival of ovarian cancer in Europe. Actions aiming to harmonise the protocols for therapy should contribute to narrowing the wide gap in survival and research on screening and early detection of ovarian cancer should be enforced.
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Remotti HE, Winner M, Saif MW. Intraductal papillary mucinous neoplasms of the pancreas: clinical surveillance and malignant progression, multifocality and implications of a field-defect. JOP : JOURNAL OF THE PANCREAS 2012; 13:135-138. [PMID: 22406584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Intraductal papillary mucinous neoplasms (IPMNs) are a heterogeneous group of mucin producing cystic tumors that involve the main pancreatic duct and/or branch ducts and may be associated with invasive carcinoma. Predicting the risk of malignant transformation of an IPMN lesion can be challenging. The Sendai criteria, based in large part on radiographic imaging features, help guide surgical intervention based on the stratification of cysts into high and low risk lesions for malignancy. Invasive carcinoma may develop in the index IPMN lesion or in a separate site within the pancreas, supporting the concept of a field defect in IPMN tumorigenesis. This stresses the importance of evaluation of the entire pancreas upon diagnosis of IPMN and continued surveillance of the residual pancreas following resection. Herein, the authors summarize the data presented at the 2012 ASCO Gastrointestinal Cancers Symposium regarding prevalence and site of invasive carcinoma detected in patients undergoing surveillance for IPMN (Abstract #152).
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Suzuki Y, Sugiyama M, Nakazato T, Yokoyama M, Abe N, Masaki T, Mori T, Hara Y, Ohkura Y. [Pancreatic ductal carcinoma concomitant with intraductal papillaly mucinous neoplasm]. Gan To Kagaku Ryoho 2012; 39:347-350. [PMID: 22421759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
IPMN is a slow-growing tumor and has a good prognosis, but is very often associated with a high incidence of pancreatic ductalcarcinoma(DC). Unlike IPMN, DC progresses rapidly, and has a poor prognosis. However, DC concomitant with IPMN has a better prognosis than DC without IPMN. The reason for the good prognosis of the former is undetermined, but perhaps it is the early detection of DC or its not so malignant behavior. It is important to thoroughly examine the entire pancreas for the potentialco -occurrence of DC in patients with IPMN.
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Aschebrook-Kilfoy B, Ward MH, Gierach GL, Schatzkin A, Hollenbeck AR, Sinha R, Cross AJ. Epithelial ovarian cancer and exposure to dietary nitrate and nitrite in the NIH-AARP Diet and Health Study. Eur J Cancer Prev 2012; 21:65-72. [PMID: 21934624 PMCID: PMC3394850 DOI: 10.1097/cej.0b013e328347622f] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ovarian cancer is a leading cause of cancer death among women in the United States and it has the highest mortality rate of all gynecologic cancers. Internationally, there is a five-fold variation in incidence and mortality of ovarian cancer, which suggests a role for environmental factors, including diet. Nitrate and nitrite are found in various food items and they are precursors of N-nitroso compounds, which are known carcinogens in animal models. We evaluated dietary nitrate and nitrite intake and epithelial ovarian cancer in the National Institutes of Health (NIH)-AARP Diet and Health Study, including 151 316 women aged 50-71 years at the time of the baseline questionnaire in 1995-1996. The nitrate and nitrite intake was assessed using a 124-item validated food frequency questionnaire. Through 31 December 2006, 709 incident epithelial ovarian cancer cases with complete dietary information were identified. Using Cox proportional hazards regression to estimate hazard ratios and 95% confidence intervals (CIs), women in the highest intake quintile of dietary nitrate had a 31% increased risk (95% CI: 1.01-1.68) of epithelial ovarian cancer, compared with those in the lowest intake quintile. Although there was no association for total dietary nitrite, those in the highest intake category of animal sources of nitrite had a 34% increased risk (95% CI: 1.05-1.69) of ovarian cancer. There were no clear differences in risk by histologic subtype of ovarian cancer. Our findings suggest that a role of dietary nitrate and nitrite in ovarian cancer risk should be followed in other large cohort studies.
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