1501
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Fang QG, Shi S, Li ZN, Zhang X, Liua FY, Xu ZF, Sun CF. Squamous cell carcinoma of the buccal mucosa: Analysis of clinical presentation, outcome and prognostic factors. Mol Clin Oncol 2013; 1:531-4. [PMID: 24649206 DOI: 10.3892/mco.2013.86] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Accepted: 02/27/2013] [Indexed: 11/05/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the buccal mucosa is a common malignancy in Southeast Asia. The purpose of this study was to present our clinical experience with buccal SCC over a period of 7 years and to analyze the factors associated with surgical outcome. We conducted a retrospective review on 67 buccal SCC patients (between September, 2005 and May, 2011) with tumors restricted to or originating from the buccal mucosa. In a univariate model, nodal stage, degree of tumor differentiation and composite resection were associated with recurrence, while in a multivariate model, the degree of differentiation was the only factor affecting locoregional control. In a survival analysis, recurrence, nodal stage and degree of differentiation were considered as significant factors. Buccal SCC is an aggressive malignant tumor and the degree of differentiation is the most significant factor affecting prognosis and survival. An adequate systemic treatment is required in the case of poorly differentiated tumors. Neck dissection (ND) exerts a positive effect on the locoregional control of buccal SCC staged as cT1-2N0. In the case of identification of positive lymph nodes during surgery, postoperative radiation is recommended in order to improve locoregional control.
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1502
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Abstract
Therapeutic cancer vaccines are an immunotherapy that targets tumor antigens to induce an active immune response. To date, Provenge® is the only therapeutic cancer vaccine approved by the United States Food and Drug Administration. Although therapeutic cancer vaccines have not been approved by the European Medicines Agency (EMA), they have been approved in several countries other than the United States (US) and the European Union (EU). Provenge® is the only approved cancer vaccine that showed significant primary endpoint efficacy in a phase III study at the time of approval. Retrospective analysis of 23 completed or terminated phase III studies showed that 74% (17/23) failed to demonstrate significant efficacy in the primary endpoint. The reasons for failure were surveyed in 13 of the 17 studies. Despite efforts to minimize tumor burden, including surgery and induction chemotherapy before therapeutic cancer vaccine therapy, 69% (9/13) of the phase III studies failed. These findings indicate that tumor burden may not be the only prognostic factor. Immunological response has often been used as a predictive factor, and a small number of sub-group analyses have succeeded in showing that immunological response is associated with the efficacy of therapeutic cancer vaccines. Being a prognostic factor, inclusion of immunological response in addition to tumor stage in the eligibility criteria or sub-group analysis may minimize study population heterogeneity, a key factor in the success of phase III studies.
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Affiliation(s)
- Chizuru Ogi
- Cooperative Major in Advanced Biomedical Sciences; Joint Graduate School of Tokyo Women's Medical University and Waseda University; Tokyo, Japan
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1503
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Yao Y, Yuan D, Liu H, Gu X, Song Y. Pretreatment neutrophil to lymphocyte ratio is associated with response to therapy and prognosis of advanced non-small cell lung cancer patients treated with first-line platinum-based chemotherapy. Cancer Immunol Immunother 2013; 62:471-9. [PMID: 22986452 PMCID: PMC11028855 DOI: 10.1007/s00262-012-1347-9] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Accepted: 08/17/2012] [Indexed: 12/27/2022]
Abstract
BACKGROUND Neutrophil to lymphocyte ratio (NLR) has been shown to be a prognosis indicator in different types of cancer. We aimed to investigate the association between NLR and therapy response, progression free survival (PFS) and overall survival (OS) in advanced non-small cell lung cancer (NSCLC) patients treated with first-line platinum-based chemotherapy. METHODS Patients who were hospitalized between January 2007 and December 2010 were enrolled and eliminated according to the inclusion and exclusion criteria. The NLR was defined as the absolute neutrophil count divided by the absolute lymphocyte count. Logistic regression analysis was applied for response rate and Cox regression analysis was adopted for PFS and OS. A P value of ≤0.05 was considered to be statistically significant. RESULTS A total of 182 patients were enrolled in the current study. The median PFS was 164.5 days and median OS was 439.5 days. The statistical analysis data indicated that low pretreatment NLR (≤ 2.63) (OR = 2.043, P = 0.043), decreased posttreatment NLR (OR = 2.368, P = 0.013), well and moderate differentiation (OR = 2.773, P = 0.021) and normal CEA level (≤ 9.6 ng/ml) (OR = 2.090, P = 0.046) were associated with response to first-line platinum-based chemotherapy. A high pretreatment NLR (HR = 1.807, P = 0.018 for PFS, HR = 1.761, P = 0.020 for OS) and distant metastasis (HR = 2.118, P = 0.008 for PFS, HR = 2.753, P = 0.000 for OS) were independent prognostic factors for PFS and OS. CONCLUSION Elevated pretreatment NLR might be a potential biomarker of worse response to first-line platinum-based chemotherapy and shorter PFS and OS for advanced NSCLC patients. To confirm these findings, larger, prospective and randomized studies are needed.
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Affiliation(s)
- Yanwen Yao
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, 305 East ZhongShan Road, Nanjing, China
| | - Dongmei Yuan
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, 305 East ZhongShan Road, Nanjing, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, 305 East ZhongShan Road, Nanjing, China
| | - Xiaoling Gu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, 305 East ZhongShan Road, Nanjing, China
| | - Yong Song
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, 305 East ZhongShan Road, Nanjing, China
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1504
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Gheissari A, Taheri D, Mozafarpour S, Beigy H, Samanianpoor P, Merrikhi A, Farajzadegan Z. The expression of cytoskeletal proteins in kidney specimens of children with primary focal segmental glomerulosclerosis. Indian J Nephrol 2013; 22:444-50. [PMID: 23439390 PMCID: PMC3573486 DOI: 10.4103/0971-4065.106037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Several studies have evaluated cytoskeletal proteins as prognostic factors for some types of nephrotic syndrome. However, studies concerning children with FSGS are scarce. This study was done to evaluate the glomerular, tubular, and interstitial expression of vimentin, desmin, and alpha smooth muscle actin (α-SMA) in kidney specimens of children with FSGS. Clinical and histologic data of 31 children with FSGS were reviewed. Thirty one formalin-fixed, paraffin-embedded kidney biopsy sections (3 μm) were selected for immunohistochemical staining. Double immunohistochemistry using a microwave-based two-color staining was applied. The mean age at onset in male and female was 56.3 ± 41.4 and 78.0 ± 60.4 months, respectively. The duration of follow-up was 46.3 ± 56.5 months. Interstitial fibrosis and tubular atrophy were reported in 42% and 54% of the patients, respectively. The latest evaluated mean blood pressure was significantly correlated with the expression of both vimentin and α-SMA in the interstitium (P < 0.05). However, we were not able to demonstrate any cytoskeletal protein expression as an independent predictor for renal survival. Further studies with larger sample size and longer follow-up periods are warranted to investigate the prognostic values of other histopathologic features in pediatrics with FSGS.
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Affiliation(s)
- A Gheissari
- Department of Pediatric Nephrology, Isfahan Kidney Diseases Research Center, Child Growth and Developement Research Center, Isfahan, Iran
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1505
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Abstract
BACKGROUND The Geriatric Nutritional Risk Index (GNRI) might be a useful screening tool for malnutrition in dialysis patients. However, data concerning the GNRI as a prognostic factor in peritoneal dialysis (PD) patients are scarce. METHODS We reviewed the medical records at Yeungnam University Hospital in Korea to identify all adults (>18 years) who received PD; 486 patients were enrolled in the study. RESULTS The initial low, middle, and high GNRI tertiles included 162, 166, and 158 patients respectively. Significant correlations were noted between the initial GNRI and body mass index, creatinine, albumin, arm circumference, fat mass index, and comorbidities. The cut-off value for the time-averaged GNRI over 1 year was 96.4, and the sensitivity and specificity for a diagnosis of a decline in lean mass were 77.1% and 40.0% respectively. A multivariate analysis adjusted for age, risk according to the Davies comorbidity index, and C-reactive protein showed that an low initial GNRI tertile was associated with mortality in PD patients. CONCLUSIONS The GNRI is a simple method for predicting nutrition status and clinical outcome in PD patients.
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Affiliation(s)
- Seok Hui Kang
- Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
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1506
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Zhong Y, Deng M, Liu B, Chen C, Li M, Xu R. Primary gastrointestinal stromal tumors: Current advances in diagnostic biomarkers, prognostic factors and management of its duodenal location. Intractable Rare Dis Res 2013; 2:11-7. [PMID: 25343095 PMCID: PMC4204577 DOI: 10.5582/irdr.2013.v2.1.11] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 02/14/2013] [Accepted: 02/17/2013] [Indexed: 02/07/2023] Open
Abstract
Gastrointestinal stromal tumors (GIST) constitute 1-3% of all gastrointestinal malignancies and is the most common mesenchymal tumor of the gastrointestinal tract. Although GIST were first described in the literature in the year 1941, important advances of kit mutation and tyrosine kinase inhibitors were not made to understand and manage GIST until the last decade. Here current advances in research of possible cellular origin, diagnostic biomarkers and prognostic factors of primary GIST are reviewed, and the management of primary duodenal GIST is focused on due to its specific location. It is possible that personalized assessment and therapy will turn out to be another milestone for primary GIST.
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Affiliation(s)
- Yuesi Zhong
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Meihai Deng
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Bo Liu
- Department of General Surgery, Lingnan Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Cheng Chen
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Mingliang Li
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Ruiyun Xu
- Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
- Address correspondence to: Dr. Ruiyun Xu, Department of Hepatobiliary Surgery, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510630, China. E-mail:
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1507
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Xu Y, Jiang Y, Yu X, Chen Q, Zhou X, Mao W. Analysis of new N-category on prognosis of oesophageal cancer with positive lymph nodes in a Chinese population. Radiol Oncol 2013; 47:63-70. [PMID: 23450452 DOI: 10.2478/v10019-012-0039-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 06/04/2012] [Indexed: 02/08/2023] Open
Abstract
Background The 7th edition of the new TNM classification system for oesophageal cancer (EC) has been published. N-category is now divided into N0, N1, N2 and N3. In this study, we aimed to validate the prognostic ability of the new N classification system in EC with positive lymph nodes in a Chinese population, and evaluate whether the new N classification system can help the decision-making for postoperative adjuvant therapy. Patients and methods From 2002 to 2008, thoracic EC who underwent oesophagectomy were retrospectively analysed. Patients pathological stage 6th edition of the American Joint Committee on Cancer / Union International Against Cancer (AJCC/UICC) TNM classification were switched to pathological stage 7th edition for this analysis. Patients with pathological stage T1-4N1-3M0 EC were selected. Kaplan-Meier method and Cox regression analysis were employed to compare overall survival (OS). Results A total of 545 patients met the inclusion criteria: 346 (63.5%) received oesophagectomy alone, 199 (36.5%) received oesophagectomy and adjuvant radiotherapy, and 36.1% (197/545) received oesophagectomy and adjuvant chemotherapy. Univariate analysis and multivariate analysis revealed significant difference in OS among patients at different postoperative pN-category (p<0.001). This was also present in patients receiving postoperative radiotherapy (p<0.001) and those undergoing postoperative chemotherapy (p<0.001). There was no marked difference in OS between patients receiving postoperative adjuvant therapy and surgery alone at the same postoperative pN-category, except that postoperative radiotherapy marginally improved OS in patients with pN2 and pN3 disease. Conclusions Our results validated the prognostic ability of new N classification system. The N-category is an independent prognostic factor in patients with resectable thoracic EC who were positive for lymph nodes in a Chinese population. Further studies are required to clarify the role of new N classification system in the decision-making for postoperative adjuvant therapy.
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1508
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Chudecka-Głaz A, Rzepka-Górska I. Evaluation of serum levels of sCD30L ligand in patients with ovarian cancer in terms of selected clinico-pathological factors. Contemp Oncol (Pozn) 2012; 16:520-5. [PMID: 23788939 DOI: 10.5114/wo.2012.32485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Revised: 05/11/2012] [Accepted: 06/21/2012] [Indexed: 01/06/2023] Open
Abstract
AIM OF THE STUDY The CD30L ligand is a membrane-associated glycoprotein expressed by activated CD4(+)Th cells, macrophages, dendritic cells, and B lymphocytes. It binds to the CD30 receptor carried on activated and helper Th cells, inducing the immune response and apoptosis. The aim of this retrospective study was to determine the level of sCD30L in the serum of patients at diagnosis of ovarian cancer and at relapse and to assess the potential association of this ligand with selected clinico-pathologic factors. MATERIAL AND METHODS We studied 69 patients with ovarian cancer allocated to two groups: A - ovarian cancer at diagnosis, B - relapse of ovarian cancer and active growth of the tumor. RESULTS We found high levels of sCD30L in ovarian cancer patients. Levels at relapse (21.48 ng/ml) were significantly higher than at diagnosis (11.81 ng/ml). Poor response to first-line chemotherapy was accompanied by higher levels of sCD30L and by several other findings: resistance to platinum analogs was common, neoadjuvant chemotherapy was needed, relapse and death during two-year follow-up were frequent. CONCLUSIONS Our present study might initially suggest that elevated concentration of sCD30L can be an important finding prognosticating a poor prognosis and is associated with platinum resistant and refractory cases of ovarian cancer. However, studies are needed on larger groups of patients.
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1509
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MICU BOGDAN, MICU CARMEN, LEUCUTA DANIELCORNELIU, CRIVII CARMEN, CONSTANTEA NICOLAE. The role and prognostic impact of lymph node ratio on stage III colorectal cancer. Clujul Med 2013; 86:245-9. [PMID: 26527956 PMCID: PMC4462499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 09/18/2013] [Indexed: 11/22/2022]
Abstract
AIM The aim of this study was to evaluate the prognostic significance of the lymph node ratio (LNR) in patients with stage III colorectal cancer. MATERIALS AND METHODS We included 35 stage III colorectal cancer patients who underwent a curative resection at the County Clinic Hospital, Cluj-Napoca, 5(th) Surgical Clinic between January 2006-July2008. Patients were categorized into LNR groups 1 to 5 according to cut-off points: <0.1; 0.21; 0.36; 0.6; >0.61. The Kaplan-Meier and the Cox proportional hazard models were used to evaluate the prognostic effect according to the LNR. RESULTS From one hundred forty-eight patients who underwent colorectal cancer resection, 33.1 % were stage III and 35 patients met the study inclusion criteria. The five-year survival rate in N1 group was 64.62% compared to the N2 group, where it was 8.57% (p<0.001) The lymph node ratio (LNR) groups consisted of 5 cases (14.2%) in LNR1 group (<0.1), five-year survival rate 100%, 6 cases (17.14%) in LNR2 group (0.11-0.21), five-year survival rate 83.33%, 8 cases (22.8%) in LNR3 group (0.22-0.36), five-year survival rate 37.5%, 12 cases (34.28%) in LNR4 group (0.37-0.60), survival rate 0%, and LNR5 group (>0.6). The relationship between the five-year survival rates in the five LNR groups results in a statistically significant proportionality (p<0.001). CONCLUSION Lymph node ratio can be considered a more accurate and potent modality for prognosis in stage III colorectal cancer and may improve stratification in this heterogenous group of patients.
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Affiliation(s)
- BOGDAN MICU
- 5th Surgical Clinic, Iuliu Haţieganu University of Medicine and Pharmacy, County Clinic Hospital, Cluj-Napoca, Romania,Address for correspondence:
| | - CARMEN MICU
- 5th Surgical Clinic, Iuliu Haţieganu University of Medicine and Pharmacy, County Clinic Hospital, Cluj-Napoca, Romania,Department of Anatomy and Embryology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - DANIEL-CORNELIU LEUCUTA
- Department of Medical Informatics and Biostatistics, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - CARMEN CRIVII
- Department of Anatomy and Embryology, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - NICOLAE CONSTANTEA
- 5th Surgical Clinic, Iuliu Haţieganu University of Medicine and Pharmacy, County Clinic Hospital, Cluj-Napoca, Romania
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1510
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Liu YP, Ling Y, Qi QF, Zhang YP, Zhang CS, Zhu CT, Wang MH, Pan YD. The effects of ERCC1 expression levels on the chemosensitivity of gastric cancer cells to platinum agents and survival in gastric cancer patients treated with oxaliplatin-based adjuvant chemotherapy. Oncol Lett 2012; 5:935-942. [PMID: 23426424 PMCID: PMC3576223 DOI: 10.3892/ol.2012.1096] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 12/24/2012] [Indexed: 01/30/2023] Open
Abstract
Excision repair cross-complementing 1 (ERCC1) is reported to be involved in the sensitivity of cancer cells to platinum-based chemotherapy. The present study was designed to evaluate the effects of ERCC1 expression on the chemosensitivity of platinum agents in gastric cancer cell lines, and on survival in gastric cancer patients treated with surgery followed by oxaliplatin-based adjuvant chemotherapy. ERCC1 expression levels were measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and western blot analysis, respectively. The chemosensitivity of a series of gastric cancer cell lines to platinum agents in vitro was evaluated using CellTiter 96 Aqueous One Solution Cell Proliferation Assay kit. The apoptotic effect of the drugs was evaluated by double staining with Annexin-V-fluorescein isothiocyanate (FITC) and propidium iodide (PI). The results demonstrated that the expression levels of ERCC1 mRNA were correlated with the chemosensitivity of platinum agents, and depletion of ERCC1 sensitized the relatively resistant MKN45 cells to cisplatin and oxaliplatin. Univariate analyses revealed that patients with low ERCC1 levels had longer relapse-free survival (RFS) and overall survival (OS) than those with high ERCC1 levels (median RFS, 18 vs. 7 months, P=0.001; median OS, 27 vs. 11 months, P=0.001). Multivariate analyses suggested that high ERCC1 expression is an independent prognostic marker of poor RFS [hazard ratio (HR), 2.16; 95% confidence interval (CI), 1.09–4.25; P= 0.026] and OS (HR, 2.21; 95% CI, 1.07–4.55; P=0.031). These results suggest that overexpression of ERCC1 is correlated with platinum drug resistance in gastric cancer cells, and that depletion of ERCC1 sensitizes gastric cancer cell lines to cisplatin and oxaliplatin. Gastric cancer patients with low levels of ERCC1 expression demonstrate a benefit from oxaliplatin-based adjuvant chemotherapy.
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Affiliation(s)
- Yong-Ping Liu
- Clinical Oncology Laboratory; Changzhou Tumor Hospital Affiliated to Suzhou University, Changzhou 213002, P.R. China
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1511
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Takeda H, Nishikawa H, Iguchi E, Ohara Y, Sakamoto A, Hatamaru K, Henmi S, Saito S, Nasu A, Komekado H, Kita R, Kimura T, Osaki Y. Impact of pretreatment serum cholinesterase level in unresectable advanced hepatocellular carcinoma patients treated with sorafenib. Mol Clin Oncol 2012; 1:241-248. [PMID: 24649154 DOI: 10.3892/mco.2012.48] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 11/16/2012] [Indexed: 12/18/2022] Open
Abstract
The value of serum cholinesterase (ChE) level as a predictive marker in sorafenib therapy for advanced hepatocellular carcinoma (HCC) has not yet been investigated. The present retrospective study therefore analyzed the impact of the serum ChE level in 93 patients with advanced HCC treated with sorafenib. Patients were categorized into two groups: group A with pretreatment serum ChE ≥140 IU/l (n=46) and group B with pretreatment serum ChE <140 IU/l (n=47). The correlation between clinicopathological findings, including serum ChE level, and overall survival (OS) and liver damage during sorafenib therapy was investigated. The median OS of the patients was 275 days, while OS was markedly higher in group A compared to group B (P=0.002). In 70 Child-Pugh A patients, serum ChE level was a significant prognostic predictor in multivariate analysis [P=0.019, hazard ratio (HR) =2.612; 95% confidence interval (CI), 1.174-5.810]. During sorafenib treatment, 22 patients developed liver dysfunction of grade 3 or higher. Only two group A patients (4.3%) developed liver dysfunction, compared to 20 group B patients (42.6%) (P<0.001). Multivariate analysis demonstrated that the pretreatment serum ChE level was the strongest predictor of liver damage (P=0.002, HR=0.061, 95% CI: 0.010-0.373), indicating serum ChE <140 IU/l to be the only independent predictor associated with severe liver function damage during sorafenib treatment in 70 patients with grade A Child-Pugh (P= 0.016; HR= 0.122; 95% CI, 0.022-0.676). In conclusion, lower serum ChE level is a significant predictor of poor prognosis and severe liver damage in HCC patients treated with sorafenib. Advanced HCC patients with lower serum ChE levels, including those with a Child-Pugh A pretreatment liver function score, should be given sorafenib therapy with caution.
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Affiliation(s)
- Haruhiko Takeda
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hiroki Nishikawa
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Eriko Iguchi
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yoshiaki Ohara
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Azusa Sakamoto
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Keiichi Hatamaru
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Shinichiro Henmi
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Sumio Saito
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Akihiro Nasu
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Hideyuki Komekado
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Ryuichi Kita
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Toru Kimura
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
| | - Yukio Osaki
- Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan
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1512
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Suda K, Tomizawa K, Mizuuchi H, Ito S, Kitahara H, Shimamatsu S, Kohno M, Yoshida T, Okamoto T, Maehara Y, Yatabe Y, Mitsudomi T. Genetic and Prognostic Differences of Non-small Cell Lung Cancer between Elderly Patients and Younger Counterparts. Aging Dis 2012; 3:438-443. [PMID: 23251849 PMCID: PMC3522510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 10/18/2012] [Accepted: 10/18/2012] [Indexed: 06/01/2023] Open
Abstract
Many elderly patients suffer from lung cancers, but it is not clear if their lung cancers differ from those of younger patients. In this study, we compared genetic and prognostic characteristics of lung cancers of patients aged ≥75 years with those of patients aged ≤ 64 years. In the genetic analysis, we explored 292 surgically treated non-squamous cell lung cancers with known mutational status of epidermal growth factor (EGFR) and anaplastic lymphoma kinase (ALK). In the prognostic analysis, we retrospectively analyzed 405 surgically treated non-small cell lung cancers (NSCLCs) before the era of routine clinical application of post-surgical adjuvant chemotherapy. Postsurgical recurrence-free survival (RFS) was compared between elderly patients and younger counterparts. The genetic analysis showed elderly non-squamous cell lung cancer patients to have higher prevalence of EGFR mutations (53.1 % vs 42.0%, P = 0.15) and lower prevalence of the ALK translocation (0 % vs 4.5%, P = 0.23) than their younger counterparts. The prognostic analysis showed postsurgical RFS was similar between the elderly NSCLC patients and the younger patients. However in multivariate analysis, adjusting for gender, smoking status, pathological stage, and histology, elderly patients had significantly worse prognoses (HR 1.57, 95% CI, 1.08-2.29; P = 0.02) compared with younger patients. These results suggest differences in genetic and prognostic aspects between elderly lung cancer patients and younger lung cancer patients.
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Affiliation(s)
- Kenichi Suda
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | | | - Hiroshi Mizuuchi
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
- Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
| | | | - Hirokazu Kitahara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Shinichiro Shimamatsu
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Mikihiro Kohno
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Tsukihisa Yoshida
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Tatsuro Okamoto
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka
| | - Yasushi Yatabe
- Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya
| | - Tetsuya Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kinki University Faculty of Medicine, Osaka-Sayama, Japan
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1513
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Zhang J, Huang Y, Li X, Guo Y, Zhao Y, Xue C, Hu Z, Zhang L, Zhao H. The impact of tumor size change after target therapy on survival: analysis of patients enrolled onto three clinical trials of advanced NSCLC from one institution. Onco Targets Ther 2012; 5:349-55. [PMID: 23172990 PMCID: PMC3501954 DOI: 10.2147/ott.s38441] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore whether changes in tumor size impact survival in advanced non-small-cell lung cancer (NSCLC) after target therapy, especially in patients with evaluation of stable disease (SD), and to review the applicability of the Response Evaluation Criteria in Solid Tumors (RECIST) criteria in target therapy. Patients and methods Data from 88 NSCLC patients receiving gefitinib (250 mg, daily [qd]), erlotinib (150 mg, qd), and ZD6474 (100 mg, qd) in three clinical trials (IRESSA registration clinical trial, TRUST study, ZD6474 study) during November 2003 to June 2005 were retrospectively analyzed. The treatment effect (complete response, partial response, stable disease [SD], or progressive disease) was evaluated with radiologic assessment according to the RECIST criteria. SD patients were divided into two groups: SD−/0, in which the sum of the longest diameter of target lesions decreased by less than 30% or did not change; and SD+, in which the sum of the longest diameter of target lesions increased by less than 20%. The differences of progression-free survival (PFS) and overall survival (OS) between these groups were analyzed. Results In the whole group, 27 patients achieved complete response or partial response as best response, 40 achieved SD, and 22 had progressive disease. The median PFS and OS were 4 months and 11.1 months, respectively. In SD patients, 27 were SD−/0 and 13 patients were SD+. The PFS and OS of SD+ patients was shorter than that of SD−/0 patients (5.65 months vs 2.03 days, P < 0.001 and 12.2 months vs 7.1 months, P < 0.001). Conclusion The applicability of RECIST criteria was called into question in the evaluation of target therapy. Change in tumor size might predict survival in advanced NSCLC patients with target therapy and may be a surrogate endpoint for efficacy in target therapy.
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Affiliation(s)
- Jianwei Zhang
- State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangzhou, China
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1514
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Zhang GJ, Zhou T, Tian HP, Liu ZL, Xia SS. High expression of ZEB1 correlates with liver metastasis and poor prognosis in colorectal cancer. Oncol Lett 2012; 5:564-568. [PMID: 23420790 PMCID: PMC3573155 DOI: 10.3892/ol.2012.1026] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/07/2012] [Indexed: 12/29/2022] Open
Abstract
Zinc finger E-box binding homeobox 1 (ZEB1) has been shown to promote invasion and metastasis in several types of human cancer and to have a prognostic role in certain cancers. However, the clinical significance of ZEB1 in colorectal cancer (CRC) has not been sufficiently investigated. This study aimed to address this issue. In this study, we compared the expression of ZEB1 between CRC tissues and normal adjacent mucosa using quantitative real-time RT-PCR. The association of ZEB1 expression with clinicopathological characteristics was analyzed by appropriate statistical analyses. Kaplan-Meier analysis and Cox proportional hazards regression models were used to investigate the association of ZEB1 expression with survival of patients. The results showed that the relative expression levels of ZEB1 were significantly higher in CRC tissues compared to the normal adjacent mucosa and higher expression of ZEB1 correlated with liver metastasis. Kaplan-Meier analysis indicated that patients with high ZEB1 had a poor overall survival. Moreover, the multivariate analysis showed that high expression of ZEB1 was an independent predictor of overall survival. Our data indicate the potential of ZEB1 as a novel prognostic biomarker for CRC.
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Affiliation(s)
- Guang-Jun Zhang
- The First Department of General Surgery, The Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R. China
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1515
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Rutherford A, King LY, Hynan LS, Vedvyas C, Lin W, Lee WM, Chung RT. Development of an accurate index for predicting outcomes of patients with acute liver failure. Gastroenterology 2012; 143:1237-1243. [PMID: 22885329 PMCID: PMC3480539 DOI: 10.1053/j.gastro.2012.07.113] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Revised: 07/25/2012] [Accepted: 07/27/2012] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Patients with acute liver failure (ALF) have high mortality and frequently require liver transplantation (LT); few reliable prognostic markers are available. Levels of M30, a cleavage product of cytokeratin-18 caspase, are significantly increased in serum samples from patients with ALF who die or undergo LT. We developed a prognostic index for ALF based on level of M30 and commonly measured clinical variables (called the Acute Liver Failure Study Group [ALFSG] index) and compared its accuracy with that of the King's College criteria (KCC) and Model for End Stage Liver Disease (MELD). We also validated our model in an independent group of patients with ALF. METHODS Serum levels of M30 and M65 antigen (the total cytokeratin-18 fragment, a marker of apoptosis and necrosis) were measured on 3 of the first 4 days following admission of 250 patients with ALF. Logistic regression was used to determine whether the following factors, measured on day 1, were associated with LT or death: age, etiology; coma grade; international normalized ratio (INR); serum pH; body mass index; levels of creatinine, bilirubin, phosphorus, arterial ammonia, and lactate; and log(10) M30 and log(10) M65. The area under the receiver operating characteristic (AUROC) was calculated for the ALFSG and other indices. RESULTS Coma grade, INR, levels of bilirubin and phosphorus, and log(10) M30 value at study entry most accurately identified patients who would require LT or die. The ALFSG index identified these patients with 85.6% sensitivity and 64.7% specificity. Based on comparison of AUROC values, the ALFSG Index (AUROC, 0.822) better identified patients most likely to require LT or die than the KCC (AUROC, 0.654) or MELD (AUROC, 0.704) (P = .0002 and P = .0010, respectively). We validated these findings in a separate group of 250 patients with ALF. CONCLUSIONS The ALFSG index, a combination of clinical markers and measurements of the apoptosis biomarker M30, better predicts outcomes of patients with ALF than the KCC or MELD.
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Affiliation(s)
- Anna Rutherford
- Department of Internal Medicine, Brigham & Women’s Hospital, Boston, Massachusetts,Division of Gastroenterology, Hepatology & Endoscopy, Brigham & Women’s Hospital, Boston, Massachusetts
| | - Lindsay Y. King
- Department of Internal Medicine, Brigham & Women’s Hospital, Boston, Massachusetts,Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Linda S. Hynan
- Departments of Clinical Sciences (Division of Biostatistics) and Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Wenyu Lin
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - William M. Lee
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Raymond T. Chung
- Gastrointestinal Unit, Massachusetts General Hospital, Boston, Massachusetts
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1516
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Abstract
Background: Biological markers that reliably predict clinical or pathological response to primary systemic therapy early during a course of chemotherapy may have considerable clinical potential. Aims: Aims of study to evaluated changes in Ki-67 (MIB-1) labeling index and apoptotic index (AI) before, during, and after neoadjuvant anthracycline chemotherapy in breast cancer in Indian women. Materials and Methods: Breast cancer tissues were collected from Grant Medical College and Sir J.J. Group of Hospitals, Mumbai, India. Twenty-seven patients receiving neoadjuvant FEC (5-fluorouracil, epirubicin, and cyclophosphamide) chemotherapy for operable breast cancer underwent repeat core biopsy after 21 days of treatment. Results: The objective clinical response rate was 56%. Eight patients (31%) achieved a pathological response by histopathological criteria; two patients had a near-complete pathological response. Increased day-21 AI was a statistically significant predictor of pathological response (p = 0.049). A strong trend for predicting pathological response was seen with higher Ki-67 indices at day 21 and AI at surgery (p = 0.06 and 0.06, respectively). Conclusion: The clinical utility of early changes in biological marker expression during chemotherapy remains unclear. Until further prospectively validated evidence confirming the reliability of predictive biomarkers is available, clinical decision-making should not be based upon individual biological tumor biomarker profiles.
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Affiliation(s)
- Amit V Patil
- Department of General Surgery, Government Medical College, Miraj, Maharashtra, India
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1517
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Shiina S, Tateishi R, Imamura M, Teratani T, Koike Y, Sato S, Obi S, Kanai F, Kato N, Yoshida H, Omata M, Koike K. Percutaneous ethanol injection for hepatocellular carcinoma: 20-year outcome and prognostic factors. Liver Int 2012; 32:1434-42. [PMID: 22712520 PMCID: PMC3466412 DOI: 10.1111/j.1478-3231.2012.02838.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 05/22/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND Ethanol injection is the best-known image-guided percutaneous ablation for hepatocellular carcinoma (HCC) and a well-tolerated, inexpensive procedure with few adverse effects. However, there have been few reports on its long-term results. AIMS We report a 20-year consecutive case series at a tertiary referral centre. METHODS We performed 2147 ethanol injection treatments on 685 primary HCC patients and analysed a collected database. RESULTS Final computed tomography demonstrated complete ablation of treated tumours in 2108 (98.2%) of the 2147 treatments. With a median follow-up of 51.6 months, 5-, 10- and 20-year survival rates were 49.0% [95% confidence interval (CI) = 45.3-53.0%], 17.9% (95% CI = 15.0-21.2%) and 7.2% (95% CI = 4..5-11.5%) respectively. Multivariate analysis demonstrated that age, Child-Pugh class, tumour size, tumour number and serum alpha-fetoprotein level were significant prognostic factors for survival. Five-, 10- and 20-year local tumour progression rates were 18.2% (95% CI = 15.0-21.4%), 18.4% (95% CI = 15.2-21.6%) and 18.4% (95% CI = 15.2-21.6%) respectively. Five-, 10- and 20-year distant recurrence rates were 53.5% (95% CI = 49.4-57.7%), 60.4 (95% CI = 56.3-64.5%) and 60.8% (95% CI = 56.7-64.9%) respectively. There were 45 complications (2.1%) and two deaths (0.09%). CONCLUSIONS Ethanol injection was potentially curative for HCC, resulting in survival for more than 20 years. This study suggests that new ablation therapies will achieve similar or even better long-term results in HCC.
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Affiliation(s)
- Shuichiro Shiina
- Department of Gastroenterology, University of Tokyo, Tokyo, Japan.
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1518
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Liu H, Zhang T, Ye J, Li H, Huang J, Li X, Wu B, Huang X, Hou J. Tumor-infiltrating lymphocytes predict response to chemotherapy in patients with advance non-small cell lung cancer. Cancer Immunol Immunother 2012; 61:1849-56. [PMID: 22456757 PMCID: PMC11029471 DOI: 10.1007/s00262-012-1231-7] [Citation(s) in RCA: 99] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2012] [Accepted: 02/20/2012] [Indexed: 12/31/2022]
Abstract
Accumulating preclinical evidence suggests that anticancer immune responses contribute to the success of chemotherapy. The predictive significance of tumor-infiltrating lymphocytes (TILs) for response to neoadjuvant chemotherapy in non-small cell lung cancer (NSCLC) remains unknown. The aim of this study was to investigate the prognostic and predictive value of TIL subtypes in patients with advanced NSCLC treated with platinum-based chemotherapy. In total, 159 patients with stage III and IV NSCLC were retrospectively enrolled. The prevalence of CD3(+), CD4(+), CD8(+) and Foxp3(+) TILs was assessed by immunohistochemistry in tumor tissue obtained before chemotherapy. The density of TILs subgroups was treated as dichotomous variables using the median values as cutoff. Survival curves were estimated by the Kaplan-Meier method, and differences in overall survival between groups were determined using the Log-rank test. Prognostic effects of TIL subsets density were evaluated by Cox regression analysis. The presence of CD3(+), CD4(+), CD8(+), and FOXP3(+) TILs was not correlated with any clinicopathological features. Neither the prevalence of TILs nor combined analysis displayed obvious prognostic performances for overall survival in Cox regression model. Instead, higher FOXP3(+)/CD8(+) ratio in tumor sites was an independent factor for poor response to platinum-based chemotherapy in overall cohort. These findings suggest that immunological CD8(+) and FOXP3(+)Tregs cell infiltrate within tumor environment is predictive of response to platinum-based neoadjuvant chemotherapy in advanced NSCLC patients. The understanding of the clinical relevance of the microenvironmental immunological milieu might provide an important clue for the design of novel strategies in cancer immunotherapy.
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Affiliation(s)
- Hui Liu
- Institute of Respiratory Diseases of Sun Yat-Sen University, Division of Pulmonary and Critical Care, Department of Internal Medicine, The Third Affiliated Hospital of Sun Yat-Sen University, No. 600 Tianhe Street, Guangzhou 510630, China.
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1519
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Căinap S, Răchisan A, Fetică B, Cosnarovici R, Mihut E, Popa G, Gheban D, Căinap C. EBV in pediatric neoplasia--intensity of infection as independent prognostic factor. J Med Life 2012; 5:283-7. [PMID: 23049629 PMCID: PMC3464995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2012] [Accepted: 09/05/2012] [Indexed: 11/02/2022] Open
Abstract
RATIONALE Cancer disease is continuously rising worldwide as far as its incidence is concerned. Efforts were made in order to identify the etiologic factors. A good example for exogenous factors is Epstein Barr virus (EBV) which is largely spread worldwide, over 90% of the adult general population being infected by it. EBV is believed to be implicated in Burkitt lymphoma, Hodgkin lymphoma, nasopharyngeal carcinoma, etc. OBJECTIVE In this paper, we will try to present the experience of two centers in Cluj County involved in the treatment of pediatric cancer, focusing on the influence of the presence of Epstein Barr virus in the outcome of the neoplasia. METHODS AND RESULTS we took into account the clinical data regarding histology, stage of the disease, titer of specific antibodies for EBV, serological and imagistic evaluations of the patients treated in a retrospective consecutive manner for 5 years--2005-2010. Regarding our cohort of 120 patients, we analyzed the items in the paper in detail together with the statistical analysis and searched for a link between the intensity of the infection of EBV and response, disease, free survival, toxicities of the treatment. DISCUSSION there are few data concerning the influence of EBV regarding the outcome of pediatric neoplasia. The published studies suggest a positive influence of EBV especially in Hodgkin disease mixed cellular subtype. In this study, EBV negative patients do better than the EBV positive, but the infection with EBV protects the patients against hematological toxicities.
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Affiliation(s)
- S Căinap
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca,Pediatric Emergency County Hospital, Cluj Napoca
| | - A Răchisan
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca,Pediatric Emergency County Hospital, Cluj Napoca
| | - B Fetică
- “I. Chiricută” National Institute of Oncology, Cluj Napoca
| | - R Cosnarovici
- “I. Chiricută” National Institute of Oncology, Cluj Napoca
| | - E Mihut
- “I. Chiricută” National Institute of Oncology, Cluj Napoca
| | - G Popa
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca,Pediatric Emergency County Hospital, Cluj Napoca
| | - D Gheban
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca,Pediatric Emergency County Hospital, Cluj Napoca
| | - C Căinap
- ”Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj Napoca, “I. Chiricută” National Institute of Oncology, Cluj Napoca
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1520
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Aglamis E, Toktas G, Unluer E, Tasdemir C, Ceylan C. Prognostic factors in radical cystectomy affecting survival. Arch Med Sci 2012; 8:650-4. [PMID: 23056076 PMCID: PMC3460501 DOI: 10.5114/aoms.2012.30288] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 09/12/2011] [Accepted: 10/02/2011] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION The aim of the study was to evaluate the prognostic factors in radical cystectomy affecting survival. MATERIAL AND METHODS A total of 100 hundred patients were included in the study. Incontinent diversion was applied to 73 of these, and continent diversion to 27. Prospective and retrospective data of the patients were examined. The prognostic value for survival was evaluated for of lymph node involvement, tumor grade (low grade: grade 0-II, high grade: ≥ III or epidermoid carcinoma), tumor stage (low stage: stage pT0-2, high stage: stage ≥ 3a pT3a), presence of preoperative unilateral of bilateral hydronephrosis, presence of preoperative uremia (serum urea value: ≤ 60), and age (> 70 and ≤ 70 years of age) on survival were investigated. Kaplan-Meier survival analysis and Log-Rank statistical methods were used in the study. RESULTS Grade, stage, uremia, and lymph node involvement had significant effects on survival (p values 0.0002, 0.03, 0.01, and 0.02, respectively). Presence of preoperative hydronephrosis and age had no statistically significant effects on survival (p values 0.8 and 0.2, respectively). CONCLUSIONS Tumor grade, tumor stage, preoperative uremia, and lymph node involvement are prognostic factors affecting survival. Advanced age and presence of preoperative hydronephrosis have no prognostic value for survival. The presence of uremia in the preoperative assessment of the patients is more important than hydronephrosis.
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Affiliation(s)
- Erdogan Aglamis
- Clinics of Urology, Elazig Education and Research Hospital, Turkey
| | - Gokhan Toktas
- Clinics of Urology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | - Erdinc Unluer
- Clinics of Urology, Istanbul Education and Research Hospital, Istanbul, Turkey
| | | | - Cavit Ceylan
- Clinics of Urology, Istanbul Education and Research Hospital, Istanbul, Turkey
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1521
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Nowicki A, Sporny S, Duda-Szymańska J. β-catenin as a prognostic factor for prostate cancer (PCa). Cent European J Urol 2012; 65:119-23. [PMID: 24578946 PMCID: PMC3921790 DOI: 10.5173/ceju.2012.03.art4] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Revised: 03/25/2012] [Accepted: 04/19/2012] [Indexed: 11/22/2022] Open
Abstract
Introduction The prostate cancer is difficult to predict, and treatment failure is associated with local infiltration, as well as distant metastases. Adhesion and migration abilities to of cancer cells play a major role in formation of metastasis. The participation of β-catenin in pathogene-sis of many types of cancer and benign processes has been an important discovery of recent years. Material and methods The studied material was obtained by transrectal, sextant core biopsy from 102 patients hospitalized in Department of Urology, Regional Hospital in Kalisz (2001-2004). The aim of our study was to determine the predictive value of β-catenin immunoexpression in prostate cancer, to analyze the prognostic aspect of some histopathological features and finally to assess the relationship between β-catenin immunoreactivity and the microscopic image of the tumor. Relationships between the investigated variables were analyzed using the Chi2 test of compatibility. We used the Kaplan-Meier curves to assess survival differences between groups of patients. Finally we established which of the studied factors significantly affect the patient outcome, using the method of Cox proportional hazard regression. Results In prostate cancer in comparison with the normal epithelium, both the location and the strength of β-catenin immunoexpression are impaired. Conclusions Our results indicate that the presence of disorders in β-catenin immunoexpression in prostate cancer cells indicates a high risk of death due to tumor progression and makes it imperative for immediate treatment procedures.
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Affiliation(s)
- Andrzej Nowicki
- Department of Pathology, Medical University of Łódź, Łódź, Poland
| | - Stanisław Sporny
- Department of Oral Pathology, Medical University of Łódź, Poland
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1522
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Mendes FD, Suzuki A, Sanderson SO, Lindor KD, Angulo P. Prevalence and indicators of portal hypertension in patients with nonalcoholic fatty liver disease. Clin Gastroenterol Hepatol 2012; 10:1028-33.e2. [PMID: 22610002 PMCID: PMC3424335 DOI: 10.1016/j.cgh.2012.05.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 04/25/2012] [Accepted: 05/03/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Little is known about the prevalence and severity of portal hypertension in patients with nonalcoholic fatty liver disease (NAFLD). We investigated the prevalence and noninvasive predictors of portal hypertension in patients with NAFLD. METHODS Signs of portal hypertension, including esophageal varices, splenomegaly, portosystemic encephalopathy, and ascites, were investigated in 354 patients with NAFLD. RESULTS One hundred patients had portal hypertension at the time of NAFLD diagnosis (28.2%), 88 of these patients had septal fibrosis or cirrhosis (88%). Fibrosis stage correlated with presence (r = 0.41, P < .0001) and number of findings (r = 0.48, P = .006) of portal hypertension. Of the 204 patients with no or mild fibrosis (stages, 0-2), 12 patients had portal hypertension (6%); they had a significantly higher grade of steatosis, based on biopsy analysis, compared with the 192 patients without portal hypertension (94%). Thrombocytopenia, hyperbilirubinemia, cirrhosis, and obesity were associated independently with portal hypertension. Esophageal varices were found in 57 of the 128 patients undergoing endoscopic screening (44.5%) and were associated independently with thrombocytopenia, type 2 diabetes, and splenomegaly. CONCLUSIONS Signs of portal hypertension were present in 25% of patients at the time of diagnosis of NAFLD; most had advanced fibrosis or cirrhosis. Portal hypertension can occur in a small proportion of patients with mild or no fibrosis and is associated with the extent of steatosis. Features of advanced liver disease and insulin resistance might identify patients with NAFLD and portal hypertension, and those expected to derive the most benefit from endoscopic screening for esophageal varices.
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Affiliation(s)
- Flavia D. Mendes
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN
| | - Ayako Suzuki
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN
| | - Schuyler O. Sanderson
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN
| | - Keith D. Lindor
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN
| | - Paul Angulo
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, MN,Division of Digestive Diseases and Nutrition, University of Kentucky Medical Center, Lexington, KY
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1523
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Salvi S, Fontana V, Boccardo S, Merlo DF, Margallo E, Laurent S, Morabito A, Rijavec E, Dal Bello MG, Mora M, Ratto GB, Grossi F, Truini M, Pistillo MP. Evaluation of CTLA-4 expression and relevance as a novel prognostic factor in patients with non-small cell lung cancer. Cancer Immunol Immunother 2012; 61:1463-72. [PMID: 22318401 PMCID: PMC11029051 DOI: 10.1007/s00262-012-1211-y] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Accepted: 01/21/2012] [Indexed: 01/09/2023]
Abstract
The role of CTLA-4 in negative regulation of T-cell mediated immune response is particularly well established. Much less is known about its expression and function in tumour cells, and to our knowledge, no data are available on its possible impact on prognosis of NSCLC patients. We investigated CTLA-4 expression and prognostic role in 81 patients with radically resected stage I-III NSCLC. The analysis was performed by tissue microarray immunohistochemistry, and the median H-score of 20 was used as a threshold to define CTLA-4 overexpressing tumours. Correlation with standard prognostic factors was performed by using absolute and relative fold change indexes. Hazard ratios (HR) and corresponding 95% confidence limits (95% CL) were computed through the Cox model. A higher frequency of CTLA-4 overexpression (>20) was found in non-squamous than in squamous NSCLC (52.8 vs. 35.7%) and in Ki67 ≤ 15 expressing tumours, as compared to those with Ki67 > 15 (51.5 vs. 38.7%). A reduced death rate was found in CTLA-4 overexpressing tumours (HR = 0.60, 95% CL = 0.28/1.23), and a further decrease was observed when considering tumours with CTLA-4 > 20 and Ki67 ≤ 15, in comparison with tumours with CTLA-4 ≤ 20 and Ki67 > 15 (HR = 0.41; 95% CL = 0.15/1.13). Our observational and exploratory study provides a first and promising indication for an independent prognostic effect of CTLA-4 overexpression in radically resected NSCLC. We presume that this effect relies on modulation of the interaction of microscopic disease with CTLA-4-ligands expressing cells leading to NSCLC cell death.
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Affiliation(s)
- Sandra Salvi
- Department of Pathology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Vincenzo Fontana
- Unit of Epidemiology, Biostatistics and Clinical Trials, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Simona Boccardo
- Department of Pathology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Domenico Franco Merlo
- Unit of Epidemiology, Biostatistics and Clinical Trials, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Edoardo Margallo
- Department of Pathology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Stefania Laurent
- Tumour Genetics and Epigenetics, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, 10, 16132 Genoa, Italy
| | - Anna Morabito
- Tumour Genetics and Epigenetics, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, 10, 16132 Genoa, Italy
| | - Erika Rijavec
- Lung Cancer Unit, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | | | - Marco Mora
- Department of Pathology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | | | | | - Mauro Truini
- Department of Pathology, IRCCS A.O.U. San Martino-IST, Genoa, Italy
| | - Maria Pia Pistillo
- Tumour Genetics and Epigenetics, IRCCS A.O.U. San Martino-IST, Largo Rosanna Benzi, 10, 16132 Genoa, Italy
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1524
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Abstract
PURPOSE Pancreatic neuroendocrine tumors (PNET) are a rare subgroup of tumors. For PNETs, the predictive factors for survival and prognosis are not well known. The purpose of our study was to evaluate the predictive factors for survival and disease progression in PNETs. MATERIALS AND METHODS We retrospectively analyzed 37 patients who were diagnosed with PNET at Severance Hospital between November 2005 and March 2010. Prognostic factors for survival and disease progression were evaluated using the Kaplan-Meier method. RESULTS The mean age of the patients was 50.0±15.0 years. Eight cases (21.6%) were described as functioning tumors and 29 cases (78.4%) as non-functioning tumors. In univariate analysis of clinical factors, patients with liver metastasis (p=0.002), without resection of primary tumors (p=0.002), or American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) stage III/IV (p=0.002) were more likely to demonstrate shorter overall survival (OS). Patients with bile duct or pancreatic duct invasion (p=0.031), sized-lesions larger than 20 mm (p=0.036), liver metastasis (p=0.020), distant metastasis (p=0.005), lymph node metastasis (p=0.009) or without resection of primary tumors (p=0.020) were more likely to demonstrate shorter progression-free survival (PFS). In multivariate analysis of clinical factors, bile duct or pancreatic duct invasion [p=0.010, hazard ratio (HR)=95.046] and tumor location (non-head of pancreas) (p=0.036, HR=7.381) were confirmed as independent factors for predicting shorter PFS. CONCLUSION Patients with liver metastasis or without resection of primary tumors were more likely to demonstrate shorter OS. Patients with bile duct or pancreatic duct invasion or tumors located at body or tail of pancreas were more likely to demonstrate shorter PFS.
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Affiliation(s)
- Tak Geun Oh
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Moon Jae Chung
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Yeop Park
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Min Bang
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Woo Park
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Bok Chung
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
| | - Si Young Song
- Division of Gastroenterology, Department of Internal Medicine and Yonsei Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea
- Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
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1525
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Miao XH, Yao YW, Yuan DM, Lv YL, Zhan P, Lv TF, Liu HB, Song Y. Prognostic value of the ratio of ground glass opacity on computed tomography in small lung adenocarcinoma: A meta-analysis. J Thorac Dis 2012; 4:265-71. [PMID: 22754665 DOI: 10.3978/j.issn.2072-1439.2012.05.09] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2012] [Accepted: 05/16/2012] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Lung cancer is the leading cause of cancer-associated death. In many countries, adenocarcinoma is the most common histologic type in lung cancer. Previously, few factors are identified to be prognostic indicators for the patients with small lung adenocarcinoma. Recently, the ground glass opacity (GGO) area found on high-resolution computed tomography (HRCT) scanning was identified as a prognostic indicator in some studies. But no clear consensus has been defined. METHODS The PubMed/MEDLINE, EMBASE, Cochrane library and SpringerLink electronic databases were searched for articles related to ground glass opacity on computed tomography in patients with small lung adenocarcinoma. Data was extracted and analyzed independently by two investigators. An estimate of the hazard ratio (HR) for comparing high GGO ratio with low GGO ratio was extracted. The respective HRs was combined into a pooled HR, and 95% confidence interval (CI) was calculated for each study. The publication heterogeneity was assessed graphically using performing Beggs' funnel plot. All the statistical tests used in our meta-analysis were performed with STATA version 11. RESULTS Thirteen studies, encompassing 2,027 patients, were included in our meta-analysis. Ten of these studies revealed that the GGO ratio in small lung adenocarcinoma is a good prognostic indicator. Seven studies were combined in a meta-analysis using overall survival (OS) as the end point of interest. The weighted HR of 7 studies was 0.85, with relative 95% CI ranging from 0.78 to 0.93 (P=0.009). For the surgical patient population, the primary endpoint of relapse-free survival (RFS) was superior with high GGO area on computed tomography (The combined HR 0.82, 95% CI 0.74-0.90; P=0.007). CONCLUSIONS The result of our meta-analysis suggested that the GGO area measured on HRCT had a prognostic value of overall survival and relapse-free survival in small lung adenocarcinoma. The GGO ratio may be an independent prognostic factor for small lung adenocarcinoma.
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1526
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Kumagai N, Origasa H, Nagao T, Takekawa H, Okuhara Y, Yamaguchi T. Prognostic significance of smoking in patients with acute ischemic stroke within 3 months of onset. J Stroke Cerebrovasc Dis 2012; 22:792-8. [PMID: 22633681 DOI: 10.1016/j.jstrokecerebrovasdis.2012.04.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Revised: 04/12/2012] [Accepted: 04/18/2012] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Various factors that have been implicated in recovery after the acute phase of stroke have not been well evaluated. METHODS To identify prognostic factors affecting outcomes at 90 days after stroke from the viewpoint of recovery patterns, we enrolled 660 patients from the Edaravone and Argatroban Stroke Therapy for Acute Ischemic Stroke study database. Fourteen groups of patients were identified based on an analysis of their recovery patterns according to changes in their National Institutes of Health Stroke Scale scores during the first 21 days. These groups were then divided into 2 groups: favorable recovery trend (patterns 1-3; n = 486) and poor recovery trend (patterns 4-14; n = 174). Patterns with >80% of the patients experiencing a favorable outcome (National Institutes of Health Stroke Scale score of ≤ 4 at 90 days) were defined as the favorable recovery trend group, whereas patterns that included ≤ 80% favorable outcomes were defined as the poor recovery trend group. RESULTS Using the poor recovery trend group, logistic regression analysis found that after controlling for covariates, lower scores at admission, fewer ischemic lesions, and nonsmoking were significant prognostic factors for a favorable outcome at 90 days. CONCLUSIONS Based on a detailed analysis of the relationship between recovery patterns after stroke and clinical outcomes in the chronic stage of stroke, smoking cessation may improve the prognosis of patients after stroke.
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Affiliation(s)
- Naoko Kumagai
- Center of Medical Information Science, Kochi University Medical School, Nankoku, Japan.
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1527
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Krstevska V, Stojkovski I, Zafirova-Ivanovska B. Concurrent radiochemotherapy in locally-regionally advanced oropharyngeal squamous cell carcinoma: analysis of treatment results and prognostic factors. Radiat Oncol 2012; 7:78. [PMID: 22640662 PMCID: PMC3404949 DOI: 10.1186/1748-717x-7-78] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 05/28/2012] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Concurrent radiochemotherapy is a recommended treatment option for patients with locally advanced squamous cell head and neck carcinomas with recent data showing the most significant absolute overall and event-free survival benefit achieved in patients with oropharyngeal tumours. The aim of this study was to analyse the results of three-dimensional conformal radiotherapy given with concomitant weekly cisplatin in patients with advanced oropharyngeal carcinoma and to identify prognostic factors influencing outcomes of this patients category. METHODS Sixty-five patients with stage III or IV squamous cell carcinoma of the oropharynx who underwent concurrent radiochemotherapy between January 2005 and December 2010 were retrospectively analyzed. All patients received radiotherapy to 70 Gy/35 fractions/2 Gy per fraction/5 fractions per week. Concurrent chemotherapy consisted of weekly cisplatin (30 mg/m(2)) started at the first day of radiotherapy. RESULTS Median age was 57 years (range, 36 to 69 years) and 59 (90.8%) patients were male. Complete composite response was achieved in 47 patients (72.3%). Local and/or regional recurrence was the most frequent treatment failure present in 19 out of 25 patients (76.0%). At a median follow-up of 14 months (range, 5 to 72 months), 2-year local relapse-free, regional relapse-free, locoregional relapse-free, disease-free, and overall survival rates were 48.8%, 57.8%, 41.7%, 33.2% and 49.7%, respectively.On multivariate analysis the only significant factor for inferior regional relapse-free survival was the advanced N stage (p = 0.048). Higher overall stage was independent prognostic factor for poorer local relapse-free survival, locoregional relapse-free survival and disease-free survival (p = 0.022, p = 0.003 and p = 0.003, respectively). Pre-treatment haemoglobin concentration was an independent prognostic factor for local relapse-free survival, regional relapse-free survival, locoregional relapse-free survival, disease-free survival, and overall survival (p = 0.002, p = 0.021, p = 0.001, p = 0.002 and p = 0.002, respectively). CONCLUSIONS Poor treatments results of this study suggested that introduction of intensity-modulated radiotherapy, use of induction chemotherapy followed by concurrent radiochemotherapy, accelerated radiotherapy regimens, and molecular targeted therapies could positively influence treatment outcomes. The incorporation of reversal of anaemia should be also expected to provide further improvement in locoregional control and survival in patients with advanced squamous cell carcinoma of the oropharynx.
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Affiliation(s)
- Valentina Krstevska
- Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - Igor Stojkovski
- Department of Head and Neck Cancer, University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - Beti Zafirova-Ivanovska
- Institute of Epidemiology, Statistics and Informatics, Faculty of Medicine, Skopje, Macedonia
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1528
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Mizuta S, Matsuo K, Maeda T, Yujiri T, Hatta Y, Kimura Y, Ueda Y, Kanamori H, Usui N, Akiyama H, Takada S, Yokota A, Takatsuka Y, Tamaki S, Imai K, Moriuchi Y, Miyazaki Y, Ohtake S, Ohnishi K, Naoe T. Prognostic factors influencing clinical outcome of allogeneic hematopoietic stem cell transplantation following imatinib-based therapy in BCR-ABL-positive ALL. Blood Cancer J 2012; 2:e72. [PMID: 22829974 DOI: 10.1038/bcj.2012.18] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 03/28/2012] [Accepted: 04/12/2012] [Indexed: 12/01/2022] Open
Abstract
We investigated prognostic factors for the clinical outcome of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) following imatinib-based therapy. Among 100 adult patients who were prospectively enrolled in the JALSG Ph+ALL202 study, 97 patients obtained complete remission (CR) by imatinib-combined chemotherapy, among whom 60 underwent allo-HSCT in their first CR. The probabilities of overall survival (OS) and disease-free survival (DFS) at 3 years after HSCT were 64% (95% CI, 49–76) and 58% (95% CI, 43–70), respectively. Prognostic factor analysis revealed that the major BCR–ABL transcript was the only unfavorable predictor for OS and DFS after HSCT by both univariate (HR, 3.67 (95% CI 1.49–9.08); P=0.005 and HR, 6.25 (95% CI, 1.88–20.8); P=0.003, respectively) and multivariate analyses (HR, 3.20 (95% CI, 1.21–8.50); P=0.019 and HR, 6.92 (95% CI, 2.09–22.9); P=0.002, respectively). Minimal residual disease status at the time of HSCT had a significant influence on relapse rate (P=0.015). Further study of the BCR–ABL subtype for the clinical impact on outcome of allo-HSCT in Ph+ALL is warranted.
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1529
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Hu Q, Li B, Garfield D, Ren S, Li A, Chen X, Zhou C. Prognostic factors for survival in a Chinese population presenting with advanced non-small cell lung cancer with an emphasis on smoking status: A regional, single-institution, retrospective analysis of 4552 patients. Thorac Cancer 2012; 3:162-168. [PMID: 28920299 DOI: 10.1111/j.1759-7714.2011.00099.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Lung cancer ranks as the top of cancer-related mortality in the world. Approximately 85-90% of all lung cancer cases are non-small cell lung cancer (NSCLC). For advanced NSCLC patients, the five-year survival rate is less than 5%. Previous studies have attempted to determine prognostic factors, such as smoking status, gender, ethnicity, age, and histological type. However, the results are controversial and conflict. In this study, we investigated prognostic factors in a Chinese population presenting with advanced NSCLC. METHODS Medical records of patients with advanced NSCLC (AJCC Stage IIIB/IV) who received treatment at our institution were reviewed. Kaplan-Meier method and Cox Proportional Hazards model were performed in both univariate and multivariate analyses. RESULTS A total of 4552 patients were entered. Among them, 1320 (29.0%) were female, 2408 non-smokers (52.9%), and all had Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) = 0/1. Univariate analysis suggested that female gender (P < 0.001), adenocarcinoma histology (P < 0.001), age <70 (P < 0.001), and non-smoker status (P < 0.001) were associated with better survival. However, multivariate analysis demonstrated that age (hazard ratio [HR]= 1.173, 95% confidence interval [CI]: 1.085-1.268, P < 0.001), smoking status (vs. non-smokers, HR = 1.212, 95% CI: 1.123-1.308, P < 0.001), and histological type (non-adenocarcinoma vs. adenocarcinoma, HR = 1.104, 95% CI: 1.031-1.181, P = 0.004), but not gender, were independent prognostic factors. CONCLUSIONS Smoking status, age, and histological type are independent prognostic factors in Chinese NSCLC patients presenting with advanced disease. Non-smoking status is associated with better overall survival in Chinese NSCLC patients.
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Affiliation(s)
- Qiong Hu
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - Bing Li
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - David Garfield
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - Aiwu Li
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - Xiaoxia Chen
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
| | - CaiCun Zhou
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Tongji University Medical School Cancer Institute, Shanghai, China ProMed Cancer Center, Shanghai, China
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1530
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Abstract
PURPOSE Despite extensive study, the use of allogeneic hematopoietic stem cell transplantation in acute myeloid leukemia (AML) vary considerably. The decision of which of these options to choose is complex and depends on both clinical and molecular variables as well as the availability and histocompatability of donor stem cells. So far there is no clear explanation on whether the expression of myeloperoxidase (MPO) relates to the prognosis of AML. MATERIALS AND METHODS We retrospectively analyzed the prognostic significance of the MPO expression in the 140 patients with diagnosed AML treated at a single institution. RESULTS In our study, MPO expression was associated with disease-free survival (DFS) and transplant was beneficial to overcome a negative prognostic effect of MPO-negative at diagnosis based upon the result that the DFS in patients received transplants are not significant between the MPO-positive group and MPO-negative group although DFS in all patients was different according to MPO expression. CONCLUSION MPO expression at diagnosis helps to choose therapy for each AML patient and can differentiate AML patients who need transplantation.
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Affiliation(s)
- Yundeok Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sulhee Yoon
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Soo Jeong Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Seok Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun-Won Cheong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yoo Hong Min
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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1531
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Zhou L, Liu C, Bai JG, Wei JC, Qu K, Tian F, Tai MH, Wang RT, Meng FD. A rare giant gastrointestinal stromal tumor of the stomach traversing the upper abdomen: a case report and literature review. World J Surg Oncol 2012; 10:66. [PMID: 22540369 PMCID: PMC3488525 DOI: 10.1186/1477-7819-10-66] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 04/27/2012] [Indexed: 01/01/2023] Open
Abstract
We present the case of a 66-year-old woman with a huge gastrointestinal stromal tumor of the stomach that traversed her upper abdomen. The predominant abdominal sign was a huge, palpable mass, but there were no other distinctive findings in her physical examination or her routine blood workup, including biochemical markers. It was difficult to judge the origin of the mass upon imaging. Furthermore, radiological findings revealed that the mass had a complex relationship with many major blood vessels. An exploratory laparotomy revealed a huge tumor protruding from the anterior wall of the stomach fundus, on the lesser curvature of the stomach, measuring approximately 21 × 34 × 11 cm in diameter and weighing 5.5 kg. A complete resection was performed and the tumor was characterized on immunohistochemistry as a gastrointestinal stromal tumor of the stomach. Preoperative diagnosis of gastrointestinal stromal tumors can be difficult, and we hope that the presentation of this rare case and literature review will benefit other diagnosing clinicians having similar problems.
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Affiliation(s)
- Lei Zhou
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Chang Liu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Ji-Gang Bai
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Ji-Chao Wei
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Kai Qu
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Feng Tian
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Ming-Hui Tai
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Rui-Tao Wang
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
| | - Fan-Di Meng
- Department of Hepatobiliary Surgery, the First Affiliated Hospital, School of Medicine, Xi’an Jiao tong University, Xi’an, 710061, China
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1532
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Pignot G, Vieillefond A, Vacher S, Zerbib M, Debre B, Lidereau R, Amsellem-Ouazana D, Bieche I. Hedgehog pathway activation in human transitional cell carcinoma of the bladder. Br J Cancer 2012; 106:1177-86. [PMID: 22361633 PMCID: PMC3304423 DOI: 10.1038/bjc.2012.55] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 01/27/2012] [Accepted: 02/03/2012] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The Hedgehog (Hh) signalling pathway functions as an organiser in embryonic development. Recent studies have shown constitutive activation of this pathway in various malignancies, but its role in bladder cancer remains poorly studied. METHODS Expression levels of 31 genes and 9 microRNAs (miRNAs) involved in the Hh pathway were determined by quantitative real-time RT-PCR in 71 bladder tumour samples (21 muscle-invasive (MIBC) and 50 non-muscle-invasive (NMIBC) bladder cancers), as well as in 6 bladder cancer cell lines. RESULTS The SHH ligand gene and Gli-inducible target genes (FOXM1, IGF2, OSF2, H19, and SPP1) were overexpressed in tumour samples as compared with normal bladder tissue. SHH overexpression was found in 96% of NMIBC and 52% of MIBC samples, as well as in two bladder cancer cell lines. Altered expression of miRNAs supported their oncogene or tumour-suppressor gene status. In univariate analysis, high expression levels of PTCH2, miRNA-92A, miRNA-19A, and miRNA-20A were associated with poorer overall survival in MIBC (P=0.02, P=0.012, P=0.047, and P=0.036, respectively). CONCLUSION We observed constitutive activation of the Hh pathway in most NMIBC and about 50% of MIBC. We also found that some protein-coding genes and miRNAs involved in the Hh pathway may have prognostic value at the individual level.
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Affiliation(s)
- G Pignot
- Department of Urology, Service d'Urologie, Université Paris Descartes, Sorbonne Paris Cité, 27 rue du Faubourg Saint Jaques, Paris F-75014, France.
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1533
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KOBAYASHI TATSUYA, MORI YOSHIMASA, TSUGAWA TAKAHIKO, HASHIZUME CHISA, TAKAHASHI HIROSHI. Prognostic factors for tumor recurrence after gamma knife radiosurgery of partially resected and recurrent craniopharyngiomas. Nagoya J Med Sci 2012; 74:141-7. [PMID: 22515120 PMCID: PMC4831259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A study was conducted to clarify the prognostic factors related to recurrence of craniopharyngioma and to improve the quality of life of patients by the treatment with intentional partial removal and gamma knife radiosurgery. One hundred cases of craniopharyngioma have been treated at Komaki City Hospital since 1991. In a mean follow-up period of 65.5 months, the tumor control rate was 79.5%. The 5- and 10-year actuarial survival rates were 94.1% and 91%, respectively. However, the recurrence-free survival rates were 73.6% at 5 years and 60.2% at 10 years. Nine factors thought to be related to the recurrence were selected from past references and previous studies, including gender, age, pediatric (< or =17 years) or adult patient, partial removal or recurrence, mean tumor diameter, tumor type (solid or cyst), pathological types (squamous cell or adamantinoma), number of previous treatments, and radiation dose. Statistical analysis was performed to determine which factors had a significant prognostic impact. Multivariate analysis showed that mean tumor diameter and radiation dose were independent predictors of outcome. To maximize the prognostic power of these factors, cut-off levels were determined using ROC analysis. These levels were 19 mm for tumor diameter and 13.2 Gy for marginal dose. Significant prognostic factors related to recurrence of craniopharyngioma are tumor diameter and radiation dose. A tumor diameter of <19 mm and a marginal dose of > or =13.2 Gy are favorable prognostic factors for gamma knife radiosurgery.
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1534
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Hirashita T, Iwashita Y, Ohta M, Komori Y, Eguchi H, Yada K, Kitano S. Expression of matrix metalloproteinase-7 is an unfavorable prognostic factor in intrahepatic cholangiocarcinoma. J Gastrointest Surg 2012; 16:842-8. [PMID: 22246855 PMCID: PMC3308001 DOI: 10.1007/s11605-011-1813-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/28/2011] [Indexed: 01/31/2023]
Abstract
BACKGROUND Intrahepatic cholangiocarcinoma (IHCC) is a highly malignant neoplasm, but the prognostic factors of IHCC are not yet fully understood. The matrix metalloproteinases (MMPs) are known to be related to tumor viability. The aim of this study was to evaluate the prognostic significance of clinicopathological and immunohistochemical characteristics of resected IHCC. PATIENTS AND METHODS From 1996 to 2006, we surgically treated 35 patients with IHCC. Clinicopathological and immunohistochemical characteristics, including expression of MMPs, vascular endothelial growth factor, and epidermal growth factor receptor in the resected specimens, were investigated, and overall survival rates were evaluated with regard to the characteristics using univariate and multivariate analyses. RESULTS Univariate analysis revealed the significant prognostic factors to be preoperative serum CEA and CA19-9, intraoperative transfusion, tumor size, surgical margin, lymph node metastasis, invasion of portal and hepatic vein, intrahepatic metastasis, UICC stage, and expression of MMP-7. Subsequent multivariate analysis indicated that MMP-7 was an independent prognostic factor (hazard ratio (HR), 4.698; 95% confidence interval (CI), 0.057-0.866; P = 0.03) along with intrahepatic metastasis (HR, 5.694; 95% CI, 0.029-0.706; P = 0.017). CONCLUSION MMP-7 expression is associated with a poor prognosis in patients with resected IHCC.
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Affiliation(s)
- Teijiro Hirashita
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Yukio Iwashita
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Masayuki Ohta
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Yoko Komori
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Hidetoshi Eguchi
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Kazuhiro Yada
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
| | - Seigo Kitano
- Department of Surgery I, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593 Japan
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1535
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SINGH AMARB, SHARMA ASHOK, SMITH JJOSHUA, KRISHNAN MOORTHY, CHEN XI, ESCHRICH STEVEN, WASHINGTON MARYK, YEATMAN TIMOTHYJ, BEAUCHAMP RDANIEL, DHAWAN PUNITA. Claudin-1 up-regulates the repressor ZEB-1 to inhibit E-cadherin expression in colon cancer cells. Gastroenterology 2011; 141:2140-53. [PMID: 21878201 PMCID: PMC3395068 DOI: 10.1053/j.gastro.2011.08.038] [Citation(s) in RCA: 124] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Revised: 08/15/2011] [Accepted: 08/18/2011] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Expression of the tight junction protein claudin-1 is dysregulated in colon tumors and associates with their progression. Up-regulation of claudin-1 reduces expression of E-cadherin. We investigated the mechanisms by which claudin-1 regulates E-cadherin expression and its effects in colon cancer cells. MATERIALS AND METHODS We used gene expression analysis, immunoblotting, and reverse transcription polymerase chain reaction to associate expression of the repressor of transcription Zinc Finger E-box binding homeobox-box1 (ZEB-1) with claudin-1. We analyzed SW480 colon cancer cells that overexpressed claudin-1, or SW620 cells in which claudin-1 expression was repressed, to determine the effects on ZEB-1 and E-cadherin expression, invasive activity, and resistance to anoikis. We studied cells that expressed constitutively active or dominant negative forms of factors in the Wnt or phosphotidylinositol-3-kinase signaling pathways and used pharmacologic inhibitors of these pathways to study their role in claudin-1-dependent regulation of ZEB-1. We used microarray analysis to examine gene expression patterns in 260 colorectal tumor and normal colon samples. RESULTS Claudin-1 down-regulates E-cadherin expression by up-regulating expression of ZEB-1. Claudin-1 activates Wnt and phosphotidylinositol-3-kinase/Akt signaling. ZEB-1 mediates claudin-1-regulated changes in cell invasion and anoikis. Expression of claudin-1 correlated with that of ZEB-1 in human colon tumor samples. In the progression from normal colonic epithelium to colon adenocarcinoma, levels of E-cadherin decreased, whereas levels of claudin-1 and ZEB-1 increased. Down-regulation of E-cadherin and up-regulation of ZEB-1 in colon tumors were associated with shorter survival times. CONCLUSIONS Claudin-1 up-regulates the repressor ZEB-1 to reduce expression of E-cadherin in colon cancer cells, increasing their invasive activity and reducing anoikis. This pathway is associated with colorectal cancer progression and patient survival.
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Affiliation(s)
- AMAR B. SINGH
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - ASHOK SHARMA
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - J. JOSHUA SMITH
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - MOORTHY KRISHNAN
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - XI CHEN
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - STEVEN ESCHRICH
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - MARY K. WASHINGTON
- Department of Pathology Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - R DANIEL BEAUCHAMP
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - PUNITA DHAWAN
- Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee,Department of Cancer Biology, Vanderbilt University Medical Center, Nashville, Tennessee
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1536
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Suzuki H, Chikazawa N, Tasaka T, Wada J, Yamasaki A, Kitaura Y, Sozaki M, Tanaka M, Onishi H, Morisaki T, Katano M. Intratumoral CD8(+) T/FOXP3 (+) cell ratio is a predictive marker for survival in patients with colorectal cancer. Cancer Immunol Immunother 2010; 59:653-61. [PMID: 19908042 PMCID: PMC11030791 DOI: 10.1007/s00262-009-0781-9] [Citation(s) in RCA: 129] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2009] [Accepted: 10/07/2009] [Indexed: 12/19/2022]
Abstract
The human immune system consists of a balance between immune surveillance against non-self antigens and tolerance of self-antigens. CD8(+) T cells and CD4(+) regulatory T cells (Tregs) are the main players for immune surveillance and tolerance, respectively. We examined immunohistochemically the immunological balance at the tumor site using 94 surgically resected colorectal cancer tissues. Forkhead box P3 (FOXP3)(+) cells were considered to be Tregs in the present study. The number of intratumoral FOXP3(+) cells (itFOXP3(+) cells) was positively correlated with lymph node metastases (P = 0.030). itCD8(+) T/itFOXP3(+) cell ratio negatively correlated with pathological stages (P = 0.048). Next, relationship between the number of itCD8(+) T cells or itFOXP3(+) cells and survival prognosis in 94 patients who underwent a curative resection was analyzed. Only itCD8(+) T/itFOXP3(+) cell ratio positively correlated with disease-free survival (0.023) and overall survival (P = 0.010). Multivariate analysis indicated that itCD8(+) T/itFOXP3(+) cell ratio is an independent prognostic factor (P = 0.035) of overall survival. The number of itFOXP3(+) cells positively correlated with transforming growth factor-beta TGF-beta production at the tumor site (P = 0.020). In conclusion, itCD8(+) T/itFOXP3(+) cell ratio is a predictive marker for both disease-free survival time and overall survival time in patients with colorectal cancer. Importantly, itCD8(+) T/itFOXP3(+) cell ratio may be an independent prognostic factor. And, tumor-producing TGF-beta may contribute to the increased number of itFOXP3(+) cells.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Cancer Therapy and Research, Kyushu University, Maidashi, Higashi-Ku, Fukuoka, Japan.
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1537
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Noronha SA, Farrar JE, Alonzo TA, Gerbing RB, Lacayo NJ, Dahl GV, Ravindranath Y, Arceci RJ, Loeb DM. WT1 expression at diagnosis does not predict survival in pediatric AML: a report from the Children's Oncology Group. Pediatr Blood Cancer 2009; 53:1136-9. [PMID: 19618455 PMCID: PMC2926132 DOI: 10.1002/pbc.22142] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
WT1 is a transcription factor that is aberrantly overexpressed in acute and chronic leukemias. Overexpression of WT1 in pediatric acute myeloid leukemia has been reported, but the prognostic significance is unclear because sample sizes in these studies have been relatively small. WT1 expression was measured by quantitative RT-PCR in samples obtained at diagnosis from 155 pediatric AML patients treated on a cooperative group protocol. Neither overall survival nor event-free survival was correlated with WT1 expression.
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Affiliation(s)
- Suzie A. Noronha
- Division of Pediatric Oncology, Department of Oncology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Jason E. Farrar
- Division of Pediatric Oncology, Department of Oncology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Todd A. Alonzo
- Children’s Oncology Group, Arcadia, California, University of Southern California, Los Angeles
| | | | - Norman J. Lacayo
- Division of Pediatric Hematology/Oncology, Stanford School of Medicine, Palo Alto, California
| | - Gary V. Dahl
- Division of Pediatric Hematology/Oncology, Stanford School of Medicine, Palo Alto, California
| | | | - Robert J. Arceci
- Division of Pediatric Oncology, Department of Oncology, The Johns Hopkins Hospital, Baltimore, Maryland
| | - David M. Loeb
- Division of Pediatric Oncology, Department of Oncology, The Johns Hopkins Hospital, Baltimore, Maryland
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1538
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Li J, Dai CH, Shi SB, Chen P, Yu LC, Wu JR. Prognostic factors and long term results of neo adjuvant therapy followed by surgery in stage IIIA N2 non-small cell lung cancer patients. Ann Thorac Med 2009; 4:201-7. [PMID: 19881166 PMCID: PMC2801045 DOI: 10.4103/1817-1737.56010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2009] [Accepted: 07/26/2009] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Prognosis of stage IIIA N2 non-small cell lung cancer (NSCLC) remains poor despite the changes in therapeutic strategies. OBJECTIVES To assess long term results of neo adjuvant therapy followed by surgery for patients with stage IIIA N2 NSCLC and to analyze factors influencing survival. MATERIALS AND METHODS The methods adopted include: Retrospective review of medical records of 91 patients with stage IIIA N2 NSCLC, who received neo adjuvant therapy followed by surgery; collection of information on demographic information, staging procedure, preoperative therapy, clinical response, type of resection, pathologic response of tumor, status of lymph nodes and adjuvant chemotherapy; survival analysis by Kaplan-Meier and calculation of prognostic factors using log-rank and Cox regression model. RESULTS All patients received a platinum-based chemotherapy and 23 (29.1%) had an associated radiotherapy. Eighty four patients underwent thoracotomy. Median survival was 26 months (95%CI, 22.6-30.8 months) with three and five year survival rates of 31.6 and 20.9%, respectively. Prognostic factors for survival on univariate analysis was clinical response (P = 0.032), complete resection (P = 0.002), pathologic tumor response ( P < 0.001), and lymph nodal down staging (P = 0.001). Multivariate analyses identified complete resection, pathologic tumor response and lymph nodal down staging as independent prognostic factors. CONCLUSION Survival of patients with stage IIIA N2 NSCLC who received neo adjuvant therapy is significantly influenced by clinical response, complete resection, pathologic tumor response, and lymph nodal down staging. These results can be helpful in guiding standard clinical practice and evaluating the outcome of neo adjuvant therapy followed by surgery in patients with stage IIIA N2 NSCLC.
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Affiliation(s)
- Jing Li
- Department of Pulmonary Medicine, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China.
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1539
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Johansson CC, Egyházi S, Masucci G, Harlin H, Mougiakakos D, Poschke I, Nilsson B, Garberg L, Tuominen R, Linden D, Stolt MF, Hansson J, Kiessling R. Prognostic significance of tumor iNOS and COX-2 in stage III malignant cutaneous melanoma. Cancer Immunol Immunother 2009; 58:1085-94. [PMID: 19039588 PMCID: PMC11030735 DOI: 10.1007/s00262-008-0631-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 11/12/2008] [Indexed: 10/21/2022]
Abstract
PURPOSE New prognostic markers are needed for malignant melanoma. Inducible nitric oxide synthase (iNOS) and cyclooxygenase type 2 (COX-2) have been described to correlate with progression of melanoma. Moreover, activating mutations in BRAF/NRAS oncogenes are often detected in melanoma. The BRAF/NRAS mutation status and expression of COX-2 and iNOS were examined to compare their prognostic value for overall survival (OS) in stage III malignant cutaneous melanoma. EXPERIMENTAL DESIGN The expression of iNOS and COX-2 in metastatic lymph nodes from 21 rapidly progressing (OS from date of diagnosis of stage III disease < or =14 months) and 17 slowly progressing (OS > or =60 months) stage III cutaneous melanoma patients was examined by immunohistochemistry. The presence of BRAF/NRAS mutations was analyzed using direct DNA sequencing. Chi2 exact trend test and logistic regression analysis were used for statistical analysis. RESULTS Both iNOS (P = 0.002) and COX-2 (P = 0.048) alone significantly predicted OS. The BRAF/NRAS mutation status did not significantly differ between patient groups, although iNOS significantly (P = 0.013) correlated with BRAF mutation frequency. Furthermore, the odds ratio (OR) with respect to OS of iNOS (OR = 10.4) was higher than that of COX-2 (OR = 5.6) and was stable in the multivariate analysis of OS together with disease stage IIIB/C, ulceration, number of metastatic lymph nodes, and Breslow tumor thickness. CONCLUSION Our data show that iNOS is an independent and stronger prognostic factor for OS in stage III malignant cutaneous melanoma than COX-2.
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Affiliation(s)
- C. Christian Johansson
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Suzanne Egyházi
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Giuseppe Masucci
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Helena Harlin
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Dimitrios Mougiakakos
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Isabel Poschke
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Bo Nilsson
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Liss Garberg
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Rainer Tuominen
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Diana Linden
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Marianne Frostvik Stolt
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Johan Hansson
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
| | - Rolf Kiessling
- Department of Oncology and Pathology, Cancer Center Karolinska, R8:01, Karolinska University Hospital, Karolinska Institutet, 171 76 Stockholm, Sweden
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1540
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Stockeld D, Falkmer U, Falkmer S, Backman L, Granström L, Fagerberg J. Response to chemoradiatiotherapy in squamous cell carcinoma of the esophagus: evaluation of some prognostic factors. Clin Exp Gastroenterol 2009; 2:41-7. [PMID: 21694826 PMCID: PMC3108642 DOI: 10.2147/ceg.s4402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To evaluate the predictive values of the expression of factor VIII, CD-34, p53, bcl-2, and DNA ploidy regarding the response to chemoradiation of squamous cell carcinoma of the esophagus. Design: Retrospective analysis of pretreatment biopsies with immunohistochemistry and flow cytometry. The results were correlated to tumor response (complete vs. noncomplete) following chemoradiation with three cycles of 5-FU and cisplatin combined with 40–64 Gy of radiation. Subjects: 44 consecutive patients with squamous cell carcinoma of the esophagus treated with chemoradiation with a curative intent from 1992–2000. Main outcome measures: Treatment response. Results: No correlations were found between the expressions of p53, bcl-2, or DNA ploidy and tumor response to chemoradiation. A positive correlation was found between factor VIII expression and a complete tumor response (p = 0.0357). However the other marker for angiogenesis, CD-34, showed a negative correlation (p = 0.0493). Both markers indicate blood vessel density meaning that, in this study, many vessels indicated a favorable response if measured with factor VIII, but a poor response if measured with CD-34. Conclusion: It is not possible to predict tumor response to our chemoradiation protocol through the analysis of pretreatment expression of p53, bcl-2 or DNA ploidy in biopsy specimens. In spite of significant correlations between complete tumor responses and the expressions of the markers for angiogenesis this significance may be questionable since one of the two markers, factor VIII had a positive and the other,CD-34, a negative correlation to tumor response.
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Affiliation(s)
- Dag Stockeld
- Department of Surgery, Danderyd Hospital, Stockholm, Sweden
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1541
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Kamegaya M, Saisu T, Takazawa M, Nakamura J. Arthrographic indicators for decision making about femoral varus osteotomy in Legg-Calvé-Perthes disease. J Child Orthop 2008; 2:261-7. [PMID: 19308553 DOI: 10.1007/s11832-008-0120-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2008] [Accepted: 07/04/2008] [Indexed: 02/03/2023] Open
Abstract
PURPOSE There is not always a good outcome after a femoral varus osteotomy (FVO) in those with Legg-Calvé-Perthes disease (LCPD), even when the severity warrants surgical treatment. The purpose of this study was to find arthrographic indicators for decision making regarding the likely surgical outcome of a FVO. METHODS We used an image of an abduction position during preoperative arthrography under general anesthesia that simulated the post-operative relationship between the femoral head and the acetabulum. In the image, we defined two indicators of how deeply the deformed epiphysis was contained within the acetabulum: an acetabular head index in abduction and an epiphyseal slip-in index. Finding the contact point between the top of epiphysis and acetabulum was the key for the epiphyseal slip-in index measurement. In 37 patients (38 hips) who underwent FVOs based on our inclusion criteria, these two indices were measured retrospectively and were analyzed for a correlation with surgical outcome. Surgical outcome was evaluated using a combination of three factors: sphericity of the femoral head (Stulberg's classification), acetabular cover (acetabular head index), and the slope of acetabular roof. RESULTS The outcome was acceptable in 20 hips (52.6%) and unacceptable in18 hips (47.4%). There was a statistically significance difference in epiphyseal slip-in index between the acceptable group (21.9 +/- 2.8%) and the unacceptable group (15.0 +/- 4.4%) (P < 0.0001). An index of 20% or more determined a safe zone for predicting an acceptable outcome with 80% sensitivity, 89% specificity, and a 7.2 likelihood ratio. However, the acetabular head index in abduction showed no such statistical significance. CONCLUSIONS In this study, we found that the epiphyseal slip-in index was a reliable indicator for predicting the effectiveness of a FVO. It is worth measuring this index when a surgeon is considering a FVO for a patient with severe LCPD. (Level of Evidence Level III.).
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1542
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Baba Y, Iyama KI, Hirashima K, Nagai Y, Yoshida N, Hayashi N, Miyanari N, Baba H. Laminin-332 promotes the invasion of oesophageal squamous cell carcinoma via PI3K activation. Br J Cancer 2008; 98:974-80. [PMID: 18283320 PMCID: PMC2266844 DOI: 10.1038/sj.bjc.6604252] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2007] [Revised: 01/15/2008] [Accepted: 01/16/2008] [Indexed: 01/16/2023] Open
Abstract
Laminin-332 is major component of epithelial basement membrane, and has an important role in cell migration and tumour invasion. Recently, the phosphatidylinositol 3-kinase (PI3K) activation induced by laminin-332 during carcinogenesis or tumour invasion has been highlighted in skin squamous cell carcinoma. The expression of laminin-332 in 126 resected oesophageal squamous cell carcinoma (ESCC) specimens was immunohistochemically examined to determine its associations with the clinicopathological characteristics, and the effect of laminin-332 on the invasiveness and the PI3K activation was assessed by in vitro experiments using ESCC cell lines (ESCCs). Sections with immunostaining signals in >30% cancer cells, which were observed in 55 of 126 cases, were judged to be positive for laminin-332. The positivity was significantly correlated with pTNM stage and poor prognosis. Inactivation of the PI3K pathway by laminin-332 blocking antibody suppressed the invasiveness of TE8 cell line, which secreted laminin-332 at high level and had high PI3K activity. The addition of the purified laminin-332 activated the PI3K pathway and increased the invasiveness of TE11 cell line, which secreted laminin-332 at lower level and had low PI3K activity. The deactivation of PI3K pathway using the PI3K inhibitor decreased the invasiveness of ESCCs and the secretion of laminin-332 in vitro. The expression of laminin-332 was one of the prognostic factors of ESCC. Laminin-332 could provide the autocrine positive-feedback loop through PI3K activation, contributing the invasive ability. Therefore, the inhibitor of PI3K pathway might be useful as the anticancer therapies for ESCC.
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Affiliation(s)
- Y Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
- Department of Surgical Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - K-i Iyama
- Department of Surgical Pathology, Kumamoto University Hospital, 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - K Hirashima
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - Y Nagai
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - N Yoshida
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - N Hayashi
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - N Miyanari
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
| | - H Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University 1-1-1 Honjo, Kumamoto City, Kumamoto 860-8556, Japan
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1543
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Abstract
PURPOSE This study was designed to evaluate the risk on development and persistence of constipation after hysterectomy. METHODS We conducted a prospective, observational, multicenter study with three-year follow-up in 13 teaching and nonteaching hospitals in The Netherlands. A total of 413 females who underwent hysterectomy for benign disease other than symptomatic uterine prolapse were included. All patients underwent vaginal hysterectomy, subtotal abdominal hysterectomy, or total abdominal hysterectomy. A validated disease-specific quality-of-life questionnaire was completed before and three years after surgery to assess the presence of constipation. RESULTS Of the 413 included patients, 344 (83 percent) responded at three-year follow-up. Constipation had developed in 7 of 309 patients (2 percent) without constipation before surgery and persisted in 16 of 35 patients (46 percent) with constipation before surgery. Preservation of the cervix seemed to be associated with an increased risk of the development of constipation (relative risk, 6.6; 95 percent confidence interval, 1.3-33.3; P = 0.02). Statistically significant risk factors for the persistence of constipation could not be identified. CONCLUSIONS Hysterectomy does not seem to cause constipation. In nearly half of the patients reporting constipation before hysterectomy, this symptom will disappear.
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Affiliation(s)
- Jan-Paul Roovers
- Department of Obstetrics and Gynecology, Academic Medical Centre, Room H4-205, PO Box 22700, 1105 DE, Amsterdam, The Netherlands.
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1544
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Scala S, Ieranò C, Ottaiano A, Franco R, La Mura A, Liguori G, Mascolo M, Staibano S, Ascierto PA, Botti G, De Rosa G, Castello G. CXC chemokine receptor 4 is expressed in uveal malignant melanoma and correlates with the epithelioid-mixed cell type. Cancer Immunol Immunother 2007; 56:1589-95. [PMID: 17410362 PMCID: PMC11030263 DOI: 10.1007/s00262-007-0303-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Accepted: 02/20/2007] [Indexed: 10/23/2022]
Abstract
PURPOSE Although relatively rare, uveal melanoma is the most common ocular tumor of adults. Up to half of uveal melanoma patients die of metastatic disease. CXCR4, a chemokine receptor, is a prognostic factor in cutaneous melanoma involved in angiogenesis and metastasis formation. The aim of this study was to evaluate the expression of CXCR4 in uveal melanoma. METHODS CXCR4 was detected by immunohistochemistry in 44 samples of uveal melanoma. Staining was categorized into three semiquantitative classes based on the rate of stained (positive) tumor cells: absence of staining, <50% of cell (+) and >50% (++). Correlations between CXCR4 expression, data on patient and tumor features were studied by contingency tables and the chi2 test. Time-to-event curves were studied using the Kaplan-Meier method. Univariate analysis was performed using the log-rank test. Ninety-five percent confidence intervals (95% CI) of hazard ratios were also reported. RESULTS Staining for CXCR4 protein was absent in 18 tumors (40.9%), present in <50% of cells in 19 (43.2%) and in >50% of cells in 7 (15.9%) tumors. CXCR4 expression correlated to the epithelioid-mixed cell type (P=0.030). No statistically significant relation emerged between CXCR4 expression, largest tumor diameter (LTD) and extracellular matrix patterns as evaluated through histological patterns stained with periodic acid-Schiff (PAS). Events occurred in 2 out of 18 patients (11.1%) with negative tumors (2 deaths), in 3 out of 19 patients (15.8%) with <50% of positive tumor cells (2 deaths and 1 occurrence of metastases) and in 1 out of 7 patients (14.3%) with >50% of positive tumor cells (1 occurrence of metastases). The cell type (P=0.0457) but not CXCR4 showed prognostic value at univariate analysis. CONCLUSION This study shows that CXCR4 is commonly expressed in uveal melanoma and correlates with cell type a well-established prognostic factor.
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Affiliation(s)
- Stefania Scala
- Department of Clinical Immunology, National Cancer Institute, G. Pascale Foundation, via Mariano Semmola, 80131, Naples, Italy.
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1545
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Choi J, Hwang YK, Choi YJ, Yoo KE, Kim JH, Nam SJ, Yang JH, Lee SJ, Yoo KH, Sung KW, Koo HH, Im YH. Neuronal apoptosis inhibitory protein is overexpressed in patients with unfavorable prognostic factors in breast cancer. J Korean Med Sci 2007; 22 Suppl:S17-23. [PMID: 17923748 PMCID: PMC2694398 DOI: 10.3346/jkms.2007.22.s.s17] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Neuronal apoptosis inhibitory protein (NAIP) is a recently identified inhibitor of apoptosis protein. However, the clinical relevance of NAIP expression is not completely understood. In an attempt to determine the clinical relevance of NAIP expression in breast cancer, the levels of NAIP and survivin expression were measured in 117 breast cancer samples and 10 normal breast tissues using quantitative reversetranscriptase-polymerase chain reaction. While there was no evidence of NAIP expression in the normal breast tissue, NAIP was expressed in all breast cancer samples. The level of NAIP expression in breast cancer was significantly higher (257 times) than in the universal tumor control. There was a strong correlation between the level of NAIP expression and the level of survivin expression (p=0.001). The level of NAIP expression in patients with a large tumor (>/=T2) and patients with an unfavorable histology (nuclear grade III) was significantly higher than in those patients with a small tumor (T1) and patients with a favorable histology (nuclear grade I, II) (p=0.026 and p=0.050, respectively). Although the level of NAIP expression was higher in patients with other unfavorable prognostic factors, it was not significant. The three-year relapse-free survival rate was not significantly the patients showing high NAIP expression and patients showing low NAIP expression (86.47plusmn;4.79% vs. 78.74plusmn;6.57%). Further studies should include the expressions of NAIP in a larger number of patients and for a longer period of follow-up to evaluate correlation with metastasis and treatment outcome. In conclusion, NAIP is overexpressed in breast cancer patients with unfavorable clinical features such as stage and tumor size, suggesting that NAIP would play a role in the disease manifestation.
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Affiliation(s)
- Jaewon Choi
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yu Kyeong Hwang
- Division of Immunotherapy, Mogam Biotechnology Research Institute, Yongin, Korea
| | - Young Jin Choi
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Eun Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Han Kim
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seok Jin Nam
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jung Hyun Yang
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sang Jin Lee
- Genitourinary Cancer Branch, National Cancer Center, Ilsan, Korea
| | - Keon Hee Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Woong Sung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Hoe Koo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young-Hyuck Im
- Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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1546
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Watson NFS, Durrant LG, Madjd Z, Ellis IO, Scholefield JH, Spendlove I. Expression of the membrane complement regulatory protein CD59 (protectin) is associated with reduced survival in colorectal cancer patients. Cancer Immunol Immunother 2006; 55:973-80. [PMID: 16151805 PMCID: PMC11030621 DOI: 10.1007/s00262-005-0055-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2005] [Accepted: 07/20/2005] [Indexed: 10/25/2022]
Abstract
It has been known for some time that the immune system can recognise growing tumours, and that tumours may respond by modulation of molecules, which make them resistant to further attack. Expression, over-expression, or loss of these molecules may function as markers of tumour progression and prognosis. Among such molecules are the membrane-bound complement regulatory proteins (mCRP), which protect cells from bystander attack by autologous complement. These include CD59 (protectin), which prevents formation of the MAC complex in the terminal stages of complement activation. In the present study, we evaluated immunohistochemical expression of CD59 in a series of over 460 well-characterised colorectal cancers using tissue microarrays (TMA), and related this information to known tumour and patient variables and to survival. The CD59 expression was observed in 69 (15%) of cases overall, and was significantly associated with tumour grade. In contrast, no associations were noted with tumour site, stage or histological type. On survival analysis, a further correlation was observed between expression of CD59 by the colorectal tumours and a reduction in disease-specific patient survival. This observation was strongest for patients with early stage disease. However, a negative impact on survival was also seen in those patients with late stage disease. These results indicate that TMA linked to good clinicopathological databases with good long term follow up are useful tools for determining new prognostic indicators that can be used in future patient management. Immune surveillance may result in immune-editing that induces variable expression of a range of target antigens, and these may be useful prognostic markers. This study has identified CD59 expression as a marker of poor prognosis in colorectal cancer patients.
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Affiliation(s)
- Nicholas F. S. Watson
- Academic Department of Clinical Oncology, City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB , UK
- Section of Gastrointestinal Surgery, Queen’s Medical Centre, University Hospital, Derby Road, Nottingham NG7 2UH , UK
| | - Lindy G. Durrant
- Academic Department of Clinical Oncology, City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB , UK
| | - Zahra Madjd
- Academic Department of Clinical Oncology, City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB , UK
| | - Ian O. Ellis
- Department of Histopathology, Nottingham City Hospital, Nottingham , UK
| | - John H. Scholefield
- Section of Gastrointestinal Surgery, Queen’s Medical Centre, University Hospital, Derby Road, Nottingham NG7 2UH , UK
| | - Ian Spendlove
- Academic Department of Clinical Oncology, City Hospital, University of Nottingham, Hucknall Road, Nottingham NG5 1PB , UK
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1547
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Abstract
Among the 665 patients who registered at our hospital, we reviewed 39 cases of high grade primary osteosarcoma in patients who were older than 40 yr of age. The aim of this study was to determine if a primary osteosarcoma in older patients has different clinical features, and a poorer prognosis than in younger patients. Two evaluations were performed. In the first, an attempt was made to determine the possible prognostic factors such as gender, location, size, alkaline phosphatase, radiological findings, chemotherapy intensity, chemotherapy-induced tumor necrosis, and surgical margin. The second evaluation involved assessment of whether there were any significant clinical differences between older patients and adolescents. According to the results, a primary osteosarcoma in older patients did not reveal any significant prognostic variables. A primary osteosarcoma in older patients showed a poorer prognosis due to relatively unusual locations, common abnormal radiological findings, and a poor response to chemotherapy. Therefore, careful attention should be paid to making an accurate diagnosis and new strategies for more effective treatment, including chemotherapy, must to be developed in order to achieve long term survival in older patients with osteosarcoma.
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Affiliation(s)
- Dae Geun Jeon
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Soo Yong Lee
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Wan Hyung Cho
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Won Seok Song
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
| | - Jong Hoon Park
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Seoul, Korea
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1548
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Mascaux C, Martin B, Paesmans M, Berghmans T, Dusart M, Haller A, Lothaire P, Meert AP, Lafitte JJ, Sculier JP. Has Cox-2 a prognostic role in non-small-cell lung cancer? A systematic review of the literature with meta-analysis of the survival results. Br J Cancer 2006; 95:139-45. [PMID: 16786043 PMCID: PMC2360613 DOI: 10.1038/sj.bjc.6603226] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 05/17/2006] [Accepted: 05/19/2006] [Indexed: 11/19/2022] Open
Abstract
Cyclooxygenase-2 (COX-2) is overexpressed in lung cancer, especially in adenocarcinoma (ADC). Our aim was to determine the prognostic value of COX-2 on survival in patients with lung cancer. Studies evaluating the survival impact of COX-2 in lung cancer, published until December 2005, were selected. Data for estimation of individual hazard ratios (HR) for survival were extracted from the publications and combined in a pooled HR. Among 14 eligible papers, all dealing with non-small-cell lung cancer, 10 provided results for meta-analysis of survival data (evaluable studies). Cyclooxygenase-2 positivity was associated with reduced survival, improved survival or no statistically significant impact in six, one and seven studies, respectively. Combined HR for the 10 evaluable studies (1236 patients) was 1.39 (95% confidence intervals (CI): 0.97-1.99). In stage I lung cancer (six evaluable studies, 554 patients), it was 1.64 (95% CI: 1.21-2.24). No significant impact was shown in ADC. A slight detrimental effect on survival in patients with lung cancer is associated with COX-2 expression, but the statistical significance is not reached. This effect is statistically significant in stage I, suggesting that COX-2 expression could be useful at early stages to distinguish those with a worse prognosis.
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Affiliation(s)
- C Mascaux
- Department of Intensive Care and Thoracic Oncology, Institut Jules Bordet, Centre des Tumeurs de l'Université Libre de Bruxelles, B-1000 Brussels, Belgium.
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1549
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Songun I, Litvinov SV, van de Velde CJH, Pals ST, Hermans J, van Krieken JHJM. Loss of Ep-CAM (CO17-1A) expression predicts survival in patients with gastric cancer. Br J Cancer 2005; 92:1767-72. [PMID: 15870832 PMCID: PMC2362035 DOI: 10.1038/sj.bjc.6602519] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2004] [Revised: 02/07/2005] [Accepted: 02/21/2005] [Indexed: 12/03/2022] Open
Abstract
Preoperative staging of gastric cancer is difficult and not optimal. The TNM stage is an important prognostic factor, but it can only be assessed reliably after surgery. Therefore, there is need for additional, reliable prognostic factors that can be determined preoperatively in order to select patients who might benefit from (neo) adjuvant treatment. Expression of immunohistochemical markers was demonstrated to be associated with tumour progression and metastasis. The expression of p53, CD44 (splice variants v5, v6 and v9), E-cadherin, Ep-CAM (CO17-1A antigen) and c-erB2/neu were investigated in tumour tissues of 300 patients from the Dutch Gastric Cancer Trial, investigating the value of extended lymphadenectomy compared to that of limited lymphadenectomy). The expression of tumour markers was analysed with respect to patient survival. Patients without loss of Ep-CAM-expression of tumour cells (19%) had a significantly better 10-year survival (P<0.0001) compared to patients with any loss: 42% (s.e.=7%) vs 22% (s.e.=3%). Patients with CD44v6 (VFF18) expression in more than 25% of the tumour cells (69% of the patients) also had a significantly better survival (P=0.01) compared to patients with expression in less than 25% of the tumour cells: 10 year survival rate of 29% (s.e.=3%) vs 19% (s.e.=4%). The prognostic value of both markers was stronger in stages I and II, and independent of the TNM stage. Ep-CAM and CD44v6-expression provides prognostic information additional to the TNM stage. Loss of Ep-CAM-expression identifies aggressive tumours especially in patients with stage I and II disease. This information may be helpful in selecting patients suitable for surgery or for additional treatment pre- or postoperatively.
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Affiliation(s)
- I Songun
- Department of Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - S V Litvinov
- Department of Pathology, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - C J H van de Velde
- Department of Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - S T Pals
- Department of Pathology, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - J Hermans
- Department of Medical Statistics, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, The Netherlands
| | - J H J M van Krieken
- Department of Pathology, Radbond University, Nijmegen Medical Center, PO Box 9101, 6500 HB Nijimegen, The Netherlands
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1550
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Abstract
Change in tumor volume after chemotherapy appears to have a prognostic significance for the outcome of osteosarcoma. A newly developed volume measurement method based on three-dimensional summation with a proved reproducibility was utilized to measure osteosarcoma tumor volume. This retrospective analysis included 38 patients with biopsy- proven, nonsurface, skeletal high-grade osteosarcoma. The treatment was started by using three cycles of preoperative chemotherapy with cisplastin (100 mg/m2) and adriamycin (30 mg/m2). The tumor volume was measured before and after preoperative chemotherapy using three-dimensional magnetic resonance image measurement. The percentage of tumor necrosis was assessed by pathologic exam. After three cycle of postoperative chemotherapy, the patients were followed up at regular interval. For the 23 good responder patients, the mean survival time was 73.2 months (95% confidence interval 61.9-84.5 months), and for the 15 poor responder patients, the mean survival time was 50.8 months (95% confidence interval 38.6-63.1 months) (p<0.05). For the 14 patients with increased tumor volume after chemotherapy, the mean survival time was 47.5 months (range: 36.3-58.6 months) and for the 24 patients with stable or decreased tumor volume, the mean survival time was 74.3 months (range: 63.79-84.88 months) (p<0.05). Among the various factors, histopathologic response and tumor volume change after chemotherapy predicted disease free survival (p<0.05). Change in the tumor volume that was measured with a reproducible method and the histopathologic response after chemotherapy were the important predictors of disease free survival for osteosarcoma patients.
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Affiliation(s)
- Seong-Hwan Moon
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Kyoo-Ho Shin
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Suck Suh
- Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Woo-Ick Yang
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Keong Noh
- Cancer Center, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Bong Hahn
- Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea
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