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Sun H, Shang J, Liu X, Ren S, Hu S, Wang X. Eukaryotic initiation factor 3a promotes the development of diffuse large B-cell lymphoma through regulating cell proliferation. BMC Cancer 2024; 24:432. [PMID: 38589831 PMCID: PMC11003032 DOI: 10.1186/s12885-024-12166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/21/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND One-third of diffuse large B-cell lymphoma (DLBCL) patients suffer relapse after standard treatment. Eukaryotic initiation factor 3a (eIF3a) is a key player in the initial stage of translation, which has been widely reported to be correlated with tumorigenesis and therapeutic response. This study aimed to explore the biological role of eIF3a, evaluate its prognostic and therapeutic potential in DLBCL. METHODS RNA-seq datasets from GEO database were utilized to detect the expression and prognostic role of eIF3a in DLBCL patients. Protein level of eIF3a was estimated by western blot and immunohistochemical. Next, DLBCL cells were transfected with lentiviral vector either eIF3a-knockdown or empty to assess the biological role of eIF3a. Then, samples were divided into 2 clusters based on eIF3a expression and differentially expressed genes (DEGs) were identified. Function enrichment and mutation analysis of DEGs were employed to detect potential biological roles. Moreover, we also applied pan-cancer and chemosensitivity analysis for deep exploration. RESULTS eIF3a expression was found to be higher in DLBCL than healthy controls, which was associated with worse prognosis. The expression of eIF3a protein was significantly increased in DLBCL cell lines compared with peripheral blood mononuclear cells (PBMCs) from healthy donors. eIF3a knockdown inhibited the proliferation of DLBCL cells and the expression of proliferation-related proteins and increase cell apoptosis rate. Besides, 114 DEGs were identified which had a close linkage to cell cycle and tumor immune. eIF3a and DEGs mutations were found to be correlated to chemosensitivity and vital signal pathways. Pan-cancer analysis demonstrated that high eIF3a expression was associated with worse prognosis in several tumors. Moreover, eIF3a expression was found to be related to chemosensitivity of several anti-tumor drugs in DLBCL, including Vincristine and Wee1 inhibitor. CONCLUSIONS We firstly revealed the high expression and prognostic role of eIF3a in DLBCL, and eIF3a might promote the development of DLBCL through regulating cell proliferation and apoptosis. eIF3a expression was related to immune profile and chemosensitivity in DLBCL. These results suggest that eIF3a could serve as a potential prognostic biomarker and therapeutic target in DLBCL.
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Affiliation(s)
- Hongkun Sun
- Department of Hematology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Department of Hematology, Binzhou Medical University Hospital, 256603, Binzhou, Shandong, China
| | - Juanjuan Shang
- Department of Hematology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
| | - Xiao Liu
- Department of Hematology, Binzhou Medical University Hospital, 256603, Binzhou, Shandong, China
| | - Shuai Ren
- Department of Oncology, Zibo Central Hospital, 255016, Zibo, Shandong, China
| | - Shunfeng Hu
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, 250021, Jinan, Shandong, China.
| | - Xin Wang
- Department of Hematology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China.
- Department of Hematology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwu Road, 250021, Jinan, Shandong, China.
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Mostafapour M, Fortier JH, Garber G. Exploring the dynamics of physician-patient relationships: Factors affecting patient satisfaction and complaints. J Healthc Risk Manag 2024; 43:16-25. [PMID: 38706117 DOI: 10.1002/jhrm.21567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
This review identifes the factors influencing the relationship between physicians and patients that can lead to patients' dissatisfaction and medical complaints. Utilizing a systemic approach 92 studies were retrieved which included quantitative, qualitative, and mixed method studies. Through a thematic analysis of the literature, we identified three interrelated main themes that can influence the relationship between physicians and patients, patients' satisfaction, and the decision to file a medico-legal complaint. The main themes include patient and physician characteristics; the interpersonal relationship between physicians and patients; and the health care system and policies, with relevant subthemes. These themes are demonstrated in a descriptive model. The review suggests areas of focus for physicians who may wish to increase their awareness around the potential sources of relational problems with their patients. Identifying these issues may assist in improvements in the therapeutic relationship with patients, can reduce their medico-legal risk, and enhance the quality of their clinical practice. The findings can also be utilized to support andragogical principles for medical learners. The article can serve as a structured framework to identify potential problems and gaps to design and test effective interventions to mitigate these potential relational problems between physician-patient.
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Affiliation(s)
- Mehrnaz Mostafapour
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Jacqueline H Fortier
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
| | - Gary Garber
- Department of Safe Medical Care Research, Canadian Medical Protective Association, Ottawa, Canada
- Department of Medicine and the School of Epidemiology and Public Health at, University of Ottawa, Ottawa, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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Bumbasirevic U, Petrovic M, Zekovic M, Coric V, Milojevic B, Lisicic N, Obucina D, Vasilic N, Bulat P, Zivkovic M, Cekerevac M, Bojanic N, Janicic A. Multifocality in Testicular Cancer: Clinicopathological Correlations and Prognostic Implications. Life (Basel) 2024; 14:257. [PMID: 38398766 PMCID: PMC10890071 DOI: 10.3390/life14020257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024] Open
Abstract
There are limited data regarding the significance of multifocality in testicular cancer patients. This study evaluated the relationship between multifocality and clinicopathological features determined at the time of radical orchiectomy. The study involved 280 consecutive patients who underwent radical orchiectomy between 2018 and 2023. Multifocality was defined as a distinct tumor focus characterized by a group of malignant cells > 1 mm, clearly differentiated from the primary tumor mass. Uni- and multivariate logistic regression analyses were employed to investigate the association between multifocality and histopathological parameters along with potential risk factors for clinical stages II + III. Multifocality was identified in 44 (15.7%) patients. Significantly smaller primary tumors were observed in subjects with multifocality (20.0 mm vs. 30.0 mm, p = 0.0001), while those exhibiting monofocality presented a markedly elevated rate of tumors exceeding 4 cm (40.3% vs. 18.2%, p = 0.005). Furthermore, multifocality was associated with a significantly higher rate of primary tumors < 2 cm (52.3% vs. 29.2%, p = 0.003). Univariate logistic regression analysis revealed a substantial decrease in the likelihood of multifocality occurrence in seminoma patients with tumors > 4 cm (OR = 0.38, p = 0.017). Meanwhile, in multivariate logistic regression, multifocality did not emerge as a significant risk factor for clinical stages II + III in either seminoma (p = 0.381) or non-seminoma (p = 0.672) cases. Our study suggests that multifocality holds no substantial prognostic relevance for clinically advanced disease in testicular cancer patients. The findings indicate that multifocality is associated with smaller primary tumors, particularly those measuring less than 2 cm.
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Affiliation(s)
- Uros Bumbasirevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Milos Petrovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Milica Zekovic
- Centre of Research Excellence in Nutrition and Metabolism, Institute for Medical Research, National Institute of Republic of Serbia, University of Belgrade, 11000 Belgrade, Serbia;
| | - Vesna Coric
- Institute of Medical and Clinical Biochemistry, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- Center of Excellence for Redox Medicine, 11000 Belgrade, Serbia
| | - Bogomir Milojevic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Nikola Lisicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - David Obucina
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Nenad Vasilic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Petar Bulat
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Marko Zivkovic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
| | - Milica Cekerevac
- Department of Pathology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia;
| | - Nebojsa Bojanic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Aleksandar Janicic
- Clinic of Urology, University Clinical Center of Serbia, 11000 Belgrade, Serbia; (M.P.); (B.M.); (N.L.); (D.O.); (N.V.); (P.B.); (M.Z.); (N.B.)
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Conduit C, Lewin J, Weickhardt A, Lynam J, Wong S, Grimison P, Sengupta S, Pranavan G, Parnis F, Bastick P, Campbell D, Hansen AR, Leonard M, McJannett M, Stockler MR, Gibbs P, Toner G, Davis ID, Tran B, Kuchel A. Patterns of Relapse in Australian Patients With Clinical Stage 1 Testicular Cancer: Utility of the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations. JCO Oncol Pract 2023; 19:973-980. [PMID: 37327464 DOI: 10.1200/op.23.00191] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 06/18/2023] Open
Abstract
PURPOSE International guidelines advocate for active surveillance as the preferred treatment strategy for patients with stage 1 testicular cancer after orchidectomy although a personalized discussion is required. MATERIALS AND METHODS We conducted an analysis of individuals registered in iTestis, Australia's testicular cancer registry, to describe the patterns of relapse and outcomes of patients treated in Australia where the Australian and New Zealand Urogenital and Prostate Cancer Trials Group Surveillance Recommendations are widely adopted. RESULTS A total of 650 individuals diagnosed between 2000 and 2020 were included, 63% (411 of 650) seminoma and 37% (239 of 650) nonseminoma. The median age was 34 years (range 14-74). 26% (106 of 411) with seminoma and 15% (36 of 239) nonseminoma received adjuvant chemotherapy. After a median follow-up of 43 months (range 0-267) postorchidectomy, relapse occurred in 10% (43 of 411) of seminoma and 18% (43 of 239) of nonseminoma. The two-year relapse-free survival was 92% (95% CI, 89 to 95) and 82% (95% CI, 78 to 87) in seminoma and nonseminoma, respectively. All relapses (86 of 86) were detected at a routine surveillance visit; 98% (85 of 86) were asymptomatic and detected solely through imaging (62 of 86, 72%), tumor markers (6 of 86, 7%), or a combination (17 of 86, 20%). The most common relapse site was isolated retroperitoneal lymphadenopathy (53 of 86, 62%). No nonpulmonary visceral metastases occurred. At relapse, 98% (84 of 86) had International Germ Cell Cancer Collaborative Group (IGCCCG) good prognosis; 2 of 86 intermediate prognosis (both nonseminoma). No deaths occurred. CONCLUSION In our cohort of stage 1 testicular cancer, where national surveillance recommendations have been widely adopted, recurrences were detected at routine surveillance visits and, almost exclusively, asymptomatic with IGCCCG good-prognosis disease. This provides reassurance that active surveillance is safe.
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Affiliation(s)
- Ciara Conduit
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Jeremy Lewin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- ONTrac at Peter Mac, Victorian Adolescent and Young Adult Cancer Service, Melbourne, VIC, Australia
| | - Andrew Weickhardt
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Olivia Newton-John Cancer Research Institute, Heidelberg, VIC, Australia
- La Trobe University, Melbourne, VIC, Australia
- Department of Medical Oncology, Austin Health, Heidelberg, VIC, Australia
| | - James Lynam
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Calvary Mater Newcastle, Waratah, NSW, Australia
- University of Newcastle, Callaghan, NSW, Australia
| | - Shirley Wong
- Department of Medical Oncology, Western Health, Footscray, VIC, Australia
| | - Peter Grimison
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
| | - Shomik Sengupta
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Urology, Eastern Health, Box Hill, VIC, Australia
| | - Ganes Pranavan
- Department of Medical Oncology, The Canberra Hospital, Garran, ACT, Australia
| | - Francis Parnis
- Department of Medical Oncology, Icon Cancer Centre, Adelaide, SA, Australia
| | - Patricia Bastick
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Southside Cancer Care Centre, Kogarah, NSW, Australia
- Department of Medical Oncology, St George/Sutherland Hospital, Caringbah, NSW, Australia
| | - David Campbell
- Department of Medical Oncology, Barwon Health, Geelong, VIC, Australia
| | - Aaron R Hansen
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- University of Queensland, Brisbane, QLD, Australia
| | - Matt Leonard
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Margaret McJannett
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Martin R Stockler
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Department of Medical Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
- University of Sydney, Camperdown, NSW, Australia
- NHMRC Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
- Department of Medical Oncology, Concord Repatriation General Hospital, Concord, NSW, Australia
| | - Peter Gibbs
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Western Health, Footscray, VIC, Australia
| | - Guy Toner
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Ian D Davis
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- Monash University Eastern Health Clinical School, Box Hill, VIC, Australia
- Department of Medical Oncology, Eastern Health, Box Hill, VIC, Australia
| | - Ben Tran
- Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, VIC, Australia
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
| | - Anna Kuchel
- The Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group, Camperdown, NSW, Australia
- University of Queensland, Brisbane, QLD, Australia
- Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
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Akdag G, Alan O, Dogan A, Yuksel Z, Yildirim S, Kinikoglu O, Kudu E, Surmeli H, Odabas H, Yildirim ME, Turan N. Outcomes of surveillance versus adjuvant treatment for patients with stage-I seminoma: a single-center experience. World J Urol 2023; 41:2201-2207. [PMID: 37351618 DOI: 10.1007/s00345-023-04482-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/04/2023] [Indexed: 06/24/2023] Open
Abstract
INTRODUCTION Testicular germ cell tumors (seminoma/non-seminoma) are the most common carcinomas in young males, comprising approximately 1% of all carcinomas. In stage-I disease, orchiectomy can cure approximately 85% of patients. Post-surgical options are adjuvant therapy and active surveillance. Our study examined the effects of management options on stage-I seminoma patients followed in our center. METHODS We evaluated the patients with stage-I testicular seminoma who underwent radical orchiectomy and followed up in the oncology center between 2001 and 2022. The outcomes of management options, survivals were retrospectively analyzed. The prognostic significance of risk factors for relapse on survival was evaluated. RESULTS Of the 140 patients with stage-I seminoma, 49 (35%) were treated with adjuvant therapy, and 91 (65%) underwent surveillance. The median follow-up duration was 37 months. During the follow-up period, nine patients in the active surveillance group and four in the adjuvant therapy group had a recurrence. There was no statistically significant difference between the two groups (p = 0.67). In the surveillance group, the univariate and multivariate analyzes identified the presence of lymphovascular invasion (p = 0.005, HR: 0.13) as significant prognostic factor for disease-free survival (DFS). In the surveillance cohort, the 5-year DFS rate was 60% for patients with lymphovascular invasion and 93% for those without. There was statistical significance between the two groups (p = 0.003). CONCLUSION Our study shows that adjuvant therapy does not significantly improve DFS compared to surveillance in patients. In addition, it has been shown that lymphovascular invasion is an important prognostic indicator for DFS in determining the treatment strategy.
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Affiliation(s)
- Goncagul Akdag
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey.
| | - Ozkan Alan
- Division of Medical Oncology, School of Medicine, Koç University, Istanbul, Turkey
| | - Akif Dogan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Zeynep Yuksel
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Sedat Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Oguzcan Kinikoglu
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Emre Kudu
- Department of Emergency Medicine, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Heves Surmeli
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Hatice Odabas
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Mahmut Emre Yildirim
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
| | - Nedim Turan
- Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No: 47, Kartal, 34865, Istanbul, Turkey
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Nalavenkata S, Li T, Patel MI. Nerve-sparing technique in RPLND for testicular cancer. Curr Opin Urol 2023; 33:281-287. [PMID: 37132366 DOI: 10.1097/mou.0000000000001100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
PURPOSE OF REVIEW The management of testicular cancer has evolved over time with multimodal therapy. Retroperitoneal lymph node dissection (RPLND), which is a complex and potentially morbid treatment option, remains the mainstay in surgical treatment. This article reviews the surgical template, approach and anatomical considerations with regards to nerve spare in RPLND. RECENT FINDINGS The standard full bilateral RPLND template has evolved over time to include the area between the renal hilum, bifurcation of the common iliac vessels, and the ureters. Morbidity with regards to ejaculatory dysfunction has led to further refinements in this procedure. Advancements in anatomical understanding of the retroperitoneal structures and their relationship to the sympathetic chain and hypogastric plexus has allowed for modification of surgical templates. Further refinements in surgical nerve sparing techniques have improved functional outcomes without sacrificing oncological outcomes. Finally, extraperitoneal access to the retroperitoneum and minimally invasive platforms have been implemented to further reduce morbidity. SUMMARY RPLND requires strict adherence to oncological surgical principles regardless of template, approach and technique. Contemporary evidence shows that outcomes are best for advanced testis cancer patients when managed at high volume tertiary care facilities with surgical expertise and access to multidisciplinary care.
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Affiliation(s)
- Sunny Nalavenkata
- Department of Urology, Westmead Hospital, Westmead, and Faculty of Medicine and Health, University of Sydney, NSW, Australia
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Ahn JY. Gastrointestinal Tract Lymphoma. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2022. [DOI: 10.7704/kjhugr.2021.0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Prognostic factors in patients with clinical stage I nonseminoma-beyond lymphovascular invasion: a systematic review. World J Urol 2022; 40:2879-2887. [PMID: 35906286 PMCID: PMC9712284 DOI: 10.1007/s00345-022-04063-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 05/18/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVE To systematically evaluate evidence on prognostic factors for tumor recurrence in clinical stage I nonseminoma patients other than lymphovascular invasion (LVI). METHODS We performed a systematic literature search in the biomedical databases Medline (via Ovid) and Cochrane Central Register of Controlled Trials (search period January 2010 to February 2021) for full text publications in English and German language, reporting on retro- or prospectively assessed prognostic factors for tumor recurrence in patients with stage I nonseminomatous germ cell tumors. RESULTS Our literature search yielded eleven studies reporting on 20 potential prognostic factors. Results are based on cohort studies of mostly moderate to low quality. Five out of eight studies found a significant association of embryonal carcinoma (EC) in the primary tumor with relapse. Among the different risk definitions of embryonal carcinoma (presence, predominance, pure), presence of EC alone seems to be sufficient for prognostification. Interesting results were found for rete testis invasion, predominant yolk sac tumor, T-stage and history of cryptorchidism, but the sparse data situation does not justify their clinical use. CONCLUSIONS No additional factors that meet the prognostic value of LVI, especially when determined by immunohistochemistry, could be identified through our systematic search. The presence of EC might serve as a second, subordinate prognostic factor for clinical use as the data situation is less abundant than the one of LVI. Further efforts are necessary to optimize the use of these two prognostic factors and to evaluate and validate further potential factors with promising preliminary data.
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Testicular germ cell tumours' clinical stage I: comparison of surveillance with adjuvant treatment strategies regarding recurrence rates and overall survival-a systematic review. World J Urol 2022; 40:2889-2900. [PMID: 36107211 PMCID: PMC9712330 DOI: 10.1007/s00345-022-04145-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 07/23/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE Testicular germ cell tumours (GCTs) represent the most common malignancy in young adult males with two thirds of all cases presenting with clinical stage I (CSI). Active surveillance is the management modality mostly favoured by current guidelines. This systematic review assesses the treatment results in CSI patients concerning recurrence rate and overall survival in non-seminoma (NS) and pure seminoma (SE) resulting from surveillance in comparison to adjuvant strategies. METHODS/SYSTEMATIC REVIEW We performed a systematic literature review confining the search to most recent studies published 2010-2021 that reported direct comparisons of surveillance to adjuvant management. We searched Medline and the Cochrane Library with additional hand-searching of reference lists to identify relevant studies. Data extraction and quality assessment of included studies were performed with stratification for histology (NS vs. SE) and treatment modalities. The results were tabulated and evaluated with descriptive statistical methods. RESULTS Thirty-four studies met the inclusion criteria. In NS patients relapse rates were 12 to 37%, 0 to 10%, and 0 to 11.8% for surveillance, chemotherapy and for retroperitoneal lymph node dissection (RPLND) while overall survival rates were 90.7-100%, 91.7-100%, and 97-99.1%, respectively. In SE CSI, relapse rates were 0-22.3%, 0-5%, and 0-12.5% for surveillance, radiotherapy, chemotherapy, while overall survival rates were 84.1-98.7%, 83.5-100%, and 92.3-100%, respectively. CONCLUSION In both histologic subgroups, active surveillance offers almost identical overall survival as adjuvant management strategies, however, at the expense of higher relapse rates. Each of the management strategies in CSI GCT patients have specific merits and shared-decision-making is advised to tailor treatment.
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Late toxicities and recurrences in patients with clinical stage I non-seminomatous germ cell tumours after 1 cycle of adjuvant bleomycin, etoposide and cisplatin versus primary retroperitoneal lymph node dissection - A 13-year follow-up analysis of a phase III trial cohort. Eur J Cancer 2021; 155:64-72. [PMID: 34371444 DOI: 10.1016/j.ejca.2021.06.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 05/20/2021] [Accepted: 06/14/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND One cycle of adjuvant chemotherapy with bleomycin, etoposide and cisplatin (BEP) has shown superiority in recurrence-free survival over retroperitoneal lymph node dissection (RPLND) in patients with clinical stage (CS) I non-seminomatous germ cell tumours (NSGCTs) of the testis in the setting of a phase III trial. We report the recurrences and late toxicities of this study after 13 years of follow-up. METHODS Questionnaires from 382 patients with CS I NSGCT treated with 1 cycle of adjuvant BEP (arm A) or RPLND + two cycles of adjuvant BEP in cases of pathological stage II disease (arm B) were evaluated regarding recurrences and late toxicity. Overall, information on recurrence status was available in 337 patients, and 170 questionnaires were evaluable for toxicity (arm A: 95; arm B: 75). RESULTS With a median follow-up of 13.8 years (0-22), 3 patients (1.6%) in arm A and 16 patients (8.4%) in arm B experienced recurrence. The 15-year PFS in arm A/B was 99% (CI 96-100%)/92% (CI 89-99%) (p = 0.0049). The 15-year OS in arm A/B was 93% (CI 87-97%)/93% (CI 86-97%) (p = 0.83). Eight patients (4.2%) in arm A and four patients (2.1%) in arm B showed metachronous secondary testicular cancer (p = 0.26). Five patients (2.6%) in arm A and four patients (2.1%) in arm B developed other malignancies. Toxicities were not significantly different apart from retrograde ejaculation, which occurred more frequently after RPLND (10% versus 24%, p = 0.01). CONCLUSIONS With long-term observation, one cycle of BEP remains superior to RPLND in preventing recurrence and was tolerated without any clinically relevant long-term toxicities.
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Zhou JG, Yang J, Jin SH, Xiao S, Shi L, Zhang TY, Ma H, Gaipl US. Development and Validation of a Gene Signature for Prediction of Relapse in Stage I Testicular Germ Cell Tumors. Front Oncol 2020; 10:1147. [PMID: 32850325 PMCID: PMC7412879 DOI: 10.3389/fonc.2020.01147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 06/08/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Testicular germ cell tumors (TGCTs) are commonly diagnosed tumors in young men. However, a satisfactory approach to predict relapse of stage I TGCTs is still lacking. Therefore, this study aimed to develop a robust risk score model for stage I TGCTs. Method: RNA-sequence data of stage I TGCTs and normal testis samples were downloaded and analyzed to identify different expression genes. Gene-based prognostic model was constructed in The Cancer Genome Atlas (TCGA) using least absolute shrinkage and selection operator (LASSO) regression analysis and validated in GSE99420 dataset. Potential biological functions of the genes in prognostic model were determined via Gene Set Enrichment Analysis (GSEA) between high-risk and low-risk patients. Results: A total of 9,391 differentially expressed genes and 84 prognosis-related genes were identified. An eight-gene-based risk score model was constructed to divide patients into high or low risk of relapse. The low-risk patients had a significantly better relapse-free survival (RFS) than high-risk patients in both training and validation cohorts (HR = 0.129, 95% CI = 0.059-0.284, P < 0.001; HR = 0.277, 95% CI = 0.116-0.661, P = 0.004, respectively). The area under the receiver operating characteristic curve (AUC) values at 5 years was 0.805 and 0.724 in the training and validation cohorts, respectively. Functional enrichment analyses showed that DNA replication, ribosome, cell cycle, and TGF-beta signaling pathway may contribute to the relapse process. Conclusion: In summary, our analysis provided a novel eight-gene signature that could predict RFS in stage I TGCT patients.
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Affiliation(s)
- Jian-Guo Zhou
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Jie Yang
- Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China
| | - Su-Han Jin
- Department of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
| | - Siyu Xiao
- Department of Clinical Laboratory, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lei Shi
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ting-You Zhang
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Hu Ma
- Department of Oncology, The Second Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Udo S. Gaipl
- Department of Radiation Oncology, Universitätsklinikum Erlangen, Erlangen, Germany
- Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
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12
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McHugh DJ, Funt SA, Silber D, Knezevic A, Patil S, O’Donnell D, Tsai S, Reuter VE, Sheinfeld J, Carver BS, Motzer RJ, Bajorin DF, Bosl GJ, Feldman DR. Adjuvant Chemotherapy With Etoposide Plus Cisplatin for Patients With Pathologic Stage II Nonseminomatous Germ Cell Tumors. J Clin Oncol 2020; 38:1332-1337. [PMID: 32109195 PMCID: PMC7164484 DOI: 10.1200/jco.19.02712] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The relapse rate after primary retroperitoneal lymph node dissection (RPLND) for patients with pathologic stage (PS) IIA nonseminomatous germ cell tumors (NSGCTs) is 10%-20% but increases to ≥ 50% for PS IIB disease. We report our experience with 2 cycles of adjuvant etoposide plus cisplatin (EP×2) after therapeutic primary RPLND. PATIENTS AND METHODS All patients with PS II NSGCT seen at Memorial Sloan Kettering Cancer Center from March 1989 to April 2016 and who were planned to receive EP×2 were included. Each cycle consisted of cisplatin 20 mg/m2 and etoposide 100 mg/m2 on days 1 through 5 at 21-day intervals. Demographic characteristics, histopathologic features, therapeutic and survival outcomes were recorded. RESULTS Of 156 patients, 30 (19%) had pathologic N1, 122 (78%) had pathologic N2 (pN2), and 4 (3%) had pathologic N3 (pN3) disease. The median number of involved lymph nodes was 3 (range, 1-37 nodes), and the median size of the largest involved node was 2.0 cm (range, 0.4-7.0 cm); extranodal extension was present in 69 patients (45%). Embryonal carcinoma was the most frequent RPLND histology, present in 143 patients (92%). One hundred fifty patients (96%) received EP×2, five received EP×1 and one received EP×4. With a median follow-up of 9 years, 2 patients (1.3%; 1 patient each with pN2 and pN3 disease) experienced relapse; both patients remain continuously disease free at more than 5 and 22 years after salvage chemotherapy. Three patients died, all unrelated to NSGCT, yielding 10-year disease-specific, relapse-free, and overall survival rates of 100%, 98%, and 99%, respectively. CONCLUSION Adjuvant EP×2 for PS II NSGCT is highly effective, has acceptable toxicity, and incurs less drug cost than 2 cycles of bleomycin, etoposide, and cisplatin. Inclusion of bleomycin in this setting is not necessary.
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Affiliation(s)
- Deaglan J. McHugh
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Samuel A. Funt
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Deborah Silber
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrea Knezevic
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Sujata Patil
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Devon O’Donnell
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Stephanie Tsai
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victor E. Reuter
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Joel Sheinfeld
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Brett S. Carver
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Robert J. Motzer
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Dean F. Bajorin
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - George J. Bosl
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
| | - Darren R. Feldman
- Genitourinary Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Medical College of Cornell University, New York, NY
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13
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Tkachev V, Sorokin M, Garazha A, Borisov N, Buzdin A. Oncobox Method for Scoring Efficiencies of Anticancer Drugs Based on Gene Expression Data. Methods Mol Biol 2020; 2063:235-255. [PMID: 31667774 DOI: 10.1007/978-1-0716-0138-9_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We describe here the Oncobox method for scoring efficiencies of anticancer target drugs (ATDs) using high throughput gene expression data. The method rationale, design, and validation are given along with the examples of its practical applications in biomedicine. The method is based on the analysis of intracellular molecular pathways activation and measuring expressions of molecular target genes for every ATD under consideration. Using Oncobox method requires collection of normal (control) expression profiles and annotated databases of molecular pathways and drug target genes. Both microarray and RNA sequencing profiles are acceptable, although the latter type of data prevails in the most recent applications of this technique.
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Affiliation(s)
| | - Maxim Sorokin
- Omicsway Corp., Walnut, CA, USA
- Laboratory of Clinical Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | | | - Nicolas Borisov
- Omicsway Corp., Walnut, CA, USA
- Laboratory of Clinical Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Anton Buzdin
- Omicsway Corp., Walnut, CA, USA.
- Laboratory of Clinical Bioinformatics, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia.
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Adjuvant carboplatin therapy in patients with clinical stage 1 testicular seminoma: is long-term morbidity increased? J Cancer Res Clin Oncol 2019; 145:2335-2342. [DOI: 10.1007/s00432-019-02965-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 07/01/2019] [Indexed: 11/25/2022]
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15
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La Vignera S, Cannarella R, Duca Y, Barbagallo F, Burgio G, Compagnone M, Di Cataldo A, Calogero AE, Condorelli RA. Hypogonadism and Sexual Dysfunction in Testicular Tumor Survivors: A Systematic Review. Front Endocrinol (Lausanne) 2019; 10:264. [PMID: 31133982 PMCID: PMC6513875 DOI: 10.3389/fendo.2019.00264] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/09/2019] [Indexed: 11/13/2022] Open
Abstract
Testicular tumor is the most common malignancy in men of reproductive age. According to the tumor histology and staging, current treatment options include orchiectomy alone or associated with adjuvant chemo- and/or radiotherapy. Although these treatments have considerably raised the percentage of survivors compared to the past, they have been identified as risk factors for testosterone deficiency and sexual dysfunction in this subgroup of men. Male hypogonadism, in turn, predisposes to the development of metabolic and cardiovascular impairment that negatively affects general health. Accordingly, longitudinal studies report a long-term risk for cardiovascular diseases after radiotherapy and/or cisplatin-based chemotherapy in testicular tumor survivors. The aim of this review was to summarize the current evidence on hypogonadism and sexual dysfunction in long-term cancer survivors, including the epidemiology of cardiovascular and metabolic disorders, to increase the awareness that serum testosterone levels, sexual function, and general health should be evaluated during the endocrinological management of these patients.
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Affiliation(s)
- Sandro La Vignera
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rossella Cannarella
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Ylenia Duca
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Federica Barbagallo
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Giovanni Burgio
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Michele Compagnone
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Andrea Di Cataldo
- Unit of Pediatric Hematology and Oncology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Aldo E. Calogero
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rosita A. Condorelli
- Section of Endocrinology, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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16
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Recommendations for surveillance and follow-up of men with testicular germ cell tumors: a multidisciplinary consensus conference by the Italian Germ cell cancer Group and the Associazione Italiana di Oncologia Medica. Crit Rev Oncol Hematol 2019; 137:154-164. [PMID: 31014511 DOI: 10.1016/j.critrevonc.2019.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/09/2019] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND No compelling evidence is available about surveillance and follow-up of patients with testicular germ cell tumour (TGCT). METHODS In the light of the best clinical evidence, the Italian Germ cell cancer Group (IGG) and the Associazione Italiana di Oncologia Medica (AIOM) set up a multidisciplinary national consensus conference, involving 42 leading experts and 3 TGCT survivors. A minimum of 50% of votes was required in order to achieve a consensus recommendation on 29 questions. RESULTS Recommendations have been summarized in three tables, divided by stage I seminoma, stage I nonseminoma and the advanced disease, which may be useful for clinicians to appropriately choose the clinical investigation and its timing during the surveillance and follow-up of TGCT patients based on an accurate estimation of their risk of disease relapse. CONCLUSIONS The IGG-AIOM consensus recommendations may help clinicians to choose appropriate clinical investigations for the surveillance and follow-up of TGCT patients.
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17
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Alsdorf W, Seidel C, Bokemeyer C, Oing C. Current pharmacotherapy for testicular germ cell cancer. Expert Opin Pharmacother 2019; 20:837-850. [PMID: 30849243 DOI: 10.1080/14656566.2019.1583745] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION With the implementation of platinum-based chemotherapy, germ cell tumors (GCTs) became a model for a curable solid tumor, with survival rates of 95% in all patients with >80% survival in metastatic stages. AREAS COVERED Herein, the authors review the current standards of adjuvant chemotherapy for stage I GCTs as well as first-line and salvage treatments for metastatic disease. Novel approaches for refractory disease are also reviewed. EXPERT OPINION Active surveillance should be considered for all stage I patients and is the preferred approach for stage I seminoma. In stage I non-seminomas with vascular invasion, one cycle of bleomycin, etoposide, and cisplatin (BEP) substantially reduces the relapse risk. For most advanced GCTs, BEP remains the first-line standard of care. For poor prognosis disease treatment, stratification according to tumor marker decline is recommended. The role of primary high-dose chemotherapy (HDCT) for selected very high-risk patients remains to be prospectively evaluated. Salvage HDCT at relapse seems superior to conventional chemotherapy, retrospectively. The treatment of multiply relapsed disease remains challenging. The gemcitabine/oxaliplatin/paclitaxel (GOP) protocol is considered the standard for refractory disease. However, overall, outcomes are poor and new treatment approaches are urgently needed with targeted therapies so far failing to yield relevant clinical activity.
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Affiliation(s)
- Winfried Alsdorf
- a Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology , University Medical Center Eppendorf , Hamburg , Germany
| | - Christoph Seidel
- a Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology , University Medical Center Eppendorf , Hamburg , Germany
| | - Carsten Bokemeyer
- a Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology , University Medical Center Eppendorf , Hamburg , Germany
| | - Christoph Oing
- a Department of Oncology, Hematology and Bone Marrow Transplantation with Division of Pneumology , University Medical Center Eppendorf , Hamburg , Germany.,b Laboratory of Radiobiology and Experimental Radiation Oncology , University Medical Center Eppendorf , Hamburg , Germany
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18
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Zolotovskaia MA, Sorokin MI, Emelianova AA, Borisov NM, Kuzmin DV, Borger P, Garazha AV, Buzdin AA. Pathway Based Analysis of Mutation Data Is Efficient for Scoring Target Cancer Drugs. Front Pharmacol 2019; 10:1. [PMID: 30728774 PMCID: PMC6351482 DOI: 10.3389/fphar.2019.00001] [Citation(s) in RCA: 100] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/03/2019] [Indexed: 12/20/2022] Open
Abstract
Despite the significant achievements in chemotherapy, cancer remains one of the leading causes of death. Target therapy revolutionized this field, but efficiencies of target drugs show dramatic variation among individual patients. Personalization of target therapies remains, therefore, a challenge in oncology. Here, we proposed molecular pathway-based algorithm for scoring of target drugs using high throughput mutation data to personalize their clinical efficacies. This algorithm was validated on 3,800 exome mutation profiles from The Cancer Genome Atlas (TCGA) project for 128 target drugs. The output values termed Mutational Drug Scores (MDS) showed positive correlation with the published drug efficiencies in clinical trials. We also used MDS approach to simulate all known protein coding genes as the putative drug targets. The model used was built on the basis of 18,273 mutation profiles from COSMIC database for eight cancer types. We found that the MDS algorithm-predicted hits frequently coincide with those already used as targets of the existing cancer drugs, but several novel candidates can be considered promising for further developments. Our results evidence that the MDS is applicable to ranking of anticancer drugs and can be applied for the identification of novel molecular targets.
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Affiliation(s)
- Marianna A Zolotovskaia
- Oncobox Ltd., Moscow, Russia.,Department of Oncology, Hematology and Radiotherapy of Pediatric Faculty, Pirogov Russian National Research Medical University, Moscow, Russia
| | - Maxim I Sorokin
- The Laboratory of Clinical Bioinformatics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Omicsway Corp., Walnut, CA, United States.,Science-Educational Center Department, M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - Anna A Emelianova
- Science-Educational Center Department, M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - Nikolay M Borisov
- The Laboratory of Clinical Bioinformatics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Omicsway Corp., Walnut, CA, United States
| | - Denis V Kuzmin
- Science-Educational Center Department, M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
| | - Pieter Borger
- Laboratory of the Swiss Hepato-Pancreato-Biliary, Department of Surgery, Transplantation Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Anton A Buzdin
- Oncobox Ltd., Moscow, Russia.,The Laboratory of Clinical Bioinformatics, IM Sechenov First Moscow State Medical University, Moscow, Russia.,Science-Educational Center Department, M. M. Shemyakin and Yu. A. Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow, Russia
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19
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Huang Y, Sheng H, Zhang J, Liu Q, Ye D, Shi G. Incorporating non-biological factors into the TNM staging system for better prognostication and decision-making in testicular cancer. World J Urol 2018; 37:2165-2173. [PMID: 30554272 DOI: 10.1007/s00345-018-2603-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND We combined county-level socioeconomic status (SES), marital status and insurance status to introduce NBF-stage, which were further incorporated into the American Joint Committee on Cancer (AJCC) TNM staging system to generate an integrated staging system for better prognostication and decision-making for testicular cancer patients. METHODS 15,324 eligible patients diagnosed with primary testicular cancer between January 1, 2007 and December 31, 2015 were strictly selected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent survival predictors were determined based on Cox proportional hazards model. The Kaplan-Meier survival curves were conducted to describe the difference in predicting survival probability and the Multivariate Cox proportion hazard regression analyses were established to compare the cancer-specific survival (CSS) and overall survival (OS) difference among NBF stages or NBF-TNM subgroups. RESULTS County-level SES, marital status and insurance status were independent prognostic non-biological factors (NBFs) in our study (P < 0.05). NBF-stage (combination of SES, marital status, and insurance status) was also an independent survival predictor in TC (P < 0.05). NBF1 patients had 167% increased risk of cancer-specific mortality (CSM) as compared to NBF0 patients in testicular cancer (P < 0.01). And NBF0 patients all had a better CSS as compared to NBF1 patients of the same TNM stage both in seminoma and non-seminomatous germ cell tumor (P < 0.05). CONCLUSIONS Incorporation of NBFs into AJCC TNM staging system in testicular cancer would potentially impact treatment decisions where treatments would not be rendered for a typically curable cancer with multi-modal therapy.
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Affiliation(s)
- Yongqiang Huang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Haoyue Sheng
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Junyu Zhang
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Qi Liu
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.,Department of Colorectal Surgery, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Guohai Shi
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
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20
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Dieckmann KP, Anheuser P, Kulejewski M, Gehrckens R, Feyerabend B. Is there still a place for retroperitoneal lymph node dissection in clinical stage 1 nonseminomatous testicular germ-cell tumours? A retrospective clinical study. BMC Urol 2018; 18:95. [PMID: 30367648 PMCID: PMC6204050 DOI: 10.1186/s12894-018-0412-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/17/2018] [Indexed: 01/22/2023] Open
Abstract
Background Primary retroperitoneal lymph node dissection (RPLND) ultimately lost its role as the standard management of clinical stage (CS) 1 nonseminomatous (NS) testicular germ cell tumours (GCTs) in Europe when the European Germ Cell Cancer Consensus Group released their recommendations in 2008. Current guide-lines recommend surgery only for selected patients but reasons for selection remain rather ill-defined. We evaluated the practice patterns of the management of CS1 patients and looked specifically to the role of RPLND among other standard treatment options. Methods We retrospectively evaluated the treatment modalities of 75 consecutive patients treated for CS1 NS at one centre during 2008–2017. The patients undergoing RPLND were selected for a closer review. Particular reasons for surgery, clinical features of patients, and therapeutic outcome were analyzed using descriptive statistical methods. Results Twelve patients (16%) underwent nerve-sparing RPLND, nine surveillance, 54 had various regimens of adjuvant chemotherapy. Particular reasons for surgery involved illnesses precluding chemotherapy (n = 2), patients´ choice (n = 4), and teratomatous histology of the primary associated with equivocal radiologic findings (n = 6). Five patients had lymph node metastases, two received additional chemotherapy. Antegrade ejaculation was preserved in all cases. One patient had a grade 2 complication that was managed conservatively. All RPLND-patients remained disease-free. Conclusions Primary RPLND is a useful option in distinct CS1 patients, notably those with concurrent health problems precluding chemotherapy, and those with high proportions of teratoma in the primary associated with equivocal radiological findings. Informed patient’s preference represents another acceptable reason for the procedure. RPLND properly suits the needs of well-selected patients with CS1 nonseminoma and deserves consideration upon clinical decision-making.
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Affiliation(s)
- K-P Dieckmann
- Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Hamburg, Germany. .,Asklepios Klinik Altona, Urologische Abteilung, Hodentumorzentrum Hamburg, Hamburg, Germany. .,Asklepios Klinik Altona, Hodentumorzentrum Hamburg, Paul Ehrlich Strasse 1, 22763, Hamburg, Germany.
| | - P Anheuser
- Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Hamburg, Germany
| | - M Kulejewski
- Albertinen-Krankenhaus Hamburg, Klinik für Urologie, Hamburg, Germany
| | - R Gehrckens
- Albertinen-Krankenhaus Hamburg, Klinik für Diagnostische Radiologie, Hamburg, Germany
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Abstract
Testicular cancer is the most common malignancy among men between 14 and 44 years of age, and its incidence has risen over the past two decades in Western countries. Both genetic and environmental factors contribute to the development of testicular cancer, for which cryptorchidism is the most common risk factor. Progress has been made in our understanding of the disease since the initial description of carcinoma in situ of the testis in 1972 (now referred to as germ cell neoplasia in situ), which has led to improved treatment options. The combination of surgery and cisplatin-based chemotherapy has resulted in a cure rate of >90% in patients with testicular cancer, although some patients become refractory to chemotherapy or have a late relapse; an improved understanding of the molecular determinants underlying tumour sensitivity and resistance may lead to the development of novel therapies for these patients. This Primer provides an overview of the biology, epidemiology, diagnosis and current treatment guidelines for testicular cancer, with a focus on germ cell tumours. We also outline areas for future research and what to expect in the next decade for testicular cancer.
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Non–risk-adapted Surveillance for Stage I Testicular Cancer: Critical Review and Summary. Eur Urol 2018; 73:899-907. [DOI: 10.1016/j.eururo.2017.12.030] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 12/27/2017] [Indexed: 11/22/2022]
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Adjuvant Therapy for Stage IB Germ Cell Tumors: One versus Two Cycles of BEP. Adv Urol 2018; 2018:8781698. [PMID: 29808086 PMCID: PMC5902120 DOI: 10.1155/2018/8781698] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 02/20/2018] [Indexed: 11/17/2022] Open
Abstract
Testicular germ cell tumours are the commonest tumours of young men and are broadly managed either as pure seminomas or as 'nonseminomas'. The management of Stage 1 nonseminomatous germ cell tumours (NSGCTs), beyond surgical removal of the primary tumour at orchidectomy, is somewhat controversial. Cancer-specific survival rates in these patients are in the order of 99% regardless of whether surveillance, retroperitoneal lymph node dissection, or adjuvant chemotherapy is employed. However, the toxicities of these treatment modalities differ. Undertreating those destined to relapse exposes them to the potentially significant toxicities of 3-4 cycles of bleomycin, etoposide, and cisplatin (BEP) chemotherapy. Conversely, giving adjuvant chemotherapy to all patients following orchidectomy results in overtreatment of a significant proportion. Therefore, the challenge lies in delineating the patient population who require adjuvant chemotherapy and in determining how much chemotherapy to give to adequately reduce relapse risk. This chapter reviews the factors to be considered when adopting a risk-adapted strategy for giving adjuvant chemotherapy in Stage 1B NSGCT sand discusses the data regarding the number of BEP cycles to administer.
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Aparicio J, Sánchez-Muñoz A, Gumà J, Domenech M, Meana J, García-Sánchez J, Bastús R, Gironés R, González-Billalabeitia E, Sagastibelza N, Ochenduszko S, Sánchez A, Terrasa J, Germà-Lluch J, García del Muro X. A Risk-Adapted Approach to Patients with Stage I Seminoma according to the Status of Rete Testis: The Fourth Spanish Germ Cell Cancer Group Study. Oncology 2018; 95:8-12. [DOI: 10.1159/000487438] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/30/2018] [Indexed: 12/11/2022]
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Genitourinary tumours in the targeted therapies era: new advances in clinical practice and future perspectives. Anticancer Drugs 2017; 27:917-43. [PMID: 27400375 DOI: 10.1097/cad.0000000000000405] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Genitourinary cancers represent a heterogeneous group of malignancies arising from genitourinary tract, and are responsible for almost 359 000 newly diagnosed cases and 58 420 related deaths in USA. Continuous advances in cancer genetics and genomics have contributed towards changing the management paradigms of these neoplasms. Neoangiogenesis, through the activation of the tyrosine-kinase receptors signalling pathways, represents the key mediator event in promoting tumour proliferation, differentiation, invasiveness and motility. In the last decade, several treatments have been developed with the specific aim of targeting different cell pathways that have been recognized to drive tumour progression. The following review attempts to provide a comprehensive overview of the literature, focusing on new advances in targeted therapies for genitourinary tumours. Furthermore, the promising results of the latest clinical trials and future perspectives will be discussed.
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Quezada Bautista A, Lara Bejarano J, García García J, Ortega-García O, Bautista Hernández M. Relapse and gastrointestinal toxicity associated with radiotherapy treatment in stage I seminoma patients. REVISTA MÉDICA DEL HOSPITAL GENERAL DE MÉXICO 2017. [DOI: 10.1016/j.hgmx.2016.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Management of Clinical Stage I Nonseminomatous Germ Cell Testicular Tumors: A 25-year Single-center Experience. Clin Genitourin Cancer 2017; 15:e1015-e1019. [PMID: 28673797 DOI: 10.1016/j.clgc.2017.05.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Revised: 05/21/2017] [Accepted: 05/23/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Surveillance after orchiectomy alone has become popular in the management of clinical stage I nonseminomatous germ cell testicular tumors (CSI NSGCTT). Efforts to identify patients at high risk of disease progression led to a search for risk factors in CSI NSGCTT. The aim of this study was to analyze a 25-year single-center experience with risk-adapted therapeutic approaches-active surveillance (AS) versus adjuvant chemotherapy (ACT). PATIENTS AND METHODS From January 1992 to January 2017, a total of 485 patients with CSI NSGCTT were stratified into the AS group (low-risk patients) and the ACT group (high-risk patients). Differences between relapse rates and overall survival rates in these groups were statistically analyzed. RESULTS In the AS group, relapse occurred in 52 (17.3%) of 301 patients with a median follow-up of 7.2 months (range, 2-86 months). Six (2.0%) patients of this group died, with a median follow-up of 34.3 months (range, 11-102 months). In the ACT group, relapse occurred in 2 (1.1%) of 184 patients with a median follow-up of 56.2 months (range, 42-70 months). One (0.54%) patient died at 139.4 months following orchiectomy. The relapse rate for the AS group was 16.7 times higher than that for the ACT group. The groups did not differ in overall survival. The 3-year overall survival of all patients with CSI NSGCTT was 99.1% (95% confidence interval, 97.7%-99.7%). Three of a total of 7 deaths occurred thereafter. CONCLUSIONS The policy of AS is recommended only in patients with low-risk CSI NSGCTT.
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Lorch A, Beyer J. How we treat germ cell cancers. Cancer 2017; 123:2190-2192. [PMID: 28513824 DOI: 10.1002/cncr.30751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/18/2017] [Accepted: 03/27/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Anja Lorch
- Department of Urology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Jörg Beyer
- Department of Oncology, University Hospital Zurich, Zurich, Switzerland
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Purshouse K, Watson RA, Church DN, Richardson C, Crane G, Traill Z, Sullivan M, Roberts I, Browning L, Turner G, Parameshwaran V, Johnson J, Chitnis M, Protheroe A, Verrill C. Value of Supraregional Multidisciplinary Review for the Contemporary Management of Testicular Tumors. Clin Genitourin Cancer 2017; 15:152-156. [DOI: 10.1016/j.clgc.2016.05.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/27/2016] [Accepted: 05/18/2016] [Indexed: 12/24/2022]
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The Evolving Management of Patients With Clinical Stage I Seminoma. Urology 2016; 98:113-119. [PMID: 27527410 DOI: 10.1016/j.urology.2016.07.037] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/01/2016] [Accepted: 07/01/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine trends in management and factors associated with men receiving either chemotherapy or radiation therapy post orchiectomy for clinical stage I (CSI) seminoma in a contemporary setting. PATIENTS AND METHODS The National Cancer Data Base was queried for all patients with CSI seminoma from 1998 to 2012. Adjuvant treatment after orchiectomy was classified into 3 groups: surveillance, radiotherapy, and chemotherapy. Yearly trends in management are described. Subgroup analysis for the years 2010-2012 was completed using logistic regression to determine predictors of receiving treatment. RESULTS Of 80,385 patients with testicular cancer, 16,931 had CSI seminoma. There was a progressive decline in the use of post-orchiectomy treatment from 1998 to 2012. In the years 2010-2012 (n = 5816), 59.9% of patients chose surveillance compared with 25.1% receiving radiotherapy and 15.0% receiving chemotherapy. Regression modeling demonstrated that men aged 18-30 were less likely (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.69-1.00, P = .048) to receive treatment than those aged 31-37. Increasing pathologic stage was associated with a greater likelihood of treatment (OR 1.77, 95% CI 1.52-2.06), whereas patients treated at academic hospitals were less likely to receive adjuvant therapy (OR 0.77, 95% CI 0.62-0.94). CONCLUSION Despite a trend toward increased use of post-orchiectomy surveillance for patients with CSI seminoma, a significant portion of patients are still receiving treatment. Pathologic stage and treating hospital type have the strongest association with management decisions. Improved guideline adherence may reduce the potential for adverse effects after chemotherapy or radiation therapy for CSI seminoma.
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Artemov A, Aliper A, Korzinkin M, Lezhnina K, Jellen L, Zhukov N, Roumiantsev S, Gaifullin N, Zhavoronkov A, Borisov N, Buzdin A. A method for predicting target drug efficiency in cancer based on the analysis of signaling pathway activation. Oncotarget 2016; 6:29347-56. [PMID: 26320181 PMCID: PMC4745731 DOI: 10.18632/oncotarget.5119] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2015] [Accepted: 07/24/2015] [Indexed: 02/07/2023] Open
Abstract
A new generation of anticancer therapeutics called target drugs has quickly developed in the 21st century. These drugs are tailored to inhibit cancer cell growth, proliferation, and viability by specific interactions with one or a few target proteins. However, despite formally known molecular targets for every "target" drug, patient response to treatment remains largely individual and unpredictable. Choosing the most effective personalized treatment remains a major challenge in oncology and is still largely trial and error. Here we present a novel approach for predicting target drug efficacy based on the gene expression signature of the individual tumor sample(s). The enclosed bioinformatic algorithm detects activation of intracellular regulatory pathways in the tumor in comparison to the corresponding normal tissues. According to the nature of the molecular targets of a drug, it predicts whether the drug can prevent cancer growth and survival in each individual case by blocking the abnormally activated tumor-promoting pathways or by reinforcing internal tumor suppressor cascades. To validate the method, we compared the distribution of predicted drug efficacy scores for five drugs (Sorafenib, Bevacizumab, Cetuximab, Sorafenib, Imatinib, Sunitinib) and seven cancer types (Clear Cell Renal Cell Carcinoma, Colon cancer, Lung adenocarcinoma, non-Hodgkin Lymphoma, Thyroid cancer and Sarcoma) with the available clinical trials data for the respective cancer types and drugs. The percent of responders to a drug treatment correlated significantly (Pearson's correlation 0.77 p = 0.023) with the percent of tumors showing high drug scores calculated with the current algorithm.
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Affiliation(s)
- Artem Artemov
- Pathway Pharmaceuticals, Wan Chai, Hong Kong, Hong Kong SAR.,D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Alexander Aliper
- D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,First Oncology Research and Advisory Center, Moscow, Russia
| | | | | | - Leslie Jellen
- Department of Genetics, Genomics, and Informatics, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Nikolay Zhukov
- D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,First Oncology Research and Advisory Center, Moscow, Russia.,Pirogov Russian National Research Medical University, Department of Oncology, Hematology and Radiotherapy, Moscow, Russia
| | - Sergey Roumiantsev
- D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,Pirogov Russian National Research Medical University, Department of Oncology, Hematology and Radiotherapy, Moscow, Russia
| | - Nurshat Gaifullin
- Moscow State University, Faculty of Fundamental Medicine, Moscow, Russia
| | - Alex Zhavoronkov
- Insilico Medicine, Inc., ETC, Johns Hopkins University, Baltimore, MD, USA
| | | | - Anton Buzdin
- Pathway Pharmaceuticals, Wan Chai, Hong Kong, Hong Kong SAR.,D. Rogachyov Federal Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia.,Group for Genomic Regulation of Cell Signaling Systems, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow, Russia
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Oldenburg J, Gietema JA. The Sound of Silence: A Proxy for Platinum Toxicity. J Clin Oncol 2016; 34:2687-9. [PMID: 27382103 DOI: 10.1200/jco.2016.68.2476] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Jan Oldenburg
- Akershus University Hospital, Lørenskog, Norway; and University of Oslo, Oslo, Norway
| | - Jourik A Gietema
- University of Groningen, University Medical Center Groningen, The Netherlands
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Ondrusova M, Balogova S, Lehotska V, Kajo K, Mrinakova B, Ondrus D. Controversies in the management of clinical stage I testicular seminoma. Cent European J Urol 2016; 69:35-9. [PMID: 27123323 PMCID: PMC4846723 DOI: 10.5173/ceju.2016.699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/21/2015] [Accepted: 12/11/2015] [Indexed: 11/22/2022] Open
Abstract
Introduction Following orchiectomy patients with clinical stage I (CSI) testicular seminoma may be managed by active surveillance (AS) or adjuvant treatment (radiotherapy or chemotherapy). In view of the published data on long-term toxicity, mainly second malignant neoplasms (SMNs), adjuvant radiotherapy (ART) is currently no longer recommended as adjuvant therapy for these patients. The purpose of our recent study was to compare the impact of two selected treatment approaches – AS versus adjuvant chemotherapy (ACT) on survival in patients with CSI testicular seminoma. Material and methods The cross-sectional study analyzed a total of 106 patients collected at a single centre between 4/2008–8/2015, with CSI testicular seminoma, stratified into two groups according to risk-adapted therapeutic approaches. Results In group A (low-risk), consisting of 84 patients, who underwent AS, relapse occurred in 10 (11.9%) patients after a mean follow-up of 13.8 months. In group B (high-risk), consisting of 22 patients, who were treated with ACT, relapse occurred in two (9.1%) patients after a mean follow-up of 13.8 months. Overall survival of patients in both groups was 100% with a mean follow-up of 25.3 months. The statistically significant difference in progression-free survival (PFS) between these two groups was not found. Conclusions ACT seems to be adequate treatment for patients with high-risk of relapse, as well as AS for those with low-risk of relapse. Despite its excellent prognosis, optimal management of CSI testicular seminoma remains controversial, with variations in expert opinion and international guidelines.
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Affiliation(s)
- Martina Ondrusova
- St. Elisabeth University of Health and Social Sciences, Bratislava, Slovak Republic; Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic; Pharm-In, Ltd., Bratislava, Slovak Republic
| | - Sona Balogova
- Department of Nuclear Medicine, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Viera Lehotska
- 2 Department of Radiology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Karol Kajo
- Department of Pathology, Slovak Medical University & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Bela Mrinakova
- Department of Medical Oncology & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
| | - Dalibor Ondrus
- 1 Department of Oncology, Comenius University, Faculty of Medicine & St. Elisabeth Cancer Institute, Bratislava, Slovak Republic
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Rossi L, Martignano F, Gallà V, Maugeri A, Schepisi G. Impact of Non-Pulmonary Visceral Metastases in the Prognosis and Practice of Metastatic Testicular Germ Cell Tumors. Oncol Rev 2016; 10:292. [PMID: 27471579 PMCID: PMC4943091 DOI: 10.4081/oncol.2016.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 04/07/2016] [Indexed: 12/03/2022] Open
Abstract
Non-pulmonary visceral metastases, in bones, brain and liver, represent nearly the 10% of metastatic sites of advanced germ cell tumors and are associated with poor prognosis. This review article summarizes major evidences on the impact of different visceral sites on the prognosis, treatment and clinical outcome of patients with germ cell tumors. The clinic-biological mechanisms by which these metastatic sites are associated with poor clinical outcome remain unclear. The multimodality treatment showed a potential better survival, in particular in patients with relapsed disease. Patients with advanced germ cell tumors with visceral metastases should be referred to centers with high expertise in the clinical management of such disease.
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Affiliation(s)
- Lorena Rossi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS , Meldola (FC), Italy
| | - Filippo Martignano
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS , Meldola (FC), Italy
| | - Valentina Gallà
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS , Meldola (FC), Italy
| | - Antonio Maugeri
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS , Meldola (FC), Italy
| | - Giuseppe Schepisi
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST)-IRCCS , Meldola (FC), Italy
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Mensah EE, Nicol D, Mayer E. Primary testicular tumours and management of clinical stage 1 testicular cancer. JOURNAL OF CLINICAL UROLOGY 2016. [DOI: 10.1177/2051415816630697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | | | - Erik Mayer
- Imperial College London, London, UK
- The Royal Marsden Hospital, London, UK
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Glaser SM, Vargo JA, Balasubramani GK, Beriwal S. Surveillance and Radiation Therapy for Stage I Seminoma—Have We Learned From the Evidence? Int J Radiat Oncol Biol Phys 2016; 94:75-84. [DOI: 10.1016/j.ijrobp.2015.09.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 09/14/2015] [Accepted: 09/16/2015] [Indexed: 10/23/2022]
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37
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Oing C, Seidel C, von Amsberg G, Oechsle K, Bokemeyer C. Pharmacotherapeutic treatment of germ cell tumors: standard of care and recent developments. Expert Opin Pharmacother 2015; 17:545-60. [DOI: 10.1517/14656566.2016.1127357] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- Darren R Feldman
- Memorial Sloan Kettering Cancer Center; and Weill Medical College of Cornell University, New York, NY
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Gillessen S, De Santis M, Rothermundt C. On Nonharming: The Debate Continues in Stage I Testicular Cancer. J Clin Oncol 2015; 33:2319-20. [DOI: 10.1200/jco.2015.61.1632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Maria De Santis
- Kaiser Franz Josef Hospital; and Applied Cancer Research–Institute for Translational Research and Ludwig Boltzmann Institute and Cluster Translational Oncology, Vienna, Austria
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Ondrusova M, Ondrus D, Miskovska V, Kajo K, Szoldova K, Usakova V, Stastna V. Management of clinical stage I testicular seminoma: active surveillance versus adjuvant chemotherapy. Int Urol Nephrol 2015; 47:1143-7. [DOI: 10.1007/s11255-015-1002-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 04/26/2015] [Indexed: 11/29/2022]
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Kollmannsberger C, Nichols C. Agenda science: turning nothing into something: a response to the editorial by Oldenburg et al. and its featured article by Vidal et al. Ann Oncol 2015; 26:1513-4. [PMID: 25899786 DOI: 10.1093/annonc/mdv198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- C Kollmannsberger
- Division of Medical Oncology, British Columbia Cancer Agency Vancouver Cancer Center, University of British Columbia, Vancouver, Canada
| | - C Nichols
- Virginia Mason Medical Center, Section of Hematology/Oncology, Seattle, USA
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42
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Affiliation(s)
- Guy C Toner
- Peter MacCallum Cancer Centre, St Andrews Place, East Melbourne, VIC 3002, Australia
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Oldenburg J, Haugnes HS, Dahl O, Karlsdottir Å, Langberg CW, Klepp O, Solberg A, Tandstad T. Behandling ved stadium I-testikkelkreft bør vurderes individuelt. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2015; 135:1340-1. [DOI: 10.4045/tidsskr.15.0544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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