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Wijesinghe K, Abeywickrama T, Chamara Y, De Silva S, Tharshan S, Jayarajah U, De Silva A. Oncoplastic breast conserving surgery versus standard breast conserving surgery for early and locally advanced breast cancer: a retrospective analysis from Sri Lanka. BMC Surg 2023; 23:273. [PMID: 37697322 PMCID: PMC10496197 DOI: 10.1186/s12893-023-02182-5] [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: 05/02/2023] [Accepted: 09/04/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Breast aesthetics is becoming increasingly important in breast cancer surgery due to changes in patient expectations and greater emphasis been placed on the psychosocial outcomes. Studies have shown no difference in local recurrence risk between mastectomy and breast conserving surgery (BCS) and also a higher overall survival rate after BCS. Breast preservation improves the quality of life substantially compared to mastectomy. Oncoplastic breast-conserving surgery (O-BCS) involves tumour excision whilst overcoming the limitations of standard breast conserving surgery (S-BCS) by allowing larger resection volumes, avoiding deformities with better aesthetic results. Our study aims to compare the oncosurgical and aesthetic outcomes of O-BCS versus S-BCS among women in Sri Lanka. METHODS We conducted a retrospective study over a 4-year period including patients who underwent breast conservation surgery for primary non-metastatic breast cancer in two tertiary care units. We assessed outcomes in terms of re-excision rates, resection margin, complications and aesthetic outcomes using a Likert scale questionnaire to grade specific outcomes such as symmetry, volume, nipple position, scar visibility. Non-parametric tests were used for statistical analyses. RESULTS Fifty-four and seventy-three patients underwent S-BCS and O-BCS respectively. The median specimen volume and the maximum tumour diameter were significantly higher in O-BCS [160(range:65-220); 4.2(range: 1.2-5.2)] compared to S-BCS [65(range:45-86); 2.4(range: 1.0-2.6)]. The median closest tumour margin was 16 mm (range:4-25 mm) in O-BCS while 6 mm (range:<1 - 12 mm) in S-BCS (p = 0.01). Close (< 1 mm) and positive margins needing re-excision were seen mostly in S-BCS. Superior aesthetic outcomes with statistical significant difference were reported in the O-BCS compared to S-BCS group with better symmetry, volume, nipple position and scar visibility. The re-excision rates were significantly lower in O-BCS group. There was no significant difference in the operative time and complications while the aesthetic outcomes were significantly superior in OBCS. CONCLUSIONS Overall, Level 2 perforator flap based reconstruction had superior aesthetic outcomes. O-BCS is safe and more aesthetically acceptable with no difference in oncological outcome and operative time. More consideration should be given to aesthetic parameters such as scar visibility, nipple position, breast volume and shape when considering the best surgical option for the patients.
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Affiliation(s)
- Kanchana Wijesinghe
- Department of Surgery, Faculty of Medical Sciences, University of Sri Jayawardenapura, Nugegoda, Sri Lanka.
| | | | - Yohan Chamara
- Department of Surgery, Faculty of Medical Sciences, University of Sri Jayawardenapura, Nugegoda, Sri Lanka
| | - Sumali De Silva
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
| | | | - Umesh Jayarajah
- University Surgical Unit, Colombo South Teaching Hospital, Kalubowila, Sri Lanka
| | - Ajith De Silva
- Department of Surgery, National Hospital of Sri Lanka, Colombo, Sri Lanka
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Njenga LW, Mbugua SN, Odhiambo RA, Onani MO. Addressing the gaps in homeostatic mechanisms of copper and copper dithiocarbamate complexes in cancer therapy: a shift from classical platinum-drug mechanisms. Dalton Trans 2023; 52:5823-5847. [PMID: 37021641 DOI: 10.1039/d3dt00366c] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
The platinum drug, cisplatin, is considered as among the most successful medications in cancer treatment. However, due to its inherent toxicity and resistance limitations, research into other metal-based non-platinum anticancer medications with diverse mechanisms of action remains an active field. In this regard, copper complexes feature among non-platinum compounds which have shown promising potential as effective anticancer drugs. Moreover, the interesting discovery that cancer cells can alter their copper homeostatic processes to develop resistance to platinum-based treatments leads to suggestions that some copper compounds can indeed re-sensitize cancer cells to these drugs. In this work, we review copper and copper complexes bearing dithiocarbamate ligands which have shown promising results as anticancer agents. Dithiocarbamate ligands act as effective ionophores to convey the complexes of interest into cells thereby influencing the metal homeostatic balance and inducing apoptosis through various mechanisms. We focus on copper homeostasis in mammalian cells and on our current understanding of copper dysregulation in cancer and recent therapeutic breakthroughs using copper coordination complexes as anticancer drugs. We also discuss the molecular foundation of the mechanisms underlying their anticancer action. The opportunities that exist in research for these compounds and their potential as anticancer agents, especially when coupled with ligands such as dithiocarbamates, are also reviewed.
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Affiliation(s)
- Lydia W Njenga
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - Simon N Mbugua
- Department of Chemistry, Kisii University, P.O. Box 408-40200, Kisii, Kenya
| | - Ruth A Odhiambo
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya.
| | - Martin O Onani
- Department of Chemical Sciences, University of the Western Cape, Private Bag X17, Belville, 7535, South Africa
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Hermawan A, Wulandari F, Hanif N, Utomo RY, Jenie RI, Ikawati M, Tafrihani AS. Identification of potential targets of the curcumin analog CCA-1.1 for glioblastoma treatment : integrated computational analysis and in vitro study. Sci Rep 2022; 12:13928. [PMID: 35977996 PMCID: PMC9385707 DOI: 10.1038/s41598-022-18348-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
The treatment of glioblastoma multiforme (GBM) is challenging owing to its localization in the brain, the limited capacity of brain cells to repair, resistance to conventional therapy, and its aggressiveness. Curcumin has anticancer activity against aggressive cancers, such as leukemia, and GBM; however, its application is limited by its low solubility and bioavailability. Chemoprevention curcumin analog 1.1 (CCA-1.1), a curcumin analog, has better solubility and stability than those of curcumin. In this study, we explored potential targets of CCA-1.1 in GBM (PTCGs) by an integrated computational analysis and in vitro study. Predicted targets of CCA-1.1 obtained using various databases were subjected to comprehensive downstream analyses, including functional annotation, disease and drug association analyses, protein–protein interaction network analyses, analyses of genetic alterations, expression, and associations with survival and immune cell infiltration. Our integrative bioinformatics analysis revealed four candidate targets of CCA-1.1 in GBM: TP53, EGFR, AKT1, and CASP3. In addition to targeting specific proteins with regulatory effects in GBM, CCA-1.1 has the capacity to modulate the immunological milieu. Cytotoxicity of CCA-1.1 was lower than TMZ with an IC50 value of 9.8 μM compared to TMZ with an IC50 of 40 μM. mRNA sequencing revealed EGFR transcript variant 8 was upregulated, whereas EGFRvIII was downregulated in U87 cells after treatment with CCA-1.1. Furthermore, a molecular docking analysis suggested that CCA-1.1 inhibits EGFR with various mutations in GBM, which was confirmed using molecular dynamics simulation, wherein the binding between CCA-1.1 with the mutant EGFR L861Q was stable. For successful clinical translation, the effects of CCA-1.1 need to be confirmed in laboratory studies and clinical trials.
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Affiliation(s)
- Adam Hermawan
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia. .,Laboratory of Macromolecular Engineering, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia.
| | - Febri Wulandari
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
| | - Naufa Hanif
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
| | - Rohmad Yudi Utomo
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia.,Laboratory of Medicinal Chemistry, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
| | - Riris Istighfari Jenie
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia.,Laboratory of Macromolecular Engineering, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
| | - Muthi Ikawati
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia.,Laboratory of Macromolecular Engineering, Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
| | - Ahmad Syauqy Tafrihani
- Faculty of Pharmacy, Cancer Chemoprevention Research Center, Universitas Gadjah Mada Sekip Utara II, Yogyakarta, 55281, Indonesia
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Bandara GBKD, Jayarajah U, Rodrigo VSD. Renal inflammatory myofibroblastic tumour presenting with a large retroperitoneal abscess. SAGE Open Med Case Rep 2022; 10:2050313X221089484. [PMID: 35401980 PMCID: PMC8984842 DOI: 10.1177/2050313x221089484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/07/2022] [Indexed: 11/21/2022] Open
Abstract
Inflammatory myofibroblastic tumour arising from the kidney is a rare occurrence. In this
case report, we present a rare case of inflammatory myofibroblastic tumour arising from
the kidney diagnosed after the presentation with a large retroperitoneal abscess for the
first time in literature. A 55-year-old woman with diabetes mellitus presented to us with
painful lump in the left lumbar region of the back for 1-week duration. On examination,
there was a firm, diffuse lump in the left lumbar region of the back. Her inflammatory
markers were high, but the serum creatinine and blood urea were within the normal range.
Abdominal ultrasonography showed a distorted left kidney with a heterogeneous mass
consisting cystic and solid components measuring approximately 7 × 9 × 8 cm in size. A
contrast-enhanced computed tomography scan showed an 11 × 9 × 9 cm-sized low-density mass
posterior to the left kidney with multiple contrast-enhancing septations which appeared
posterior to but separate from the left kidney within the left renal fascia. There was
breeching of the Gerota’s fascia with extension posteriorly up to subcutaneous tissue.
Since the radiological opinion was in favour of a complex perinephric abscess, open
drainage of the abscess was performed after failed attempts of ultrasound-guided drainage.
The biopsy of the abscess wall was suggestive of a renal cell carcinoma and radical
nephrectomy was planned. Due to tumour invasion, the radical nephrectomy was combined with
a splenectomy and the specimen sent for histology. It showed an inflammatory
myofibroblastic tumour or pseudotumour with the periphery showing ulceration and abscess
formation. The patient had an uneventful recovery following surgery. Thus, we report the
first case of renal inflammatory myofibroblastic tumour presenting with a large
retroperitoneal abscess extending to the subcutaneous tissue plane. Final diagnosis was
made only after radical surgery which was curative.
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Affiliation(s)
| | - Umesh Jayarajah
- Department of Surgery, District General Hospital, Chilaw, Sri Lanka
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Othman IMM, Alamshany ZM, Tashkandi NY, Gad-Elkareem MAM, Abd El-Karim SS, Nossier ES. Synthesis and biological evaluation of new derivatives of thieno-thiazole and dihydrothiazolo-thiazole scaffolds integrated with a pyrazoline nucleus as anticancer and multi-targeting kinase inhibitors. RSC Adv 2022; 12:561-577. [PMID: 35424523 PMCID: PMC8694192 DOI: 10.1039/d1ra08055e] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/15/2021] [Indexed: 12/17/2022] Open
Abstract
Deregulation of various protein kinases is considered as one of the important factors resulting in cancer development and metastasis, thus multi-targeting the kinase family is one of the most important strategies in current cancer therapy. This context represents the design and synthesis of two sets of derivatives bearing a pyrazoline-3-one ring conjugated either with a thieno[3,2-d]thiazole or with a dihydrothiazolo[4,5-d]thiazole scaffold via an NH linker, 3a–d and 5a–d respectively, using the pyrazolinone–thiazolinone derivative 1 as a key precursor. All the newly synthesized compounds were assessed in vitro for their anticancer activity against two cancer cell lines (MCF-7 and HepG-2). The safety profile of the most active cytotoxic candidates 1 and 3c was further examined against the normal cell line WI-38. The compounds 1 and 3c were further evaluated as multi-targeting kinase inhibitors against EGFR, VEGFR-2 and BRAFV600E, exhibiting promising suppression impact. Additionally, the latter compounds were investigated for their impact on cell cycle and apoptosis induction potential in the MCF-7 cell line. Moreover, the antimicrobial activity of all the new analogues was evaluated against a panel of Gram-positive and Gram-negative bacteria, yeast and fungi in comparison to streptomycin and amphotericin-B as reference drugs. Interestingly, both 1 and 3c showed the most promising microbial inhibitory effect. Molecular docking studies showed promising binding patterns of the compounds 1 and 3c with the prospective targets, EGFR, VEGFR-2 and BRAFV600E. Finally, additional toxicity studies were performed for the new derivatives which showed their good drug-like properties and low toxicity risks in humans. Deregulation of various protein kinases is considered as one of the important factors resulting in cancer development and metastasis, thus multi-targeting the kinase family is one of the most important strategies in current cancer therapy.![]()
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Affiliation(s)
- Ismail M. M. Othman
- Department of Chemistry, Faculty of Science, Al-Azhar University, Assiut 71524, Egypt
| | - Zahra M. Alamshany
- Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 42805, Jeddah 21551, Saudi Arabia
| | - Nada Y. Tashkandi
- Department of Chemistry, Faculty of Science, King Abdulaziz University, P.O. Box 42805, Jeddah 21551, Saudi Arabia
| | | | - Somaia S. Abd El-Karim
- Department of Therapeutic Chemistry, National Research Centre, Dokki, Cairo 12622, Egypt
| | - Eman S. Nossier
- Department of Pharmaceutical Medicinal Chemistry, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo 11754, Egypt
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Jayarajah U, Gunawardene M, Willaraarachchi M, Chandrasiri S, Udayakumaran P, Sosai C, Abeygunasekera A. Clinical characteristics and outcome of genitourinary tuberculosis in Sri Lanka: an observational study. BMC Infect Dis 2021; 21:1279. [PMID: 34961480 PMCID: PMC8711141 DOI: 10.1186/s12879-021-06990-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although genitourinary Tuberculosis (GUTB) is the second commonest source of extrapulmonary TB in most countries, the reported rate of GUTB in Sri Lanka remains low. The characteristics of GUTB in Sri Lanka have not been studied and documented so far. We aimed to study the clinical and imaging characteristics, treatment modalities and outcome of GUTB in Sri Lanka. METHODS Data collected from patients treated by a single urological surgeon in two institutes consecutively over a period of 21 years were analysed. All patients with a microbiological and/or histopathological diagnosis of GUTB were included. Median duration of follow-up was 24 months (range: 6-96). RESULTS There were 82 patients and 45 (54.9%) were men. The median age was 51 (range: 26-75) years. Most patients (39%, n = 32) had vague non-specific symptoms at presentation. Common specific symptoms at presentation were haematuria (15.8%, n = 13) and scrotal manifestations (15.8%, n = 13). Mantoux test was done in 70 patients and was > 10 mm in 62 (88.5%). Erythrocyte sedimentation rate was available in 69 patients and was > 30 mm in 54 (78.3%) patients. Chest x-ray and x-ray kidney-ureter-bladder (KUB) abnormalities were detected in 9 (11%) and 6 (7.3%) respectively. CT-urography was performed in 72 patients and abnormalities were detected in 57 (79%) patients. Forty-two patients underwent cystoscopy and 73.8% (n = 31) had abnormal findings. Microbiological diagnosis was feasible in 43 (52.4%) and rest were diagnosed histopathologically. Commonest organs involved were kidney (64.6%, n = 53), ureter (51.2%, n = 42), bladder (43.9%, n = 36) and testis/epididymis (15.8%, n = 13). One patient had TB of the prostate. All were treated primarily with anti-TB drugs however, 50 (61%) required ancillary therapeutic interventions. The majority of interventions were reconstructive surgeries (n = 20, 24.4%) followed by excisional surgeries (n = 19, 23.2%) and drainage procedures (n = 11, 13.4%). Seven patients developed serious adverse reactions to anti-TB drugs. Five patients developed a thimble bladder with disabling storage symptoms. Eight patients had deranged renal functions at diagnosis and three patients developed progressive deterioration of renal function and two patients died of end stage renal disease. CONCLUSIONS The combination of urine for acid-fast bacilli, Mantoux test, CT-Urography, cystoscopy and histopathology is necessary to diagnose GUTB in resource-poor settings. Most ureteric strictures, non-functioning kidneys and epididymal masses need surgical treatment. Long-term follow up is essential to detect progressive deterioration of renal function.
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Affiliation(s)
- Umesh Jayarajah
- Department of Urology, Colombo South Teaching Hospital, No: B229 Hospital Road, Dehiwala, 10350 Sri Lanka
| | - Milan Gunawardene
- Department of Urology, Colombo South Teaching Hospital, No: B229 Hospital Road, Dehiwala, 10350 Sri Lanka
| | - Munipriya Willaraarachchi
- Department of Urology, Colombo South Teaching Hospital, No: B229 Hospital Road, Dehiwala, 10350 Sri Lanka
| | - Shirani Chandrasiri
- Department of Microbiology, Colombo South Teaching Hospital, Dehiwala, Sri Lanka
| | | | - Cherine Sosai
- Department of Pathology, Colombo South Teaching Hospital, Dehiwala, Sri Lanka
| | - Anuruddha Abeygunasekera
- Department of Urology, Colombo South Teaching Hospital, No: B229 Hospital Road, Dehiwala, 10350 Sri Lanka
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