1
|
Ene R, Dimitriu AL, Peride I, Țigliș M, Popescu EG, Georgescu EC, Neagu TP, Checherita IA, Niculae A. Giant Myxofibrosarcoma in the Lower Limb: An Overview of Diagnostic and Clinical Management. Diagnostics (Basel) 2024; 14:1298. [PMID: 38928713 PMCID: PMC11202561 DOI: 10.3390/diagnostics14121298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/08/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Myxofibrosarcoma (MFS), an aggressive soft tissue sarcoma, is one of the undifferentiated pleomorphic sarcomas; it has a low incidence, affecting people in the sixth to eighth decades of life. It usually involves the extremities and is painless with a slow-growing pattern. Based on the case of a 52-year-old female patient who presented with a painful, massive, rapid-growing, ulcerated tumor of the anterior surface of the left thigh, we performed a literature review regarding the current standard of care for patients with MFS. Computed tomography examination, followed by magnetic resonance imaging and surgical biopsy with histopathological examination, confirmed the diagnosis and the presence of lung and inguinal lymph node metastases. Due to the rapid-growing pattern and the local aggressiveness, our tumor board team recommended emergency excisional surgery, with subsequent reconstructive procedures followed by referral to an oncological center. This review emphasizes the importance of proper and rapid diagnosis, followed by multidisciplinary management, for MFS cases with atypical presentation and distal metastases to improve overall outcomes.
Collapse
Affiliation(s)
- Răzvan Ene
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Alexandru Lisias Dimitriu
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Ileana Peride
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Mirela Țigliș
- Department of Anesthesia and Intensive Care, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania
| | - Elisa Georgiana Popescu
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Eduard Cătălin Georgescu
- Clinical Department No. 14, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Tiberiu Paul Neagu
- Clinical Department No. 11, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | | | - Andrei Niculae
- Clinical Department No. 3, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| |
Collapse
|
2
|
Werenski JO, Gonzalez MR, Fourman MS, Hung YP, Lozano-Calderón SA. Does Wound VAC Temporization Offer Patient-Reported Outcomes Similar to Single-Stage Excision Reconstruction After Myxofibrosarcoma Resection? Ann Surg Oncol 2024; 31:2757-2765. [PMID: 38197999 DOI: 10.1245/s10434-023-14839-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 12/12/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Vacuum-assisted closure (VAC) temporization is a promising technique to achieve local control in aggressive soft tissue sarcomas. Despite its previously reported efficacy, adoption of VAC temporization remains limited, primarily due to the scarce literature on patient-reported outcomes (PROs) supporting its efficacy. This study compared the postoperative PROs after VAC temporization or single-stage (SS) excision and reconstruction for patients undergoing surgical resection for myxofibrosarcoma management. METHODS A retrospective analysis of myxofibrosarcoma patients who underwent surgical resections at our institution from 2016 to 2022 was performed. Postoperative PROs collected prospectively for those treated with VAC temporization or SS excision/reconstruction were compared using a visual analog scale (VAS) for pain and three Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires: Global Health Short-Form Mental (SF Mental), Global Health Short-Form Physical (SF Physical), and Physical Function Short-Form 10a (SF 10a). Absolute and differential (postoperative minus preoperative) scores at the 1-month, 3-month, 6-month, 1-year, and 2-year time points were compared. RESULTS The analysis included 79 patients (47 treated with VAC temporization and 32 treated with SS excision/reconstruction). All outcomes were similar between the groups except for physical function 1 year after surgery, in which the differential PROMIS SF 10a scores were higher in the SS group (p = 0.001). All the remaining absolute and differential PROMIS and VAS pain scores were similar between the groups at all time points. Postoperative complications did not differ between the groups. CONCLUSION The PROs for physical and mental health, physical function, and pain were similar between the myxofibrosarcoma patients who had VAC temporization and those who had SS excision/reconstruction after surgical resection.
Collapse
Affiliation(s)
- Joseph O Werenski
- Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Marcos R Gonzalez
- Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mitchell S Fourman
- Department of Orthopaedic Surgery, Montefiore-Einstein, New York, NY, USA
| | - Yin P Hung
- Division of Bone and Soft Tissue Pathology, Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Santiago A Lozano-Calderón
- Orthopaedic Oncology Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
3
|
Dahl V, Lee Y, Rate W, Guertin MP, Pretell-Mazzini J. Epidemiology and survival factors of appendicular myxofibrosarcoma: a SEER-retrospective study. Rep Pract Oncol Radiother 2024; 28:711-719. [PMID: 38515824 PMCID: PMC10954266 DOI: 10.5603/rpor.97733] [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: 05/17/2023] [Accepted: 10/02/2023] [Indexed: 03/23/2024] Open
Abstract
Background The low incidence of myxofibrosarcoma (MFS) makes high power studies difficult to perform. Demographic and prognostic factors for MFS and how they differ from all extremity soft tissue sarcomas (STS) are not well understood. The purpose of this study was to characterize a large cohort of patients with MFS and evaluate epidemiologic and survival factors when compared to all STS. Materials and methods We performed a retrospective review of the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2015 to identify 1,440 patients diagnosed with MFS and 12,324 with STS. Survival curves were creased using Kaplan-Meier, and Cox regression analyses were performed to identify hazard ratios (HRs). Results Overall survival was greater for STS than MFS (79% vs. 67%). Patients with MFS had a higher average age at diagnosis than STS (62 vs. 56), and older age was strongly associated with decreased survivorship for MFS (HR = 7.94). A greater proportion of patients under 30 diagnosed with MFS were female when compared to STS (49.6% vs. 45.4%). The incidence of MFS and STS increased over the 15-year period, with MFS increasing at a greater rate than STS (1.25% vs. 2.59%). Survival increased for patients diagnosed after 2008 for both STS (9.4%) and MFS (13.2%). Conclusions There are differences between patient demographics and survival factors when comparing MFS to all STS. Monitoring changes in demographic and survival trends for rare STS subtypes like MFS is important to improve diagnostic algorithms and treatment options.
Collapse
Affiliation(s)
- Victoria Dahl
- Miller School of Medicine, University of Miami, Miami, United States
| | - Yonghoon Lee
- Miller School of Medicine, University of Miami, Miami, United States
| | - William Rate
- Department of Orthopedic Surgery, Jackson Memorial Hospital, University of Miami, Miami, United States
| | | | - Juan Pretell-Mazzini
- Department of Orthopedic Oncology, Baptist Health South Florida, Miami, United States
| |
Collapse
|
4
|
Lun W, Luo C. Second primary colorectal cancer in adults: a SEER analysis of incidence and outcomes. BMC Gastroenterol 2023; 23:253. [PMID: 37495987 PMCID: PMC10373234 DOI: 10.1186/s12876-023-02893-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/18/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND At present, there was no large epidemiological study exploring the actual incidence and survival of second primary colorectal cancer (spCRC). The different characteristics and survival of patients with spCRC and initial primary colorectal cancer (ipCRC) still need to be elucidated. In addition, the factors leading to different survival status of spCRC and ipCRC were still unclear. Our study plan to explore the annual incidence trend of spCRC as well as the factors influencing the occurrence and survival outcome of spCRC. METHODS This cohort study analyzed the data of 4680 spCRC patients and 330,937 initial primary colorectal cancer (ipCRC) patients. Whether patients had spCRC and whether spCRC patients survived or died were regarded as outcomes. The annual incidence of spCRC from 2004 to 2016 was analyzed by Jointpoint regression analysis. The truncation points were found, and the annual percentage change (APC) of each segment was calculated to explore the trend of spCRC change in the United States. Univariate and multivariable cox regression analyses were conducted to identify factors associated with the occurrence and prognosis of spCRC patients. RESULTS The total incidence of spCRC was decreased during 2000-2016 on the whole. The overall incidence of spCRC was lowered in both males and females despite 2013-2014, in the left colon, right colon, rectum and others. The incidence of spCRC was decreased in both 18-49 years' people and ≥ 50 years' people during 2000-2016, and the incidence of spCRC in the ≥ 50 years' people group was higher than those of 18-49 years. Insured (OR = 0.867 (0.778-0.966), initial primary site of other digestive (OR = 0.46, 95%CI: 0.42-0.50), rectum (OR = 0.74, 95%CI: 0.66-0.82), or right colon (OR = 0.73, 95%CI: 0.68-0.79), N 1 stage (OR = 0.87, 95%CI: 0.76-0.99), M 1 stage (OR = 0.49, 95%CI: 0.30-0.80), AJCC II stage (OR = 0.70, 95%CI: 0.60-0.82), AJCC III stage (OR = 0.69, 95%CI: 0.56-0.84), and radiation (OR = 0.69, 95%CI: 0.57-0.83) were associated with the risk of spCRC. At the end of follow-up, 2,246 spCRC patients were survived and 2,434 spCRC patients were dead. Patients with spCRC had poor survival probability than patients with ipCRC. Older age (HR = 1.02, 95%CI: 1.02-1.03), male (HR = 1.13, 95%CI: 1.04-1.23), Black (HR = 1.20, 95%CI: 1.06-1.35), uninsured (HR = 1.36, 95%CI: 1.16-1.59), Signet ring cell carcinoma (HR = 1.64, 95%CI: 1.19-2.25), T4 stage (HR = 1.63, 95%CI: 1.32-2.01), N2 stage (HR = 1.36, 95%CI: 1.08-1.72), M1 stage (HR = 4.51, 95%CI: 2.00-10.18), AJCC III (HR = 1.47, 95%CI: 1.08-1.98), and radiation (HR = 1.82, 95%CI: 1.43-2.33) were associated with increased risk of mortality in spCRC patients. CONCLUSION The incidence of spCRC was decreased except in people with initial primary tumor grade IV and those aged 15-39 years. The overall survival of spCRC patients was lower than ipCRC patients. Cancer patients with older age, high tumor grade, TNM stage, and AJCC stage should be caution to the occurrence of spCRC and timely interventions should be provided for spCRC patients to improve their outcomes.
Collapse
Affiliation(s)
- Weijian Lun
- Gastroenterology department of The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, 120# Guidan Road, Nanhai District, Foshan, 528200, Guangdong Province, China.
| | - Canhua Luo
- Gastroenterology department of The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, 120# Guidan Road, Nanhai District, Foshan, 528200, Guangdong Province, China
| |
Collapse
|
5
|
Li X, Huo X, Zhao C, Chen Z, Xu Z, Yu J, Sun X. A novel chromatin regulator signature predicts the prognosis, clinical features and immunotherapy of colon cancer. Epigenomics 2022; 14:1325-1341. [PMID: 36545887 DOI: 10.2217/epi-2022-0266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Aim: To elucidate the potential function and prognostic value of chromatin regulators (CRs) in colon cancer. Materials & methods: A comprehensive analysis of CR RNA expression data from public databases was conducted. Results: The authors successfully established and validated a 17 CR-based signature using public databases. Ten CRs of the signature were eventually verified at the protein level using the Human Protein Atlas database. Functional enrichment showed that CRs were significantly enriched in cancer-related pathways. This signature was remarkably relevant to immune cell infiltration, immune checkpoints, tumor immune dysfunction and exclusion (TIDE) score and drug sensitivity. Conclusion: The authors identified a novel, reliable prognostic signature for colon cancer. The study provided new insights into the function of CRs and has important clinical implications for immunotherapy for colon cancer.
Collapse
Affiliation(s)
- Xiaopeng Li
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xiongwei Huo
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Chenye Zhao
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Zilu Chen
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Zhengshui Xu
- Department of Thoracic Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China
| | - Junhui Yu
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xuejun Sun
- Department of General Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| |
Collapse
|
6
|
Yu B, Tian Y, Zhang Y, Lv B, Li J, Gong S. Experimental verification and validation of immune biomarkers based on chromatin regulators in ischemic stroke. Front Genet 2022; 13:992847. [PMID: 36105086 PMCID: PMC9465164 DOI: 10.3389/fgene.2022.992847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 08/08/2022] [Indexed: 12/01/2022] Open
Abstract
Ischemic stroke (IS) is a disease characterized by rapid progression and high mortality and disability rates. Its pathophysiological process is inseparable from immune dysfunction. Recently, chromatin regulators (CRs) have been described as a class of enzymes that can recognize, form, and maintain the epigenetic state of an organism, and are closely associated with immune regulation. Nevertheless, the role of CR-related genes in IS has not been fully elucidated. In this study, seven CR-related immune biomarkers in the GSE58294 and GSE22255 datasets were identified by combining differential gene expression analysis, weighted correlation network analysis, and single sample gene set enrichment analysis. After experimental validation using quantitative polymerase chain reaction, four genes (DPF2, LMNB1, MLLT3, and JAK2) were screened as candidate immune biomarkers. These four biomarkers demonstrated good predictive power in the clinical risk model (area under the curve, 0.775). Molecular docking simulations revealed that mevastatin, WP1066, cladribine, trichostatin A, mequitazine, and zuclomiphene may be potential immunomodulatory drugs for IS. Overall, the results of this study contribute to the identification of CR-related immune therapeutics target in IS and provide an important reference for further research.
Collapse
Affiliation(s)
- Beibei Yu
- Department of Neurourgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
| | - Yunze Tian
- Department of Neurourgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
| | - Yongfeng Zhang
- Department of Neurourgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
| | - Boqiang Lv
- Department of Neurourgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
| | - Jianzhong Li
- Department of Thoracic Surgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
- *Correspondence: Jianzhong Li, ; Shouping Gong,
| | - Shouping Gong
- Department of Neurourgery, the Second Affiliated Hospital of Xi’an Jiao Tong University, Xi’an, China
- *Correspondence: Jianzhong Li, ; Shouping Gong,
| |
Collapse
|
7
|
Thiel JT, Daigeler A, Kolbenschlag J, Rachunek K, Hoffmann S. The Role of CDK Pathway Dysregulation and Its Therapeutic Potential in Soft Tissue Sarcoma. Cancers (Basel) 2022; 14:3380. [PMID: 35884441 PMCID: PMC9323700 DOI: 10.3390/cancers14143380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/07/2022] [Accepted: 07/09/2022] [Indexed: 02/04/2023] Open
Abstract
Soft tissue sarcomas (STSs) are tumors that are challenging to treat due to their pathologic and molecular heterogeneity and their tumor biology that is not yet fully understood. Recent research indicates that dysregulation of cyclin-dependent kinase (CDK) signaling pathways can be a strong driver of sarcogenesis. CDKs are enzyme forms that play a crucial role in cell-cycle control and transcription. They belong to the protein kinases group and to the serine/threonine kinases subgroup. Recently identified CDK/cyclin complexes and established CDK/cyclin complexes that regulate the cell cycle are involved in the regulation of gene expression through phosphorylation of critical components of transcription and pre-mRNA processing mechanisms. The current and continually growing body of data shows that CDKs play a decisive role in tumor development and are involved in the proliferation and growth of sarcoma cells. Since the abnormal expression or activation of large numbers of CDKs is considered to be characteristic of cancer development and progression, dysregulation of the CDK signaling pathways occurs in many subtypes of STSs. This review discusses how reversal and regulation can be achieved with new therapeutics and summarizes the current evidence from studies regarding CDK modulation for STS treatment.
Collapse
Affiliation(s)
- Johannes Tobias Thiel
- Department of Hand, Plastic, Reconstructive and Burn Surgery, BG Unfallklinik Tuebingen, University of Tuebingen, 72076 Tuebingen, Germany; (A.D.); (J.K.); (K.R.); (S.H.)
| | | | | | | | | |
Collapse
|