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Prime S, Schiff JP, Hosni A, Stanescu T, Dawson LA, Henke LE. The Use of MR-Guided Radiation Therapy for Liver Cancer. Semin Radiat Oncol 2024; 34:36-44. [PMID: 38105091 DOI: 10.1016/j.semradonc.2023.10.006] [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: 12/19/2023]
Abstract
The role of radiotherapy in the management of primary and metastatic liver malignancies has expanded in recent years due to advances such as IGRT and SBRT. MRI-guided radiotherapy (MRgRT) has arisen as an excellent option for the management of hepatocellular carcinoma, cholangiocarcinoma, and liver metastases due to the ability to combine improved hepatic imaging with conformal treatment planning paradigms like adaptive radiotherapy and advanced motion management techniques. Herein we review the data for MRgRT for liver malignancies, as well as describe workflow and technical considerations for the 2 commercially available MRgRT delivery platforms.
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Affiliation(s)
- Sabrina Prime
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - Joshua P Schiff
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - Ali Hosni
- Radiation Medicine Program, Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Teodor Stanescu
- Radiation Medicine Program, Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Laura A Dawson
- Radiation Medicine Program, Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Lauren E Henke
- University Hospitals/Case Western Reserve University, Department of Radiation Oncology, Cleveland, OH.
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2
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Xuan M, Gu X, Li J, Huang D, Xue C, He Y. Polyamines: their significance for maintaining health and contributing to diseases. Cell Commun Signal 2023; 21:348. [PMID: 38049863 PMCID: PMC10694995 DOI: 10.1186/s12964-023-01373-0] [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: 08/26/2023] [Accepted: 10/29/2023] [Indexed: 12/06/2023] Open
Abstract
Polyamines are essential for the growth and proliferation of mammalian cells and are intimately involved in biological mechanisms such as DNA replication, RNA transcription, protein synthesis, and post-translational modification. These mechanisms regulate cellular proliferation, differentiation, programmed cell death, and the formation of tumors. Several studies have confirmed the positive effect of polyamines on the maintenance of health, while others have demonstrated that their activity may promote the occurrence and progression of diseases. This review examines a variety of topics, such as polyamine source and metabolism, including metabolism, transport, and the potential impact of polyamines on health and disease. In addition, a brief summary of the effects of oncogenes and signaling pathways on tumor polyamine metabolism is provided. Video Abstract.
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Affiliation(s)
- Mengjuan Xuan
- Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, 450052, Henan, China
| | - Xinyu Gu
- Department of Oncology, College of Clinical Medicine, The First Affiliated Hospital, Henan University of Science and Technology, Luoyang, 471000, Henan, China
| | - Juan Li
- Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, 450052, Henan, China
| | - Di Huang
- Department of Child Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, Henan, China
| | - Chen Xue
- Department of Infectious Disease, The First Affiliated Hospital of Zhengzhou University, No. 1 Jianshe East Road, Erqi District, Zhengzhou, 450052, Henan, China.
| | - Yuting He
- Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, Henan, China.
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3
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Zhang Y, Gabere M, Tylor MA, Simoes CC, Dumbauld C, Barro O, Tesfay MZ, Graham AL, Ferdous KU, Savenka AV, Chamcheu JC, Washam CL, Alkam D, Gies A, Byrum SD, Conti M, Post SR, Kelly T, Borad MJ, Cannon MJ, Basnakian A, Nagalo BM. Repurposing live attenuated trivalent MMR vaccine as cost-effective cancer immunotherapy. Front Oncol 2022; 12:1042250. [DOI: 10.3389/fonc.2022.1042250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/12/2022] [Indexed: 11/10/2022] Open
Abstract
It has long been known that oncolytic viruses wield their therapeutic capability by priming an inflammatory state within the tumor and activating the tumor immune microenvironment, resulting in a multifaceted antitumor immune response. Vaccine-derived viruses, such as measles and mumps, have demonstrated promising potential for treating human cancer in animal models and clinical trials. However, the extensive cost of manufacturing current oncolytic viral products makes them far out of reach for most patients. Here by analyzing the impact of intratumoral (IT) administrations of the trivalent live attenuated measles, mumps, and rubella viruses (MMR) vaccine, we unveil the cellular and molecular basis of MMR-induced anti-cancer activity. Strikingly, we found that IT delivery of low doses of MMR correlates with tumor control and improved survival in murine hepatocellular cancer and colorectal cancer models via increased tumor infiltration of CD8+ granzyme B+ T-cells and decreased macrophages. Moreover, our data indicate that MMR activates key cellular effectors of the host’s innate and adaptive antitumor immunity, culminating in an immunologically coordinated cancer cell death. These findings warrant further work on the potential for MMR to be repurposed as safe and cost-effective cancer immunotherapy to impact cancer patients globally.
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Erkent M, Aydın HO, Tezcaner T, Avcı T, Kavasoğlu L, Ayvazoğlu Soy EH, Yıldırım S, Haberal M. Comparison of Mortality Rates in Patients Waiting for Liver Transplant and Patients With Colorectal Metastatic Tumors. EXP CLIN TRANSPLANT 2022; 20:273-278. [PMID: 35352633 DOI: 10.6002/ect.2021.0452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We aimed to identify outcomes of liver surgery in patients with hepatocellular carcinoma and colorectal cancer, which result in primary and secondary liver tumors. MATERIALS AND METHODS Our study included 51 patients with colorectal cancer and liver metastases and 63 patients with hepatocellular carcinoma who were prepared for liver transplant due to cirrhosis who underwent hepatic resection or local ablation treatments; patients were seen between January 2011 and December 2021. RESULTS Most patients with colorectal cancer were men (58.8%). Mean age was 65.76 ± 13.818 years (range, 27-88 y). Most patients had planned, elective surgery (86.3%). Neoadjuvant chemotherapy was administered to 58.8% of patients. The most common location of metastasis in the liver was in the right lobe (43.1%), and the most common surgery was low anterior resection (17 patients). During simultaneous liver surgery, 31 patients required metastasectomy and 7 patients required radiofrequency ablation plus metastasectomy. No deaths occurred in the early posttransplant period, and cumulative survival was 82.624 ± 7.962 months. Disease-free survival was 45.2 ± 7.495 months. Most patients with hepatocellular carcinoma were men (82.5%). Mean age was 58.73 ± 17.428 years. Hepatocellular carcinoma lesions were mostly located in both the right and left lobes (23.8%). In the hepatocellular cancer group, 60.3% had transarterial chemoembolization and 42.9% had radiofrequency ablation. The primary surgical resection was metastasectomy (17.9%) because of multiple localized lesions. Median follow-up was 22 months (range, 1-126 mo). Overall survival was 101.898 ± 7.169 months, with 10-year overall survival of 38%. Disease-free survival was 74.081 ± 8.732 months, with 1-year and 5-year disease-free survival of 90.5% and 54%. CONCLUSIONS Better survival was shown in patients with hepatocellular carcinoma than in patients with colorectal cancer.Therefore, more aggressive treatment options, as used in hepatocellular carcinoma, including liver transplant, may be options for patients with colorectal cancer.
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Affiliation(s)
- Murathan Erkent
- From the Department of General Surgery, Medical School, Baskent University, Ankara
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5
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Loosen SH, Heise D, Dejong CH, Roy S, Tacke F, Trautwein C, Roderburg C, Luedde T, Neumann UP, Binnebösel M. Circulating Levels of Osteopontin Predict Patients' Outcome after Resection of Colorectal Liver Metastases. J Clin Med 2018; 7:jcm7110390. [PMID: 30373147 PMCID: PMC6262509 DOI: 10.3390/jcm7110390] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 02/07/2023] Open
Abstract
For colorectal liver metastases (CRLM), surgical resection is the only potentially curative therapy, but even successfully resected patients often face disease recurrence, leading to 5-year survival rate below 50%. Despite available preoperative stratification strategies, it is not fully elucidated which patients actually benefit from CRLM resection. Here we evaluated osteopontin, a secreted glyco-phosphoprotein, as a biomarker in the context of CRLM resection. Tissue levels of osteopontin were analysed in CRLM using reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry. Pre- and postoperative osteopontin serum concentrations were analysed by enzyme-linked immunosorbent assay (ELISA) in 125 patients undergoing resection of CRLM as well as 65 healthy controls. Correlating with an upregulation of osteopontin tissue expression in CRLM, osteopontin serum levels were significantly elevated in patients with CRLM compared to healthy controls. Importantly, high pre- and post-operative osteopontin serum levels were associated with a poor prognosis after tumour resection. Patients with initial osteopontin serum levels above our ideal cut-off value of 264.4 ng/mL showed a significantly impaired median overall survival of 304 days compared to 1394 days for patients with low osteopontin levels. Together, our data suggest a role of osteopontin as a prognostic biomarker in patients with resectable CRLM that might help to identify patients who particularly benefit from liver resection.
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Affiliation(s)
- Sven H Loosen
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Daniel Heise
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Cees H Dejong
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52062 Aachen, Germany.
- Department of Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
| | - Sanchari Roy
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Frank Tacke
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Christian Trautwein
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Christoph Roderburg
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Tom Luedde
- Department of Medicine III, University Hospital RWTH Aachen, 52062 Aachen, Germany.
- Division of Gastroenterology, Hepatology and Hepatobiliary Oncology, University Hospital RWTH Aachen, 52062 Aachen, Germany.
| | - Ulf P Neumann
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52062 Aachen, Germany.
- Department of Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
| | - Marcel Binnebösel
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52062 Aachen, Germany.
- Department of Surgery, Maastricht University Medical Centre, 6229 HX Maastricht, The Netherlands.
- Department of General and Visceral Surgery, Klinikum Bielefeld, 33604 Bielefeld, Germany.
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6
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McCluney SJ, Giakoustidis AA, Segler A, Bissel J, Miller RL, Valente R, Hutchins RR, Abraham A, Bhattacharya S, Kocher HM. Predicting complications in hepatic resection for colorectal liver metastasis: the lymphocyte-to-monocyte ratio. ANZ J Surg 2018; 88:E782-E786. [PMID: 30014560 DOI: 10.1111/ans.14725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/01/2018] [Accepted: 05/05/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND Colorectal cancer is one of the most common malignancies worldwide; whilst approximately 20% of patients have hepatic disease at presentation. Hepatic resection remains the gold standard of care; however, it is associated with significant morbidity. We sought to establish whether the lymphocyte-to-monocyte ratio (LMR) could help predict post-operative complications, thus improving patient outcomes. METHODS We performed a retrospective cohort study of patients undergoing hepatic resection at a single centre. Baseline demographics and complications within 30 days following surgery were recorded. White blood cell counts and C-reactive protein (CRP) were recorded pre-operatively, and until post-operative day 7. RESULTS A total of 188 operations were included. About 47.3% of resections had a complicated recovery, of which 31.46% were major. The median LMR was 1.29 across the cohort, 1.60 for uncomplicated procedures, 1.14 for those with complications and 0.85 in major complications. For detecting major complications versus an uncomplicated recovery, median LMR was the best parameter (area under the curve 0.78), whilst it was the only parameter to accurately predict such complications within 48 hours of surgery (area under the curve 0.72 on day 1). It was consistently the most accurate parameter at detecting uncomplicated versus complicated recovery, minor versus major complications, and major complications versus an uncomplicated recovery, at numerous timepoints over the post-operative period. CONCLUSION The LMR appears better at predicting complications following hepatic resection for colorectal liver metastases, as opposed to conventionally measured parameters.
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Affiliation(s)
- Simon J McCluney
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK.,Barts Cancer Institute, Queen Mary University of London, London, UK
| | - Alexandros A Giakoustidis
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Angela Segler
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Juliane Bissel
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Robert L Miller
- The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Roberto Valente
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Robert R Hutchins
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Ajit Abraham
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Satyajit Bhattacharya
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Hemant M Kocher
- Barts and The London HPB Centre, Department of Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK.,Barts Cancer Institute, Queen Mary University of London, London, UK
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7
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Wang C, Ruan P, Zhao Y, Li X, Wang J, Wu X, Liu T, Wang S, Hou J, Li W, Li Q, Li J, Dai F, Fang D, Wang C, Xie S. Spermidine/spermine N1-acetyltransferase regulates cell growth and metastasis via AKT/β-catenin signaling pathways in hepatocellular and colorectal carcinoma cells. Oncotarget 2018; 8:1092-1109. [PMID: 27901475 PMCID: PMC5352037 DOI: 10.18632/oncotarget.13582] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 11/12/2016] [Indexed: 01/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) and colorectal cancer (CRC) are among the most common cancers across the world. Therefore, identifying the potential molecular mechanisms that promote HCC and CRC progression and metastasis are urgently needed. Spermidine/spermine N1-acetyltransferase (SSAT) is a catabolic enzyme that acetylates the high-order polyamines spermine and spermidine, thus decreasing the cellular content of polyamines. Several publications have suggested that depletion of intracellular polyamines inhibited tumor progression and metastasis in various cancer cells. However, whether and how SSAT regulates cell growth, migration and invasion in hepatocellular and colorectal carcinoma cells remains unclear. In this study, depletion of polyamines mediated by SSAT not only attenuated the tumor cell proliferation but also dramatically inhibited cell migration and invasion in hepatocellular and colorectal carcinoma cells. Subsequent investigations revealed introduction of SSAT into HepG2, SMMC7721 hepatocellular carcinoma cells and HCT116 colorectal carcinoma cells significantly suppressed p-AKT, p-GSK3β expression as well as β-catenin nuclear translocation, while inhibition of GSK3β activity or exogenous polyamines could restore SSAT-induced decreases in the protein expression of p-AKT, p-GSK3β and β-catenin. Conversely, knockdown of SSAT in Bel7402 hepatocellular carcinoma cells and HT-29 colorectal carcinoma cells which expressed high levels of SSAT endogenously significantly promoted the expression of p-AKT, p-GSK3β as well as β-catenin nuclear translocation. Taken together, our results indicated depletion of polyamines by SSAT significantly inhibited cell proliferation, migration and invasion through AKT/GSK3β/β-catenin signaling pathway in hepatocellular carcinoma and colorectal cancer cells.
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Affiliation(s)
- Cong Wang
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Ping Ruan
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Ying Zhao
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Xiaomin Li
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Jun Wang
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Xiaoxiao Wu
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Tong Liu
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Shasha Wang
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Jiuzhou Hou
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Wei Li
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Qian Li
- The Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, 475004, China
| | - Jinghua Li
- The Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, 475004, China
| | - Fujun Dai
- The Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, 475004, China
| | - Dong Fang
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
| | - Chaojie Wang
- The Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, 475004, China
| | - Songqiang Xie
- Institute of Chemical Biology, College of Pharmacy, Henan University, Kaifeng, 475004, China
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Rao C, Smith F, Martin A, Dhadda A, Stewart A, Gollins S, Collins B, Athanasiou T, Sun Myint A. A Cost-Effectiveness Analysis of Contact X-ray Brachytherapy for the Treatment of Patients with Rectal Cancer Following a Partial Response to Chemoradiotherapy. Clin Oncol (R Coll Radiol) 2018; 30:166-177. [DOI: 10.1016/j.clon.2017.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 10/07/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
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9
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Current Trends on the Treatment Sequence for Colorectal Cancer with Liver Metastases. CURRENT COLORECTAL CANCER REPORTS 2018. [DOI: 10.1007/s11888-018-0402-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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10
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Liu Q, Hao L, Lou Z, Gao X, Gong H, Hong Y, Fu C, Zhang W. Survival time and prognostic factors of patients with initial noncurative colorectal liver metastases. Medicine (Baltimore) 2017; 96:e8831. [PMID: 29390420 PMCID: PMC5758122 DOI: 10.1097/md.0000000000008831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 10/08/2017] [Accepted: 11/01/2017] [Indexed: 02/07/2023] Open
Abstract
The true survival benefit of different curative strategies involving type of operative procedure and timing for patients with initial noncurative colorectal liver metastases remains uncertain. The goal of this study was to examine the effect of primary tumor resection on patients' survival and to clarify the predictive factors related to overall survival (OS).This was a retrospective study that included 219 patients with initial noncurative colorectal liver metastases without extrahepatic disease. The clinicopathological characteristics of patients and their survival were examined. Survival analysis was performed using the Kaplan-Meier method. All variables associated with P <.05 in univariate analysis were included in multivariate analysis using a Cox proportional-hazard regression model.The 1-, 3-, 5-year OS rates of patients with simultaneous liver resection were 79.1%, 39.1%, and 28.4%, respectively, and those of patients with staged liver resection were 83.3%, 46.7%, and 36.8%, respectively (P = .380). The 1-, 3-, 5-year OS rates of patients with primary tumor resection were 57.0%, 18.2%, and 12.3%, respectively, while for the patients without primary tumor resection were 38.9%, 5.6%, and 0%, respectively (P = .012). Independent prognostic factors for OS were carbohydrate antigen19-9, primary tumor resection, tumor differentiation, and adjuvant chemotherapy.No difference in OS was observed between simultaneous liver resection and staged liver resection, while primary tumor resection was beneficial to noncurative colorectal liver metastases.
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Affiliation(s)
- Qizhi Liu
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Liqiang Hao
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Zheng Lou
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Xianhua Gao
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Haifeng Gong
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Yonggang Hong
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
| | - Chuangang Fu
- Department of Colorectal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei Zhang
- Department of Colorectal Surgery, Changhai Hospital, Second Military Medical University
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Chen HH, Lin JK, Chen JB, Chuang CH, Liu MC, Wang JY, Changchien CR. Neoadjuvant therapy of bevacizumab in combination with oxaliplatin and capecitabine (XELOX) for patients with metastatic colorectal cancer with unresectable liver metastases: a phase II, open-label, single-arm, noncomparative trial. Asia Pac J Clin Oncol 2017; 14:61-68. [DOI: 10.1111/ajco.12692] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/30/2017] [Indexed: 12/17/2022]
Affiliation(s)
| | - Jen-Kou Lin
- Taipei Veterans General Hospital; Taipei Taiwan
| | - Joe-Bin Chen
- Taichung Veterans General Hospital; Taichung Taiwan
| | | | - Mei-Ching Liu
- Koo Foundation Sun Yat-Sen Cancer Center; Taipei Taiwan
| | - Jen-Yi Wang
- Chang Gung Memorial Hospital; Chai-Yi Taiwan
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12
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Reyes A, Marti J, Marfà S, Jiménez W, Reichenbach V, Pelegrina A, Fondevila C, Garcia Valdecasas JC, Fuster J. Prognostic prediction by liver tissue proteomic profiling in patients with colorectal liver metastases. Future Oncol 2017; 13:875-882. [PMID: 28088872 DOI: 10.2217/fon-2016-0461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
AIM To obtain proteomic profiles in patients with colorectal liver metastases (CRLM) and identify the relationship between profiles and the prognosis of CRLM patients. MATERIALS & METHODS Prognosis prediction (favorable or unfavorable according to Fong's score) by a classification and regression tree algorithm of surface-enhanced laser desorption/ionization TOF-MS proteomic profiles from cryopreserved CRLM (patients) and normal liver tissue (controls). RESULTS The protein peak 7371 m/z showed the clearest differences between CRLM and control groups (94.1% sensitivity, 100% specificity, p < 0.001). The algorithm that best differentiated favorable and unfavorable groups combined 2970 and 2871 m/z protein peaks (100% sensitivity, 90% specificity). CONCLUSION Proteomic profiling in liver samples using classification and regression tree algorithms is a promising technique to differentiate healthy subjects from CRLM patients and to classify the severity of CRLM patients.
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Affiliation(s)
- Adalgiza Reyes
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Josep Marti
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Santiago Marfà
- Biochemistry & Molecular Genetics Service, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Wladimiro Jiménez
- Biochemistry & Molecular Genetics Service, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain.,Physiological Sciences Department I, University of Barcelona, Casanova, 143, 08036, Barcelona, Spain
| | - Vedrana Reichenbach
- Biochemistry & Molecular Genetics Service, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Amalia Pelegrina
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Constantino Fondevila
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Juan Carlos Garcia Valdecasas
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
| | - Josep Fuster
- Liver Surgery & Transplantation Unit, Department of Surgery, ICMDM, Hospital Clinic, IDIBAPS, CIBERehd, Villarroel, 170, 08036, Barcelona, Spain
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Abstract
BACKGROUND Radical surgery is associated with significant perioperative mortality in elderly and comorbid populations. Emerging data suggest for patients with a clinical complete response after neoadjuvant chemoradiotherapy that a watch-and-wait approach may provide equivalent survival and oncological outcomes. OBJECTIVE The purpose of this study was to compare the cost-effectiveness of watch and wait and radical surgery for patients with rectal cancer after a clinical complete response following chemoradiotherapy. DESIGN Decision analytical modeling and a Markov simulation were used to model long-term costs, quality-adjusted life-years, and cost-effectiveness after watch and wait and radical surgery. Sensitivity analysis was used to investigate the effect of uncertainty in model parameters. SETTINGS A third-party payer perspective was adopted. PATIENTS Patients included in the study were a 60-year-old male cohort with no comorbidities, 80-year-old male cohorts with no comorbidities, and 80-year-old male cohorts with significant comorbidities. INTERVENTIONS Radical surgery and watch-and-wait approaches were studied. MAIN OUTCOME MEASURES Incremental cost, effectiveness, and cost-effectiveness ratio over the entire lifetime of the hypothetical patient cohorts were measured. RESULTS Watch and wait was more effective (60-year-old male cohort with no comorbidities = 0.63 quality-adjusted life-years (95% CI, 2.48-3.65 quality-adjusted life-years); 80-year-old male cohort with no comorbidities = 0.56 quality-adjusted life-years (95% CI, 0.52-1.59 quality-adjusted life-years); 80-year-old male cohort with significant comorbidities = 0.72 quality-adjusted life-years (95% CI, 0.34-1.76 quality-adjusted life-years)) and less costly (60-year-old male cohort with no comorbidities = $11,332.35 (95% CI, $668.50-$23,970.20); 80-year-old male cohort with no comorbidities = $8783.93 (95% CI, $2504.26-$21,900.66); 80-year-old male cohort with significant comorbidities = $10,206.01 (95% CI, $2762.014-$24,135.31)) independent of patient cohort age and comorbidity. Consequently, watch and wait was more cost-effective with a high degree of certainty (range, 69.6%-89.2%) at a threshold of $50,000/quality-adjusted life-year. LIMITATIONS Long-term outcomes were derived from modeled cohorts. Analysis was performed for a United Kingdom third-party payer perspective, limiting generalizability to other healthcare contexts. CONCLUSIONS Watch and wait is likely to be cost-effective compared with radical surgery. These findings strongly support the discussion of organ-preserving strategies with suitable patients.
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Reiter MJ, Hannemann NP, Schwope RB, Lisanti CJ, Learn PA. Role of imaging for patients with colorectal hepatic metastases: what the radiologist needs to know. ACTA ACUST UNITED AC 2016. [PMID: 26194812 DOI: 10.1007/s00261-015-0507-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Surgical resection of colorectal metastatic disease has increased as surgeons have adopted a more aggressive ideology. Current exclusion criteria are patients for whom a negative resection margin is not feasible or a future liver remnant (FLR) of greater than 20% is not achievable. The goal of preoperative imaging is to identify the number and distribution of liver metastases, in addition to establishing their relation to relevant intrahepatic structures. FLR can be calculated utilizing cross-sectional imaging to select out patients at risk for hepatic dysfunction after resection. MRI, specifically with gadoxetic acid contrast, is currently the preferred modality for assessment of hepatic involvement for patients with newly diagnosed colorectal cancer, to include those who have undergone neoadjuvant chemotherapy. Employment of liver-directed therapies has recently expanded and they may provide an alternative to hepatectomy in order to obtain locoregional control in poor surgical candidates or convert patients with initially unresectable disease into surgical candidates.
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Affiliation(s)
- Michael J Reiter
- Department of Radiology, Stony Brook University Medical Center, HSC Level 4, Room 120 East Loop Road, Stony Brook, NY, 11794, USA.
| | - Nathan P Hannemann
- Department of Radiology, Brooke Army Medical Center, San Antonio, TX, USA
| | - Ryan B Schwope
- Department of Radiology, Brooke Army Medical Center, San Antonio, TX, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Christopher J Lisanti
- Department of Radiology, Brooke Army Medical Center, San Antonio, TX, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Peter A Learn
- Department of Surgery, Brooke Army Medical Center, San Antonio, TX, USA
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15
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PS341 inhibits hepatocellular and colorectal cancer cells through the FOXO3/CTNNB1 signaling pathway. Sci Rep 2016; 6:22090. [PMID: 26915315 PMCID: PMC4768146 DOI: 10.1038/srep22090] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 02/05/2016] [Indexed: 12/13/2022] Open
Abstract
Hepatocellular carcinoma (HCC) and colorectal cancer (CRC) are among the most common cancers across the world. Particularly, a large number of patients with CRC also have liver metastasis. Currently, there are just a few targeted drugs against these two kinds of tumors which can only benefit a very small population of patients. Therefore, the need of more effective therapeutic drugs or strategies for these two types of cancers is urgent. PS341 (Bortezomib) is the first proteasome inhibitor drug which has been approved in clinical treatment for multiple myeloma. Here we demonstrated that PS341 negatively regulated HCC and CRC both in vitro and in vivo, including the inhibition of cell proliferation, epithelial-mesenchymal transition (EMT), the expression of stemness-related genes, cell migration and invasiveness. Mechanically, PS341 upregulated the expression of FOXO3, which inhibited the transcriptional activation of CTNNB1. The downregualtion of CTNNB1 led to apoptosis, cell cycle arrest, and the inhibition of migration, invasion, self-renewal and tumor formation of these two cancer types. In sum, our findings shed light on the PS341 mediated targeted therapy against both HCC and CRC in the future.
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16
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Joensuu H, Reichardt P, Eriksson M, Sundby Hall K, Vehtari A. Gastrointestinal stromal tumor: a method for optimizing the timing of CT scans in the follow-up of cancer patients. Radiology 2013; 271:96-103. [PMID: 24475826 DOI: 10.1148/radiol.13131040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To develop a mathematical model to adjust the timing of computed tomography (CT) scans with the hazard of cancer recurrence in time to facilitate early detection of cancer recurrence. MATERIALS AND METHODS The clinical data were extracted from the randomized Scandinavian Sarcoma Group (SSG) XVIII/Arbeitsgemeinschaft Internistische Onkologie (AIO) trial database. The SSG XVIII/AIO trial was registered (trial no. NCT00116935) and approved by the national or institutional review boards. In the trial, 1- and 3-year durations of adjuvant imatinib mesylate in the treatment of patients with gastrointestinal stromal tumor (GIST) were compared. A nonhomogeneous Poisson model with a piecewise log-constant hazard in time that accounts for the nonlinear pattern of GIST recurrence was applied to tumor site, mitotic count, and recurrence data. The optimal times to obtain follow-up CT scans were computed by modifying the frequency of CT scans with the hazard of tumor recurrence in time. The hazard-adjusted follow-up schedules were compared with the National Comprehensive Cancer Network (NCCN) guidelines of the United States, which suggest imaging with CT at intervals of 3-6 months for 3-5 years and then annually. RESULTS Optimized timing of CT scans on the basis of hazard of recurrence resulted in follow-up schedule options where CT is performed more sparsely than in the NCCN guidelines during adjuvant imatinib administration and more frequently, at approximately 3-month intervals, during the first 2 years that follow imatinib discontinuation when the risk of recurrence was the greatest. The number of CT scans could be reduced by a median of 31% (from 13 to nine) compared with the standard schedules within the first 6 years of follow-up without increasing the delay in recurrence detection. CONCLUSION Detection of GIST recurrence may be enhanced by adjusting the timing of the CT scans with the hazard of recurrence. The method may be applicable to other human tumor types. Online supplemental material is available for this article.
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Affiliation(s)
- Heikki Joensuu
- From the Department of Oncology, Helsinki University Central Hospital, Haartmaninkatu 4, PO Box 180, FIN-00029 Helsinki, Finland (H.J.); Sarkomzentrum Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin, Germany (P.R.); Department of Oncology, Skåne University Hospital, Lund University, Lund, Sweden (M.E.); Department of Oncology, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway (K.S.H.); and Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland (A.V.)
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