Incidence and Survival Outcomes of Breast Cancer with Synchronous Hepatic Metastases: A Population-Based Study

Evaluation of liver metastasis in patients with breast cancer: Comparison of single-phase abdominopelvic CT and multi-phase liver CT

PURPOSE

To compare the usefulness of multi-phase liver CT and single-phase abdominopelvic CT (APCT) in evaluating liver metastasis in newly diagnosed breast cancer patients.

METHODS

In this retrospective study, a total of 7621 newly diagnosed breast cancer patients (mean age, 49.7 years ± 10.1; 7598 women) who underwent single-phase APCT (n = 5536) or multi-phase liver CT (n = 2085) for staging workup between January 2016 and June 2019 were included. The staging CTs were categorized as having no metastasis, probable metastasis, or indeterminate lesions. MRI referral rate (proportion of patients underwent additional liver MRI), negative MRI rate (patients without true hepatic metastasis / patients underwent liver MRI), true positive CT rate (patients with true metastasis / patients categorized as probable metastasis), true metastasis rate among CT indeterminate (patients with true metastasis / patients categorized as indeterminate lesions), and overall liver metastasis rate were compared between the two groups. Further, the radiation dose was recorded for every patient.

RESULTS

The proportions of having no metastasis and indeterminate lesions on the results of CT interpretation were significantly different between the two groups (P = 0.006). However, the MRI referral rate, negative MR rate, true positive CT rate, true metastasis rate among CT indeterminate, and overall liver metastasis rate were not significantly different between the two groups. Radiation dose of multi-phase CT was three times higher than that of single-phase CT.

CONCLUSION

Multi-phase liver CT has little benefit over single-phase APCT in assessing liver metastasis in patients with breast cancer.

Targeting Hypoxic Tumors with Hybrid Nanobullets for Oxygen-Independent Synergistic Photothermal and Thermodynamic Therapy

Hypoxia is a feature of solid tumors and it hinders the therapeutic efficacy of oxygen-dependent cancer treatment. Herein, we have developed all-organic oxygen-independent hybrid nanobullets ZPA@HA-ACVA-AZ for the "precise strike" of hypoxic tumors through the dual-targeting effects from surface-modified hyaluronic acid (HA) and hypoxia-dependent factor carbonic anhydrase IX (CA IX)-inhibitor acetazolamide (AZ). The core of nanobullets is the special zinc (II) phthalocyanine aggregates (ZPA) which could heat the tumor tissues upon 808-nm laser irradiation for photothermal therapy (PTT), along with the alkyl chain-functionalized thermally decomposable radical initiator ACVA-HDA on the side chain of HA for providing oxygen-independent alkyl radicals for ablating hypoxic cancer cells by thermodynamic therapy (TDT). The results provide important evidence that the combination of reverse hypoxia hallmarks CA IX as targets for inhibition by AZ and synergistic PTT/TDT possess incomparable therapeutic advantages over traditional (reactive oxygen species (ROS)-mediated) cancer treatment for suppressing the growth of both hypoxic tumors and their metastasis.

Risk factors and survival outcomes of laryngeal squamous cell carcinoma patients with lung metastasis: A population-based study

OBJECTIVE

It remains elusive which factors may influence the morbidity and mortality of lung metastasis (LM) in Laryngeal Squamous Cell Carcinoma (LSCC) patients. The aim of the present study was to investigate factors influencing LM and the survival outcomes of LSCC patients with LM.

METHODS

We identified 10,935 patients with LSCC from 2010 to 2014 using the Surveillance, Epidemiology and End Results database. Multivariate logistic regression analysis was used to determine the factors associated with the presence of LM. Multivariate cox regression analysis was used to identify covariates associated with increased all-cause mortality in patients with LM.

RESULTS

Among 10,935 patients with LSCC, 232 (2.12%) patients had LM. The median survival time of patients with LM was 8 months, and 8.37% of patients survived after 3 years. Patients with age ≥ 60 years old, unmarried status, supraglottis, overlapping lesion of larynx, subglottis, pathological grade III, T4 stage, N1 stage, N2 stage, N3 stage and bone, brain or liver metastases were more likely to have LM. Survival analysis showed that chemotherapy and radiotherapy suggested better survival of LSCC patients with LM while pathological grade IV was associated with an increased all-cause mortality.

CONCLUSION

The incidence of LSCC patients with LM varied by age, married status, and tumor subtypes. LSCC patients with LM had poor survival, and only 8.37% of patients survived after 3 years. However, chemotherapy and radiotherapy were found as independent favorable prognostic factors for survival.

Immunogenic-cell-killing and immunosuppression-inhibiting nanomedicine

Combining chemo-therapeutics with immune checkpoint inhibitors facilitates killing cancer cells and activating the immune system through inhibiting immune escape. However, their treatment effects remain limited due to the compromised accumulation of both drugs and inhibitors in certain tumor tissues. Herein, a new poly (acrylamide-co-acrylonitrile-co-vinylimidazole-co-bis(2-methacryloyl) oxyethyl disulfide) (PAAVB) polymer-based intelligent platform with controllable upper critical solution temperature (UCST) was used for the simultaneous delivery of paclitaxel (PTX) and curcumin (CUR). Additionally, a hyaluronic acid (HA) layer was coated on the surface of PAAVB NPs to target the CD44-overexpressed tumor cells. The proposed nanomedicine demonstrated a gratifying accumulation in tumor tissue and uptake by cancer cells. Then, the acidic microenvironment and high level of glutathione (GSH) in cancer cells could spontaneously decrease the UCST of polymer, leading to the disassembly of the NPs and rapid drug release at body temperature without extra-stimuli. Significantly, the released PTX and CUR could induce the immunogenic cell death (ICD) to promote adaptive anti-tumor immunogenicity and inhibit immunosuppression through suppressing the activity of indoleamine 2,3-dioxygenase 1 (IDO1) enzyme respectively. Therefore, the synergism of this intelligent nanomedicine can suppress primary breast tumor growth and inhibit their lung metastasis.

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A new copolymer PAAVB was prepared with pH- and GSH- controllable upper critical solution temperature (UCST) properties.

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A nano-platform with PAAVB copolymer core and HA shell was developed and showed the capability to deliver PTX and CUR.

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The antitumor immune response was synergistically stimulated by PTX-induced ICD and CUR induced IDO1activity suppression.

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The synergism of intelligent nanomedicine could suppress the primary breast tumor growth and inhibit their lung metastasis.