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Romero-Ruiz A, Granados-Rodríguez M, Bura FI, Valenzuela-Molina F, Rufián-Andújar B, Martínez-López A, Rodríguez-Ortiz L, Ortega-Salas R, Torres-Martínez M, Moreno-Serrano A, Castaño J, Michán C, Alhama J, Vázquez-Borrego MC, Arjona-Sánchez Á. Breaking the Mucin Barrier: A New Affinity Chromatography-Mass Spectrometry Approach to Unveil Potential Cell Markers and Pathways Altered in Pseudomyxoma Peritonei. Biol Proced Online 2024; 26:13. [PMID: 38750435 PMCID: PMC11094946 DOI: 10.1186/s12575-024-00239-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/25/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare peritoneal mucinous carcinomatosis with largely unknown underlying molecular mechanisms. Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy is the only therapeutic option; however, despite its use, recurrence with a fatal outcome is common. The lack of molecular characterisation of PMP and other mucinous tumours is mainly due to the physicochemical properties of mucin. RESULTS This manuscript describes the first protocol capable of breaking the mucin barrier and isolating proteins from mucinous tumours. Briefly, mucinous tumour samples were homogenised and subjected to liquid chromatography using two specific columns to reduce mainly glycoproteins, albumins and immunoglobulin G. The protein fractions were then subjected to mass spectrometry analysis and the proteomic profile obtained was analysed using various bioinformatic tools. Thus, we present here the first proteome analysed in PMP and identified a distinct mucin isoform profile in soft compared to hard mucin tumour tissues as well as key biological processes/pathways altered in mucinous tumours. Importantly, this protocol also allowed us to identify MUC13 as a potential tumour cell marker in PMP. CONCLUSIONS In sum, our results demonstrate that this protein isolation protocol from mucin will have a high impact, allowing the oncology research community to more rapidly advance in the knowledge of PMP and other mucinous neoplasms, as well as develop new and effective therapeutic strategies.
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Affiliation(s)
- Antonio Romero-Ruiz
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain.
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain.
| | - Melissa Granados-Rodríguez
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - Florina I Bura
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - Francisca Valenzuela-Molina
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Surgical Oncology Unit, Surgery Department, Reina Sofía University Hospital, Córdoba, Spain
| | - Blanca Rufián-Andújar
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Surgical Oncology Unit, Surgery Department, Reina Sofía University Hospital, Córdoba, Spain
| | - Ana Martínez-López
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Pathology Unit, HURS, Córdoba, Spain
| | - Lidia Rodríguez-Ortiz
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Surgical Oncology Unit, Surgery Department, Reina Sofía University Hospital, Córdoba, Spain
| | - Rosa Ortega-Salas
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Pathology Unit, HURS, Córdoba, Spain
| | - María Torres-Martínez
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - Ana Moreno-Serrano
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - Justo Castaño
- Department of Cell Biology, Physiology, and Immunology, University of Córdoba, Córdoba, Spain
- CIBER Fisiopatología de La Obesidad y Nutrición, Córdoba, Spain
| | - Carmen Michán
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - José Alhama
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
| | - Mari C Vázquez-Borrego
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain.
| | - Álvaro Arjona-Sánchez
- Maimonides Biomedical Research Institute of Córdoba, IMIBIC and University of Córdoba, Av. Menéndez Pidal, s/n, Córdoba, 14004, Spain
- Surgical Oncology Unit, Surgery Department, Reina Sofía University Hospital, Córdoba, Spain
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Villarejo Campos P, Vázquez-Borrego MC, Martínez-Quintanilla J, Cabot D, Romero-Ruíz A, Granados-Rodríguez M, Bura FI, García-Arranz M, García-Olmo D, Arjona-Sánchez A. Undetectable circulating tumor DNA confirms the inability of pseudomyxoma peritonei to systemic dissemination. Eur J Surg Oncol 2024; 50:108395. [PMID: 38735236 DOI: 10.1016/j.ejso.2024.108395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/25/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
The study of circulating tumor DNA (ctDNA) plays a pivotal role in advancing precision oncology, providing valuable information for individualized patient care and contributing to the ongoing effort to improve cancer diagnosis, treatment, and management. However, its applicability in pseudomyxoma peritonei (PMP) remains unexplored. In this multicenter retrospective study involving 21 PMP patients, we investigated ctDNA presence in peripheral blood using three distinct methodologies. Despite mucinous tumor tissues exhibiting KRAS and GNAS mutations, ctDNA for these mutations was undetectable in blood samples. In this pilot study, circulating tumor DNA was not detected in blood when the tumor harbored mutations of known significance. In the future, a study with a larger sample size is needed to confirm these findings and to determine whether ctDNA could identify patients at risk for early recurrence and/or systemic metastases.
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Affiliation(s)
- P Villarejo Campos
- IIS-FJD. UAM. Fundación Instituto de Investigación Sanitaria Fundación Jiménez Diaz, Madrid, Spain
| | - M C Vázquez-Borrego
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Córdoba, Spain
| | - J Martínez-Quintanilla
- Translational Program, Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - D Cabot
- Translational Program, Stem Cells and Cancer Laboratory, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - A Romero-Ruíz
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Córdoba, Spain
| | - M Granados-Rodríguez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Córdoba, Spain
| | - F I Bura
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Department of Biochemistry and Molecular Biology, University of Córdoba, Spain
| | - M García-Arranz
- IIS-FJD. UAM. Fundación Instituto de Investigación Sanitaria Fundación Jiménez Diaz, Madrid, Spain
| | - D García-Olmo
- IIS-FJD. UAM. Fundación Instituto de Investigación Sanitaria Fundación Jiménez Diaz, Madrid, Spain.
| | - A Arjona-Sánchez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain; Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.
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Rodríguez-Ortiz L, Vázquez-Borrego MC, Bura FI, Granados-Rodríguez M, Valenzuela-Molina F, Rufián-Andújar B, Martínez-López A, Ortega-Salas R, Espejo-Herrero JJ, Romero-Ruiz A, Arjona-Sánchez Á. Intra-tumoural bromelain and N-acetylcysteine for recurrent and unresectable pseudomyxoma peritonei: phase I/II trial. Br J Surg 2024; 111:znae045. [PMID: 38477594 DOI: 10.1093/bjs/znae045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Lidia Rodríguez-Ortiz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofía University Hospital, Córdoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
| | - Mari C Vázquez-Borrego
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
| | - Florina I Bura
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
| | - Melissa Granados-Rodríguez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
| | - Francisca Valenzuela-Molina
- Unit of Surgical Oncology, Department of Surgery, Reina Sofía University Hospital, Córdoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
| | - Blanca Rufián-Andújar
- Unit of Surgical Oncology, Department of Surgery, Reina Sofía University Hospital, Córdoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
| | - Ana Martínez-López
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Unit of Pathology, Reina Sofia University Hospital, Córdoba, Spain
| | - Rosa Ortega-Salas
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Unit of Pathology, Reina Sofia University Hospital, Córdoba, Spain
| | | | - Antonio Romero-Ruiz
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
- Department of Biochemistry and Molecular Biology, University of Córdoba, Córdoba, Spain
| | - Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofía University Hospital, Córdoba, Spain
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimónides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
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Valenzuela-Molina F, Bura FI, Vázquez-Borrego MC, Granados-Rodríguez M, Rufián-Andujar B, Rufián-Peña S, Casado-Adam Á, Sánchez-Hidalgo JM, Rodríguez-Ortiz L, Ortega-Salas R, Martínez-López A, Michán C, Alhama J, Arjona-Sánchez Á, Romero-Ruiz A. Intraoperative oxygen tension and redox homeostasis in Pseudomyxoma peritonei: A short case series. Front Oncol 2023; 13:1076500. [PMID: 36776312 PMCID: PMC9909963 DOI: 10.3389/fonc.2023.1076500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
Introduction Pseudomyxoma peritonei (PMP) is a rare malignant disease characterized by a massive multifocal accumulation of mucin within the peritoneal cavity. The current treatment option is based on complete cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy. However, the recurrence is frequent with subsequent progression and death. To date, most of the studies published in PMP are related to histological and genomic analyses. Thus, the need for further studies unveiling the underlying PMP molecular mechanisms is urgent. In this regard, hypoxia and oxidative stress have been extensively related to tumoral pathologies, although their contribution to PMP has not been elucidated. Methods In this manuscript, we have evaluated, for the first time, the intratumoral real-time oxygen microtension (pO2mt) in the tumor (soft and hard mucin) and surrounding healthy tissue from five PMP patients during surgery. In addition, we measured hypoxia (Hypoxia Inducible Factor-1a; HIF-1α) and oxidative stress (catalase; CAT) markers in soft and hard mucin from the same five PMP patient samples and in five control samples. Results The results showed low intratumoral oxygen levels, which were associated with increased HIF-1α protein levels, suggesting the presence of a hypoxic environment in these tumors. We also found a significant reduction in CAT activity levels in soft and hard mucin compared with healthy tissue samples. Discussion In conclusion, our study provides the first evidence of low intratumoral oxygen levels in PMP patients associated with hypoxia and oxidative stress markers. However, further investigation is required to understand the potential role of oxidative stress in PMP in order to find new therapeutic strategies.
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Affiliation(s)
- Francisca Valenzuela-Molina
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Florina I. Bura
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Mari C. Vázquez-Borrego
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain,*Correspondence: Álvaro Arjona Sánchez, ; Mari C. Vázquez Borrego,
| | - Melissa Granados-Rodríguez
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Blanca Rufián-Andujar
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Sebastián Rufián-Peña
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ángela Casado-Adam
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Juan Manuel Sánchez-Hidalgo
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Lidia Rodríguez-Ortiz
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rosa Ortega-Salas
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain,Pathology Unit, Reina Sofia University Hospital, Cordoba, Spain
| | - Ana Martínez-López
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain,Pathology Unit, Reina Sofia University Hospital, Cordoba, Spain
| | - Carmen Michán
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - José Alhama
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Álvaro Arjona-Sánchez
- Surgical Oncology Unit, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain,GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain,*Correspondence: Álvaro Arjona Sánchez, ; Mari C. Vázquez Borrego,
| | - Antonio Romero-Ruiz
- GE09 Research in peritoneal and retroperitoneal oncological surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
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5
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Arjona-Sánchez Á, Martínez-López A, Valenzuela-Molina F, Rufián-Andújar B, Rufián-Peña S, Casado-Adam Á, Sánchez-Hidalgo JM, Rodríguez-Ortiz L, Medina-Fernández FJ, Díaz-López C, Granados-Rodríguez M, Ortega-Salas R, Castaño JP, Tena-Sempere M, Briceño-Delgado J, Romero-Ruíz A. ASO Visual Abstract: A Proposal for Modification of PSOGI Classification According to Ki-67 Proliferation Index in Pseudomyxoma peritonei. Ann Surg Oncol 2021. [PMID: 34260007 DOI: 10.1245/s10434-021-10427-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain. .,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
| | - Ana Martínez-López
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.,Pathology Unit, Reina Sofia University Hospital, Cordoba, Spain
| | - Francisca Valenzuela-Molina
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Blanca Rufián-Andújar
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Sebastián Rufián-Peña
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Ángela Casado-Adam
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Juan Manuel Sánchez-Hidalgo
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Lidia Rodríguez-Ortiz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Francisco Javier Medina-Fernández
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Cesar Díaz-López
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Melissa Granados-Rodríguez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Rosa Ortega-Salas
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.,Pathology Unit, Reina Sofia University Hospital, Cordoba, Spain
| | - Justo P Castaño
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - Manuel Tena-Sempere
- CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute, Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - Javier Briceño-Delgado
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain
| | - Antonio Romero-Ruíz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
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6
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Arjona-Sánchez Á, Martínez-López A, Valenzuela-Molina F, Rufián-Andújar B, Rodríguez-Ortiz L, Granados-Rodríguez M, Romero-Ruíz A. ASO Author Reflections: Towards a Precision Medicine in Pseudomyxoma Peritonei. Ann Surg Oncol 2021; 29:137-138. [PMID: 34254212 DOI: 10.1245/s10434-021-10435-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 06/29/2021] [Indexed: 12/20/2022]
Affiliation(s)
- Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain. .,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.
| | - Ana Martínez-López
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain.,Pathology Unit, Reina Sofia University Hospital, Cordoba, Spain
| | - Francisca Valenzuela-Molina
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Blanca Rufián-Andújar
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Lidia Rodríguez-Ortiz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Melissa Granados-Rodríguez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Antonio Romero-Ruíz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Av. Menendez Pidal, s/n, 14004, Cordoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research, Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
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Arjona-Sánchez Á, Martínez-López A, Valenzuela-Molina F, Rufián-Andújar B, Rufián-Peña S, Casado-Adam Á, Sánchez-Hidalgo JM, Rodríguez-Ortiz L, Medina-Fernández FJ, Díaz-López C, Granados-Rodríguez M, Ortega-Salas R, Castaño JP, Tena-Sempere M, Briceño-Delgado J, Romero-Ruíz A. A Proposal for Modification of the PSOGI Classification According to the Ki-67 Proliferation Index in Pseudomyxoma Peritonei. Ann Surg Oncol 2021; 29:126-136. [PMID: 34215955 DOI: 10.1245/s10434-021-10372-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/15/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pseudomyxoma peritonei (PMP) is a rare malignancy, classified according to the Peritoneal Surface Oncology Group International (PSOGI) classification, whose response to treatment remains highly heterogeneous within the high-grade (HG) category. Molecular profiling of PMP cases might help to better categorize patients and predict treatment responses. METHODS We studied the Ki-67 proliferation rate and P53 overexpression in tissue samples from our historical cohort of HG-PMP patients. We established as cut-off levels the third quartile of each marker to perform univariate and multivariate Cox regression survival analyses. According to these results, the HG-PMP category was divided into subcategories and a new survival analysis was performed. RESULTS A total of 90/117 patients with PMP undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) were selected for secondary analysis. The survival analysis of the HG-PMP category for preoperative variables showed that a proliferation index defined by Ki-67 >15% is a bad prognostic factor, with a hazard ratio (HR) of 3.20 (95% confidence interval [CI] 1.24-8.25). Accordingly, the HG-PMP group was divided using the Ki-67 15% cut-off. The new PSOGI/Ki-67 variable was an independent prognostic factor for overall survival (OS), with an HR of 3.74 (95% CI 1.88-7.47), and disease-free survival (DFS), with an HR of 4.184 (95% CI 1.79-9.75). The estimated 5-year OS rate was 100%, 70% and 24% for the LG-PMP, HG-PMP ≤15% and HG-PMP >15% groups, respectively (p = 0.0001), while the 5-year DFS rate was 90%, 44% and 0%, respectively (p = 0.0001). CONCLUSION Division of the HG-PMP category of the PSOGI classification, according to the Ki-67 proliferation index, provides two well-defined subcategories, with significant differences in terms of OS and DFS, and hence high prognostic value.
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Affiliation(s)
- Álvaro Arjona-Sánchez
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain. .,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain.
| | - Ana Martínez-López
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain.,Pathology Unit, Reina Sofia University Hospital, Córdoba, Spain
| | - Francisca Valenzuela-Molina
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Blanca Rufián-Andújar
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Sebastián Rufián-Peña
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Ángela Casado-Adam
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Juan Manuel Sánchez-Hidalgo
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Lidia Rodríguez-Ortiz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Francisco Javier Medina-Fernández
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Cesar Díaz-López
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Melissa Granados-Rodríguez
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
| | - Rosa Ortega-Salas
- GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain.,Pathology Unit, Reina Sofia University Hospital, Córdoba, Spain
| | - Justo P Castaño
- CIBER Physiopathology of Obesity and Nutrition (CIBERobn), Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - Manuel Tena-Sempere
- CIBER Pathophysiology of Obesity and Nutrition, Carlos III Health Institute. Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Cordoba, Spain
| | - Javier Briceño-Delgado
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain
| | - Antonio Romero-Ruíz
- Unit of Surgical Oncology, Department of Surgery, Reina Sofia University Hospital, Córdoba, Spain.,GE09 Research in Peritoneal and Retroperitoneal Oncological Surgery, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, ReinaCórdoba, Spain
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