Pub Date : 2022-01-24DOI: 10.31487/j.cor.2022.01.01
John M. Baust, Kimberly L. Santucci, Kristi K. Snyder, A. Robilotto, John G. Baust, R. V. Van Buskirk, Thomas J. Polascik
The 5-year survival rate for localized kidney cancer is 93%, but only 13% for those presenting with metastatic disease (2019 SEER data). Cryosurgery is an established treatment modality for renal cell cancer (RCC), with outcomes showing equipoise to radiofrequency ablation (RFA) and partial nephrectomy. Sorafenib is a targeted therapy for RCC utilized in more advanced stage diseases. Given the success of both cryoablation and sorafenib as monotherapies for RCC, in this study, we investigated the cellular response of RCC to combinatorial sorafenib pre-treatment and cryoablation in vitro using cell culture and tissue-engineered tumor models. In vitro samples were exposed to a single or repeat (double) 5-minute freeze at -10°C, -15°C, or -20°C representing temperatures within the periphery of a cryolesion. A repeat freeze to -20°C was necessary to fully ablate samples yielding day 1 viability of 2.9% (±0.2) with no recovery observed over the 7 days post-treatment culture. These findings were consistent with published data on the lethal temperature in RCC, suggesting that -25°C is necessary to destroy RCC following a single freeze event. Pre-treatment of samples with sorafenib at concentrations of 10.61 and 21.21 µM (½ clinical and clinical dose, respectively) was combined with a single or repeat 5-minute freeze to -10°C, -15°C, or -20°C. At the time of drug removal (day 0/pre-freeze), 10.61 µM sorafenib treated samples yielded 25.3% (±0.4) viability, yet samples regrew to control levels by day 7. Following combination freeze and sorafenib exposure, sample viability was found to be 27.5% (±0.7), 2.9% (±0.4), and 0.2% (±0.02) following a single freeze and 15.6% (±0.5), 0.7% (±0.1), and 0.1% (±0.01) following a repeat (double freeze), respectively. Regrowth was observed over the 7-day assessment period in samples exposed to a -10°C single or double freeze and a -15°C single freeze, but not in the -20°C single freeze or -15°C double freeze conditions. Thus, pre-treatment with 10.61 µM sorafenib was found to increase the minimum lethal temperature from the reported -25°C to -20°C following a single freeze event and from -20°C to -15°C following a double freeze. Results of the cell culture studies were confirmed in the 3D tissue-engineered tumor model, wherein the combination of 10.61 µM sorafenib and freezing was found to further increase the lethal temperature from <-20°C to -15°C following a single freeze event. This increased freeze susceptibility yielded a 32% improvement in the overall ablative volume of the ice ball following combinatorial treatment versus freezing alone. These in vitro results suggest that the combination of sorafenib and cryoablation may provide a possible combinatorial treatment path for RCC.
{"title":"In Vitro Investigation of Renal Cell Carcinoma Response to Combination Sorafenib and Cryoablation Treatment","authors":"John M. Baust, Kimberly L. Santucci, Kristi K. Snyder, A. Robilotto, John G. Baust, R. V. Van Buskirk, Thomas J. Polascik","doi":"10.31487/j.cor.2022.01.01","DOIUrl":"https://doi.org/10.31487/j.cor.2022.01.01","url":null,"abstract":"The 5-year survival rate for localized kidney cancer is 93%, but only 13% for those presenting with metastatic disease (2019 SEER data). Cryosurgery is an established treatment modality for renal cell cancer (RCC), with outcomes showing equipoise to radiofrequency ablation (RFA) and partial nephrectomy. Sorafenib is a targeted therapy for RCC utilized in more advanced stage diseases. Given the success of both cryoablation and sorafenib as monotherapies for RCC, in this study, we investigated the cellular response of RCC to combinatorial sorafenib pre-treatment and cryoablation in vitro using cell culture and tissue-engineered tumor models. In vitro samples were exposed to a single or repeat (double) 5-minute freeze at -10°C, -15°C, or -20°C representing temperatures within the periphery of a cryolesion. A repeat freeze to -20°C was necessary to fully ablate samples yielding day 1 viability of 2.9% (±0.2) with no recovery observed over the 7 days post-treatment culture. These findings were consistent with published data on the lethal temperature in RCC, suggesting that -25°C is necessary to destroy RCC following a single freeze event. Pre-treatment of samples with sorafenib at concentrations of 10.61 and 21.21 µM (½ clinical and clinical dose, respectively) was combined with a single or repeat 5-minute freeze to -10°C, -15°C, or -20°C. At the time of drug removal (day 0/pre-freeze), 10.61 µM sorafenib treated samples yielded 25.3% (±0.4) viability, yet samples regrew to control levels by day 7. Following combination freeze and sorafenib exposure, sample viability was found to be 27.5% (±0.7), 2.9% (±0.4), and 0.2% (±0.02) following a single freeze and 15.6% (±0.5), 0.7% (±0.1), and 0.1% (±0.01) following a repeat (double freeze), respectively. Regrowth was observed over the 7-day assessment period in samples exposed to a -10°C single or double freeze and a -15°C single freeze, but not in the -20°C single freeze or -15°C double freeze conditions. Thus, pre-treatment with 10.61 µM sorafenib was found to increase the minimum lethal temperature from the reported -25°C to -20°C following a single freeze event and from -20°C to -15°C following a double freeze. Results of the cell culture studies were confirmed in the 3D tissue-engineered tumor model, wherein the combination of 10.61 µM sorafenib and freezing was found to further increase the lethal temperature from <-20°C to -15°C following a single freeze event. This increased freeze susceptibility yielded a 32% improvement in the overall ablative volume of the ice ball following combinatorial treatment versus freezing alone. These in vitro results suggest that the combination of sorafenib and cryoablation may provide a possible combinatorial treatment path for RCC.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85055112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-31DOI: 10.31487/j.cor.2021.11.01
Ioana Maria Ion, Anca Badoiu, E. Thouvenot, Morgane Petot, V. Boudousq
Multiple paraneoplastic syndromes are a rare clinical manifestation. We describe the case of an 82-year-old woman who presented with neurological (rapidly progressive cerebellar syndrome and combined sensory-motor neuronopathy) and rheumatological (palmar fasciitis and polyarthritis syndrome) paraneoplastic syndromes associated with two onconeural antibodies (anti-Yo and Zic4), that revealed an ovarian cancer. The involvement of multiple organ systems should be a clue to take into consideration a paraneoplastic etiology that could permit early detection of cancer. However, despite the existence of treatments, the prognosis of these conditions remains poor.
{"title":"Multiple Paraneoplastic Neurological and Rheumatological Syndromes Revealing an Ovarian Cancer","authors":"Ioana Maria Ion, Anca Badoiu, E. Thouvenot, Morgane Petot, V. Boudousq","doi":"10.31487/j.cor.2021.11.01","DOIUrl":"https://doi.org/10.31487/j.cor.2021.11.01","url":null,"abstract":"Multiple paraneoplastic syndromes are a rare clinical manifestation. We describe the case of an 82-year-old woman who presented with neurological (rapidly progressive cerebellar syndrome and combined sensory-motor neuronopathy) and rheumatological (palmar fasciitis and polyarthritis syndrome) paraneoplastic syndromes associated with two onconeural antibodies (anti-Yo and Zic4), that revealed an ovarian cancer. The involvement of multiple organ systems should be a clue to take into consideration a paraneoplastic etiology that could permit early detection of cancer. However, despite the existence of treatments, the prognosis of these conditions remains poor.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91047461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-12-29DOI: 10.31487/j.cor.2021.12.01
Bao‐an Chen, Yi Zhu, Fei Wang, Xue Wu
Objective: To investigate the prognostic factors of adult acute myeloid leukemia (AML). Methods: A total of 51 patients with AML initially treated in Zhongda Hospital affiliated to Southeast University in the past 7 years were selected to investigate the gender, age (60-year-old) and WBC count (>=30*109/L), whether there is a history of MDS and other factors related to survival rate. Results: The results showed that age and the history of MDS prodrome were independent prognostic factors affecting OS. The OS rates of CD19 negative, CD11b positive and CD64 negative patients were significantly lower than those without the above factors at the onset of the disease, and the differences were statistically significant (all P<0.05). Conclusion: The prognosis of AML patients is affected by multiple factors, so prognosis should be stratified according to risk factors, and appropriate chemotherapy regimens should be selected for patients of different age groups.
{"title":"Factors Influencing the Prognosis of Acute Myeloid Leukemia","authors":"Bao‐an Chen, Yi Zhu, Fei Wang, Xue Wu","doi":"10.31487/j.cor.2021.12.01","DOIUrl":"https://doi.org/10.31487/j.cor.2021.12.01","url":null,"abstract":"Objective: To investigate the prognostic factors of adult acute myeloid leukemia (AML). \u0000Methods: A total of 51 patients with AML initially treated in Zhongda Hospital affiliated to Southeast University in the past 7 years were selected to investigate the gender, age (60-year-old) and WBC count (>=30*109/L), whether there is a history of MDS and other factors related to survival rate.\u0000Results: The results showed that age and the history of MDS prodrome were independent prognostic factors affecting OS. The OS rates of CD19 negative, CD11b positive and CD64 negative patients were significantly lower than those without the above factors at the onset of the disease, and the differences were statistically significant (all P<0.05).\u0000Conclusion: The prognosis of AML patients is affected by multiple factors, so prognosis should be stratified according to risk factors, and appropriate chemotherapy regimens should be selected for patients of different age groups.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89502575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-11DOI: 10.31487/j.cor.2021.10.03
F. M. Fernández-Gordón Sánchez, E. Gómez Domínguez, C. Garfia Castillo, Jorge Arroyo Andres, L. Robles Díaz, Y. Rodríguez Gil
Immunotherapy with checkpoint inhibitors is associated with termed inflammatory and immune-related side effects (irAE). Upper gastrointestinal symptoms are infrequent and appear mainly in patients on combination therapy with two checkpoint inhibitor drugs. We present the case of a patient with IIIB stage cutaneous melanoma treated with Nivolumab in monotherapy who developed an immune-mediated gastritis. Histopathologically, due to the paucity of published cases, no specific pattern of Nivolumab-immune-mediated gastritis has been described. We have reviewed the literature and compared the histopathology of the cases available in the literature.
{"title":"In Search of a Histopathological Pattern of Immune-Mediated Gastritis from Nivolumab Therapy: A Case Report with Literature Review","authors":"F. M. Fernández-Gordón Sánchez, E. Gómez Domínguez, C. Garfia Castillo, Jorge Arroyo Andres, L. Robles Díaz, Y. Rodríguez Gil","doi":"10.31487/j.cor.2021.10.03","DOIUrl":"https://doi.org/10.31487/j.cor.2021.10.03","url":null,"abstract":"Immunotherapy with checkpoint inhibitors is associated with termed inflammatory and immune-related side effects (irAE). Upper gastrointestinal symptoms are infrequent and appear mainly in patients on combination therapy with two checkpoint inhibitor drugs. We present the case of a patient with IIIB stage cutaneous melanoma treated with Nivolumab in monotherapy who developed an immune-mediated gastritis. Histopathologically, due to the paucity of published cases, no specific pattern of Nivolumab-immune-mediated gastritis has been described. We have reviewed the literature and compared the histopathology of the cases available in the literature.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86867932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-28DOI: 10.31487/j.cor.2020.10.04
S. Macías-Díaz, Ana Lilia Castruita Avila, J. G. Reinoso Toledo, M. García Carrasco
Background: Vitamin D deficiency has been associated with not achieving a complete pathological response in patients with breast cancer after neoadjuvant chemotherapy. The objective of this study was to determine whether vitamin D deficiency is associated with tumor response failure in patients with breast cancer operated and who received neoadjuvant chemotherapy. Materials and Methods: This was a prospective, cross-sectional, analytical and observational study. Vitamin D was measured in patients with breast cancer who had received neoadjuvant chemotherapy and its association with tumor response was determined. For the inferential analysis, the Student’s t-test, chi-square test, and Fisher’s exact test were used. A p value <0.05 was considered statistically significant. Results: Thirty-six patients were included. There was tumor response failure to treatment in 69.3% and vitamin D deficiency occurred in 58.3%. No association was found between vitamin D deficiency and tumor response failure (p = 0.729), histological type (p = 0.691), molecular profile (p = 0.969), clinical stage (p = 0.468) or menopause status (p = 0.701). Conclusion: Vitamin D deficiency is not associated with tumor response failure in breast cancer patients who received neoadjuvant chemotherapy.
{"title":"Vitamin D Deficiency and Tumor Response Failure in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy at a Medical Center in Mexico","authors":"S. Macías-Díaz, Ana Lilia Castruita Avila, J. G. Reinoso Toledo, M. García Carrasco","doi":"10.31487/j.cor.2020.10.04","DOIUrl":"https://doi.org/10.31487/j.cor.2020.10.04","url":null,"abstract":"Background: Vitamin D deficiency has been associated with not achieving a complete pathological response in patients with breast cancer after neoadjuvant chemotherapy. The objective of this study was to determine whether vitamin D deficiency is associated with tumor response failure in patients with breast cancer operated and who received neoadjuvant chemotherapy.\u0000Materials and Methods: This was a prospective, cross-sectional, analytical and observational study. Vitamin D was measured in patients with breast cancer who had received neoadjuvant chemotherapy and its association with tumor response was determined. For the inferential analysis, the Student’s t-test, chi-square test, and Fisher’s exact test were used. A p value <0.05 was considered statistically significant.\u0000Results: Thirty-six patients were included. There was tumor response failure to treatment in 69.3% and vitamin D deficiency occurred in 58.3%. No association was found between vitamin D deficiency and tumor response failure (p = 0.729), histological type (p = 0.691), molecular profile (p = 0.969), clinical stage (p = 0.468) or menopause status (p = 0.701).\u0000Conclusion: Vitamin D deficiency is not associated with tumor response failure in breast cancer patients who received neoadjuvant chemotherapy.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81025960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-15DOI: 10.31487/j.cor.2021.08.11
N. Baskaran, S. Vignesh, V. Chandrasekar
Biomarkers are substances that are either secreted by the tumor or produced by the body in response to the presence of cancer. Biomarkers serve as an objective measure for evaluation of normal and pathological processes as well as pharmacological responses to a therapeutic intervention. Cancer studies are usually difficult to interpret, especially based on the contemporary medical diagnosis. In this circumstance, biomarkers are developing as reliable diagnostic metabolites, which have many promising applications in oncological screening, differential diagnosis, risk assessment, response to treatment, and examining the progression of disease. Genome or protein based prognostic biomarkers are available, for numerous cancer types, for potential inclusion into clinical prognostic staging methods. However, there lies difficulty in translating these biomarkers into clinical outcomes. This review concerns important biomarkers related to wide varieties of cancer and also elucidates mode of action of few major biomarkers.
{"title":"Biochemical and Molecular Diagnostic Indicators for Cancer","authors":"N. Baskaran, S. Vignesh, V. Chandrasekar","doi":"10.31487/j.cor.2021.08.11","DOIUrl":"https://doi.org/10.31487/j.cor.2021.08.11","url":null,"abstract":"Biomarkers are substances that are either secreted by the tumor or produced by the body in response to the presence of cancer. Biomarkers serve as an objective measure for evaluation of normal and pathological processes as well as pharmacological responses to a therapeutic intervention. Cancer studies are usually difficult to interpret, especially based on the contemporary medical diagnosis. In this circumstance, biomarkers are developing as reliable diagnostic metabolites, which have many promising applications in oncological screening, differential diagnosis, risk assessment, response to treatment, and examining the progression of disease. Genome or protein based prognostic biomarkers are available, for numerous cancer types, for potential inclusion into clinical prognostic staging methods. However, there lies difficulty in translating these biomarkers into clinical outcomes. This review concerns important biomarkers related to wide varieties of cancer and also elucidates mode of action of few major biomarkers.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"10 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91442094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-13DOI: 10.31487/j.cor.2021.09.06
K. Iqbal, Noreen Amjad, S. Butt, Fajar Rafi Ranjha, S. Minhas, Q. Shamsi
Purpose: The study of clinical effectiveness of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and organs at risk (OARs) evaluation. A retrospective study was conducted to assess the heart and ipsilateral lung V30 for DIBH technique and to compare with free breathing (FB) technique. Clinical data shows that by increasing the inhalation amplitude value (cm), the maximum heart distance decreases in the treatment field. Materials and Methods: Thirty left-sided breast and chest wall patients were CT scanned on 4DCT with DIBH. These patients were chosen for the DIBH technique with the ability to hold their breath for more than 20 seconds. Radiotherapy of these patients was planned using field-in-field planning technique, and OAR doses were observed using the institutionally specified DIBH protocol. Results: The mean heart dose was less than 3Gy. Whereas V2Gy and V10Gy were less than 30% and 5%. The mean ipsilateral lung dose was 7.59 Gy. Ipsilateral lung V30 was less than 25% with ±10% margins. It is found that by increasing the inhaling amplitude (cm) heart involvement in the tangential treatment field decreases. Conclusion: DIBH is an easy and highly efficient treatment technique for reducing the mean dose of the heart and V30 of ipsilateral lung. The maximum heart distance decreases as the baseline of inhalation increases due to heart doses.
{"title":"Deep-Inspirational Breath-Hold (DIBH) Technique in Left-Sided Breast Cancer: An Institutional Review","authors":"K. Iqbal, Noreen Amjad, S. Butt, Fajar Rafi Ranjha, S. Minhas, Q. Shamsi","doi":"10.31487/j.cor.2021.09.06","DOIUrl":"https://doi.org/10.31487/j.cor.2021.09.06","url":null,"abstract":"Purpose: The study of clinical effectiveness of deep-inspirational breath-hold (DIBH) in left breast cancer radiotherapy (RT) was aimed at focusing on dosimetry and organs at risk (OARs) evaluation. A retrospective study was conducted to assess the heart and ipsilateral lung V30 for DIBH technique and to compare with free breathing (FB) technique. Clinical data shows that by increasing the inhalation amplitude value (cm), the maximum heart distance decreases in the treatment field.\u0000Materials and Methods: Thirty left-sided breast and chest wall patients were CT scanned on 4DCT with DIBH. These patients were chosen for the DIBH technique with the ability to hold their breath for more than 20 seconds. Radiotherapy of these patients was planned using field-in-field planning technique, and OAR doses were observed using the institutionally specified DIBH protocol.\u0000Results: The mean heart dose was less than 3Gy. Whereas V2Gy and V10Gy were less than 30% and 5%. The mean ipsilateral lung dose was 7.59 Gy. Ipsilateral lung V30 was less than 25% with ±10% margins. It is found that by increasing the inhaling amplitude (cm) heart involvement in the tangential treatment field decreases.\u0000Conclusion: DIBH is an easy and highly efficient treatment technique for reducing the mean dose of the heart and V30 of ipsilateral lung. The maximum heart distance decreases as the baseline of inhalation increases due to heart doses.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79939976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-29DOI: 10.31487/j.cor.2021.10.01
Bruno Soriano Pignataro, Emne Ali Abdallah, Vinicius Fernando Calsavara, Celso Abdon Lopes Mello, K. Nishinari, Guilherme Yazbek, L. T. Domingos Chinen
Background: Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in oncology patients. There are no accurate risk assessment tools to predict venous thromboembolism (VTE). Circulating tumor cells (CTCs), circulating tumor microemboli (CTM), and high platelet-lymphocyte ratio (PLR) may predispose to VTE. Objective: To evaluate correlations of CTCs, CTM, and PLR with VTE and progression-free survival (PFS) in gastric cancer patients. Methods: Patients with gastric cancer were recruited (March 2016 to April 2017). CTCs were assayed by ISET at two timepoints: before neoadjuvant treatment (CTC1) and after surgery/before adjuvant therapy (CTC2) for patients with localized disease, and before first-line chemotherapy (CTC1) and after 6 months (CTC2) for patients with metastases. VTE incidence was determined retrospectively. PFS was estimated by Kaplan-Meier analysis. Results: We studied 93 patients. According to Khorana scores, 63 (67.7%) patients were at intermediate and 30 (32.3%) were at high risk for VTE. VTE incidence was 20.4% and CTM were found in 39.8%. VTE developed in 7/37 (18.9%) CTM-positive and in 11/50 (22%) CTM-negative patients (p=0.93). When PLR >288, VTE occurred in 7/14 patients (p=0.005). PLR also associated with poor PFS (p<0.0001). CTC2 was associated with poor PFS (p<0.0001). CTC2, PLR and VTE were independent prognostic factors for PFS (p=0.005, 0.043, and <0.0001 respectively). Conclusion: PLR is a prognostic indicator for PFS and for VTE in gastric cancer. Neither CTC, nor CTM improved risk stratification for VTE in our population.
{"title":"Platelet-Lymphocyte Ratio, Circulating Tumor Cells and Circulating Tumor Microemboli as Predictors of Thrombosis in Patients with Gastric Cancer","authors":"Bruno Soriano Pignataro, Emne Ali Abdallah, Vinicius Fernando Calsavara, Celso Abdon Lopes Mello, K. Nishinari, Guilherme Yazbek, L. T. Domingos Chinen","doi":"10.31487/j.cor.2021.10.01","DOIUrl":"https://doi.org/10.31487/j.cor.2021.10.01","url":null,"abstract":"Background: Cancer-associated thrombosis (CAT) is a major cause of morbidity and mortality in oncology patients. There are no accurate risk assessment tools to predict venous thromboembolism (VTE). Circulating tumor cells (CTCs), circulating tumor microemboli (CTM), and high platelet-lymphocyte ratio (PLR) may predispose to VTE. \u0000Objective: To evaluate correlations of CTCs, CTM, and PLR with VTE and progression-free survival (PFS) in gastric cancer patients.\u0000Methods: Patients with gastric cancer were recruited (March 2016 to April 2017). CTCs were assayed by ISET at two timepoints: before neoadjuvant treatment (CTC1) and after surgery/before adjuvant therapy (CTC2) for patients with localized disease, and before first-line chemotherapy (CTC1) and after 6 months (CTC2) for patients with metastases. VTE incidence was determined retrospectively. PFS was estimated by Kaplan-Meier analysis.\u0000Results: We studied 93 patients. According to Khorana scores, 63 (67.7%) patients were at intermediate and 30 (32.3%) were at high risk for VTE. VTE incidence was 20.4% and CTM were found in 39.8%. VTE developed in 7/37 (18.9%) CTM-positive and in 11/50 (22%) CTM-negative patients (p=0.93). When PLR >288, VTE occurred in 7/14 patients (p=0.005). PLR also associated with poor PFS (p<0.0001). CTC2 was associated with poor PFS (p<0.0001). CTC2, PLR and VTE were independent prognostic factors for PFS (p=0.005, 0.043, and <0.0001 respectively).\u0000Conclusion: PLR is a prognostic indicator for PFS and for VTE in gastric cancer. Neither CTC, nor CTM improved risk stratification for VTE in our population.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83322158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-29DOI: 10.31487/j.cor.2021.09.02
Ihsan Ceceli, S. Ceylan
Sinonasal undifferentiated carcinoma is a rare malignancy of the head and neck region. Its diagnosis and treatment are difficult due to its rare and aggressive tumor nature and the complex anatomy of its localization. A 70-year-old male who presented with symptoms caused by this rare tumor was reported. The patient presented with pain on the left side of the head and vision loss in the left eye for 1 month, and his endoscopic biopsy was reported as undifferentiated carcinoma. This case report aimed to discuss the diagnosis and treatment of sinonasal undifferentiated carcinoma.
{"title":"A Rare Malignancy of Head And Neck Region: Sinonasal Undifferentiated Carcinoma","authors":"Ihsan Ceceli, S. Ceylan","doi":"10.31487/j.cor.2021.09.02","DOIUrl":"https://doi.org/10.31487/j.cor.2021.09.02","url":null,"abstract":"Sinonasal undifferentiated carcinoma is a rare malignancy of the head and neck region. Its diagnosis and treatment are difficult due to its rare and aggressive tumor nature and the complex anatomy of its localization. A 70-year-old male who presented with symptoms caused by this rare tumor was reported. The patient presented with pain on the left side of the head and vision loss in the left eye for 1 month, and his endoscopic biopsy was reported as undifferentiated carcinoma. This case report aimed to discuss the diagnosis and treatment of sinonasal undifferentiated carcinoma.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81254924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-29DOI: 10.31487/j.cor.2021.09.04
N. Subramaniam, K. Parthasarathi, K. Cheng, D. Leinkram, D. Howes, J. Wykes, S. Ch’ng, Tsu-Hui (Hubert) Low, C. Palme, Jonathan Robert Clark
Background: Virtual surgical planning (VSP) helps optimize vascularized bone flap reconstruction and dental rehabilitation in maxillomandibular defects, improving accuracy, reducing errors and reducing the time required for surgery. In this manuscript, we describe a robust but flexible virtual protocol for functional maxillomandibular reconstruction optimized for oral cancer patients using in-house digital planning and provide templates to streamline communication among the team members. Methods: Based on our previous experience of VSP in oral cancer (n=17), we derived a workflow to improve efficiency. It included a virtual surgical template and a protocol focused on the minimal time requirements for three different reconstructive approaches: prefabrication/prelamination, primary implant placement using the SM-ART approach, and digital planning without primary implant placement. We performed a prospective validation (n=4) to determine its validity and if the proposed timelines could be adhered to. Results: The protocol allowed a smooth and coordinated framework for team members to communicate and plan the patient’s treatment. The time period required for VSP was described for patients undergoing bony reconstruction with primary dental placement in those with and without custom plates, drill guides and for patients with prefabrication (Rohner’s procedure). The minimum time required for VSP ranged between 17 and 30 days. The protocol could be reliably applied to the prospective group without any modification. Conclusion: Bony reconstruction with primary dental implant placement in the context of oral cancer can be performed successfully with good functional outcomes. By adopting this protocol, virtual surgical planning can be performed efficiently, avoiding potentially costly delays in treatment.
{"title":"Establishing A Virtual Planning Protocol for Functional Maxillomandibular Reconstruction in Oral Cancer Patients","authors":"N. Subramaniam, K. Parthasarathi, K. Cheng, D. Leinkram, D. Howes, J. Wykes, S. Ch’ng, Tsu-Hui (Hubert) Low, C. Palme, Jonathan Robert Clark","doi":"10.31487/j.cor.2021.09.04","DOIUrl":"https://doi.org/10.31487/j.cor.2021.09.04","url":null,"abstract":"Background: Virtual surgical planning (VSP) helps optimize vascularized bone flap reconstruction and dental rehabilitation in maxillomandibular defects, improving accuracy, reducing errors and reducing the time required for surgery. In this manuscript, we describe a robust but flexible virtual protocol for functional maxillomandibular reconstruction optimized for oral cancer patients using in-house digital planning and provide templates to streamline communication among the team members. \u0000Methods: Based on our previous experience of VSP in oral cancer (n=17), we derived a workflow to improve efficiency. It included a virtual surgical template and a protocol focused on the minimal time requirements for three different reconstructive approaches: prefabrication/prelamination, primary implant placement using the SM-ART approach, and digital planning without primary implant placement. We performed a prospective validation (n=4) to determine its validity and if the proposed timelines could be adhered to. \u0000Results: The protocol allowed a smooth and coordinated framework for team members to communicate and plan the patient’s treatment. The time period required for VSP was described for patients undergoing bony reconstruction with primary dental placement in those with and without custom plates, drill guides and for patients with prefabrication (Rohner’s procedure). The minimum time required for VSP ranged between 17 and 30 days. The protocol could be reliably applied to the prospective group without any modification. \u0000Conclusion: Bony reconstruction with primary dental implant placement in the context of oral cancer can be performed successfully with good functional outcomes. By adopting this protocol, virtual surgical planning can be performed efficiently, avoiding potentially costly delays in treatment.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"216 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76591883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}