Pub Date : 2020-08-17DOI: 10.31487/j.cor.2020.08.03
F. Bruns, Anne Caroline Knöchelmann, C. Henkenberens, H. Christiansen
Background: To assess the efficacy of two reminder interventions in improving post-radiotherapy followup attendance rates of breast cancer patients. Methods: Three periods of three months were assessed, a baseline period, an intervention period and a confirmation period. In the intervention period, a two-step reminder system was used. This system consisted of a mail reminder (IV1) that was sent to all patients three to four weeks prior to the post-radiotherapy follow-up visit, which was followed by up to two telephone calls (IV2) for all patients who did not attend this follow-up visit. During the confirmation period, IV2 was used exclusively to assess the maximal possible efficacy of the telephone reminder. Results: The non-attendance rate of breast cancer patients was 18.1% (19/105) in the baseline period; this rate decreased to 13.1% in the intervention period (23/176; p=0.33) after IV1 and then decreased to 6.3% (11/176; p=0.03) after IV2. In the confirmation period, 24.4% (42/172) of breast cancer patients did not attend their post-radiotherapy follow-up visit; the non-attendance rate decreased significantly after (exclusive) IV2 from 24.4% (42/172) to 9.3% (16/172; p<0.001). Significance was observed for the first call but not for the second call in the chi-square test. Conclusion: Telephone reminder is an effective tool for improving breast cancer patient adherence to the post-radiotherapy follow-up visit. In this study, the telephone reminder system was more effective than the mail reminder system.
{"title":"Non-Attendance to Post-Radiotherapy Follow-Up in Breast Cancer: Efficacy of Mail and Telephone Reminders","authors":"F. Bruns, Anne Caroline Knöchelmann, C. Henkenberens, H. Christiansen","doi":"10.31487/j.cor.2020.08.03","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.03","url":null,"abstract":"Background: To assess the efficacy of two reminder interventions in improving post-radiotherapy followup attendance rates of breast cancer patients.\u0000Methods: Three periods of three months were assessed, a baseline period, an intervention period and a\u0000confirmation period. In the intervention period, a two-step reminder system was used. This system consisted\u0000of a mail reminder (IV1) that was sent to all patients three to four weeks prior to the post-radiotherapy\u0000follow-up visit, which was followed by up to two telephone calls (IV2) for all patients who did not attend\u0000this follow-up visit. During the confirmation period, IV2 was used exclusively to assess the maximal\u0000possible efficacy of the telephone reminder.\u0000Results: The non-attendance rate of breast cancer patients was 18.1% (19/105) in the baseline period; this\u0000rate decreased to 13.1% in the intervention period (23/176; p=0.33) after IV1 and then decreased to 6.3%\u0000(11/176; p=0.03) after IV2. In the confirmation period, 24.4% (42/172) of breast cancer patients did not\u0000attend their post-radiotherapy follow-up visit; the non-attendance rate decreased significantly after\u0000(exclusive) IV2 from 24.4% (42/172) to 9.3% (16/172; p<0.001). Significance was observed for the first\u0000call but not for the second call in the chi-square test.\u0000Conclusion: Telephone reminder is an effective tool for improving breast cancer patient adherence to the\u0000post-radiotherapy follow-up visit. In this study, the telephone reminder system was more effective than the\u0000mail reminder system.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87833700","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 : 2020-08-13DOI: 10.31487/j.cor.2020.08.16
C. Restrepo
COVID-19 pandemic has introduced a shift in accepted and routine handling of elective cases in hospital administration. This shift introduced a delay in the treatment of all non-COVID-19 cases, including cancer patients. Usually, non-complicated cases of cancer do not require immediate surgery, but procrastination is not an option. The pandemic is taking a longer time to be defeated as previously thought, and medical infrastructure is overwhelmed in many countries. Therefore, procrastination for non-COVID-19 cases became a reality. To this, we must add that there are specific cancer problems that require urgent resolution. The problem is having a heavy toll on almost all the involved continents. South and Central America are no exception. Unfortunately, South and Central America do not have all the resources available to the developed world, and this makes the issue of timely cancer surgery even more troublesome. A distressed hospital system needs a systematic approach to deliver cancer care in time. This paper has the intention to show how a Central American country such as Panama dealt and is dealing with cancer surgery in the middle of the severe limitations imposed by pandemics.
{"title":"The COVID-19 Pandemic Impact on Cancer in Latin America","authors":"C. Restrepo","doi":"10.31487/j.cor.2020.08.16","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.16","url":null,"abstract":"COVID-19 pandemic has introduced a shift in accepted and routine handling of elective cases in hospital\u0000administration. This shift introduced a delay in the treatment of all non-COVID-19 cases, including cancer\u0000patients. Usually, non-complicated cases of cancer do not require immediate surgery, but procrastination is\u0000not an option. The pandemic is taking a longer time to be defeated as previously thought, and medical\u0000infrastructure is overwhelmed in many countries. Therefore, procrastination for non-COVID-19 cases\u0000became a reality. To this, we must add that there are specific cancer problems that require urgent resolution.\u0000The problem is having a heavy toll on almost all the involved continents. South and Central America are no\u0000exception. Unfortunately, South and Central America do not have all the resources available to the\u0000developed world, and this makes the issue of timely cancer surgery even more troublesome. A distressed\u0000hospital system needs a systematic approach to deliver cancer care in time. This paper has the intention to\u0000show how a Central American country such as Panama dealt and is dealing with cancer surgery in the middle\u0000of the severe limitations imposed by pandemics.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84614727","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 : 2020-08-12DOI: 10.31487/j.cor.2020.08.14
M. A. Noor, O. Shakeel, A. Malik, Toqeer Zahid, A. Anwer, S. Khattak, A. Syed
Objective: To study the outcomes of post esophagectomy diaphragmatic hernia managed at our institute. Methodology: We conducted a retrospective case series among patients who underwent surgical resection for esophageal cancer in the last 10 years from Jan 2010 to Dec 2019. Patient’s charts were reviewed and postoperative surveillance CT scans were reviewed for the development of post-operative diaphragmatic hernias. Demographic and variables related to diaphragmatic hernia and its management were recorded and analysed. Results: Out of 590 patients, 10 patients developed post esophagectomy diaphragmatic hernia. All patients received neo adjuvant chemo-radiotherapy. 8 patients underwent three stage esophagectomy, one had Ivor Lewis esophagectomy and one had transhiatal esophagectomy. CT scan was used as a modality of choice for the diagnosis. Two patients developed hernia during their hospital stay and 8 patients presented late. 7 patients were diagnosed due to complications of the hernia. One patient presented with acute abdomen and ischaemic gut. 2 presented with severe epigastric pain. 4 presented with shortness of breath. 3 patients were diagnosed on surveillance CT scans. All patients underwent surgery for closure of the hernia defect. Laparoscopic surgical management was performed in 5 patients. Five patients had primary tension free closure while five patients had mesh repair. Two patients had recurrence. Both were re-operated and mesh repair was done. There was no 30 days mortality. Conclusion: Diaphragmatic hernia is a serious complication. Early surgical intervention is needed for the treatment. With minimally invasive techniques, incidence has increased. For standardization of management and quality of care, randomized control trials are needed.
{"title":"Post Esophagectomy Diaphragmatic Hernia (PEDH): An Experience of a Dedicated Cancer Center of Pakistan","authors":"M. A. Noor, O. Shakeel, A. Malik, Toqeer Zahid, A. Anwer, S. Khattak, A. Syed","doi":"10.31487/j.cor.2020.08.14","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.14","url":null,"abstract":"Objective: To study the outcomes of post esophagectomy diaphragmatic hernia managed at our institute.\u0000Methodology: We conducted a retrospective case series among patients who underwent surgical resection\u0000for esophageal cancer in the last 10 years from Jan 2010 to Dec 2019. Patient’s charts were reviewed and\u0000postoperative surveillance CT scans were reviewed for the development of post-operative diaphragmatic\u0000hernias. Demographic and variables related to diaphragmatic hernia and its management were recorded and\u0000analysed.\u0000Results: Out of 590 patients, 10 patients developed post esophagectomy diaphragmatic hernia. All patients\u0000received neo adjuvant chemo-radiotherapy. 8 patients underwent three stage esophagectomy, one had Ivor\u0000Lewis esophagectomy and one had transhiatal esophagectomy. CT scan was used as a modality of choice\u0000for the diagnosis. Two patients developed hernia during their hospital stay and 8 patients presented late. 7\u0000patients were diagnosed due to complications of the hernia. One patient presented with acute abdomen and\u0000ischaemic gut. 2 presented with severe epigastric pain. 4 presented with shortness of breath. 3 patients were\u0000diagnosed on surveillance CT scans. All patients underwent surgery for closure of the hernia defect.\u0000Laparoscopic surgical management was performed in 5 patients. Five patients had primary tension free\u0000closure while five patients had mesh repair. Two patients had recurrence. Both were re-operated and mesh\u0000repair was done. There was no 30 days mortality.\u0000Conclusion: Diaphragmatic hernia is a serious complication. Early surgical intervention is needed for the\u0000treatment. With minimally invasive techniques, incidence has increased. For standardization of management\u0000and quality of care, randomized control trials are needed.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84874618","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 : 2020-08-10DOI: 10.31487/j.cor.2020.08.10
A. Jamal, J. Mohsin, I. Haq, N. Mobeen, S. Begum, O. Shakeel, Syed Irfan Kabir, A. Syed, S. Khattak
Introduction: Insulinoma of pancreas is a rare neuroendocrine tumor (NET). Mostly insulinomas are benign and solitary. They can have association with multiple endocrine neoplasia 1 (MEN -1). Insulinomas presents with symptoms of hypoglycemia. Most of the times the symptoms are vague and result in delay in the diagnosis and hence management. After appropriate diagnostic and localization investigations along with metastatic workup, surgery is the treatment of choice. Surgery can offer cure. Minimally invasive surgery can offer potential benefits of minimal morbidity and at least equal oncological outcomes. Study Design: Case series. Place and Duration of Study: Department of Surgical Oncology, Shaukat Khanam Memorial Cancer Hospital & Research Center (SKMCH&RC), from January 2011 to March 2020. Methodology: We studied a total of five patients that presented to SKMCH&RC in the above-mentioned period. Detailed clinical information of these five patients, including sociodemographic variables, symptomatology, diagnostic and localization investigations, clinical and pathological staging, comprehensive details of surgery, postoperative course, oncological outcomes, postoperative resolution of symptoms, postoperative diabetes, prognosis and follow up duration were analysed. The record was being retrospectively retrieved from Hospital Information System (HIS) that is prospectively maintained. We are a paperless hospital and all data and record of the patient is maintained through HIS. Results: A total of five patients presented to SKMCH&RC with a mean age of 41 (18 -80) years. The median duration of symptoms was 24 (6-60) months. Symptomatic hypoglycemia was present in all 5 (100%) of the patients. Tumor distribution in the pancreas was as follows; uncinate 1 (20%), body 1 (20%) and tail 3 (60%). All five patients (100%) were treated by surgery. Resolution of symptoms occurred in all five (100%) of the patients. Conclusion: Insulinoma of pancreas is a rare disease with varied symptomatology, physicians shall have an index of suspicion for this disorder to aid early diagnosis that is pivotal for the management and prevention of possible fatal complications of hypoglycemia. Appropriate diagnostic and localizing investigations are required. Adequate surgery can offer cure. Minimally invasive surgery can be safely offered with equal oncological outcomes.
{"title":"Insulinoma of Pancreas, Brief Experience at a Dedicated Surgical Oncology Department","authors":"A. Jamal, J. Mohsin, I. Haq, N. Mobeen, S. Begum, O. Shakeel, Syed Irfan Kabir, A. Syed, S. Khattak","doi":"10.31487/j.cor.2020.08.10","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.10","url":null,"abstract":"Introduction: Insulinoma of pancreas is a rare neuroendocrine tumor (NET). Mostly insulinomas are\u0000benign and solitary. They can have association with multiple endocrine neoplasia 1 (MEN -1). Insulinomas\u0000presents with symptoms of hypoglycemia. Most of the times the symptoms are vague and result in delay in\u0000the diagnosis and hence management. After appropriate diagnostic and localization investigations along\u0000with metastatic workup, surgery is the treatment of choice. Surgery can offer cure. Minimally invasive\u0000surgery can offer potential benefits of minimal morbidity and at least equal oncological outcomes.\u0000Study Design: Case series.\u0000Place and Duration of Study: Department of Surgical Oncology, Shaukat Khanam Memorial Cancer\u0000Hospital & Research Center (SKMCH&RC), from January 2011 to March 2020.\u0000Methodology: We studied a total of five patients that presented to SKMCH&RC in the above-mentioned\u0000period. Detailed clinical information of these five patients, including sociodemographic variables,\u0000symptomatology, diagnostic and localization investigations, clinical and pathological staging,\u0000comprehensive details of surgery, postoperative course, oncological outcomes, postoperative resolution of\u0000symptoms, postoperative diabetes, prognosis and follow up duration were analysed. The record was being\u0000retrospectively retrieved from Hospital Information System (HIS) that is prospectively maintained. We are\u0000a paperless hospital and all data and record of the patient is maintained through HIS.\u0000Results: A total of five patients presented to SKMCH&RC with a mean age of 41 (18 -80) years. The\u0000median duration of symptoms was 24 (6-60) months. Symptomatic hypoglycemia was present in all 5\u0000(100%) of the patients. Tumor distribution in the pancreas was as follows; uncinate 1 (20%), body 1 (20%)\u0000and tail 3 (60%). All five patients (100%) were treated by surgery. Resolution of symptoms occurred in all\u0000five (100%) of the patients.\u0000Conclusion: Insulinoma of pancreas is a rare disease with varied symptomatology, physicians shall have\u0000an index of suspicion for this disorder to aid early diagnosis that is pivotal for the management and\u0000prevention of possible fatal complications of hypoglycemia. Appropriate diagnostic and localizing\u0000investigations are required. Adequate surgery can offer cure. Minimally invasive surgery can be safely\u0000offered with equal oncological outcomes.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"140 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79998960","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 : 2020-08-07DOI: 10.31487/j.cor.2020.08.09
A. Jamal, Sadaf Batool, I. Haq, Faizan Ullah, O. Shakeel, J. Mohsin, A. Anwer, S. Khattak, A. Syed
Objectives: Extra Levator Abdominoperineal Excision (ELAPE) is an emerging technique for the management of locally advanced distal rectal cancers. Current evidence suggests that this technique is associated with better oncological outcomes and hence survival. Extra levator abdominoperineal excision is associated with significant perineal complications both in short and long term. The objective of the current study is to emphasize on the early wound complications of the above-mentioned procedure. Study Design: It was a retrospective observational study with continent sampling. Place and Duration of Study: The study was conducted at department of Surgical Oncology Shaukat Khanum Memorial Cancer Hospital & Research Center Lahore, Pakistan. The study period was from 1st January 2014 to 31st December, 2019. Patients and Methods: A total of 84 patients were included in the study who underwent extra levator abdominoperineal excision (ELAPE). All patients undergoing extra levator abdominoperineal excision during the said period were included. Results: A total of 84 patients underwent Extra Levator Abdominoperineal Excision between January 2014 and December 2019. Wound infection was observed in 32 (38.09%) of the patients. Wound dehiscence was seen is five patients. Median day of detection of infection was day 10 (5-22). Median hospital stay was 7 (4-22) days. Conclusion: Extra Levator Abdominoperineal Excision is a procedure with significant perineal wound complication rate. The occurrence of perineal wound complications is multifactorial. Judicial use of the procedure is warranted
{"title":"Early Post-Operative Perineal Wound Complications in Patients Undergoing Extra Levator Abdominoperineal Excision, A Retrospective Study at Department of Surgical Oncology","authors":"A. Jamal, Sadaf Batool, I. Haq, Faizan Ullah, O. Shakeel, J. Mohsin, A. Anwer, S. Khattak, A. Syed","doi":"10.31487/j.cor.2020.08.09","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.09","url":null,"abstract":"Objectives: Extra Levator Abdominoperineal Excision (ELAPE) is an emerging technique for the\u0000management of locally advanced distal rectal cancers. Current evidence suggests that this technique is\u0000associated with better oncological outcomes and hence survival. Extra levator abdominoperineal excision\u0000is associated with significant perineal complications both in short and long term. The objective of the current\u0000study is to emphasize on the early wound complications of the above-mentioned procedure.\u0000Study Design: It was a retrospective observational study with continent sampling.\u0000Place and Duration of Study: The study was conducted at department of Surgical Oncology Shaukat\u0000Khanum Memorial Cancer Hospital & Research Center Lahore, Pakistan. The study period was from 1st\u0000January 2014 to 31st December, 2019.\u0000Patients and Methods: A total of 84 patients were included in the study who underwent extra levator\u0000abdominoperineal excision (ELAPE). All patients undergoing extra levator abdominoperineal excision\u0000during the said period were included.\u0000Results: A total of 84 patients underwent Extra Levator Abdominoperineal Excision between January 2014\u0000and December 2019. Wound infection was observed in 32 (38.09%) of the patients. Wound dehiscence was\u0000seen is five patients. Median day of detection of infection was day 10 (5-22). Median hospital stay was 7\u0000(4-22) days.\u0000Conclusion: Extra Levator Abdominoperineal Excision is a procedure with significant perineal wound\u0000complication rate. The occurrence of perineal wound complications is multifactorial. Judicial use of the\u0000procedure is warranted","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87064573","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 : 2020-08-03DOI: 10.31487/j.cor.2020.08.04
Shashanka K. Prasad, D. Devananda
Annona muricata L. has been widely used in traditional medicine for the treatment of various diseases ranging from fever to cancer. In this study, we evaluate the in vitro anticancer potential of methanol extracted A. muricata fruit pulp (AMPM) and seeds (AMSM) phytochemicals against breast (MCF-7), cervical (HeLa), prostate (PC-3) and colorectal (HCT-116) cancer cell lines. Additionally, the in vitro antiinflammatory and antioxidant activities of the extracts have been carried. The findings suggest that the AMSM is the most potent among the either extracts. Notwithstanding, both AMPM and AMSM showed significant dose and cell line-dependent anticancer potential(s).
{"title":"Evaluating the Anticancer Potentials of Methanol Extracted Annona muricata Fruit Pulp and Seed(s) Phytochemicals","authors":"Shashanka K. Prasad, D. Devananda","doi":"10.31487/j.cor.2020.08.04","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.04","url":null,"abstract":"Annona muricata L. has been widely used in traditional medicine for the treatment of various diseases\u0000ranging from fever to cancer. In this study, we evaluate the in vitro anticancer potential of methanol\u0000extracted A. muricata fruit pulp (AMPM) and seeds (AMSM) phytochemicals against breast (MCF-7),\u0000cervical (HeLa), prostate (PC-3) and colorectal (HCT-116) cancer cell lines. Additionally, the in vitro antiinflammatory and antioxidant activities of the extracts have been carried. The findings suggest that the\u0000AMSM is the most potent among the either extracts. Notwithstanding, both AMPM and AMSM showed\u0000significant dose and cell line-dependent anticancer potential(s).\u0000","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83710203","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 : 2020-08-01DOI: 10.31487/j.cor.2020.08.02
Baolin Chen, Xiaoyu Li, Fei Wang, Yixin Zhou
Objective: To analyse the clinical features and survival of patients with refractory/relapsed acute myeloid leukemia (AML) in our center, thus, to find out whether there is a trend of improvement in the survival of these patients in the past years and to search for prognostic factors which are associated with patients’ survival. Method: A total of 45 patients with refractory/relapsed AML were retrospectively reviewed. Clinical data, including gender, age, FAB classification of AML, performance status (PS), cytogenetic and molecular abnormities, complete remission (CR) duration, choices of treatment (whether to undergo hematopoietic stem cell transplantation) before and after relapse. The Kaplan-Meier method and the Log-rank test were conducted to determine the influence of those above factors on the patients’ survival. Results: The mean survival time of the 45 patients with refractory/relapsed AML was (36.25±8.40) months and the median follow up was (9±2.58) months. The one-year and two-years overall survival (OS) rate was (40.6±7.5) % and (23.7±7.0) %, respectively. Univariate analysis results demonstrated that age (p<0.05) and undergoing hematopoietic stem cell transplantation (HSCT) after relapse (p<0.01) were significantly related to OS in these patients. Conclusion: Age and whether to undergo HSCT after relapse are the key factors for the survival of patients with refractory/relapsed AML in our center. HSCT is still an effective salvage therapy for patients with refractory/relapsed AML. Our findings highlight the divergent outcomes of these patients and provide evidence to support the importance of timely HSCT after relapse, which is beneficial for clinicians to make clinical decisions in the future.
{"title":"Analysis of Clinical Features and Prognosis in Patients with Refractory/Relapsed Acute Myeloid Leukemia- Results from Our Center","authors":"Baolin Chen, Xiaoyu Li, Fei Wang, Yixin Zhou","doi":"10.31487/j.cor.2020.08.02","DOIUrl":"https://doi.org/10.31487/j.cor.2020.08.02","url":null,"abstract":"Objective: To analyse the clinical features and survival of patients with refractory/relapsed acute myeloid\u0000leukemia (AML) in our center, thus, to find out whether there is a trend of improvement in the survival of\u0000these patients in the past years and to search for prognostic factors which are associated with patients’\u0000survival.\u0000Method: A total of 45 patients with refractory/relapsed AML were retrospectively reviewed. Clinical data,\u0000including gender, age, FAB classification of AML, performance status (PS), cytogenetic and molecular\u0000abnormities, complete remission (CR) duration, choices of treatment (whether to undergo hematopoietic\u0000stem cell transplantation) before and after relapse. The Kaplan-Meier method and the Log-rank test were\u0000conducted to determine the influence of those above factors on the patients’ survival.\u0000Results: The mean survival time of the 45 patients with refractory/relapsed AML was (36.25±8.40) months\u0000and the median follow up was (9±2.58) months. The one-year and two-years overall survival (OS) rate was\u0000(40.6±7.5) % and (23.7±7.0) %, respectively. Univariate analysis results demonstrated that age (p<0.05)\u0000and undergoing hematopoietic stem cell transplantation (HSCT) after relapse (p<0.01) were significantly\u0000related to OS in these patients.\u0000Conclusion: Age and whether to undergo HSCT after relapse are the key factors for the survival of patients\u0000with refractory/relapsed AML in our center. HSCT is still an effective salvage therapy for patients with\u0000refractory/relapsed AML. Our findings highlight the divergent outcomes of these patients and provide\u0000evidence to support the importance of timely HSCT after relapse, which is beneficial for clinicians to make\u0000clinical decisions in the future.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78321139","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 : 2020-07-24DOI: 10.31487/j.cor.2020.07.10
K. Smetana, Mikulenková D, Otevřelová P, Karban J, Trněný M
It is generally known that the nucleus : cytoplasmic ratio is a very useful marker for the evaluation of the cell activity and identification. In contrary, the nucleolus : nucleus ratio was less studied. The present study was undertaken to provide more information on that ratio during the differentiation and maturation of human lymphocytes. The ratio of nucleolar bodies to the nuclear body indicated that the size of the nuclear space occupied by nucleolar bodies in B chronic lymphocytic leukemia (CLL) during the cell differentiation and maturation (terminal differentiation) decreased in both untreated and treated patients with the anti-leukemic therapy. However, the nuclear space occupied by nucleolar bodies was apparently characteristic for each differentiation and maturation step. A similar trend was apparent in non-leukemic T lymphocytes of blood donors using in vitro de-differentiated lymphocytes as progenitors. During the cell differentiation and maturation, the size reduction of nucleolar bodies of both patients suffering from CLL and blood donors was apparently larger than that of the nucleus. As it was expected, the decreased size of nucleolar bodies was accompanied by the decreasing nucleolar transcription activity expressed by the reduced number of fibrillar centers.
{"title":"The Rough Estimate of the Nuclear Space Occupied by Nucleolar Bodies in Lymphocytes of Patients Suffering from B Chronic Lymphocytic Leukemia and Blood Donors","authors":"K. Smetana, Mikulenková D, Otevřelová P, Karban J, Trněný M","doi":"10.31487/j.cor.2020.07.10","DOIUrl":"https://doi.org/10.31487/j.cor.2020.07.10","url":null,"abstract":"It is generally known that the nucleus : cytoplasmic ratio is a very useful marker for the evaluation of the\u0000cell activity and identification. In contrary, the nucleolus : nucleus ratio was less studied. The present study\u0000was undertaken to provide more information on that ratio during the differentiation and maturation of human\u0000lymphocytes. The ratio of nucleolar bodies to the nuclear body indicated that the size of the nuclear space\u0000occupied by nucleolar bodies in B chronic lymphocytic leukemia (CLL) during the cell differentiation and\u0000maturation (terminal differentiation) decreased in both untreated and treated patients with the anti-leukemic\u0000therapy. However, the nuclear space occupied by nucleolar bodies was apparently characteristic for each\u0000differentiation and maturation step. A similar trend was apparent in non-leukemic T lymphocytes of blood\u0000donors using in vitro de-differentiated lymphocytes as progenitors. During the cell differentiation and\u0000maturation, the size reduction of nucleolar bodies of both patients suffering from CLL and blood donors\u0000was apparently larger than that of the nucleus. As it was expected, the decreased size of nucleolar bodies\u0000was accompanied by the decreasing nucleolar transcription activity expressed by the reduced number of\u0000fibrillar centers.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90184014","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 : 2020-07-21DOI: 10.31487/j.cor.2020.07.13
Chien-An A. Hu, Warren Laskey, S. Fu, Y. Qiu, Yulan Liu, X. Ding, Yulong Yin, T. Ma, H. Chand, L. Sklar
Apoptosis, one of the major regulated cell death pathways, is a highly regulated suicide mechanism used for the elimination of damaged and unwanted cells in multicellular organisms. Derailed apoptosis has been observed in two extremes of the disease spectrum, for example, cancer (too little apoptosis) and acute myocardial infarction (AMI; too much apoptosis). Using human cellular models and patient samples, we have previously shown that human apolipoprotein L6 (ApoL6), when overexpressed intracellularly, induces mitochondria- and reactive oxygen species (ROS)-mediated apoptosis. ApoL6 also blocks Beclin 1-initiated autophagy in both human colorectal cancer cells (DLD-1) and atherosclerotic lesion-derived cells. We speculated that small compounds enhancing ApoL6-induced apoptosis are candidate drugs to treat cancer. In the present study, we use our established human cellular models, high throughput and targeted screening strategies, and well-defined assays to identify nifedipine, L-proline, L-tryptophan, and picolinic acid as antiapoptotic agents, which would be candidate drugs for treating diseases such as AMI. We also identified fulvestrant and L-lysine, two compounds that can further enhance ApoL6-induced apoptosis in cancer cells.
{"title":"Apoptosis Cellular Models in Cancer Therapeutics","authors":"Chien-An A. Hu, Warren Laskey, S. Fu, Y. Qiu, Yulan Liu, X. Ding, Yulong Yin, T. Ma, H. Chand, L. Sklar","doi":"10.31487/j.cor.2020.07.13","DOIUrl":"https://doi.org/10.31487/j.cor.2020.07.13","url":null,"abstract":"Apoptosis, one of the major regulated cell death pathways, is a highly regulated suicide mechanism used\u0000for the elimination of damaged and unwanted cells in multicellular organisms. Derailed apoptosis has been\u0000observed in two extremes of the disease spectrum, for example, cancer (too little apoptosis) and acute\u0000myocardial infarction (AMI; too much apoptosis). Using human cellular models and patient samples, we\u0000have previously shown that human apolipoprotein L6 (ApoL6), when overexpressed intracellularly, induces\u0000mitochondria- and reactive oxygen species (ROS)-mediated apoptosis. ApoL6 also blocks Beclin 1-initiated\u0000autophagy in both human colorectal cancer cells (DLD-1) and atherosclerotic lesion-derived cells. We\u0000speculated that small compounds enhancing ApoL6-induced apoptosis are candidate drugs to treat cancer.\u0000In the present study, we use our established human cellular models, high throughput and targeted screening\u0000strategies, and well-defined assays to identify nifedipine, L-proline, L-tryptophan, and picolinic acid as antiapoptotic agents, which would be candidate drugs for treating diseases such as AMI. We also identified\u0000fulvestrant and L-lysine, two compounds that can further enhance ApoL6-induced apoptosis in cancer cells.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86027184","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 : 2020-07-04DOI: 10.31487/j.cor.2020.07.04
A. Schech, A. Brodie, J. Lewis, K. Tkaczuk, M. Edelman, N. Tait, S. Chumsri, T. Bao, V. Stearns
Purpose: Considerable preclinical and clinical data indicate that only a small subset of tumor cells has longterm proliferating capacity. These cells are termed cancer stem cells (CSCs). Failure to eradicate CSCs is hypothesized to be a cause of cancer recurrence after potentially curative therapies. Therefore, approaches that target CSCs have the potential to improve outcomes. We evaluated the combination of vorinostat and lapatinib to target CSCs and metastasis. Experimental Design: We conducted preclinical studies and a phase I/II clinical trial to determine the effects of vorinostat and lapatinib to CSCs. Results: Our preclinical studies demonstrated that vorinostat and lapatinib further reduced CSCs compared to either single agent. Reduction in self-renewal proteins, mammospheres, epithelial-mesenchymal transition (EMT) markers, and cell migration was also observed. Based on these findings, the combination was evaluated in the phase I trial to which a total of 12 patients were enrolled. Dose-limiting toxicity was not observed in phase I, and the recommended phase II dose was vorinostat 400 mg 4 days on 3 days off and lapatinib 1,250 mg daily. In HER2-positive breast cancer patients, the clinical benefit rate was observed in 43% of subjects. Interestingly, patients who remained on vorinostat and lapatinib did not develop any new site of metastasis. Conclusion: The combination of vorinostat and lapatinib is safe and active in HER2-positive breast cancer. Further studies are needed to evaluate this strategy to target CSCs and metastasis.
{"title":"Targeting Cancer Stem Cells and Metastasis with Epigenetic Modulation and Anti-HER2 Therapy: Phase I/II Trial of Vorinostat in Combination with Lapatinib","authors":"A. Schech, A. Brodie, J. Lewis, K. Tkaczuk, M. Edelman, N. Tait, S. Chumsri, T. Bao, V. Stearns","doi":"10.31487/j.cor.2020.07.04","DOIUrl":"https://doi.org/10.31487/j.cor.2020.07.04","url":null,"abstract":"Purpose: Considerable preclinical and clinical data indicate that only a small subset of tumor cells has longterm proliferating capacity. These cells are termed cancer stem cells (CSCs). Failure to eradicate CSCs is\u0000hypothesized to be a cause of cancer recurrence after potentially curative therapies. Therefore, approaches\u0000that target CSCs have the potential to improve outcomes. We evaluated the combination of vorinostat and\u0000lapatinib to target CSCs and metastasis.\u0000Experimental Design: We conducted preclinical studies and a phase I/II clinical trial to determine the\u0000effects of vorinostat and lapatinib to CSCs.\u0000Results: Our preclinical studies demonstrated that vorinostat and lapatinib further reduced CSCs compared\u0000to either single agent. Reduction in self-renewal proteins, mammospheres, epithelial-mesenchymal\u0000transition (EMT) markers, and cell migration was also observed. Based on these findings, the combination\u0000was evaluated in the phase I trial to which a total of 12 patients were enrolled. Dose-limiting toxicity was\u0000not observed in phase I, and the recommended phase II dose was vorinostat 400 mg 4 days on 3 days off\u0000and lapatinib 1,250 mg daily. In HER2-positive breast cancer patients, the clinical benefit rate was observed\u0000in 43% of subjects. Interestingly, patients who remained on vorinostat and lapatinib did not develop any\u0000new site of metastasis.\u0000Conclusion: The combination of vorinostat and lapatinib is safe and active in HER2-positive breast cancer.\u0000Further studies are needed to evaluate this strategy to target CSCs and metastasis.","PeriodicalId":10487,"journal":{"name":"Clinical Oncology and Research","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83940422","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}
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