Tumori最新文献

Objective: This retrospective study aims to clarify the association between epidermal growth factor receptor (EGFR) mutation types and brain metastasis incidence in early-stage non-small-cell lung cancer after surgery.

Methods: Patients pathologically diagnosed with stage I to III non-small-cell lung cancer were consecutively enrolled from January 2010 to January 2017 and reviewed. First-generation TKIs were selected as postoperative therapy for those with EGFR mutations, and platinum-based chemotherapy was used as postoperative therapy for patients with negative wild-type gene mutations. A Kaplan-Meier approach was used to calculate the cumulative incidence of brain metastasis and overall survival. Candidate prognostic factors were checked by log-rank test.

Results: A total of 669 patients were eligible for the study, comprising 309 who were EGFR(+), and 360 who were EGFR(-). Patients with any type of EGFR mutation have a significantly higher risk of developing brain metastases compared to those with EGFR wild-type (hazard ratio=1.957, P=0.012). The incidence of brain metastasis was 17.1% higher in patients with the 19Del mutation than in those with the L858R mutation (13.6%), other mutations (13.3%), or wild-type EGFR (6.1%). Moreover, those with 19Del mutations showed the greatest increase in incidence of brain metastasis (hazard ratio=3.009, P=0.001); those with L858R mutations showed a smaller increase (hazard ratio=2.750, P=0.003).

Conclusions: EGFR mutations are predictive factors for the cumulative incidence of brain metastasis. EGFR-mutant non-small-cell lung cancer patients may need more frequent brain magnetic resonance imaging to detect earlier occurrence of brain metastases, allowing for timely and effective treatment to improve patient prognosis.

Introduction: Postoperative radiotherapy is recommended for all patients with cutaneous and non-cutaneous squamous cell carcinoma of the head and neck in the presence of clinical and incidental perineural infiltration. Perineural infiltration represents one of the most important adverse prognostic factors and may impact negatively patient outcomes. While guidelines exist for defining radiotherapy treatment volumes in patients with cutaneous squamous cell carcinoma and clinical perineural infiltration, there is a notable gap in the literature regarding recommendations for cases with incidental perineural infiltration and parotid involvement.

Methods: A case of cutaneous squamous cell carcinoma of the auricular zone was proposed to an expert radiation oncologist panel.

Results: The main issues concerned the inclusion of the surgical bed alone or the extension to the adjacent zone.

Conclusion: This paper aims to provide a review of literature data and to propose a comprehensive approach to target volume definition in this setting of patients.

If, as widely recognized in the scientific community, adolescent and young adult cancer patients are in many ways unique, then the spaces where they receive care should be equally special. The design of hospital environments that cater to the specific needs of young patients is a crucial factor in defining the essential features that care centers should ideally include to provide the best possible support for adolescent and young adult patients.This paper explores the growing importance of hospital design in fostering continuity in patients' lives, balancing both functionality and aesthetics. While healthcare systems face logistical and financial constraints, it is essential to recognize and promote the role of architecture, culture, and the arts as integral components of a holistic approach to care. Beauty in healthcare settings should not be considered a luxury, but rather a fundamental aspect of upholding the right to health.

Objective: we compared and analyzed the imaging features, tumor markers, pathological immunohistochemistry, and lymph node metastasis rates of solitary and multiple lung adenocarcinoma to provide a valuable reference for clinical diagnosis and treatment.

Methods: A retrospective analysis of 212 patients who underwent thoracic surgery in our hospital from 2022 to 2023, including 149 patients with a solitary lung adenocarcinoma nodule and 63 patients with multiple primary nodules. Via propensity score matching, the imaging features, tumor serological markers, pathological immunohistochemistry, and lymph node metastasis rates of the two groups were compared, and the differences in lymph node metastasis rates between solitary and multiple nodules were explored by binary logistic regression.

Results: After propensity score matching, there were significant differences in the mean CT value (P = 0.001), Ki-67 expression (P < 0.001), PD-L1 expression (P = 0.002), and the lymph node metastasis rate (P = 0.030) between the two groups, but there were no significant differences in nodule type, imaging features, tumor serological marker levels, and the ALK-positive and SYN-positive rates. With lymph node metastasis as the dependent variable, solitary or multiple nodules as the categorical covariate, and the three variables were included as independent variables for binary logistic regression analysis. The probability of lymph node metastasis was 80.8% lower in patients with multiple primary lung adenocarcinoma nodules than in those with a solitary one (P = 0.042).

Conclusion: Multiple primary adenocarcinoma nodules exhibit milder biological behavior than solitary adenocarcinoma nodules and carry a lower risk of lymph node metastasis.

Background and aims: Vascular endothelial growth factor (VEGF) gene polymorphisms are associated with the response to pharmaceutical therapy in many cancers. This study aimed to investigate the effects of VEGF gene polymorphisms in esophageal squamous cell carcinoma patients receiving pharmaceutical therapy.

Methods: This literature-based meta-analysis was performed with keywords related to VEGF gene polymorphisms and clinical response in esophageal squamous carcinoma patients receiving pharmaceutical therapy (including 5-FU, cisplatin, oxaliplatin, and calcium folinate). After a series of bias grading analyses and DerSimonian-Laird method analysis, odds ratios and 95% confidence intervals were calculated to examine the potential relationships. Sensitivity and subgroup analyses were subsequently performed to determine the major causes of heterogeneity.

Results: Heterogeneity was dramatically reduced after the removal of one study from the analysis (I² = 37%, P = 0.19). The remaining studies involved 5-FU-based treatment. The presence of VEGF G-1154A and VEGF-634C/G was found to be correlated with patient response to 5-FU/CDDP-based treatment, whereas VEGF-2549I/D was correlated with response to 5-FU/oxaliplatin-based treatment, and VEGF-936C/T was associated with both 5-FU/CDDP- and 5-FU/oxaliplatin-based treatment response.

Conclusion: VEGF gene polymorphisms affect the response of esophageal squamous carcinoma patients receiving pharmaceutical therapy, especially 5-FU-based treatments.

Background: Patients with high-grade serous ovarian carcinoma (HGSOC) often have a personal and/or family history of breast cancers. However, the clinical association and underlying molecular interaction between breast cancer and HGSOC is not well understood. In this study, the clinical characteristics and outcomes of HGSOC patients with or without breast cancer were compared.

Methods: Eligible patient information was extracted from the Surveillance, Epidemiology, and End Results database. Kaplan-Meier and Cox proportional hazards regression models were used to determine survival outcomes and prognostic factors.

Results: A total of 3065 HGSOC (ICD-O-3 code 8461/3) patients were identified from 1975 to 2020, among whom 239 (9.56%) had co-existing breast cancers. HGSOC with breast cancers tended to have more stage I-II ovarian cancer (20.92% vs 13.79%), less metastatic diseases (25.1% vs 32.13%) and had a higher probability of undergoing surgery (94.1% vs 87.9%). The overall survival of HGSOC patients with breast cancer was better than that of patients without breast cancer (HR = 0.77, 95% CI 0.65 to 0.91; P = 0.0015). Further, patients who developed ovarian cancer before breast cancer had better overall survival than those who developed breast cancer before or simultaneously with ovarian cancer (HR = 0.35, 95% CI 0.23 to 0.52; P < 0.001).

Conclusion: HGSOC combined with breast cancer is a common phenomenon. HGSOC patients with breast cancer, especially those diagnosed with ovarian cancer before breast cancer have a better prognosis. Further validation is warranted and more genetic and mechanistical study is needed.

Purpose: To compare the safety and efficacy of hepatic arterial infusion chemotherapy followed by transarterial embolization (HAIC+TAE) to transarterial chemoembolization (TACE) for the treatment of unresectable hepatocellular carcinoma (uHCC).

Materials and methods: The clinical data of patients who received HAIC+TAE or TACE between April 2020 and April 2022 was collected. Propensity score-matching was used to balance the baseline characteristics of the two groups. Tumor response according to mRECIST, median time to progression (TTP) and overall survival (OS) were investigated. ALBI score was applied to evaluate the changes of liver function and other relative adverse reactions were recorded.

Results: A total of 98 patients with uHCC were enrolled in the study, including 71 in the TACE group and 27 in the HAIC+TAE group. After propensity score matching, 23 pairs of patients were investigated. The HAIC+TAE group showed a longer median TTP and OS than TACE group (mTTP 316 vs. 235 days, P=0.023; mOS 580 vs. 493 days, P=0.020). Objective response rates in HAIC+TAE group and TACE group were 65.2% and 47.8% (P=0.234). Disease-control rates were 87.0% and 82.6% (P=1.000). No significant difference was found in the incidence of adverse events between the two groups (P>0.05).

Conclusion: The combination treatment strategy of HAIC+TAE in patients with uHCC appears to be a safe regimen, with the potential to prolong mTTP and mOS relative to TACE. The sequential application of this therapy merits consideration as an innovative treatment strategy for individuals with uHCC.

Background: Establishment of sister chromatid cohesion N-acetyltransferase 1 (ESCO1) plays an important role in mitosis and is involved in tumor progression of human bladder and prostate cancer. However, its pathological effects on renal cell cancer (RCC) remain unknown. Here, we aimed to assess the impact of ESCO1 down-regulation in RCC cells and explore its role as potential prognosis biomarker for RCC.

Methods: This is a retrospective study. Tumor samples from 263 RCC patients were collected, and survival data were analyzed to detect the relationship between ESCO1 expression and patient survival. For mechanistic exploration, the impact of silence ESCO1 on proliferation, migration and apoptosis were studied in ESCO1-knockdown RCC cells.

Results: Significantly over-expression of ESCO1 was observed in renal tumor tissues. ESCO1 expression was related to the malignant degree and a high expression was associated with unfavorable prognosis in RCC patients. Moreover, down-regulation of ESCO1 attenuated cell proliferation and migration. The flow cytometry assay revealed that the knockdown of ESCO1 inhibited RCC cells from entering the G1 phase.

Conclusions: The increased ESCO1 expression in renal tumor tissues might be a useful biomarker for prognosis of RCC patients. Knockdown of ESCO1 undermined proliferation, migration of renal cancer cells, and induced the apoptosis of renal cancer cells.

Background: The increasing incidence, rapidly evolving classification, rarity and heterogeneity of neuroendocrine neoplasms (NENs) pose challenges to NEN registration including difficulty in distinguishing neuroendocrine carcinoma (NEC) and neuroendocrine tumours (NETs). Thus, in Italy a higher NEC incidence was reported. Focusing on gastroenteropancreatic (GEP) NEN, we aimed to review GEP NEN, and in particular cases of neuroendocrine carcinoma, not otherwise specified (NOS) and estimate the incidence of NEN, NET and NEC of the GEP.MethodsWe launched a pilot study examining cases of neuroendocrine carcinomas NOS (ICD-O3 code 8246) of GEP incidents in the years 2012-2020. Cancer registries (CRs) reviewed information included in the pathology report regarding differentiation and tumour cells proliferation to decide whether to confirm the case as neuroendocrine carcinoma NOS or register it as NET or NEC. After the review, we estimated the GEP NEN, NET and NEC incidence.

Results: Nine CRs contributed to the pilot study. After review, in all CRs, only 31% of GEP NOS neuroendocrine carcinomas were confirmed; 50% were recoded as NETs, and approximately 17% of cases were non-NENs. The IR of GEP NENs was 2.99/100,000, and the incidence of NETs was higher than that of NECs.

Conclusion: After the review, the incidence of GEP NEN, NET and NEC in the eight Italian CRs involved was comparable to that reported in other European countries.

Impact: Our results confirmed that heterogeneity of cancer registries in the registration of NEN requires collaborative work to define and promote a standard definition to be extended to all Italian registries.