Pub Date : 2022-07-19DOI: 10.21608/resoncol.2022.92845.1151
Nervana Hussien, Zeinab M. Elsayed, D. Ibrahim, Fatma Eltabakh
Background: Identification of prognostic factors in patients with cancer of unknown primary (CUP) is important to optimize their management. Aim: To study the clinicopathological characteristics of patients with CUP and to identify factors that influence their survival. Methods: A retrospective review of the medical records of 102 patients who presented with CUP in two Egyptian cancer care facilities during six years from 2012 to 2017 inclusive. Results: The median age of patients was 61 years (range : 40-96) and 63% were males. Well-/moderately-differentiated adenocarcinoma was the most common histopathological diagnosis (60%) followed by poorly-differentiated carcinoma (25%). The common sites of metastases were the liver (56%), lymph nodes (56%), lungs (44%), and bones (38%). The initial treatment plan was single modality treatment in 43% of patients, combined modality in 16%, and best supportive care in 41%. The 6-month time-to-progression (TTP) and overall survival (OS) rates were 52.7% and 56.1%, respectively. Eastern Cooperative Oncology Group (ECOG) performance status >1, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter TTP. Age ≥65 years, ECOG performance status >1, comorbidities, >1 metastatic site, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, best supportive care / single modality treatment plan and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter OS. Conclusions: Many factors may affect the prognosis of CUP patients, e.g., old age, poor performance status, and low serum albumin. Further studies including a larger sample size are needed to develop predictive models based on these factors in patients with CUP.
{"title":"Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt","authors":"Nervana Hussien, Zeinab M. Elsayed, D. Ibrahim, Fatma Eltabakh","doi":"10.21608/resoncol.2022.92845.1151","DOIUrl":"https://doi.org/10.21608/resoncol.2022.92845.1151","url":null,"abstract":"Background: Identification of prognostic factors in patients with cancer of unknown primary (CUP) is important to optimize their management. Aim: To study the clinicopathological characteristics of patients with CUP and to identify factors that influence their survival. Methods: A retrospective review of the medical records of 102 patients who presented with CUP in two Egyptian cancer care facilities during six years from 2012 to 2017 inclusive. Results: The median age of patients was 61 years (range : 40-96) and 63% were males. Well-/moderately-differentiated adenocarcinoma was the most common histopathological diagnosis (60%) followed by poorly-differentiated carcinoma (25%). The common sites of metastases were the liver (56%), lymph nodes (56%), lungs (44%), and bones (38%). The initial treatment plan was single modality treatment in 43% of patients, combined modality in 16%, and best supportive care in 41%. The 6-month time-to-progression (TTP) and overall survival (OS) rates were 52.7% and 56.1%, respectively. Eastern Cooperative Oncology Group (ECOG) performance status >1, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter TTP. Age ≥65 years, ECOG performance status >1, comorbidities, >1 metastatic site, bone metastasis, low serum albumin, elevated serum alkaline phosphatase, best supportive care / single modality treatment plan and single agent chemotherapy treatment (compared to combination chemotherapy) were associated with significantly shorter OS. Conclusions: Many factors may affect the prognosis of CUP patients, e.g., old age, poor performance status, and low serum albumin. Further studies including a larger sample size are needed to develop predictive models based on these factors in patients with CUP.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44685994","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 : 2022-06-30DOI: 10.21608/resoncol.2021.73214.1142
Enas El Nadi, Mariam Elsherif, M. Elwakeel, H. Taha, Maged M Elshafiey, Gehad Ahmed, M. Zagloul, Dina Elgalaly, Elham Khaled, Sahar Ahmed
Background: Primary vaginal malignancies are rare in children. Their management has evolved during the last decades from radical surgery to neoadjuvant chemotherapy followed by local control with conservative surgery or radiotherapy. Aim: To describe the presentation, management, and outcome of pediatric vaginal malignancies. Methods: Retrospective review of the medical records of children with 1 ry vaginal malignancies who had been treated at the Children’s Cancer Hospital Egypt (CCHE)-57357 from June 2007 till December 2018. Results: During the 11 years, 34 pediatric patients with 1 ry vaginal malignancies were identified. The histopathology was rhabdomyosarcoma (RMS) in 19 (55.9%) patients, germ cell tumor (GCT) in 13 (38.2%), and clear cell adenocarcinoma (CCA) in two (5.9%). Vaginal bleeding was the presenting symptom in 65% of the patients. The 5-year overall survival and event-free survival rates were 73.7% and 77.8%, respectively, in RMS patients. In GCT patients, the 5-year overall survival and event-free survival rates were 84.6% and 61.5%, respectively. One of the two CCA patients died because of disease progression and the other was alive with progressive disease. Conclusions: Primary vaginal tumors are rare in children and generally have a good prognosis. Treatment with chemotherapy only or with either conservative surgery or radiotherapy may achieve an excellent outcome in pediatric primary vaginal RMS and GCT.
{"title":"Vaginal Tumors in the Pediatric Age Group: The Children's Cancer Hospital Egypt (CCHE)-57357 Experience","authors":"Enas El Nadi, Mariam Elsherif, M. Elwakeel, H. Taha, Maged M Elshafiey, Gehad Ahmed, M. Zagloul, Dina Elgalaly, Elham Khaled, Sahar Ahmed","doi":"10.21608/resoncol.2021.73214.1142","DOIUrl":"https://doi.org/10.21608/resoncol.2021.73214.1142","url":null,"abstract":"Background: Primary vaginal malignancies are rare in children. Their management has evolved during the last decades from radical surgery to neoadjuvant chemotherapy followed by local control with conservative surgery or radiotherapy. Aim: To describe the presentation, management, and outcome of pediatric vaginal malignancies. Methods: Retrospective review of the medical records of children with 1 ry vaginal malignancies who had been treated at the Children’s Cancer Hospital Egypt (CCHE)-57357 from June 2007 till December 2018. Results: During the 11 years, 34 pediatric patients with 1 ry vaginal malignancies were identified. The histopathology was rhabdomyosarcoma (RMS) in 19 (55.9%) patients, germ cell tumor (GCT) in 13 (38.2%), and clear cell adenocarcinoma (CCA) in two (5.9%). Vaginal bleeding was the presenting symptom in 65% of the patients. The 5-year overall survival and event-free survival rates were 73.7% and 77.8%, respectively, in RMS patients. In GCT patients, the 5-year overall survival and event-free survival rates were 84.6% and 61.5%, respectively. One of the two CCA patients died because of disease progression and the other was alive with progressive disease. Conclusions: Primary vaginal tumors are rare in children and generally have a good prognosis. Treatment with chemotherapy only or with either conservative surgery or radiotherapy may achieve an excellent outcome in pediatric primary vaginal RMS and GCT.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46392054","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 : 2022-06-24DOI: 10.21608/resoncol.2021.77935.1145
H. Sayed, Radwa R Hussein, Haisam Atta, M. Abdelhamed, A. Shibl
Background: Despite the treatment progress of acute leukemias, neurological complications (NCs) can occur and may have a detrimental impact on the outcome. Aim: To study the pattern and outcome of NCs occurring during treatment of pediatric acute leukemias in Upper Egypt and to study possible factors influencing their outcomes. Methods: Children with AL who developed NCs during treatment were included. Patients with central nervous system (CNS) infiltration at diagnosis and those with any neurological insults before diagnosis were excluded. Data were retrospectively collected from patient files and included NCs, their outcome, and possible associated factors. Results: Neurological complications occurred in 89 out of 537 (16.6%) reviewed patients. Age was ≥ 10 years in 47.2% of patients, acute lymphoblastic leukemia was the most common diagnosis (77.5%) and the majority (77.9%) were classified as high-risk. Almost half of the patients suffered from NCs during the induction phase of treatment. Motor deficits and seizures were the most frequent manifestations. Neurovascular causes and peripheral neuropathy constituted 27% and 21.3% of the etiology. Other causes included CNS relapse (19.1%), seizures due to systemic causes (13.5%), CNS infections (12.4%), and leukoencephalopathy (6.7%). The treatment phase and recovery time differed significantly according to the type of NCs. The outcome of NCs was complete recovery in 67.4% of the patients, incomplete recovery in 7.9%, and no recovery and death in 24.7%. The etiology of NCs was the only factor that had a significant correlation with the outcome of the patients. Conclusions: Neurological complications during treatment occur in a significant proportion of pediatric patients with acute leukemia in South Egypt. Neurovascular causes and peripheral neuropathy are the most common NCs, and CNS hemorrhage is the most fatal. Supportive measures for these NCs must be optimized to improve outcome.
{"title":"Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt","authors":"H. Sayed, Radwa R Hussein, Haisam Atta, M. Abdelhamed, A. Shibl","doi":"10.21608/resoncol.2021.77935.1145","DOIUrl":"https://doi.org/10.21608/resoncol.2021.77935.1145","url":null,"abstract":"Background: Despite the treatment progress of acute leukemias, neurological complications (NCs) can occur and may have a detrimental impact on the outcome. Aim: To study the pattern and outcome of NCs occurring during treatment of pediatric acute leukemias in Upper Egypt and to study possible factors influencing their outcomes. Methods: Children with AL who developed NCs during treatment were included. Patients with central nervous system (CNS) infiltration at diagnosis and those with any neurological insults before diagnosis were excluded. Data were retrospectively collected from patient files and included NCs, their outcome, and possible associated factors. Results: Neurological complications occurred in 89 out of 537 (16.6%) reviewed patients. Age was ≥ 10 years in 47.2% of patients, acute lymphoblastic leukemia was the most common diagnosis (77.5%) and the majority (77.9%) were classified as high-risk. Almost half of the patients suffered from NCs during the induction phase of treatment. Motor deficits and seizures were the most frequent manifestations. Neurovascular causes and peripheral neuropathy constituted 27% and 21.3% of the etiology. Other causes included CNS relapse (19.1%), seizures due to systemic causes (13.5%), CNS infections (12.4%), and leukoencephalopathy (6.7%). The treatment phase and recovery time differed significantly according to the type of NCs. The outcome of NCs was complete recovery in 67.4% of the patients, incomplete recovery in 7.9%, and no recovery and death in 24.7%. The etiology of NCs was the only factor that had a significant correlation with the outcome of the patients. Conclusions: Neurological complications during treatment occur in a significant proportion of pediatric patients with acute leukemia in South Egypt. Neurovascular causes and peripheral neuropathy are the most common NCs, and CNS hemorrhage is the most fatal. Supportive measures for these NCs must be optimized to improve outcome.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42910821","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 : 2022-05-06DOI: 10.21608/resoncol.2022.123861.1162
S. Mousa, H. Shiba, S. Kamal, Doaa S Mahmoud, W. Edesa
Background: Polymorphisms in microRNAs (miRNAs) encoding genes are involved in carcinogenesis. However, their relation to lymphomagenesis is still unclear. Aim: To investigate the influence of miRNA-146a rs2910164 G/C polymorphism and miRNA-196a2 rs11614913 C/T polymorphism on risk and clinical outcome of high-grade B cell non-Hodgkin lymphoma (HGB-NHL). Methods: Seventy-five patients with HGB-NHL and 100 matched controls were screened for miRNA-146a rs2910164 G/C and miRNA-196a2 rs11614913 C/T polymorphisms by Polymerase Chain Reaction-Restriction Fragment length Polymorphism (PCR-RFLP). Results: The two studied miRNA polymorphisms were not associated with the risk of NHL. The GG genotype of miRNA-146a rs2910164 was associated with a worse disease-free survival (DFS) compared to the GC and CC genotypes (HR =5.7; 95% CI=1.05-31.09; p=0.044). The miRNA-196a2 rs11614913 CC genotype was associated as well with worse DFS compared to the CT and TT genotypes (HR=10.37; 95% CI=1.80-59.62; p = 0.009). No significant association was found between the studied miRNA polymorphisms and patients’ overall survival. Conclusions: miRNA-146a rs2910164 G/C and miRNA-196a2 rs11614913 C/T polymorphisms may be associated with shorter DFS in HGB-NHL.
{"title":"Genetic Variants of MicroRNA-146a and MicroRNA-196a2 are Associated with Poor Outcome but not Risk of High-Grade B- Cell Non-Hodgkin Lymphoma","authors":"S. Mousa, H. Shiba, S. Kamal, Doaa S Mahmoud, W. Edesa","doi":"10.21608/resoncol.2022.123861.1162","DOIUrl":"https://doi.org/10.21608/resoncol.2022.123861.1162","url":null,"abstract":"Background: Polymorphisms in microRNAs (miRNAs) encoding genes are involved in carcinogenesis. However, their relation to lymphomagenesis is still unclear. Aim: To investigate the influence of miRNA-146a rs2910164 G/C polymorphism and miRNA-196a2 rs11614913 C/T polymorphism on risk and clinical outcome of high-grade B cell non-Hodgkin lymphoma (HGB-NHL). Methods: Seventy-five patients with HGB-NHL and 100 matched controls were screened for miRNA-146a rs2910164 G/C and miRNA-196a2 rs11614913 C/T polymorphisms by Polymerase Chain Reaction-Restriction Fragment length Polymorphism (PCR-RFLP). Results: The two studied miRNA polymorphisms were not associated with the risk of NHL. The GG genotype of miRNA-146a rs2910164 was associated with a worse disease-free survival (DFS) compared to the GC and CC genotypes (HR =5.7; 95% CI=1.05-31.09; p=0.044). The miRNA-196a2 rs11614913 CC genotype was associated as well with worse DFS compared to the CT and TT genotypes (HR=10.37; 95% CI=1.80-59.62; p = 0.009). No significant association was found between the studied miRNA polymorphisms and patients’ overall survival. Conclusions: miRNA-146a rs2910164 G/C and miRNA-196a2 rs11614913 C/T polymorphisms may be associated with shorter DFS in HGB-NHL.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43929750","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 : 2022-04-05DOI: 10.21608/resoncol.2022.114548.1159
R. Chakraborty, C. Darido, A. Alnakli, Honghua Hu, K. Vickery
Background: Aberrant proliferation is a hallmark of cancer. Cellular proliferation mechanisms and various cytokines contribute to the progression of cancer. The tumor suppressor protein Suppressor of Cytokine Signalling 3 (SOCS3), which acts via the JAK/STAT pathway, have a role in the progression of cancer. Aim: To explore the role of SOCS3 in all the hallmarks of cancer. To exhibit SOCS3 action on proliferation pathways and immune aspect affecting cancer progression. Methods: The PubMed database was searched using the keywords proliferation, SOCS3, JAK/STAT, interleukins, and tumor suppressor. Articles relevant to SOCS3 were considered for this review. Results: In this review, we have illustrated the dual action of SOCS3, which inhibits various proliferative mechanisms and affects certain interleukins that counterbalance the progression of cancer. In addition, SOCS3 affects all the hallmarks of cancer. Conclusion: We hope that this review will stimulate further investigation of SOCS3, which has the potential to become a new target for the pharmacological treatment of various cancers in the future.
{"title":"A Review on the Dual Role of SOCS3 in Cancer","authors":"R. Chakraborty, C. Darido, A. Alnakli, Honghua Hu, K. Vickery","doi":"10.21608/resoncol.2022.114548.1159","DOIUrl":"https://doi.org/10.21608/resoncol.2022.114548.1159","url":null,"abstract":"Background: Aberrant proliferation is a hallmark of cancer. Cellular proliferation mechanisms and various cytokines contribute to the progression of cancer. The tumor suppressor protein Suppressor of Cytokine Signalling 3 (SOCS3), which acts via the JAK/STAT pathway, have a role in the progression of cancer. Aim: To explore the role of SOCS3 in all the hallmarks of cancer. To exhibit SOCS3 action on proliferation pathways and immune aspect affecting cancer progression. Methods: The PubMed database was searched using the keywords proliferation, SOCS3, JAK/STAT, interleukins, and tumor suppressor. Articles relevant to SOCS3 were considered for this review. Results: In this review, we have illustrated the dual action of SOCS3, which inhibits various proliferative mechanisms and affects certain interleukins that counterbalance the progression of cancer. In addition, SOCS3 affects all the hallmarks of cancer. Conclusion: We hope that this review will stimulate further investigation of SOCS3, which has the potential to become a new target for the pharmacological treatment of various cancers in the future.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68554299","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 : 2022-02-11DOI: 10.21608/resoncol.2021.99181.1153
A. Elashwah, A. Badran, M. Elshenawy, A. Azzam, Rania Naguib, Aisha Alshibani, Reem Alrakaf, A. Eldali, T. Amin
Background: Peritoneal sarcomatosis (PS) is an aggressive disease; cytoreductive surgery (CRS) could be curative. Can the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) +/- intraoperative radiation therapy (IORT) overcome treatment failure with an overall survival benefit. Methods: Retrospective review of the medical records of patients with PS treated by CRS, HIPEC and IORT at a comprehensive cancer center in the period between 2011-2016. Results: Twenty-four patients were identified. Fifteen were men and their median age was 58 years. Liposarcoma was the most frequent diagnosis (50%). Cytoreduction completeness (CC) score 0/1 was achieved in 19 patients, with a median pathological peritoneal cancer index (pPCI) of 12. Intraoperative radiation therapy was given in 16 patients. Eight patients developed grade III-IV Clavien-Dindo post-operative complications and 1 patient died 5 days post operative. Adjuvant chemotherapy was received in 9 patients. After a median follow-up of 28.5 months, the median PFS was 20.7 months, while the estimated 2- and 4-year PFS were 37.1% and 19.1%, respectively. The median OS was 176.5 months and the estimated 2- and 4-year OS were 95.8% and 79.8%, respectively. In the univariate analysis, the PFS differed significantly according to the CC score only. The median PFS for patients with CC 0-1 was 23.8 vs. 8.8 months for those with CC 2-3 (p = 0.027). Conclusions: The addition of HIPEC and IORT to CRS in the management of PS is feasible and safe. Comparing our results to several studies, this multimodality approach seems to improve local and regional control rates. A larger cohort of patients is needed for further evaluation and to give a concrete conclusion.
{"title":"Outcome and Safety of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) +/- Intraoperative Radiation Therapy (IORT) in the Management of Peritoneal Sarcomatosis: A Real-World Experience","authors":"A. Elashwah, A. Badran, M. Elshenawy, A. Azzam, Rania Naguib, Aisha Alshibani, Reem Alrakaf, A. Eldali, T. Amin","doi":"10.21608/resoncol.2021.99181.1153","DOIUrl":"https://doi.org/10.21608/resoncol.2021.99181.1153","url":null,"abstract":"Background: Peritoneal sarcomatosis (PS) is an aggressive disease; cytoreductive surgery (CRS) could be curative. Can the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) +/- intraoperative radiation therapy (IORT) overcome treatment failure with an overall survival benefit. Methods: Retrospective review of the medical records of patients with PS treated by CRS, HIPEC and IORT at a comprehensive cancer center in the period between 2011-2016. Results: Twenty-four patients were identified. Fifteen were men and their median age was 58 years. Liposarcoma was the most frequent diagnosis (50%). Cytoreduction completeness (CC) score 0/1 was achieved in 19 patients, with a median pathological peritoneal cancer index (pPCI) of 12. Intraoperative radiation therapy was given in 16 patients. Eight patients developed grade III-IV Clavien-Dindo post-operative complications and 1 patient died 5 days post operative. Adjuvant chemotherapy was received in 9 patients. After a median follow-up of 28.5 months, the median PFS was 20.7 months, while the estimated 2- and 4-year PFS were 37.1% and 19.1%, respectively. The median OS was 176.5 months and the estimated 2- and 4-year OS were 95.8% and 79.8%, respectively. In the univariate analysis, the PFS differed significantly according to the CC score only. The median PFS for patients with CC 0-1 was 23.8 vs. 8.8 months for those with CC 2-3 (p = 0.027). Conclusions: The addition of HIPEC and IORT to CRS in the management of PS is feasible and safe. Comparing our results to several studies, this multimodality approach seems to improve local and regional control rates. A larger cohort of patients is needed for further evaluation and to give a concrete conclusion.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47381047","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 : 2022-01-30DOI: 10.21608/resoncol.2021.75528.1144
A. Shibl, H. Sayed, A. Zahran
Background: Relapse is the main reason of treatment failure in childhood acute Lymphoblastic leukemia (ALL). Aim: To study the treatment outcome of first ALL relapse in response to two different reinduction regimens and prognostic factors predicting outcome. Methods: A retrospective study that included 82 children with ALL in the 1st relapse from two tertiary oncology centers in Upper Egypt. Patients were treated according to the St. Jude ALL-R16 protocol. Seventeen patients were treated with a standard reinduction (regimen 1) and 65 were treated with a modified reinduction regimen in which anthracycline was added and asparaginase was reduced to 9 doses (regimen 2). Response, survival and prognostic factors were analyzed. Results: Second, complete remission (CR2) was achieved in 57% of all patients (65% with regimen 2 vs. 29% with regimen 1, p = 0.009). FLAG regimen resulted in achieving CR2 in all patients with reinduction failure. Treatment related mortality was more common with regimen 2 than with regimen 1 (34% vs. 12%, respectively). For all patients, the 2-year overall and event-free survival rates were 30% and 25%. In multivariate analysis, high initial total leukocytic count, isolated medullary relapse, regimen 1 and very early relapse were independently associated with worse event free survival (p = 0.031, 0.017, 0.037 and 0.001; respectively). Conclusions: The overall outcome of treatment of first ALL relapse in children in our region is poor. New intensive chemotherapy regimens may help in improving the treatment outcome.
{"title":"First Relapse of Acute Lymphoblastic Leukemia in Children in Upper Egypt: Survival Outcome and Prognostic Factors","authors":"A. Shibl, H. Sayed, A. Zahran","doi":"10.21608/resoncol.2021.75528.1144","DOIUrl":"https://doi.org/10.21608/resoncol.2021.75528.1144","url":null,"abstract":"Background: Relapse is the main reason of treatment failure in childhood acute Lymphoblastic leukemia (ALL). Aim: To study the treatment outcome of first ALL relapse in response to two different reinduction regimens and prognostic factors predicting outcome. Methods: A retrospective study that included 82 children with ALL in the 1st relapse from two tertiary oncology centers in Upper Egypt. Patients were treated according to the St. Jude ALL-R16 protocol. Seventeen patients were treated with a standard reinduction (regimen 1) and 65 were treated with a modified reinduction regimen in which anthracycline was added and asparaginase was reduced to 9 doses (regimen 2). Response, survival and prognostic factors were analyzed. Results: Second, complete remission (CR2) was achieved in 57% of all patients (65% with regimen 2 vs. 29% with regimen 1, p = 0.009). FLAG regimen resulted in achieving CR2 in all patients with reinduction failure. Treatment related mortality was more common with regimen 2 than with regimen 1 (34% vs. 12%, respectively). For all patients, the 2-year overall and event-free survival rates were 30% and 25%. In multivariate analysis, high initial total leukocytic count, isolated medullary relapse, regimen 1 and very early relapse were independently associated with worse event free survival (p = 0.031, 0.017, 0.037 and 0.001; respectively). Conclusions: The overall outcome of treatment of first ALL relapse in children in our region is poor. New intensive chemotherapy regimens may help in improving the treatment outcome.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43094694","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 : 2022-01-20DOI: 10.21608/resoncol.2021.79122.1146
H. H. Zawam, Ahmed Selim, N. Osman, W. Edesa
Background: Testicular germ cell tumors (TGCTs) are the most common cancer in young adult males, and they represent one of the most curable solid tumors. The treatment modalities of different stages are variable among centers. Aim: To describe the management of TGCTs and its outcome in an Egyptian cancer center. Methods: The medical records of patients with TGCT treated between January 2012 and December 2016 were retrospectively reviewed. Thirty-two patients were included. Demographic, clinical, treatment, and outcome data were analyzed. Results: The median age of the patients was 34.5 years. The most common presentation was unilateral painless testicular mass (87.5%). Seminoma represented 53% of cases and almost half of them had Stage I disease. For all patients, the clinical stage and International Germ Cell Cancer Collaborative Group (IGCCC) risk classification were significantly associated with survival outcomes. Five-year overall survival for stage I patients was 100%, compared to 87.5% for stage II (p<0.0001). Patients with good risk had a 5-year OS of 87.4% while none of the poor risk group survived for 5 years (p =0.002). The 5-year disease-free survival for stage I was 83% for those who remained under active surveillance versus 87.5% for those who received adjuvant carboplatin (p=0.364). Conclusions: Stage I TGCTs has an excellent overall survival regardless of the treatment modality received. In advanced disease, the clinical stage and IGCCC risk stratification remain valid prognostic risk factors.
{"title":"Factors Influencing the Response Rate and Survival of Testicular Germ Cell Tumors: A Single Institution Experience from Egypt","authors":"H. H. Zawam, Ahmed Selim, N. Osman, W. Edesa","doi":"10.21608/resoncol.2021.79122.1146","DOIUrl":"https://doi.org/10.21608/resoncol.2021.79122.1146","url":null,"abstract":"Background: Testicular germ cell tumors (TGCTs) are the most common cancer in young adult males, and they represent one of the most curable solid tumors. The treatment modalities of different stages are variable among centers. Aim: To describe the management of TGCTs and its outcome in an Egyptian cancer center. Methods: The medical records of patients with TGCT treated between January 2012 and December 2016 were retrospectively reviewed. Thirty-two patients were included. Demographic, clinical, treatment, and outcome data were analyzed. Results: The median age of the patients was 34.5 years. The most common presentation was unilateral painless testicular mass (87.5%). Seminoma represented 53% of cases and almost half of them had Stage I disease. For all patients, the clinical stage and International Germ Cell Cancer Collaborative Group (IGCCC) risk classification were significantly associated with survival outcomes. Five-year overall survival for stage I patients was 100%, compared to 87.5% for stage II (p<0.0001). Patients with good risk had a 5-year OS of 87.4% while none of the poor risk group survived for 5 years (p =0.002). The 5-year disease-free survival for stage I was 83% for those who remained under active surveillance versus 87.5% for those who received adjuvant carboplatin (p=0.364). Conclusions: Stage I TGCTs has an excellent overall survival regardless of the treatment modality received. In advanced disease, the clinical stage and IGCCC risk stratification remain valid prognostic risk factors.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43868438","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 : 2022-01-15DOI: 10.21608/resoncol.2021.72839.1140
Mohamed I Abdelaziz, S. Monib
Background: Sentinel lymph node biopsy (SLNB) after primary chemotherapy for node-positive breast cancer patients has been gaining popularity as part of the de-escalation of treatment. Aim: The 1ry aim was to assess the surgical outcome of node-positive patients who received primary chemotherapy followed by SLNB. A 2ry aim was to determine the rate of sentinel lymph node identification using the patent blue dye only technique. Methods: A prospective study that included 86 patients with invasive breast cancer and axillary lymph nodes metastasis as proved by ultrasound scan guided core biopsy. Following the completion of primary chemotherapy, sentinel lymph node biopsy was carried out for all patients at the time of breast surgery using the patent blue dye technique. Patients with negative SLNB underwent no further axillary procedure. Completion of axillary lymph node clearance was performed for positive SLNB patients. Results: The sentinel lymph node identification rate using the patent blue dye directed technique was 79%. Sixtyseven (78%) patients underwent wide local excision, and 35% did not need completion of axillary lymph node clearance due to downstaging following primary chemotherapy. Conclusions: Sentinel lymph node biopsy following primary chemotherapy for invasive breast cancer appears to be a safe, reliable technique, with an acceptable identification rate, even when using the patent blue dye technique only.
{"title":"Evaluation of Sentinel Lymph Node Biopsy After Primary Chemotherapy as Part of De-Escalation of Breast Cancer Treatment","authors":"Mohamed I Abdelaziz, S. Monib","doi":"10.21608/resoncol.2021.72839.1140","DOIUrl":"https://doi.org/10.21608/resoncol.2021.72839.1140","url":null,"abstract":"Background: Sentinel lymph node biopsy (SLNB) after primary chemotherapy for node-positive breast cancer patients has been gaining popularity as part of the de-escalation of treatment. Aim: The 1ry aim was to assess the surgical outcome of node-positive patients who received primary chemotherapy followed by SLNB. A 2ry aim was to determine the rate of sentinel lymph node identification using the patent blue dye only technique. Methods: A prospective study that included 86 patients with invasive breast cancer and axillary lymph nodes metastasis as proved by ultrasound scan guided core biopsy. Following the completion of primary chemotherapy, sentinel lymph node biopsy was carried out for all patients at the time of breast surgery using the patent blue dye technique. Patients with negative SLNB underwent no further axillary procedure. Completion of axillary lymph node clearance was performed for positive SLNB patients. Results: The sentinel lymph node identification rate using the patent blue dye directed technique was 79%. Sixtyseven (78%) patients underwent wide local excision, and 35% did not need completion of axillary lymph node clearance due to downstaging following primary chemotherapy. Conclusions: Sentinel lymph node biopsy following primary chemotherapy for invasive breast cancer appears to be a safe, reliable technique, with an acceptable identification rate, even when using the patent blue dye technique only.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42464460","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 : 2021-04-16DOI: 10.21608/RESONCOL.2021.40562.1113
W. Hashem, T. el-nahas, Marine Fawzy, S. Mashhour, M. Zedan, K. Mashhour
Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. To optimize its management, different risk stratification schemes had been developed for GIST. Aim: To describe the clinicopathological profile and management of GIST and to evaluate three different GIST risk stratification schemes. Methods: Retrospective review of patients treated in a single Egyptian center during an 11-year period. High-risk GIST was identified using three different risk stratification schemes; the Armed Forces Institute of Pathology (AFIP) scheme, the National Institute of Health (NIH) consensus scheme and the American Joint Committee on Cancer (AJCC) TNM staging system. Results: The disease extent at the presentation of 34 patients was localized in 19 (56%), locally advanced in 4 (12%) and metastatic in 11 (32%). Twenty-one (62%) underwent surgery and achieved complete remission. Their median overall survival was not reached. The median disease-free survival (DFS) was 58.2 months (95%CI: 28.8 – 58.2) and the 3-year rate was 66%. Non-gastric GIST, larger tumors (>10cm) and high mitotic index (>5 / 50 HPF) was associated with shorter DFS (p = 0.146, 0.047 and 0.06, respectively). The AFIP, NIH consensus and AJCC TNM risk stratification methods identified high-risk groups that had a significantly shorter median DFS than lower-risk groups (p = 0.022, 0.009 and 0.22, respectively). Conclusion: All the studied three risk stratification schemes categorized a high-risk group with significantly poorer outcome. According to the information available, any of these schemes may be used in identifying high-risk GIST.
{"title":"Gastrointestinal Stromal Tumor: Clinicopathological Features, Management, and Comparison of Three Risk Stratification Schemes","authors":"W. Hashem, T. el-nahas, Marine Fawzy, S. Mashhour, M. Zedan, K. Mashhour","doi":"10.21608/RESONCOL.2021.40562.1113","DOIUrl":"https://doi.org/10.21608/RESONCOL.2021.40562.1113","url":null,"abstract":"Background: Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. To optimize its management, different risk stratification schemes had been developed for GIST. Aim: To describe the clinicopathological profile and management of GIST and to evaluate three different GIST risk stratification schemes. Methods: Retrospective review of patients treated in a single Egyptian center during an 11-year period. High-risk GIST was identified using three different risk stratification schemes; the Armed Forces Institute of Pathology (AFIP) scheme, the National Institute of Health (NIH) consensus scheme and the American Joint Committee on Cancer (AJCC) TNM staging system. Results: The disease extent at the presentation of 34 patients was localized in 19 (56%), locally advanced in 4 (12%) and metastatic in 11 (32%). Twenty-one (62%) underwent surgery and achieved complete remission. Their median overall survival was not reached. The median disease-free survival (DFS) was 58.2 months (95%CI: 28.8 – 58.2) and the 3-year rate was 66%. Non-gastric GIST, larger tumors (>10cm) and high mitotic index (>5 / 50 HPF) was associated with shorter DFS (p = 0.146, 0.047 and 0.06, respectively). The AFIP, NIH consensus and AJCC TNM risk stratification methods identified high-risk groups that had a significantly shorter median DFS than lower-risk groups (p = 0.022, 0.009 and 0.22, respectively). Conclusion: All the studied three risk stratification schemes categorized a high-risk group with significantly poorer outcome. According to the information available, any of these schemes may be used in identifying high-risk GIST.","PeriodicalId":33915,"journal":{"name":"Research in Oncology","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44375587","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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