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Predictors of Survival of Patients with Cancer of Unknown Primary Site: A Retrospective Study from Two Institutions in Egypt 原发部位未知的癌症患者的生存预测因素:来自埃及两个机构的回顾性研究
Pub Date : 2022-07-19 DOI: 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.
背景:确定未知原发癌(CUP)患者的预后因素对优化其治疗具有重要意义。目的:探讨CUP患者的临床病理特点,探讨影响其生存的因素。方法:回顾性分析2012年至2017年(含6年)期间在埃及两家癌症护理机构就诊的102例CUP患者的病历。结果:患者中位年龄为61岁(40-96岁),63%为男性。高/中分化腺癌是最常见的组织病理学诊断(60%),其次是低分化癌(25%)。常见的转移部位为肝脏(56%)、淋巴结(56%)、肺部(44%)和骨骼(38%)。43%的患者的初始治疗计划为单一模式治疗,16%的患者采用联合模式治疗,41%的患者采用最佳支持治疗。6个月的进展时间(TTP)和总生存率(OS)分别为52.7%和56.1%。东部肿瘤合作组(ECOG)工作状态>1、骨转移、低血清白蛋白、血清碱性磷酸酶升高、单药化疗(与联合化疗相比)与TTP显著缩短相关。年龄≥65岁、ECOG表现状态>、合并症、>转移部位、骨转移、低血清白蛋白、血清碱性磷酸酶升高、最佳支持治疗/单一模式治疗方案和单药化疗(与联合化疗相比)与较短的OS相关。结论:影响CUP患者预后的因素很多,如年龄大、运动状态差、血清白蛋白水平低等。需要进一步的研究,包括更大的样本量来建立基于这些因素的CUP患者的预测模型。
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引用次数: 0
Vaginal Tumors in the Pediatric Age Group: The Children's Cancer Hospital Egypt (CCHE)-57357 Experience 儿科年龄组的阴道肿瘤:埃及癌症儿童医院(CCHE)-557357经验
Pub Date : 2022-06-30 DOI: 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.
背景:原发性阴道恶性肿瘤在儿童中很少见。在过去的几十年里,他们的治疗已经从根治性手术发展到新辅助化疗,然后用保守手术或放疗进行局部控制。目的:描述儿童阴道恶性肿瘤的表现、治疗和预后。方法:回顾性分析2007年6月至2018年12月在埃及儿童肿瘤医院(CCHE)-57357治疗的1 ry阴道恶性肿瘤患儿的医疗记录。结果:在11年的时间里,34例儿童患者被确诊为1例阴道恶性肿瘤。组织病理为横纹肌肉瘤19例(55.9%),生殖细胞瘤13例(38.2%),透明细胞腺癌2例(5.9%)。65%的患者以阴道出血为主要症状。RMS患者的5年总生存率和无事件生存率分别为73.7%和77.8%。GCT患者的5年总生存率和无事件生存率分别为84.6%和61.5%。2例CCA患者中1例因疾病进展而死亡,另1例因疾病进展而存活。结论:儿童原发阴道肿瘤少见,预后良好。在儿童原发性阴道RMS和GCT中,单纯化疗或保守性手术或放疗均可获得很好的治疗效果。
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引用次数: 0
Pattern and Outcome of Neurological Complications During the Treatment of Pediatric Acute Leukemias in Upper Egypt 上埃及儿童急性白血病治疗过程中神经系统并发症的模式和结果
Pub Date : 2022-06-24 DOI: 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.
背景:尽管急性白血病的治疗取得了进展,但神经系统并发症(nc)仍可能发生,并可能对治疗结果产生不利影响。目的:研究上埃及地区儿童急性白血病治疗过程中发生的NCs的模式和结局,并探讨影响其结局的可能因素。方法:纳入在治疗过程中发生nc的AL患儿。排除诊断时有中枢神经系统(CNS)浸润及诊断前有神经损伤的患者。从患者档案中回顾性收集数据,包括nc、其结果和可能的相关因素。结果:537例患者中有89例(16.6%)出现神经系统并发症。年龄≥10岁的患者占47.2%,急性淋巴细胞白血病是最常见的诊断(77.5%),大多数(77.9%)被归为高危。在治疗的诱导阶段,几乎一半的患者患有神经细胞癌。运动障碍和癫痫是最常见的表现。神经血管病因和周围神经病变分别占27%和21.3%。其他原因包括中枢神经系统复发(19.1%)、全身性原因引起的癫痫发作(13.5%)、中枢神经系统感染(12.4%)和脑白质病(6.7%)。不同nc类型的治疗期和恢复时间有显著差异。NCs的结果为67.4%的患者完全恢复,7.9%的患者不完全恢复,24.7%的患者无恢复和死亡。NCs的病因是唯一与患者预后有显著相关性的因素。结论:在治疗过程中神经系统并发症发生在南埃及急性白血病儿童患者的显著比例。神经血管原因和周围神经病变是最常见的nc,而中枢神经系统出血是最致命的。必须优化对这些国家的支持措施,以改善结果。
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引用次数: 0
Genetic Variants of MicroRNA-146a and MicroRNA-196a2 are Associated with Poor Outcome but not Risk of High-Grade B- Cell Non-Hodgkin Lymphoma MicroRNA-146a和MicroRNA-196a2的遗传变异与预后不良相关,但与高级别B细胞非霍奇金淋巴瘤的风险无关
Pub Date : 2022-05-06 DOI: 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.
背景:microRNAs (miRNAs)编码基因的多态性参与了肿瘤的发生。然而,它们与淋巴瘤发生的关系尚不清楚。目的:探讨miRNA-146a rs2910164 G/C多态性和miRNA-196a2 rs11614913 C/T多态性对高级别B细胞非霍奇金淋巴瘤(HGB-NHL)发病风险和临床结局的影响。方法:采用聚合酶链反应限制性片段长度多态性(PCR-RFLP)对75例HGB-NHL患者和100例匹配对照进行miRNA-146a rs2910164 G/C和miRNA-196a2 rs11614913 C/T多态性筛选。结果:研究的两种miRNA多态性与NHL的风险无关。与GC和CC基因型相比,miRNA-146a rs2910164的GG基因型与更差的无病生存(DFS)相关(HR =5.7;95%可信区间= 1.05 - -31.09;p = 0.044)。与CT和TT基因型相比,miRNA-196a2 rs11614913 CC基因型与更差的DFS相关(HR=10.37;95%可信区间= 1.80 - -59.62;P = 0.009)。所研究的miRNA多态性与患者总生存期之间未发现显著相关性。结论:miRNA-146a rs2910164 G/C和miRNA-196a2 rs11614913 C/T多态性可能与HGB-NHL患者DFS缩短有关。
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引用次数: 0
A Review on the Dual Role of SOCS3 in Cancer SOCS3在癌症中的双重作用研究进展
Pub Date : 2022-04-05 DOI: 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.
背景:异常增生是癌症的一个标志。细胞增殖机制和各种细胞因子参与了癌症的发展。肿瘤抑制蛋白细胞因子信号传导3 (SOCS3)通过JAK/STAT通路起作用,在癌症的进展中起作用。目的:探讨SOCS3在癌症的所有标志中的作用。研究SOCS3在影响肿瘤进展的增殖途径和免疫方面的作用。方法:使用关键词增殖、SOCS3、JAK/STAT、白细胞介素、肿瘤抑制因子等检索PubMed数据库。本综述考虑了与SOCS3相关的文章。结果:在这篇综述中,我们阐明了SOCS3的双重作用,它抑制多种增殖机制,并影响某些平衡癌症进展的白细胞介素。此外,SOCS3影响癌症的所有特征。结论:我们希望这篇综述能激发对SOCS3的进一步研究,它有可能成为未来各种癌症药物治疗的新靶点。
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引用次数: 2
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 细胞减灭术(CRS)和腹膜内热疗(HIPEC)+/-术中放疗(IORT)治疗腹膜肉瘤的疗效和安全性:真实世界的经验
Pub Date : 2022-02-11 DOI: 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.
背景:腹膜肉瘤病(PS)是一种侵袭性疾病;细胞减缩手术(CRS)可以治愈。腹腔高温化疗(HIPEC) +/-术中放射治疗(IORT)是否能克服治疗失败并提高总体生存期?方法:回顾性分析2011-2016年在某综合癌症中心接受CRS、HIPEC和IORT治疗的PS患者的病历。结果:共发现24例患者。其中15人是男性,平均年龄为58岁。脂肪肉瘤是最常见的诊断(50%)。19例患者达到细胞减少完整性(CC)评分0/1,中位病理性腹膜癌指数(pPCI)为12。术中放疗16例。8例患者出现III-IV级Clavien-Dindo术后并发症,1例患者术后5天死亡。9例患者接受辅助化疗。中位随访28.5个月后,中位PFS为20.7个月,而估计的2年和4年PFS分别为37.1%和19.1%。中位OS为176.5个月,估计2年和4年OS分别为95.8%和79.8%。在单变量分析中,PFS仅根据CC评分存在显著差异。CC 0-1患者的中位PFS为23.8个月,CC 2-3患者的中位PFS为8.8个月(p = 0.027)。结论:在CRS基础上加用HIPEC和IORT治疗PS是可行且安全的。将我们的结果与几项研究进行比较,这种多模式方法似乎提高了地方和区域控制率。需要更大的患者队列进行进一步评估并给出具体结论。
{"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}
引用次数: 0
First Relapse of Acute Lymphoblastic Leukemia in Children in Upper Egypt: Survival Outcome and Prognostic Factors 上埃及儿童急性淋巴细胞白血病首次复发:生存结局和预后因素
Pub Date : 2022-01-30 DOI: 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.
背景:复发是儿童急性淋巴细胞白血病(ALL)治疗失败的主要原因。目的:研究两种不同再诱导方案对首次ALL复发的治疗效果以及预测结果的预后因素。方法:一项回顾性研究,包括来自上埃及两个三级肿瘤中心的82名首次复发的ALL儿童。根据圣犹达ALL-R16方案对患者进行治疗。17名患者接受标准再诱导治疗(方案1),65名患者接受改良再诱导治疗,其中添加蒽环类药物并将天冬酰胺酶减少至9剂(方案2)。分析疗效、生存率和预后因素。结果:第二,57%的患者获得了完全缓解(CR2)(方案2为65%,方案1为29%,p=0.009)。FLAG方案导致所有再诱导失败的患者获得CR2。与方案1相比,方案2的治疗相关死亡率更常见(分别为34%和12%)。所有患者的2年总生存率和无事件生存率分别为30%和25%。在多变量分析中,高初始总白细胞计数、孤立性骨髓复发、方案1和非常早期的复发与较差的无事件生存率独立相关(分别为p=0.031、0.017、0.037和0.001)。结论:我们地区儿童首次ALL复发的治疗总体效果不佳。新的强化化疗方案可能有助于改善治疗效果。
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引用次数: 1
Factors Influencing the Response Rate and Survival of Testicular Germ Cell Tumors: A Single Institution Experience from Egypt 影响睾丸生殖细胞肿瘤应答率和生存率的因素:埃及单一机构的经验
Pub Date : 2022-01-20 DOI: 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.
背景:睾丸生殖细胞肿瘤(TGCT)是青年男性最常见的癌症,也是最可治愈的实体瘤之一。不同阶段的治疗方式因中心而异。目的:描述埃及癌症中心TGCT的管理及其结果。方法:回顾性分析2012年1月至2016年12月期间接受TGCT治疗的患者的病历。包括32名患者。对人口统计学、临床、治疗和结果数据进行分析。结果:患者的中位年龄为34.5岁。最常见的表现是单侧无痛性睾丸肿块(87.5%),占53%的病例为精原细胞瘤,其中近一半为I期疾病。对于所有患者,临床分期和国际癌症生殖细胞合作小组(IGCC)风险分类与生存结果显著相关。I期患者的5年总生存率为100%,与II期的87.5%相比(p<0.0001)。高危患者的5年OS为87.4%,而低危组无一存活5年(p=0.002)。仍在积极监测下的患者I期的5年无病生存率为83%,而接受卡铂辅助治疗的患者为87.5%(p=0.364)。结论:I期TGCT具有良好的总生存率而不管所接受的治疗方式如何。在晚期疾病中,临床分期和IGCC风险分层仍然是有效的预后风险因素。
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引用次数: 2
Evaluation of Sentinel Lymph Node Biopsy After Primary Chemotherapy as Part of De-Escalation of Breast Cancer Treatment 原发性化疗后前哨淋巴结活检作为乳腺癌治疗降级的一部分的评估
Pub Date : 2022-01-15 DOI: 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.
背景:淋巴结阳性乳腺癌患者原发性化疗后前哨淋巴结活检(SLNB)作为降级治疗的一部分越来越受欢迎。目的:第一个目的是评估淋巴结阳性患者接受原发性化疗后SLNB的手术结果。一个主要的目的是确定前哨淋巴结的识别率使用专利的蓝色染料技术。方法:对86例浸润性乳腺癌伴腋窝淋巴结转移患者进行前瞻性研究,经超声引导下的核心活检证实。在完成初次化疗后,所有患者在乳房手术时使用专利的蓝色染料技术进行前哨淋巴结活检。SLNB阴性的患者不接受进一步的腋窝手术。SLNB阳性患者完成腋窝淋巴结清扫。结果:专利蓝染料定向技术对前哨淋巴结的检出率为79%。67例(78%)患者接受了广泛的局部切除,35%的患者由于初次化疗后分期降低而不需要完成腋窝淋巴结清扫。结论:侵袭性乳腺癌原发性化疗后前哨淋巴结活检似乎是一种安全可靠的技术,即使仅使用专利的蓝色染料技术,也具有可接受的识别率。
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引用次数: 0
Gastrointestinal Stromal Tumor: Clinicopathological Features, Management, and Comparison of Three Risk Stratification Schemes 胃肠道间质瘤:临床病理特征、管理和三种风险分层方案的比较
Pub Date : 2021-04-16 DOI: 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.
背景:胃肠道间质瘤(GIST)是胃肠道最常见的间质肿瘤。为了优化GIST的管理,对GIST制定了不同的风险分层方案。目的:描述GIST的临床病理特征和治疗,并评估三种不同的GIST风险分层方案。方法:回顾性分析11年间在埃及某一中心接受治疗的患者。使用三种不同的风险分层方案确定高风险GIST;美国武装部队病理研究所(AFIP)方案、美国国立卫生研究院(NIH)共识方案和美国癌症联合委员会(AJCC) TNM分期系统。结果:34例患者首发时病变范围局限19例(56%),局部进展4例(12%),转移11例(32%)。21例(62%)接受了手术并获得完全缓解。他们的中位总生存期没有达到。中位无病生存期(DFS)为58.2个月(95%CI: 28.8 - 58.2), 3年生存率为66%。非胃间质瘤、较大肿瘤(>0 cm)和高有丝分裂指数(>5 / 50 HPF)与较短的DFS相关(p分别为0.146、0.047和0.06)。AFIP、NIH consensus和AJCC TNM风险分层方法确定高危组的中位DFS显著短于低危组(p分别= 0.022、0.009和0.22)。结论:所研究的三种风险分层方案均属于预后明显较差的高危人群。根据现有信息,这些方案中的任何一种都可用于识别高风险GIST。
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Research in Oncology
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