Journal of Buon最新文献

Coronavirus-related Severe Acute Respiratory Syndrome (SARS-CoV) in 2002/2003, Middle-East Respiratory Syndrome (MERS-Cov) in 2012/2013, and especially the current 2019/2020 Severe Acute Respiratory Syndrome-2 (SARS-CoV-2) tested the national health systems' endurance worldwide. In order to fight this emergency situation, a variety of pharmaceutical companies focused on the design and development of efficient vaccines that are considered necessary for providing a level of normalization in totally affected human social-economical activity worldwide. COVID-19 led to an increased uncertainty in the field of oncological patients' management disrupting the normal conditions of therapeutic and monitoring procedures. In the current article, we explored the impact of SARS-CoV-2 infection on oral carcinoma patients. We observed COVD-19 pandemic negatively affects the normality regarding early diagnosis and optimal management (surgical operation, post-operational follow up/monitoring) in HNSCC/OSCC patients. Understanding the involvement of SARS-CoV-2 in the progression of malignancies is the first critical step for targeting the virus by efficient monoclonal antibodies and vaccines.

Molecular biology of cancer cell is a domain of medical science that is rapidly growing in our days. Knowing the ways and paths that cancer cells follow is crucial to the prevention of cancer itself. Central role to these paths, concerning the cell cycle and the process of apoptosis, has the protein p53. The whole mechanism of the cell cycle is activated by the action of various mitogens, such as growth factors, hormones and cytokines. Carcinogenesis involves alterations of genes (proto-oncogenes and tumor suppressor genes), which encode proteins of the signal transduction. Many of the damages that lead to carcinogenesis may be due to the lack of repressive signals for cell division, but also to the absence of the sensitivity of cells to repressive signals. The cell has mechanisms of receiving apoptotic-antitumor signals and mechanisms of execution of these instructions. A percentage of cancers (4-8%) are etiologically linked to germ (stem) cells mutations and occur at an increased frequency in families (hereditary cancers). Substantial progress in understanding the mechanisms of carcinogenesis, filtration and metastasis of cancer has highlighted the key role of specific genes, primarily oncogenes and tumor suppressor genes.

Cancer-related lymphedema is the result of surgical operation or radiation therapy of the corresponding lymph nodes and is due to the obstruction of the lymphatic drainage in the affected area. In lymphedema the lymphatic stasis causes an inflammatory reaction that leads to the proliferation of adipose tissue and fibrosis, resulting in mild to severe permanent swelling of the affected part of the body. It is more often found in the upper extremities of women with breast cancer. It may, however, appear at one or more extremities and may include the corresponding quadrant of the trunk. It may also affect head and neck, breast, genitals and lower extremities, depending on the surgery the patient has undergone. It is often associated with obesity (BMI>40). Early diagnosis and treatment of lymphedema is related with better therapeutic outcome. Women with breast cancer confront more problems with lymphedema than with mastectomy. Its effect on patients' quality of life is relevant to changes in body image, self-esteem, feelings of weakness, fear and anxiety about disease progression, financial costs, and reduced limb function. More recent studies support the effectiveness of contemporary surgical techniques in lymphedema's treatment. In conservative management, CDT remains the treatment of choice and in combination with exercise, weight control programs and self-care training seems to significantly improve patients' quality of life.

Purpose: The aim of the present study is to evaluate the concordance between preoperative endometrial sampling histopathology performed by conventional dilatation and curettage (D&C) and final histopathological diagnosis after total hysterectomy concerning tumor grade and subtype in patients with endometrial cancer (EC).

Methods: In this comparative retrospective study, 203 women with endometrial cancer were included who underwent at first dilatation and curettage and then total hysterectomy. The preoperative histopathological report obtained by dilatation and curettage was compared with the final histopathology after total hysterectomy to assess the accuracy of endometrial sampling.

Results: Comparison of preoperative with postoperative histopathological results showed an overall 5.9% and 10.9% discordance regarding endometrial cancer histological subtype and grade, respectively. Six (4.9%) of the patients with preoperative grade 1 were grade 2 and 1 (0.8%) was found to be grade 3. Three (8.3%) of the patients with preoperative grade 2 were found to be grade 3 after hysterectomy. Discordance is higher for endometrioid endometrial cancer grade 2 (25%) compared with grade 1 (5.7%) and 3 (18.8%).

Conclusion: Patients should be informed and consent for the potential discrepancy between the pre and postoperative histopathological features of malignancy. This discrepancy may result in either under or overtreatment. Thus, it should be accounted for when counseling for a major operation.

Purpose: To evaluate the sexual functions of prostate cancer patients receiving radiotherapy (RT) with curative intent.

Methods: Fifty patients with low-risk prostate cancer who responded to the international index of erectile function (IIEF) questionnaire before and after RT were included in the study Results: Statistically significant decline was observed in sexual functions by the end of RT. While the average sexual desire scores of the patients before RT was 6.24, it decreased to 3.62 (p=0.001) after RT. The average of sexual satisfaction scores dropped from 8.94 to 4.6 (p=0.001), the average of erection function scores dropped from 20.14 to 11.76 (p=0.001), orgasmic function scores dropped from 9.6 to 3.9 (p=0.001) and the average of overall satisfaction scores dropped from 7.48 to 4.36 (p=0.001).

Conclusion: Sexual functions evaluated by the IIEF questionnaire decrease by the end of RT.

Purpose: The neutrophil-to-lymphocyte ratio (NLR) is an accessible marker from a routine blood test. This study explored the prognostic and predictive value of a change in NLR (c-NLR) after chemotherapy, baseline NLR (bNLR) and chemotherapy response, in metastatic gastric cancer (mGC) patients.

Methods: A total of 116 mGC patients treated between 2009 to 2019 at seven hospitals from Galician Research Group on Digestive Tumors (GITuD) were reviewed in a multicentre, ambispective and observational study. NLR was calculated and the optimal cut-off was defined as NLR=3.96 based on ROC method. NLR was determined at baseline and after two chemotherapy cycles in first line treatment. Change NLR was calculated as NLR after two chemotherapy cycles minus bNLR. The relation of bNLR and c-NLR to overall survival (OS) was evaluated by Kaplan-Meier method and compared by log-rank test. Dynamic Score (DScore) based on c-NLR and baseline NLR were correlated with OS and radiological response. Univariate, multivariate and chi-square analyses were performed.

Results: Median patient age was 68.7 years, and 66% were male. Univariate analysis showed OS correlation for bNLR ≥3.96 (5.97 vs 10.87 months, p=0.001), c-NLR increase (6.63 vs 10.34 months, p=0.021) and DScore (12.74 vs 7.68 vs 2.43 months, p<0.001). High DScore was associated with radiological progression after two cycles (x2=10.26, p=0.006). Multivariate analysis: bNLR ≥3.96 (HR=2.16, p=0.003) and c-NLR increase (HR= 2.36, p=0.003) were prognostic factors of poor OS.

Conclusion: High bNLR and increased NLR after chemotherapy were associated with worse outcome. Dynamic measurement of NLR provides information for stratifying patients to guide optimal treatment.

Purpose: To investigate the difference of clinicopathologic characteristics and prognosis between invasive papillary carcinoma (IPC) and invasive ductal carcinoma (IDC) in breast cancer patients, and to further confirm the influence of molecular subtype on prognosis of IPC.

Methods: A total of 158,132 eligible patients from 2010 to 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database, of which 348 patients were IPC and 157,784 patients were IDC. We assessed the clinicopathologic characteristics, molecular subtypes and prognostic value of IPC and compared them with those of IDC.

Results: IPC was more frequently presented with older age at diagnosis, less proportion of married and white race, lower grade, smaller tumor size, higher rates of negative nodal status, more AJCC stage I disease and HR+/Her2- breast cancer, and was less likely to be treated with mastectomy, chemotherapy, and radiation therapy than IDC (p<0.05). IPC had a better 5-year breast cancer-specific survival (BCSS) and overall survival (OS) rates than IDC. After adjusting confounding and matching the confounding factors, IPC patients were still associated with better BCSS. Regarding patients with specific subtypes, patients with IPC had more HR+/Her2- subtypes. In addition, HR+/Her2--IPC patients had a better BCSS than HR+/Her2--IDC patients, but OS was similar between the two groups. However, BCSS and OS did not differ in the two groups after matching the confounding factors. Subgroup analysis indicated that molecular subtype may be the main confounding factor in IPC prognosis.

Conclusions: IPC showed more favorable behavior than IDC, but prognosis was not as favorable as people once thought. The determination of the appropriate therapeutic regimen for IPC still needs to be made according to risk factors such as histological grade, pathological stage and molecular subtype.

Purpose: Complete cytoreduction has been established as the most significant factor of long-term survival in epithelial ovarian cancer. Perioperative intraperitoneal chemotherapy has been added in the treatment of ovarian cancer the last 20 years. The purpose of the study was to determine the outcome of women with ovarian cancer using the data of one surgical team.

Methods: Women with ovarian cancer treated from 2000 to 2019 by the same surgical team were enrolled in the study. The patients underwent cytoreductive surgery combined with perioperative intraperitoneal chemotherapy. Clinical and histopathological variables were correlated to hospital mortality, morbidity, survival and recurrences.

Results: The mean age of 350 women was 59.5+11.7 years. The hospital mortality and morbidity rate were 2.0% and 28.3%, respectively. Complete cytoreduction was possible in 60% of the cases. The overall 5- and 10-year survival rate was 47% and 39%, respectively. The prognostic variables of survival were the extent of peritoneal malignancy, the extent of previous surgery, the grade of differentiation, the use of adjuvant chemotherapy, the lymphadenectomy of the resected large bowel, and the postoperative morbidity. The recurrence rate was 45.7%. The extent of peritoneal carcinomatosis, the extent of previous surgery, and the grade of differentiation were the prognostic variables of recurrence.

Conclusions: The limited extent of peritoneal carcinomatosis in women with well differentiated ovarian cancer that do not have history of previous surgery, who undergo standard pelvic peritonectomy procedure, and receive adjuvant chemotherapy are expected to be long-term survivors.

Purpose: To explore the expression of Kelch-like ECH-associated protein 1 (Keap1) and its clinical significance and function in cervical cancer (CC).

Methods: Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot assays were used to detect the expression of Keap1 in tissues from CC patients as well as CC cells and control cells in vitro. The relationship between Keap1 expression and CC clinicopathologic characteristics was statistically analyzed. Further, effects of Keap1 on the cell proliferation and apoptosis were evaluated through MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide) and flow cytometry assay, respectively.

Results: Keap1 expression was downregulated in CC and the expression level of Keap1 was associated with stroma invasion, vascular invasion, parametrial invasion, lymph node metastasis and clinical stage. In in vitro study, upregulation of Keap1 in CC cells by transfection could significantly restrict cell proliferation and promote cell apoptosis.

Conclusions: Keap1 was a novel factor involved in CC progression, and constituted a potential biomarker and therapeutic target for the CC patients.

Purpose: To demonstrate whether early changes in systemic inflammatory markers are related with pazopanib treatment response in soft tissue sarcoma and renal cell carcinoma.

Methods: Forty-one patients with metastatic clear cell renal carcinoma (mRCC) (n=22) and advanced stage soft tissue sarcoma (STS) (n=19) were assessed. Systemic inflammatory markers such as neutrophils, lymphocytes, c-reactive protein (CRP), mean platelet volume (MPV), lactate dehydrogenase (LDH) and neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) at both baseline and 1-month of pazopanib treatment were obtained and their relation with the first radiological response about 3-months later after pazopanib treatment was evaluated.

Results: Disease control rate (DCR) at the first initial radiological evaluation was 58.5 % for all, it was 77.3% for the RCC group and 36.8% in the STS group. Serum neutrophil, NLR and CRP levels were significantly decreased from baseline in RCC patients who had DCR with pazopanib treatment. Also, serum CRP levels after pazopanib treatment was significantly lower in RCC patients who had DCR (+) rather than those who progressed.

Conclusions: Early decline in serum CRP, neutrophil and NLR levels in RCC patients who received pazopanib at the first month was significantly associated with disease control, assuming a predictive role for the first radiological assessment. However, there was no significant association between change in serum inflammatory marker levels and disease control in STS patients.