Cancer diagnosis & prognosis最新文献

Background/aim: Primary ocular adnexal lymphomas pose a diagnostic challenge for physicians due to their nonspecific symptom presentation and resemblance to other periorbital masses, such as skin and soft tissue infections. Early diagnosis and appropriate management are crucial for optimizing outcomes and coordination of therapy.

Case report: We present a case of a 67-year-old male with a history of infraorbital trauma, initially managed as a soft tissue infection, which was later revealed to be a large B-cell lymphoma. Despite multiple specialty evaluations, including dermatology, ophthalmology, plastic surgery, and ENT, among others, diagnosis was delayed, leading to worsening symptoms and vision impairment.

Conclusion: This case highlights the importance of considering ocular adnexal lymphomas in the differential diagnosis of periorbital masses and the need for interdisciplinary collaboration for timely recognition and treatment.

Background/aim: Head and neck photoimmunotherapy (HN-PIT) is a promising treatment for unresectable locally advanced or recurrent head and neck cancers. However, the optimal tumor characteristics and treatment schedules remain unclear. This study aimed to identify factors associated with treatment efficacy and assess the effectiveness of treatment schedules.

Patients and methods: A retrospective cohort study of patients treated with HN-PIT at Aichi Cancer Center Hospital from January 2021 to October 2024 was conducted. Tumor characteristics, treatment cycles, and outcomes were analyzed. The thickness and longest diameter of the tumors were evaluated, and treatment intervals were assessed for their association with complete response (CR).

Results: Among the 19 patients (30 cycles), CR was observed exclusively in local lesions. Smaller and thinner lesions showed significantly better treatment responses. Thinner lesions were more likely to achieve CR after a single cycle, whereas intermediate-thickness tumors often required multiple cycles with shorter intervals. The regional lesions did not achieve CR, even with multiple cycles and shorter intervals. Age was a significant factor influencing CR.

Conclusion: HN-PIT demonstrated promising efficacy for local lesions, particularly for smaller and thinner lesions. Optimizing treatment schedules, including shorter intervals for intermediate lesions, is critical for improving outcomes. Further research is needed to enhance the efficacy for regional lesions and refine treatment schedules.

Background/aim: While transcatheter arterial chemoembolization (TACE) is a treatment option for patients with Barcelona Clinic Liver Cancer stage B hepatocellular carcinoma, it is associated with physical and psychological pain, with concerns regarding its effect on quality of life (QOL). In December 2020, we introduced radiology nurse-led preoperative visits to patients undergoing TACE. This study aimed to examine QOL improvement following a preoperative visit.

Patients and methods: Among patients scheduled to undergo TACE for hepatocellular carcinoma, 48 received a preoperative visit and 22 did not (control group). We compared QOL variables between the groups using the Short-Form 36 (SF-36) at hospital admission and discharge.

Results: No significant between-group differences in clinical backgrounds were observed. In the control group, SF-36 scores at admission/discharge were as follows: physical function (PF), 42.87±14.46/34.71±19.70 and mental health (MH), 51.32±8.67/45.26±11.35, respectively. In the subgroup analysis, the PF/MH item results were PF 40.89±14.55/31.46±19.25 and MH 51.10±9.07/44.79±12.04 for older adult patients in the control group. In the preoperative visit group, PF (admission, 42.31±14.23; discharge, 41.54±14.12; p=0.989) and MH (admission, 48.45±10.97; discharge, 49.59±10.05; p=0.399) were maintained.

Conclusion: PF/MH items at admission and discharge were maintained or improved in the preoperative visit group, whereas those in the control group showed a significant decrease. Preoperative visits contributed to maintaining patient QOL.

Background/aim: Tall women are more likely to develop breast cancer (BC). High Mobility Group AT-Hook 1 (HMGA1), an oncofetal protein, plays a role in BC progression. Variants near HMGA1 have been associated with increased height. This study examines the relationship between HMGA1, height, and BC risk and prognosis using UK Biobank data.

Patients and methods: Data from 10,527 women with invasive BC were analyzed. Subjects were grouped by height: short (<155 cm), medium (155-175 cm), and tall (>175 cm). HMGA1 SNP rs41269028, a single nucleotide intron variant, was evaluated for its influence on height, BC risk, and survival. Statistical analysis included Fisher's exact test, regression models, and survival analysis using the log-rank test.

Results: HMGA1 SNP rs41269028 carriers (CT+TT) were taller (162.88 cm) compared to homozygotes for the major allele (162.29 cm, p=0.005). Tall women with BC showed poorer survival than short women (p=0.032). However, HMGA1 genotype did not significantly affect BC risk (p=0.602) or survival (p=0.439). Multivariate analysis confirmed an independent effect of age and HMGA1 genotype on height.

Conclusion: While HMGA1 influences height, no direct association with increased BC risk or poor prognosis in tall women was demonstrated. Nevertheless, tall women with BC had worse survival, suggesting height might be considered in treatment decisions. Future studies should explore mechanisms linking height to BC outcomes.

Background/aim: Patients with unresectable advanced and recurrent colorectal cancer (CRC) and the BRAF V600E mutation have poor prognosis, and conventional chemotherapy is often ineffective. This study aimed to retrospectively evaluate the clinicopathological features and prognosis of this patient population.

Patients and methods: We examined clinicopathological characteristics and treatment outcomes of 26 patients with BRAF V600E-mutated unresectable advanced and recurrent CRC treated between June 2015 and October 2022.

Results: The mean age was 63.1±14.0 years; out of 26 patients, nine (34.6%) were female, 12 (46.2%) had right-sided CRC, and eight (30.8%) had poorly differentiated or mucinous adenocarcinoma. One patient (3.8%) had a RAS mutation, and three (11.5%) had high microsatellite instability. The median overall survival (OS) was 12.0 months. The median OS for patients treated with the BEACON regimen (encorafenib plus cetuximab, with or without binimetinib) was 13.3 months, which was significantly better than that of patients treated without it (7.2 months; hazard ratio=4.180, 95% confidence interval=1.036-18.631, p=0.029). The median progression-free survival for patients treated with BEACON regimen was 6.6 months.

Conclusion: The BRAF V600E mutation was associated with poor prognosis. The BEACON regimen resulted in improved OS compared with other CRC treatment regimens.

Background/aim: Lung cancers are malignant neoplasms located in the lung tissues. miRNAs are short non-coding RNAs. It is known that miRNA-124 prevents metastasis in lung cancers. The phosphatidylinositol 3-kinases (PI3K) signaling pathway, a basic signaling pathway interconnected with other pathways, is activated during cancer development. This study aimed to compare miRNA-124-5p and PI3K serum levels in patient and control groups.

Materials and methods: miRNA isolated from patient and control serum samples were converted into cDNA. miRNA-124-5p expression was determined using Real-Time PCR and a SYBR GREEN kit. PI3K serum level was determined using the Enzyme-Linked Immunosorbent Assay.

Results: While miRNA-124-5p serum level was statistically significantly lower in the patient group (p>0.02), serum PI3K level was higher in the patient group than in the control group but the difference was not statistically significant (p>0.11).

Conclusion: Lower serum levels of miRNA-124-5p and high PI3K levels observed in the patient group, compared to the control group, may be associated with a poor disease prognosis.

Background/aim: This study aimed to evaluate the long-term outcomes, treatment-related toxicity, and factors affecting postoperative prostate cancer patients treated with intensity-modulated radiation therapy and image-guided radiation therapy (IMRT-IGRT) using TomoTherapy as salvage radiotherapy (SRT).

Patients and methods: A total of 71 consecutive patients who underwent SRT after radical prostatectomy between 2011 and 2023 were included in the study. Treatment outcomes, including the progression-free rate (PFR) and overall survival, were calculated using Kaplan-Meier curves. Associations between treatment outcomes and factors were analyzed using the Cox proportional hazards regression analysis.

Results: The median follow-up time after SRT was 60 months (range=1-148 months). The 5-year and 10-year PFR were 69.05% and 54.73%, respectively. In multivariate analysis, maximum PSA >0.7 ng/ml was significantly associated with worse PFR (p<0.05). Additionally, eight patients (11.3%) experienced late grade 2 genitourinary toxicity, and one (1.4%) patient developed late grade 2 gastrointestinal toxicity. No adverse events were rated higher than grade 3.

Conclusion: Our findings demonstrate a comparable PFR at 5-year (69.05%) and 10-year (54.73%) intervals with those of previous reports, confirming the efficacy of IMRT-IGRT as a viable option for SRT. Worse PFR was associated with factors such as mass PSA >0.7 ng/ml, providing critical insights into prognostication. SRT for prostate cancer with IMRT and IGRT using TomoTherapy showed similar treatment outcomes and low toxicity rates compared with those of previous studies.

Background/aim: Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor predisposition syndrome. In approximately 30% of cases, plexiform neurofibromas (PNFs) are identified, which are precursor lesions for malignant peripheral nerve sheath tumors (MPNSTs). MPNST is a major cause of the reduced life expectancy of NF1 patients.

Case report: The patient, a two-year-old at the time of surgical treatment, had been diagnosed with an orbital nerve sheath tumor causing lid swelling and ptosis since birth. The tumor showed disproportionately rapid growth, leading to increasing functional (mechanical) restrictions in lid elevation. Surgical exploration of the orbit indicated a PNF with areas of a MPNST. Two months later, a new biopsy confirmed the MPNST. The tumor was treated with multimodal chemotherapy. After completion of chemotherapy, orbital exenteration was performed. The tissue specimens only comprised tissue of a benign PNF. However, within six months, the patient developed an intracranial recurrence and died from a rapidly growing intracerebral tumor fraction, which histologically proved to be a MPNST.

Conclusion: Orbital PNF is a rare and characteristic manifestation of facial NF1. Typically, tumors in this localization are associated with severe functional disabilities and aesthetic disfigurement, resulting from invasive tumor growth and skeletal deformities. Histological classification of the tumors may be challenging due to varying histological differentiation in different tumor locations. Thus, early diagnosis with representative tumor sampling and complete histological work-up of the specimen together with multimodal therapy are essential prerequisites to overcome the poor prognosis of these tumors.

Background/aim: Options for the reconstruction of bone defects following resection of primary bone sarcomas of the humerus include massive endoprostheses or biological reconstruction. We report the oncological, clinical, and functional outcomes in patients treated with biological reconstructions.

Patients and methods: This study included 23 consecutive patients with primary bone sarcoma of humerus who underwent en-bloc resection and biological reconstructions at a single institution. Four groups of patients were identified. Group A: twelve patients with vascularized fibula epiphyseal transfer. Group B: four patients with structural grafts with vascularized fibula. Group C: four patients with structural grafts with non-vascularized fibula. Group D: three patients with only structural grafts (allograft or reimplanted bone only). The postoperative oncological outcomes, complications, reoperation rates, and postoperative limb function using the Musculoskeletal Tumor Society (MSTS) scores were evaluated.

Results: The median age at diagnosis was 8 years (range=3-54 years). The median follow-up was 87 months (range=6-172 months). Graft complications at recipient sites occurred in 13 patients including fracture in seven, non-union in four, and avascular necrosis in two. Donor site peroneal nerve palsy occurred in seven patients. Local recurrence and metastases occurred in one and two patients, respectively. At the last follow-up, twenty‑two patients were alive (21 continuously disease-free for a median of 87 months, and one with no evidence of disease), and one patient died of disease. The mean MSTS scores for all patients was 78.9%, and this was similar in the four groups: 77.5%, 72.5%, 85.8%, and 83.3% in Groups A, B, C, and D, respectively.

Conclusion: Biological reconstruction of the humerus is a complex procedure with a risk of complications but has good oncological and functional outcomes.

Background/aim: Second hepatic resection is a well-established and effective treatment for recurrent hepatocellular carcinoma (HCC). Despite this, the recurrence rate of HCC remains high. The efficacy of third liver resection for re-recurrent HCC is uncertain, and prognostic factors affecting survival after third hepatectomy have not been comprehensively evaluated. This study aimed to investigate the short- and long-term outcomes of third liver resection for re-recurrent HCC and identify prognostic factors affecting survival.

Patients and methods: In total, 27 patients who underwent three liver resections for primary, recurrent, and re-recurrent HCC were retrospectively reviewed. The prognostic factors of long-term survival were evaluated using clinical data including those of previous liver resections.

Results: No cases of perioperative mortality after third liver resection for re-recurrent HCC were found. The median overall survival and disease-free survival were 38.3 and 5.8 months, respectively. The 5-year overall survival and disease-free survival rates were 56.8% and 10.9%, respectively. Clinical parameters such as tumor marker level, primary tumor size, and surgical interval of the third liver resection and of the first and second surgeries were significantly associated with long-term survival.

Conclusion: The survival rate of third liver resection for re-recurrent HCC in our study was similar to that reported for second and third hepatectomies in previous studies. Clinical information on previous surgeries could be a useful determinant of third liver resection for re-recurrent HCC.