Changes in the clinical characteristics, treatment options, and therapy outcomes in patients with phyllodes tumor of the breast during 55 years of experience.

BACKGROUND: Data from the literature suggests that the clinical picture of phyllodes tumor (PT) of the breast, as well as treatment options and perhaps therapy outcomes, have significantly changed. The aim of this work was to review these changes by analysis of consecutive patients with PT over a 55-year period at a single institution. MATERIAL AND METHODS: From 1952 to 2007, 280 women with PT were treated surgically at the Maria Sklodowska-Curie Memorial Institute of Oncology, Cancer Center in Cracow. Age, size of breast tumor, microscopic type, extent of surgery, and therapy outcomes were compared between 2 groups: 190 patients treated from 1952 to 1991 vs 90 patients treated from 1992 to 2007. RESULTS: The results show that the 1992-2007 group compared to the 1952-1991 included more patients <50 years of age, with tumor <5 cm in diameter, undergoing breast-conserving therapy, as well as no evidence of disease at 5-year survival had increased and this change was statistically significant. In addition, malignant PT cases had decreased in frequency. CONCLUSIONS: The results of this study show that patients with PT are increasingly younger, the breast tumors at diagnosis are smaller, malignant PT is becoming less frequent, and BCT is now the treatment of choice. Most importantly, the general treatment outcomes are significantly better.

Preoperative radiotherapy does not alter pre- and early postoperative serum C-reactive protein and albumin concentrations in colorectal cancer patients.

AIM OF THE STUDY: We aimed to assess the alterations of serum C-reactive protein (CRP) and albumin levels in colorectal cancer patients who underwent preoperative radio(chemo)therapy and those who did not. MATERIAL AND METHODS: The determinations of albumin and CRP were performed before and at 2, 3, 5 and 7 days after surgery in 60 colorectal cancer patients. 25 healthy subjects served as a reference group. For each patient the modified Glasgow Prognostic Score (mGPS) was calculated. RESULTS: On the operation day CRP and albumin concentrations were not different in preoperatively treated or radiotherapy naïve patients. On postoperative day 2, 3, 5 and 7 no significant differences were observed between the two groups, with the only exception for albumin concentration, which was significantly higher on postoperative days 2 and 7 in the radiation naïve group. In all patients perioperative alterations of serum CRP level were significant at all time points (preoperatively vs. day 2, day 2 vs. day 3, day 3 vs. day 5, day 5 vs. day 7). The albumin decrease from the preoperative day to postoperative day 2 was significant, as was its increase from postoperative day 3 to 5. CONCLUSIONS: We have seen no differences in the CRP and albumin concentrations in preoperatively irradiated versus non-irradiated colorectal cancer patients on the day of surgery and on postoperative days 2, 3, 5 and 7. There were, however, significant concentration changes in the value of these two serum markers from preoperatively to postoperative day 2 and over the following postoperative week, but presumably related to the surgical trauma, not the neoadjuvant treatment.

Utility of ProGRP determinations in cancer patients.

BACKGROUND: The aim of this study was to assess the utility of ProGRP determinations in patients with selected cancer localization, during and after therapy. MATERIALS AND METHODS: The study involved a reference group and a population of lung, breast, ovarian, and prostate cancer patients. ProGRP was evaluated using two-step chemiluminescent microparticle immunoassay (CMIA) manufactured by Abbott Diagnostics, and Architect i2000 analyzer. RESULTS: During follow-up of SCLC patients, an increased value for ProGRP was found in 51% and for NSE only in 25.5% of the patients, whereas in NSCLC patients, percentages with elevated ProGRP and CYFRA 21-1 were 8.6% and 55.7%, respectively. SCLC patients also had the highest AUC values for ProGRP. In other cancers, the frequency of elevated ProGRP results were as follows: 13.1%--in breast cancer patients, 19.6%--in ovarian cancer patients, and 15.1%--in prostate cancer patients. CONCLUSIONS: The presented study revealed that ProGRP is a tumor marker of choice in SCLC, because of its high diagnostic specificity in relation to the reference group and to the group with other malignancies.

Pro-gastrin-releasing peptide (ProGRP) as a biomarker in small-cell lung cancer diagnosis, monitoring and evaluation of treatment response.

Lung cancer belongs to malignant tumors that possess the highest rates of morbidity and mortality in the world. A number of morphological, biological and clinical features justify the distinction of small-cell carcinoma with respect to the other histological types of lung cancer. The predominant neuroendocrine phenotype is critical for the selection of biomarkers used in diagnostics, monitoring and evaluation of treatment response; early onset relapses in patients with small-cell lung cancer (SCLC) and the evaluation of their prognosis. Although for a long time the neuron-specific enolase (NSE) was considered to be the marker of choice for this tumor, it is now increasingly important to pay attention to concentrations of pro-gastrin-releasing peptide (ProGRP). The results of this marker have been implicated in the differential diagnosis of non-small lung cancer and SCLC, chemotherapy and radiotherapy monitoring as well as evaluation of treatment response. The subject of this series of studies is to determine the usefulness of ProGRP in the evaluation of patients' prognosis and its predictive value. The current aim for the optimization of the effectiveness of biochemical diagnostics of SCLC is recommended by complementary ProGRP and NSE studies. The present work is a summary of the latest reports regarding diagnostic utility of these markers in SCLC.

IL-6 and VEGF in small cell lung cancer patients.

Recent data suggest a link between chronic inflammation, angiogenesis, and the development of cancer. The aim of this study was the evaluation of serum IL-6 and VEGF in comparison with the tumor markers NSE and ProGRP, with respect to the prognosis of small cell lung cancer patients. The study of IL-6, VEGF, NSE, ProGRP and platelet count was performed in a group of 72 patients with previously untreated small cell lung cancer at different stages of disease: 40 with limited and 32 with extensive disease. Significantly higher IL-6 and VEGF concentrations and platelet count, as well as NSE and ProGRP levels, were found in patients with small cell lung cancer in comparison with the reference group. Patients with extensive cancer had significantly higher levels of IL-6, VEGF, NSE and ProGRP than those with limited cancer. Elevated VEGF levels, with no significant differences in frequency of elevated NSE and ProGRP concentrations, were often observed in patients with IL-6 levels higher than 5.1 ng/l. Univariate analysis confirmed a significant relationship not only between overall survival and stage of disease or gender, but also with VEGF, IL-6, NSE and ProGRP levels. Moreover, multivariate analysis revealed that only the extent of the disease and IL-6 may be independent prognostic factors in the group of small cell lung cancer patients under investigation. However, simultaneous determinations of ProGRP and IL-6, as well as ProGRP and VEGF, in addition to the extent of the disease, may serve as additional, independent prognostic factors in small cell lung cancer.