Weight loss at the time of diagnosis is not associated with prognosis in patients with advanced-stage non-small cell lung cancer.

PURPOSE: To investigate the prognostic value of weight loss before diagnosis in patients with advanced stage non-small cell lung cancer (NSCLC) treated with first-line chemotherapy. METHODS: A total of 81 NSCLC patients with stages IIIB/IV were included in this retrospective cross-sectional study. Study variables were weight loss in the last 3 months before diagnosis, patient demographic, clinical and laboratory characteristics and histological features of the tumor before administering first-line chemotherapy. Then, the patients were stratified into 4 groups based on their weight loss before being diagnosed with NSCLC. RESULTS: The patients were predominantly male (68%), with a smoking history (62%), 5 to 10 kg weight loss in the last 3 months (31%), and had metastatic disease (64%) and adenocarcinoma (40%) at the time of diagnosis. On the other hand, most of the patients with 5 to 10 kg weight loss in the last 3 months before diagnosis had squamous cell carcinoma (44%), stage IV disease (56%), and the first disease progression was in the brain (64%). Pre-diagnosis weight loss had a negative impact on progression-free survival (PFS), independent from weight loss during first-line chemotherapy, but no such effect was noticed on overall survival (OS). CONCLUSIONS: Pre-diagnosis weight loss was found to have a negative impact on PFS in patients with NSCLC treated by first-line chemotherapy. Similar studies in larger patient series are warranted.

Role of increased mean platelet volume (MPV) and decreased MPV/platelet count ratio as poor prognostic factors in lung cancer.

OBJECTIVES: In this study, they investigated whether mean thrombocyte volume (MPV) and MPV/platelet count ratio have a prognostic significance in advanced NSCLC or not. METHODS: A total of 496 NSCLC patients at stage IIIB/IV and did not meet exclusion criteria were included in the study. The demographic features (age, gender, smoking habit), clinical characteristics (performance status, weight loss, disease stage, first-line treatment regimen), laboratory tests (levels of hemoglobin, lactate dehydrogenase and calcium as well as MPV, MPV/platelet count ratio and counts of white blood cell, platelet), and histological features (histologic type, tumor grade) were recorded. RESULTS: The MPV levels of all patients were determined as 10.2 {plus minus} 3.4 (range, 6.4-14.1 fL). With ROC curve analysis, the MPV/PC ratio was associated with a sensitivity of 67.8% and a specificity of 84.8% at a cutoff value of 0.47424 for presence of brain metastasis at the time of diagnosis. Univariate analysis showed that OS was significantly shorter in the group with an increased MPV level than in the other group (median OS time 6.8 months vs. 11.5 months, log-rank, P = .032). Multivariate analysis confirmed that an increased MPV level was an independent poor prognostic factor for OS (HR: 1.704, 95% CI: 1.274-3.415, P = .014). CONCLUSIONS: Unlike results of previous studies, the study showed that increased MPV was an important prognostic factor in patients with NSCLC. Hence, an increased MPV level may be used as a prognostic biomarker to estimate for poor overall survival in patients with NSCLC.

Hyperuricemia at The Time Of Diagnosis is a Factor for Poor Prognosis in Patients With Stage II and III Colorectal Cancer (Uric Acid and Colorectal Cancer)

Purpose: In this pilot study we investigated whether serum levels of uric acid, the final breakdown product of purine metabolism, might influence cancer-related events in stage II and III colorectal cancer patients. Material and methods: In this cross-sectional retrospective study, a total of 150 stage II and III colorectal adenocarcinoma patients with no exclusion criteria were included. Serum uric acid levels of the patients measured at diagnosis and demographic, clinical, laboratory analyses were performed and histologically features recorded. Patients were stratified into quartiles according to serum uric acid level with different cut-off values. Results: The mean serum uric acid level of all patients was determined o be 6.97±2.87 md/dL (range, 3.1-12.4). Median follow-up time was 98 (range 9-98) months and the proportion of patients who did not relapse was 22%. It was determined that majority of the patients who had serum uric acid levels over 8.37 mg/dL had stage IIIB lesions, were smokers, were among those who lost weight, with metastasis to the liver and with significantly leukocyte and platelet counts. Conclusions: Serum uric acid levels measured at the time of diagnosis may be associated

Cutaneous sinus formation is a rare complication of thyroid fine needle aspiration biopsy.

Fine needle aspiration biopsy (FNAB) is essential in the diagnosis and management of thyroid nodules. In this paper, we report a rare complication, cutaneous sinus formation, after diagnostic FNAB guided by palpation. Sixty-three-year-old female patient was admitted with the complaints of hoarseness and discharge from the anterior neck wall which were present for the last 6 months. The patient underwent a near total thyroidectomy 17 years ago. Recurrent nodular goiter was detected six months before and a diagnostic FNAB guided by palpation was performed. Two weeks later the patient had wound discharge and hoarseness. Physical examination of the patient revealed a sinus, which was located superior to the thyroidectomy incision. A 1 cm nodule was palpated in the left side of her neck. A cervical ultrasonography (USG) showed a 9 × 7 mm nodule in the remnant thyroid and a 9.5 × 3.5 mm fistulized fluid collection. The patient underwent sinus tract and remnant thyroid removal. This case report presents a cutaneous sinus formation deriving from the granulation tissue, probably due to the silk suture reaction in the previous surgery, by the FNAB guided by palpation procedure. We suggest USG guided FNAB to achieve more accurate and safe diagnosis in evaluating the thyroid nodules.