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1.
Zhonghua Xue Ye Xue Za Zhi ; 41(1): 40-46, 2020 Jan 14.
Artículo en Chino | MEDLINE | ID: mdl-32023753

RESUMEN

Objective: To explore the clinical characteristics, the best treatment and prognostic factors of primary pulmonary NK/T-cell lymphoma. Methods: A total of 24 cases with primary pulmonary NK/T-cell lymphoma from April 2011 to May 2019 were analyzed retrospectively. Survival analysis was performed using the Kaplan-Meier method and groups were compared using the log-rank test. Multivariate analysis using Cox proportional hazard regression model was conducted to confirm independent prognostic factors for overall survival (OS) and progression-free survival (PFS) . Results: ①The cohort of 24 patients included 16 male and 8 female with a median age of 49 years (range, 4-76 years) old. ②Most patients initially presented with a fever (66.7%) , cough and dyspnea. Chest imaging manifestations were primarily unilateral (45.8%) or bilateral (54.2%) pulmonary consolidation, nodules or mass. ③20 patients received chemotherapy, radiotherapy or hematopoietic stem cell transplantation, the rest 4 cases palliative treatment. Median OS was 9.5 months (range, 0.1-26.0 months) . The estimated 1-year OS rate was 45.8%. Overall response rate of patients treated with asparaginase-based regimen was 88.2%. ④In univariate survival analysis, age≤60 was prognostic for longer OS and PFS, compared with age>60 (P=0.002 and 0.004, respectively) ; ECOG≤2 was prognostic for longer OS and PFS, compared with ECOG>2 (P=0.042 and 0.004, respectively) . In multivariate survival analysis, age>60 and ECOG>2 were significantly correlated with inferior OS and PFS (OS: P=0.024 and 0.024, respectively; PFS: P=0.035 and 0.024, respectively) . Conclusions: Primary pulmonary NK/T-cell lymphoma was a rare disease with poor prognosis. Asparaginase-based regimens appeared to be effective. Age and ECOG served as independent prognostic factors for primary pulmonary NK/T-cell lymphoma patients.


Asunto(s)
Linfoma Extranodal de Células NK-T , Adolescente , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica , Asparaginasa , Niño , Preescolar , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Adulto Joven
2.
Anticancer Res ; 40(1): 379-386, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892590

RESUMEN

BACKGROUND/AIM: We evaluated the efficacy and safety of carbon-ion radiotherapy (CIRT) alone for Stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Data of 65 patients (median age=73 years) with Stage III NSCLC who underwent CIRT alone in the QST Hospital, Chiba, Japan, between 1997 and 2015 were retrospectively analysed. The median dose was 72.0 Gy (relative biological effectiveness). RESULTS: The median follow-up was 27.6 months (range=1.6-207.7 months). Two-year local control, progression-free survival (PFS), and overall survival (OS) rates were 73.9%, 38.6%, and 54.9%, respectively. Overall, 1 (2%), 4 (6%), and 1 (2%) patient developed Grade 4 (mediastinal haemorrhage), Grade 3 (radiation pneumonitis), and Grade 3 (bronchial fistula) toxicities, respectively. On univariate analysis, clinical T and N stage and CIRT timing were significant predictors of PFS and OS; clinical target volume was a significant predictor of PFS. CONCLUSION: CIRT alone is effective with acceptable toxicity for Stage III NSCLC.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/radioterapia , Radioterapia de Iones Pesados/efectos adversos , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Resultado del Tratamiento
3.
Anticancer Res ; 40(1): 405-412, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892594

RESUMEN

BACKGROUND/AIM: To evaluate the outcomes of curative resection for Borrmann type IV gastric cancer through an analysis of the clinical, surgical and pathological data and through identifying which of these prognostic factors are associated with survival. PATIENTS AND METHODS: We retrospectively analyzed 2798 patients who had undergone excision of the primary lesion and 122 patients with type IV gastric cancer undergoing curative resection (R0 or 1) at Yokohama City University Hospital and Kanagawa Cancer Center between November 1995 and May 2016. RESULTS: Borrmann type IV gastric cancer had more advanced and unfavorable clinicopathological factors compared to other types. The 5-year overall survival rate was 28%, and the median survival was 21.8 months. The overall survival rate was influenced by the depth of invasion, lymph node metastasis, peritoneal lavage cytology (CY), stage and intraoperative blood loss. Of these, independent prognostic factors were intraoperative blood loss (<400 vs. ≥400 ml, risk ratio 1.64; p=0.045) and CY (0 vs. 1, risk ratio 2.25; p=0.004). CONCLUSION: The control of intraoperative bleeding had a positive impact on the survival of patients receiving curative resection for Borrmann type IV gastric cancer.


Asunto(s)
Pérdida de Sangre Quirúrgica , Cuidados Intraoperatorios , Neoplasias Gástricas/cirugía , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia/patología , Pronóstico , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Resultado del Tratamiento
4.
Anticancer Res ; 40(1): 435-441, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892598

RESUMEN

AIM: The purpose of the Imadje study was to confirm the efficacy and safety of imatinib, following resection of kit-positive gastrointestinal stromal tumour (GIST), in the adjuvant setting in the Greek population. PATIENTS AND METHODS: A total of 34 adult patients already receiving imatinib were enrolled. Recurrence-free (RFS) and overall survival, as well as time to treatment failure and safety were assessed. RESULTS: Overall survival could not be estimated in the present study, as no death occurred. Overall, 91.2% of patients were recurrence-free at 36 months, while the median time to treatment failure was 35 months. No new or unexpected safety findings were observed. Mutation analysis in 14 patients showed that the most frequent mutations were located in KIT exon 11 (64.3%) and exon 9 (28.6%). Univariate analysis showed that only surgical resection with a margin classification of R0 was associated with better RFS. CONCLUSION: Adjuvant treatment with imatinib for 3 years in patients with intermediate to high risk of recurrence was proven to prolong RFS, while being well-tolerated and not exhibiting a negative impact on patient compliance with therapy.


Asunto(s)
Tumores del Estroma Gastrointestinal/tratamiento farmacológico , Mesilato de Imatinib/uso terapéutico , Recurrencia Local de Neoplasia/patología , Análisis Mutacional de ADN , Supervivencia sin Enfermedad , Femenino , Grecia , Humanos , Mesilato de Imatinib/efectos adversos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
5.
Anticancer Res ; 40(1): 451-458, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892600

RESUMEN

BACKGROUND/AIM: We evaluated the clinical implications of pre- and post-treatment hematological parameters as prognostic factors in patients with locally advanced cervical cancer (LACC) who received definitive concurrent chemoradiotherapy (CCRT). PATIENTS AND METHODS: We retrospectively analyzed 125 patients with LACC (FIGO stage IIB to IIIB) who received definitive CCRT. Clinical factors and hematological parameters, including neutrophil-to-lymphocyte ratio (NLR) were assessed pre- and post-CCRT. Univariate and multivariate analysis for disease-free survival (DFS) and overall survival (OS) were performed using clinicopathological and hematological parameters. RESULTS: Disease recurred in 46 (36.8%) patients, and 24 patients (19.2%) died. On multivariate analysis, post-treatment NLR, ΔNLR (pre-treatment NLR/post-treatment NLR) and ΔPLR (platelet-to-lymphocyte ratio) (pretreatment PLR/post-treatment PLR) were significant prognostic factors for DFS, and only post-treatment NLR was a significant prognostic factor for OS (p<0.001). However, pre-treatment hematological parameters were not associated with prognosis. CONCLUSION: Post-treatment hematological parameters, particularly NLR, may serve as a prognostic indicator in patients with LACC who received definitive CCRT.


Asunto(s)
Quimioradioterapia , Neoplasias del Cuello Uterino/sangre , Neoplasias del Cuello Uterino/terapia , Supervivencia sin Enfermedad , Femenino , Humanos , Linfocitos/patología , Persona de Mediana Edad , Análisis Multivariante , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Neutrófilos/patología , Pronóstico , Neoplasias del Cuello Uterino/inmunología , Neoplasias del Cuello Uterino/patología
6.
Anticancer Res ; 40(1): 465-472, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892602

RESUMEN

AIM: The purpose of the present multicentric study was to review stereotactic body radiotherapy (SBRT) with or without chemotherapy (CHT) experience in locally advanced pancreatic cancer (LAPC). Endpoints were overall survival (OS), local control (LC), and distant metastasis-free survival (DMFS). Several parameters' impact on these outcomes was assessed. MATERIALS AND METHODS: Fifty-six patients with LAPC undergoing SBRT+/-CHT were included. SBRT median BEDα/ß10Gy was 48.0 Gy (range=28.0-78.7). Survival curves were calculated by Kaplan-Meier method. A Cox regression model was fitted. RESULTS: At a median follow-up of 15.0 months, 2-year OS, LC, DMFS were: 33.8% 55.4%, and 22.9%, respectively. Patients treated with BEDα/ß10Gy≥48 Gy showed improved OS (p=0.020) and LC (p=0.024). At multivariate analysis, BEDα/ß10Gy≥48 Gy was significantly associated to both higher OS (p=0.042) and LC (p=0.045), while post-SBRT CHT improved DMFS (p=0.003). CONCLUSION: SBRT proved to be tolerable and effective in LAPC. Moreover, BEDα/ß10Gy≥48 Gy was significantly correlated with improved OS and LC.


Asunto(s)
Neoplasias Pancreáticas/radioterapia , Radiocirugia , Adulto , Anciano , Anciano de 80 o más Años , Supervivencia sin Enfermedad , Relación Dosis-Respuesta en la Radiación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Supervivencia
7.
Lancet Haematol ; 7(2): e100-e111, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31958417

RESUMEN

BACKGROUND: Previous trials testing prevention strategies for chronic graft versus host disease (GVHD) have measured its cumulative incidence. In this trial of anti-thymocyte globulin, we measured treatment-independence at a long-term timepoint as the primary endpoint. METHODS: This was a randomised, open-label, multicentre, phase 3 trial done at ten centres in Canada and one in Australia. Eligible patients had a haematological malignancy (leukaemia, myelodysplastic syndrome, or lymphoma), were between 16 and 70 years of age, eligible for transplantation with a Karnofsky score of at least 60, and received an unrelated donor (fully matched or one-locus mismatched at HLA-A, HLA-B, HLA-C, or DRB1 loci) graft following myeloablative or non-myeloablative-reduced intensity conditioning. Patients were randomly assigned to receive anti-thymocyte globulin 4·5 mg/kg plus standard GVHD prophylaxis (cyclosporine or tacrolimus plus methotrexate or mycophenolate) or standard GVHD prophylaxis alone. The primary endpoint, freedom from immunosuppressive therapy without resumption at 12 months, was previously reported. Here we report on the prespecified 24-month analysis. Analyses were per-protocol, excluding those patients who did not proceed to transplantation. This trial is registered as ISRCTN 29899028 and NCT01217723, status completed. FINDINGS: Between June 9, 2010, and July 8, 2013, we recruited and randomly assigned 203 eligible patients to receive anti-thymocyte globulin (n=101) or no additional treatment (n=102) along with standard GVHD prophylaxis. 7 (3%) patients did not receive a transplant and were excluded from the analysis. 38 (38%) of 99 evaluable patients in the anti-thymocyte globulin plus GVHD prophylaxis group were free from immunosuppressive therapy at 24 months compared with 18 (19%) of 97 patients in the standard GVHD prophylaxis group (adjusted odds ratio [OR] 3·49 [95% CI 1·60-7·60]; p=0·0016. At 24 months, the cumulative incidence of relapse was 16·3% (95% CI 8·9-23·7) in the anti-thymocyte globulin plus GVHD prophylaxis group compared with 17·5 (9·9-25·1) in the standard GVHD prophylaxis group (p=0·73) and non-relapse mortality was 21·2% (95% CI 13·2-29·2) versus 31·3% (21·9-40·7; p=0·15). The cumulative incidence of chronic GVHD at 24 months was 26·3% (95% CI 17·5-35·1) in the anti-thymocyte globulin group and 41·3% (31·3-51·3) in the standard GVHD prophylaxis group (p=0·032). Overall survival at 24 months was 53·3% (95% CI 42·8-62·7) in the anti-thymocyte globulin plus GVHD prophylaxis group compared with 70.6% (95% CI 60·6-78·6) in the standard GVHD prophylaxis group (adjusted hazard ratio [HR] 0·56, 95% CI [0·35-0·90]; p=0·017. Symptoms of chronic GVHD by the Lee Scale were more prevalent in the standard GVHD prophylaxis group, with scores of 13·27 (SD 10·94) in the anti-thymocyte globulin plus GVHD prophylaxis group and 20·38 (SD 14·68) in the standard GVHD prophylaxis group (p=0·040). Depressive symptoms were more prominent in the standard GVHD prophylaxis group, the mean Center for Epidemiological Studies Depression scale (CES-D) scores were 10·40 (SD 9·88) in the anti-thymocyte globulin group and 14·62 (SD 12·26) in the standard GVHD prophylaxis group (p=0·034). Serious adverse events (CTCAE grade 4 or 5) occurred in 38 (38%) patients in the anti-thymocyte globulin group and in 49 (51%) in the standard GVHD prophylaxis group, the most common being infection and GVHD. One patient died of Epstein-Barr virus hepatitis. INTERPRETATION: The results of this prespecified 24-month analysis suggest that pretreatment with anti-thymocyte globulin provides clinically meaningful benefits when added to standard GVHD prophylaxis in patients undergoing unrelated donor transplantation, including a decrease in use of immunosuppressive therapy, chronic GVHD and its symptoms, depressive symptoms, and improved overall survival. Anti-thymocyte globulin could be included in the preparative regimens of patients with haematological malignancies selected for unrelated donor transplantation. FUNDING: Canadian Institutes of Health Research and Sanofi.


Asunto(s)
Suero Antilinfocítico/uso terapéutico , Trasplante de Médula Ósea/efectos adversos , Enfermedad Injerto contra Huésped/prevención & control , Neoplasias Hematológicas/terapia , Inmunosupresores/uso terapéutico , Trasplante de Células Madre de Sangre Periférica/efectos adversos , Adolescente , Adulto , Anciano , Ciclosporina/administración & dosificación , Ciclosporina/uso terapéutico , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Enfermedad Injerto contra Huésped/etiología , Humanos , Inmunosupresores/administración & dosificación , Estimación de Kaplan-Meier , Masculino , Metotrexato/administración & dosificación , Metotrexato/uso terapéutico , Persona de Mediana Edad , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/uso terapéutico , Medición de Resultados Informados por el Paciente , Linfocitos T/inmunología , Tacrolimus/administración & dosificación , Tacrolimus/uso terapéutico , Trasplante Homólogo/efectos adversos , Resultado del Tratamiento , Donante no Emparentado , Adulto Joven
8.
Arch Esp Urol ; 73(1): 41-46, 2020 Jan.
Artículo en Inglés, Español | MEDLINE | ID: mdl-31950922

RESUMEN

INTRODUCTION: The standard of care in muscle invasive bladder cancer is radical cystectomy; however; transurethral resection (TUR) followed by external radiotherapy and systemic chemotherapy demonstrates comparable results with radical cystectomy in terms of local control and survival rates. OBJECTIVES: To evaluate our results of multimodality bladder preservation therapy (BPT) in patients who had muscle-invasive bladder cancer and were reluctant to radical cystectomy. METHODS: The retrospective analysis of twenty-three patients with stage T2 transitional cell bladder cancer that were consecutively treated with BPT was performed. Treatment strategy included radical TUR followed by 3 cycles of cisplatin, gemcitabine combination, and radiotherapy of 64 Gy as adjuvant treatment. The Kaplan-Meier survival estimates and log rank were calculated. RESULTS: Median follow-up time was 58 (15-158) months. Disease-free survival (DFS) and five year overall survival (OS) rates for 23 patients were 55.9% and 63.9%, respectively. Cancer-specific OS was 67%. There were no grade 3 or higher complications. CONCLUSIONS: Our small patient group suggests that BPT can be safely applied in selected cases with bladder cancer or in patients that refused radical cystectomy.


Asunto(s)
Carcinoma de Células Transicionales , Cistectomía , Tratamientos Conservadores del Órgano , Neoplasias de la Vejiga Urinaria , Carcinoma de Células Transicionales/patología , Carcinoma de Células Transicionales/terapia , Terapia Combinada , Cistectomía/métodos , Supervivencia sin Enfermedad , Humanos , Invasividad Neoplásica , Estudios Retrospectivos , Tasa de Supervivencia , Resultado del Tratamiento , Vejiga Urinaria/cirugía , Neoplasias de la Vejiga Urinaria/patología , Neoplasias de la Vejiga Urinaria/cirugía
9.
Anticancer Res ; 40(1): 201-211, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892568

RESUMEN

BACKGROUND/AIM: This retrospective study focused on the correlation between molecular markers and prognostic outcomes of colon cancer patients depending on sidedness. MATERIALS AND METHODS: A total of 117 stage I-III colon cancer patients who underwent colectomy were enrolled. Novel methylation markers (KIF1A, PAX5 and VGF) were selected for epigenetic evaluation and p53 and ERCC1 protein expression was examined for the investigation of genetic alterations. RESULTS: High frequency of methylation was observed in 68.2% of right-sided and 39.7% of left-sided colon cancer cases (p=0.004). Abnormal p53 was identified in 52.3% of right-sided and 75.3% of left-sided cases (p=0.015). In right-sided cases, highly methylated genes demonstrated significantly favorable disease-free survival (p=0.049). Regarding left-sided cases, advanced T stage (p=0.028) and abnormal p53 (p=0.028) were revealed to be significant predictive factors of the disease-free survival outcome. CONCLUSION: Molecular alterations, as significant prognostic factors, might differ depending on the sidedness of colon cancers.


Asunto(s)
Biomarcadores de Tumor/genética , Neoplasias del Colon/genética , Neoplasias del Colon/patología , Anciano , Metilación de ADN/genética , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Análisis Multivariante , Proteínas de Neoplasias/metabolismo , Curva ROC , Análisis de Supervivencia
10.
Anticancer Res ; 40(1): 239-244, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892572

RESUMEN

BACKGROUND: In previous studies, we demonstrated the significant role of microRNA-449a (miR-449a) in colorectal cancer with in vivo and clinical samples. The importance of miR-449a in gastric cancer is still to be elucidated. This study examined the impact of miR-449a expression in tumor tissue and serum and investigated its potential as a prognostic marker in gastric cancer. MATERIALS AND METHODS: Sixty-six patients with gastric cancer who underwent surgery were included in the study. miR-449a expression in tumor tissue and serum were investigated by real-time polymerase chain reaction analysis. The association of miR-449a expression with clinicopathological factors and patient prognosis were also investigated. RESULTS: miR-449a expression was lower in tumor tissue than non-tumor tissue. miR-449a in tumor tissue negatively correlated with the malignancy of tumor and clinical stage. Increased carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels were seen at significantly higher frequencies in patients with low miR-449a expression. Patients with low miR-449a expression had poorer cancer-specific survival compared to those with high miR-449a expression. The univariate analysis showed that lymphovascular invasion, increased CEA and CA19-9 and a low expression of miR-449a were associated with a poorer 5-year cancer-specific survival. miR-449a expression level in serum correlated to that in tumor tissue and was also associated with tumor malignancy. CONCLUSION: The miR-449a level in tumor tissue might be useful as a prognostic indicator for patients with gastric cancer and miR-449a in serum appears to reflect its expression in tumor tissue.


Asunto(s)
Regulación Neoplásica de la Expresión Génica , MicroARNs/genética , Neoplasias Gástricas/genética , Anciano , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , MicroARNs/sangre , MicroARNs/metabolismo , Pronóstico , Neoplasias Gástricas/sangre
11.
Anticancer Res ; 40(1): 261-269, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892575

RESUMEN

BACKGROUND: Pulmonary pleomorphic carcinoma (PPC) is a rare aggressive neoplasm, with dismal prognosis. Whether tumor immunity is associated with the progressive biological behavior of PPC remains unclear. The purpose of this study was to examine the prognostic significance of tumor immunity-related markers such as programmed death-1 ligand (PD-L1) and CD4+ or CD8+ tumor-infiltrating lymphocytes (TILs) in patients with surgically resected PPC. PATIENTS AND METHODS: Ninety-nine patients with surgically resected PPC were assessed by immunohistochemistry. The expression of PD-L1, CD4, and CD8 was examined in specimens of the resected tumors. RESULTS: PD-L1 was highly expressed in 61% (60/99) of lesions and high expression of CD4 and CD8 was identified in 42% (42/99) and 51% (51/99) of lesions, respectively. There was no relationship between the expression PD-L1 and the numbers of CD4+ or CD8+ TILs. The expression of PD-L1 was not identified as a significant prognostic marker; however, a low number of CD4+ TILs was identified as an independent marker for predicting a worse outcome after surgical resection of PPC, especially in patients with an epithelial component of adenocarcinoma or early stage of disease. By univariate analysis, a low number of CD8+ TILs was found to be a significant prognostic marker linked to poor overall survival in patients with non-adenocarcinoma components. CONCLUSION: A low number of CD4+ TILs is an independent marker for predicting a favorable prognosis after surgical resection in patients with PPC, especially in patients with adenocarcinoma components or early stage of disease.


Asunto(s)
Adenoma Pleomórfico/inmunología , Inmunidad , Neoplasias Pulmonares/inmunología , Adenoma Pleomórfico/patología , Adulto , Anciano , Anciano de 80 o más Años , Antígeno B7-H1/metabolismo , Biomarcadores de Tumor/metabolismo , Antígenos CD4/metabolismo , Antígenos CD8/metabolismo , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Pronóstico
12.
Anticancer Res ; 40(1): 281-286, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892577

RESUMEN

BACKGROUND/AIM: Neoadjuvant chemotherapy (NAC) for breast cancer (BC) is the gold standard treatment for locally advanced tumors (LABC) that aims at achieving a complete pathological response (pCR). Studies have been conducted to evaluate and identify te concordance between radiological, histopathological and biological variables of BC and final response to therapy, verified by definitive histological examination after surgery. PATIENTS AND METHODS: Ninety-five BC patients were examined and subjected to NAC. Immunohistochemical markers including oestrogen-receptor (ER), progesterone-receptor (PR), Ki67 index, and human epidermal growth factor receptor 2 (HER2) score were examined before and after neoadjuvant treatment. RESULTS: Younger age and a significant decrease in ER expression were associated with better prognosis. Triple Negative (TN) and Her2-type breast cancers benefited most from neoadjuvant chemotherapy with higher frequency of pCR. CONCLUSION: HER2-type and TN BC are correlated with best response to NAC. A statistically significant correlation between radiological images and definitive histological examination was not observed.


Asunto(s)
Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Terapia Neoadyuvante , Neoplasias de la Mama/diagnóstico por imagen , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunofenotipificación , Antígeno Ki-67/metabolismo , Persona de Mediana Edad , Receptores Estrogénicos/metabolismo , Receptores de Progesterona/metabolismo
13.
Anticancer Res ; 40(1): 341-347, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892585

RESUMEN

BACKGROUND/AIM: The prognostic significance of biomarkers related to gastric cancer prognosis has not been fully elucidated. The aim of study was to use immunohistochemical biomarkers to reveal prognosis. PATIENTS AND METHODS: A total of 682 patients who had undergone curative surgery were evaluated regarding the correlation of prognosis and immunohistochemical biomarkers. RESULTS: The COX2-positive groups showed a poor 5-year overall and disease-free survival. Further analysis revealed that COX2 positivity was a significant risk factor for poorer disease-free survival in the group with clinical stage I disease (p=0.016). We also noted a marked trend between COX2 positivity and poorer overall survival. The COX2-positive group showed general postoperative pathological up-staging compared with the COX2-negative group. CONCLUSION: This study showed the potential of COX2 as a biomarker for gastric cancer prognosis. Preoperative evaluation of COX2 might be a useful tool for generating optimal treatment strategies in patients with clinical stage I gastric cancer.


Asunto(s)
Biomarcadores de Tumor/metabolismo , Ciclooxigenasa 2/metabolismo , Neoplasias Gástricas/enzimología , Neoplasias Gástricas/patología , Supervivencia sin Enfermedad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Análisis de Supervivencia
14.
Anticancer Res ; 40(1): 357-366, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31892587

RESUMEN

BACKGROUND/AIM: This study was carried out to compare the efficacy and toxicity of consolidation with cytarabine only to consolidation with anthracycline combination in patients with acute myeloid leukemia (AML) achieving complete remission (CR). PATIENTS AND METHODS: This was a multicenter, retrospective, longitudinal cohort study set between January 2010 and December 2016. RESULTS: Generally, high-dose cytarabine Ied to better survival compared to anthracycline-containing consolidation therapy, as expected. However, for patients not undergoing hematopoietic stem cell transplantation (HSCT), anthracycline use was not necessarily associated with worse survival, depending on the number of consolidation cycles. Post-remission, pre-HSCT consolidation with high-dose cytarabine did not negatively affect survival compared to previous reports. For those without FMS-like tyrosine kinase 3 (FLT3) mutation, anthracycline use was associated with a worse survival, but for those with mutation, anthracycline use did not negatively affect survival. CONCLUSION: For patients who are ineligible for HSCT, selective use of anthracycline consolidation can be a viable option, while for patients with the intention of HSCT, post-remission high-dose cytarabine is a reasonable option in the absence of available donors.


Asunto(s)
Antraciclinas/uso terapéutico , Quimioterapia de Consolidación , Leucemia Mieloide Aguda/tratamiento farmacológico , Adolescente , Adulto , Anciano , Antraciclinas/efectos adversos , Antraciclinas/farmacología , Citarabina/uso terapéutico , Supervivencia sin Enfermedad , Relación Dosis-Respuesta a Droga , Femenino , Trasplante de Células Madre Hematopoyéticas , Humanos , Idarrubicina/farmacología , Idarrubicina/uso terapéutico , Leucemia Mieloide Aguda/patología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Modelos de Riesgos Proporcionales , Adulto Joven
15.
Ann Hematol ; 99(2): 265-276, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31897675

RESUMEN

Autologous stem cell transplantation (autoSCT) can achieve long-term remission in primary refractory or relapsed Hodgkin lymphoma (r/r HL); however, still up to 50% of patients relapse after autoSCT. In this retrospective analysis, we investigated the impact of autologous stem cell transplantation in a consecutive, unselected cohort of primary refractory and relapsed Hodgkin lymphoma patients (n = 66) with the majority of patients treated in the pre-brentuximab vedotin and immune checkpoint inhibitor era. In our cohort, a 5-year overall survival (OS) from autoSCT of 59.5% and a 5-year progression-free survival (PFS) after autoSCT of 46.1% was achieved. Multivariate analysis revealed primary refractory disease and early relapse (< 12 months) after initial therapy as well as the presence of B symptoms at relapse as independent risk factors associated with a higher risk for relapse and an inferior PFS and OS. Several other clinical factors, including the presence of extranodal disease at relapse and failure to achieve a complete response to salvage chemotherapy, were associated with a trend towards an inferior survival. Patients relapsing after autoSCT had a particularly poor outcome, regardless of eligibility to undergo allogeneic stem cell transplantation (alloSCT). We further evaluated recently published prognostic models for r/r HL patients undergoing autoSCT and could validate several risk scores in our independent "real world" cohort.


Asunto(s)
Enfermedad de Hodgkin/mortalidad , Enfermedad de Hodgkin/terapia , Trasplante de Células Madre , Adolescente , Adulto , Anciano , Autoinjertos , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Enfermedad de Hodgkin/patología , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia , Factores de Tiempo
16.
Ann Hematol ; 99(2): 293-299, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31897678

RESUMEN

The objective of this study is to investigate the prognostic value of the percentage change of maximum standardized uptake value (ΔSUVmax) assessed by PET/CT scan after 2 cycles of chemotherapy (iPET2) in patients with classic Hodgkin's lymphoma (CHL). ΔSUVmax was calculated as follows: the ratio of (SUVmax at baseline-SUVmax at iPET2)/SUVmax at baseline which was determined before initiation of ABVD chemotherapy. The median ΔSUVmax of 46 patients at iPET2 was 87.9% (range - 6.1-100.0%). The optimal ΔSUVmax cutoff value for progression-free survival (PFS) was 83.0% with the receiver operating characteristic curve. The area under the curve for PFS was 0.886 (95% CI 0.788-0.984, p < 0.001). The median PFS of 29 (63.0%) patients who achieved a SUVmax reduction of more than 83.0% was 34 months. The median PFS of 17 (37.0%) patients with ΔSUVmax < 83.0% was 9 months. This difference was significant (p < 0.001). Cohen's kappa coefficient of Deauville Score (DS)- and ΔSUVmax-judged positivity was 0.752 (95% CI 0.592-0.992, p < 0.001), suggesting a strong consistency. Multivariate analysis showed that ΔSUVmax at iPET2 less than 83.0% of SUVmax at diagnosis was an independent factor predicting PFS [HR = 11.339, 95% CI 2.485-51.742, p = 0.002]. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ΔSUVmax<83.0% was 84.6%, 81.8%, 67.7%, 93.1%, and 82.6%, which was similar to that of DS as 61.5%, 87.9%, 66.7%, 85.3%, and 80.4%, respectively. ΔSUVmax<83.0% of iPET2 effectively predicts prognosis of patients with CHL treated with ABVD.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Enfermedad de Hodgkin , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adolescente , Adulto , Anciano , Bleomicina/administración & dosificación , Dacarbazina/administración & dosificación , Supervivencia sin Enfermedad , Doxorrubicina/administración & dosificación , Femenino , Enfermedad de Hodgkin/diagnóstico por imagen , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Tasa de Supervivencia , Vinblastina/administración & dosificación
17.
Ann Hematol ; 99(2): 255-264, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31897676

RESUMEN

We assessed the efficacy and toxicity of etoposide, methylprednisolone, high-dose cytarabine, and oxaliplatin (ESHAOx) combination chemotherapy in patients with refractory or relapsed Hodgkin's lymphoma (HL). This was an open-label, non-randomized, multi-center phase II study. The ESHAOx regimen consisted of intravenous (i.v.) etoposide 40 mg/m2 on days 1 to 4, i.v. methylprednisolone 500 mg on days 1 to 5, i.v. cytarabine 2 g/m2 on day 5, and i.v. oxaliplatin 130 mg/m2 on day 1. Cycles (up to six) were repeated every 3 weeks. In an effort to identify prognostic markers, the serum levels of cytokines including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and vascular endothelial growth factor (VEGF) were measured at the time of study entry. A total of 37 patients were enrolled, and 36 were available for evaluation of tumor response. The overall response rate was 72.2% (26/36) (complete response, 33.3% [12/36]; partial response, 38.9% [14/36]). The median time to progression was 34.9 months (95% confidence interval, 23.1-46.7 months). The most common grade 3 or 4 hematological adverse events were neutropenia (16/37, 43.2%), followed by thrombocytopenia (10/37, 27.0%). Grade 3 or 4 non-hematological adverse events were nausea (3/37, 8.1%), anorexia (2/37, 5.4%), mucositis (1/37, 2.7%), and skin rash (1/37, 2.7%). There were no treatment-related deaths. High levels of TNF-α and CRP were significantly associated with poorer overall survival (p = 0.00005 for TNF-α, p = 0.0004 for CRP, respectively). The ESHAOx regimen exhibited antitumor activity and an acceptable safety profile in patients with refractory or relapsed HL. Trial Registration: ClinicalTrials.gov. Registered February 21, 2011, https://clinicaltrials.gov/ct2/show/NCT01300156.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Enfermedad de Hodgkin , Proteínas de Neoplasias/sangre , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Proteína C-Reactiva/metabolismo , Citarabina/administración & dosificación , Citarabina/efectos adversos , Supervivencia sin Enfermedad , Etopósido/administración & dosificación , Etopósido/efectos adversos , Femenino , Enfermedad de Hodgkin/sangre , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/mortalidad , Humanos , Masculino , Metilprednisolona/administración & dosificación , Metilprednisolona/efectos adversos , Persona de Mediana Edad , Oxaliplatino/administración & dosificación , Oxaliplatino/efectos adversos , Recurrencia , Tasa de Supervivencia , Factores de Tiempo , Factor de Necrosis Tumoral alfa/sangre , Factor A de Crecimiento Endotelial Vascular/sangre
18.
Ann Hematol ; 99(2): 229-239, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31907572

RESUMEN

The prognostic significance of hypercalcemia in lymphoma has only been studied on small series to date. We conducted a retrospective, monocentric, matched-control study that aimed to compare the outcome of patients diagnosed with any histological subtype of lymphoma associated with hypercalcemia, at diagnosis or relapse, with a group of controls matched for histological and prognostic factors. Sixty-two and 118 comparable patients treated between 2000 and 2016 were included in hypercalcemia and control cohorts, respectively. Hypercalcemia was found mainly at diagnosis (71%) in higher-risk patients (prognosis scores ≥ 3, 76%) and those with diffuse large B cell lymphoma (67.7%), stage III/IV disease (91.9%), and elevated LDH (90.3%). Two-year progression-free survival (PFS) was shorter in the hypercalcemia than control cohort [30.1% (95% confidence interval (95% CI) 18.3-41.9) vs 63.9% (95% CI 5.1-72.7), p < 0.001]. Two-year overall survival (OS) was 40.6% (95% CI 28.1-53.1) and 77.7% (95% CI 70.1-85.3) in the hypercalcemia and control cohorts, respectively (p < 0.001). Hypercalcemia was independently associated with poor PFS [HR = 2.5 (95% CI 1.4-3.5)] and OS [HR = 4.7 (95% CI 2.8-7.8)] in multivariate analysis. Among the 40 patients who received autologous stem cell transplantation (ASCT), hypercalcemia was still associated with shorter OS [2-year OS: 65% (95% CI 40.1-89.9) vs 88.0 (95% CI 75.3-100), p = 0.04]. Hypercalcemia may be associated with chemo-resistance, given its impact on PFS and OS. Hence, these data suggest that alternate strategies for lymphoma patients with hypercalcemia should be developed.


Asunto(s)
Hipercalcemia , Linfoma de Células B Grandes Difuso , Trasplante de Células Madre , Anciano , Autoinjertos , Supervivencia sin Enfermedad , Femenino , Humanos , Hipercalcemia/sangre , Hipercalcemia/diagnóstico , Hipercalcemia/mortalidad , Hipercalcemia/terapia , Linfoma de Células B Grandes Difuso/sangre , Linfoma de Células B Grandes Difuso/diagnóstico , Linfoma de Células B Grandes Difuso/mortalidad , Linfoma de Células B Grandes Difuso/terapia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
19.
Zhonghua Yi Xue Za Zhi ; 100(2): 130-135, 2020 Jan 14.
Artículo en Chino | MEDLINE | ID: mdl-31937053

RESUMEN

Objective: To study the relationship between the expression of Chromobox protein homolog (CBX) mRNA and the clinicopathological prognosis of breast cancer, and to investigate the possibility of Chromobox protein homolog 2 as a therapeutic target for breast cancer. Methods: First, we analyzed the mRNA expression of 8 CBX family genes by METABRIC database, and investigated the relationship between the expression of CBX2 mRNA and the clinicopathological parameters of breast cancer. Then we explored its relationship with prognosis. CBX2 siRNA was used to treat breast cancer cell lines with high expression of CBX2(SUM159 and SUM1315). The effects of knockdown of CBX20 on mRNA and protein expression and cell proliferation were observed. Results: According to the analysis of METABRIC database, among the 8 CBX genes, the most obvious increase in mRNA expression was CBX2, and 22.47% (445/1 980) of the patients showed high mRNA expression. The high expression of CBX2 was closely related to tumor histological grade and the molecular type of breast cancer (P<0.001). Compared with the low-expression group of CBX2 mRNA, the proportion of HER2 breast cancer (28.1% vs 7.5%) and Basal-like (44.5% vs 8.5%) in the high-expression group were both higher. Patients with high CBX2 expression had significantly shorter disease-free survival (DFS) and overall survival (OS). The knockdown of CBX2 by siRNA inhibited the proliferation of breast cancer cells. Conclusion: CBX2 is closely related to the prognosis of breast cancer and may be a target for breast cancer treatment.


Asunto(s)
Neoplasias de la Mama , Supervivencia sin Enfermedad , Humanos , Células MCF-7 , Complejo Represivo Polycomb 1 , Pronóstico
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