Metastatic Esophageal Carcinoma: Prognostic Factors and Survival.

BACKGROUND: Worldwide, esophageal cancer is the eighth most common cancer and the sixth leading cause of cancer-related death. At initial diagnosis, about 50% of esophageal cancer patients present with metastasis. The prognosis of metastatic esophageal cancer is poor with 5-year survival rate of less than 5%. METHODS: This is a retrospective study of stage IV esophageal cancer patients registered at Clinical Oncology and Nuclear Medicine department and Oncology Center Mansoura University in the period from 2009 to 2018 inclusive. Eligibility criteria were all pathologically proven stage IV esophageal cancer patients. The medical files of patients were reviewed. RESULTS: Most patients were ≥ 50 years (67.8%) with male predominance (76.7%). Middle third was the most common site of primary tumor (38.9%). Squamous cell carcinoma was more common with incidence of grade 3 (40%). T3-4 lesion was recorded in 61.1% and node positive in 66.7%. As regards metastasis; liver was the most common one (45.5%) followed by lung (30%). One-year survival rate was 25.6% with median survival time of 8 months. Multivariate analysis indicated that age (p = 0.03), site (p = 0.04), grade of primary tumor (p = 0.049), T classification (p = 0.0038), ECOG PS (p = 0.046), site (p = 0.026), and number of metastasis (p = 0.04) significantly affect prognosis while sex (p = 0.74) and histologic type (p = 0.94) do not. CONCLUSION: Metastatic esophageal carcinoma is a disease of poor prognosis especially in patients with the following criteria: old age, lower third location, high grade and large tumors, poor performance status, multiple sites of metastasis and presence of bone secondaries.

Mannan Oligosaccharide Enhanced the Growth Rate, Digestive Enzyme Activity, Carcass Composition, and Blood Chemistry of Thinlip Grey Mullet (Liza ramada).

Mannan oligosaccharide (MOS) is prebiotic with high functionality in aquaculture. The current study investigated the potential roles of MOS on the growth performance, digestive enzyme activity, carcass composition, and blood chemistry of Thinlip grey mullet (Liza ramada). Four tested diets with 34.49% crude protein and 6.29% of total lipids were prepared and fortified with 0, 0.5, 1, and 2% MOS. Fish of initial weight = 5.14 ± 0.11 g/fish were distributed in 12 hapas (0.5 × 0.5 × 1 m) at 15 fish per hapa (triplicates) and fed the test diets to the satiation level two times a day (08:00 and 15:00) for eight weeks. At the end of the trial, all fish were weighed individually for growth performance calculation. Blood was collected to check blood chemistry traits, and intestines were dissected for digestive enzyme analysis. Fish treated with MOS had marked enhancement in the final body weight, feed conversion ratio, protein gain, and protein retention regardless of inclusion dose (p < 0.05). The weight gain, specific growth rate, and protein efficiency ratio were meaningfully enhanced by including MOS at 0.5 and 1%, followed by fish fed with 2% MOS, while the lowest values were in the control group (p < 0.05). Insignificant influences of MOS were seen on the chemical composition of carcass components (moisture, crude protein, total lipids, and ash) (p > 0.05). Fish treated with MOS at 0.5 and 1% had marked enhancement in the amylase, lipase, and protease activities regardless of inclusion dose (p < 0.05). The blood total protein and albumin levels were meaningfully enhanced by including MOS at 0.5 and 1%, followed by fish fed with 2% MOS, while the lowest values were in the control group (p < 0.05). The blood globulin was significantly enhanced in fish fed 1% MOS than fish treated with 0, 0.5, and 2% of MOS (p < 0.05). The blood lysozyme activity was meaningfully enhanced by including MOS at 1%, followed by fish treated with 0.5 and 2%, while the lowest values were in the control group (p < 0.05). Phagocytic activity and phagocytic index were markedly improved in fish treated with 1 and 2% MOS, followed by those fed 0.5% compared with fish fed MOS-free diet (p < 0.05). Superoxide dismutase and glutathione peroxidase were markedly improved in fish treated with 1, and 2% MOS, followed by those fed 0.5% compared with fish fed MOS-free diet (p < 0.05). Dietary MOS (0.5, 1, and 2%) meaningfully enhanced catalase activity while decreased the malondialdehyde concentration (p < 0.05). In summary, dietary MOS is required at 0.5-1% for enhancing the growth rate, feed efficiency, digestive enzyme activity, blood chemistry, and antioxidative capacity of grey mullet.

The Prognostic Significance of Lymph Node Status and Lymph Node Ratio (LNR) on Survival of Right Colon Cancer Patients: a Tertiary Center Experience.

BACKGROUND: Colon cancer is a major health problem and is one of the most frequent cancers all over the world. In Egypt, the incidence of colon cancer is relatively low, but its mortality rate is high. Lymphatic spread of colon cancer is one of the most important factors affecting the prognosis of patients. Recently, the lymph node ratio (LNR) has been evaluated as a prognostic parameter for survival. This study aimed at evaluation of nodal status of resected specimens and LNR, as well as its impact on the disease-free survival (DFS) and overall survival (OS) after curative resection of right colon cancer. METHODS: The institutional registry of the Oncology Center Mansoura University (OCMU) was revised for node-positive right colon cancer cases that were operated in the period between January 2010 and January 2015. Fifty-three patients met the inclusion criteria and were followed up till January 2020. RESULTS: A total of 766 lymph nodes were excised from the patients. Thirty-two patients (60.4%) had a LN yield of ≥12 LNs with a mean LNR of 0.257 ± 0.27. Multivariate analysis of outcomes showed that LNR was significantly correlated with both DFS (p = 0.015) and OS (p = 0.024). Moreover, the number of resected LNs was also associated with statistically significant relationship with the DFS and OS. CONCLUSION: Our study confirms the validity of LNR as a prognostic tool that correlates with the survival of patients. Moreover, LNR cutoff values may help predict those of high chance of tumor recurrence. TRIAL REGISTRATION: MS/20.03.1087 (Institutional IRB), date of registration: March 10, 2020, "retrospectively registered".