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1.
Am J Clin Oncol ; 43(9): 628-635, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32889832

RESUMO

OBJECTIVES: Stereotactic body radiation treatment represents an intriguing therapeutic option for patients with early-stage prostate cancer. In this phase II study, stereotactic body radiation treatment was delivered by volumetric modulated arc therapy with flattening filter free beams and was gated using real-time electromagnetic transponder system to maximize precision of radiotherapy and, potentially, to reduce toxicities. MATERIALS AND METHODS: Patients affected by histologically proven prostate adenocarcinoma and National Comprehensive Cancer Network (NCCN) intermediate class of risk were enrolled in this phase II study. Beacon transponders were positioned transrectally within the prostate parenchyma 7 to 10 days before simulation computed tomography scan. The radiotherapy schedule was 38 Gy in 4 fractions delivered every other day. Toxicity assessment was performed according to Common Terminology Criteria for Adverse Events (CTCAE), v4.0. RESULTS: Thirty-six patients were enrolled in this study. Median initial prostate-specific antigen was 7.0 ng/mL (range: 2.3 to 14.0 ng/mL). Median nadir-prostate-specific antigen after treatment was 0.2 ng/mL (range: 0.006 to 4.8 ng/mL). A genitourinary acute toxicity was observed in 21 patients (dysuria grade [G] 1: 41.7%, G2: 16.7%). Gastrointestinal acute toxicity was found in 9 patients (proctitis G1: 19.4%, G2: 5.6%). Late toxicity was mild (genitourinary toxicity G1: 30.6%; G2: 8.3%; gastrointestinal toxicity G1: 13.9%; G2: 19.4%). At a median follow-up time of 41 months, 3 biochemical recurrences were observed (2 local recurrences, 1 distant metastasis). Three-year biochemical recurrence-free survival was 89.8% (International Society of Urologic Pathology Grade Group 2: 100%, Grade Group 3: 77.1%, P=0.042). CONCLUSION: Ultrahypofractionated radiotherapy, delivered with flattening filter free-volumetric modulated arc therapy and gated by electromagnetic transponders, is a valid option for intermediate-risk prostate cancer.


Assuntos
Adenocarcinoma/radioterapia , Recidiva Local de Neoplasia/sangue , Neoplasias da Próstata/radioterapia , Radiocirurgia/métodos , Radioterapia de Intensidade Modulada , Adenocarcinoma/secundário , Idoso , Diarreia/etiologia , Intervalo Livre de Doença , Fracionamento da Dose de Radiação , Disuria/etiologia , Fenômenos Eletromagnéticos , Humanos , Masculino , Pessoa de Meia-Idade , Noctúria/etiologia , Proctite/etiologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Lesões por Radiação/etiologia , Radiocirurgia/efeitos adversos , Radioterapia de Intensidade Modulada/efeitos adversos
3.
Medicine (Baltimore) ; 99(30): e21328, 2020 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-32791729

RESUMO

The purpose of this study was to report the clinicopathological characteristics and treatment outcomes of 45 rectal cancer patients who have a history of cervical cancer with or without remote radiotherapy. Twenty-nine patients (64.4%) with a history of cervical cancer treated with pelvic radiotherapy were classified as group A, 16 (35.6%) patients with a history of cervical cancer not treated with radiotherapy were classified as group B. The median duration between radiotherapy for cervical cancer and rectal adenocarcinoma diagnosis was 18 years. At the time of rectal cancer diagnosis, 5 (17.2%) patients presented stage I disease, 15 (51.7%) had stage II, 1 (3.4%) had stage III, and 8 (27.6%) had stage IV. The patients in group A had older age, higher rates of gross ulcerative lesions, low hemoglobin levels, and a lower rate of lymph node metastases. The patients with secondary rectal cancer developed after radiotherapy for cervical cancer usually presented with abnormal abdominal symptoms, such as proctitis, cystitis, or rectal fistula. Higher colostomy rate was found in this group of patients due to severe pelvic fibrosis or proctitis.


Assuntos
Segunda Neoplasia Primária/patologia , Radioterapia/efeitos adversos , Neoplasias Retais/patologia , Neoplasias do Colo do Útero/patologia , Adenocarcinoma/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Colostomia/estatística & dados numéricos , Cistite/epidemiologia , Cistite/etiologia , Feminino , Humanos , Metástase Linfática/patologia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Neoplasias Induzidas por Radiação/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Proctite/epidemiologia , Proctite/etiologia , Prognóstico , Fístula Retal/epidemiologia , Fístula Retal/etiologia , Neoplasias Retais/mortalidade , Estudos Retrospectivos , Taiwan/epidemiologia , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade , Neoplasias do Colo do Útero/radioterapia
4.
Am J Surg Pathol ; 44(9): 1224-1234, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32804454

RESUMO

This study determined the frequency and the clinicopathologic and genetic features of colorectal carcinomas driven by oncogenic fusions of the anaplastic lymphoma kinase gene (ALK). Of the 8150 screened tumors, 12 (0.15%) were immunohistochemically ALK-positive with D5F3 antibody. These cancers harbored CAD-ALK (n=1), DIAPH2-ALK (n=2), EML4-ALK (n=2), LOC101929227-ALK (n=1), SLMAP-ALK (n=1), SPTBN1-ALK (n=4), and STRN-ALK (n=1) fusions, as detected by an RNA-based next-generation sequencing assay. ALK fusion carcinomas were diagnosed mostly in older patients with a 9:3 female predominance (median age: 72 y). All tumors, except a rectal one, occurred in the right colon. Most tumors were stage T3 (n=7) or T4 (n=3). Local lymph node and distant metastases were seen at presentation in 9 and 2 patients. These tumors showed moderate (n=6) or poor (n=3) glandular differentiation, solid medullary growth pattern (n=2), and pure mucinous morphology (n=1). DNA mismatch repair-deficient phenotype was identified in 10 cases. Tumor-infiltrating lymphocytes were prominent in 9 carcinomas. In 4 carcinomas, tumor cells showed strong, focal (n=3), or diffuse programmed death-ligand 1 immunoreactivity. CDX2 expression and loss of CK20 and MUC2 expression were frequent. CK7 was expressed in 5 tumors. Four patients died of disease within 3 years, and 7 were alive with follow-up ranging from 1 to 8 years. No mutations in BRAF, RAS, and in genes encoding components of PI3K-AKT/MTOR pathway were identified. However, 1 tumor had a loss-of-function PTEN mutation. Aberration of p53 signaling, TP53 mutations, and/or nuclear accumulation of p53 protein was seen in 9 cases. ALK fusion colorectal carcinomas are a distinct and rare subtype of colorectal cancers displaying some features of mismatch repair-deficient tumors.


Assuntos
Adenocarcinoma/genética , Quinase do Linfoma Anaplásico/genética , Biomarcadores Tumorais/genética , Neoplasias Colorretais/genética , Fusão Gênica , Rearranjo Gênico , Adenocarcinoma/química , Adenocarcinoma/secundário , Adenocarcinoma/terapia , Idoso , Biomarcadores Tumorais/análise , Neoplasias Colorretais/química , Neoplasias Colorretais/patologia , Neoplasias Colorretais/terapia , Análise Mutacional de DNA , Europa (Continente) , Feminino , Predisposição Genética para Doença , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Japão , Metástase Linfática , Masculino , Mutação , Estadiamento de Neoplasias , Fenótipo , Resultado do Tratamento , Estados Unidos
5.
Medicine (Baltimore) ; 99(31): e21146, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756092

RESUMO

BACKGROUND: Cervical cancer is one of the common malignancies that afflict women worldwide. In rare cases, cervical cancer leads to ovarian metastasis (OM), resulting in poor outcomes. We conducted a systematic review and meta-analysis to evaluate the incidence and risk factors of OM in patients with adenocarcinoma (ADC) or squamous cell carcinoma (SCC) of the cervix. METHODS: We searched articles focused on OM in cervical carcinoma in PubMed, Embase, and the Cochrane Central Register of Controlled Trials. A meta-analysis was performed including selected publications. Pooled odds ratio (OR) and 95% confidence interval (95% CI) were calculated using random-effects models. The heterogeneity was evaluated by the I test. I > 50% was considered high heterogeneity. RESULTS: A total of 12 studies with 18,389 patients with cervical cancer in International Federation of Gynecology and Obstetrics stages IA to IIB were included in the meta-analysis. The overall incidence of OM was 3.61% among patients with ADC and 1.46% among patients with SCC (ADC vs SCC: OR 3.89, 95% CI 2.62-5.78; P < .001). Risk factors for OM were age >40 years (OR 1.79, 95% CI 1.02-3.13), bulky tumor (OR 2.65, 95% CI 1.77-3.95), pelvic lymph node involvement (PLNI; OR 9.33, 95% CI 6.34-13.73), lymphovascular space involvement (LVSI; OR 4.38, 95% CI 1.86-10.31), parametrial invasion (PMI; OR 7.87, 95% CI 5.01-12.36), and corpus uteri invasion (CUI; OR 7.64, 95% CI 2.51-23.24). PLNI, LVSI, and PMI were the leading risk factors, contributing to OM with respective population attributable fractions of 64.8%, 58.8%, and 51.5%. CONCLUSION: The incidence of OM is relatively low in ADC and SCC patients. Risk factors for OM include PLNI, LVSI, PMI, bulky tumor, CUI, or age over 40 years, with the first 3 contributing more to risk of OM.


Assuntos
Neoplasias Ovarianas/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Adenocarcinoma/epidemiologia , Adenocarcinoma/secundário , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/secundário , Feminino , Humanos , Incidência , Metástase Linfática , Estadiamento de Neoplasias , Neoplasias Ovarianas/secundário , Fatores de Risco , Neoplasias do Colo do Útero/patologia
6.
Medicine (Baltimore) ; 99(29): e21215, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702890

RESUMO

RATIONALE: Penile metastasis in rectal cancer is very rare and often originates from prostatic or bladder cancer. The prognosis of penile metastasis is poor and its treatments are more often palliative than curative due to association with disseminated metastases. Pathologic complete response (pCR) in rectal cancer with neoadjuvant chemoradiotherapy (CRT) has been shown to be surrogate marker of favorable long-term outcomes and currently has no report of penile metastasis. Here, we first report isolated penile metastasis in rectal cancer with pCR after neoadjuvant CRT. PATIENT CONCERN: The patient was a 74-year-old male with metastasis to the glans penis from rectal cancer diagnosed 9 months after abdominoperineal resection. Physical examination revealed palpable multiple nodules on the glans penis. DIAGNOSIS: Penile biopsy revealed metastatic carcinoma from the rectal cancer. INTERVENTION: Chemotherapy was started as soon as possible, because patient suffered urinary discomfort by rapid growing metastatic lesions. He is currently receiving palliative chemotherapy with modified FOLFOX-6 (mFOLFOX-6; oxaliplatin with 5-fluorouracil and folinic acid) plus bevacizumab. OUTCOME: The patient is still alive 4 months after diagnosis with markedly decreased metastatic lesions. LESSON: We propose that although penile metastasis in rectal cancer with pCR after preoperative neoadjuvant CRT is extremely rare, it might help to start early palliative chemotherapy and clinicians should be aware of this possibility.


Assuntos
Adenocarcinoma/diagnóstico , Neoplasias Penianas/diagnóstico , Pênis , Neoplasias Retais/diagnóstico , Adenocarcinoma/secundário , Adenocarcinoma/terapia , Idoso , Quimiorradioterapia , Diagnóstico Diferencial , Humanos , Masculino , Terapia Neoadjuvante , Metástase Neoplásica , Neoplasias Penianas/secundário , Neoplasias Penianas/terapia , Neoplasias Retais/patologia , Neoplasias Retais/terapia
7.
PLoS One ; 15(6): e0233443, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497056

RESUMO

Large (> 1 µm) tumor-derived extracellular vesicles (tdEVs) enriched from the cell fraction of centrifuged whole blood are prognostic in metastatic castration-resistant prostate cancer (mCRPC) patients. However, the highest concentration of tdEVs is expected in the cell-free plasma fraction. In this pilot study, we determine whether mCRPC patients can be discriminated from healthy controls based on detection of tdEVs (< 1µm, EpCAM+) and/or other EVs, in cell-free plasma and/or urine. The presence of marker+ EVs in plasma and urine samples from mCRPC patients (n = 5) and healthy controls (n = 5) was determined by flow cytometry (FCM) and surface plasmon resonance imaging (SPRi) using an antibody panel and lactadherin. For FCM, the concentrations of marker positive (+) particles and EVs (refractive index <1.42) were determined. Only the lactadherin+ particle and EV concentration in plasma measured by FCM differed significantly between patients and controls (p = 0.017). All other markers did not result in signals exceeding the background on both FCM and SPRi, or did not differ significantly between patients and controls. In conclusion, no difference was found between patients and controls based on the detection of tdEVs. For FCM, the measured sample volumes are too small to detect tdEVs. For SPRi, the concentration of tdEVs is probably too low to be detected. Thus, to detect tdEVs in cell-free plasma and/or urine, EV enrichment and/or concentration is required. Furthermore, we recommend testing other markers and/or a combination of markers to discriminate mCRPC patients from healthy controls.


Assuntos
Adenocarcinoma/secundário , Vesículas Extracelulares/metabolismo , Citometria de Fluxo/métodos , Neoplasias de Próstata Resistentes à Castração/sangue , Neoplasias de Próstata Resistentes à Castração/urina , Ressonância de Plasmônio de Superfície/métodos , Adenocarcinoma/sangue , Adenocarcinoma/urina , Idoso , Idoso de 80 Anos ou mais , Antígenos de Superfície/sangue , Biomarcadores Tumorais , Linhagem Celular Tumoral , Meios de Cultivo Condicionados , Vesículas Extracelulares/química , Humanos , Masculino , Proteínas do Leite/sangue , Proteínas de Neoplasias/sangue , Proteínas de Neoplasias/urina , Projetos Piloto , Neoplasias de Próstata Resistentes à Castração/patologia
10.
Medicine (Baltimore) ; 99(19): e20064, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384472

RESUMO

To shed light on the interaction between the American Joint Committee on Cancer (AJCC) T stage and M stage in the determination of the overall survival (OS) and cancer-specific survival (CSS) of esophageal carcinoma patients. Moreover, to confirm our hypothesis that tumors that metastasize to distant sites in the early T stage may reflect a more biologically aggressive disease compared with those that metastasize in more advanced T stages.We performed a retrospective cohort study with patients who were pathologically diagnosed with esophageal cancer between 2004 and 2014 in the surveillance epidemiology and end results (SEER) database. The primary study variables were the T and M stage, as well as their interaction terms. We performed a survival analysis of the interaction terms using unadjusted Kaplan-Meier methods and adjusted Cox proportional hazards models. Furthermore, we performed an exploratory analysis with stratification by histological type, esophageal adenocarcinoma (EAC), and esophageal squamous cell carcinoma (ESCC).Data of 19,078 patients were retrieved from the SEER database. Unadjusted Kaplan-Meier curve indicated that patients with T2 and T3 stage had longer median OS and CSS (3 months and 4 months, respectively) than with T1 stage in distantly metastatic esophageal cancer (M1 stage). Multivariate analysis revealed a significant interaction between the T stage and M stage when determining the OS and CSS of esophageal cancer (P < .001). Using T1M0 as a reference, patients with T1M1 had significantly worse OS and CSS than those with T2M1 and T3M1 stage (P < .001). A similar pattern was also observed among patients with EAC and ESCC.Our analysis suggests that the T1 stage predicts worse survival compared with T2 and T3 stage in distantly metastatic esophageal cancer and might be a surrogate for biologically aggressive disease, indicating that those patients should receive more aggressive treatments. Our findings also encourage researchers to discover new genomic changes in this subset of tumors with the potential to uncover new prognostic markers or drug targets. Further researches on the association between T stage and survival in metastatic esophageal cancer are warranted to validate our findings.


Assuntos
Adenocarcinoma/mortalidade , Neoplasias Esofágicas/mortalidade , Carcinoma de Células Escamosas do Esôfago/mortalidade , Adenocarcinoma/patologia , Adenocarcinoma/secundário , Idoso , Estudos de Coortes , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/secundário , Carcinoma de Células Escamosas do Esôfago/patologia , Carcinoma de Células Escamosas do Esôfago/secundário , Feminino , Humanos , Masculino , Estadiamento de Neoplasias , Estudos Retrospectivos , Análise de Sobrevida , Taxa de Sobrevida
11.
Internist (Berl) ; 61(7): 741-745, 2020 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-32430688

RESUMO

Adenocarcinoma of the esophagus is the oncologic entity with the most progressive incidence in western countries over the last 30 years. This is caused by, among other factors, a growing rate of obesity and the associated gastroesophageal reflux disease. Typical sites of metastasis include the liver, lymph nodes and peritoneum. Adrenal glands and thoraco-abdominal skeleton can also be affected. Cerebral metastasis is infrequent and there are only a handful cases described in the literature. The case presented here relates to a 61-year-old woman with osteolytic metastasis that was infiltrating the orbital cavity and was initially diagnosed as a dacryoadenitis.


Assuntos
Adenocarcinoma/secundário , Adenocarcinoma/cirurgia , Neoplasias Esofágicas/secundário , Refluxo Gastroesofágico/complicações , Neoplasias Orbitárias/diagnóstico , Neoplasias Orbitárias/secundário , Pseudotumor Orbitário/diagnóstico , Dacriocistite , Edema/etiologia , Feminino , Refluxo Gastroesofágico/diagnóstico , Humanos , Pessoa de Meia-Idade
14.
Medicine (Baltimore) ; 99(19): e20056, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32384470

RESUMO

RATIONALE: Cervical cancer primarily spreads through direct invasion or via local lymphatics, and hematogenous metastasis is infrequent. Previous reports have shown that lung, liver, and bone are the organs most frequently affected by hematogenous metastasis of cervical cancer, while skeletal muscle is very rarely involved. PATIENT CONCERNS: A 75-year-old Japanese woman presented with a painful muscular mass in her right lower abdomen. Five years ago, she was treated for her International Federation of Gynecology and Obstetrics stage IB2 cervical adenocarcinoma with radical surgery plus adjuvant chemotherapy. DIAGNOSES: The patient was diagnosed with isolated oblique muscle metastasis from cervical adenocarcinoma as a first site of recurrence. INTERVENTIONS: The patient was treated with salvage surgery consisting of partial resection of the oblique muscle and ilium. The tumor was completely excised with an adequate surgical margin by a partial resection of the oblique muscle and ilium OUTCOMES:: The patient is currently free of disease at 10 months after the development of recurrent disease. LESSONS: We describe a rare case of isolated oblique muscle metastasis as a first site of recurrence of the International Federation of Gynecology and Obstetrics stage IB2 cervical adenocarcinoma, which was successfully treated with surgery. Although skeletal muscle metastasis is rare, this condition should be considered during the follow-up period, especially when patients complain of muscular pain with insidious progression. The present case and our literature review highlighted the possibility that loco-regional treatment may be curative for selected recurrent cervical cancer developed in skeletal muscles.


Assuntos
Músculos Abdominais Oblíquos , Adenocarcinoma/secundário , Neoplasias Musculares/secundário , Neoplasias do Colo do Útero/patologia , Idoso , Feminino , Humanos
15.
World Neurosurg ; 139: 196-199, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311552

RESUMO

BACKGROUND: Incidence of chronic subdural hematoma (CSH) associated with metastases of extraneural malignancies is rare. We report a rare case of CSH wherein most of the CSH cavity was occupied with metastatic cancer cells; in addition, we review the literature. CASE DESCRIPTION: A 68-year-old man with a history of gastric cancer presented to our hospital with dysarthria and shoulder paralysis; CSH was diagnosed from preoperative imaging findings. When the hematoma was removed via a small craniotomy, besides the hematoma, we observed an abnormal mass of tissue in the capsule. Pathologically, the mass was consistent with the findings of metastatic gastric cancer. Although the symptoms immediately disappeared postoperatively, a symptomatic acute subdural hematoma with midline shift was observed on postoperative day 27. Emergency craniotomy and hematoma and tumor removal were performed. Pathologic examination showed hemorrhagic necrosis in the tumor, which had not been initially observed. The postoperative course progressed without hematoma recurrence. CONCLUSIONS: To the best of our knowledge, this is the first report of a CSH accompanied by tumor metastasis in most of the CSH cavity. Although rare, if a patient with cancer has CSH, the CSH should be treated considering the possibility of metastasis.


Assuntos
Adenocarcinoma/secundário , Neoplasias do Sistema Nervoso Central/secundário , Hematoma Subdural Agudo/cirurgia , Hematoma Subdural Crônico/cirurgia , Neoplasias Gástricas/patologia , Adenocarcinoma/complicações , Adenocarcinoma/cirurgia , Idoso , Neoplasias do Sistema Nervoso Central/complicações , Neoplasias do Sistema Nervoso Central/cirurgia , Craniotomia , Drenagem , Hematoma Subdural Agudo/etiologia , Hematoma Subdural Crônico/etiologia , Humanos , Masculino , Recidiva
16.
Urologe A ; 59(9): 1092-1094, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32248276

RESUMO

We report about the rare occurrence of symptomatic testicular metastasis of an acinar adenocarcinoma of the prostate. Testicular metastases are usually incidentally detected in patients treated with bilateral orchiectomy or more often during autopsy. In the literature, there are only a few clinical cases describing symptomatic testicular metastases. However, the possibility of such metastases should be considered in patients diagnosed with advanced prostate cancer. Testicular examination should be performed regularly, even in patients with low prostate-specific antigen levels.


Assuntos
Adenocarcinoma/secundário , Carcinoma de Células Acinares/patologia , Neoplasias da Próstata/patologia , Neoplasias Testiculares/secundário , Células Acinares , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Carcinoma de Células Acinares/cirurgia , Humanos , Masculino , Orquiectomia , Neoplasias da Próstata/cirurgia , Neoplasias Testiculares/patologia , Neoplasias Testiculares/cirurgia
17.
PLoS One ; 15(4): e0231833, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32298379

RESUMO

INTRODUCTION: Reflux promotes esophageal adenocarcinomas (EAC) creating a chronic inflammatory environment. EAC show an increasing incidence in the Western World and median survival rates are still low. The main reasons for poor prognosis despite new multimodal therapies are diagnosis of EACs at an already advanced stage and distant metastases. Hence, we wanted to investigate the presence of systemic inflammatory interleukins (IL) and their impact on patient prognosis. MATERIAL AND METHODS: Systemic expression levels of pro- and anti-inflammatory markers (IL-2, IL-4, IL-6, IL-10, IL-17A and IL-22) in the sera of 43 EAC patients without neoadjuvant radiochemotherapy were measured by flow cytometric analysis. A correlation to clinicopathological data was performed. Log-rank and Cox regression analysis were used to investigate the impact on patient survival. 43 sera of age and gender matched healthy volunteers were used as controls. RESULTS: Increased systemic IL-6 (p = 0.044) and lower IL-17A (p = 0.002) levels were found in EAC patients as opposed to controls. A correlation of IL-10 levels with an increased T stage was found (p = 0.020). Also, systemic IL-10 levels were highly elevated in patients with distant metastasis (p<0.001). However, only systemic IL-17A levels had an influence on patient survival in multivariate analysis. CONCLUSION: Systemic IL-6 levels are increased, while IL-17A levels are reduced in EAC patients compared to healthy controls. In addition, circulating IL-10 might help to identify patients with advanced disease and high IL-17A might indicate a limited prognosis.


Assuntos
Adenocarcinoma/sangue , Adenocarcinoma/mortalidade , Neoplasias Esofágicas/sangue , Neoplasias Esofágicas/mortalidade , Interleucina-10/sangue , Interleucina-17/sangue , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Neoplasias Esofágicas/secundário , Feminino , Humanos , Interleucina-6/sangue , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estatísticas não Paramétricas
19.
World Neurosurg ; 138: e445-e449, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32147556

RESUMO

BACKGROUND: Brain metastases from prostate cancer are rare and poorly described. We sought to assess the proportion of brain metastases arising from prostate cancer and to detail clinical characteristics, treatment modalities, and survival outcomes. METHODS: We retrospectively identified and reviewed the charts of 31 patients with intraparenchymal brain metastases from prostate adenocarcinoma seen at our institution from 2008 to 2018. RESULTS: Among all patients with brain metastases, the proportion originating from prostate adenocarcinoma was 0.86%. The median age at the time of brain metastasis diagnosis was 69 (range, 57-90). The median original Gleason score was 8 (range, 6-10), and the median prostate-specific antigen at the time of brain metastasis was 60 ng/mL (range, 0.34-4600). The median months from initial cancer diagnosis to brain metastasis was 81 (range, 3-195). The median number of brain metastases was 2 (range, 1-5). Patients had concurrent metastases to bone (100%), lung (48%), and liver (35%). Median overall survival was 3 months (range, 0.4-25.0). Treatment of the brain metastases was correlated with an increase in median survival from 1.2 months to 4.6 months with radiosurgery (hazard ratio = 0.11, P = 0.001) and surgical resection plus radiotherapy to 13 months (hazard ratio = 0.05, P < 0.001). All patients died of advanced, systemic disease and not of their intracranial disease. CONCLUSIONS: Brain metastasis from prostate cancer constitutes a small fraction of total brain metastases, but is associated with poor prognosis and is seen in the setting of advanced, castrate resistant disease. These data enable treating physicians to appropriately counsel their patients with prostate adenocarcinoma brain metastasis.


Assuntos
Adenocarcinoma/secundário , Neoplasias Encefálicas/secundário , Neoplasias da Próstata/patologia , Adenocarcinoma/mortalidade , Adenocarcinoma/radioterapia , Idoso , Idoso de 80 Anos ou mais , Neoplasias Encefálicas/mortalidade , Neoplasias Encefálicas/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Prognóstico , Próstata/patologia , Neoplasias da Próstata/mortalidade , Radiocirurgia , Taxa de Sobrevida , Resultado do Tratamento
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