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1.
World J Surg Oncol ; 19(1): 266, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479600

RESUMO

BACKGROUND: MicroRNA-140 (miR-140) is one of the most widely investigated miRNAs in cell carcinogenesis and cancer development. Despite present proposals of employing miR-140 as a candidate biomarker for cancer prognosis, its effectiveness in predicting patient survival and clinicopathological outcome is still under debate. METHODS: A systematic search for English literature using online databases was performed with pre-established criteria. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to delineate the correlation between miR-140 levels and cancer patient prognosis. RESULTS: For this meta-analysis, we selected 12 papers for analysis, involving 1386 participants. Based on our analysis, high levels of miR-140 were strongly correlated with enhanced patient overall survival (OS) (HR = 0.728, 95% CI = 0.601-0.882, P = 0.001). In addition, we also observed that elevated miR-140 levels significantly led to better OS in patients with cancers in different parts of the body like digestive system (HR = 0.675, 95% CI = 0.538-0.848, P = 0.001), digestive tract (HR = 0.709, 95% CI = 0.565-0.889, P = 0.003), and head and neck (HR = 0.603, 95% CI = 0.456-0.797, P < 0.001). Additionally, we verified that the low miR-140 levels was related to advanced TNM stage (OR = 0.420, 95% CI = 0.299-0.590, P < 0.001), worse histologic grade (OR = 0.410, 95% CI = 0.261-0.643, P < 0.001), and positive lymph node metastasis status (OR = 0.341, 95% CI = 0.144-0.807, P = 0.014). CONCLUSIONS: Taken together, our results suggest that elevated miR-140 levels can be employed as a favorable biomarker for cancer patient prognosis. This information can greatly benefit in the formation of an individualized therapeutic plan for the treatment of cancer patients.


Assuntos
MicroRNAs , Neoplasias , Biomarcadores Tumorais/genética , Humanos , Metástase Linfática , MicroRNAs/genética , Neoplasias/genética , Prognóstico , Modelos de Riscos Proporcionais
2.
J Int Med Res ; 49(9): 3000605211038137, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34486433

RESUMO

Primary pulmonary high-grade mucoepidermoid carcinoma (MEC) with a cystic airspace is uncommon, and early metastasis is extremely rare. In such cases, however, it is clinically important for clinicians to consider whether the tumor has spread to the lymph nodes through the cystic airspace. A 77-year-old man presented to our hospital with cough and hemoptysis. Chest computed tomography showed a 25-mm-diameter mass with a cystic airspace located in the upper lobe of the left lung. The possibility of malignancy was considered. Without a definitive preoperative diagnosis, left upper lobectomy and mediastinal lymphadenectomy were performed. Histopathological examination revealed the typical histological characteristics of high-grade MEC (stage IA) and no lymph node metastasis. However, lymph node metastasis was found 6 months after surgical resection, and radiochemotherapy was performed. The patient developed widespread metastatic disease 4 months following completion of radiochemotherapy and died 2 months later. Primary pulmonary MEC with a cystic airspace is a rare malignant disease with uncommon imaging findings. Complete surgical resection is the main treatment method for high-grade MEC. In this case, we hypothesize that early metastasis was caused by seeding of tumor cells through the cystic airspace.


Assuntos
Carcinoma Mucoepidermoide , Neoplasias Pulmonares , Idoso , Carcinoma Mucoepidermoide/diagnóstico por imagem , Carcinoma Mucoepidermoide/cirurgia , Humanos , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Excisão de Linfonodo , Metástase Linfática , Masculino
3.
Rozhl Chir ; 100(6): 271-276, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465116

RESUMO

INTRODUCTION: The role of sentinel lymph node biopsy (SLNB) in patients with breast cancer after neoadjuvant chemotherapy (NAC) is currently under discussion. The aim of our study was to determine the false negativity rate (FNR) of SLNB, the accuracy of ultrasound examination in the evaluation of the status of lymph nodes and the accuracy of perioperative cryobiopsy of the sentinel lymph node (SLN). METHODS: Prospective multicentre study, which took place in years 20182020 at three centres in the Czech Republic. A total of 59 patients were evaluated. RESULTS: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC was 12.5%. The FNR of perioperative histological examination of the SLN was 38.5%. The FNR of ultrasound examination of axillary lymph nodes in patients after NAC was 35.5%, and the false positivity rate was 16.7%. The incidence of inflammatory complications in our cohort was 3.3%. CONCLUSION: The FNR of SLNB in the group of patients with cN1 before NAC and ycN0 after NAC exceeds the tolerable limit of 10%. The FNR of perioperative histological examination of the SLN is high; definitive histological examination of the SLN may change the original diagnostic-therapeutic plan. Ultrasound examination of the axillary lymph nodes in patients after NAC is a method with high false negativity and positivity and may not correspond with the perioperative finding. The incidence of inflammatory complications in our cohort in patients after NAC is comparable to literature data on the frequency of complications in patients without NAC.


Assuntos
Neoplasias da Mama , Biópsia de Linfonodo Sentinela , Axila , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos , Metástase Linfática , Terapia Neoadjuvante , Estudos Prospectivos
4.
Rozhl Chir ; 100(6): 285-294, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34465118

RESUMO

INTRODUCTION: Neoadjuvant therapy (NT) is one of the possible oncological treatment strategies for breast cancer. Its aim is to achieve down-staging of the tumour in the breast and axilla and thus the possibility of converting mastectomy to a breast-conserving procedure, and also to allow for a less burdensome and more targeted operation of the axillary lymph nodes. The role of the radiologist is to utilise imaging procedures for precise local staging of the malignancy prior to NT, to evaluate the effect of treatment during its course and upon its completion, and to perform restaging of the cancer in the breast and axilla. CASE REPORTS: The authors present three case reports of female patients with breast cancer who underwent neoadjuvant chemotherapy (NCT). They describe the diagnostic procedure and imaging methods used to establish local staging of the cancer prior to treatment, to monitor the disease during the course of treatment, and to perform restaging of the cancer after completing NCT. The radiological response after NCT completion was correlated with the pathological response. CONCLUSION: Correct determination of the extent of the cancer in the breast and axilla by the radiologist before NT and precise histological analysis of the tumour by the pathologist are fundamental for selecting the appropriate treatment for patients at the multidisciplinary breast tumour board.


Assuntos
Neoplasias da Mama , Terapia Neoadjuvante , Axila/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/cirurgia , Feminino , Humanos , Excisão de Linfonodo , Linfonodos/patologia , Metástase Linfática , Mastectomia , Estadiamento de Neoplasias , Radiologistas , Biópsia de Linfonodo Sentinela
5.
Medicine (Baltimore) ; 100(35): e27106, 2021 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-34477150

RESUMO

BACKGROUND: To analyze the characteristics, related risk factors, and prognosis of lymph node metastasis (Number [No.] 5 and No.6) in the group of adenocarcinoma of esophagogastric junction (AEG). METHODS: The patients with Siewert II AEG who underwent total gastrectomy and D2 lymph node dissection from September 2015 to December 2018 in Lanzhou University Second Hospital were enrolled in this study. The pathological features of the postoperative specimens were analyzed (sex, age, maximum diameter, location, depth of invasion, degree of differentiation, neurological and vascular invasion, etc), and the lymph node metastasis rate of No.5, No.6 groups were calculated. The analysis was performed by IBM SPSS statistical software. The risk factors associated with lymph node metastasis in No.5 and No.6 groups were analyzed. Survival analysis was performed by Kaplan-M method, and survival rate was estimated, Log-rank test was used for comparison, and the difference was statistically significant at P < .05. RESULTS: There were 142 cases of Siewert type II AEG with the positive rate of No.5 lymph nodes being 10.81% (8/74), and the positive rate of No.6 lymph nodes was 8.33% (11/132). No.5 and No.6 lymph nodes metastasis were not associated with gender, age, tumor maximum diameter, location (cardiac left/cardiac right) (P > .05), and were associated with invasion depth, differentiation degree, nerve and vascular invasion (P < .05). In the No.5 lymph node-positive group, the 3-year Overall Survival (OS) was 25.0%, and the No.5 lymph node-negative group had a 5-year OS of 57.8%, which was statistically different (P < .05). The 3-year OS was 18.2% in No.6 node-positive group and 53.8% in No.6 node-negative group, and the difference was statistically significant (P < .05). CONCLUSION: For Siewert type II AEG, the lymph node metastasis rate was higher in No.5 and No.6 groups when the tumor invaded all layers of gastric wall and was poorly differentiated complicated with vascular nerve invasion, and the lymph node metastasis rate was lower at 3 years, which may be more appropriate for total gastrectomy +D2 lymph node dissection.


Assuntos
Adenocarcinoma/complicações , Junção Esofagogástrica/anormalidades , Excisão de Linfonodo/estatística & dados numéricos , Metástase Linfática/fisiopatologia , Adenocarcinoma/diagnóstico por imagem , Idoso , Junção Esofagogástrica/diagnóstico por imagem , Feminino , Humanos , Excisão de Linfonodo/métodos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/terapia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos
6.
Clin Plast Surg ; 48(4): 599-606, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34503720

RESUMO

The eighth edition of the American Joint Committee on Cancer melanoma staging system relies on assessments of the primary tumor (T), regional lymph nodes (N), and distant metastatic sites (M). Its notable updates include tumor thickness measurements to the nearest 0.1 mm, revision of T1a and T1b definitions, re-evaluation of N category descriptors, increased number of stage III subgroupings, and incorporation of a new M1d designation, among others. These changes were based on analyses of a large contemporary international melanoma database. Ultimately, these revisions were made to improve staging and prognostication, risk stratification, and selection of patients for clinical trials.


Assuntos
Melanoma , Neoplasias Cutâneas , Humanos , Metástase Linfática , Melanoma/patologia , Estadiamento de Neoplasias , Prognóstico , Estados Unidos/epidemiologia
7.
Clin Plast Surg ; 48(4): 607-616, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34503721

RESUMO

Melanoma tumor thickness and ulceration are the strongest predictors of nodal spread. The recommendations for sentinel lymph node biopsy (SLNB) have been updated in recent American Joint Committee on Cancer and National Comprehensive Cancer Network guidelines to include tumor thickness ≥0.8 mm or any ulcerated melanoma. Mitotic rate is no longer considered an indicator for determining T category. Improvements in disease-specific survival conferred from SLNB were demonstrated through level I data in the Multicenter Selective Lymphadenectomy Trial (MSLT) I. The role for completion lymph node dissection has evolved to less surgery in lieu of recent domestic (MSLT II) and international (Dermatologic Cooperative Oncology Group Selective Lymphadenectomy Trial [DeCOG-SLT]) level I data having similar melanoma-specific survival. Treatment options for the prevention of treatment of lymphedema have progressed to include immediate lymphatic reconstruction, lymphovenous anastomosis, and vascularized lymph node transfer.


Assuntos
Linfedema , Melanoma , Neoplasias Cutâneas , Humanos , Excisão de Linfonodo , Linfonodos/cirurgia , Metástase Linfática , Linfedema/cirurgia , Melanoma/cirurgia , Estudos Multicêntricos como Assunto , Biópsia de Linfonodo Sentinela , Neoplasias Cutâneas/cirurgia
8.
Zhonghua Yi Xue Za Zhi ; 101(34): 2717-2722, 2021 Sep 14.
Artigo em Chinês | MEDLINE | ID: mdl-34510879

RESUMO

Objective: To evaluate the diagnostic efficacy of combined diagnostic model based on extreme gradient boosting (XGBoost) algorithm to determine the pathological grading of gastric neuroendocrine neoplasms (NENs). Methods: A total of 81 gastric NENs patients in the First Affiliated Hospital of Zhengzhou University confirmed by definite pathological grading from August 2012 to December 2019 were enrolled. The data of clinical and CT findings were collected. The number of lesions, tumor location, shape, lymph node metastasis, thickness, longitude of tumor and CT values in arterial and venous phase were analyzed. ITK-SNAP software and Python 2.1.0 PyRadiomics software were used to perform the image preprocessing and radiomics features extraction from segmented images. XGBoost algorithm was used to build the CT findings model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model. The diagnostic efficacy of CT imaging model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model were evaluated by accuracy, mean squared error (MSE) and mean absolute error (MAE). Results: The subjects were 28.0 to 78.0 (58.6+10.7) years old, including 56 males (69.1%). The number of lesions, tumor location, shape, lymph node metastasis, thickness and longitude of tumor between G1/G2 and G3 patients showed statistic significances (all P values<0.05), while there were no differences in CT values in arterial and venous phase (both P values>0.05). Six most important features in the combined diagnostic model were A_logarithm_glcm_Imc1, P_squareroot_glcm_Maximum Probability, thickness, longitude, A_wavelet-HHL_glrlm_GrayLevelNonUniformity and P_wavelet-LLL_ngtdm_Contrast, respectively. The accuracy of CT findings model, radiomics model in arterial phase, radiomics model in venous phase and combined diagnostic model were 81.8%, 86.0%, 87.8% and 91.0%, respectively; with MSE were 539.41, 490.08, 429.99 and 371.92, respectively; and MAE were 16.72, 15.25, 14.23 and 12.33, respectively. The MAE value of the combined diagnostic model was lower than those of CT findings model and radiomics model in arterial phase (P<0.001 and 0.004, respectively), while no statistically difference was detected compared to radiomics model in venous phase (P=0.111). Conclusion: The combined diagnostic model based on XGBoost algorithm have a good diagnostic efficiency for the pathological grading of gastric NENs.


Assuntos
Tumores Neuroendócrinos , Neoplasias Gástricas , Adulto , Idoso , Algoritmos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Tumores Neuroendócrinos/diagnóstico por imagem , Tomografia Computadorizada por Raios X
10.
J Int Med Res ; 49(9): 3000605211041509, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34510959

RESUMO

Perivascular epithelioid cell tumour (PEComa) is an extremely rare neoplasm with distinctive morphology and specific expression of immunohistochemical markers. The lesion is typically diagnosed in middle-aged women, with few reports of paediatric cases, and there is no standardized treatment for the tumour type. Here, the case of a 17-year-old female, who presented with painless haematochezia for 2 days and was diagnosed with gastrointestinal PEComa of the sigmoid colon with regional lymph node metastasis after serial examination, is presented. She was treated by surgical resection of the tumour and cytotoxic chemotherapy comprising 900 mg/m2 gemcitabine and 100 mg/m2 docetaxel every 3 weeks for six cycles. Haematochezia did not recur, and complete response was achieved, with progression-free survival at the 24-month follow-up examination. Surgical resection with adjuvant conventional cytotoxic chemotherapy may be considered as an option for treating gastrointestinal PEComa.


Assuntos
Colo Sigmoide , Neoplasias de Células Epitelioides Perivasculares , Adolescente , Criança , Desoxicitidina/análogos & derivados , Docetaxel/uso terapêutico , Feminino , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neoplasias de Células Epitelioides Perivasculares/tratamento farmacológico , Neoplasias de Células Epitelioides Perivasculares/cirurgia
11.
Int J Gynaecol Obstet ; 155(1): 43-47, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34520062

RESUMO

To revise the FIGO staging for carcinoma of the vulva using a new approach that involves analyses of prospectively collected data. The FIGO Committee for Gynecologic Oncology reviewed the recent literature to gain an insight into the impact of the 2009 vulvar cancer staging revision. The Committee resolved to revise the staging with a goal of simplification and actively collaborated with the United States National Cancer Database to analyze prospectively collected data on carcinoma of the vulva. Many tumor characteristics were collected for all stages of vulvar cancer treated between 2010 and 2017. Statistical analysis was performed with SAS software. Overall survival was estimated based on tumor characteristics. Log-rank and Wilcoxon tests were used to analyze overall survival similarities between and within groups of tumor characteristics. Characteristics with similar survivals were then grouped into the same stages and substages. Kaplan-Meier overall survival curves were generated for the resulting stages and substages. There were 12 063 cases with available data. The resulting new staging for carcinoma of the vulva has two substages in Stage I, no substage in Stage II, three substages in Stage III, and two substages in Stage IV. The Kaplan-Meier overall survival curves showed clear separation between stages and substages. The 2021 vulvar cancer staging is the first from the FIGO Committee for Gynecologic Oncology to be derived from data analyses. This revision has a new definition for depth of invasion, uses the same definition for lymph node metastases utilized in cervical cancer, and allows findings from cross-sectional imaging to be incorporated into vulvar cancer staging. The 2021 FIGO staging for carcinoma of the vulva is data-derived, validated, and much simpler than earlier revisions.


Assuntos
Neoplasias Vulvares , Feminino , Humanos , Metástase Linfática , Estadiamento de Neoplasias , Prognóstico , Neoplasias Vulvares/patologia
12.
Gan To Kagaku Ryoho ; 48(9): 1165-1167, 2021 Sep.
Artigo em Japonês | MEDLINE | ID: mdl-34521797

RESUMO

A 74-year-old man presented to our hospital because of anorexia. Upper gastrointestinal endoscopy revealed type 3 gastric cancer. Further examination disclosed metastasis to the perigastric lymph nodes and to the liver, and a diagnosis of non- resectable advanced gastric cancer(cT4N2H1P0M0)in cStage Ⅳ was made. A total of 4 courses of S-1 plus oxaliplatin therapy(80 mg/body/day and 100 mg/m2/cycle, respectively, for 2 weeks followed by a 1-week rest)were administered as the primary chemotherapy. Then, another metastasis to the abdominal lymph nodes and increased liver metastasis were found; thus, the patient's condition was rated as progressive disease(PD). Secondary chemotherapy comprising 10 courses of weekly nab-paclitaxel(nab-PTX)plus ramucirumab(RAM)therapy(100 mg/m2 on days 1, 8, and 15 and 8 mg/kg on days 1 and 15, respectively, every 4 weeks)were administered. Although temporary reductions in the perigastric lymph node metastasis and liver metastasis as compared with the baseline were observed, another metastasis to the abdominal lymph nodes occurred subsequently, resulting in PD. As tertiary chemotherapy, nivolumab therapy(240 mg/body, every 3 weeks) was repeated up to a total of 30 courses over 13 months. This therapy was markedly effective, achieving a near complete response. The patient is currently being followed up as an outpatient.


Assuntos
Nivolumabe , Neoplasias Gástricas , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Humanos , Linfonodos , Metástase Linfática , Masculino , Nivolumabe/uso terapêutico , Neoplasias Gástricas/tratamento farmacológico
13.
Zhonghua Zhong Liu Za Zhi ; 43(9): 944-948, 2021 Sep 23.
Artigo em Chinês | MEDLINE | ID: mdl-34530577

RESUMO

Objective: To investigate the correlation between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and central lymph node metastasis (CLNM) in patients with cN0 papillary thyroid microcarcinoma (PTMC). Methods: The clinicopathological data of PTMC patients confirmed by surgery and pathology in the 81st Military Hospital of People's Liberation Army from 2016 to 2019 were collected, and the relationship between preoperative NLR, PLR levels and postoperative PTMC CLNM were analyzed. Logistic regression analysis was used for multivariate analysis. Receiver operating characteristic (ROC) curve was used to determine the cutoff value of NLR and PLR. The interaction relative excess risk was used to analyze the relationship between NLR, PLR and CLNM. Results: Among 220 patients with cN0 stage PTMC, 92 were CLNM. The ROC curve showed that when the cutoff value of NLR was 2.5 and the cutoff value of PLR was 175, the highest Youden index was 0.318 and 0.264, respectively. NLR and PLR were both related to CLNM (P<0.05). The tumor long diameter, multifocality, NLR≥2.5 and PLR≥175 were independent impact factors of CLNM (P<0.05). The results of the interaction showed that the relative excess risk of the interaction was 5.531 (95%CI: 0.160, 10.901, P=0.016), the attribution ratio was 0.512 (95%CI: 0.230, 0.794, P=0.009), and the synergy index was 2.294 (95%CI: 1.492, 4.579, P=0.022), suggested that NLR and PLR had an interactive effect, and these two synergistically promoted CLNM. Conclusions: NLR and PLR are independent risk factors for cN0 stage PTMC CLNM. When NLR≥2.5 and PLR≥175, preventive central lymph node dissection should be routinely performed.


Assuntos
Neutrófilos , Neoplasias da Glândula Tireoide , Carcinoma Papilar , Humanos , Linfonodos/cirurgia , Metástase Linfática , Linfócitos , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/cirurgia
14.
Acta Biomed ; 92(4): e2021214, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34487080

RESUMO

The use of multiparametric prostate magnetic resonance imaging (mpMRI) is recommended, in the European Association of Urology (EAU) guidelines, for local staging of patients with prostate cancer (PCa). Systemic staging is recommended only for patients with unfavourable intermediate and high-risk disease; with bone and lymph node assessments usually being performed using bone scan (BS) and computed tomography (CT), respectively. Magnetic resonance imaging (MRI) is the imaging technique with the highest sensitivity for the detection of bone metastases and has shown promising results also for lymph node assessments. In this report we illustrate how MRI provided a comprehensive assessment of local disease as well as bone and lymph node metastases in a patient with PCa. (www.actabiomedica.it).


Assuntos
Neoplasias da Próstata , Humanos , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Metástase Linfática/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Estadiamento de Neoplasias , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/patologia
15.
Medicine (Baltimore) ; 100(36): e27184, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516518

RESUMO

ABSTRACT: The oncological safety of immediate breast reconstruction (IBR) in lymph node-positive patients is unclear. In the present study, the impact of IBR on recurrence based on data of patients with axillary lymph node metastases only was examined.The subjects were 232 patients who underwent breast surgery. The patients were grouped into 2 cohorts: non-IBR patients who underwent mastectomy with axillary lymph node dissection; and IBR patients with tissue expander or flap transfer and axillary lymph node dissection. The Non-IBR group included 165 patients, and the IBR group included 67 patients. For the comparison of oncological outcomes between the 2 groups, propensity score matching was performed. The propensity scores were calculated by logistic regression analysis, including age, tumor staging, human epidermal growth factor receptor 2 status, and estrogen receptor status. There was no difference in locoregional recurrence-free survival (LRRFS) between the non-IBR and IBR groups. The 5-year LRRFS rate was 78.9% in the non-IBR group and 85.1% in the IBR group. There was no difference in recurrence-free survival (RFS) between the non-IBR and IBR groups. The 5-year RFS rate was 75.6% in the non-IBR group and 78.8% in the IBR group. In all patients, the 5-year LRRFS rate was 77.3%, and the RFS rate was 70.5%. Multivariate Cox regression analysis to identify factors affecting RFS in all patients showed that estrogen receptor status and high nuclear grade were significant prognostic factors; IBR was irrelevant.This is the first report of an analysis using propensity score matching limited to node-positive breast cancer patients, and it showed that IBR is relatively safe in such patients.


Assuntos
Neoplasias da Mama/cirurgia , Metástase Linfática , Recidiva Local de Neoplasia/cirurgia , Pontuação de Propensão , Neoplasias da Mama/patologia , Estudos de Coortes , Intervalo Livre de Doença , Feminino , Humanos , Japão , Mamoplastia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 55(8): 990-994, 2021 Aug 06.
Artigo em Chinês | MEDLINE | ID: mdl-34445838

RESUMO

To investigate the risk factors of lymph node metastasis in early gastric cancer (EGC) and to develop a risk model for the presence of lymph node metastasis. A total of 172 EGC patients, with a median age of 62(52, 68) years, who underwent gastric cancer resection in the First Affiliated Hospital of Nanjing Medical University from January 2017 to June 2019 were selected. Clinical data of the patients were collected through the case system. Logistic regression analysis was used to determine the variables significantly related to lymph node metastasis. ROC curve and calibration curve were used to evaluate the risk model. The results showed that the lymph node metastasis rate of 172 EGC patients was 19.19% (33/172). Tumor size, depth of invasion, degree of differentiation and vascular tumor thrombus were associated with lymph node metastasis (P<0.05), but age ≥ 60 years (OR=5.556, 95%CI: 1.757-17.569, P=0.004), invasion depth (OR=4.218,95%CI:1.418-12.548, P=0.010) and vascular cancer embolus (OR=13.878,95%CI:4.081-47.196,P<0.001) were independent risk factors for lymph node metastasis of EGC. The consistency index of the risk model based on the above risk factors was 0.8835 (95%CI: 0.818 8-0.948 2). The calibration curve shows that the risk assessment model is in good agreement with the actual results, indicating that the model has high accuracy and discrimination.The most common site of metastasis was group 3, followed by group 4. Therefore, patients over 60 years old with submucosal invasion and vascular tumor thrombus may have a higher risk of lymph node metastasis.


Assuntos
Neoplasias Gástricas , Humanos , Excisão de Linfonodo , Metástase Linfática , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
17.
BMJ Open ; 11(8): e050378, 2021 08 23.
Artigo em Inglês | MEDLINE | ID: mdl-34426469

RESUMO

OBJECTIVE: To investigate the prognostic efficacy of lymph node ratio (LNR) and log odds of positive lymph nodes (LODDS) in node-positive cardia gastric adenocarcinoma (CGA). DESIGN: A registry-based retrospective cohort study. SETTING: Patients diagnosed with node-positive CGA in the Surveillance, Epidemiology, and End Results database from 2010 to 2015. PARTICIPANTS: A total of 1038 patients were enrolled and randomly assigned (7:3) to the training set (n=723) or validating set (n=315). PRIMARY OUTCOME MEASURE: Cancer-specific survival (CSS). RESULTS: The baseline characteristics of the training and validation sets were similar. Based on the optimal cut-off values, LNR was classified into low (<0.09), medium (0.09~0.33) and high (>0.33) groups; LODDS was also classified into low (<-2.09), medium (-2.09~-0.65) and high (>-0.65) groups. CSS was significantly different across LNR and LODDS subgroups. The Harrell concordance index of the N stage was lower than that of the LNR or LODDS. The Akaike information criterion of the N stage was higher than that of the LNR or LODDS. Independent predictors included race, T stage, M stage and LNR (or LODDS), and they were incorporated into nomograms for 1-year, 2-year and 5-year CSS prediction. Calibration plots showed satisfactory results for internal and external validity of the nomogram. CONCLUSIONS: LNR and LODDS staging methods have better prognostic efficacy than the traditional N staging method in CGA with node metastasis. Moreover, the two values are promising substitutes for N staging in nomogram development when other independent prognostic factors are incorporated.


Assuntos
Neoplasias Gástricas , Cárdia , Humanos , Linfonodos , Metástase Linfática , Prognóstico , Estudos Retrospectivos
18.
Medicine (Baltimore) ; 100(33): e26834, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34414934

RESUMO

ABSTRACT: Anti-differentiation non-coding RNA (ANCR), a long non-coding RNA, is involved in the development, progression and metastasis of various human cancers. However, its clinical significance in nasopharyngeal carcinoma (NPC) still remains unknown. This study aimed to investigate ANCR expression and its clinical significance in NPC.Totally, 96 NPC tissues and 24 non-cancerous nasopharyngeal mucosa tissues were used. The levels of ANCR were determined by qRT-PCR. Relationship of ANCR with patient clinical characteristics, disease-free survival and overall survival (OS) was evaluated.ANCR expression was increased in NPC tissues compared to non-cancerous nasopharyngeal mucosae. ANCR expression was significantly related to lymph node metastasis, clinical stage, and tumor differentiation (P < .05). Kaplan-Meier survival analysis revealed that high level of ANCR expression was significantly associated with poor disease-free survival but not with OS in NPC patients. Univariate analysis showed a significant association between increased ANCR expression and adverse OS (P < .05), but multivariate analysis suggested that ANCR could not be used as an independent prognostic factor for NPC patients.ANCR is involved in the development and progression of NPC, but whether it can be used as an effective therapeutic target for NPC needs further study.


Assuntos
Regulação Neoplásica da Expressão Gênica , Carcinoma Nasofaríngeo/genética , Neoplasias Nasofaríngeas/genética , RNA Longo não Codificante/genética , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Carcinoma Nasofaríngeo/química , Carcinoma Nasofaríngeo/mortalidade , Carcinoma Nasofaríngeo/secundário , Neoplasias Nasofaríngeas/química , Neoplasias Nasofaríngeas/mortalidade , Neoplasias Nasofaríngeas/patologia , Estadiamento de Neoplasias , RNA Longo não Codificante/análise , Estudos Retrospectivos , Taxa de Sobrevida
19.
Lancet Oncol ; 22(8): e348-e357, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34339655

RESUMO

In patients with prostate cancer who have a high risk of pelvic nodal disease, the use of elective whole pelvis radiotherapy is still controversial. Two large, randomised, controlled trials (RTOG 9413 and GETUG-01) did not show a benefit of elective whole pelvis radiotherapy over prostate-only radiotherapy. In 2020, the POP-RT trial established the role of elective whole pelvis radiotherapy in patients who have more than a 35% risk of lymph node invasion (known as the Roach formula). POP-RT stressed the importance of patient selection. In patients with cN1 (clinically node positive) disease or pN1 (pathologically node positive) disease, the addition of whole pelvis radiotherapy to androgen deprivation therapy significantly improved survival compared with androgen deprivation therapy alone, as shown in large, retrospective studies. This patient population might increase in the future because use of the more sensitive prostate-specific membrane antigen PET-CT will become the standard staging procedure. Additionally, the SPORTT trial suggested a benefit of whole pelvis radiotherapy in biochemical recurrence-free survival in the salvage setting. A correct definition of the upper field border, which should include the bifurcation of the abdominal aorta, is key in the use of pelvic radiotherapy. As a result of using modern radiotherapy technology, severe late urinary and intestinal toxic effects are rare and do not seem to increase compared with prostate-only radiotherapy.


Assuntos
Metástase Linfática/radioterapia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/radioterapia , Humanos , Masculino
20.
Adv Exp Med Biol ; 1330: 1-19, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34339027

RESUMO

Ovarian cancer (OC) is the most lethal gynecological malignancy among women worldwide. In most cases, it is diagnosed late at an advanced stage and does not respond well to existing therapies leading to its poor prognosis. In addition, other factors including epidemiological, complex histological diversity, multiple molecular alterations, and overlapping signaling pathways are also important contributors to poor disease outcome. Efforts have continued to develop a deeper understanding of the molecular pathogenesis and altered signaling nodes that provide hope for better clinical management through the development of novel approaches for early diagnosis, disease subtyping, prognosis, and therapy. In this chapter, we provide a detailed overview of OC and its histological subtypes and discuss prevalent molecular aberrations and active signaling pathways that drive OC progression. We also summarize various diagnostic and prognostic markers and therapeutic approaches currently being employed and discuss emerging findings that hold the potential to change the future course of OC management.


Assuntos
Neoplasias Ovarianas , Carcinoma Epitelial do Ovário , Feminino , Humanos , Metástase Linfática , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Transdução de Sinais
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