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2.
Clin Epigenetics ; 15(1): 5, 2023 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-36611168

RESUMO

BACKGROUND: Combination chemotherapy has contributed to increased survival from Hodgkin disease (HD) and testicular cancer (TC). However, questions concerning the quality of spermatozoa after treatment have arisen. While studies have shown evidence of DNA damage and aneuploidy in spermatozoa years following anticancer treatment, the sperm epigenome has received little attention. Our objectives here were to determine the impact of HD and TC, as well as their treatments, on sperm DNA methylation. Semen samples were collected from community controls (CC) and from men undergoing treatment for HD or TC, both before initiation of chemotherapy and at multiple times post-treatment. Sperm DNA methylation was assessed using genome-wide and locus-specific approaches. RESULTS: Imprinted gene methylation was not affected in the sperm of HD or TC men, before or after treatment. Prior to treatment, using Illumina HumanMethylation450 BeadChip (450 K) arrays, a subset of 500 probes was able to distinguish sperm samples from TC, HD and CC subjects; differences between groups persisted post-treatment. Comparing altered sperm methylation between HD or TC patients versus CC men, twice as many sites were affected in TC versus HD men; for both groups, the most affected CpGs were hypomethylated. For TC patients, the promoter region of GDF2 contained the largest region of differential methylation. To assess alterations in DNA methylation over time/post-chemotherapy, serial samples from individual patients were compared. With restriction landmark genome scanning and 450 K array analyses, some patients who underwent chemotherapy showed increased alterations in DNA methylation, up to 2 to 3 years post-treatment, when compared to the CC cohort. Similarly, a higher-resolution human sperm-specific assay that includes assessment of environmentally sensitive regions, or "dynamic sites," also demonstrated persistently altered sperm DNA methylation in cancer patients post-treatment and suggested preferential susceptibility of "dynamic" CpG sites. CONCLUSIONS: Distinct sperm DNA methylation signatures were present pre-treatment in men with HD and TC and may help explain increases in birth defects reported in recent clinical studies. Epigenetic defects in spermatozoa of some cancer survivors were evident even up to 2 years post-treatment. Abnormalities in the sperm epigenome both pre- and post-chemotherapy may contribute to detrimental effects on future reproductive health.


Assuntos
Doença de Hodgkin , Neoplasias Testiculares , Humanos , Masculino , Epigenoma , Sêmen , Metilação de DNA , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/genética , Doença de Hodgkin/tratamento farmacológico , Doença de Hodgkin/genética , Doença de Hodgkin/metabolismo , Espermatozoides/metabolismo
4.
Medicina (Kaunas) ; 59(1)2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36676757

RESUMO

Background and Objectives: The aim of this article is to present a single-surgeon, open retroperitoneal lymph node dissection (RPLND) series for testicular cancer in a high-volume center. Materials and Methods: We reviewed data from patients who underwent RPLND performed by an experienced surgeon at our institution between 2000 and 2019. We evaluated surgical and perioperative outcomes, complications, Recurrence-Free Survival (RFS), Overall Survival (OS), and Cancer-Specific Survival (CSS). Results: RPLND was performed in primary and secondary settings in 21 (32%) and 44 (68%) patients, respectively. Median operative time was 180 min. Median hospital stay was 6 days. Complications occurred in 23 (35%) patients, with 9 (14%) events reported as Clavien grade ≥ 3. Patients in the primary RPLND group were significantly younger, more likely to have NSGCT, had higher clinical N0 and M0, and had higher nerve-sparing RPLND (all p ≤ 0.04) compared to those in the secondary RPLND group. In the median follow-up of 120 (56-180) months, 10 (15%) patients experienced recurrence. Finally, 20-year OS, CSS, and RFS were 89%, 92%, and 85%, respectively, with no significant difference in survival rates between primary vs. secondary RPLND subgroups (p = 0.64, p = 0.7, and p = 0.31, respectively). Conclusions: Open RPLND performed by an experienced high-volume surgeon achieves excellent oncological and functional outcomes supporting the centralization of these complex procedures.


Assuntos
Neoplasias Testiculares , Masculino , Humanos , Centros de Atenção Terciária , Espaço Retroperitoneal/cirurgia , Espaço Retroperitoneal/patologia , Estudos Retrospectivos , Excisão de Linfonodo/métodos , Estadiamento de Neoplasias , Resultado do Tratamento
5.
Pediatr Blood Cancer ; 70(3): e30200, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36625403

RESUMO

This paper retrospectively investigated the site and the detection method of relapses in children and adolescents with malignant germ cell tumors enrolled in the TCGM-AIEOP-2004 Study and subsequently developed a relapse, in order to evaluate a possible reduction in radiological exposure during follow-up. Including all malignant cases, serum tumor markers identified a relapse in more than 70% and, according to the selection criteria published by Children Oncology Group in 2018, in more than 90% of cases. These results confirm the importance of serum tumor markers as a relapse detection method, with possible reduction of radiology exams in specific subgroups.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Neoplasias Testiculares , Criança , Adolescente , Humanos , Masculino , Estudos Retrospectivos , Recidiva Local de Neoplasia/diagnóstico , Diagnóstico por Imagem , Neoplasias Embrionárias de Células Germinativas/diagnóstico por imagem , Biomarcadores Tumorais
6.
Immunotherapy ; 15(1): 17-25, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36647794

RESUMO

Little information is available regarding the therapeutic efficacy of immune checkpoint inhibitors and the prediction of DNA damage-repair (DDR) genes in mixed testicular germ-cell tumors (TGCTs). Here we report a pretreated patient with metastatic mixed TGCT harboring variations of three important DDR genes - BRCA2, MSH6 and PMS2 - identified by next-generation sequencing using plasma-based circulating tumor DNA. He obtained stable clinical benefit from PD-1 blockade. At the latest follow-up, he had a progression-free survival of more than 28 months and had survived 6.75 years since diagnosis. To our knowledge, this case is the first report of long-term clinical outcome obtained from immune checkpoint inhibitor therapy in a pretreated patient with mixed metastatic TGCT harboring co-mutations in DDR genes.


Assuntos
Neoplasias Testiculares , Masculino , Humanos , Mutação/genética , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/genética , Neoplasias Testiculares/patologia , Dano ao DNA
7.
Rev Med Suisse ; 19(N° 809-10): 86-89, 2023 Jan 18.
Artigo em Francês | MEDLINE | ID: mdl-36660844

RESUMO

Over the last year, urologic progress remains driven by evolutions in oncological and functionnal urology. Prostate cancer imaging modalities are improving, as well as treatment options for advanced stages. Kidney and bladder cancer are benefiting from new treatment modalities including immunotherapy, whose role in the peri-operative setting is still unclear. Surveillance startegies for testicular cancer has been greatly simplified, for the benefit of the patients. In functional urology, a new therapeutic class in now available for the treatment of overactive bladder. Mutliples alternatives to transurethral resection are emerging in the surgical treatment of benign prostatic hypertrophy, whose expected benefits will need to be validated by long-term studies.


Les progrès de cette année sont marqués par des avancées en uro-oncologie et urologie fonctionnelle. La prise en charge du cancer de la prostate s'améliore tant dans la qualité de son diagnostic que dans le traitement des stades avancés. Les cancers du rein et de la vessie bénéficient de nouvelles options de traitement incluant l'immunothérapie, qui cherche encore sa place en périopératoire. Quant au cancer des testicules, il a vu sa surveillance grandement simplifiée au bénéfice des patients. En urologie fonctionnelle, une nouvelle classe thérapeutique est désormais disponible pour le traitement de l'hyperactivité vésicale et de multiples alternatives à la résection endoscopique de la prostate émergent dans le traitement chirurgical de l'hypertrophie bénigne de la prostate. Il faudra toutefois valider les avantages espérés par des études à long terme.


Assuntos
Hiperplasia Prostática , Neoplasias da Próstata , Neoplasias Testiculares , Urologia , Masculino , Humanos , Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/cirurgia , Procedimentos Cirúrgicos Urológicos , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/cirurgia
8.
Reprod Biol Endocrinol ; 21(1): 5, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653793

RESUMO

INTRODUCTION: Infertility affects one in every six couples in developed countries, and approximately 50% is of male origin. In 2021, sperm DNA fragmentation (SDF) testing became an evidence-based test for fertility evaluations depicting fertility more clearly than standard semen parameters. Therefore, we aimed to summarize the potential prognostic factors of a higher SDF. METHODS: We conducted a systematic search in three medical databases and included studies investigating any risk factors for SDF values. We calculated mean differences (MD) in SDF with 95% confidence interval (CI) for exposed and non-exposed individuals. RESULTS: We included 190 studies in our analysis. In the group of associated health conditions, varicocele (MD = 13.62%, CI: 9.39-17.84) and impaired glucose tolerance (MD = 13.75%, CI: 6.99-20.51) had the most significant increase in SDF. Among malignancies, testicular tumors had the highest impact, with a maximum of MD = 11.3% (CI: 7.84-14.76). Among infections, the overall effects of both Chlamydia and HPV were negligible. Of lifestyle factors, smoking had the most disruptive effect on SDF - an increase of 9.19% (CI: 4.33-14.06). Different periods of sexual abstinence did not show significant variations in SDF values. Age seemed to have a more drastic effect on SDF from age 50 onwards, with a mean difference of 12.58% (CI: 7.31-17.86). Pollution also had a detrimental effect - 9.68% (CI: 6.85-12.52). CONCLUSION: Of the above risk factors, varicocele, impaired glucose tolerance, testicular tumors, smoking, pollution, and paternal age of over 50 were associated with the highest SDF. TRIAL REGISTRATION: CRD42021282533.


Assuntos
Intolerância à Glucose , Infertilidade Masculina , Neoplasias Testiculares , Varicocele , Humanos , Masculino , Pessoa de Meia-Idade , Sêmen , Fragmentação do DNA , Varicocele/patologia , Intolerância à Glucose/patologia , Espermatozoides/patologia , Estilo de Vida , Neoplasias Testiculares/patologia , Infertilidade Masculina/genética
9.
An. pediatr. (2003. Ed. impr.) ; 98(1): 19-27, ene. 2023. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-214783

RESUMO

Introducción: Se ha descrito que la autoexploración testicular se realiza en un bajo porcentaje de los adolescentes. Objetivo: Evaluar el impacto de una maniobra educativa a corto y largo plazo (6 meses) sobre el conocimiento y la actitud de los adolescentes varones en la autoexploración testicular. Métodos: Se realizó un cuasiexperimento, antes y después en adolescentes varones. Se validó un cuestionario para evaluar el conocimiento y la actitud (conciencia, intenciones y comportamiento) sobre la autoexploración testicular. La maniobra educativa consistió en una charla informativa de manera grupal que incluía esquemas y folletos. Se les aplicó el cuestionario antes y después de la maniobra educativa. Se citaron a los 6 meses posteriores y se les dio nuevamente la charla aplicándose un cuestionario antes y después de la misma. Resultados: Se incluyeron 139 adolescentes con una mediana para la edad de 14 años. El conocimiento (18,3% vs. 78,9% p=0,02) y la actitud (5,6% vs. 53,5% p=0,02) mejoraron posteriormente a la primera charla informativa. A los 6 meses de seguimiento (n=98) el conocimiento no se modificó (87,0% vs. 93,0% p=0,671); sin embargo, la actitud mejoró tras la segunda charla (58,0% vs. 78,0% p=0,009). Conclusión: Una maniobra educativa sobre la autoexploración testicular mejoró la proporción de una adecuada actitud (5,6% vs. 53,5%) y conocimiento (18,3% vs. 78,9%) en los adolescentes. El reforzamiento de la maniobra a los 6 meses mejora la proporción de adolescentes con una adecuada actitud (53,5% vs. 86,4%). (AU)


Introduction: There is evidence that the percentage of adolescents that practice testicular self-examination is low. Objective: To assess the short-term and long-term (6 months) impact in male adolescents of an educational intervention on the knowledge of testicular self-examination and attitude toward it. Methods: We conducted a quasi-experimental pre-test post-test study in male adolescents. A questionnaire was validated to assess knowledge on testicular self-examination and attitudes towards it (awareness, intentions, and behaviour). The educational intervention was group-based and consisted in an instructional talk with the aid of diagrams and brochures. The questionnaire was administered before and after the intervention. A follow-up was scheduled 6 months later, and the talk was delivered again, with administration of the questionnaire before and after. Results: The study included 139 adolescents with a median age of 14 years. We found an improvement in knowledge (18.3% vs. 78.9%; P=.02) and attitude (5.6% vs. 53.5%; P=.02) after the initial intervention. At the 6-month follow-up (n=98), there was no change in knowledge (87.0% vs. 93.0%; P=.671), but attitude improved after the second intervention (58.0% vs. 78.0%; P=.009). Conclusion: An educational intervention on testicular self-examination improved the proportion of adolescents with an adequate attitude (5.6% vs. 53.5%) and adequate knowledge (18.3% vs. 78.9%). The repetition of the intervention at 6 months increased the proportion of adolescents with an adequate attitude (53.5% vs. 86.4%). (AU)


Assuntos
Humanos , Masculino , Adolescente , Autoexame , Neoplasias Testiculares , Testículo , Inquéritos e Questionários , Conhecimentos, Atitudes e Prática em Saúde
10.
Int J Clin Oncol ; 28(1): 28-40, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36527578

RESUMO

Among adolescents and young adults, hematological tumors are the most common malignancies in younger patients; however, solid tumors also increase with advancing age. The pathogenesis of some of these tumors differs from that of tumors which develop in children, or middle-aged and older adults, and special care should be taken in their treatment and management. A treatment plan that takes into consideration future fertility is necessary for testicular tumors, and an educational campaign to encourage early detection is also essential. The treatment of adolescents with advanced testicular tumors should resemble therapeutic approaches for young adults and not a pediatric regimen. Adrenal tumors often develop as part of familiar hereditary syndrome. Therefore, taking the personal and family history is very important, and genetic counseling should be also recommended. In renal tumors, the incidence of translocation renal cell carcinomas is higher. Complete resection is the only promising method for long-term prognosis because of no established treatment for translocation renal cell carcinomas with distant metastasis. Bladder tumors are often detected by symptoms of gross hematuria and are found at a relatively early stage. Along with renal tumors, oncological evaluation including cystoscopy is also considered essential for gross hematuria. Wilms tumors and rhabdomyosarcomas could be managed in accordance with pediatric protocols to improve the treatment outcomes. The dedicated cancer survivorship care for adolescents and young adults could be also indispensable to conquer cancer and maintain a better quality of life.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Neoplasias Testiculares , Masculino , Pessoa de Meia-Idade , Humanos , Criança , Adolescente , Adulto Jovem , Idoso , Carcinoma de Células Renais/patologia , Hematúria , Qualidade de Vida , Neoplasias Renais/diagnóstico , Neoplasias Renais/terapia , Neoplasias Renais/patologia , Neoplasias Testiculares/patologia
11.
Cancer ; 129(4): 634-642, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36504384

RESUMO

BACKGROUND: Before postchemotherapy retroperitoneal lymph node dissection (pcRPLND), in patients with metastasized germ cell tumors (GCTs), those harboring necrosis (NEC) cannot be distinguished from those who have teratoma (TER), resulting in relevant overtreatment, whereas microRNA-371a-3p may be predictive for viable GCT. The purpose of this study was to explore messenger RNA (mRNA) and proteins to distinguish TER from NEC in pcRPLND tissue. METHODS: The discovery cohort consisted in total of 48 patients, including 16 each with TER, viable GCT, and NEC. Representative areas were microdissected. A NanoString panel and proteomics were used to analyze 770 genes and >5000 proteins. The most significantly and differentially expressed combination of both parameters, mRNA and its associated protein, between TER and NEC was validated using immunohistochemistry (IHC) in an independent validation cohort comprising 66 patients who were not part of the discovery cohort. RESULTS: The authors observed that anterior gradient protein 2 homolog (AGR2) and keratin, type I cytoskeletal 19 (KRT19) were significantly differentially expressed in TER versus NEC in mRNA and protein analyses (proteomics). The technical validation using IHC was successful in the same patients. These proteins were further validated by IHC in the independent patient cohort and exhibited significantly higher levels in TER versus NEC (p < .0001; area under the curve, 1.0; sensitivity and specificity, 100% each). CONCLUSIONS: The current study demonstrated that KRT19 and AGR2 mRNA and protein are overexpressed in TER versus NEC in pcRPLND tissue and might serve as a future diagnostic target to detect TER, for instance, by functional imaging, to avoid overtreatment. PLAIN LANGUAGE SUMMARY: The proteins and the corresponding genes called AGR2 and KRT19 can differentiate between teratoma and necrosis in remaining tumor masses after chemotherapy in patients who have metastasized testicular cancer. This may be a way to improve presurgical diagnostics and to reduce the current overtreatment of patients with necrosis only, who could be treated sufficiently by surveillance.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Teratoma , Neoplasias Testiculares , Masculino , Humanos , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/genética , Neoplasias Testiculares/cirurgia , Espaço Retroperitoneal/patologia , Excisão de Linfonodo/métodos , Teratoma/tratamento farmacológico , Teratoma/genética , Teratoma/cirurgia , Neoplasias Embrionárias de Células Germinativas/cirurgia , Necrose , Mucoproteínas/uso terapêutico , Proteínas Oncogênicas/genética , Proteínas Oncogênicas/uso terapêutico
12.
Appl Immunohistochem Mol Morphol ; 31(1): 47-50, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36476600

RESUMO

We present an 18-year-old male patient who presented with a 16 cm testicular tumor alongside multiple lesions in the lungs, right pelvis with involvement of the ischio/pubic bone, and enlarged pelvic lymph nodes on imaging, suspicious for metastatic disease. Histologic and immunohistochemical examinations revealed an embryonic type neuroectodermal tumor (somatic-type malignancy, 10%) arising in a malignant mixed germ cell tumor composed of teratoma (50%), embryonal carcinoma (10%) and yolk sac tumor (30%). After treatment with chemotherapy and radiation, repeat imaging demonstrated a right pelvic sidewall mass that decreased in size from 40 mm at 11 months after the initial diagnosis to 18 mm at 22 months after the initial diagnosis. A right pelvis medial thigh wall mass that had a lytic bone component showed a slight increase in size from 151 mm at 11 months after the initial diagnosis to 154 mm at 22 months after the diagnosis. On biopsies performed at 3, 10, and 26 months after the initial diagnosis, this lytic lesion consistently demonstrated a neoplasm composed of low-grade neuroglial differentiation. This is the first case in the medical literature where a residual malignant germ cell tumor consisting of low-grade neuroglial neoplasm is in a site that is not amenable to resection without significant morbidity. The tumor initially regressed with the traditional first-line chemo-radiotherapy regimen but regrew and stabilized with a second regimen of chemotherapy. The clinical course of this case invites consideration for an active surveillance approach in cases with similar characteristics.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Neoplasias Testiculares , Humanos , Masculino , Adolescente
13.
Ann Diagn Pathol ; 62: 152070, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36495736

RESUMO

BACKGROUND: Germ cell tumors (GCT) are the most common malignancy in men in the third and fourth decades of life. The occurrence of malignant GCT in men aged 50 years or over is rare, and their histopathologic characteristics and outcome is insufficiently characterized in the medical literature. Hence, we report the histopathologic features and clinical outcome of malignant GCTs in men aged ≥50 years at our institution. DESIGN: We performed a retrospective search of our database from 2005 to 2021 to identify men aged 50 years or older with malignant GCT. Cases of spermatocytic tumor were excluded. Clinical and histopathologic features of the tumors were reviewed. RESULTS: Forty-seven cases were identified, showing a sharp decline in incidence over the age of 65. Thirty-nine (83 %) tumors were testicular while eight (17 %) were non-testicular in presentation. Cases included 26 (55 %) seminomas, 15 (32 %) non-seminoma/mixed malignant GCT, and 5 (11 %) regressed testicular germ cell tumors. The most common component in mixed malignant GCTs was embryonal carcinoma (77 %), followed by seminoma and yolk sac tumor (62 % each). Germ cell neoplasia in situ (GCNIS) accompanied 57 % of the cases. Aggressive pathologic features, including lymphovascular invasion, retroperitoneal/lymph node involvement and higher stage at presentation, were identified in a significant proportion of cases (36/47, 77 %). Clinical follow up showed six patients (14 %) died of disease-related causes. CONCLUSION: Our findings expand and corroborate the previously reported data on malignant GCT in older men. Unique characteristics include tendency for higher stage at presentation with adverse pathologic features and more aggressive clinical course.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Seminoma , Neoplasias Testiculares , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Estudos Retrospectivos , Neoplasias Testiculares/patologia , Seminoma/epidemiologia , Seminoma/patologia
14.
BMC Cancer ; 22(1): 1245, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36457081

RESUMO

BACKGROUND: The optimal surveillance period and frequency after curative resection for oesophageal squamous cell carcinoma (OSCC) remain unclear, and current guidelines are mainly based on traditional Kaplan-Meier analyses of cumulative incidence rather than risk analysis. The aim of this study was to determine a suitable follow-up surveillance program following oesophagectomy for OSCC using the hazard function. METHODS: A total of 1187 patients who underwent curative resection for OSCC between 2000 and 2014 were retrospectively analyzed. The changes in the estimated hazard rates (HRs) of recurrence over time were analyzed according to tumour-node-metastasis stage. RESULTS: Four hundred seventy-eight (40.2%) patients experienced recurrence during the follow-up period (median, 116.5 months). The risk of recurrence peaked at 9.2 months after treatment (HR = 0.0219) and then decreased to half the peak value at 24 months post-surgery. The HRs for Stage I and II patients were low (< 0.007) post-treatment. The HR for Stage III patients peaked at 9.9 months (HR = 0.031) and the hazard curve declined to a plateau at 30 months. Furthermore, the HR peaked at 10.8 months (HR = 0.052) in Stage IV patients and then gradually declined from 50 months. CONCLUSIONS: According to tumour-node-metastasis stage, changes in the HRs of postoperative recurrence in OSCC varied significantly. Intensive surveillance should be undertaken for 3 years in Stage III patients and for 4 years in Stage IV patients, followed by annual screening. For Stage I OSCC patients, a reduction in the surveillance intensity could be taken into consideration.


Assuntos
Neoplasias Esofágicas , Carcinoma de Células Escamosas do Esôfago , Neoplasias Testiculares , Humanos , Masculino , Carcinoma de Células Escamosas do Esôfago/cirurgia , Estudos Retrospectivos , Neoplasias Esofágicas/cirurgia , Esofagectomia/efeitos adversos , Células Epiteliais
15.
BMC Cancer ; 22(1): 1256, 2022 Dec 02.
Artigo em Inglês | MEDLINE | ID: mdl-36461029

RESUMO

BACKGROUND: In traditional opinion, solid pulmonary nodule suspected lung cancer should be confirmed by pathology before the operation to exclude small cell lung cancer (SCLC), considering SCLC tends to be aggressive and surgical effect in the management of SCLC remains controversial. The aim of this study was to evaluate the survival result and risk factors of postoperative unsuspected SCLC. METHODS: A total of 120 patients with postoperative unsuspected SCLC who were confirmed by pathology and referred to Chinese PLA General Hospital between 2000 and 2021 were retrospectively analyzed (surgery group). Additionally, 120 patients with limited-stage SCLC who underwent chemotherapy and radiotherapy in the same period were enrolled in the chemoradiotherapy group.. Kaplan-Meier method was used to estimate survival; the Log-Rank test was used to compare survival rates between different groups; a COX stepwise regression model was used for multivariate analysis. RESULTS: Among 120 patients in the surgery group, 28 were with central type and other 92 with peripheral type. The median survival (OS) was 44.85 months, and the 5-year survival rate was 46%. The 5-year survival rates for stage I, II, and III were 52.1%, 45.4%, and 27.8%, respectively. The mean disease-free survival time (DFS) was 30.63 ± 4.38 months, and the 5-year DFS rate was 31.5%. In the chemoradiotherapy group, the mean OS was 21.4 ± 4.26 months, and the 5-year survival rate was 28.3%. The 5-year survival rates for clinical stage I, II, and III were 42.5%, 39.8%, and 20.5%, respectively. The mean progression-free survival (PFS) was 10.63 ± 3.6 months. In the surgery group, one-way ANOVA revealed that the gender, symptoms, smoking history, tumor location, and postoperative radiotherapy were not associated with OS (P ≥ 0.05), while age, surgical approach, surgical method, N stage, TNM stage, and vascular tumor thrombus were related to OS (P < 0.05). Multivariate analysis indicated that the N stage was associated with OS (HR = 1.86 P = 0.042). CONCLUSION: Surgery and adjuvant therapy were found to have encouraging outcomes in postoperative unsuspected SCLC. Patients with stage I, stage II and part of stage IIIA SCLC could benefit from surgery and the standard lobectomy, and systematic lymph node dissection, is also recommended for these patients.


Assuntos
Neoplasias Pulmonares , Carcinoma de Pequenas Células do Pulmão , Neoplasias Testiculares , Humanos , Masculino , Carcinoma de Pequenas Células do Pulmão/cirurgia , Estudos Retrospectivos , Neoplasias Pulmonares/cirurgia , Período Pós-Operatório , Quimiorradioterapia
16.
J Avian Med Surg ; 36(3): 325-332, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36468811

RESUMO

A 20-year-old male Moluccan eclectus (Eclectus roratus) was presented with a history of falling off the perch, ataxia, unilateral blindness, hyporexia, and progressive lethargy. The eclectus was found to have a leukocytosis (52 × 103 cells/µL), characterized by an absolute and relative heterophilia (42.6 × 103 cells/µL and 82%, respectively), relative lymphopenia (18%), elevated bile acids (88 µmol/L), and elevated triglycerides (236 mg/dL). Radiographic images revealed a mass effect within the caudal coelom. After 13 days of outpatient supportive care, the patient was rechecked and had normalized bile acids (<35 µmol/L), static triglycerides (232 mg/ dL), and hyperuricemia (18.6 mg/dL). Computed tomography was performed antemortem with and without iodinated contrast agent, 4 mL/kg IV over 2 minutes, and a mass was found associated with the left kidney. Due to worsening neurologic signs and involvement with surrounding structures, the owner elected euthanasia. Before the postmortem examination, a postmortem intravascular contrast agent was used to provide a more thorough visualization of internal anatomical structures, including left renal vasculature disruption, mass vasculature, caudal coelomic organ displacement, and increased irregular optic chiasm radiodensity. Postmortem, a 4 × 4.1 × 5.1-cm white to tan mass was identified. Histopathology confirmed a seminoma with metastasis to the kidneys and optic chiasm. Seminomas have been described in avian species; however, seminoma metastasis in an eclectus parrot confirmed by histopathology has not been reported, and optic chiasm metastasis of a seminoma has not been described in any avian species. This report describes postmortem computed tomographic angiography of metastatic seminoma in a Moluccan eclectus with metastasis to the optic chiasm.


Assuntos
Papagaios , Seminoma , Neoplasias Testiculares , Animais , Masculino , Seminoma/diagnóstico por imagem , Seminoma/veterinária , Meios de Contraste , Encéfalo , Rim , Neoplasias Testiculares/diagnóstico por imagem , Neoplasias Testiculares/veterinária , Ácidos e Sais Biliares , Triglicerídeos
17.
J Cancer Res Ther ; 18(Supplement): S449-S454, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36511002

RESUMO

Background: Spermatocytic tumours are a rare subset of testicular tumours seen in elderly patients with distinct clinicopathological features and a favourable outcome. The typical presentation and characteristic histological features usually suffice for the diagnosis. Most of the cases are amenable to surgical excision. However, occasional cases which have a sarcomatous transformation may behave more aggressively and warrant adjuvant therapy. Methods: We present the clinicopathological features of a series of 26 cases diagnosed as Spermatocytic tumour at our tertiary cancer institute from 2002-2019. Results: Twenty-four of these cases had the typical cytological features of a spermatocytic tumour while two cases showed sarcomatous change, one with rhabdomyosarcomatous differentiation and the other being an undifferentiated spindle cell sarcoma. Although the tumor can show varied patterns, the tripartite cytomorphology is typical in all cases. Conclusions: Careful note of these patterns and variations in histology is essential to prevent an erroneous diagnosis of other testicular neoplasms and guide the therapy.


Assuntos
Sarcoma , Seminoma , Neoplasias de Tecidos Moles , Neoplasias Testiculares , Masculino , Humanos , Idoso , Seminoma/patologia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/terapia , Neoplasias Testiculares/patologia , Sarcoma/diagnóstico , Sarcoma/terapia , Sarcoma/patologia
18.
J Cancer Res Ther ; 18(Supplement): S481-S485, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36511010

RESUMO

The objective is to report a rare case of extragonadal seminoma over the manubrium sterni on the chest wall. A 42-year-old male patient, a chronic alcoholic for 10 years presented with a firm mass of approximate size 10 cm × 12 cm overlying the manubrium part of the sternum. A clinical diagnosis of soft-tissue tumor was made. All relevant preoperative workup was done. Fine-needle aspiration cytology of the mass was suggestive of serous cystic lesion with chronic inflammation. Wide local excision of the mass and primary closure of the wound was done, followed by histopathological examination. Unanticipatedly, on histology, the mass turned out to be extragonadal seminoma. Postoperative wound healing was satisfactory. Subsequently, the patient underwent adjuvant chemotherapy. Primary extragonadal seminoma itself is a rare tumor that affects mainly young people with mediastinum as the most commonly involved site and has higher chances of metastasis. This case of extragonadal seminoma (extragonadal germ cell tumour) over manubrium sterni without any mediastinal involvement in a patient in early forties presenting as soft-tissue tumor, itself is a rarer entity and perhaps one of the kinds. Hence, the case needs to be reported and further progression and prevention have to be discussed.


Assuntos
Neoplasias do Mediastino , Neoplasias Embrionárias de Células Germinativas , Seminoma , Neoplasias de Tecidos Moles , Neoplasias Testiculares , Masculino , Humanos , Adolescente , Adulto , Seminoma/diagnóstico , Seminoma/cirurgia , Seminoma/patologia , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias Embrionárias de Células Germinativas/cirurgia , Quimioterapia Adjuvante , Neoplasias Testiculares/diagnóstico , Neoplasias do Mediastino/diagnóstico , Neoplasias do Mediastino/cirurgia , Neoplasias do Mediastino/patologia
19.
P R Health Sci J ; 41(4): 250-253, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36516214

RESUMO

Primary testicular rhabdomyosarcoma is a rare pediatric genitourinary tumor with few cases reported in the literature. The clinical presentation is identical to that of other common testicular neoplasms. Diagnosis entails careful microscopic examination and immunohistochemical analysis to rule out other primary testicular malignancies. Treatment consists of radical orchiectomy and adjuvant chemotherapy with possible retroperitoneal lymph node dissection. This multimodal approach is required to improve survival outcomes and reduce disease recurrence. We present the case of a primary testicular embryonal rhabdomyosarcoma in a 19-year-old male who presented with a rapidly, enlarging, painless testicular mass. He was treated with radical orchiectomy and adjuvant chemotherapy. Once found with metastatic disease, he then received salvage chemotherapy and radiotherapy without success.


Assuntos
Neoplasias Embrionárias de Células Germinativas , Rabdomiossarcoma Embrionário , Neoplasias Testiculares , Masculino , Criança , Humanos , Adulto Jovem , Adulto , Rabdomiossarcoma Embrionário/terapia , Rabdomiossarcoma Embrionário/tratamento farmacológico , Recidiva Local de Neoplasia , Neoplasias Testiculares/diagnóstico , Neoplasias Testiculares/cirurgia , Neoplasias Embrionárias de Células Germinativas/cirurgia , Orquiectomia
20.
Arthritis Res Ther ; 24(1): 270, 2022 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-36514134

RESUMO

BACKGROUND: The associations of rheumatoid arthritis (RA) with risk of site-specific cancers beyond lymphohematopoietic cancer have been scarcely explored. We conducted a Mendelian randomization investigation of the associations of RA with site-specific cancers in European and East Asian populations. METHODS: Independent genetic variants strongly associated with RA in European and East Asian populations were selected as instrumental variables from genome-wide association studies of 58,284 European individuals (14,361 cases and 43,923 controls) and 22,515 East Asian individuals (4873 cases and 17,642 controls), respectively. The associations of genetic variants with overall and 22 site-specific cancers were extracted from the UK Biobank study (n = 367,561), the FinnGen study (n = 260,405), Biobank Japan (n = 212,453), and international consortia. The associations for one outcome from different data sources were combined by meta-analysis. RESULTS: In the European population, the combined odds ratios per 1-unit increase in log odds of genetic liability to RA were 1.06 (95% confidence interval [CI] 1.03-1.10) for head and neck cancer, 1.06 (95% CI 1.02-1.10) for cervical cancer, 0.92 (95% CI 0.87-0.96) for testicular cancer, and 0.94 (95% CI 0.90-0.98) for multiple myeloma. In the East Asian population, the corresponding odds ratios were 1.17 (95% CI 1.06-1.29) for pancreatic cancer, 0.91 (95% CI 0.88-0.94) for breast cancer, and 0.90 (95% CI 0.84-0.96) for ovarian cancer. There were suggestive associations for breast and ovarian cancer and overall cancer in the European population. No other associations were observed. CONCLUSION: This study suggests that RA may play a role in the development of several site-specific cancers.


Assuntos
Artrite Reumatoide , Neoplasias Ovarianas , Neoplasias Testiculares , Masculino , Humanos , Feminino , Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Predisposição Genética para Doença/genética , Polimorfismo de Nucleotídeo Único , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/genética
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