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1.
Medicine (Baltimore) ; 98(44): e17711, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689805

RESUMO

We aimed to identify the factors for very early recurrence (within 6 months) of ampullary cancer following curative resection and to compare the immunohistochemical expression rate of various antibodies between the 2 main histologic subtypes of ampullary adenocarcinoma.In this retrospective study, the postoperative outcomes and clinicopathologic factors for very early recurrence that occurred in 14 of 93 patients who underwent pancreaticoduodenectomy (PD) for ampullary adenocarcinoma between January 2002 and August 2014 were analyzed. Thereafter, we identified the factors associated with very early recurrence following surgery. Additionally, we compared the expression rates of CK7, CK20, MUC1, MUC2, MUC5AC, MUC6, S100P, and CDX2 between the 2 main histologic subtypes of ampullary adenocarcinoma (NCC2019-0138).The patients who underwent PD for ampullary cancer were divided into 2 groups: very early recurrence and others. Compared with the other patients, the 14 patients (32.6%) who developed very early recurrence had shorter median disease-free survival (4.2 vs 49.7 months, P = .001) and overall survival (18.2 vs 113.7 months, P < .001). Large tumor, lymph node metastasis, and pancreatobiliary type were independently associated with very early recurrence of ampullary cancer following PD.Large tumor, lymph node metastasis, and pancreatobiliary type were the independent risk factors for very early recurrence of ampullary cancer following curative resection. Therefore, ampullary cancer patients with these factors should be considered to receive aggressive adjuvant treatment and frequent post-operative follow-up.


Assuntos
Adenocarcinoma/patologia , Ampola Hepatopancreática/patologia , Neoplasias do Ducto Colédoco/patologia , Recidiva Local de Neoplasia/mortalidade , Pancreaticoduodenectomia/mortalidade , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Idoso , Ampola Hepatopancreática/cirurgia , Neoplasias do Ducto Colédoco/mortalidade , Neoplasias do Ducto Colédoco/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
2.
Zhonghua Yi Xue Za Zhi ; 99(40): 3139-3144, 2019 Oct 29.
Artigo em Chinês | MEDLINE | ID: mdl-31694104

RESUMO

Objective: To investigate the efficacy and prognosis of the dynamic monitoring lymphocyte to monocyte ratio (LMR) in patients with diffuse large B-cell lymphoma (DLBCL). Methods: The clinical data of 261 patients with DLBCL in the Affiliated Cancer Hospital of Zhengzhou University between March 2012 to March 2018, were analyzed retrospectively. The optimal cut-off values of LMR was determined using the receiver operating characteristic curve (ROC) method. Patients were divided into low LMR group and high LMR group according to the optimal cut-off value. The changes of LMR before and after treatment in two groups were dynamically monitored, and the relationship between LMR and efficacy and survival were analyzed. Results: Complete remission (CR) rate in patients with high LMR (64.7%) before treatment was significantly higher than that in patients with low LMR (33.3%) (P<0.05). Compared with the 5-year overall survival(OS) and progress free survival(PFS) (56.96% and 43.55%, respectively) in the low LMR group, the 5-year OS and PFS (82.92% and 66.25%, respectively) in the high LMR group were higher, and the difference was statistically significant (all P<0.05). Patients with elevated LMR after treatment in the high or low LMR group had a significant higher 5-year OS and PFS compared with patients with LMR reduction(P<0.05). LMR in both high and low LMR group were significantly lower at the last follow-up than those at the disease recurrence (all P<0.05). Both single and multivariate analyses showed that low LMR was an independent prognostic factor in patients with DLBCL (all P<0.05). Conclusions: LMR can be used as an indicator of risk stratification, efficacy, disease replase and prognosis in patients with DLBCL. Low LMR before and after treatment were poor prognostic factors in patients with DLBCL.


Assuntos
Linfoma Difuso de Grandes Células B , Monócitos , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Linfócitos , Recidiva Local de Neoplasia , Prognóstico , Estudos Retrospectivos
3.
Anticancer Res ; 39(11): 6249-6257, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704854

RESUMO

BACKGROUND/AIM: Therapeutic targeting of receptor protein tyrosine kinases (PTKs) has proven successful in treating cancer. However, reports about PTKs in treating prostate cancer are few. Elevated expression of the erythropoietin-producing hepatocellular receptor A2 (EPHA2) receptor tyrosine kinase, a transmembrane protein, is associated with poor prognosis of certain cancer types when the enzyme is dephosphorylated. This study investigated whether EPHA2 is useful in predicting the biochemical recurrence of prostate cancer. PATIENTS AND METHODS: Data from 241 patients who had undergone total prostatectomy between 2007 and 2011 were used. EPHA2 protein expression was categorized as high or low by two pathologists. The relationship was examined between EPHA2 expression level (high vs. low) and clinicopathological factors including biochemical recurrence. Correlations were examined between EPHA2, low-molecular-weight protein tyrosine phosphatase (LMW-PTP), E-cadherin, and Ki-67. RESULTS: EPHA2 expression was high in 121 (50.2%) and low in 120 (49.8%) patients. A log-rank test revealed early biochemical recurrence in the high-expression group. Gleason score, Ki-67 labeling index, and biochemical recurrence were more frequent in the high-expression group. Furthermore, multivariate analyses revealed that high EPHA2 expression was an independent prognostic factor for biochemical recurrence (hazard ratio=3.62, 95% confidence interval=2.39-5.61). Correlations between EPHA2 and both LMW-PTP and Ki-67 labeling index were positive, whereas EPHA2 and E-cadherin were negatively correlated. CONCLUSION: EPHA2 overexpression is predictive of aggressive prostate cancer behavior. EPHA2 may be a powerful prognostic biomarker for decision-making in postoperative follow-up after total prostatectomy, and regarding the need for palliative treatment. Additionally, it may be an important therapeutic target.


Assuntos
Biomarcadores Tumorais/metabolismo , Efrina-A2/metabolismo , Proteínas de Neoplasias/metabolismo , Recidiva Local de Neoplasia/metabolismo , Neoplasias da Próstata/metabolismo , Idoso , Análise de Variância , Caderinas/metabolismo , Humanos , Estimativa de Kaplan-Meier , Antígeno Ki-67/metabolismo , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Proteínas Tirosina Fosfatases/metabolismo , Curva ROC
4.
Anticancer Res ; 39(11): 6299-6305, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704860

RESUMO

BACKGROUND/AIM: A minority of grade I meningiomas (MG1s) recur after surgical resection and their progression is associated with high grade transformation (HGT). This study aimed to characterize the clinicoradiological features of recurrent MGs (RMG) with HGT. PATIENTS AND METHODS: We identified 17 patients diagnosed with MG1 who then underwent surgery for RMG. Patients were categorized into HGT group vs. non-HGT (nHGT) group based on RMG histological grade and clinicoradiological features were comparatively analyzed. RESULTS: HGT was observed in 41.4% of RMGs. Original tumor size was larger in the HGT group and recurrence time interval was shorter. Following recurrence, 57.1% in the HGT group experienced further disease progression, compared to 22.2% in the nHGT group. CONCLUSION: A considerable HGT rate in RMGs developed after MG1 was observed. Although HGT was not distinguished from nHGT by radiological features, HGT in RMG was associated with larger initial tumor size and shorter recurrence time interval.


Assuntos
Transformação Celular Neoplásica/patologia , Neoplasias Meníngeas/patologia , Meningioma/patologia , Recidiva Local de Neoplasia/patologia , Adulto , Idoso , Progressão da Doença , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Neoplasias Meníngeas/diagnóstico por imagem , Neoplasias Meníngeas/cirurgia , Meningioma/diagnóstico por imagem , Meningioma/cirurgia , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/diagnóstico por imagem , Fatores de Tempo , Resultado do Tratamento , Carga Tumoral
5.
Anticancer Res ; 39(11): 6365-6372, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704869

RESUMO

BACKGROUND/AIM: Although few studies have shown the effectiveness of adjuvant therapy with acridine orange (AO) for soft tissue sarcoma (STS) patients, no study has investigated this among cases with marginal resection. The aim of the study was to evaluate the effectiveness of AO therapy directly by comparing it to marginal resection cases that did not receive AO. PATIENTS AND METHODS: This retrospective study included 19 and 33 patients with STS who received AO therapy (AO group) and marginal resection without AO therapy (non-AO group), respectively. The patients' clinical information was collected, and the clinical courses were compared. RESULTS: The local recurrence rate in the AO group was significantly lower than that in the non-AO group (p<0.05). The local recurrence-free survival curves significantly differed between the two groups (p<0.05). High grade malignancy and no treatment with AO were identified as risk factors for local recurrence (p<0.05). CONCLUSION: AO therapy strongly suppressed local recurrence after marginal resection of STS.


Assuntos
Laranja Acridina/uso terapêutico , Corantes Fluorescentes/uso terapêutico , Margens de Excisão , Recidiva Local de Neoplasia , Sarcoma/tratamento farmacológico , Sarcoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos , Estudos de Casos e Controles , Terapia Combinada/métodos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Estudos Retrospectivos , Sarcoma/patologia
6.
Nihon Shokakibyo Gakkai Zasshi ; 116(11): 934-943, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31708506

RESUMO

Serous cystic neoplasms (SCNs) of the pancreas are slow-growing benign tumors. They are mostly monitored without surgical management. Solid SCN is rare and differentiating it from hypervascular tumors of the pancreas using preoperative imaging may be difficult. A 69-year-old woman was referred to our department for surgical treatment of an enlarged pancreatic tail tumor with a size of 22mm based on the abdominal computed tomography (CT). At the age of 60, she underwent thyroidectomy for papillary thyroid carcinoma and mastectomy for breast cancer. Initially, consecutive annual CT examinations did not show signs of recurrence. However, after 9 years, a hypervascular pancreatic tumor was detected and assumed to be either a neuroendocrine tumor or metastasis. The patient underwent distal pancreatectomy, and the resected specimen was histopathologically diagnosed as solid SCN of the pancreas. Before being referred for pancreatic resection, this patient had been followed up with serial annual CT examinations for over 9 years after a previous malignant disease. Retrospectively, the abdominal CT scans showed that the pancreatic tumor already existed 5 years ago and had gradually increased in size thereafter. In this case report, we focused on the characteristics of solid SCN to address the difficulty in diagnosing this rare malignancy.


Assuntos
Neoplasias da Mama , Neoplasias Pancreáticas , Idoso , Feminino , Humanos , Mastectomia , Recidiva Local de Neoplasia , Pâncreas , Pancreatectomia , Estudos Retrospectivos
7.
Rinsho Ketsueki ; 60(10): 1425-1430, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31695002

RESUMO

A 70-year-old man was admitted to our hospital due to fever, lymphadenopathy, and leukocytosis. White blood cell count was 22,700/µl with 92% blastoid cells. Bone marrow examination revealed abnormal lymphoid cell expansion. Abnormal cells expressed surface CD5 (dim), CD10, CD19, CD20, CD23 (dim) antigens, and kappa immunoglobulin light chains. Cytogenetic analysis of bone marrow cells at the time of diagnosis showed t (11:14) (q13;q32), t (14;18) (q32;q21), and t (8;14;18) (q24;q32;q21). Fluorescence in situ hybridization analyses of bone marrow identified translocations of IGH/MYC, IGH/BCL2, and IGH/CCND1. The patient was diagnosed with aggressive B-cell lymphoma with IGH/MYC, IGH/BCL2, and IGH/CCND1 translocation and was treated with various chemotherapies including R-CHOP, R-ESHAP, DA-EPOCH-R, R-hyper-CVAD, and radiotherapy. However, the lymphoma recurred after every chemotherapy session. Finally, he died after 6 months after first admission. Double-hit lymphoma/triple-hit lymphoma has previously been reported to present with an aggressive clinical course. In the present case, co-existence of IGH/CCND1, IGH/MYC, and IGH/BCL2 is very rare. Further clinical and biological investigations are necessary to establish an optimal treatment strategy.


Assuntos
Linfoma de Células B/genética , Translocação Genética , Idoso , Ciclina D1/genética , Evolução Fatal , Humanos , Cadeias Pesadas de Imunoglobulinas/genética , Hibridização in Situ Fluorescente , Linfoma de Células B/tratamento farmacológico , Masculino , Recidiva Local de Neoplasia , Proteínas Proto-Oncogênicas c-bcl-2/genética , Proteínas Proto-Oncogênicas c-myc/genética
8.
Rinsho Ketsueki ; 60(10): 1468-1470, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31695009

RESUMO

A 50-year-old male was diagnosed with multiple myeloma (MM) and treated by high-dose melphalan followed by autologous stem cell transplantation in April 2014. However, he relapsed and received non-myeloablative bone marrow transplantation from an unrelated HLA-matched donor (UR-BMT) in July 2016. After 100 days of UR-BMT, the disease remained stable disease and the patient was treated with carfilzomib, lenalidomide, and dexamethaonse (KRd) therapy. After 10 cycles of KRd, he obtained stringent complete response without exacerbation of graft-versus-host disease. We concluded that KRd after allogeneic stem cell transplantation is one of the useful treatment regimens for relapsed refractory MM.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica , Dexametasona/uso terapêutico , Transplante de Células-Tronco Hematopoéticas , Lenalidomida/uso terapêutico , Mieloma Múltiplo/terapia , Oligopeptídeos/uso terapêutico , Transplante de Medula Óssea , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Transplante Autólogo
9.
Kyobu Geka ; 72(11): 901-904, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588105

RESUMO

We report a case of a dialysis patient with severe aortic stenosis(AS) along with bilateral pheochromocytomas. A 52-year-old man presented with syncope and was diagnosed with severe AS. Although aortic valve replacement(AVR) was scheduled, bilateral pheochromocytomas were found during preoperative examination. There was a high possibility of developing hemodynamical crisis during AVR, and we planned to perform adrenalectomy prior to AVR. To avoid circulatory collapse just after adrenalectomy, balloon aortic valvuloplasty (BAV) was performed beforehand. Two weeks after the adrenalectomy, AVR was performed in a stable condition.


Assuntos
Neoplasias das Glândulas Suprarrenais , Estenose da Valva Aórtica , Valvuloplastia com Balão , Feocromocitoma , Valva Aórtica , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Diálise Renal , Resultado do Tratamento
10.
Kyobu Geka ; 72(11): 914-917, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588108

RESUMO

A 52-year-old man with a history of von Recklinghausen's disease presented to our hospital with abrupt onset of right chest and back pain. A contrast-enhanced chest computed tomography (CT) revealed massive right hemothorax, extravasation of the contrast medium at a branch of the right subclavian artery, and a tumor surrounding the second right dorsal rib. Based on findings from emergent angiography, hemothorax secondary to the rupture of an aneurysm of a branch of the right subclavian artery was diagnosed, and transcatheter arterial embolization(TAE) was performed. After hemostasis, intrathoracic hematoma was removed by surgery, and a recurrence of hemothorax did not occur until at least 8 months after the initial TAE procedure.


Assuntos
Aneurisma , Neurofibromatose 1 , Hemotórax , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Artéria Subclávia
11.
Kyobu Geka ; 72(11): 958-961, 2019 Oct.
Artigo em Japonês | MEDLINE | ID: mdl-31588117

RESUMO

A 69-year-old man was pointed out the anterior mediastinal mass on chest computed tomography (CT). Since the thymoma was suspected, thymectomy was performed through median sternotomy. The tumor was encapsulated and did not directly invade adjacent organs. The tumor was 8.3×5.3×8.2 cm in size. Histological examination of the resected specimen showed a large mucinous component and a small fibrous component, both containing many atypical spindle cells and multinuclear giant cells, and fat cells and atypical lipoblasts observed in a small part of the specimen. The postoperative pathological diagnosis was dedifferentiated liposarcoma. No relapse is observed without adjuvant therapy at 1 year after surgery.


Assuntos
Lipossarcoma , Neoplasias do Mediastino , Timoma , Neoplasias do Timo , Idoso , Humanos , Masculino , Mediastino , Recidiva Local de Neoplasia
12.
Medicine (Baltimore) ; 98(41): e17018, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31593076

RESUMO

Paget's disease can arise in the breast (mammary Paget disease) or in other locations (extramammary Paget disease) such as anogenital skin in both males and females (Paget disease of the vulva [PDV]). Underlying adenocarcinoma can be found in some cases. This study aims to report clinical aspects, surgical procedures, outcomes, and recurrences of patients with PDV.A retrospective chart review was conducted on patients with pathologically confirmed diagnosis of PDV managed at the Department of Obstetrics and Gynecology, University of Bari, and the "Giovanni Paolo II" National Cancer Institute in Bari, between 1998 and 2018.Records of 24 cases of PDV were examined. Median age of the patients at diagnosis was 69.3 (range 38-84), diagnosis of synchronous cancer was made in 2 cases and in 2 other cases of metachronous disease. Three patients had previously been diagnosed with other oncological diseases. All patients underwent surgery including wide local excision (6), simple vulvectomy (8), and extended vulvectomy (10). Lymphadenectomy was performed in 2 cases and reconstructions with advancement flaps in 7 cases. Four patients were found to have invasive disease and 1 had inguinal node involvement. Positive margins were found in 11 patients. Wound dehiscence and urethral stenosis were found in 4 and 1 case each. Eight recurrences (33.33%) were observed, regardless of positive surgical margins.PDV has a low rate of malignancy but a high rate of recurrence. It should be diagnosed early to avoid repeated surgery and to reduce symptoms and morbidity.


Assuntos
Adenocarcinoma/patologia , Doença de Paget Extramamária/patologia , Neoplasias Vulvares/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/cirurgia , Doença de Paget Extramamária/cirurgia , Estudos Retrospectivos , Vulva/patologia , Vulva/cirurgia , Neoplasias Vulvares/cirurgia
13.
Cancer Discov ; 9(10): 1340-1342, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31575562

RESUMO

Effective options are limited for patients with small-cell lung cancer who develop progressive disease during or after etoposide plus platinum-based therapy. In this issue of Cancer Discovery, Farago and colleagues highlight the data for temozolomide plus olaparib in this patient population and demonstrate the potential to accelerate biomarker discovery through co-clinical trials utilizing patient-derived xenografts.See related article by Farago et al., p. 1372.


Assuntos
Neoplasias Pulmonares , Inibidores de Poli(ADP-Ribose) Polimerases , Animais , Biomarcadores , Linhagem Celular Tumoral , Xenoenxertos , Humanos , Recidiva Local de Neoplasia , Ftalazinas , Piperazinas , Temozolomida , Ensaios Antitumorais Modelo de Xenoenxerto
14.
Prague Med Rep ; 120(2-3): 74-83, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31586506

RESUMO

To evaluate the role of magnetic resonance spectroscopy imaging (MRSI) parameters to predict early biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with non-metastatic prostate cancer (PCa). Between November 2010 and March 2012, 60 consecutive patients with clinically non-metastatic biopsy confirmed PCa underwent RP after MRSI assessment in a prospective study. Demographic, clinicopathological, magnetic resonance imaging (MRI) staging, MRSI parameters, and postoperative serum prostate-specific antigen were recorded. The univariate and multivariate Cox regression analyses were used to assess the association between potential prognosticators and early BCR (BCR less than 12 months after RP). In univariate Cox regression, preoperative serum PSA (prostate-specific antigen) (HR - hazard ratio = 1.016, p=0.003), surgical Gleason score > 7 (HR = 5.034, p=0.006) and MRSI risk score (HR = 4.061, p=0.0001); and in multivariate model, preoperative serum PSA (HR = 1.012; p=0.046), surgical GS > 7 (HR = 4.196; p=0.017) and MRSI risk score (HR = 3.256; p=0.013) were associated with early BCR. The greatest AUC (area under the curve) was related to MRSI risk score (AUC = 0.733) and the AUC of the multivariate model was 0.776. MRI/MRSI parameters specially MRSI risk score might be acceptable predictors of early BCR. These parameters can improve the accuracy of predictive nomograms to assess the risk of BCR after RP.


Assuntos
Imagem por Ressonância Magnética/métodos , Recidiva Local de Neoplasia/diagnóstico por imagem , Prostatectomia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/cirurgia , Humanos , Masculino , Estudos Prospectivos
15.
Rinsho Ketsueki ; 60(9): 1257-1264, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31597851

RESUMO

The introduction of proteasome inhibitors (PIs), such as bortezomib (BTZ), and immunomodulatory drugs (IMiDs), including thalidomide (THAL) and lenalidomide (LEN), as first-line therapies in multiple myeloma (MM) has markedly improved the clinical outcomes of patients. However, MM remains incurable, and most patients eventually relapse. Moreover, prognosis is poor in patients who exhibit resistance to BTZ or LEN, and novel therapeutic approaches for such patients are urgently needed. Currently, the following six drugs are available for use in relapsed patients: second generation PIs (carfilzomib and ixazomib), an IMiD (pomalidomide), a histone deacetylase (HDAC) inhibitor (panobinostat), and two monoclonal antibodies (elotuzumab and daratumumab). The choice of treatment should be individualized based on certain factors, such as age, presence of comorbidities, frailty, cytogenetic risk, efficacy and toxicity of prior treatments, and the duration of the previous response. A course of triplet therapy containing two novel agents along with DEX is recommended, on first relapse, in fit and healthy patients, whereas doublet therapy is preferred for unfit or frail patients. Retreatment of relapsed/refractory MM (RRMM) with monoclonal antibodies and IMiDs is promising because these drugs have immunostimulatory effects. In addition, novel agents, including an anti-BCMA antibody-drug conjugate, are being studied. Clinical trials are needed to define the optimal treatment strategy for RRMM.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Inibidores de Histona Desacetilases/uso terapêutico , Mieloma Múltiplo/terapia , Inibidores de Proteassoma/uso terapêutico , Humanos , Recidiva Local de Neoplasia
16.
Rev Prat ; 69(4): 454-460, 2019 Apr.
Artigo em Francês | MEDLINE | ID: mdl-31626506

RESUMO

At the instigation of the Aeras convention -Insuring and borrowing with an aggravated health risk - and the 2014- 2019 Cancer Plan, the Law of 26 January 2016 introduces the « right to be forgotten ¼ for people with cancer. Thus, people wishing to take out an insurance policy for a mortgage or consumer credit do not have to declare their cancer 10 years after the end of the therapeutic protocol, in the absence of relapse. This period is reduced to 5 years for cancers occurring before the age of 18 years. Associated with this right, the « reference grid ¼ identifies situations for which insurance will be granted without surcharge or exclusion of guarantee, or under conditions that are close to standard conditions. This concerns both cancer -breast, thyroid, prostate cancers ...- and noncancer diseases -HIV, hepatitis C, cystic fibrosis ...-. Through his relationship with his patient, the doctor plays a key role in providing the best insight and helping him in his efforts.


Assuntos
Sobreviventes de Câncer , Seguro , Humanos , Recidiva Local de Neoplasia
17.
Medicine (Baltimore) ; 98(39): e17277, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574842

RESUMO

Breast cancer is the most common cancer among women worldwide, and it is a main cause of death in women. As with breast cancer, metabolic components are important risk factors for the development of nonalcoholic fatty liver disease (NAFLD). In this retrospective cohort study, we aimed to determine the prevalence of NAFLD in patients with breast cancer and the impact of NAFLD on the prognosis of breast cancer.Patients with breast cancer were enrolled in the study from January 2007 to June 2017. Hepatic steatosis was evaluated through non-enhanced computed tomography scan by measuring Hounsfield Units in the liver and spleen, respectively; 123 healthy controls who underwent non-enhanced computed tomography scan were also analyzed.The prevalence of NAFLD in patients with breast cancer was 15.8% (251/1587), which was significantly higher than in healthy controls (8.9%, 11/123) (P = .036). Overall survival did not significantly differ between the groups with and without NAFLD (P = .304). However, recurrence-free survival was significantly higher in patients without NAFLD than in those with NAFLD (P = .009). Among breast cancer patients receiving endocrine treatment, the NAFLD group showed a higher cumulative incidence of significant liver injury than the group without NAFLD (P < .001).The prevalence of NAFLD in patients with breast cancer is significantly higher than in healthy controls. Moreover, breast cancer patients with NAFLD showed poorer prognosis in terms of recurrence. Therefore, diagnostic evaluation for NALFD is important in managing patients with breast cancer.


Assuntos
Neoplasias da Mama/patologia , Mastectomia/efeitos adversos , Recidiva Local de Neoplasia/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Complicações Pós-Operatórias/epidemiologia , Neoplasias da Mama/complicações , Neoplasias da Mama/cirurgia , Feminino , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/etiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Complicações Pós-Operatórias/etiologia , Período Pré-Operatório , Prevalência , Prognóstico , Estudos Retrospectivos , Fatores de Risco
18.
Medicine (Baltimore) ; 98(39): e17340, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574873

RESUMO

Radiotherapy after breast-conserving surgery or mastectomy has clinical benefits including reducing local recurrence and improving overall survival. Deep inspiration breath-hold (DIBH) technique using the Abches system is an easy and practical method to reduce radiation dose to the heart and lungs. This retrospective study was proposed to investigate the dosimetric difference between Abches system and free breathing technique in treating left-sided breast cancer.Eligible patients underwent computed tomography (CT) scans to acquire both free breathing (FB) and DIBH technique data using the Abches. For each patient, both FB and DIBH image sets were planned based on the volumetric modulated arc therapy (VMAT). Radiation dose to the heart, ipsilateral lung, and contralateral lung was compared between the Abches system and FB.No significant differences in the planning target volume (PTV) (674.58 vs 665.88 cm, P = .29), mean dose (52.28 vs 52.03 Gy, P = .13), and volume received at the prescribed dose (Vpd) (94.66% vs 93.92%, P = .32) of PTV were observed between the FB and DIBH plans. Significant differences were found in mean heart (6.71 Gy vs 4.21 Gy, P < .001), heart V5 (22.73% vs 14.39%, P = .002), heart V20 (10.96% vs. 5.62%, P < .001), mean left lung (11.51 vs 10.07 Gy, P = .01), left lung V20 (22.88% vs 19.53%, P = .02), left lung V30 (18.58 vs 15.27%, P = .005), and mean right lung dose (.89 vs 72 Gy, P = .03).This is the first report on reduced mean left lung, mean right lung dose, and V20 of left lung using VMAT and Abches. The combination of Abches and VMAT can practically and efficiently reduce extraradiation doses to the heart and lungs.


Assuntos
Radioterapia de Intensidade Modulada/métodos , Terapia Respiratória/métodos , Neoplasias Unilaterais da Mama/radioterapia , Adulto , Idoso , Suspensão da Respiração , Terapia Combinada , Feminino , Coração/efeitos da radiação , Humanos , Inalação , Pulmão/efeitos da radiação , Mastectomia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/prevenção & controle , Órgãos em Risco/efeitos da radiação , Dosagem Radioterapêutica , Estudos Retrospectivos , Resultado do Tratamento
19.
Anticancer Res ; 39(10): 5623-5630, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570459

RESUMO

BACKGROUND: This study aimed to investigate p16 and COX2 expression in oropharyngeal squamous cell carcinoma (OPSCC), and evaluate the prognostic role of COX2 expression under the new TNM classification. MATERIALS AND METHODS: Biopsy specimens obtained from 75 patients with OPSCC were stained for p16 and COX2 expression immunohistochemically. The results and clinical records were analyzed retrospectively. RESULTS: Fifty-nine patients (79%) were positive for p16. COX2 expression was correlated with poor relapse-free survival in patients overall, and in p16-positive patients. Smoking was positively associated with COX2 expression. Moreover, both positive COX2 expression and anterior wall tumor subsite were independently correlated with lymph node metastasis, which was the only independent prognostic factor in p16-positive OPSCC. CONCLUSION: The p16-positive rate in this study was comparable with that in the USA and Europe, and higher than that in other Asian countries. COX2 expression might affect the prognosis of p16-positive OPSCC through promoting lymph node metastasis.


Assuntos
Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/patologia , Metástase Linfática/genética , Metástase Linfática/patologia , Neoplasias Orofaríngeas/genética , Neoplasias Orofaríngeas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidor p16 de Quinase Dependente de Ciclina/genética , Ciclo-Oxigenase 2/genética , Intervalo Livre de Doença , Feminino , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/genética , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia/genética , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias/métodos , Prognóstico , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/genética , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia
20.
Anticancer Res ; 39(10): 5631-5637, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570460

RESUMO

BACKGROUND/AIM: Pelvic exenteration is a radical procedure for certain advanced or recurrent gynaecological cancers, performed with curative or palliative intent. Its validity has evolved as operative mortality and morbidity have improved. This surgery was evaluated to determine the validity of these claims. PATIENTS AND METHODS: The details of surgery and outcomes of 13 patients who underwent pelvic exenteration (6 curative intent, 7 palliative intent) for advanced or recurrent gynaecological cancers in our Department were retrospectively evaluated. RESULTS: There were no significant differences in blood loss, surgical time, hospital stay, and complications between curative pelvic exenteration and palliative pelvic exenteration. The curative intent group had a good prognosis; the palliative-intent group showed a trend to a worse prognosis. All patients' symptoms were relieved, but in patients with short survival, symptom relief lasted for up to 3 months. CONCLUSION: Pelvic exenteration is an acceptable and valuable procedure for gynaecological cancers.


Assuntos
Neoplasias dos Genitais Femininos/cirurgia , Recidiva Local de Neoplasia/cirurgia , Adulto , Idoso , Feminino , Neoplasias dos Genitais Femininos/mortalidade , Ginecologia/métodos , Humanos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Duração da Cirurgia , Exenteração Pélvica/métodos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Adulto Jovem
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