Primary solitary peritoneal tumor of the abdominal wall—report of a rare case and review of the literature

Abstract

Abdominal wall tumors are sometimes diagnosed as metastases of ovarian cancer, however, primary peritoneal tumors should be taken into consideration in the final diagnosis. A 49-year-old female patient was admitted in our Department for the excision of a pulpable abdominal wall lump, with no other abnormalities shown on imaging investigation. On histology examination, the excised specimen revealed characteristics of metastatic high-grade serous ovarian carcinoma. Total hysterectomy, bilateral oophorectomy, omentectomy and appendectomy were performed. No signs of malignancy were proved on histology, leading to the final diagnosis of a primary serous peritoneal tumor. This is the third described case of solitary primary serous peritoneal tumor located in the abdominal wall. This condition should be included in the differential diagnosis of a probable metastatic ovarian carcinoma, as both present similar histologic characteristics.

http://ift.tt/2qYN6Vj

Constant maintenance of an alternative route of coronary flow in radical surgery for gastric cancer following coronary artery bypass grafting involving the right gastroepiploic artery: a case report

Abstract

We describe a 64-year-old man diagnosed as having gastric cancer with a patent right gastroepiploic artery (RGEA) used for coronary artery bypass grafting (CABG). Before gastrectomy, the native coronary artery was revascularized to safely dissect the infrapyloric lymphatic tissue along the layer recently identified as an appropriate layer for radical lymphadenectomy, in anticipation of preserving the radically skeletonized RGEA. The perioperative strategy was feasible. Postoperatively, hemorrhage extended the stopping period of antiplatelet therapy. However, since the RGEA was preserved, an alternative route was available for coronary flow. After a 41-month postoperative follow-up, the patient remained in good health, with no recurrence or cardiac ischemia. In this case, the alternative route of coronary flow could be constantly maintained, although radical infrapyloric lymphadenectomy had been performed. Preoperative revascularization and preserving the RGEA with radical skeletonization can be a safe yet permissibly radical strategy for gastric cancer treatment following CABG involving the RGEA.

http://ift.tt/2qYSnMu

Synchronous contralateral adrenal metastasis of colorectal cancer: case report

Abstract

The most frequent sites of distant metastasis of colorectal cancer (CRC) are primarily liver and lung, followed by brain and bone metastases. Infrequently, metastases are found in the adrenal glands. They usually have a metachronous and homolateral character. We present a case of contralateral synchronic adrenal metastasis of CRC and its surgical resolution.

http://ift.tt/2qYTjjS

Breast Implant-Associated Anaplastic Large Cell Lymphoma – from diagnosis to treatment

Publication date: Available online 7 June 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): Ilkka Kaartinen, Kaisa Sunela, Johanna Alanko, Katja Hukkinen, Marja-Liisa Karjalainen-Lindsberg, Catarina Svarvar
Breast lymphomas comprise a rare group of malignant breast tumors. Among these, a new entity has emerged as a potentially under-diagnosed disease. Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) most often manifests as a late periprosthetic effusion between 1 to 10 years after the implantation of silicone or saline-filled breast prostheses. BI-ALCL is an anaplastic lymphoma kinase-negative T-cell lymphoma that has a distinctively different clinical course than other breast lymphomas or ALCLs. Diagnosis is based on aspiration of the effusion around the implant and CD30 positivity of the sample. Every periprosthetic effusion after breast augmentation or reconstruction using implants should be considered as potential BI-ALCL until proven otherwise. The majority of cases at diagnosis are in the in situ stage, i.e., confined to the lumen around the prosthesis. Most patients have an excellent prognosis when complete removal of the capsule and prosthesis with negative margins is achieved surgically. Some patients, however, develop infiltrative disease with a potentially life-threatening clinical course. Treatment planning regarding the extent of surgery and role of adjuvant therapy, especially in advanced cases, requires further investigation.



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An update on genomic-guided therapies for pediatric solid tumors

Future Oncology Ahead of Print.


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Cancer care in lesbian, gay, bisexual, transgender and queer populations

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r464Od
via IFTTT

Potential prognostic value of clinical characteristics, hormone status and major depressive disorder in breast cancer

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r3ZWG2
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Opportunities to significantly reduce expenditure associated with cancer drugs

Future Oncology Ahead of Print.


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Prognostic value of Ki-67 expression in patients with extensive-stage small cell lung cancer

Future Oncology Ahead of Print.


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Report from European Association for the Study of the Liver: HCC Summit, Geneva, Switzerland, 2–5 February 2017

Future Oncology Ahead of Print.


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The emerging role of professional social media use in oncology

Future Oncology Ahead of Print.


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Imatinib mesylate in desmoplastic small round cell tumors

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rOccr5
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Leukemic transformation in patients with myeloproliferative neoplasms: a population-based retrospective study

Future Oncology Ahead of Print.


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via IFTTT

Next steps in Ewing sarcoma (epi-)genomics

Future Oncology Ahead of Print.


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Targeting ALK-rearranged non-small-cell lung cancer: an update

Future Oncology Ahead of Print.


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Variation in genital human papillomavirus infection prevalence and vaccination coverage among men and women in the USA

Future Oncology Ahead of Print.


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A review of binimetinib for the treatment of mutant cutaneous melanoma

Future Oncology Ahead of Print.


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via IFTTT

Cancer care in lesbian, gay, bisexual, transgender and queer populations

Future Oncology Ahead of Print.


http://ift.tt/2r464Od

An update on genomic-guided therapies for pediatric solid tumors

Future Oncology Ahead of Print.


http://ift.tt/2rO42PI

Potential prognostic value of clinical characteristics, hormone status and major depressive disorder in breast cancer

Future Oncology Ahead of Print.


http://ift.tt/2r3ZWG2

Opportunities to significantly reduce expenditure associated with cancer drugs

Future Oncology Ahead of Print.


http://ift.tt/2rNRIip

Prognostic value of Ki-67 expression in patients with extensive-stage small cell lung cancer

Future Oncology Ahead of Print.


http://ift.tt/2r45ZKp

Report from European Association for the Study of the Liver: HCC Summit, Geneva, Switzerland, 2–5 February 2017

Future Oncology Ahead of Print.


http://ift.tt/2rOa0A9

The emerging role of professional social media use in oncology

Future Oncology Ahead of Print.


http://ift.tt/2r463tD

Imatinib mesylate in desmoplastic small round cell tumors

Future Oncology Ahead of Print.


http://ift.tt/2rOccr5

Leukemic transformation in patients with myeloproliferative neoplasms: a population-based retrospective study

Future Oncology Ahead of Print.


http://ift.tt/2r3D5dL

Next steps in Ewing sarcoma (epi-)genomics

Future Oncology Ahead of Print.


http://ift.tt/2rNXAb6

Targeting ALK-rearranged non-small-cell lung cancer: an update

Future Oncology Ahead of Print.


http://ift.tt/2r4aqVR

Variation in genital human papillomavirus infection prevalence and vaccination coverage among men and women in the USA

Future Oncology Ahead of Print.


http://ift.tt/2rNPn74

A review of binimetinib for the treatment of mutant cutaneous melanoma

Future Oncology Ahead of Print.


http://ift.tt/2r4fvgX

Incidence and mortality of pancreatic cancer on a rapid rise in Taiwan, 1999–2012

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Chao-Ming Tseng, Shih-Pei Huang, Wei-Chih Liao, Chun-Ju Chiang, Ya-Wen Yang, Chi-Yang Chang, Yao-Chun Hsu, Hui-Chi Chen, Han-Sun Chiang, Jaw-Town Lin
BackgroundAccumulating data has revealed a rapidly rising incidence of pancreatic cancer in Western countries, but convincing evidence from the East remains sparse. We aimed to quantify how the incidence and mortality rates of pancreatic malignancy changed over time in Taiwan, and to develop future projection for the next decade.MethodsThis nationwide population-based study analyzed the Taiwan National Cancer Registry and the National Cause of Death Registry to calculate the annual incidence and mortality rates of pancreatic malignancy from 1999 to 2012 in this country. The secular trend of the incidence was also examined by data from the National Health Insurance Research Database.ResultsA total of 21,986 incident cases of pancreatic cancer and 20,720 related deaths occurred during the study period. The age-standardized incidence rate increased from 3.7 per 100,000 in 1999 to 5.0 per 100,000 in 2012, with a significant rising trend (P<0.01). The increase was nationwide, consistently across subgroups stratified by age, gender, geographic region, and urbanization. Data from the National Health Insurance Research Database corroborated the rise of incident pancreatic cancer. Mortality also increased with time, with the age-standardized rate rising from 3.5 per 100,000 in 1999 to 4.1 per 100,000 in 2012 (P<0.01). In accordance with the incidence, the mortality trend was consistent in all subgroups. Both the incidence and mortality were projected to further increase by approximately 20% from 2012 to 2027.ConclusionThe incidence and mortality of pancreatic cancer have been rapidly rising and presumably will continue to rise in Taiwan.



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The completeness and timeliness of cancer registration and the implications for measuring cancer burden

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Conan Donnelly, Victoria Cairnduff, Jingwen Jessica Chen, Therese Kearney, Deirdre Fitzpatrick, Colin Fox, Anna Gavin
BackgroundPopulation based cancer registration provides a critical role in disease surveillance in terms of incidence, survival, cancer cluster investigations and prevalence trends, and therefore high levels of completeness and timeliness are required. This study estimates completeness and variation between early and late registrations in the N. Ireland Cancer Registry (NICR) and assesses the implications for reporting cancer incidence and for registry-based research.MethodsTwo main approaches assessed completeness. For the period 2010–2012, incidence reported in the first year of data publication was compared to incidence reported in subsequent years until 2015. Demographic characteristics and survival of incident cases ascertained before the first publication year were compared to those ascertained in subsequent years. The flow method approach was used to estimate completeness annually after the incident year.ResultsOverall incidence for all cancers increased between the first year of data publication and subsequent years up to 2015, irrespective of year of diagnosis. Late registrations had poorer survival. The flow method approach estimated the completeness of case ascertainment of NICR data to be 96% complete at five years for all cancers combined.ConclusionThe estimated completeness levels for the NICR are comparable to other high quality cancer registries internationally. While data timeliness has little impact on incidence estimates, delays in registration may have implications for specific research studies into incidence and survival. This means that improvements in the timeliness of reporting should be a target for all registries but not at the expense of completeness.



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Management of advanced ovarian cancer in South West Wales − a comparison between primary debulking surgery and primary chemotherapy treatment strategies in an unselected, consecutive patient cohort

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): F. Drews, G. Bertelli, K. Lutchman-Singh
ObjectivesThis study represents the first reported outcomes for patients with advanced ovarian cancer (AOC) in South-West Wales undergoing treatment with primary debulking surgery or primary chemotherapy respectively.MethodsThis is a retrospective study of consecutive, unselected patients with advanced ovarian, fallopian tube or primary peritoneal cancer (FIGO III/IV) presenting to a regional cancer centre between October 2007 and October 2014. Patients were identified from Welsh Cancer Services records and relevant data was extracted from electronic National Health Service (NHS) databases. Main outcome measures were median overall survival (OS), progression free survival (PFS) and perioperative adverse events. Hazard ratio estimation was carried out with Cox Regression analysis and survival determined by Kaplan-Meier plots.ResultsOf 220 women with AOC, 32.3% underwent primary debulking surgery (PDS) and 67.7% primary chemotherapy and interval debulking (PCT-IDS). Patients were often elderly (median age 67 years) with a poor performance status (26.5% PS >1). Complete cytoreduction (0cm residual) was achieved in 32.4% of patients in the PDS group and in 50.0% of patients undergoing IDS. Median OS for all patients was 21.9 months (PDS: 27.0 and PCT-IDS: 19.2 months; p >0.05) and median PFS was 13.1 months (PDS: 14.3 months and PCT-IDS: 13.0 months; p >0.05). Median overall and progression free survival for patients achieving complete cytoreduction were 48.0 and 23.2 months respectively in the PDS group and 35.4 months and 18.6 months in the IDS group (p >0.05).ConclusionThis retrospective study of an unselected, consecutive cohort of women with AOC in South West Wales shows comparable survival outcomes with recently published trials, despite the relatively advanced age and poor performance status of our patient cohort. Over the seven-year study period, our data also demonstrated a non-significant trend towards improved survival following primary surgery in patients who achieved maximal cytoreduction. Our future aim therefore is to examine and develop the role of extended surgery in these patients.



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Incidence and mortality of pancreatic cancer on a rapid rise in Taiwan, 1999–2012

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Chao-Ming Tseng, Shih-Pei Huang, Wei-Chih Liao, Chun-Ju Chiang, Ya-Wen Yang, Chi-Yang Chang, Yao-Chun Hsu, Hui-Chi Chen, Han-Sun Chiang, Jaw-Town Lin
BackgroundAccumulating data has revealed a rapidly rising incidence of pancreatic cancer in Western countries, but convincing evidence from the East remains sparse. We aimed to quantify how the incidence and mortality rates of pancreatic malignancy changed over time in Taiwan, and to develop future projection for the next decade.MethodsThis nationwide population-based study analyzed the Taiwan National Cancer Registry and the National Cause of Death Registry to calculate the annual incidence and mortality rates of pancreatic malignancy from 1999 to 2012 in this country. The secular trend of the incidence was also examined by data from the National Health Insurance Research Database.ResultsA total of 21,986 incident cases of pancreatic cancer and 20,720 related deaths occurred during the study period. The age-standardized incidence rate increased from 3.7 per 100,000 in 1999 to 5.0 per 100,000 in 2012, with a significant rising trend (P<0.01). The increase was nationwide, consistently across subgroups stratified by age, gender, geographic region, and urbanization. Data from the National Health Insurance Research Database corroborated the rise of incident pancreatic cancer. Mortality also increased with time, with the age-standardized rate rising from 3.5 per 100,000 in 1999 to 4.1 per 100,000 in 2012 (P<0.01). In accordance with the incidence, the mortality trend was consistent in all subgroups. Both the incidence and mortality were projected to further increase by approximately 20% from 2012 to 2027.ConclusionThe incidence and mortality of pancreatic cancer have been rapidly rising and presumably will continue to rise in Taiwan.



http://ift.tt/2rO4oWm

The completeness and timeliness of cancer registration and the implications for measuring cancer burden

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): Conan Donnelly, Victoria Cairnduff, Jingwen Jessica Chen, Therese Kearney, Deirdre Fitzpatrick, Colin Fox, Anna Gavin
BackgroundPopulation based cancer registration provides a critical role in disease surveillance in terms of incidence, survival, cancer cluster investigations and prevalence trends, and therefore high levels of completeness and timeliness are required. This study estimates completeness and variation between early and late registrations in the N. Ireland Cancer Registry (NICR) and assesses the implications for reporting cancer incidence and for registry-based research.MethodsTwo main approaches assessed completeness. For the period 2010–2012, incidence reported in the first year of data publication was compared to incidence reported in subsequent years until 2015. Demographic characteristics and survival of incident cases ascertained before the first publication year were compared to those ascertained in subsequent years. The flow method approach was used to estimate completeness annually after the incident year.ResultsOverall incidence for all cancers increased between the first year of data publication and subsequent years up to 2015, irrespective of year of diagnosis. Late registrations had poorer survival. The flow method approach estimated the completeness of case ascertainment of NICR data to be 96% complete at five years for all cancers combined.ConclusionThe estimated completeness levels for the NICR are comparable to other high quality cancer registries internationally. While data timeliness has little impact on incidence estimates, delays in registration may have implications for specific research studies into incidence and survival. This means that improvements in the timeliness of reporting should be a target for all registries but not at the expense of completeness.



http://ift.tt/2r4tao7

Management of advanced ovarian cancer in South West Wales − a comparison between primary debulking surgery and primary chemotherapy treatment strategies in an unselected, consecutive patient cohort

Publication date: August 2017
Source:Cancer Epidemiology, Volume 49
Author(s): F. Drews, G. Bertelli, K. Lutchman-Singh
ObjectivesThis study represents the first reported outcomes for patients with advanced ovarian cancer (AOC) in South-West Wales undergoing treatment with primary debulking surgery or primary chemotherapy respectively.MethodsThis is a retrospective study of consecutive, unselected patients with advanced ovarian, fallopian tube or primary peritoneal cancer (FIGO III/IV) presenting to a regional cancer centre between October 2007 and October 2014. Patients were identified from Welsh Cancer Services records and relevant data was extracted from electronic National Health Service (NHS) databases. Main outcome measures were median overall survival (OS), progression free survival (PFS) and perioperative adverse events. Hazard ratio estimation was carried out with Cox Regression analysis and survival determined by Kaplan-Meier plots.ResultsOf 220 women with AOC, 32.3% underwent primary debulking surgery (PDS) and 67.7% primary chemotherapy and interval debulking (PCT-IDS). Patients were often elderly (median age 67 years) with a poor performance status (26.5% PS >1). Complete cytoreduction (0cm residual) was achieved in 32.4% of patients in the PDS group and in 50.0% of patients undergoing IDS. Median OS for all patients was 21.9 months (PDS: 27.0 and PCT-IDS: 19.2 months; p >0.05) and median PFS was 13.1 months (PDS: 14.3 months and PCT-IDS: 13.0 months; p >0.05). Median overall and progression free survival for patients achieving complete cytoreduction were 48.0 and 23.2 months respectively in the PDS group and 35.4 months and 18.6 months in the IDS group (p >0.05).ConclusionThis retrospective study of an unselected, consecutive cohort of women with AOC in South West Wales shows comparable survival outcomes with recently published trials, despite the relatively advanced age and poor performance status of our patient cohort. Over the seven-year study period, our data also demonstrated a non-significant trend towards improved survival following primary surgery in patients who achieved maximal cytoreduction. Our future aim therefore is to examine and develop the role of extended surgery in these patients.



http://ift.tt/2rOeypV

Cancer care in lesbian, gay, bisexual, transgender and queer populations

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r464Od
via IFTTT

An update on genomic-guided therapies for pediatric solid tumors

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rO42PI
via IFTTT

Potential prognostic value of clinical characteristics, hormone status and major depressive disorder in breast cancer

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r3ZWG2
via IFTTT

Opportunities to significantly reduce expenditure associated with cancer drugs

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rNRIip
via IFTTT

Prognostic value of Ki-67 expression in patients with extensive-stage small cell lung cancer

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r45ZKp
via IFTTT

Report from European Association for the Study of the Liver: HCC Summit, Geneva, Switzerland, 2–5 February 2017

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rOa0A9
via IFTTT

The emerging role of professional social media use in oncology

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r463tD
via IFTTT

Imatinib mesylate in desmoplastic small round cell tumors

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rOccr5
via IFTTT

Leukemic transformation in patients with myeloproliferative neoplasms: a population-based retrospective study

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r3D5dL
via IFTTT

Next steps in Ewing sarcoma (epi-)genomics

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rNXAb6
via IFTTT

Targeting ALK-rearranged non-small-cell lung cancer: an update

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2r4aqVR
via IFTTT

Variation in genital human papillomavirus infection prevalence and vaccination coverage among men and women in the USA

Future Oncology Ahead of Print.


from Cancer via ola Kala on Inoreader http://ift.tt/2rNPn74
via IFTTT

A review of binimetinib for the treatment of mutant cutaneous melanoma

Future Oncology Ahead of Print.


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Dual Checkpoint Blockade Takes Aim at Relapsed Mesothelioma [News in Brief]

The addition of ipilimumab to nivolumab nudged up response rates and survival outcomes for patients—but with increased toxicity.

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Dacomitinib Beats Gefitinib for EGFR+ NSCLC [News in Brief]

The second-generation EGFR inhibitor extended progression-free survival, but proved more toxic.

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Immunological effect of local ablation combined with immunotherapy on solid malignancies

Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeply involved in tumor progression, metastasis, and response to treatment. Furthermore, several immunoth...

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Immunological effect of local ablation combined with immunotherapy on solid malignancies

Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeply involved in tumor progression, metastasis, and response to treatment. Furthermore, several immunoth...

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Long-term adverse effects after retropubic and robot-assisted radical prostatectomy. Nationwide, population-based study

Background and Objectives

Surgery for prostate cancer is associated with adverse effects. We studied long-term risk of adverse effects after retropubic (RRP) and robot-assisted radical prostatectomy (RARP).

Methods

In the National Prostate Cancer Register of Sweden, men who had undergone radical prostatectomy (RP) between 2004 and 2014 were identified. Diagnoses and procedures indicating adverse postoperative effects were retrieved from the National Patient Register. Relative risk (RR) of adverse effects after RARP versus RRP was calculated in multivariable analyses adjusting for year of surgery, hospital surgical volume, T stage, Gleason grade, PSA level at diagnosis, patient age, comorbidity, and educational level.

Results

A total of 11 212 men underwent RRP and 8500 RARP. Risk of anastomotic stricture was lower after RARP than RRP, RR for diagnoses 0.51 (95%CI = 0.42-0.63) and RR for procedures 0.46 (95%CI = 0.38-0.55). Risk of inguinal hernia was similar after RARP and RRP but risk of incisional hernia was higher after RARP, RR for diagnoses 1.48 (95%CI = 1.01-2.16), and RR for procedures 1.52 (95%CI = 1.02-2.26).

Conclusions

The postoperative risk profile for RARP and RRP was quite similar. However, risk of anastomotic stricture was lower and risk of incisional hernia higher after RARP.

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Cost analysis of postmastectomy reconstruction: A comparison of two staged implant reconstruction using tissue expander and acellular dermal matrix with abdominal-based perforator free flaps

Background and Objectives

Two staged tissue expander-implant with acellular dermal matrix (TE/I + ADM) and deep inferior epigastric perforator (DIEP) flap are the most common implant and autologous methods of reconstruction in the U.S. Implant-based techniques are disproportionally more popular, partially due to its presumed cost effectiveness. We performed a comprehensive cost analysis to compare TE/I + ADM and DIEP flap.

Methods

A comparative cost analysis of TE/I + ADM and DIEP flap was performed. Medicare reimbursement costs for each procedure and their associated complications were calculated. Pooled probabilities of complications including cellulitis, seroma, skin necrosis, implant removal, flap loss, partial flap loss, and fat necrosis, were calculated using published studies from 2010 to 2016.

Results

Average actual cost for successful TE/I + ADM and DIEP flap were $13 304.55 and $10 237.13, respectively. Incorporating pooled complication data from published literature resulted in an increase in cost to $13 963.46 for TE/I + ADM and $12 624.29 for DIEP flap. The expected costs for successful TE/I + ADM and DIEP flap were $9700.35 and $8644.23, which are lower than the actual costs.

Conclusions

DIEP flap breast reconstruction incurs lower costs compared to TE/I + ADM. These costs are lower at baseline and when additional costs from pooled complications are incorporated.

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Cost analysis of postmastectomy reconstruction: A comparison of two staged implant reconstruction using tissue expander and acellular dermal matrix with abdominal based perforator free flaps

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Current and future therapies for advanced pancreatic cancer

Pancreatic cancer remains a deadly disease with a 5-year survival rate of only 8%. Even after surgical resection, most patients have recurrence of their cancer. Over the last 10 years, improvements in chemotherapy regimens led to a doubling in median overall survival. Here we review the management of advanced pancreatic cancer and highlight vaccine therapy as a novel modality of treatment.

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Pneumococcal meningitis with normal cerebrospinal biochemistry and no pneumococci at microscopy, mimicking a stroke: a case report

Bacterial meningitis commonly presents with symptoms such as headache, impaired consciousness, neck stiffness, and fever. In most cases, cerebrospinal fluid analysis will yield white cell counts >100/mm3. Atypica...

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Sequencing of DICER1 in sarcomas identifies biallelic somatic DICER1 mutations in an adult-onset embryonal rhabdomyosarcoma

Sequencing of DICER1 in sarcomas identifies biallelic somatic DICER1 mutations in an adult-onset embryonal rhabdomyosarcoma

British Journal of Cancer 116, 1621 (6 June 2017). doi:10.1038/bjc.2017.147

Authors: Leanne de Kock, Barbara Rivera, Timothée Revil, Paul Thorner, Catherine Goudie, Dorothée Bouron-Dal Soglio, Catherine S Choong, John R Priest, Paul J van Diest, Jantima Tanboon, Anja Wagner, Jiannis Ragoussis, Peter FM Choong & William D Foulkes

http://ift.tt/2pZkL0u

Phase I dose-escalation studies of roniciclib, a pan-cyclin-dependent kinase inhibitor, in advanced malignancies

Phase I dose-escalation studies of roniciclib, a pan-cyclin-dependent kinase inhibitor, in advanced malignancies

British Journal of Cancer 116, 1505 (6 June 2017). doi:10.1038/bjc.2017.92

Authors: Rastislav Bahleda, Juneko E Grilley-Olson, Ramaswamy Govindan, Fabrice Barlesi, Laurent Greillier, Maurice Perol, Isabelle Ray-Coquard, Dirk Strumberg, Beate Schultheis, Grace K Dy, Gérard Zalcman, Glen J Weiss, Annette O Walter, Martin Kornacker, Prabhu Rajagopalan, David Henderson, Hendrik Nogai, Matthias Ocker & Jean-Charles Soria

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BAG-1 as a biomarker in early breast cancer prognosis: a systematic review with meta-analyses

BAG-1 as a biomarker in early breast cancer prognosis: a systematic review with meta-analyses

British Journal of Cancer 116, 1585 (6 June 2017). doi:10.1038/bjc.2017.130

Authors: E S Papadakis, T Reeves, N H Robson, T Maishman, G Packham & R I Cutress

http://ift.tt/2qpLuqj

The differential expression of omega-3 and omega-6 fatty acid metabolising enzymes in colorectal cancer and its prognostic significance

The differential expression of omega-3 and omega-6 fatty acid metabolising enzymes in colorectal cancer and its prognostic significance

British Journal of Cancer 116, 1612 (6 June 2017). doi:10.1038/bjc.2017.135

Authors: Abdo Alnabulsi, Rebecca Swan, Beatriz Cash, Ayham Alnabulsi & Graeme I Murray

http://ift.tt/2sbfh4h

Efficacy and safety of gemcitabine plus S-1 in pancreatic cancer: a pooled analysis of individual patient data

Efficacy and safety of gemcitabine plus S-1 in pancreatic cancer: a pooled analysis of individual patient data

British Journal of Cancer 116, 1544 (6 June 2017). doi:10.1038/bjc.2017.128

Authors: Chikuma Hamada, Takuji Okusaka, Takaaki Ikari, Hiroyuki Isayama, Junji Furuse, Hiroshi Ishii, Yousuke Nakai, Shogo Imai & Shota Okamura

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Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

British Journal of Cancer 116, 1526 (6 June 2017). doi:10.1038/bjc.2017.122

Authors: A Custodio, A Carmona-Bayonas, P Jiménez-Fonseca, M L Sánchez, A Viudez, R Hernández, J M Cano, I Echavarria, C Pericay, M Mangas, L Visa, E Buxo, T García, A Rodríguez Palomo, F Álvarez Manceñido, A Lacalle, I Macias, A Azkarate, A Ramchandani, A Fernández Montes, C López, F Longo, R Sánchez Bayona, M L Limón, A Díaz-Serrano, A Hurtado, R Madero, C Gómez & J Gallego

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Inhibition of neurotensin receptor 1 induces intrinsic apoptosis via let-7a-3p/Bcl-w axis in glioblastoma

Inhibition of neurotensin receptor 1 induces intrinsic apoptosis via let-7a-3p/Bcl-w axis in glioblastoma

British Journal of Cancer 116, 1572 (6 June 2017). doi:10.1038/bjc.2017.126

Authors: Zhen Dong, Qian Lei, Rui Yang, Shunqin Zhu, Xiao-Xue Ke, Liqun Yang, Hongjuan Cui & Liang Yi

http://ift.tt/2r7ZwuG

Phase I dose-escalation studies of roniciclib, a pan-cyclin-dependent kinase inhibitor, in advanced malignancies

Phase I dose-escalation studies of roniciclib, a pan-cyclin-dependent kinase inhibitor, in advanced malignancies

British Journal of Cancer 116, 1505 (6 June 2017). doi:10.1038/bjc.2017.92

Authors: Rastislav Bahleda, Juneko E Grilley-Olson, Ramaswamy Govindan, Fabrice Barlesi, Laurent Greillier, Maurice Perol, Isabelle Ray-Coquard, Dirk Strumberg, Beate Schultheis, Grace K Dy, Gérard Zalcman, Glen J Weiss, Annette O Walter, Martin Kornacker, Prabhu Rajagopalan, David Henderson, Hendrik Nogai, Matthias Ocker & Jean-Charles Soria

http://ift.tt/2qwhy9u

Herpes zoster risk after 21 specific cancers: population-based case–control study

Herpes zoster risk after 21 specific cancers: population-based case–control study

British Journal of Cancer 116, 1643 (6 June 2017). doi:10.1038/bjc.2017.124

Authors: Erik Hansson, Harriet J Forbes, Sinéad M Langan, Liam Smeeth & Krishnan Bhaskaran

http://ift.tt/2p3r6Hb

The differential expression of omega-3 and omega-6 fatty acid metabolising enzymes in colorectal cancer and its prognostic significance

The differential expression of omega-3 and omega-6 fatty acid metabolising enzymes in colorectal cancer and its prognostic significance

British Journal of Cancer 116, 1612 (6 June 2017). doi:10.1038/bjc.2017.135

Authors: Abdo Alnabulsi, Rebecca Swan, Beatriz Cash, Ayham Alnabulsi & Graeme I Murray

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A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

British Journal of Cancer 116, 1513 (6 June 2017). doi:10.1038/bjc.2017.99

Authors: Muhammed R S Siddiqui, Constantinos Simillis, Chris Hunter, Manish Chand, Jemma Bhoday, Aurelie Garant, Te Vuong, Giovanni Artho, Shahnawaz Rasheed, Paris Tekkis, Al-Mutaz Abulafi & Gina Brown

http://ift.tt/2prWzql

Inhibition of neurotensin receptor 1 induces intrinsic apoptosis via let-7a-3p/Bcl-w axis in glioblastoma

Inhibition of neurotensin receptor 1 induces intrinsic apoptosis via let-7a-3p/Bcl-w axis in glioblastoma

British Journal of Cancer 116, 1572 (6 June 2017). doi:10.1038/bjc.2017.126

Authors: Zhen Dong, Qian Lei, Rui Yang, Shunqin Zhu, Xiao-Xue Ke, Liqun Yang, Hongjuan Cui & Liang Yi

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Clinical value of R-spondins in triple-negative and metaplastic breast cancers

Clinical value of R-spondins in triple-negative and metaplastic breast cancers

British Journal of Cancer 116, 1595 (6 June 2017). doi:10.1038/bjc.2017.131

Authors: F Coussy, F Lallemand, S Vacher, A Schnitzler, W Chemlali, M Caly, A Nicolas, S Richon, D Meseure, R El Botty, L De-Plater, L Fuhrmann, T Dubois, S Roman-Roman, V Dangles-Marie, E Marangoni & I Bièche

http://ift.tt/2p33eID

Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study

Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study

British Journal of Cancer 116, 1520 (6 June 2017). doi:10.1038/bjc.2017.103

Authors: Luca Triggiani, Filippo Alongi, Michela Buglione, Beatrice Detti, Riccardo Santoni, Alessio Bruni, Ernesto Maranzano, Frank Lohr, Rolando D'Angelillo, Alessandro Magli, Alberto Bonetta, Rosario Mazzola, Nadia Pasinetti, Giulio Francolini, Gianluca Ingrosso, Fabio Trippa, Sergio Fersino, Paolo Borghetti, Paolo Ghirardelli & Stefano Maria Magrini

http://ift.tt/2prOxxp

Pre-diagnosis diet and survival after a diagnosis of ovarian cancer

Pre-diagnosis diet and survival after a diagnosis of ovarian cancer

British Journal of Cancer 116, 1627 (6 June 2017). doi:10.1038/bjc.2017.120

Authors: Mary C Playdon, Christina M Nagle, Torukiri I Ibiebele, Leah M Ferrucci, Melinda M Protani, Jonathan Carter, Simon E Hyde, Deborah Neesham, James L Nicklin, Susan T Mayne & Penelope M Webb

http://ift.tt/2qw7D3Q

Herpes zoster risk after 21 specific cancers: population-based case–control study

Herpes zoster risk after 21 specific cancers: population-based case–control study

British Journal of Cancer 116, 1643 (6 June 2017). doi:10.1038/bjc.2017.124

Authors: Erik Hansson, Harriet J Forbes, Sinéad M Langan, Liam Smeeth & Krishnan Bhaskaran

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Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

Nomogram-based prediction of survival in patients with advanced oesophagogastric adenocarcinoma receiving first-line chemotherapy: a multicenter prospective study in the era of trastuzumab

British Journal of Cancer 116, 1526 (6 June 2017). doi:10.1038/bjc.2017.122

Authors: A Custodio, A Carmona-Bayonas, P Jiménez-Fonseca, M L Sánchez, A Viudez, R Hernández, J M Cano, I Echavarria, C Pericay, M Mangas, L Visa, E Buxo, T García, A Rodríguez Palomo, F Álvarez Manceñido, A Lacalle, I Macias, A Azkarate, A Ramchandani, A Fernández Montes, C López, F Longo, R Sánchez Bayona, M L Limón, A Díaz-Serrano, A Hurtado, R Madero, C Gómez & J Gallego

http://ift.tt/2qvSEXD

A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

A meta-analysis comparing the risk of metastases in patients with rectal cancer and MRI-detected extramural vascular invasion (mrEMVI) vs mrEMVI-negative cases

British Journal of Cancer 116, 1513 (6 June 2017). doi:10.1038/bjc.2017.99

Authors: Muhammed R S Siddiqui, Constantinos Simillis, Chris Hunter, Manish Chand, Jemma Bhoday, Aurelie Garant, Te Vuong, Giovanni Artho, Shahnawaz Rasheed, Paris Tekkis, Al-Mutaz Abulafi & Gina Brown

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One-carbon metabolism in cancer

One-carbon metabolism in cancer

British Journal of Cancer 116, 1499 (6 June 2017). doi:10.1038/bjc.2017.118

Authors: Alice C Newman & Oliver D K Maddocks

http://ift.tt/2pFdkOy

Clinical value of R-spondins in triple-negative and metaplastic breast cancers

Clinical value of R-spondins in triple-negative and metaplastic breast cancers

British Journal of Cancer 116, 1595 (6 June 2017). doi:10.1038/bjc.2017.131

Authors: F Coussy, F Lallemand, S Vacher, A Schnitzler, W Chemlali, M Caly, A Nicolas, S Richon, D Meseure, R El Botty, L De-Plater, L Fuhrmann, T Dubois, S Roman-Roman, V Dangles-Marie, E Marangoni & I Bièche

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Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records

Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records

British Journal of Cancer 116, 1536 (6 June 2017). doi:10.1038/bjc.2017.127

Authors: Luke T A Mounce, Sarah Price, Jose M Valderas & William Hamilton

http://ift.tt/2r7C5l4

Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study

Efficacy of stereotactic body radiotherapy in oligorecurrent and in oligoprogressive prostate cancer: new evidence from a multicentric study

British Journal of Cancer 116, 1520 (6 June 2017). doi:10.1038/bjc.2017.103

Authors: Luca Triggiani, Filippo Alongi, Michela Buglione, Beatrice Detti, Riccardo Santoni, Alessio Bruni, Ernesto Maranzano, Frank Lohr, Rolando D'Angelillo, Alessandro Magli, Alberto Bonetta, Rosario Mazzola, Nadia Pasinetti, Giulio Francolini, Gianluca Ingrosso, Fabio Trippa, Sergio Fersino, Paolo Borghetti, Paolo Ghirardelli & Stefano Maria Magrini

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Efficacy and safety of gemcitabine plus S-1 in pancreatic cancer: a pooled analysis of individual patient data

Efficacy and safety of gemcitabine plus S-1 in pancreatic cancer: a pooled analysis of individual patient data

British Journal of Cancer 116, 1544 (6 June 2017). doi:10.1038/bjc.2017.128

Authors: Chikuma Hamada, Takuji Okusaka, Takaaki Ikari, Hiroyuki Isayama, Junji Furuse, Hiroshi Ishii, Yousuke Nakai, Shogo Imai & Shota Okamura

http://ift.tt/2p2UG4w

Pre-diagnosis diet and survival after a diagnosis of ovarian cancer

Pre-diagnosis diet and survival after a diagnosis of ovarian cancer

British Journal of Cancer 116, 1627 (6 June 2017). doi:10.1038/bjc.2017.120

Authors: Mary C Playdon, Christina M Nagle, Torukiri I Ibiebele, Leah M Ferrucci, Melinda M Protani, Jonathan Carter, Simon E Hyde, Deborah Neesham, James L Nicklin, Susan T Mayne & Penelope M Webb

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Human papillomavirus association is the most important predictor for surgically treated patients with oropharyngeal cancer

Human papillomavirus association is the most important predictor for surgically treated patients with oropharyngeal cancer

British Journal of Cancer 116, 1604 (6 June 2017). doi:10.1038/bjc.2017.132

Authors: Steffen Wagner, Claus Wittekindt, Shachi Jenny Sharma, Nora Wuerdemann, Theresa Jüttner, Miriam Reuschenbach, Elena-Sophie Prigge, Magnus von Knebel Doeberitz, Stefan Gattenlöhner, Ernst Burkhardt, Jörn Pons-Kühnemann & Jens Peter Klussmann

http://ift.tt/2pFvP5g

GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

British Journal of Cancer 116, 1551 (6 June 2017). doi:10.1038/bjc.2017.129

Authors: Sally C Benton, Piers Butler, Katy Allen, Michelle Chesters, Sally Rickard, Sally Stanley, Richard Roope, Daniel Vulkan & Stephen W Duffy

http://ift.tt/2rkf810

One-carbon metabolism in cancer

One-carbon metabolism in cancer

British Journal of Cancer 116, 1499 (6 June 2017). doi:10.1038/bjc.2017.118

Authors: Alice C Newman & Oliver D K Maddocks

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Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases

Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases

British Journal of Cancer 116, 1558 (6 June 2017). doi:10.1038/bjc.2017.142

Authors: Sagun Parakh, John J Park, Shehara Mendis, Rajat Rai, Wen Xu, Serigne Lo, Martin Drummond, Catherine Rowe, Annie Wong, Grant McArthur, Andrew Haydon, Miles C Andrews, Jonathan Cebon, Alex Guminski, Richard F Kefford, Georgina V Long, Alexander M Menzies, Oliver Klein & Matteo S Carlino

http://ift.tt/2rknRQw

Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records

Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records

British Journal of Cancer 116, 1536 (6 June 2017). doi:10.1038/bjc.2017.127

Authors: Luke T A Mounce, Sarah Price, Jose M Valderas & William Hamilton

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The contribution of body mass index to appraisal delay in colorectal cancer diagnosis: a structural equation modelling study

The contribution of body mass index to appraisal delay in colorectal cancer diagnosis: a structural equation modelling study

British Journal of Cancer 116, 1638 (6 June 2017). doi:10.1038/bjc.2017.123

Authors: Karen E Dyer, Levent Dumenci, Laura A Siminoff, Maria D Thomson & Jennifer Elston Lafata

http://ift.tt/2qvSFe9

BAG-1 as a biomarker in early breast cancer prognosis: a systematic review with meta-analyses

BAG-1 as a biomarker in early breast cancer prognosis: a systematic review with meta-analyses

British Journal of Cancer 116, 1585 (6 June 2017). doi:10.1038/bjc.2017.130

Authors: E S Papadakis, T Reeves, N H Robson, T Maishman, G Packham & R I Cutress

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Mutation status among patients with sinonasal mucosal melanoma and its impact on survival

Mutation status among patients with sinonasal mucosal melanoma and its impact on survival

British Journal of Cancer 116, 1564 (6 June 2017). doi:10.1038/bjc.2017.125

Authors: Moran Amit, Samantha Tam, Ahmed S Abdelmeguid, Dianna B Roberts, Yoko Takahashi, Shaan M Raza, Shirley Y Su, Michael E Kupferman, Franco DeMonte & Ehab Y Hanna

http://ift.tt/2r7HjgD

Statin use, candidate mevalonate pathway biomarkers, and colon cancer survival in a population-based cohort study

Statin use, candidate mevalonate pathway biomarkers, and colon cancer survival in a population-based cohort study

British Journal of Cancer 116, 1652 (6 June 2017). doi:10.1038/bjc.2017.139

Authors: Ronan T Gray, Maurice B Loughrey, Peter Bankhead, Chris R Cardwell, Stephen McQuaid, Roisin F O'Neill, Kenneth Arthur, Victoria Bingham, Claire McGready, Anna T Gavin, Jacqueline A James, Peter W Hamilton, Manuel Salto-Tellez, Liam J Murray & Helen G Coleman

http://ift.tt/2pZcmuc

Human papillomavirus association is the most important predictor for surgically treated patients with oropharyngeal cancer

Human papillomavirus association is the most important predictor for surgically treated patients with oropharyngeal cancer

British Journal of Cancer 116, 1604 (6 June 2017). doi:10.1038/bjc.2017.132

Authors: Steffen Wagner, Claus Wittekindt, Shachi Jenny Sharma, Nora Wuerdemann, Theresa Jüttner, Miriam Reuschenbach, Elena-Sophie Prigge, Magnus von Knebel Doeberitz, Stefan Gattenlöhner, Ernst Burkhardt, Jörn Pons-Kühnemann & Jens Peter Klussmann

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GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

GP participation in increasing uptake in a national bowel cancer screening programme: the PEARL project

British Journal of Cancer 116, 1551 (6 June 2017). doi:10.1038/bjc.2017.129

Authors: Sally C Benton, Piers Butler, Katy Allen, Michelle Chesters, Sally Rickard, Sally Stanley, Richard Roope, Daniel Vulkan & Stephen W Duffy

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Sequencing of DICER1 in sarcomas identifies biallelic somatic DICER1 mutations in an adult-onset embryonal rhabdomyosarcoma

Sequencing of DICER1 in sarcomas identifies biallelic somatic DICER1 mutations in an adult-onset embryonal rhabdomyosarcoma

British Journal of Cancer 116, 1621 (6 June 2017). doi:10.1038/bjc.2017.147

Authors: Leanne de Kock, Barbara Rivera, Timothée Revil, Paul Thorner, Catherine Goudie, Dorothée Bouron-Dal Soglio, Catherine S Choong, John R Priest, Paul J van Diest, Jantima Tanboon, Anja Wagner, Jiannis Ragoussis, Peter FM Choong & William D Foulkes

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Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases

Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases

British Journal of Cancer 116, 1558 (6 June 2017). doi:10.1038/bjc.2017.142

Authors: Sagun Parakh, John J Park, Shehara Mendis, Rajat Rai, Wen Xu, Serigne Lo, Martin Drummond, Catherine Rowe, Annie Wong, Grant McArthur, Andrew Haydon, Miles C Andrews, Jonathan Cebon, Alex Guminski, Richard F Kefford, Georgina V Long, Alexander M Menzies, Oliver Klein & Matteo S Carlino

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The contribution of body mass index to appraisal delay in colorectal cancer diagnosis: a structural equation modelling study

The contribution of body mass index to appraisal delay in colorectal cancer diagnosis: a structural equation modelling study

British Journal of Cancer 116, 1638 (6 June 2017). doi:10.1038/bjc.2017.123

Authors: Karen E Dyer, Levent Dumenci, Laura A Siminoff, Maria D Thomson & Jennifer Elston Lafata

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Mutation status among patients with sinonasal mucosal melanoma and its impact on survival

Mutation status among patients with sinonasal mucosal melanoma and its impact on survival

British Journal of Cancer 116, 1564 (6 June 2017). doi:10.1038/bjc.2017.125

Authors: Moran Amit, Samantha Tam, Ahmed S Abdelmeguid, Dianna B Roberts, Yoko Takahashi, Shaan M Raza, Shirley Y Su, Michael E Kupferman, Franco DeMonte & Ehab Y Hanna

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Statin use, candidate mevalonate pathway biomarkers, and colon cancer survival in a population-based cohort study

Statin use, candidate mevalonate pathway biomarkers, and colon cancer survival in a population-based cohort study

British Journal of Cancer 116, 1652 (6 June 2017). doi:10.1038/bjc.2017.139

Authors: Ronan T Gray, Maurice B Loughrey, Peter Bankhead, Chris R Cardwell, Stephen McQuaid, Roisin F O'Neill, Kenneth Arthur, Victoria Bingham, Claire McGready, Anna T Gavin, Jacqueline A James, Peter W Hamilton, Manuel Salto-Tellez, Liam J Murray & Helen G Coleman

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Long-term adverse effects after retropubic and robot-assisted radical prostatectomy. Nationwide, population-based study

Background and Objectives

Surgery for prostate cancer is associated with adverse effects. We studied long-term risk of adverse effects after retropubic (RRP) and robot-assisted radical prostatectomy (RARP).

Methods

In the National Prostate Cancer Register of Sweden, men who had undergone radical prostatectomy (RP) between 2004 and 2014 were identified. Diagnoses and procedures indicating adverse postoperative effects were retrieved from the National Patient Register. Relative risk (RR) of adverse effects after RARP versus RRP was calculated in multivariable analyses adjusting for year of surgery, hospital surgical volume, T stage, Gleason grade, PSA level at diagnosis, patient age, comorbidity, and educational level.

Results

A total of 11 212 men underwent RRP and 8500 RARP. Risk of anastomotic stricture was lower after RARP than RRP, RR for diagnoses 0.51 (95%CI = 0.42-0.63) and RR for procedures 0.46 (95%CI = 0.38-0.55). Risk of inguinal hernia was similar after RARP and RRP but risk of incisional hernia was higher after RARP, RR for diagnoses 1.48 (95%CI = 1.01-2.16), and RR for procedures 1.52 (95%CI = 1.02-2.26).

Conclusions

The postoperative risk profile for RARP and RRP was quite similar. However, risk of anastomotic stricture was lower and risk of incisional hernia higher after RARP.

http://ift.tt/2rWQFie

Cost analysis of postmastectomy reconstruction: A comparison of two staged implant reconstruction using tissue expander and acellular dermal matrix with abdominal-based perforator free flaps

Background and Objectives

Two staged tissue expander-implant with acellular dermal matrix (TE/I + ADM) and deep inferior epigastric perforator (DIEP) flap are the most common implant and autologous methods of reconstruction in the U.S. Implant-based techniques are disproportionally more popular, partially due to its presumed cost effectiveness. We performed a comprehensive cost analysis to compare TE/I + ADM and DIEP flap.

Methods

A comparative cost analysis of TE/I + ADM and DIEP flap was performed. Medicare reimbursement costs for each procedure and their associated complications were calculated. Pooled probabilities of complications including cellulitis, seroma, skin necrosis, implant removal, flap loss, partial flap loss, and fat necrosis, were calculated using published studies from 2010 to 2016.

Results

Average actual cost for successful TE/I + ADM and DIEP flap were $13 304.55 and $10 237.13, respectively. Incorporating pooled complication data from published literature resulted in an increase in cost to $13 963.46 for TE/I + ADM and $12 624.29 for DIEP flap. The expected costs for successful TE/I + ADM and DIEP flap were $9700.35 and $8644.23, which are lower than the actual costs.

Conclusions

DIEP flap breast reconstruction incurs lower costs compared to TE/I + ADM. These costs are lower at baseline and when additional costs from pooled complications are incorporated.

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Cost analysis of postmastectomy reconstruction: A comparison of two staged implant reconstruction using tissue expander and acellular dermal matrix with abdominal based perforator free flaps

http://ift.tt/2rWZ7ho

Current and future therapies for advanced pancreatic cancer

Pancreatic cancer remains a deadly disease with a 5-year survival rate of only 8%. Even after surgical resection, most patients have recurrence of their cancer. Over the last 10 years, improvements in chemotherapy regimens led to a doubling in median overall survival. Here we review the management of advanced pancreatic cancer and highlight vaccine therapy as a novel modality of treatment.

http://ift.tt/2sUY1zT

Immune-Related Tumor Response Dynamics in Melanoma Patients Treated with Pembrolizumab: Identifying Markers for Clinical Outcome and Treatment Decisions

Purpose: Characterize tumor burden dynamics during PD-1 inhibitor therapy and investigate the association with overall survival (OS) in advanced melanoma.

Experimental Design: The study included 107 advanced melanoma patients treated with pembrolizumab. Tumor burden dynamics were assessed on serial CT scans using irRECIST and were studied for the association with OS.

Results: Among 107 patients, 96 patients had measurable tumor burden and 11 had nontarget lesions alone at baseline. In the 96 patients, maximal tumor shrinkage ranged from –100% to 567% (median, –18.5%). Overall response rate was 44% (42/96; 5 immune-related complete responses, 37 immune-related partial responses). Tumor burden remained <20% increase from baseline throughout therapy in 57 patients (55%). Using a 3-month landmark analysis, patients with <20% tumor burden increase from baseline had longer OS than patients with ≥20% increase (12-month OS rate: 82% vs. 53%). In extended Cox models, patients with <20% tumor burden increase during therapy had significantly reduced hazards of death [HR = 0.19; 95% confidence interval (CI), 0.08–0.43; P < 0.0001 univariate; HR = 0.18; 95% CI, 0.08–0.41; P < 0.0001, multivariable]. Four patients (4%) experienced pseudoprogression; 3 patients had target lesion increase with subsequent response, which was noted after confirmed immune-related progressive disease (irPD). One patient without measurable disease progressed with new lesion that subsequently regressed.

Conclusions: Tumor burden increase of <20% from the baseline during pembrolizumab therapy was associated with longer OS, proposing a practical marker for treatment decision guides that needs to be prospectively validated. Pseudoprogressors may experience response after confirmed irPD, indicating a limitation of the current strategy for immune-related response evaluations. Evaluations of patients without measurable disease may require further attention. Clin Cancer Res; 1–9. ©2017 AACR.

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Immune-Related Tumor Response Dynamics in Melanoma Patients Treated with Pembrolizumab: Identifying Markers for Clinical Outcome and Treatment Decisions

Purpose: Characterize tumor burden dynamics during PD-1 inhibitor therapy and investigate the association with overall survival (OS) in advanced melanoma.

Experimental Design: The study included 107 advanced melanoma patients treated with pembrolizumab. Tumor burden dynamics were assessed on serial CT scans using irRECIST and were studied for the association with OS.

Results: Among 107 patients, 96 patients had measurable tumor burden and 11 had nontarget lesions alone at baseline. In the 96 patients, maximal tumor shrinkage ranged from –100% to 567% (median, –18.5%). Overall response rate was 44% (42/96; 5 immune-related complete responses, 37 immune-related partial responses). Tumor burden remained <20% increase from baseline throughout therapy in 57 patients (55%). Using a 3-month landmark analysis, patients with <20% tumor burden increase from baseline had longer OS than patients with ≥20% increase (12-month OS rate: 82% vs. 53%). In extended Cox models, patients with <20% tumor burden increase during therapy had significantly reduced hazards of death [HR = 0.19; 95% confidence interval (CI), 0.08–0.43; P < 0.0001 univariate; HR = 0.18; 95% CI, 0.08–0.41; P < 0.0001, multivariable]. Four patients (4%) experienced pseudoprogression; 3 patients had target lesion increase with subsequent response, which was noted after confirmed immune-related progressive disease (irPD). One patient without measurable disease progressed with new lesion that subsequently regressed.

Conclusions: Tumor burden increase of <20% from the baseline during pembrolizumab therapy was associated with longer OS, proposing a practical marker for treatment decision guides that needs to be prospectively validated. Pseudoprogressors may experience response after confirmed irPD, indicating a limitation of the current strategy for immune-related response evaluations. Evaluations of patients without measurable disease may require further attention. Clin Cancer Res; 1–9. ©2017 AACR.

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Less Chemotherapy May Be Best Choice for Some Patients with Colon Cancer, Study Shows

A shorter course of chemotherapy following surgery may be preferred to longer treatment for some patients with colon cancer, results of an international collaborative study suggest.

http://ift.tt/2r3mbMe

Reirradiation with IMRT for recurrent head and neck cancer: A single-institutional report on disease control, survival, and toxicity

Publication date: July–August 2017
Source:Reports of Practical Oncology & Radiotherapy, Volume 22, Issue 4
Author(s): Parveen Ahlawat, Sheh Rawat, Anjali Kakria, Bharti Devnani, Inderjit Kaur Wahi, David K Simson
AimTo study and explores the feasibility and efficacy of re-irradiation (Re-RT) for locally recurrent head and neck cancer (HNC) and second primary (SP) malignancies.BackgroundThe most common form of treatment failure after radiotherapy (RT) for HNC is loco-regional recurrence (LRR), and around 20–50% of patients develop LRR. Re-irradiation (Re-RT) has been the primary standard of care in the last decade for unresectable locally recurrent/SP HNC.Materials and methodsIt was a retrospective analysis in which we reviewed the medical records of 51 consecutive patients who had received Re-RT to the head and neck region at our institute between 2006 and 2015.ResultsForty-eight patients were included for assessment of acute and late toxicities, response evaluation at 3 months post Re-RT, and analyses of locoregional control (LRC) and overall survival (OS). The median LRC was 11.2 months, and at 2 and 5 years the LRC rates were 41% and 21.2%, respectively. A multivariate analysis revealed two factors: initial surgical resection performed prior to Re-RT, and achievement of CR at 3 months after completion of Re-RT to be significantly associated with a better median LRC. The median OS was 28.2 months, and at 1, 2, and 5 years, OS were 71.1%, 55.9% and 18%, respectively. A multivariate analysis revealed initial surgical resection performed prior to Re-RT, and achievement of CR at 3 months post completion of Re-RT being only two factors significantly associated with a better median OS. Acute toxicity reports showed that no patients developed grade 5 toxicity, and 2 patients developed grade 4 acute toxicities.ConclusionRe-RT for the treatment of recurrent/SP head and neck tumors is feasible and effective, with acceptable toxicity. However, appropriate patient selection criteria are highly important in determining survival and treatment outcomes.



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Less Chemotherapy May Be Best Choice for Some Patients with Colon Cancer, Study Shows

A shorter course of chemotherapy following surgery may be preferred to longer treatment for some patients with colon cancer, results of an international collaborative study suggest.

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TEP/tomodensitométrie et imagerie spectroscopique par résonance magnétique tridmensionnelle pour le diagnostic différentiel entre radionécrose cérébrale et rechute tumorale après irradiation en conditions stéréotaxiques de métastases cérébrales : place dans l’arbre décisionnel

Publication date: Available online 7 June 2017
Source:Cancer/Radiothérapie
Author(s): I. Menoux, G. Noël, I. Namer, D. Antoni
Objectif de l'étudeAprès irradiation en conditions stéréotaxiques des métastases cérébrales, l'une des complications est la radionécrose. Le diagnostic différentiel avec la récidive tumorale peut être aidé par différentes modalités d'imageries, même si le diagnostic histologique reste la référence. Selon les sites de prise en charge, la pratique diverge. L'objectif de cette étude rétrospective monocentrique est de définir l'intérêt de l'IRM, de la tomographie par émission de positons (TEP)/tomodensitométrie et de l'imagerie spectroscopique par résonance magnétique nucléaire tridimensionnelle en vue d'établir un arbre décisionnel.Matériel et méthodesCette étude concernait les patients irradiés en conditions stéréotaxiques pour des métastases cérébrales en place, ayant eu au cours de leur suivi à la fois une TEP/tomodensitométrie et une imagerie spectroscopique par résonance magnétique nucléaire pour établir le diagnostic différentiel entre radionécrose et récidive tumorale. De 2010 à 2015, 25 patients correspondaient à ces critères.RésultatsL'IRM en technique classique, avec pour critère le mismatch T1/T2, a obtenu une spécificité de 75 % et une sensibilité de seulement 44 %. Un lesion quotient supérieur à 0,3 a permis de suspecter une récidive avec une sensibilité de 92 %. La TEP/tomodensitométrie a associé le meilleur couple sensibilité–spécificité, respectivement de 92 % et 69 %. Quels que soient les seuils utilisés en imagerie spectroscopique par résonance magnétique nucléaire pour les rapports choline/N-acétyl-aspartate et choline/créatine, la puissance de cet examen ne dépassait pas celle de la TEP/tomodensitométrie.ConclusionLes critères décrits en IRM classique constituent une première étape d'aiguillage mais ne permettent pas à eux seuls d'établir le diagnostic différentiel. L'examen à réaliser en première intention en cas de doute est la TEP/tomodensitométrie, car il associe les meilleures sensibilité et spécificité, tandis que l'imagerie spectroscopique par résonance magnétique nucléaire utilisée seule ou en association ne semble pas améliorer ces facteurs.PurposeAfter stereotactic radiation therapy for brain metastases, one of the complications is radionecrosis. Differential diagnosis with tumour recurrence can be helped by different methods of imaging, although histology remains the gold standard. According to the treatment centres, practice diverges. The objective of this single-centre retrospective study was to define the power of MRI, PET scan and NMR spectroscopy to establish a decision tree.Material and methodsThis study included patients who underwent stereotactic radiation therapy for brain metastases, and required, during follow-up, both a PET scan and NMR spectroscopy in order to differentiate a radiation necrosis and tumour recurrence. From 2010 to 2015, 25 patients were consistent with these criteria.ResultsConventional MRI technique, with the T1/T2 mismatch criterion, had a specificity of 75% and a sensitivity of only 44%. A lesion quotient greater than 0.3 diagnosed a recurrence with a sensitivity of 92%. PET scan combined the best sensitivity and specificity, respectively of 92% and 69%. Whatever the thresholds used in NMR spectroscopy for choline/N-acetylaspartate and choline/creatin ratios, the power of this imaging modality did not exceed that of PET scan.ConclusionThe criteria described in conventional MRI cannot by themselves establish the differential diagnosis. In first intention in case of doubt, PET scan should be done, combining the best sensitivity and specificity, whereas NMR spectroscopy used in combination does not improve these factors.



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TEP/tomodensitométrie et imagerie spectroscopique par résonance magnétique tridmensionnelle pour le diagnostic différentiel entre radionécrose cérébrale et rechute tumorale après irradiation en conditions stéréotaxiques de métastases cérébrales : place dans l’arbre décisionnel

Publication date: Available online 7 June 2017
Source:Cancer/Radiothérapie
Author(s): I. Menoux, G. Noël, I. Namer, D. Antoni
Objectif de l'étudeAprès irradiation en conditions stéréotaxiques des métastases cérébrales, l'une des complications est la radionécrose. Le diagnostic différentiel avec la récidive tumorale peut être aidé par différentes modalités d'imageries, même si le diagnostic histologique reste la référence. Selon les sites de prise en charge, la pratique diverge. L'objectif de cette étude rétrospective monocentrique est de définir l'intérêt de l'IRM, de la tomographie par émission de positons (TEP)/tomodensitométrie et de l'imagerie spectroscopique par résonance magnétique nucléaire tridimensionnelle en vue d'établir un arbre décisionnel.Matériel et méthodesCette étude concernait les patients irradiés en conditions stéréotaxiques pour des métastases cérébrales en place, ayant eu au cours de leur suivi à la fois une TEP/tomodensitométrie et une imagerie spectroscopique par résonance magnétique nucléaire pour établir le diagnostic différentiel entre radionécrose et récidive tumorale. De 2010 à 2015, 25 patients correspondaient à ces critères.RésultatsL'IRM en technique classique, avec pour critère le mismatch T1/T2, a obtenu une spécificité de 75 % et une sensibilité de seulement 44 %. Un lesion quotient supérieur à 0,3 a permis de suspecter une récidive avec une sensibilité de 92 %. La TEP/tomodensitométrie a associé le meilleur couple sensibilité–spécificité, respectivement de 92 % et 69 %. Quels que soient les seuils utilisés en imagerie spectroscopique par résonance magnétique nucléaire pour les rapports choline/N-acétyl-aspartate et choline/créatine, la puissance de cet examen ne dépassait pas celle de la TEP/tomodensitométrie.ConclusionLes critères décrits en IRM classique constituent une première étape d'aiguillage mais ne permettent pas à eux seuls d'établir le diagnostic différentiel. L'examen à réaliser en première intention en cas de doute est la TEP/tomodensitométrie, car il associe les meilleures sensibilité et spécificité, tandis que l'imagerie spectroscopique par résonance magnétique nucléaire utilisée seule ou en association ne semble pas améliorer ces facteurs.PurposeAfter stereotactic radiation therapy for brain metastases, one of the complications is radionecrosis. Differential diagnosis with tumour recurrence can be helped by different methods of imaging, although histology remains the gold standard. According to the treatment centres, practice diverges. The objective of this single-centre retrospective study was to define the power of MRI, PET scan and NMR spectroscopy to establish a decision tree.Material and methodsThis study included patients who underwent stereotactic radiation therapy for brain metastases, and required, during follow-up, both a PET scan and NMR spectroscopy in order to differentiate a radiation necrosis and tumour recurrence. From 2010 to 2015, 25 patients were consistent with these criteria.ResultsConventional MRI technique, with the T1/T2 mismatch criterion, had a specificity of 75% and a sensitivity of only 44%. A lesion quotient greater than 0.3 diagnosed a recurrence with a sensitivity of 92%. PET scan combined the best sensitivity and specificity, respectively of 92% and 69%. Whatever the thresholds used in NMR spectroscopy for choline/N-acetylaspartate and choline/creatin ratios, the power of this imaging modality did not exceed that of PET scan.ConclusionThe criteria described in conventional MRI cannot by themselves establish the differential diagnosis. In first intention in case of doubt, PET scan should be done, combining the best sensitivity and specificity, whereas NMR spectroscopy used in combination does not improve these factors.



http://ift.tt/2r3nRVP

The role of hERG1 ion channels in epithelial-mesenchymal transition and the capacity of riluzole to reduce cisplatin resistance in colorectal cancer cells

Abstract

Purpose

The transition of cells from the epithelial to the mesenchymal state (EMT) plays an important role in tumor progression. EMT allows cells to acquire mobility, stem-like behavior and resistance to apoptosis and drug treatment. These features turn EMT into a central process in tumor biology. Ion channels are attractive targets for the treatment of cancer since they play critical roles in controlling a wide range of physiological processes that are frequently deregulated in cancer. Here, we investigated the role of ether-a-go-go-related 1 (hERG1) ion channels in the EMT of colorectal cancer cells.

Methods

We studied the epithelial-mesenchymal profile of different colorectal cancer-derived cell lines and the expression of hERG1 potassium channels in these cell lines using real-time PCR. Next, we knocked down hERG1 expression in HCT116 cells using lentivirus mediated RNA interference and characterized the hERG1 silenced cells in vitro and in vivo. Finally, we investigated the capacity of riluzole, an ion channel-modulating drug used in humans to treat amyotrophic lateral sclerosis, to reduce the resistance of the respective colorectal cancer cells to the chemotherapeutic drug cisplatin.

Results

We found that of the colorectal cancer-derived cell lines tested, HCT116 showed the highest mesenchymal profile and a high hERG1 expression. Subsequent hERG1 expression knockdown induced a change in cell morphology, which was accompanied by a reduction in the proliferative and tumorigenic capacities of the cells. Notably, we found that hERG1expression knockdown elicited a reversion of the EMT profile in HCT116 cells with a reacquisition of the epithelial-like profile. We also found that riluzole increased the sensitivity of HCT116 cisplatin-resistant cells to cisplatin.

Conclusions

Our data indicate that hERG1 plays a role in the EMT of colorectal cancer cells and that its knockdown reduces the proliferative and tumorigenic capacities of these cells. In addition, we conclude that riluzole may be used in combination with cisplatin to reduce chemo-resistance in colorectal cancer cells.

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Development of tau PET Imaging Ligands and their Utility in Preclinical and Clinical Studies

Abstract

The pathological features of Alzheimer's disease are senile plaques which are aggregates of β-amyloid peptides and neurofibrillary tangles in the brain. Neurofibrillary tangles are aggregates of hyperphosphorylated tau proteins, and these induce various other neurodegenerative diseases, such as progressive supranuclear palsy, corticobasal degeneration, frontotemporal lobar degeneration, frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17), and chronic traumatic encephalopathy. In the case of Alzheimer's disease, the measurement of neurofibrillary tangles associated with cognitive decline is suitable for differential diagnosis, disease progression assessment, and to monitor the effects of therapeutic treatment. This review discusses considerations for the development of tau ligands for imaging and summarizes the results of the first-in-human and preclinical studies of the tau tracers that have been developed thus far. The development of tau ligands for imaging studies will be helpful for differential diagnosis and for the development of therapeutic treatments for tauopathies including Alzheimer's disease.

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Development of tau PET Imaging Ligands and their Utility in Preclinical and Clinical Studies

Abstract

The pathological features of Alzheimer's disease are senile plaques which are aggregates of β-amyloid peptides and neurofibrillary tangles in the brain. Neurofibrillary tangles are aggregates of hyperphosphorylated tau proteins, and these induce various other neurodegenerative diseases, such as progressive supranuclear palsy, corticobasal degeneration, frontotemporal lobar degeneration, frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17), and chronic traumatic encephalopathy. In the case of Alzheimer's disease, the measurement of neurofibrillary tangles associated with cognitive decline is suitable for differential diagnosis, disease progression assessment, and to monitor the effects of therapeutic treatment. This review discusses considerations for the development of tau ligands for imaging and summarizes the results of the first-in-human and preclinical studies of the tau tracers that have been developed thus far. The development of tau ligands for imaging studies will be helpful for differential diagnosis and for the development of therapeutic treatments for tauopathies including Alzheimer's disease.

http://ift.tt/2rUC4nk

The role of hERG1 ion channels in epithelial-mesenchymal transition and the capacity of riluzole to reduce cisplatin resistance in colorectal cancer cells

Abstract

Purpose

The transition of cells from the epithelial to the mesenchymal state (EMT) plays an important role in tumor progression. EMT allows cells to acquire mobility, stem-like behavior and resistance to apoptosis and drug treatment. These features turn EMT into a central process in tumor biology. Ion channels are attractive targets for the treatment of cancer since they play critical roles in controlling a wide range of physiological processes that are frequently deregulated in cancer. Here, we investigated the role of ether-a-go-go-related 1 (hERG1) ion channels in the EMT of colorectal cancer cells.

Methods

We studied the epithelial-mesenchymal profile of different colorectal cancer-derived cell lines and the expression of hERG1 potassium channels in these cell lines using real-time PCR. Next, we knocked down hERG1 expression in HCT116 cells using lentivirus mediated RNA interference and characterized the hERG1 silenced cells in vitro and in vivo. Finally, we investigated the capacity of riluzole, an ion channel-modulating drug used in humans to treat amyotrophic lateral sclerosis, to reduce the resistance of the respective colorectal cancer cells to the chemotherapeutic drug cisplatin.

Results

We found that of the colorectal cancer-derived cell lines tested, HCT116 showed the highest mesenchymal profile and a high hERG1 expression. Subsequent hERG1 expression knockdown induced a change in cell morphology, which was accompanied by a reduction in the proliferative and tumorigenic capacities of the cells. Notably, we found that hERG1expression knockdown elicited a reversion of the EMT profile in HCT116 cells with a reacquisition of the epithelial-like profile. We also found that riluzole increased the sensitivity of HCT116 cisplatin-resistant cells to cisplatin.

Conclusions

Our data indicate that hERG1 plays a role in the EMT of colorectal cancer cells and that its knockdown reduces the proliferative and tumorigenic capacities of these cells. In addition, we conclude that riluzole may be used in combination with cisplatin to reduce chemo-resistance in colorectal cancer cells.

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The role of hERG1 ion channels in epithelial-mesenchymal transition and the capacity of riluzole to reduce cisplatin resistance in colorectal cancer cells

Abstract

Purpose

The transition of cells from the epithelial to the mesenchymal state (EMT) plays an important role in tumor progression. EMT allows cells to acquire mobility, stem-like behavior and resistance to apoptosis and drug treatment. These features turn EMT into a central process in tumor biology. Ion channels are attractive targets for the treatment of cancer since they play critical roles in controlling a wide range of physiological processes that are frequently deregulated in cancer. Here, we investigated the role of ether-a-go-go-related 1 (hERG1) ion channels in the EMT of colorectal cancer cells.

Methods

We studied the epithelial-mesenchymal profile of different colorectal cancer-derived cell lines and the expression of hERG1 potassium channels in these cell lines using real-time PCR. Next, we knocked down hERG1 expression in HCT116 cells using lentivirus mediated RNA interference and characterized the hERG1 silenced cells in vitro and in vivo. Finally, we investigated the capacity of riluzole, an ion channel-modulating drug used in humans to treat amyotrophic lateral sclerosis, to reduce the resistance of the respective colorectal cancer cells to the chemotherapeutic drug cisplatin.

Results

We found that of the colorectal cancer-derived cell lines tested, HCT116 showed the highest mesenchymal profile and a high hERG1 expression. Subsequent hERG1 expression knockdown induced a change in cell morphology, which was accompanied by a reduction in the proliferative and tumorigenic capacities of the cells. Notably, we found that hERG1expression knockdown elicited a reversion of the EMT profile in HCT116 cells with a reacquisition of the epithelial-like profile. We also found that riluzole increased the sensitivity of HCT116 cisplatin-resistant cells to cisplatin.

Conclusions

Our data indicate that hERG1 plays a role in the EMT of colorectal cancer cells and that its knockdown reduces the proliferative and tumorigenic capacities of these cells. In addition, we conclude that riluzole may be used in combination with cisplatin to reduce chemo-resistance in colorectal cancer cells.

http://ift.tt/2r2DbSC

Incremental diagnostic utility of systematic double-bed SPECT/CT for bone scintigraphy in initial staging of cancer patients

Abstract

Background

SPECT/CT has been shown to increase the diagnostic performance of bone scintigraphy for staging of malignancies. A systematic double-bed SPECT/CT of the trunk may allow further improvement. However, this would be balanced by higher dosimetry and longer acquisition time. The objective was to assess the incremental diagnostic utility of a systematic double-bed SPECT/CT acquisition for bone scintigraphy in initial staging of cancer patients, especially compared with the usual approach consisting in a whole body planar scan (WBS) plus one single-bed targeted SPECT/CT.

Methods

One hundred two consecutive patients referred for bone scintigraphy for initial staging of malignancy were analyzed. All patients underwent a double-bed SPECT/CT acquisition of the trunk. Images were interpreted by two nuclear medicine physicians in a 3-step procedure. Firstly, only WBS planar images were used; secondly, one additional single-bed SPECT/CT chosen based on planar images was used; finally, WBS planar and double-bed SPECT/CT images were interpreted. Lesions were classified as benign, equivocal or suspicious for metastasis. A per-lesion, per-anatomical region and per-patient analysis was performed.

Results

In a per-lesion analysis, the number of equivocal and suspicious lesions was 91 and 241 using WBS planar images, 17 and 259 using a single-bed SPECT/CT acquisition and 11 and 269 using double-bed SPECT/CT images, respectively. In a per-patient analysis, the diagnostic conclusion was negative, equivocal or suspicious for malignancy in 35, 53 and 14 patients using WB planar images, 77, 6 and 19 patients using an additional single-bed SPECT/CT and 76, 7 and 19 using double-bed SPECT/CT images, respectively.

Seventeen lesions unseen on WBS images were interpreted as suspicious (n = 12) or equivocal (n = 5) on double-bed SPECT/CT images. Six lesions unseen on "WBS + targeted single-bed SPECT/CT" were interpreted as suspicious on double-bed SPECT/CT, with no shift in the metastatic status of patients.

Conclusion

A systematic double-bed SPECT/CT acquisition has a limited incremental diagnostic value over an oriented single-bed SPECT/CT in terms of specificity and conclusiveness of bone scintigraphy in the initial staging of cancer patients. However, it slightly improved the sensitivity of the test by detecting unseen lesions on WBS, which may be of value for initial staging of cancer.

http://ift.tt/2r2jzOH

Incremental diagnostic utility of systematic double-bed SPECT/CT for bone scintigraphy in initial staging of cancer patients

Abstract

Background

SPECT/CT has been shown to increase the diagnostic performance of bone scintigraphy for staging of malignancies. A systematic double-bed SPECT/CT of the trunk may allow further improvement. However, this would be balanced by higher dosimetry and longer acquisition time. The objective was to assess the incremental diagnostic utility of a systematic double-bed SPECT/CT acquisition for bone scintigraphy in initial staging of cancer patients, especially compared with the usual approach consisting in a whole body planar scan (WBS) plus one single-bed targeted SPECT/CT.

Methods

One hundred two consecutive patients referred for bone scintigraphy for initial staging of malignancy were analyzed. All patients underwent a double-bed SPECT/CT acquisition of the trunk. Images were interpreted by two nuclear medicine physicians in a 3-step procedure. Firstly, only WBS planar images were used; secondly, one additional single-bed SPECT/CT chosen based on planar images was used; finally, WBS planar and double-bed SPECT/CT images were interpreted. Lesions were classified as benign, equivocal or suspicious for metastasis. A per-lesion, per-anatomical region and per-patient analysis was performed.

Results

In a per-lesion analysis, the number of equivocal and suspicious lesions was 91 and 241 using WBS planar images, 17 and 259 using a single-bed SPECT/CT acquisition and 11 and 269 using double-bed SPECT/CT images, respectively. In a per-patient analysis, the diagnostic conclusion was negative, equivocal or suspicious for malignancy in 35, 53 and 14 patients using WB planar images, 77, 6 and 19 patients using an additional single-bed SPECT/CT and 76, 7 and 19 using double-bed SPECT/CT images, respectively.

Seventeen lesions unseen on WBS images were interpreted as suspicious (n = 12) or equivocal (n = 5) on double-bed SPECT/CT images. Six lesions unseen on "WBS + targeted single-bed SPECT/CT" were interpreted as suspicious on double-bed SPECT/CT, with no shift in the metastatic status of patients.

Conclusion

A systematic double-bed SPECT/CT acquisition has a limited incremental diagnostic value over an oriented single-bed SPECT/CT in terms of specificity and conclusiveness of bone scintigraphy in the initial staging of cancer patients. However, it slightly improved the sensitivity of the test by detecting unseen lesions on WBS, which may be of value for initial staging of cancer.

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Recent advances in the use of PI3K inhibitors for glioblastoma multiforme: current preclinical and clinical development

Abstract

Glioblastoma multiforme (GBM) is the most common and aggressive malignant primary tumor in the central nervous system. One of the most widely used chemotherapeutic drugs for GBM is temozolomide, which is a DNA-alkylating agent and its efficacy is dependent on MGMT methylation status. Little progress in improving the prognosis of GBM patients has been made in the past ten years, urging the development of more effective molecular targeted therapies. Hyper-activation of the phosphatidylinositol 3-kinase (PI3K)/Akt pathway is frequently found in a variety of cancers including GBM, and it plays a central role in the regulation of tumor cell survival, growth, motility, angiogenesis and metabolism. Numerous PI3K inhibitors including pan-PI3K, isoform-selective and dual PI3K/mammalian target of rapamycin (mTOR) inhibitors have exhibited favorable preclinical results and entered clinical trials in a range of hematologic malignancies and solid tumors. Furthermore, combination of inhibitors targeting PI3K and other related pathways may exert synergism on suppressing tumor growth and improving patients' prognosis. Currently, only a handful of PI3K inhibitors are in phase I/II clinical trials for GBM treatment. In this review, we focus on the importance of PI3K/Akt pathway in GBM, and summarize the current development of PI3K inhibitors alone or in combination with other inhibitors for GBM treatment from preclinical to clinical studies.

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Characterization of MED12 , HMGA2 , and FH alterations reveals molecular variability in uterine smooth muscle tumors

Abstract

Uterine smooth muscle tumors range from benign leiomyomas to malignant leiomyosarcomas. Based on numerous molecular studies, leiomyomas and leiomyosarcomas mostly lack shared mutations and the majority of tumors are believed to develop through distinct mechanisms. To further characterize the molecular variability among uterine smooth muscle tumors, and simultaneously insinuate their potential malignant progression, we examined the frequency of known genetic leiomyoma driver alterations (MED12 mutations, HMGA2 overexpression, biallelic FH inactivation) in 65 conventional leiomyomas, 94 histopathological leiomyoma variants (18 leiomyomas with bizarre nuclei, 22 cellular, 29 highly cellular, and 25 mitotically active leiomyomas), and 51 leiomyosarcomas. Of the 210 tumors analyzed, 107 had mutations in one of the three driver genes. No tumor had more than one mutation confirming that all alterations are mutually exclusive. MED12 mutations were the most common alterations in conventional and mitotically active leiomyomas and leiomyosarcomas, while leiomyomas with bizarre nuclei were most often FH deficient and cellular tumors showed frequent HMGA2 overexpression. Highly cellular leiomyomas displayed the least amount of alterations leaving the majority of tumors with no known driver aberration. Our results indicate that based on the molecular background, histopathological leiomyoma subtypes do not only differ from conventional leiomyomas, but also from each other. The presence of leiomyoma driver alterations in nearly one third of leiomyosarcomas suggests that some tumors arise through leiomyoma precursor lesion or that these mutations provide growth advantage also to highly aggressive cancers. It is clinically relevant to understand the molecular background of various smooth muscle tumor subtypes, as it may lead to improved diagnosis and personalized treatments in the future.

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Recent advances in the use of PI3K inhibitors for glioblastoma multiforme: current preclinical and clinical development

Abstract

Glioblastoma multiforme (GBM) is the most common and aggressive malignant primary tumor in the central nervous system. One of the most widely used chemotherapeutic drugs for GBM is temozolomide, which is a DNA-alkylating agent and its efficacy is dependent on MGMT methylation status. Little progress in improving the prognosis of GBM patients has been made in the past ten years, urging the development of more effective molecular targeted therapies. Hyper-activation of the phosphatidylinositol 3-kinase (PI3K)/Akt pathway is frequently found in a variety of cancers including GBM, and it plays a central role in the regulation of tumor cell survival, growth, motility, angiogenesis and metabolism. Numerous PI3K inhibitors including pan-PI3K, isoform-selective and dual PI3K/mammalian target of rapamycin (mTOR) inhibitors have exhibited favorable preclinical results and entered clinical trials in a range of hematologic malignancies and solid tumors. Furthermore, combination of inhibitors targeting PI3K and other related pathways may exert synergism on suppressing tumor growth and improving patients' prognosis. Currently, only a handful of PI3K inhibitors are in phase I/II clinical trials for GBM treatment. In this review, we focus on the importance of PI3K/Akt pathway in GBM, and summarize the current development of PI3K inhibitors alone or in combination with other inhibitors for GBM treatment from preclinical to clinical studies.

http://ift.tt/2rVlljM

Characterization of MED12 , HMGA2 , and FH alterations reveals molecular variability in uterine smooth muscle tumors

Abstract

Uterine smooth muscle tumors range from benign leiomyomas to malignant leiomyosarcomas. Based on numerous molecular studies, leiomyomas and leiomyosarcomas mostly lack shared mutations and the majority of tumors are believed to develop through distinct mechanisms. To further characterize the molecular variability among uterine smooth muscle tumors, and simultaneously insinuate their potential malignant progression, we examined the frequency of known genetic leiomyoma driver alterations (MED12 mutations, HMGA2 overexpression, biallelic FH inactivation) in 65 conventional leiomyomas, 94 histopathological leiomyoma variants (18 leiomyomas with bizarre nuclei, 22 cellular, 29 highly cellular, and 25 mitotically active leiomyomas), and 51 leiomyosarcomas. Of the 210 tumors analyzed, 107 had mutations in one of the three driver genes. No tumor had more than one mutation confirming that all alterations are mutually exclusive. MED12 mutations were the most common alterations in conventional and mitotically active leiomyomas and leiomyosarcomas, while leiomyomas with bizarre nuclei were most often FH deficient and cellular tumors showed frequent HMGA2 overexpression. Highly cellular leiomyomas displayed the least amount of alterations leaving the majority of tumors with no known driver aberration. Our results indicate that based on the molecular background, histopathological leiomyoma subtypes do not only differ from conventional leiomyomas, but also from each other. The presence of leiomyoma driver alterations in nearly one third of leiomyosarcomas suggests that some tumors arise through leiomyoma precursor lesion or that these mutations provide growth advantage also to highly aggressive cancers. It is clinically relevant to understand the molecular background of various smooth muscle tumor subtypes, as it may lead to improved diagnosis and personalized treatments in the future.

http://ift.tt/2sTO45A

What can Global Health Case Reports do for the “Neglected Stepchild of Global Health”?

By Nathan Douthit

Access to safe, affordable surgery is an essential aspect of global health. Eight million people are killed or injured every year due to inadequate availability of surgical services. Five billion are at risk due to lack of access to these services. Despite investment in surgery providing a 10:1 benefit:cost ratio for developing economies, surgery remains "the neglected stepchild of global health."

 

The case report "Penetrating cardiac injury: sustaining health by building team resilience in growing civilian violence" by Pol et al addresses some of these issues. The report includes two cases, both of young men. This represents a demographic at greater risk for perpetrating and being victims of violence. The case report addresses the issue raised by the greater availability of cheap firearms, so called 'desi-kattas' in India. Readily available firearms represent a risk for global health in both developed and developing nations. Pol et al discuss the importance of government initiative to curb violence as well as to build multi-disciplinary surgical teams capable of handling the surgical emergencies created by these underlying issues. One third of the global burden of disease is addressed surgically, and without these systems in place, needless death and disability will occur.

 

BMJ Case Reports invites authors to draw more attention to problems created by violence and conflict and the need for surgery in global health as well as the successes in this field. Case reports can expose:

-Increasing prevalence of surgical disease in developing countries

-Complications associated with delayed presentation

-Issues faced by vulnerable populations in the developed and developing world

-Management of surgical care in limited resource settings

-Violence and conflict and their effect on the health of populations

The Lancet Commission on Global Surgery discussed the importance of supporting research in developing countries by partnering with local practitioners in the developing world. This literature can be submitted by students, physicians and other medical professionals and will be necessary in helping to develop solutions to these global health problems.

 

Selected references on conflict, resilience and surgery within BMJ Global Health Case Reports:

–Landmines in the Golan Heights: a patient's perspective

–Complications of Dysgerminoma: meeting the health needs of patients in conflict zones

–The Tell-Tale Thigh

–Rheumatic fever with severe carditis: still prevalent in the South West Pacific

–Birth brachial plexus palsy: a race against time

–A Syrian Man with Abdominal Pain

For further guidance on how to write for BMJ Case Reports, please see here.

Selected references outside of BMJCR

1. Ng-Kamstra JS, Greenberg SL, Abdullah F, Amado V, Anderson GA, Cossa M, Costas-Chavarri A, Davies J, Debas HT, Dyer GS, Erdene S. Global Surgery 2030: a roadmap for high income country actors. BMJ Global Health. 2016 Apr 1;1(1):e000011.
2. Stewart F. Root causes of violent conflict in developing countries. BMJ: British Medical Journal. 2002 Feb 9;324(7333):342
3. Bruno E, Shrine MG. Surgery: The Neglected Stepchild of Global Health. The New York Times: Opinion. 2016 Apr 20. Accessed online at http://ift.tt/2rByfTt on 2017 June 4
4. Weinberger SE. Curbing Firearm Violence: Identifying a Target for Physician Action. Annals of internal medicine. 2016 Aug 2;165(3):221-2.

 

http://ift.tt/2r5Y0Ib

Immunological effect of local ablation combined with immunotherapy on solid malignancies

Abstract

Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeply involved in tumor progression, metastasis, and response to treatment. Furthermore, several immunotherapeutic trials have achieved successful results, and the immunotherapeutic agents are available in clinical practice. To enhance their demonstrated efficacy, combination of immunotherapy and ablation has begun to emerge. Local ablations have considerable advantages as an alternative therapeutic option, especially its minimal invasiveness. In addition, local ablations have shown immune-regulatory effect in preclinical and clinical studies. Although the corresponding mechanisms are still unclear, the local ablations combined with immunotherapy have been suggested in the treatment of several solid malignancies. This article aims to review the published data on the immune-regulatory effects of local ablations including stereotactic body radiotherapy, cryoablation, radiofrequency ablation, and high-intensity-focused ultrasound. We also discuss the value of local ablations combined with immunotherapy. Local ablations have the potential to improve future patient outcomes; however, the effectiveness and safety of local ablations combined with immunotherapy should be further investigated.

http://ift.tt/2sTkQ7c

Immunological effect of local ablation combined with immunotherapy on solid malignancies

Abstract

Recent comprehensive investigations clarified that immune microenvironment surrounding tumor cells are deeply involved in tumor progression, metastasis, and response to treatment. Furthermore, several immunotherapeutic trials have achieved successful results, and the immunotherapeutic agents are available in clinical practice. To enhance their demonstrated efficacy, combination of immunotherapy and ablation has begun to emerge. Local ablations have considerable advantages as an alternative therapeutic option, especially its minimal invasiveness. In addition, local ablations have shown immune-regulatory effect in preclinical and clinical studies. Although the corresponding mechanisms are still unclear, the local ablations combined with immunotherapy have been suggested in the treatment of several solid malignancies. This article aims to review the published data on the immune-regulatory effects of local ablations including stereotactic body radiotherapy, cryoablation, radiofrequency ablation, and high-intensity-focused ultrasound. We also discuss the value of local ablations combined with immunotherapy. Local ablations have the potential to improve future patient outcomes; however, the effectiveness and safety of local ablations combined with immunotherapy should be further investigated.

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Favorable response of colonic mixed adenoneuroendocrine carcinoma to streptozocin monotherapy

Abstract

Mixed adenoneuroendocrine carcinoma (MANEC) of the colon is rare and has a poor prognosis. Here, we report a case of MANEC in the ascending colon, in which streptozocin monotherapy achieved a partial response. A 36-year-old woman underwent right hemicolectomy for colonic polyposis, which included ascending colon cancer. Pathological examination revealed that some mucosal polyps were adenocarcinoma while one submucosal polyp was neuroendocrine carcinoma. Adjuvant chemotherapy was not administered, and 5 months after the operation, multiple liver metastases were identified. She was started on modified (5-FU, leucovorin, oxaliplatin) followed by XELOX (capecitabine, oxaliplatin) plus bevacizumab. Although these regimens helped achieve stable disease, computed tomography showed that the hepatic metastatic lesions had enlarged 4 months later. Subsequently, the regimen was changed to streptozocin monotherapy (1000 mg/m², weekly). After 5 cycles, the regimen achieved partial response and was continued for a total of 17 courses without significant adverse events until progressive disease. As a third-line chemotherapy regimen, cisplatin plus etoposide (EP) was administered. The EP regimen reduced the size of the hepatic and ovarian metastatic lesions but severe neutropenia and anemia was observed. Amrubicin monotherapy was also administered as fourth-line chemotherapy but a good clinical response was not detected, and the patient died 20 months after the operation. Streptozocin monotherapy has the potential to be a therapeutic option for mixed adenoneuroendocrine carcinoma of the colon.

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