Πέμπτη 19 Αυγούστου 2021

Surgical Outcomes in Patients With Centrally Located Non-small Cell Lung Cancer

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2815-2820. doi: 10.21873/invivo.12568.

ABSTRACT

BACKGROUND/AIM: Identification of prognostic factors is helpful in selecting optimal treatment for centrally-located non-small cell lung cancer (NSCLC). This study aimed to detect prognostic factors in patients with centrally-located NSCLC.

PATIENTS AND METHODS: NSCLCs in the hilar area requiring pneumonectomy or sleeve lobectomy for complete removal are defined as centrally-located NSCLCs. We retrospectively investigated the clinical courses of 45 patients with such lesions.

RESULTS: Sleeve lobectomies were performed on 33 patients and pneumonectomies on 12. Three and five-year survival rates were 72% and 62%, respectively. Presence of comorbidities (p=0.013), severe symptoms (p=0.001), high white cell count (p=0.001), and pathological T3-4 stage (p=0.004) were identified as independent predictors of poor prognosis. Operative procedures did not cor relate with outcomes (p=0.722).

CONCLUSION: Presence of comorbidities, severe symptoms, high white cell counts, and pathological T stage are independent predictors of poor prognosis. These data can contribute in selecting appropriate treatments for such lesions.

PMID:34410973 | DOI:10.21873/invivo.12568

View on the web

Prognostic Impact of Sarcopenia in Patients With Biliary Tract Cancer Undergoing Chemotherapy

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2909-2915. doi: 10.21873/invivo.12581.

ABSTRACT

AIM: Sarcopenia affects the treatment of various cancer types but its impact on chemotherapy efficacy and prognosis in biliary tract cancer remains unclear. Thus, we evaluated whether sarcopenia independently affects the outcome of chemotherapy for biliary tract cancer.

PATIENTS AND METHODS: Data of 50 patients who underwent chemotherapy for biliary tract cancer at two affiliated centres were retrospectively analysed. The association of clinical factors, including sarcopenia, with overall survival and time to treatment failure was analysed.

RESULTS: Sarcopenia was an independent factor negatively influencing overall survival and time to treatment failure in univariate and multivariate analyses (median overall survival, sarcopenic vs. non-sarcopenic patients: 10.6 vs. 16.6 months; hazard ratio=2.19, p=0.018; time to treatment failure: 5.3 vs. 13.1 mo nths, hazard ratio=2.50, p=0.019).

CONCLUSION: Sarcopenia may affect the efficacy of chemotherapy and prognosis in biliary tract cancer. Thus, improving sarcopenia may improve the prognosis of patients with biliary tract cancer undergoing chemotherapy.

PMID:34410986 | DOI:10.21873/invivo.12581

View on the web

The Expression of NRIP1 and LCOR in Endometrioid Endometrial Cancer

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2631-2640. doi: 10.21873/invivo.12545.

ABSTRACT

BACKGROUND: The aim of the study was to analyze the expression of nuclear receptor interacting protein 1 (NRIP1) and its partner ligand-dependent nuclear receptor co-repressor (LCOR) in endometrioid endometrial cancer and to investigate their association with estrogen receptor (ER), progesterone receptor (PR), Ki-67, clinicopathological parameters and patient survival.

MATERIALS AND METHODS: Immunohistochemical evaluation was carried out to investigate the subcellular expression of NRIP1 and LCOR in endometrioid endometrial cancer samples. Statistical analysis was used to identify the correlations of NRIP1 and LCOR expression with clinicopathological variables and to estimate the survival rates.

RESULTS: Endometrial cancer tissues exhibited higher expression of NRIP1 and LCOR in comparison with the normal tissues. Cytoplasmic LCOR expression was pos itively associated with ER and PR expression, while cytoplasmic NRIP1 expression was positively associated with ER expression. Moreover, cytoplasmic expression of NRIP1 was positively associated with Ki-67.

CONCLUSION: Our study demonstrated that high cytoplasmic expression of LCOR may predict a longer overall survival of patients with endometrioid endometrial cancer. Patients with tumors expressing low levels of LCOR showed a worse survival compared to those expressing high levels.

PMID:34410950 | DOI:10.21873/invivo.12545

View on the web

Risk Factors for Overall Complications and Remote Infection After Gastrectomy in Elderly Gastric Cancer Patients

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2917-2921. doi: 10.21873/invivo.12582.

ABSTRACT

BACKGROUND/AIM: A significant predictive factor for the occurrence of complications after gastrectomy in elderly gastric cancer patients is yet to be determined. We aimed to evaluate the clinical factors associated with overall complications including remote infection after gastrectomy in elderly gastric cancer patients.

PATIENTS AND METHODS: We retrospectively analyzed data of 101 patients aged over 80 years, who underwent curative gastrectomy. We analyzed the clinicopathological factors that were independently associated with the occurrence of overall complications or remote infection by a logistic regression model.

RESULTS: The overall complication rate was 24.8%. We identified pneumonia as a remote infection, and the occurrence rate of remote infections was 5.9%. On multivariate analysis, hemoglobin (<11 g/dl) and operation time (>240 min) were significantly correlated with the occurrence of overall complications. Regarding the occurrence of remote infection, performing total gastrectomy and a hemoglobin level <11 g/dl were identified as significant risk factors.

CONCLUSION: Preoperative anemia and intraoperative factors, including the surgical procedure, could affect the occurrence of postoperative complications in elderly patients.

PMID:34410987 | DOI:10.21873/invivo.12582

View on the web

Combined Therapy of ATRA and Imatinib Mesylate Decreases BCR-ABL and ABCB1/MDR1 Expression Through Cellular Differentiation in a Chronic Myeloid Leukemia Model

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2661-2667. doi: 10.21873/invivo.12549.

ABSTRACT

BACKGROUND/AIM: Chronic Myeloid Leukemia (CML) is a clonal myeloproliferative disease, and a major challenge for the eradication of CML is to understand the cause of the permanence of minimal residual disease (DRM). This work aimed to induce the maturation of leukemic stem cells with All-trans-retinoic acid (ATRA), making them sensitive to treatment with Imatinib (IM).

MATERIALS AND METHODS: K562 cells were treated with IM and with the combined therapy of ATRA together with IM for 48 and 72 h. The expression of BCR-ABL gene and multidrug resistance gene ABCB1 were evaluated using RT-qPCR.

RESULTS: The combined ATRA and IM therapy showed a discreet cell differentiation pattern, evidenced by the panoptic morphology analysis at 48 and 72 h of treatment. The BCR-ABL expression showed no statistical difference when treated alone with IM, however in combi nation with ATRA, the expression was statistically significant in 48 and 72 h (p≤0.0001) and when the treatment groups were compared to each other (p≤0.001). The ABCB1 gene expression showed a decrease in isolated IM therapy (p≤0.05) and in the combination in 48 and 72 h (p≤0.0001).

CONCLUSION: Combined ATRA and IM therapy was shown to be effective in decreasing BCR-ABL and ABCB1 genes, possibly through the differentiation of blast cells, demonstrating that the therapy could be potentially effective in the blast crisis of the disease and for those patients who develop resistance to available CML treatments.

PMID:34410954 | DOI:10.21873/invivo.12549

View on the web

Association Between S100b Levels and COVID-19 Pneumonia: A Case Control Study

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2923-2928. doi: 10.21873/invivo.12583.

ABSTRACT

BACKGROUND/AIM: Extracellular S100b effects are mediated by the receptor for advanced glycation end products (RAGE), which is the S100b membrane receptor. RAGE belongs to the immunoglobulin superfamily of cell surface molecules and serves as a multiligand receptor and is expressed in high abundance by alveolar type I (AT-I) cells in adult pulmonary tissue. This study aimed to provide an insight into the association between the severity of COVID-19 disease and serum S100b levels during admission to the emergency department (ED).

PATIENTS AND METHODS: A total of 64 patients (34 mild cases; 30 severe cases) were diagnosed with COVID-19 pneumonia and 30 healthy volunteers were admitted to study. Serum S100b levels were measured by using enzymle linked immunoassay method from blood serum samples.

RESULTS: Serum S100b levels showed a significantly higher mean value in mild and severe disease cohorts than in healthy controls (p=0.036 and p=0.028 respectively). Receiver operating characteristic (ROC) analysis indicated greater area under the curve (AUC) for serum S100b levels of the COVID-19 patients (AUC=0.663, 95% CI=0.541-0.785; p=0.014). In addition, serum S100b concentration was measured as 151.7 ng/ml at 79.3% sensitivity and 51.7% specificity (p=0.014). Serum S100b protein levels can serve as a valuable clinical marker in establishing diagnosis of patients. Though not useful in identifying different stages of COVID-19 infection, serum S100b concentration along with other known markers can be utilized to reliably predict clinical severity along with other clinical parameters.

PMID:34410988 | DOI:10.21873/invivo.12583

View on the web

The Contribution of a Collagen Patch Coated With Fibrin Glue in Sealing Upper Gastrointestinal Defects: An Experimental Study

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2697-2702. doi: 10.21873/invivo.12553.

ABSTRACT

BACKGROUND/AIM: We aimed to evaluate the safety and efficacy of sealing primary upper gastrointestinal (GI) perforations with a collagen patch coated with fibrin glue (Tachosil®).

MATERIALS AND METHODS: Thirty New Zealand rabbits were used in this study. An iatrogenic gastric perforation was created, and primary repair was performed on the control group. Tachosil®, without suturing the deficit, was used in the intervention group.

RESULTS: Leakage was observed in 3 (20%) and 2 rabbits (13.3%) in the control and intervention group, respectively; however, the difference was not statistically significant (p=0.62). Moreover, adhesions formed in 10/15 and all rabbits in the intervention and control group, respectively (p=0.014); however, based on the Zuhlke adhesion's classification, there was no statistically significant differenc e between the two groups.

CONCLUSION: A collagen patch coated with fibrin glue is not a replacement but can be considered a safe option for the reinforcement of suturing, preventing leakages in the upper GI tract.

PMID:34410958 | DOI:10.21873/invivo.12553

View on the web

Successful Conversion Surgery for Advanced Gastric Cancer With Multiple Liver Metastases Following Ramucirumab Plus Paclitaxel Combination Treatment

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2929-2935. doi: 10.21873/invivo.12584.

ABSTRACT

AIM: To present the case of a patient with unresectable gastric cancer showing a remarkable effect by second-line drug treatment with ramucirumab plus paclitaxel and conversion surgery.

CASE REPORT: A 68-year-old woman who was diagnosed with gastric cancer was referred to us. Esophagogastroduodenoscopy showed an ulcerated lesion with an irregular nodulated border in the lower third of the stomach, and histology of biopsied specimens indicated a poorly differentiated adenocarcinoma. Enhanced computed tomography revealed extensive invasion of the liver, and the patients was treated using S-1 plus oxaliplatin as first-line chemotherapy. Because she developed liver metastases, the treatment regimen was changed to ramucirumab plus paclitaxel as the second-line treatment. After four cycles of weekly paclitaxel with ramucirumab treatment, the liver metastases ha d completely disappeared. Because no other metastatic lesions in other organs were detected, we performed total gastrectomy with D2 lymphadenectomy. The macroscopic findings of the surgically resected specimen revealed an ulcerated lesion with an irregularly modulated lesion measuring 9.5×4.5 cm. Pathological analysis demonstrated a poorly differentiated adenocarcinoma in the stomach, with invasion to the liver through the serosal layer, and seven lymph node metastases. The postoperative course was unremarkable, and she received ramucirumab in combination with paclitaxel treatment. However, liver metastasis appeared at 4 months after the operation, for which she was treated with irinotecan. Although the patient continued to receive irinotecan chemotherapy for 10 months, her general condition gradually deteriorated, and she was started on best supportive care 13 months after conversion surgery.

CONCLUSION: Conversion surgery may prolong survival not only through first-line but also second-line treatments in selected patients with unresectable advanced gastric cancer; however, assessments of additional cases and further studies are required to establish this treatment strategy.

PMID:34410989 | DOI:10.21873/invivo.12584

View on the web

A Diagnostic Score (DS) in the Difficult Diagnosis of Non-specific Abdominal Pain (NSAP)

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2729-2738. doi: 10.21873/invivo.12557.

ABSTRACT

BACKGROUND/AIM: The diagnostic scores (DSs) for patients with non-specific abdominal pain (NSAP) have been rarely evaluated.

PATIENTS AND METHODS: In the NSAP study group there were 614 patients (268 females and 346 males) versus 719 patients in the non-NSAP group including 368 females and 351 males. The clinical symptoms (n=22), signs and tests (n=14) and laboratory analyses (n=3) were recorded in each patient. Meta-analytical techniques were used to detect the summary sensitivity (Se) and specificity (Sp) estimates for each data set (symptoms, signs and tests as well as DS models).

RESULTS: In receiver operating characteristic (ROC) analysis, the area under curve (AUC) values for i) symptoms ii) signs and tests and iii) DS were as following: i) AUC=0.542 (95% CI=0.512-0.572); ii) AUC=0.625 (95% CI=0.550-0.700), and iii) AUC=0.874 (95% CI=0.850-0.8 98). The differences between these AUC values are as following: between i and ii, p=0.097; between i and iii, p<0.0001 and between ii and iii, p<0.0001.

CONCLUSION: This is the first study to provide evidence that DS may help in the difficult diagnosis of NSAP.

PMID:34410962 | DOI:10.21873/invivo.12557

View on the web

Relapse of Rectal Cancer in an Anal Fistula: A Rare Case

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2937-2940. doi: 10.21873/invivo.12585.

ABSTRACT

BACKGROUND: Colorectal cancer is the second most common cause of cancer-related death worldwide. It is well-known that metasta sis to the liver and lung and local recurrences can occur. Additionally, colorectal cancer occasionally metastasizes to other sites. Only a few reports of such metastases have been published and no definitive therapeutic strategies have been proposed for them.

CASE REPORT: The case of a 77-year-old man who was diagnosed with rectal cancer is presented. Eighteen months after curative laparoscopic low anterior resection and D3 lymph node resection, an anal fistula metastasis was diagnosed by computed tomography and biopsy. After administering radiotherapy, percutaneous excision of the lesion. was performed. At 21 months from the surgery, the patient is healthy and no recurrence has been found.

CONCLUSION: Metachronous metastas is of a colorectal cancer to an anal fistula is rare. Careful investigation and optimal treatment can result in a disease-free status.

PMID:34410990 | DOI:10.21873/invivo.12585

View on the web

Emotional Problems Prior to Adjuvant Radiation Therapy for Breast Cancer

xlomafota13 shared this article with you from Inoreader

In Vivo. 2021 Sep-Oct;35(5):2763-2770. doi: 10.21873/invivo.12561.

ABSTRACT

BACKGROUND/AIM: Being scheduled for radiotherapy can cause emotional distress. This study aimed to identify risk factors in 338 patients assigned to radiotherapy for breast cancer.

PATIENTS AND METHODS: Nineteen potential risk factors including the COVID-19 pandemic were investigated for associations with the six emotional problems included in the National Comprehensive Cancer Network Distress Thermometer.

RESULTS: Worry and fears were significantly associated with age ≤60 years; sadness with age and Karnofsky performance score (KPS) <90; depression with KPS and Charlson Comorbidity Index ≥3; loss of interest with KPS. Trends were found for associations between sadness and additional breast cancer/DCIS, Charlson Index and chemotherapy; between depression and additional breast cancer/DCIS, treatment volume and nodal stage N1-3; between nervous ness and additional breast cancer/DCIS, mastectomy and triple-negativity; between loss of interest and Charlson Index, family history of breast cancer/DCIS, invasive cancer, chemotherapy, and treatment volume. The COVID-19 pandemic did not increase emotional problems.

CONCLUSION: Several risk factors for emotional problems were identified. Patients with such factors should receive psychological support well before radiotherapy.

PMID:34410966 | DOI:10.21873/invivo.12561

View on the web