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Multiple primary lung cancer (MPLC) refers to patients with two or more primary lesions of lung cancer. It can be divided into synchronous MPLC (sMPLC) and metachronous MPLC (mMPLC) based on the timing of occurrence. In recent years, the detection rate of MPLC has gradually increased. However, considerable controversy exists in distinguishing MPLC from intrapulmonary metastasis (IM), especially when the histopathological types are identical. Given the significant differences in treatment strategies and prognosis in clinical practice currently, accurate diagnosis of MPLC is crucial for personalized precision therapy. Molecular genetics and sequencing technologies offer effective strategies for assessing the clonal origin of tumors. There have been reports of coexisting mutations in the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) fusion genes in non-small cell lung cancer, but case of EGFR mutation following an ALK mutation has not been mentioned. This article accurately diagnoses and retrospectively analyzes the clinical data of a case of ALK mutant adenocarcinoma in a male patient who developed an EGFR mutation with multiple metastases four years after surgery, and reviews the relevant literature. This paper aims to deepen the understanding of mMPLC and provide clinical references for the diagnosis and treatment of such patients. [ABSTRACT FROM AUTHOR]

Due to the high incidence of head and neck cancer and under-diagnosis in the early stages, non-invasive and highly accurate diagnostic tests are required for cancer detection. Recent advances in Raman spectroscopy techniques have yielded promising sensitivity and specificity results in the evaluation of cancer. The aim of this study was to investigate the potential value of Raman spectroscopy in oral cavity and oropharyngeal cancer diagnosis based on currently available scientific papers. A search of the PubMed database was performed using a specific strategy and according to the PRISMA guidelines. Raman spectroscopy achieved a maximum accuracy of 98% in cancer detection, while accuracy was 97.24% for tumour grading evaluation, 95% for cancer treatment assessment, and 77% for the detection of cancer recurrence. Moreover, early-stage cancer can be identified by Raman spectroscopy investigation of liquid biopsy samples. An in vivo technique with direct mucosa examination by fibre-optic Raman spectroscopy obtained a maximum accuracy of 94% in cancer diagnosis. The most prominent markers of the presence of malignancy were an increase in Raman signal intensity for proteins, nucleic acids, and water and a decrease for lipids. These cancer discriminants were detected in both fingerprint and high wavenumber regions. In conclusion, Raman spectroscopy is a promising tool for oral cavity and oropharyngeal cancer screening. [ABSTRACT FROM AUTHOR]

The current review paper was written in collaboration with breast cancer surgeons from the European Breast Cancer Research Association of Surgical Trialists (EUBREAST), a breast pathologist from the Danish Breast Cancer Group (DBCG), and representatives from the European SocieTy for Radiotherapy & Oncology (ESTRO) breast cancer course. Herein we summarize the different mastectomies and reconstruction procedures and define high-risk anatomical areas for breast cancer recurrences, to further specify the challenges in the surgical procedure, histopathological evaluation, and target volumes in case of postmastectomy irradiation, as recommended by the ESTRO guidelines according to the surgical procedure. The paper has original figures and illustrations for all disciplines for in-depth understanding of the differences between the procedures. • Mastectomy techniques and reconstruction evolved to improve cosmetic outcomes. • Different techniques maybe associated with different amount of residual breast tissue. • More data is needed to estimate who are the patients at risk for residual disease or recurrence. • Multidisciplinary work needed to individualise treatment for optimal oncological outcomes while maintaining the significant improvements in achieving better cosmesis for these patients. [ABSTRACT FROM AUTHOR]

Consolidation tumor ratio (CTR) is a hot issue in lung cancer imaging studies in recent years. It is defined as the proportion of the maximum consolidation diameter divided by the maximum tumor diameter in the lung window scanned by high resolution computed tomography (HRCT). Many studies have also confirmed that it can be used as an indicator to identify whether a lung tumor is benign or malignant at the early stage, the main basis on which to decide whether sublobectomy can be performed, and is an independent factor for the recurrence and prognosis of early-stage lung cancer. Especially after tumor size and CTR results of JCOG0804 and JCOG0802 trials in Japan were published, a breakthrough in the treatment method upends the conventional surgical approach, which benefits patients with early-stage lung cancer. But insufficient research data on CTR leads to the fact that an evaluation system to measure CTR is yet to be built. This paper discusses the research progress in CTR prediction of benign or malignancy of pulmonary nodules, how to choose a surgical approach, lymph node dissection, spread through air spaces (STAS) and other hot issues. It also investigates the possible indicators to predict efficacy based on CTR, summarizes and analyzes the development trend of surgical methods to treat early-stage peripheral lung cancer and challenges, to provide new ideas for clinical application. [ABSTRACT FROM AUTHOR]

Hormone Therapy (HT) is recommended for most women with HR-positive primary breast cancer. When taken as intended, HT reduces breast cancer recurrence by 40% and mortality by one-third. The recommended duration of treatment ranges from 5 to 10 years depending on risk of recurrence and the specific HT regimen. However, recent data indicates that rates of HT non-adherence are high and research suggests this may be due to the impact of HT side effects. The contribution of side effects to non-adherence and non-persistence behaviours has rarely been systematically explored, thereby hindering the implementation of targeted intervention strategies. Our aim is to identify, evaluate and summarise the relationship between HT side effects and patterns of adherence and persistence. Electronic searches were conducted from inception and were completed by September 2021, utilising Cochrane CENTRAL, Medline, Embase, Web of Science and PsycINFO databases. Searches included a combination of terms related to breast cancer, adherence, hormone therapy and side effects. Sixty-two eligible papers were identified and study quality varied by study type. Most observational and cross-sectional studies were rated good quality, whereas most controlled intervention studies were rated fair quality. Three studies were rated poor quality. The most frequently measured side effects were pain, low mood, hot flashes, insomnia, anxiety, fatigue, weight gain, concentration/memory problems. This review identified a lack of consistency in the measurement of adherence and the definition of persistence across studies. The instruments used to measure side effects also varied significantly. This variation and lack of consistency makes it difficult to evaluate and summarise the role of HT side effects in HT adherence and persistence behaviour. • Hormone Therapy (HT) reduces breast cancer recurrence and mortality yet HT non-adherence and non-persistence is high. • The experience of HT side effects may contribute to HT non-adherence and non-persistence. • Pain, low mood, hot flashes, insomnia and poor concentration are amongst the most commonly reported HT side-effects. • Assessment tools measuring HT side effects vary significantly across studies, making cross-study comparisons difficult. • There is a lack of cross-study consistency in defining persistence and measuring adherence. • Poor cross-study consistency limits understanding of the role of HT side effects in adherence and persistence behaviour. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to investigate the influencing factors of breast cancer recurrence by comparing the risk factors and lifestyle patterns related to breast cancer in Korean women with and without recurrence. Methods: This cross-sectional survey comprised 241 Korean women diagnosed with breast cancer who had received follow-up treatment. Participants were recruited from a university hospital in Seoul and an online social media platform for breast cancer patients. Data were collected either via online or a paper survey, using a structured questionnaire that included general and disease-related characteristics and lifestyle behaviors. Data were analyzed using descriptive statistics, univariate analysis, and logistic regression. Results: Recurrence of breast cancer was influenced by four factors; childbirth experience, consumption of green/yellow vegetables, drinking behavior, and recovery from fatigue after sleep. Prevalence of recurrent breast cancer was associated with no childbirth experience (OR=2.29, p=.010), fewer green/yellow vegetables (OR=0.71, p=.008), drinking behavior (OR=0.24, p=.001), and a lower level of recovery from fatigue after sleep (OR=0.51, p<.001). Conclusion: Aside from having experienced childbirth, this study identified several modifiable factors that influence breast cancer recurrence. Increasing green/ yellow vegetable intake, alleviating fatigue, and reducing alcohol intake are important. Intervention strategies in clinical research and practice can be applied to address risk factors and reduce the prevalence of recurrent breast cancer. [ABSTRACT FROM AUTHOR]

The concept of spread through air spaces (STAS) was first proposed in the World Health Organization (WHO) Classification of Tumors of the Lung, Pleura, Thymus and Heart (version 2015). STAS is defined as the micropapillary clusters, solid nests or single cells of tumor that exist in the air spaces of the surrounding lung parenchyma beyond the edge of the main tumor. Meanwhile, apart from the traditional invasion modes of lung adenocarcinoma (interstitial, visceral pleura and lym-phovascular invasion), STAS has been identified as the fourth invasion mode of lung adenocarcinoma. In recent years, the research on STAS has been a hot spot in the field of lung adenocarcinoma. The existence of STAS is related to lung cancer histopathology, gene mutation and other factors, and many studies have also confirmed that it can be used as an independent factor for tumor recurrence and prognosis. However, according to some studies, human factors can cause morphological artifacts of STAS, which still needs to be distinguished in clinical work. This paper reviews the research progress of STAS classification, related pathological features, genetic status changes, and human factors that may cause STAS artifacts. [ABSTRACT FROM AUTHOR]

Tumor spread through air spaces (STAS) as a new pathological invasion mode is closely related to many clinicopathological factors. In lung adenocarcinoma, micropapillary and solid pathological subtypes are most related; STAS for early stage lung adenocarcinoma, surgical type of lobectomy seems to benefit better than sublobar resection, which may up-regulate the pathological stage of early lung cancer; Moreover, STAS is closely related to squamous cell carcinoma and other non-small cell lung cancer (NSCLC). In addition, intraoperative frozen-section pathological detection of STAS is difficult and controversial. STAS as an independent risk factor for tumor recurrence is also an important factor indicating poor prognosis. This paper reviews the research status and progress of STAS. [ABSTRACT FROM AUTHOR]

Abstract Background Colon cancer outcomes are now inferior to rectal cancer outcomes. The sigmoid colon is the most common site of colonic cancer. The aim of this review was to investigate the oncological outcomes for sigmoid cancer. Methods A systematic review and meta-analysis was performed. We included any study of the oncological outcomes for sigmoid cancer such as local recurrence, distant recurrence and disease free survival. A systematic search was conducted in Medline from inception to November 2016. Study quality was evaluated with the Newcastle-Ottawa Scale. The study was registered on PROSPERO (CRD42017069326). Results The search terms returned 1323 results. We identified a total of 17 eligible studies including 5953 patients. The pooled local recurrence rate was 10.5% in 15 studies with 5148 patients (95% CI 0.07–0.14) and heterogeneity measured by I2 was 94%. The pooled distant recurrence rate was 19.5% (7 studies, 2040 patients, 95% CI (0.14–0.25), I2 90%). The pooled disease free survival at 5 years was 80.4% (5 studies, 2336 patients, 95% CI 78.6%–82.1%, I2 11.5%.). The median Newcastle-Ottawa score was 4 out of 9. R1 and R2 resections were excluded or not described in 16/17 studies. Two studies described R1 and R2 rates of 15–20%. Conclusion The pooled local recurrence rate of sigmoid cancer of 10.5% is higher than contemporary rates of local recurrence of rectal cancer. A large number of papers fail to describe or include R1 resections of sigmoid cancer, which are frequently described as palliative. [ABSTRACT FROM AUTHOR]

Microwave has a promising therapeutic future due to its excellent minimally invasive, tissue penetrating and organ specificity. Microwave-triggered therapeutic technology has received increasing attention in recent years as a promising clinical treatment, which may offer many noteworthy opportunities and benefits, such as deep penetration depth, low phototoxicity, mild temperatures, and few side effects. However, previous studies have also demonstrated its inherent limitations, such as prone to recurrence and metastasis of tumor, and limited ablation area. On the other hand, functionalized nanomaterials can generate thermal effect or reactive oxygen species under microwave triggering, providing a viable way to overcome the intrinsic flaws of the microwave therapy. This paper reviews the recent progress of microwave therapy based on nanomaterials and the combined therapies with immunotherapy, photothermal therapy, photodynamic therapy, chemotherapy, and radiotherapy. Finally, the prospects and challenges of the nanomaterials in microwave therapy have been briefly introduced. [Display omitted] • A systematic summary of the research status of microwave therapy combined with nanomaterials has been provided. • The mechanism of microwave generation and development is discussed. • The latest status of the combined application of microwave therapy with other therapeutic modalities is summarized. • Further opportunities and challenges of the combined application of nanomaterials and microwave therapy are discussed. [ABSTRACT FROM AUTHOR]

Abstract Purpose To integrate the available data published on central odontogenic fibroma (COF) into a comprehensive analysis of its clinical/radiologic/histological features. Methods An electronic search was undertaken in September 2017. Eligibility criteria included publications reporting cases of COF having enough clinical, radiological and histological information to confirm the diagnosis. Demographic data, lesion site and size, treatment approach, and recurrence were analysed. The cases included in the analysis presented follow-up time. Concerning recurrence analysis, tumour location, cortical bone perforation, lesion locularity, radiopacities, lesions associated with a tooth, tooth displacement, histological type and treatment used were evaluated. Results Eighty-three publications reporting 173 COFs were included. Lesions were slightly more prevalent in men than women (M: F – 1.13: 1); mean age was 31.6 years, with the highest prevalence in the second decade of life. Lesions were more prevalent in the posterior mandible. The difference in recurrence rate (when information about recurrence was provided) presented a statistically significant result for COF for location, cortical bone perforation and locularity of the lesion. Conclusions Our paper highlights that patients with COF who present a lesion located in the maxilla with multilocular aspects and cortical bone perforation tend to show a higher recurrence rate. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Lung Cancer is the property of Chinese Journal of Lung Cancer and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psychologists as part of routine care. Patients completed self-report scales before the first treatment session and, a second time, 1 month after the last session. Overall, 33 patients had clinical levels of FCR at baseline. The participants’ satisfaction toward the group CBT for FCR was high. Significant reductions on the total score and most subscales of the Fear of Cancer Recurrence Inventory (FCRI) were observed, as well as significant improvements on most of the other psychological variables measured (i.e., insomnia, anxiety, depression, dysfunctional beliefs about cancer, and intolerance of uncertainty). In addition, 52% of the patients with clinical levels of FCR (FCRI-severity subscale score ≥ 13) at baseline no longer reached this clinical threshold at posttreatment. These preliminary results suggest that our group CBT for FCR is well accepted and feasible, and shows promising efficacy for decreasing FCR and improving other psychological variables among cancer patients. The next step is to investigate the efficacy of this minimal intervention in larger and controlled clinical trials, as well as its usefulness as part of a stepped care approach. This low-cost intervention is easy to implement in various clinical settings and has a strong potential to help large numbers of patients with FCR. [ABSTRACT FROM AUTHOR]

Copyright of Revista Odonto Ciencia is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: “Ensemble processing” combines the results (outputs) of several different models, each “looking at” a disease from a different perspective. A number of different methods are available to support ensemble processing: (1) averaging, (2) weighted-averaging,(3) Adaboost, and (4) other processing methods that use gate variables in forming a “tree structure”. Gate variables are used here as an integral part of the Expectation operation in a maximum likelihood estimator. This paper presents the application of a “Generalized Regression Neural Network Predictive Model,” called the “GRNN oracle,” that takes advantage(s) of correlation(s) (synergies) that exist between intelligent predictive input model outputs by combining them (at the variance level) for generating both clinical and microarray lung cancer data to improve cancer recurrence modeling and predictive performance, when compared to any one output taken alone. The hypothesis is: Given a validation data set that contains a sufficient sample size, then the GRNN oracle will provide a synergistic combination of output data which is superior in predictive performance accuracy (as measured by an ROC analysis) when compared to all input intelligent models, taken individually. This paper will discuss the results of our work in evaluating the validity of this hypothesis. [Copyright &y& Elsevier]

Purpose: To assess the effectiveness of rectal wash out in preventing local recurrence for patients who undergo anterior resection for recto-sigmoid cancer.Materials and Methods: A best evidence topic was constructed according to a structured protocol. Medline 1948-2015 and EMBASE 1980 to 2015 using the OVID interface: ( Rectal) AND (Washout) AND (Anterior Resection). In addition, the reference lists of the relevant papers were searched.Outcomes: Eight papers among the 17 relevant articles were identified as representing the best evidence including 3 prospective non-randomized studies, 1 retrospective non randomized study and 4 meta-analyses.Conclusions: On the basis of current evidence, rectal washout does not stop local recurrence of cancer after anterior resection or left sided colonic resection, but it may reduce the rate of local recurrence. A randomised controlled trial to address this issue would formally answer this question. [ABSTRACT FROM AUTHOR]

The article highlights several papers related to the study of urology that were published from November 2007 to November 2008. For genital traumas, one study suggested that conservative therapy may be introduced in patients with superficial traumas external to the tunica dartos. For bladder cancer, one research paper found that the treatment of superficial bladder cancer using transurethral resection has two main goals, which are, to reduce relapse state and to prevent disease manifestations.

Background The purpose of this study was to compare patient outcomes between immediate breast reconstruction (IBR) after mastectomy and mastectomy alone. Methods We conducted a comprehensive literature search of PUBMED, EMBASE, Web of Science, and Cochrane Library. The primary outcomes evaluated in this review were overall survival, disease-free survival and local recurrence. Secondary outcome was the incidence of surgical site infection. All data were analyzed using Review Manager 5.3. Results Thirty-one studies, involving of 139,894 participants were included in this paper. Pooled data demonstrated that women who had IBR after mastectomy were more likely to experience surgical site infection than those treated with mastectomy alone (risk ratios 1.51, 95% CI: 1.22–1.87; p = 0.0001). There were no significant differences in overall survival (hazard ratios 0.92, 95% CI: 0.80–1.06; p = 0.25) and disease-free survival (hazard ratios 0.96, 95% CI: 0.84–1.10; p = 0.54) between IBR after mastectomy and mastectomy alone. No significant difference was found in local recurrence between two groups (risk ratios 0.92, 95% CI: 0.75–1.13; p = 0.41). Conclusions Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of breast cancer. Besides, no evidence shows that IBR after mastectomy increases the frequency of local recurrence. [ABSTRACT FROM AUTHOR]

Rhabdomyosarcomas make up 5% of all pediatric malignant tumors. They are extremely rare in neonates. Furthermore, the external ear as a primary tumor site is very uncommon. In this paper, a neonate with a congenital auricular rhabdomyosarcoma is presented. At birth, a newborn male was noted to have a right posterior auricular mass. He is admitted to a children's hospital where he has diagnostic imaging, undergoes a biopsy, and then surgical resection of the auricular mass. Pathology confirms an infantile spindle cell rhabdomyosarcoma. He completes 22 weeks of chemotherapy without incident. At one year of age, there is no evidence of metastasis or recurrence of the auricular tumor. A rare case of a neonate with a congenital auricular rhabdomyosarcoma is presented. The prognosis of congenital auricular rhabdomyosarcomas tends to be favorable. [ABSTRACT FROM AUTHOR]

TO ESTABLISH THE RISK OF TUMORAL RECURRENCE FOR NON-MUSCLE INVASIVE BLADDER CANCER (NMIBC) DEPENDING ON HISTOLOGICAL OR ENVIRONMENTAL FACTORS. THE AIM OF THIS PAPER IS TO IMPROVE THE STANDARD CLINICAL CARE IN NMIBC PATIENTS FOLLOW-UP.WE INITIALLY EVALUATED 987 PATIENTS DIAGNOSED WITH BLADDER CANCER BETWEEN JANUARY 2005 AND DECEMBER 2014. MUSCLE-INVASIVE BLADDER CANCER (MIBC) WAS DIAGNOSED FOR 309 PATIENTS (31.3%) WHILE 678 (68.7%) HAD NMBIC. A TOTAL OF 540 PATIENTS WITH NMIBC WERE ANALYZED IN THE STUDY, WHILE THE OTHER 138 (20.4%) WERE EXCLUDED DUE TO INCOMPLETE CLINICAL DATA OR FOLLOW-UP. THE RETROSPECTIVE STUDY ANALYZED PATIENTS' CHARTS, DISCHARGE NOTES, ONCOLOGY REPORTS. PATIENTS WITH AT LEAST 3 YEARS COMPLETE FOLLOW-UP DATA WERE ENROLLED.THE AVERAGE AGE OF DIAGNOSED PATIENTS WITH NMIBC WAS 65.3 YEARS. THE MAJORITY OF PATIENTS WERE DIAGNOSED WITH SINGLE TUMORS (68.5%). NMIBC WAS PREDOMINANT IN MALES, WITH A SEX RATIO 3.25:1 FOR MALES. BLADDER TRIGON IS THE MAIN LOCATION FOR BLADDER TUMORS. SMOKING WAS THE MAIN RISK FACTOR ACCORDING TO OUR RESULTS. SMOKERS HAD A 4 TIMES HIGHER RISK FOR NMIBC DEVELOPMENT. PATIENTS WITH MULTIPLE BLADDER TUMORS HAD 2.28 HIGHER RISK OF RECURRENCE. OVERALL RECURRENCE FOR NMIBC WAS 49.1%.SMOKING IS THE MOST IMPORTANT RISK FACTOR AND THE RECURRENCE RATE IS HIGHER IN SMOKING-PATIENTS.ALSO, PATIENTS WITH MULTIPLE TUMOURS HAVE BEEN DIAGNOSED WITH HIGHER RISK FOR TUMOR RECURRENCE (P<0.05). LARGE TUMORS AND PATIENTS WITH ASSOCIATED UROLOGICAL CONDITIONS HAVE HIGHER RISK OF TUMORAL RECURRENCE (OR =2.2). [ABSTRACT FROM AUTHOR]

Background: Among Latinas and Hispanics (henceforth referred to as Latinas), breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related deaths. However, few interventions have been developed to meet the needs of Latina women undergoing active treatment for breast cancer. Objective: This paper aims to describe the procedures and methods of My Guide for Breast Cancer Treatment and the plans for conducting a multisite randomized controlled trial to investigate the feasibility and preliminary efficacy of this smartphone-based app for Latina women in active treatment for breast cancer. Methods: Study participants will be randomized to the My Guide for Breast Cancer Treatment intervention or the enhanced usual care control condition for 12 weeks. Participants will have access to innovative features such as gamification via virtual awards to reinforce usage and an adaptive section that presents targeted material based on their self-reported concerns and needs. Using a stepped-care approach, intervention participants will also receive telecoaching to enhance their adherence to the app. Study outcomes and intervention targets will be measured at study enrollment (before randomization), 6 and 12 weeks after initial app use. General and disease-specific health-related quality of life (HRQoL) and symptom burden are the study's primary outcomes, whereas anxiety, depression, fear of cancer recurrence, physical activity, and dietary intake are secondary outcomes. Results: Recruitment began in August 2019 and is expected to be completed by August 2020. We expect to submit study results for publication by fall 2020. Conclusions: My Guide for Breast Cancer Treatment has the potential to improve HRQoL and reduce symptom burden, and increase access to supportive care resources among Latina breast cancer patients. International Registered Report Identifier (IRRID): PRR1-10.2196/14339 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Abstract: Introduction: The local treatment option for pelvic Ewing sarcoma (ES) remains uncertain and challenging as surgery is often disabling while radiotherapy alone has a higher risk of local recurrence but not necessarily a worse survival. The aim is to analyse the outcome of patients with pelvic ES after radiotherapy as the primary local treatment in combination with a temporary intrapelvic surgically placed tissue expander (TE) to reduce bowel complications. Materials and methods: 20 patients were retrospectively analysed. All patients had neoadjuvant and adjuvant chemotherapy. We identified survival, time to develop local recurrence and metastasis, dose of radiotherapy administered, local complications related to the use of the tissue expander and bowel effects of radiotherapy. Results: The median follow-up was 41 months. 14 patients were stage IIb and six stage III. There were no problems after insertion of the TE and only one patient who developed mild diarrhoea. Local recurrence occurred in six patients. At the last follow-up 12 patients have died from sarcoma, five are disease free and three have had recurrent disease. Conclusions: In this paper we reviewed pelvic Ewing sarcoma with all the special considerations that this entails. We think that tissue expander can be safely used when radiotherapy is chosen to treat pelvic ES. It does appear to prevent bowel problems and is a low morbidity procedure. New treatment approaches should be considered to give a chance of cure to those patients with “bad prognostic” pelvic ES. [Copyright &y& Elsevier]

Abstract: A best evidence topic was written according to a structured protocol. The question addressed was whether there is a survival benefit from life-long follow-up after treatment for thyroid cancer. A total of 137 papers were identified using the reported searches of which 7 represented the best evidence to answer the clinical question. The authors, date, journal, study type, population, main outcome measures and results are tabulated. The existing guidelines for follow-up in thyroid cancer recommend life-long follow-up as recurrence may present after 5 years. However, the strategy of life-long follow-up for everyone (as advised by the British, European and American Thyroid Association guidelines) is not evidence-based. The issue is that some of the recurrences may present after 5 years and low volume recurrence may be more effectively treated. However, as in many other malignancies, there is no study that reliably shows a survival benefit conferred from life-long follow-up, especially in stage 1 disease. Moreover, the risk of recurrence only parallels the risk of disease-specific mortality in the older thyroid cancer patient group (>45 years at diagnosis). The evidence from the present review supports a risk stratified approach to follow-up for thyroid cancer since low-risk thyroid cancer is associated with low recurrence rates and mortality compared to the other groups. For young patients (<45 years at diagnosis) with stage 1 disease, there is no proven survival benefit from life-long follow-up following primary treatment. These patients could be safely discharged to primary care after 5 years for follow-up with yearly thyroglobulin measurements. [Copyright &y& Elsevier]

Abstract: Improved disease-free survival for oral squamous cell carcinoma (SCC) with the use of postoperative radiotherapy (PORT) has to be balanced against the risk of recurrence, the relative morbidity of radiotherapy, reduced options for treatment, and survival with recurrent disease. In the absence of randomised trials, a review of current evidence is timely because of increasing differences in outcome and response to treatment for cancers of the larynx, oropharynx, and oral cavity. From a search of 109 papers, 25 presented relevant data in tabular form, and reported local, regional, and total recurrence, and overall survival. Most data come from non-randomised studies that compared the effects of interventions with previous or historical information. A summary of the results shows local recurrence of 11%, 17%, and 15% for early, late, and all stages after operation alone, compared with 13%, 16%, and 19% after PORT. Regional recurrence is reported as 13%, 12%, and 11% for early, late, and all stages after operation alone compared with 6%, 11%, and 9% after PORT. Overall survival is reported as 76%, 74%, and 77% for operation alone compared with 65%, 62%, and 62% for early, late and all stages of oral SCC, respectively. It is acknowledged that this is a weak level of evidence as patients who have PORT probably have a high pathological-stage of disease. Knowing that PORT increases morbidity and reduces salvage rates and options for treating recurrent disease, this difference in overall survival emphasises the need for randomised studies or a re-evaluation of our current protocols. [Copyright &y& Elsevier]

Abstract: Background: The main priorities in the surgical treatment of patients with breast cancer are to achieve cure, local control and prevent recurrence. It is increasingly important to address quality of life and self-image with women undergoing surgical intervention for breast cancer. There is a lack of consensus as to the oncologic safety of immediate breast reconstruction (IBR). The purpose of this paper is to systematically review the literature and compare the frequency of recurrence in patients with and without IBR following mastectomy for breast cancer. Methods: Two independent investigators searched PubMed, Embase, and the Cochrane database using predefined search terms. After application of inclusion and exclusion criteria, 10 articles remained. Each article was assessed for quality. Relevant data was collected including recurrence rates, cancer stage, type of mastectomy and reconstruction, adjuvant treatments, and duration of follow-up. Results: Inter-rater reliability was good at 74% (95% CI: 0, 93%). There was no evidence of study heterogeneity (p for Q-statistic=0.34 and I 2 =12%). The OR ratio for recurrence of breast cancer for mastectomy with IBR as compared to mastectomy alone was 0.98 (95% CI: 0.62, 1.54). Conclusion: This meta-analysis demonstrated no evidence for increased frequency of local breast cancer recurrence with IBR compared with mastectomy alone [Copyright &y& Elsevier]

Background: Approximately 300 cases of leiomyosarcoma of the inferior vena cava (IVC) have been reported in the literature to date. In this study, we combined the experience from 2 institutions to provide additional clinical outcomes data. Methods: We performed a retrospective analysis from 1984 to 2009 that included 17 patients treated between the 2 institutions. Clinicopathologic data, surgical and adjuvant therapy, and survival outcomes were obtained. Results: The median age of patients in the study was 48 years. The tumor location was infrarenal in 8 patients, juxtarenal in 6, and suprahepatic in 2 patients; 7 patients had high-grade tumors. All patients underwent complete resection; the IVC was repaired primarily in 5 patients, ligated in 5, and reconstructed with a prosthetic tube graft in 7 patients. There was no perioperative mortality; 6 patients had complications. Median follow-up was 49 months; median survival had not been reached when this paper was written. The 5-year overall and disease -free survival were 56% and 37%, respectively. Of the 17 patients, 10 experienced disease recurrence and underwent numerous treatment modalities for these recurrences. Conclusion: Aggressive resection of primary leiomyosarcoma of the IVC can be performed safely and result in long-term survival, irrespective of IVC management. Despite high recurrence rates, no consensus yet exists regarding adjuvant treatment. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Ameloblastoma is rare worldwide. Delayed treatment can result in significant morbidity from facial deformity and infiltration of adjacent tissues. Mortality can occur from invasion of vital structures in the head and neck, super infection, recurrent and even distant metastases. Recurrence after radical treatment is not common. Case report: This paper presents a case of soft issue recurrence in the chin 21 years after radical resection of the mandible for ameloblastoma. The iliac crest bone grafted to the site was not involved in the tumour recurrence. Conclusion. Radical surgical resection is accepted treatment for solid/multicystic ameloblastoma. However, the surgical review should be for life as recurrence can occur after a long interval. [Copyright &y& Elsevier]

Abstract: CD133+ cells in glioblastoma (GBM) display cancer stem cell-like properties and have been considered as the culprit of tumor recurrence, justifying exploration of potential therapeutic modalities targeting CD133+ cancer stem-like cells (CSCs). For photothermolysis studies, GBM-CD133+ and GBM-CD133– cells mixed with various ratios were challenged with single-walled carbon nanotubes (SWNTs) conjugated with CD133 monoclonal antibody (anti-CD133) and then irradiated with near-infrared laser light. Results show that GBM-CD133+ cells were selectively targeted and eradicated, whereas GBM-CD133– cells remained viable. In addition, in vitro tumorigenic and self-renewal capability of GBM-CD133+ treated with localized hyperthermia was significantly blocked. Furthermore, GBM-CD133+ cells pretreated with anti-CD133-SWNTs and irradiated by near-infrared laser 2 days after xenotransplantation in nude mice did not exhibit sustainability of CSC features for tumor growth. Taken altogether, our studies demonstrated that anti-CD133-SWNTs have the potential to be utilized as a thermal-coupling agent to effectively target and destroy GBM CSCs in vitro and in vivo. From the Clinical Editor: Glioblastoma remains one of the most notorious cancer from the standpoint of recurrence and overall resistance to therapy. CD133+ stem cells occur among GBM cells, and may be responsible for the huge recurrence risk. This paper discusses a targeted elimination method of these cells, which may enable more efficient therapy in an effort to minimize or prevent recurrence. [ABSTRACT FROM AUTHOR]

Abstract: Fractionation regimes for individual tumour sites have varied greatly across the UK for many years. This has been particularly true for breast cancer which accounts for up to 40% of a radiotherapy department’s work load. Over the last 30 years or so many UK oncology centres have coped with this large case load and a lack of megavoltage machines by reducing fractionation and routinely using internationally non standard regimes so that these regimes have themselves become one of the options for standard treatment. Nowadays, medicine is largely evidence based rather than historically relying more on clinical experience or intuition. Large studies particularly in the UK and Canada set out to address this question and have shown that fewer fractions are equivalent in terms of local recurrence, late tissue effects and cosmesis. Current studies are focusing on further hypofractionation and partial breast radiotherapy (see papers Yarnold (2010) Is it safe to push “hypofractionation” further?. The Breast (this issue). Lehman (2010) The less than whole breast radiotherapy approach. The Breast (this issue)). [Copyright &y& Elsevier]

Summary: Introduction: GBM is the comment glioma. GBM-outcome had not changed much over two decades despite leaps in medical technology. Fewer than 25% survive 2 years. There is no jacket that fits all GBMs. This paper reviews the evidence for PDT in GBMs. Rationale: Maximum safe resection is supported by level-II evidence. PDT-technology (PDTT) provides means to maximize safe resection. PDTT paints GBM red in contrast to brain because of selective uptake and retention of photosensitizers. Exposure to specific light wave produces cytotoxic singlet oxygen. PDT-applications: [(1)] Fluorescence image guided biopsy to sample high grade components of what looks like low grade glioma on MRI, 89% sensitive. [(2)] Fluorescence image guided surgery for maximum safe surgical resection is >84% sensitive, achieves complete resection in >65% and prolongs tumor free survival (1 observational and 2 RCT, p <0.001). [(3)] Photodynamic treatment supported by several observational studies with combined total of >1000 patients and 3 RCT used PDT in GBMs. PDT was highly selective, safe, significantly improved good quality survival, and delayed tumor relapse (p <0.001). Safety: PDT had a very high safety track record, thromboemolism 2%, brain-oedema 1.3%, and skin photosensitivity complications 1–3%. Conclusion: PDT in GBMs is safe, selective, and sensitive and leads to significant prolongation of good quality survival, delay in tumor relapse and significant reduction of further interventions. It would be impractical, impossible and probably unethical to randomize patients between PDT and placebo, in the same way it would be unethical to carry out a RCT to prove that the parachute saves lives. [Copyright &y& Elsevier]

Abstract: Reduction in the duration of a study and in the number of patients required can be obtained when we adopt a sequential design. In this paper we re-analyse a trial completed by the British Medical Research Council on the effects of chemotherapy to prevent the recurrence of surgically removed superficial bladder cancer as if it had been monitored sequentially. The aim is to illustrate the use and benefits of sequential designs (stopping rules) and to highlight how to handle some potential problems when the assumptions of the statistical model are not satisfied. These problems are not exclusive to the sequential design, but are also present when a conventional design is used. [Copyright &y& Elsevier]

Abstract: Breast cancer is now considered to be a systemic disease from the outset, with no correlation seen between the intensity of local treatment and survival or recurrence. Adjuvant therapy has clearly demonstrated a reduction in local and distant relapse; neoadjuvant therapy is similarly being assessed. It aims to treat occult metastases and decrease tumour bulk. Its use has demonstrated down-staging of the tumour with increased rates of breast-conserving surgery. Though neoadjuvant therapy seems to be associated with an increase in loco-regional recurrence compared to adjuvant therapy, no overall difference in survival has been demonstrated. This paper reviews several trials that compare neoadjuvant to adjuvant therapy, and the controversies around managing the axilla in the neoadjuvant setting. [Copyright &y& Elsevier]

Abstract: Background: Primary adenocarcinomas of the parotid gland are rare and account for less than 5% of all head and neck malignant neoplasms. There is considerable variation in biological behaviour within this group; low-grade tumours exhibit slow growth rates with minimal or no local invasion. High-grade tumours, however, show a high incidence of local recurrence and distant metastasis. Aim: The purpose of this paper is to analyse the important prognostic indicators for this cancer. Methods: A systematic review was performed involving 19 published studies from 1987 to 2005 which included 4631 patients. T stage, grade of tumour, N stage and adjuvant radiotherapy on overall (5year) survival were analysed as prognostic indicators. Results: T stage (p =0.041, hazard ratio 1.8 (confidence interval 1.2–2.9)), N stage (p =0.05, hazard ratio 1.1 (0.2–1.8)), and high-grade (p =0.001, hazard ratio 2.1 (1.5–2.7)) were associated with a significantly worse survival. The effect of adjuvant radiotherapy was to improve overall survival: p =0.002, hazard ratio 2.9 (1.5–4.7). The mean 5year survival for advanced high-grade parotid cancer was 35%. Conclusion: High-grade advanced parotid cancers are associated with a poor survival. Adjuvant radiotherapy is indicated in these tumours and this improves survival. [Copyright &y& Elsevier]

PURPOSE: To carry out a systematic review on the treatment outcome of buccal squamous cell carcinoma (BSCC) treated with or without neck treatment and with or without radiotheraphy after surgery using Meta analysis. METHODS: The following words were used for electronic searching, buccal mucosa/ squamous cell carcinoma/ treatment/ therapy/ radiotherapy/ chemotherapy/ combined therapy/ neck dissection/ prognosis within the databases of PubMed, CCTR, CNKI, VIP Information. RESULTS: 11 of 118 papers searched out were selected based on the entrance criteria. Relative risk (RR) of recurrence rate and odds ratio (OR) of survival rate under the condition with/without neck treatment or radiotherapy after surgery was analyzed using the software RevMan4.2.10. CONCLUSIONS: It is recommended that simultaneous neck dissection should be performed for BSCC patients with early stage. Neck dissection and postoperative radiotherapy should be routinely performed for BSCC patients with advanced stage or pathologic positive nodes or positive margin. [ABSTRACT FROM AUTHOR]

Background: Continued smoking in cancer patients undergoing treatment results in significantly higher rates of treatment toxicities and persistent effects, increased risk of recurrence and second malignancy, and increased all-cause mortality. Despite this, routine tobacco use screening and the provision of smoking cessation treatment has yet to be implemented widely in the cancer setting.Objective: The objective of this study was to implement and evaluate the adoption and impact of an innovative Smoking Cessation e-referral System (CEASE) to promote referrals to smoking cessation programs in cancer patients.Methods: A patient-directed electronic smoking cessation platform (CEASE) was developed to promote smoking screening and referral and implemented at 1 of Canada's largest cancer centers. The implementation and evaluation were guided by the Ottawa Model of Research Use. An interrupted time series design was used to examine the impact of CEASE on screening rates, referrals offered, and referrals accepted compared with a previous paper-based screening program. A subsample of smokers or recent quitters was also assessed and compared pre- and postimplementation to examine the effect of CEASE on subsequent contact with smoking cessation programs and quit attempts.Results: A total of 17,842 new patients attended clinics over the 20-month study period. The CEASE platform was successfully implemented across all disease sites. Screening rates increased from 44.28% (2366/5343) using the paper-based approach to 65.72% (3538/5383) using CEASE (P<.01), and referrals offered to smokers who indicated interest in quitting increased from 18.6% (58/311) to 98.8% (421/426; P<.01). Accepted referrals decreased from 41% (24/58) to 20.4% (86/421), though the overall proportion of referrals generated from total current/recent tobacco users willing to quit increased from 5.8% (24/414) to 20.2% (86/426) due to the increase in referrals offered. At 1-month postscreening, there was no significant difference in the proportion that was currently using tobacco and had not changed use in the past 4 weeks (pre: 28.9% [24/83] and post: 28.8% [83/288]). However, contact with the referral program increased from 0% to 78% in the postCEASE cohort (P<.001).Conclusions: CEASE is an innovative tool to improve smoking screening and can be implemented in both a time- and cost-effective manner which promotes sustainability. CEASE was successfully implemented across all clinics and resulted in improvements in overall screening and referral rates and engagement with referral services. [ABSTRACT FROM AUTHOR]

It has been associated with a wide spectrum of diseases such as type 2 diabetes mellitus, obesity, drugs and malignancies (Malignant Acanthosis Nigricans, MAN). MAN regression is observed in 90-95% of patients who undergo treatment of the primary tumour: the skin lesions usually are resistant to conventional treatments such as corticoids or vitamin D. Although in literature there are several cases of MAN in patients with primary gastric neoplasm, to our knowledge only one paper reports the development of MAN in gastric cancer recurrence (Tab. It could be therefore considered pathognomonic for tumour recurrence in elder patients with positive history for abdominal neoplasms. [Extracted from the article]

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Abstract: Cancer recurrence is one of the most important causes of cancer-related deaths. In present, it has been revealed that there exist some factors especially opioids being able to affect the recovery of cancer patients in a long period. As the most commonly used potent analgesics in practice, morphine appears to be of crucial importance in the regulation of neoplastic tissues by modulating immune responses and promoting angiogenesis. Indeed, regulatory T cells have been shown to inhibit the response of the immune system to tumor and thereby to worsen prognoses. Some reliable evidences indicate that morphine acts directly on regulatory T cells through VEGFR 2 and opioid receptors present in, both of which play a vital role in the cancer recurrence. In addition, morphine might have a noticeable effect on regulatory T cells by regulating the function of some other immune cells or cytokines, TGF-β and IL-2 for instance. Thus, this paper speculates that morphine could induce cancer recurrence by disturbing the behavior of the regulatory T cells and provides a logical reasoning. [Copyright &y& Elsevier]

Abstract: Glomus tympanicum (GT) tumors are usually characterized by pulsatile tinnitus and hearing loss. We report on a woman 53 years of age who was diagnosed with a GT tumor within her right ear with no associated tinnitus or hearing loss on presentation. An early GT tumor without the characteristic symptoms is seldom encountered. Although several papers have dealt with GT tumor diagnosis and management, very few have demonstrated such a condition in which the entire GT tumor appeared in the middle ear cavity and was totally removed during the operation. There was no recurrence at 24 months of follow-up. We describe a novel surgical technique in this article and demonstrate an en bloc GT surgical removal that has been seldom published before in the literature. [Copyright &y& Elsevier]

Oral cancer patients with recurrence or distant metastasis often present poor prognosis. Majority of advanced oral cancer patients suffer from treat-related adverse events and drug resistance. For those patients, the survival time and quality of life are urgent to be improved. Anlotinib, as a multi-targets tyrosine kinase inhibitor (TKI), has been demonstrated to be effective in many refractory tumors by inhibiting tumor angiogenesis and partial functions of tumor cells. In this paper, we performed CCK-8 assay, wound healing assay and transwell assay to explore the effect of anlotinib on human tongue squamous carcinoma Tca8113 cell line. Preliminary data indicated that anlotinib significantly inhibited Tca8113 cells proliferation, migration and invasion in vitro. Together, we proposed a hypothesis that anlotinib might be effective in prolonging survival time of patients with advanced oral cancer. [ABSTRACT FROM AUTHOR]

Luminal breast cancers demonstrate significant molecular and clinical heterogeneity, despite the commonality of shared expression of the estrogen receptor (ER). To date, no clinical trial has prospectively investigated the optimal chemotherapy regime according to luminal type, highlighting a paucity of data furthermore required to guide treatment decisions. Current methods of predicting advantage from adjuvant chemotherapy lack refinement and can over-estimate the risk of relapse, inevitably leading to a proportion of patients being unnecessarily exposed to chemotherapy. This paper will explore the evidence behind modalities which may add further value to existing known clinicopathological and molecular profiling techniques in predicting clinical benefit from chemotherapy. Adjuvant chemotherapy regime choice in the context of early luminal breast cancer types will be discussed, and areas for further research and debate identified. [ABSTRACT FROM AUTHOR]

Thyroid nodules can be frequently detected in general population, most of them are benign, however malignant cases are rising in the past decades. Ultrasound (US) is the most common imaging modality to assess thyroid nodular lesions, plan patient work-up and guide minimally invasive treatment. The present review paper has been researched to evaluate the current status of radiofrequency ablation (RFA) treatment in order to evaluate indications, techniques, complications, limitations and outcome assessment in benign solid, partially cystic nodules and recurrent malignant nodules. RFA comparison with other ablation techniques has been provided as well. US guided Radiofrequency ablation has been proved to be effective and safe in cases of benign thyroid nodules and a promising treatment method alternative to surgery for patients with recurrent papillary thyroid cancer. It's major role lies in significant reduction of thyroid nodule mean volume and improvement of the patient symptoms. However, future multicenter studies are warranted to better clarify the multi-parametric patient selection criteria and evaluate RFA technique efficacy, advantages and limitations in the variety of thyroid nodular disease. [ABSTRACT FROM AUTHOR]

Adjuvant endocrine therapy (ET) reduces the odds of distant recurrence and mortality by nearly one-half in women with hormone receptor (HR) positive early stage breast cancer. While the risk of recurrence is lower for HR positive than negative patients during the first 5–7 years, HR positive patients suffer ongoing recurrences between 0.5 and 2% year over subsequent years. Extended adjuvant ET further reduces recurrence during this late phase of follow-up. ET is associated with post-menopausal side effects (hot flashes, sexual dysfunction, mood changes, and weight gain), and occasional major toxicities (thrombosis and endometrial cancer with tamoxifen; bone mineral loss and possibly heart disease with AIs) persist throughout therapy. Accurate and reliable estimates of the risk of recurrence after five years of ET for women with prior HR positive breast cancer would permit appropriate extended ET decisions. The risk of long-term relapse is related to lymph node status and size of tumor, but these are relatively crude. Several groups have investigated whether multi-parameter tumor biomarker tests might identify those patients whose risk of recurrence is so low that extended ET is not justified. These assays include IHC4, the 21-gene “OncotypeDX”, the 12-gene “Endopredict,” the PAM50, and the 2-gene “Breast Cancer Index (BCI)” assays. The clinical validity of all these tests for this use context have been established, with at least one paper for each that shows a statistically significant difference in risk of distant recurrence during the 5–10 years after the initial five years of adjuvant endocrine therapy. However, the stakes are high, and although each of these represents a “prospective retrospective” study, they require further validation in subsequent datasets before they should be considered to have “clinical utility” and are used to withhold potentially life-saving treatment. Perhaps more importantly, the clinical breast cancer community, and especially the patient, need to determine how low the risk of late recurrence needs to be to forego the toxicities and side effects of extended adjuvant ET. [ABSTRACT FROM AUTHOR]

Abstract: Ameloblastomas have a high recurrence rate, and because of their biological tendency towards local invasion are considered borderline tumours. Despite this, reports of metastasis of these tumours are rare. This report presents a patient with mandibular ameloblastoma that recurred 29 years after surgery and metastasized to both lungs. Because of the large range of the area of metastasis, complete surgical resection of the tumours was impossible. After confirming the diagnosis by biopsy of the pulmonary lesions the pulmonary metastases were not treated actively. Observation over 4 years showed no obvious change in the lung metastasis. Recent cases are summarized and analyzed in this paper, with respect to its occurrence, pathological types, methods of treatment and other related aspects. [Copyright &y& Elsevier]