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Resumen Objetivos La mayoria de los ensayos clinicos realizados sobre pacientes con cancer escamoso anal (CEA) excluyen pacientes inmunodeprimidos. El objetivo del presente estudio es comparar las caracteristicas y los resultados oncologicos entre pacientes con CEA inmunocomprometidos e inmunocompetentes. Metodos Estudio multicentrico comparativo retrospectivo que incluye 2 cohortes consecutivas de pacientes, inmunocomprometidos e inmunocompetentes, diagnosticados de carcinoma escamoso anal. Se han investigado las caracteristicas de los pacientes, los tratamientos realizados, la respuesta clinica al tratamiento con quimiorradioterapia (QRT), la recidiva local o a distancia, la supervivencia global (SG) y la supervivencia libre de enfermedad (SLE). Resultados De enero 2012 a diciembre 2017 hemos estudiado a 84 pacientes, 47 (55,6%) mujeres, afectos de CEA, de los cuales 22 (26%) han sido pacientes inmunocomprometidos y 62 (74%) inmunocompetentes. Los pacientes inmunocomprometidos fueron mas jovenes (53 vs. 61 anos; p = 0,001), con un menor tamano tumoral (p = 0,044), y presentaban un mayor consumo de tabaco (p = 0,034) y de drogas de uso parenteral (p = 0,001). No se objetivaron diferencias significativas en los tratamientos administrados (p = 0,301), tampoco difirio la respuesta clinica a la QRT (83 vs. 100%). Tampoco se observaron diferencias significativas en la supervivencia global (60 vs. 64%; p = 0,756) o en la supervivencia libre de enfermedad a 5 anos (SLE) (65 vs. 68%; p = 0,338). Conclusiones En el presente estudio no se observaron diferencias significativas en relacion con los resultados oncologicos a largo plazo entre pacientes inmunocompetentes e inmunocomprometidos diagnosticados de CEA, con un grado de cumplimiento del tratamiento similar. Esta evidencia podria deberse al estrecho seguimiento y buen control terapeutico de pacientes infectados por HIV.

Background: Smoking participates in pathogenesis of lung cancer. Long non-coding RNAs (lncRNAs) play some specific roles during development of lung cancers. Objective: To investigate effects of smoking on lncRNA alterations in lung cancer. Methods: There are 522 lung adenocarcinoma (LUAD) and 504 lung squamous cell carcinoma (LUSC) participants. Clinical and lncRNA genetic data were downloaded from The Cancer Genome Atlas (TCGA) database. LncRNA alterations were analyzed in lung cancer patients. Smoking category and packs were evaluated. Correlations between smoking and LncRNA alterations were analyzed. Kaplan-Meier analysis was performed to determine overall survival and disease free survival. Results: There are more non-smokers in LUSC than in LUAD. In both LUAD and LUSC, smoking could increase total mutation counts and fraction of copy number alterations. Smoking index positively correlated with total mutations in LUAD, but not in LUSC. Smoking could trigger lncRNA alterations both in LUAD and LUSC. Smoking regulated different lncRNA between male and female. EXOC3-AS1 and LINC00603 alterations were positively correlated with smoking index in male LUAD smokers. In female LUAD smokers, smoking index was positively correlated with SNHG15, TP53TG1 and LINC01600 and negatively with LINC00609 and PTCSC3. In both male and female LUSC patients, smoking increased or decreased several lncRNA alterations. DGCR5 alteration increased in male LUSC than in female LUSC patients. In female LUSC patients, LOH12CR2 alteration was positively correlated with smoking index. Conclusions: Smoking promoted LUAD and LUSC development by affecting different lncRNA alterations in different genders.

Objective To examine the performance of Leibovich score versus GRade, Age, Nodes, and Tumor score in predicting disease recurrence in renal cell carcinoma. Methods In total, 7653 patients diagnosed with renal cell carcinoma from 2010 to 2018 were captured in the nationwide DaRenCa database; 2652 underwent radical or partial nephrectomy and had full datasets regarding the GRade, Age, Nodes, and Tumor score and Leibovich score. Discrimination was assessed with a Cox regression model. The results were evaluated with concordance index analysis. Results Median follow-up was 40 months (interquartile range 24-56). Recurrence occurred in 17%, and 15% died. A significant proportion of patients (36%) had missing data for the calculation of the Leibovich score. Among 1957 clear cell renal cell carcinoma patients the distribution of GRade, Age, Nodes, and Tumor score of 0, 1, 2, or 3/4 was 21%, 56%, 21% and 1.4%, respectively, and for Leibovich score of low/intermediate/high this was 47%, 36% and 18%, respectively. A similar distribution was seen in 655 non-clear cell patients. Both Leibovich and GRade, Age, Nodes, and Tumor scores performed well in predicting outcomes for the favorable patient risk groups. The Leibovich score was better at predicting recurrence-free survival (concordance index 0.736 versus 0.643), but not overall survival (concordance index 0.657 versus 0.648). Similar results were obtained in non-clear cell renal cell carcinoma. Conclusion GRade, Age, Nodes, and Tumor and Leibovich scores were validated in clear cell and non-clear cell renal cell carcinoma. Leibovich score outperformed the GRade, Age, Nodes, and Tumor score in predicting recurrence-free survival and should remain the standard approach to risk stratify patients during follow-up when all data are available.

Purpose. The objective of this study is to review randomized clinical trials systematically that compare the outcomes of preoperative and postoperative radiotherapy in the management of rectal cancer regarding locoregional recurrance, disease free survival and overall survival.Methods. The relevant randomized clinical trials are searched via online databases such as Pubmed, Ebsco, and Proquest. RCTs publised in English between 2000 until 2020 are selected and reviewed systematically.Result. Locoregional recurrence at 5 years was statistically lower in preoperative radiotherapy group than in postoperative radiotherapy group based on two studies. Disease free survival at 5-years was statistically higher in preoprative radiotherapy group than the postoperative one based on two studies. Overall survival at 5 years was not statistically significant between two groups for each study.Conclusion. Preoperative radiotherapy is superior to postoperative radiotherapy for controlling locoregional recurrence and disease free survival, but both are equal in overall survival.

Introduction Colorectal cancer (CRC) is the third most common cancer, accounting for approximately 10% of all cancer deaths. The incidence of CRC in young adults and the adolescent population is increasing. This study aims to highlight short-term outcomes for young patients with CRC. Methods Data were collected retrospectively for all patients aged less than 50 years diagnosed with CRC at a university teaching hospital between October 2012 and June 2018. The primary endpoints were disease-free survival (DFS) and overall survival (OS). Results A total of 120 patients (65 males, 55 females) with CRC aged under 50 years were initially included; 20 did not receive surgical treatment (12 metastatic adenocarcinoma, 5 metastatic squamous cell cancer (SCC), 3 neuroendocrine tumours (NET)), and 13 patients had insufficient data for analysis and were excluded. A total of 87 patients underwent surgical intervention and 66 with diagnosis of adenocarcinoma were included in survival analysis. Median age of patients was 42 years (19–49 years). Cancer recurrence was seen in 14 patients, 10 showing local, 3 liver and 1 lung metastasis. The median OS was 28 months (3–156 months). The median DFS was 13 months (3–85 months). Overall 5-year survival and DFS were 72% and 59%, respectively. Median survival in the group who did not undergo surgery was 4.5 months (1–15 months). Conclusions CRC is often more advanced and aggressive in younger patients. Current guidelines can result in young patients being investigated/treated for other gastrointestinal conditions before referral for CRC investigation.

Asmaa M Zahran,1 Omnia El-Badawy,2 Lamiaa M Kamel,3 Amal Rayan,4 Khalid Rezk,5 Mona H Abdel-Rahim2 1Department of Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 2Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 4Clinical Oncology Department, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Surgical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, EgyptCorrespondence: Amal Rayan Email amal3774rayan@gmail.com; amalrayan@aun.edu.egBackground and Aim: The present study was conducted to evaluate the number of Tregs in triple negative breast cancer (TNBC), in normal breast parenchyma and in the peripheral blood of these patients and controls, in addition to their correlations with the clinico-pathologic features and the outcomes of TNBC.Methods: Thirty adult treatment-naïve women with non-metastatic TNBC were recruited. In addition, 20 ages matched healthy females participated as a control group. Peripheral blood samples were collected from all participants in tubes containing heparin, fresh tumor tissues were also obtained from all patients undergoing surgery, and 20 normal breast tissue samples were obtained from the same patients’ areas adjacent to the safety margins; all these samples were taken for flow cytometric detection of Tregs.Results: The mean percentages of CD4+CD25+highT cells and Tregs were higher in TNBC peripheral blood than healthy controls and in malignant tissue than normal tissue. Moreover, the frequencies of tumor-infiltrating CD4+T cells and Tregs were exceeding those in the peripheral blood of cancer patients. Only tumor-infiltrating Tregs have shown increasing levels with the increase in the tumor size and were significantly higher in patients with local recurrences than those without recurrence. In addition, Tregs showed significant inverse relation with DFS and direct relation with the level of the peripheral Tregs.Conclusion: The findings of the current study support the possibility that TNBC microenvironment conveys specific characteristics on Tregs distinguishing them from those in normal breast tissue or Tregs in peripheral blood, improving the capabilities of tumor-infiltrating Tregs to enhance tumor growth, local recurrence and reduce the DFS.Keywords: triple negative breast cancer, Tregs, disease free survival, recurrences

Background The expression of S100A8 and S100A9 is found to be related with the survival of cancer patients, but the results and information regarding their prognostic significance are inconsistent in literature. This study, therefore, aimed to perform a comprehensive meta-analysis and determine the prognostic significance of S100A8 and S100A9 expression in patients with cancer. Methods Data were collected by performing a literature search on the PubMed, Cochrane library, and Scopus databases. Pooled hazard ratio (HR) with confidence interval (CI) was calculated to assess the correlation between S100A8 and S100A9 expression and survival in patients with cancer. Results In total, 5 studies that enrolled 735 cancer patients were included in the meta-analysis. The pooled HR concerning S100A8 and S100A9 expression was 1.98 (95% CI: 1.20–3.29, P=0.008) for disease-free survival (DFS), indicating an association between high expression of S100A8 and S100A9 and poor DFS in cancer patients. However, the expression of S100A8 and S100A9 was not significantly correlated with disease-specific survival (HR 1.71, 95% CI: 0.86–3.40, P=0.128). Discussion The current meta-analysis revealed that S100A8 and S100A9 expression may be a potential prognosticator of DFS in cancer patients. The present systematic review is the first to investigate the survival outcomes of cancer patients with S100A8 and S100A9 expression.

Introduction: The objective of our study was to identify the clinicopathologic factors that are associated with increased risk of recurrence in borderline ovarian tumors (BOTs). Materials and Metho...

Background Triple negative breast cancer (TNBC) which is treated with taxane, adriamycin and cyclophosphamide (TAC) chemotherapy regimen show variation in treatment response. CYP1B1 4326 C>G polymorphism has been implicated in contributing to the differences in treatment response in various types of cancers. Aim The objective of the present study was to investigate whether this polymorphism modulate the risk of disease recurrence in TNBC patients undergoing TAC chemotherapy regimen. Methods Blood samples of 76 immunohistochemistry confirmed TNBC patients were recruited. The genotyping of CYP1B1 4326 C>G polymorphism was carried out using PCR-RFLP technique. The genotype patterns were categorized into homozygous wildtype, heterozygous and homozygous variant. Kaplan-Meier analysis followed by Cox proportional hazard regression model were performed to evaluate the TNBC patients' recurrence risk. Results Out of 76 TNBC patients, 25 (33.0%) showed disease recurrence after one-year evaluation. Kaplan Meier analysis showed that TNBC patients who are carriers of CYP1B1 4326 GG variant genotypes (37.0%) had a significantly lower probability of disease-free rates as compared to TNBC patients who are carriers of CYP1B1 4326 CC/CG genotypes (71.0%). Univariate and multivariate Cox analysis demonstrated that TNBC patients who carried CYP1B1 4326 GG variant genotype had a significantly higher risk of recurrence with HR: 2.50 and HR: 4.18 respectively, even after adjustment as compared to TNBC patients who were carriers of CYP1B1 4326 CC and CG genotypes. Conclusion Our results demonstrate the potential use of CYP1B1 4325 GG variant genotype as a candidate biomarker in predicting risk of recurrence in TNBC patients undergoing TAC chemotherapy regimen.

Purpose:We investigated whether T2-weighted magnetic resonance imaging findings could improve upon established prognostic indicators of metastatic disease and prostate cancer specific survival.Mate...

Background and Aim: In 10–30% of colorectal cancer (CRC) patients, toxic reactions occur after fluoropyrimidine-based chemotherapy. A dihydropyridine dehydrogenase (DPYD) gene variant, c.1905 + 1G>...

In the present study, the potential of Raman spectroscopy (RS) in predicting disease-free survival (DFS) in oral cancer patients has been explored. Raman spectra were obtained from the tumor and contralateral regions of 94 oral squamous cell carcinoma patients. These patients were managed surgically and recommended for adjuvant therapy. The Cox proportional survival analysis was carried out to identify the spectral regions that can be correlated to DFS. The survival analysis was performed with 95% confidence intervals, hazard ratio, and p-values in the 1200-1800 cm-1 spectral region. Out of a total of 182 spectral points, 76 were found to be correlating with DFS, suggesting their utility to predict the patient outcome. The cut-off points of each correlating RS-point values were defined and tested towards predicting the DFS. The performance of predicting the power of spectral points was validated through Brier value, and it was found to be closer to the actual progression. The 76 spectral points identified from the tumors have the potential to accurately predict DFS in oral squamous cell carcinoma through a relatively simplistic prediction model in the absence of confounding factors.

Introduction: The purpose of our study is to identify the association between body mass index (BMI) and absolute lymphocyte count (ALC), and to determine the effect of these two factors on the prognosis of breast cancer patients.Methods: We retrospectively identified 16,375 healthy female and 1,226 primary invasive breast cancer patients from Gangnam Severance Hospital. BMI and complete blood count (CBC) information at the time of diagnosed was collected. A multivariate Cox proportional hazard model was used to variable associated with disease-free survival (DFS).Results: BMI and ALC has positive correlation in breast cancer patients as well as health female (both P < .001). However, the effect of BMI and ALC on prognosis was the opposite. Overweight and obese had worse DFS (HR, 2.00; 95% CIs, 1.36-2.96; P < .001) than underweight or normal weight, but patients with high ALC had better DFS than those with low ALC (HR, 0.42; 95% CIs, 0.28-0.63; P < .001). When the risk stratification group was divided according to BMI /ALC, the high-risk group who had high BMI and low ALC had worse DFS than low-risk group (HR, 2.61; 95% CIs, 1.51-4.51; P = .001). In subgroup analysis, Her2-overexpressing and early stage tumor was more affected by BMI/ALC.Conclusions: The impact of BMI and ALC on prognosis in breast cancer was the opposite although BMI and ALC had positive correlation. Patients with high BMI and low ALC had worse DFS than others. Weight management is essential to breast cancer patients, and additional study about correlation between BMI and ALC affecting prognosis is needed in the future. Citation Format: Sung Min Ko. The significance of body mass index and absolute lymphocyte count as a prognostic factor for disease-free survival in Korean breast cancer patients [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS6-44.

Background: Breast cancer is the most common cancer worldwide. There has been emerging interest in studying differences in breast tumor phenotypes between South Asian and South American women given that racial/ethnic disparities in incidence and mortality have been demonstrated in multiple studies. South Asian women are more likely to be diagnosed with an advanced stage breast tumor despite lower incidence than in North American women. There is evidence that computer-extracted nuclear morphological features on H&E slide images may be associated with breast cancer aggressiveness, specifically recurrence and disease free survival. However, studies have mostly focused on North American women. In this work, we evaluated whether there is a difference in computer extracted features of nuclear morphology from H&E tissue slide images between South Asian (SA) and North American (NA) women and we also investigated how these differences could impact the development of population specific breast cancer prognostic models. Methods: H&E slides of breast tumors from patients who were diagnosed with ER+ early stage invasive breast cancer from Tata Memorial Centre, India (SA: 69 (20 recurrence)) and from University Hospitals Cleveland Medical Center (NA: 121 (20 recurrence)), along with outcome information were collected. All slides were digitized on either a Ventana DP 200 or a Roche Ventana iScan HT slide scanner. For each image, a conditional Generative Adversarial Network model was employed to segment the individual nuclei, which were used to generate 241 nuclear features including nuclear architecture, shape, orientation disorder, and texture features. Half of the patients (95) were randomly selected as the training set (Stra) with the remaining patients as the hold-out validation set (Stest). Three elastic net regularized Cox regression models (MSA, MNA, MSA+NA) were trained fitting between the nuclear features and disease free survival (DFS) respectively for SA subset, NA subset, and SA & NA set in Stra. The top five prognostic features were identified respectively from each of the three models (MSA, MNA, MSA+NA) which were further validated on Stest to evaluate their prognostic value in prediction of DFS. Results: We found that the prognostic features identified by MNA and MSA+NA were mostly shape features (three out of five for MNA, four out of five for MSA+NA), while the prognostic features identified by the model specifically trained with the SA population (MSA) were mostly texture features (three out of five), possibly reflecting chromatin patterns in the cell. MSA yielded a better performance (Hazard Ratio=4.99 (p=0.00928, CI=1.32-18.9) from log-rank test between model derived high and low risk categories) on SA population in Stest compared to MNA and MSA+NA. Conclusion: We found that nuclear histomorphometry features were different between breast cancer patients from South Asia and those from North America. The prognostic capability of the computational pathology-based models for South Asian women could be significantly improved by taking into account population-specific information. An additional independent validation set is needed to confirm the preliminary findings presented here. Citation Format: Haojia Li, Kaustav Bera, Paula Toro, Pingfu Fu, Vidya Rao, Shabina Siddique, Aparna Harbhajanka, Haley Sechrist, Zelin Zhang, Sangeeta Desai, Vani Parmar, Anant Madabhushi. Computerized image analysis of nuclear morphological features reveals differences in phenotype and prognosis of disease free survival of early stage ER+ breast cancers for South Asian and North American women [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS4-45.

Purpose: This study aims to analyse disease-free survival, overall survival and risk factors after orbital exenteration in patients with conjunctival and uveal melanoma. Methods: Patients who underwent orbital exenteration due to conjunctival and uveal melanoma were included in this retrospective study (March 2000 to March 2018). Results: A total of 76 patients were enrolled in this study: 60 patients had a conjunctival melanoma and 16 had a uveal melanoma. In conjunctival melanoma, the mean age was 68.4 years. The overall survival rate was 82% after 1 year and 52% after 5 years. Univariate analysis of overall survival found that the following parameters were predictive of a worse prognosis: gender, extent of the primary tumour, lymph node metastases, distant metastases, adjuvant chemotherapy or radiotherapy and relapse. In multivariate analysis, relapse and adjuvant radiotherapy appeared to contribute to a significantly worse prognosis. In uveal melanoma, the mean age was 63.6 years. Eleven patients died during follow-up (mean follow up 30.7 months). The overall survival and disease-free survival rates after 1 year were 62% and 57%, respectively. An analysis of risk factors was not possible due to the small number of cases. Conclusion: Orbital exenterations in conjunctival and uveal melanoma are rarely necessary, but can be performed as an ultima ratio treatment with curative intent. Disease-free survival and overall survival are significantly lower for both groups due to the advanced stage of the disease compared to patients treated without exenteration in the literature. If a recurrence occurs after exenteration, the prognosis is poor in both groups.

Background: Claspin (CLSPN) expression is acknowledged as a poor clinical prognostic factor in various tumors. However, the clinical characteristics and biological functions of CLSPN in prostate ca...

Objective: This study aimed to investigate the roles of MRPL27 in survival from cholangiocarcinoma patients in The Cancer Genome Atlas (TCGA) database. Methods: In TCGA-CHOL profile, MRPL27 gene expression and clinical data were obtained. Cox regression models were used to evaluate the potential links between MRPL27 and cholangiocarcinoma survival. Enrichment analysis of MRPL27 was conducted in Metascape and Gene Set Enrichment Analysis (GSEA) databases. Results: 36 cholangiocarcinoma patients were included in this analysis. MRPL27 mRNA was significantly upregulated in tumor tissues in cholangiocarcinoma patients including intrahepatic, distal and hilar/perihilar cholangiocarcinoma cases (all p < 0.01). Cholangiocarcinoma patients with high MRPL27 had worse overall survival (OS) and disease-free survival (DFS) compared to those with low MRPL27 (all p < 0.05). Univariate and multivariate Cox models indicated that MRPL27 should be a risk factor for the OS and DFS in cholangiocarcinoma patients (both p < 0.01). Bioinformatic analysis revealed that MRPL27 mainly involved in the processes of mitochondrial translation elongation, respiratory electron transport, ATP synthesis, and inner mitochondrial membrane organization. No mutations of MRPL27 were screened in cholangiocarcinoma patients. Conclusion: Upregulated in tumors, MRPL27 contributes to unfavorable survival in cholangiocarcinoma patients.

Objective: CA125 is a commonly used tumor marker in ovarian cancer patients for both diagnostic evaluation and follow-up period. In this study, we investigated the clinical importance of postoperative serum CA125 level normalization in ovarian cancer patients with high preoperative levels in terms of recurrence risk and disease free survival.Materials and Methods: We retrospectively analyzed operated ovarian cancer patients who were followed up in medical oncology clinic of Izmir Katip Celebi University Ataturk Training and Research Hospital between years 2005 – 2013. Two different analyses were done according to different CA125 cut-off levels; 35 IU/ml and 65 IU/ml.Results: There are 132 and 119 patients who had basal CA125 levels above normal (cut-off levels were >35 IU/ml and 65 IU/ml respectively). The number of patients who had normalized CA125 levels after surgery was 54 and 58, and who had still high levels was 78 and 61, respectively. For both CA125 cut-off values, there were statistically significant differences in disease free survival (32 month vs. 18 month p:0.015 - 32 month vs. 17 months p:0.001) and overall survival (108 month vs. 36 month p:0.015 - 89 month vs. 33 month p:0.000) between patients with normalized and not normalized postoperative CA125 levels.Conclusion: In operated ovarian cancer patients, who had high preoperative CA125 levels, the decrease in this value postoperatively must be evaluated and normalization of this tumor marker may give us an idea about the recurrence of the disease., Amaç: CA125, over kanseri hastalarında gerek tanı aşamasında gerekse tedavi sonrası takiplerde tümör belirteci olarak kullanılmaktadır. Biz de çalışmamızda preoperatif serum CA125 değeri yüksek olan over kanseri hastalarında operasyondan sonraki değerlerinin normale dönüp dönmemesinin nüks riskini belirleme ve nükse kadar geçen süre açısından önemini araştırdık. Yöntem: Çalışmamızda 2005 – 2013 yılları arasında İzmir Katip Çelebi Üniversitesi Atatürk Eğitim ve Araştırma Hastanesi Tıbbi Onkoloji Kliniğinde opere over kanseri tanısıyla takip ve tedavi edilen hastalar retrospektif olarak taranmıştır. CA125 sınır değeri olarak hem 35 IU/ml hem de 65 IU/ml kullanılarak iki farklı analiz yapılmıştır. Bulgular: Çalışmamıza bazal CA125 değeri yüksek olan (sınır değer >35 IU/ml ve 65 IU/ml alındığında) sırasıyla 132 ve 119 hasta alınmıştır. Preoperatif CA125 değeri yüksek olup postoperatif normale gelen hastaların sayısı sırasıyla 54 ve 58 iken bu değeri normalleşmeyen hastaların sayısı 78 ve 61’dir. Her iki CA125 sınır değeri için, postoperatif CA125 değeri normalleşenlerle normalleşmeyen hastalarda hem nükse kadar geçen süre (32 aya karşı 18 ay p:0,015 - 32 aya karşı 17 ay p:0,001) hem de tüm sağkalım açısından (108 aya karşı 36 ay p:0,015 - 89 aya karşı 33 ay p:0,000) istatistiksel anlamlı fark saptanmıştır.Sonuç: Opere over kanseri hastalarından bazal CA125 değeri yüksek saptanan hastalarda ameliyat sonrasındaki düşüşü değerlendirip, bu değerin normal sınırlara düşüp düşmemesine göre nüks süreci hakkında fikir sahibi olunabilinir.

Introduction Selected patients with colorectal cancer liver metastases (CRLM) and synchronous extrahepatic disease (EHD) are considered for surgery. Objectives To evaluate the change in surgical management and long-term survival (disease-free survival [DFS] and overall survival [OS]) for patients with CRLM and EHD who undergo positron emission tomography combined with computed tomography (PET-CT) vs no PET-CT. Methods Patients with CRLM were enrolled in a trial evaluating the effect of PET-CT (vs no PET-CT) on surgical management, DFS, and OS. This is a sub-study of the trial, including only patients with synchronous EHD. Cox proportional hazard models were used to calculate risks for recurrence and death. Survival were described by Kaplan-Meier method and compared with log-rank test. Results Of 25 patients with EHD (PET-CT arm: 14/270 (5%) and no PET-CT arm: 11/134 (8%)), PET-CT changed surgical management in 14%, all of which avoided liver resection due to more extensive disease. Complete metastasectomy was achieved in 36% (5/14) and 72% (8/11), respectively. Respectively, PET-CT vs no PET-CT had statistically similar median DFS, 5.6 months (95% confidence interval (CI) 3.6-18) vs 7.6 months (95% CI 2.9-15) and median OS, 42 months (95% CI 25-48) vs 29 months (95% CI 17-41). EHD was associated with worse DFS (hazard ratio HR = 1.89, 95% CI 1.41-2.52) and OS (HR = 2.47, 95% CI 1.6-3.83). Conclusions Preoperative PET-CT for the management of resectable CRLM did not improve long-term outcomes among patients who had synchronous EHD; however, it changed surgical management in a relatively significant proportion of patients.

Ramifications of postoperative complications on long-term survival after mastectomy are uncertain.Overall complications (Clavien-Dindo Grades I-IIIB) and wound complications were analyzed using the Kaplan-Meier method for impact on 5-year overall (OS) and disease-free survival (DFS).A total of 378 patients underwent mastectomy alone (157, 41%) or mastectomy with reconstruction (221, 59%) for Stage I-III disease with a median follow-up of 5 years. Postoperative complications occurred in 186 patients (49%), requiring non-surgical (I/II = 83, 22%) or surgical (IIIa/IIIb = 103, 27%) management. Wound complications occurred in 140 patients (37%). Reconstruction was associated with a higher rate of complication (P 0.001). Postoperative complications after mastectomy (with or without reconstruction) did not significantly affect OS or DFS. Wound complications also showed no significant effect on OS or DFS following mastectomy alone, or mastectomy with reconstruction.Postoperative complications after mastectomy, with or without reconstruction, bear no significant impact on 5-year survival.

Breast cancer is one of the most common malignant tumors in woman. Ovarian and pelvic metastasis in breast cancer are very rare, and the prognosis is often poor. Lacking typical clinical manifestation, misdiagnose is common. We report a case about a middle-aged postmenopausal woman with complaints of finding a left breast mass and irregular vaginal bleeding. Through ultrasound-guided core-needle biopsy of the masses, the patient’s final diagnosis was breast cancer with ovarian and pelvic metastasis. The patient received combinations of chemotherapy (intravenous infusion or peritoneal perfusion), radical surgery (gynecological operation and modified radical mastectomy), radiation and endocrine therapy. Forty-eight months follow-up showed that the patient is generally in good condition and had no signs of local recurrence or metastasis. Invasive ductal carcinoma (IDC) of the breast with unilateral ovarian and pelvic metastasis is rare. It is not easy to differentiate from primary ovarian malignant tumor, and the prognosis is generally poor. We chose a combination chemotherapy regimen sensitive to both breast and ovarian tumors for the patient. The therapeutic effect is remarkable. Only a small number of tumor cells were found in pelvic and ovarian tumors. The patient’s breast tumors reached pathological complete remission (pCR), which might be the reason for the patient’s good prognosis.

BACKGROUND Colorectal cancer is a common digestive cancer worldwide. As a comprehensive treatment for locally advanced rectal cancer (LARC), neoadjuvant therapy (NT) has been increasingly used as the standard treatment for clinical stage II/III rectal cancer. However, few patients achieve a complete pathological response, and most patients require surgical resection and adjuvant therapy. Therefore, identifying risk factors and developing accurate models to predict the prognosis of LARC patients are of great clinical significance. AIM To establish effective prognostic nomograms and risk score prediction models to predict overall survival (OS) and disease-free survival (DFS) for LARC treated with NT. METHODS Nomograms and risk factor score prediction models were based on patients who received NT at the Cancer Hospital from 2015 to 2017. The least absolute shrinkage and selection operator regression model were utilized to screen for prognostic risk factors, which were validated by the Cox regression method. Assessment of the performance of the two prediction models was conducted using receiver operating characteristic curves, and that of the two nomograms was conducted by calculating the concordance index (C-index) and calibration curves. The results were validated in a cohort of 65 patients from 2015 to 2017. RESULTS Seven features were significantly associated with OS and were included in the OS prediction nomogram and prediction model: Vascular_tumors_bolt, cancer nodules, yN, body mass index, matchmouth distance from the edge, nerve aggression and postoperative carcinoembryonic antigen. The nomogram showed good predictive value for OS, with a C-index of 0.91 (95%CI: 0.85, 0.97) and good calibration. In the validation cohort, the C-index was 0.69 (95%CI: 0.53, 0.84). The risk factor prediction model showed good predictive value. The areas under the curve for 3- and 5-year survival were 0.811 and 0.782. The nomogram for predicting DFS included ypTNM and nerve aggression and showed good calibration and a C-index of 0.77 (95%CI: 0.69, 0.85). In the validation cohort, the C-index was 0.71 (95%CI: 0.61, 0.81). The prediction model for DFS also had good predictive value, with an AUC for 3-year survival of 0.784 and an AUC for 5-year survival of 0.754. CONCLUSION We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.

Prostate cancer (PC) is the most common non-cutaneous malignancy among men in the western world. However, heterogeneity remains a pressing clinical problem.The least absolute shrinkage and selection operator (LASSO) was used to screen the prognostic signature. Weighted correlation network analysis (WGCNA) was used to identify the target genes associated with high-risk characteristics. Gene set enrichment analysis was used to suggest the molecular mechanism ofTen DNA methylation sites were selected as the prognostic signature. A high expression ofWe developed a DNA methylation 10-CpG prognostic signature to predict the prognosis of PC patients. And the high expression of

PURPOSE Few studies have explored the relationship between body habitus and breast cancer outcomes in Caribbean women of African ancestry. This study evaluates the association between body mass index (BMI) and disease-free survival (DFS) in a retrospective cohort of 224 female Haitian patients with nonmetastatic breast cancer. PATIENTS AND METHODS BMI was obtained from the medical records and categorized as normal weight (< 25 kg/m2), overweight (25-29.9 kg/m2), and obese (≥ 30 kg/m2). DFS was defined as time from surgical resection to disease recurrence, death, or censoring. Kaplan-Meier survival curves were generated, and the association between BMI and DFS was evaluated using Cox proportional hazard models to control for multiple confounders. Exploratory analyses were conducted on weight changes during adjuvant chemotherapy. RESULTS Eighty-three patients (37.1%) were normal weight, 66 (29.5%) were overweight, and 75 (33.5%) were obese. There were no statistical differences in baseline characteristics or treatments received by BMI group. Twenty-six patients died and 73 had disease recurrence. Median DFS was 41.1 months. Kaplan-Meier estimates showed no significant DFS differences by BMI categories. After controlling for confounders, normal weight patients, when compared with overweight and obese patients, had adjusted hazard ratios of 0.85 (95% CI, 0.49 to 1.49) and 0.90 (95% CI, 0.52 to 1.55), respectively. Overall, mean weight loss of 2% of body weight was noted over the course of adjuvant chemotherapy. Patients who were postmenopausal ( P = .007) and obese ( P = .05) lost more weight than other groups. However, chemotherapy-related weight changes did not have an impact on DFS. CONCLUSION Baseline BMI and weight changes during adjuvant chemotherapy did not have an impact on DFS in this cohort. Future prospective studies in similar Caribbean breast cancer cohorts are needed to verify study findings.

Resumen Introduccion y objetivos Alrededor del 12% de los pacientes tratados con radioterapia pelvica desarrollan complicaciones en la vejiga. La terapia de oxigeno hiperbarico (TOHB) es una opcion para el manejo de la cistitis hemorragica inducida por radioterapia (CHIR). El objetivo de este estudio fue evaluar la eficacia de la TOHB para tratar la cistitis por radioterapia e identificar factores predictivos para un resultado exitoso. Material y metodos Revisamos retrospectivamente a 105 pacientes diagnosticados de CHIR que recibieron un tratamiento de TOHB entre 2007 y 2016 en nuestro centro. Los pacientes recibieron oxigeno al 100% en una camara hiperbarica multiplaza a 2,4 ATA durante 80 min. Todos los pacientes cumplimentaron un cuestionario en el que se documentaba la gravedad de los sintomas previos a la TOHB y tras el periodo de seguimiento. Resultados Despues de una media de 40 sesiones de TOHB, hubo una tasa de exito del 92,4% en el control de la hematuria. Durante el periodo de seguimiento (mediana de 63 meses), el 24,7% de los pacientes presentaron recurrencia de la hematuria. La puntuacion media de las variables evaluadas en el cuestionario —disuria, frecuencia urinaria y hematuria— fue significativamente menor despues del periodo de seguimiento (p Nuestros datos muestran que cuanto antes se administre la TOHB despues del primer episodio de hematuria, se logran mejores tasas de respuesta y se registran menores recurrencias en relacion con la hematuria (p Conclusiones Nuestros resultados apoyan la seguridad y los beneficios a largo plazo de la TOHB para la CHIR y otros sintomas molestos de la vejiga, lo que supondria una mejora en la calidad de vida de nuestros pacientes.

BACKGROUND AND OBJECTIVES Precise prognostic prediction for an individual hepatocellular carcinoma (HCC) patient before and after liver resection is important. We aimed to establish simple prognostic models to predict disease-free survival (DFS) for these patients. METHODS Six hundred and ninety-eight HCC patients with liver resections were reviewed. Preoperative (model 1) and postoperative (model 2) nomogram-based scoring systems were constructed by multivariate analyses, and DFS was estimated. RESULTS Among 698 patients, 490 (70.2%) patients had tumor recurrence at a median follow-up of 84.4 months. Risk factors of tumor recurrence in model 1 included viral hepatitis, platelet count, albumin, indocyanine green retention rate, multiplicity of tumor, and radiologic total tumor volume (TTV). Prognostic variables identified in model 2 were viral hepatitis, platelet count, multiplicity of tumor, cirrhosis, microvascular invasion, and pathologic TTV. By nomogram in model 1, the patients were classified into three groups with 5-year DFS of 61.0%, 35.7%, and 21.1%, respectively (P

Objective To compare drug (paclitaxel)-coated balloon angioplasty with femoropopliteal bypass surgery in the treatment of femoropopliteal lesions. Methods A retrospective study was performed between January 2015 and January 2019, covering a four-year period. All subjects who underwent femoropopliteal bypass surgery and drug-coated balloon angioplasty over a four-year period were evaluated. The subjects’ demographic characteristics, lesion characteristics, treatment outcomes and disease-free survival were collected. Subjects were divided into the femoropopliteal bypass group (Group A) and the drug-coated balloon angioplasty (Group B) group. Results In total, 220 subjects were enrolled. Both Group A and Group B consisted of 110 subjects. The proportion of patients with a claudication distance between 0 and 50 m was significantly higher in Group A, and the proportion of patients with a claudication distance between 50 and 100 m was significantly higher in Group B ( p = 0.001). In terms of the Rutherford levels, moderate claudication was significantly higher in Group B, and severe claudication was significantly higher in Group A ( p = 0.001). The lesion length for the subjects in Group A was significantly longer than that in Group B (24.61 ± 2.79 mm for Group A and 18.59 ± 3.95 mm for Group B, p = 0.001). The stenosis degree in Group A was also significantly higher than that in Group B (96.82 ± 4.32% for Group A and 94.85 ± 4.55% for Group B, p = 0.001). The duration of the procedure, duration of hospitalization and rate of bleeding in Group A were significantly higher than those in Group B. The incidence of overall morbidity and reintervention rates in Group B were significantly higher than that in Group A. The preoperative ankle brachial index values of the subjects in Group B were statistically significantly higher than those in Group A (0.56 ± 0.08 for Group A and 0.61 ± 0.08 for Group B, p = 0.001). The change in the ankle brachial index measurement of the subjects in Group A with respect to the preprocedure value was significantly greater than that in Group B ( p = 0.001). For primary patency, there was a significant difference between the groups in the distribution of the duplex ultrasound results at the 3rd, 6th, 9th and 12th month control points ( p = 0.001). At all control points, Group A had better primary patency rates, whereas the secondary patency rates did not differ. In total, among the 220 patients, 125 (56.8%) were disease free, and 95 (43.2%) experienced recurrence. The mean disease-free survival times for Group A and Group B were 10.45 ± 0.28 months and 9.11 ± 0.37 months, respectively. The disease-free survival rates were significantly higher in Group A ( p = 0.001, p Conclusion Femoropopliteal bypass resulted in better disease-free survival rates than drug-coated balloon angioplasty and serves as an effective modality for the treatment of femoropopliteal lesions.

Objective: To evaluate all the known factors that may play a role in predicting response to Neoadjuvant chemotherapy in breast cancer and to see impact of response on five years’ disease free survival (DFS) and Overallsurvival (OS). Material and Method: Data of 156 patients was reviewed retrospectively from January 2012 to December 2012 at Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore, Pakistan. All received neoadjuvant chemotherapy (NAC) and had no distant metastasis. The response was measured in term of percentage reduction from 1st radiological size on presentation to final size on histopathology (of resected specimen). Four groups were identified, complete responder (CR) (100% reduction), Responders (R) (>50% reduction), Partial responder (PR) (

BACKGROUND Gastric cancer is the second most common malignant tumor in China, ranking third among all malignant tumor mortality rates. Hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to increase significantly the effectiveness of intraperitoneal chemotherapeutic drugs, prolong the action time of these drugs on intraperitoneal tumor cells, and enhance their diffusion in tumor tissues. HIPEC may be one of the best choices for the eradication of residual cancer cells in the abdominal cavity. AIM The aim of this study was to study the role of preventive HIPEC after radical gastrectomy. METHODS A prospective analysis was performed with patients with cT4N0-3M0 gastric cancer to compare the effects of postoperative prophylactic HIPEC plus intravenous chemotherapy with those of routine adjuvant chemotherapy. Patients’ medical records were analyzed, and differences in the peritoneal recurrence rate, disease-free survival time, and total survival time between groups were examined. RESULTS The first site of tumor recurrence was the peritoneum in 11 cases in the conventional adjuvant chemotherapy group and in 2 cases in the HIPEC group (P = 0.020). The 1-year and 3-year disease-free survival rates were 91.9% and 60.4%, respectively, in the conventional adjuvant chemotherapy group and 92.1% and 63.0%, respectively, in the HIPEC group. The 1-year and 3-year overall survival rates were 95.2% and 66.3%, respectively, in the conventional adjuvant chemotherapy group and 96.1% and 68.6%, respectively, in the HIPEC group. No significant difference in postoperative or chemotherapy complications was observed between groups. CONCLUSION In patients with cT4N0-3M0 gastric cancer, prophylactic HIPEC after radical tumor surgery is beneficial to reduce peritoneal tumor recurrence and prolong survival.

BACKGROUND: Recently, the GRANT (GRade, Age, Nodes, and Tumor) score was validated through an adjuvant trial population. METHODS: This retrospective study evaluated the performance of the GRANT score as a prognostic model for disease-free survival (DFS), compared to the University of California Los Angeles Integrated Staging System (UISS) score, in a “real-life” population of early renal cell carcinoma patients. A uni-/multivariate analysis of DFS was also performed, to weigh the roles of baseline clinical factors. RESULTS: From February 1998 to January 2018, 134 consecutive patients were enrolled, of which 85 patients (63.4%) had a favorable GRANT score, 49 (36.6%) an unfavorable GRANT score, and 21 (15.7%), 84 (62.6%), and 29 (21.6%) patients had a low, intermediate, or high risk of recurrence according to the UISS score, respectively. The median follow-up was 96 months. The median DFS of the overall study population was 53.7 months (95% CI: 38.4-87.8). Only bilateral renal cell carcinoma (p = 0.0041), Fuhrman grade 3/4 (p = 0.0008), pT3b- 4 (p = 0.0324), and pN1-2 (p = 0.0303) pathological status were confirmed as independent predictors of a shorter DFS by the multivariate analysis. The median DFS of patients with favorable and unfavorable GRANT scores were 84.9 (95% CI: 49.8-129) and 38.4 months (95% CI: 24.4-87.8), respectively, with a statistically significant difference (p = 0.0147). The median DFS of patients with low, intermediate, and high risk of recurrence according to the UISS score were 92.3 (95% CI: 18.1-153.9), 51.7 (95% CI: 36.2-87.8), and 49.8 months (95% CI: 31.3-129), respectively, without statistically significant differences (p = 0.4728). DFS c-statistic values were 0.59 (95% CI: 0.51-0.67) and 0.51 (95% CI: 0.42-0.60) for the GRANT and the UISS scores, respectively. CONCLUSION: The GRANT score might be a useful tool that is user-friendly and easy to perform in clinical practice.

Background Anastomotic leak remains a critical complication after restorative rectal cancer surgery and is associated with significant morbidity and mortality rates, whereas reported rates range from 4% to 29%. Whether the occurrence of leak may have an impact on long-term oncological outcomes is under debate. Objective This study aimed to describe the oncological impact of anastomotic leak on patients undergoing sphincter-preserving surgery for rectal adenocarcinoma. Design This is a retrospective review of a prospectively maintained database. Settings The study was conducted at a high-volume colorectal center. Patients Data on patients who underwent restorative surgery for rectal adenocarcinoma from January 2000 until December 2013 were retrospectively analyzed. Main outcome measures The primary outcome measured was the impact of anastomotic leak, defined according to the classification proposed by the International Study Group of Rectal Cancer, on long-term overall survival, disease-free survival, disease-specific survival, and local recurrence. Results A total of 787 patients undergoing sphincter-preserving surgery for rectal cancer met the inclusion criteria. Forty-two (5.3%) patients presented a symptomatic anastomotic leak. The median follow-up period was 64 months. Fifty-one (6.5%) patients experienced a cancer-related death, 2 of 42 in the anastomotic leak group. Five-year overall survival, disease-specific survival, and disease-free survival were 88%, 94.7%, and 85.3%. Local recurrence rate was 2%. There was no difference in long-term overall survival, disease-specific survival, disease-free survival, and local recurrence rate between groups. On a multivariable analysis, anastomotic leak did not impact oncological outcomes. Limitations This study was limited by retrospective analysis. Conclusions The occurrence of anastomotic leak after restorative resection for rectal cancer did not impact long-term oncological outcomes in our cohort of patients. See Video Abstract at http://links.lww.com/DCR/B187. RESULTADOS ONCOLOGICOS A LARGO PLAZO DESPUES DE UNA FUGA ANASTOMOTICA EN CIRUGIA DE CANCER RECTAL: La fuga anastomotica sigue siendo una complicacion critica despues de la cirugia restauradora del cancer rectal y se asocia con tasas significativas de morbilidad y mortalidad, mientras que las tasas reportadas varian del 4% al 29%. Se esta debatiendo si la aparicion de fugas puede tener un impacto en los resultados oncologicos a largo plazo.Describir el impacto oncologico de la fuga anastomotica en pacientes sometidos a cirugia de preservacion del esfinter para adenocarcinoma rectal.Revision retrospectiva de una base de datos mantenida prospectivamente.El estudio se realizo en un centro colorrectal de alto volumen.Se analizaron retrospectivamente los datos de pacientes que se sometieron a cirugia reparadora por adenocarcinoma rectal desde Enero de 2000 hasta Diciembre de 2013.Impacto de la fuga anastomotica, definida de acuerdo con la clasificacion propuesta por el Grupo de Estudio Internacional del Cancer Rectal (International Study Group of Rectal Cancer), sobre la supervivencia general a largo plazo, la supervivencia libre de enfermedad, la supervivencia especifica de la enfermedad y la recurrencia local.Un total de 787 pacientes sometidos a cirugia para preservar el esfinter por cancer rectal cumplieron con los criterios de inclusion. Cuarenta y dos (5.3%) pacientes presentaron una fuga anastomotica sintomatica. El tiempo mediano del periodo de seguimiento fue de 64 meses. Cincuenta y un (6.5%) pacientes sufrieron muerte relacionada con el cancer, 2 de 42 en el grupo de fuga anastomotica. La supervivencia global a cinco anos, la supervivencia especifica de la enfermedad y la supervivencia libre de enfermedad fueron del 88%, 94.7% y 85.3%, respectivamente. La tasa de recurrencia local fue del 2%. No hubo diferencias en la supervivencia global a largo plazo, la supervivencia especifica de la enfermedad, la supervivencia libre de enfermedad y la tasa de recurrencia local entre los grupos. En un analisis multivariable, la fuga anastomotica no afecto los resultados oncologicos.Este estudio fue limitado por analisis retrospectivo.La aparicion de fuga anastomotica despues de la reseccion restauradora para el cancer rectal no afecto los resultados oncologicos a largo plazo en nuestra cohorte de pacientes. Consulte Video Resumen en http://links.lww.com/DCR/B187. (Traduccion-Dr. Yesenia Rojas-Kahlil).

BACKGROUND Physical activity might be directly or indirectly linked to the risk of colorectal cancer and the prognosis of patients with colorectal cancer. OBJECTIVE This study aimed to elucidate whether preoperative physical activity plays a role in reducing short-term postoperative complications and improving long-term survival of patients with colorectal cancer. DESIGN This was a retrospective analysis of prospectively collected data. SETTINGS This study was conducted at a department of colorectal surgery in a tertiary teaching hospital between January 1995 and December 2016. PATIENTS Patients who underwent curative resection for stage I to III primary colorectal cancer were enrolled. According to the preoperative leisure-time weekly metabolic equivalent of task values, patients were divided into 2 groups: the metabolic equivalent of task

The aim was to evaluate the clinical impact of IGF-1/IGF-1R in Tunisian laryngeal carcinoma. A high IGF-1R immunohistochemical expression was found in our series (81.43%). A tendency toward an association between IGF-1R expression and lymph node metastasis was found (

Renal cell carcinoma (RCC) is known to recur decades after nephrectomy; however, isolated cutaneous metastasis is rare. Previous clinical history plays vital role. Newly occurring skin lesions in follow‐through patients of RCC should be carefully evaluated, and possibility of its metastasis should be acknowledged. Disease‐free survival postmetastasectomy is possible.

The aim of the current study was to investigate the possible association of HOTAIR gene rs1899663 polymorphism with kidney cancer patients survival and clinicopathological characteristics of kidney cancer. Methods. The whole venous blood of 101 patients with clear cell renal cell carcinoma (CCRCC) (42 women and 59 men) was used in the study. Genotyping of rs1899663 HOTAIR gene polymorphic locus was performed by polymerase chain reaction followed by restriction fragment length polymorphism analysis (PCR-RFLP). Statistical analysis was performed using SPSS (version 17.0). The Kaplan-Meier test and the Cox regression were used to test the possible association between rs1899663 polymorphism of long non-coding RNA HOTAIR gene and the age of CCRCC onset. P values ​​< 0.05 were considered as statistically significant. Results. The results of HOTAIR gene rs1899663 polymorphism genotyping showed that the ratio of GG-homozygotes, GT-heterozygotes and TT-homozygotes in CCRCC patients was 39.6%, 52.5%, and 7.9%, respectively. This distribution did not deviate from the expected by Hardy-Weinberg law (P = 0.143). Results of one-way ANOVA showed that rs1899663-locus of HOTAIR gene was not associated with tumor size of CCRCC patients (P > 0.05), was not related to body mass index, erythrocyte sedimentation rate, fasting glucose, hemoglobin, creatinine and leukocyte amount in the blood of CCRCC patients (P > 0.05). In addition, the results of the Kaplan-Meyer test showed that life expectancy until the CCRCC occurrence does not depend on rs1899663 SNP (log-rank P = 0.739). At the same time, the results of Cox regression analysis both before and after adjusting for covariates (sex, body mass index, metastases, smoking habits and alcohol abuse) showed that CCRCC risk development with age does not depend on HOTAIR gene rs1899663 polymorphism (P > 0.05). Conclusions. This is the first report about the possible link between HOTAIR gene polymorphism and survival of kidney cancer patients both in Ukraine and worldwide. The rs1899663 polymorphic site of HOTAIR gene is not associated with the age of CCRCC onset in the Ukrainian population. In addition, the rs1899663 SNP is also not related to tumor size and clinical фтв laboratory data in patients with kidney cancer.

Background Phyllodes tumours represent less than 1% of all UK breast neoplasms. Histological features allow classification into benign, borderline or malignant, which has a significant impact on prognosis and recurrence. Currently, there is no consensus for the optimal surgical excision margin. This systematic review aims to provide a comparative summary of outcomes (local recurrence, metastasis and survival) for borderline and malignant phyllodes tumours resected with either ≥1cm or Methods MEDLINE and Embase were systematically searched (1990 to July 2019), in line with PRISMA guidelines. Study quality was assessed using the Newcastle–Ottawa scale. Results Ten retrospective studies were included (Newcastle–Ottawa scale mean score: 5.6, range: 8–4). Nine reported local recurrence rates, four reported distant metastasis and four reported survival. Meta-analysis pooling demonstrated no statistically significant difference between Conclusion Current evidence suggests that margins

Background: Prognosis of oral squamous cell carcinoma (OSCC) can be predicted by evaluating both clinicopathological parameters and molecular markers. Understanding the reasons of recurrence is important to increase the morbidity and mortality of the patient. Objectives: The objectives are to study the immunoexpression of p53 and Ki-67 in recurrent and non recurrent OSCC. And correlate the clinicopathological parameters among non-recurrent and recurrent OSCC to predict the prognosis of OSCC. Methods: Clinicopathological and immunoexpression of p53 and Ki-67 at the histologically negative margin (HNM) and invasive tumor front (ITF) were assessed in 50 cases of non-recurrent and recurrent OSCC. Overall survival and disease free survival was estimated. Statistical tests like Mann Whitney U test, t Test, Pearson correlation coefficient, Kaplan Meier curve and Log Rank test were used. Results: The Labelling Index (LI) of p53 and Ki-67 was marginally higher in recurrent than in non-recurrent OSCC cases. When compared with clinicopathologic parameters, non-recurrent OSCC cases showed no significance with p53 LI in margin and ITF except for site, muscle invasion, pattern of invasion (POI) and muscle invasion, whereas in recurrent OSCC cases p53 LI in HNM and ITF did not show any statistical significance except for duration. In both groups, OS and DFS was higher in patients with lesser LI while higher in the greater LI but more number of deaths occurred in this category respectively. Conclusion: To conclude p53 and Ki-67 positivity in the HNM and ITF of non-recurrent and recurrent OSCC was seen and thus can be an important marker for identification of high and low risk individuals.

PURPOSE Dose-escalated radiotherapy (RT) with androgen-deprivation therapy (ADT) is a standard definitive treatment of localized prostate cancer (LPCa). The optimal sequencing of these therapies is unclear. Our phase III trial compared neoadjuvant versus concurrent initiation of ADT in combination with dose-escalated prostate RT (PRT). PATIENTS AND METHODS Patients with newly diagnosed LPCa with Gleason score ≤ 7, clinical stage T1b to T3a, and prostate-specific antigen < 30 ng/mL were randomly allocated to neoadjuvant and concurrent ADT for 6 months starting 4 months before RT (neoadjuvant group) or concurrent and adjuvant ADT for 6 months starting simultaneously with RT (concurrent group). The primary end point was biochemical relapse-free survival (bRFS). Stratified log-rank test was used to compare bRFS and overall survival (OS). Incidence of grade ≥ 3 late RT-related toxicities was compared by log-rank test. RESULTS Overall, 432 patients were randomly assigned to the neoadjuvant (n = 215) or concurrent group (n = 217). At 10 years, bRFS rates for the two groups were 80.5% and 87.4%, respectively. Ten-year OS rates were 76.4% and 73.7%, respectively. There was no significant difference in bRFS ( P = .10) or OS ( P = .70) between the two groups. Relative to the neoadjuvant group, the hazard ratio for the concurrent group was 0.66 (95% CI, 0.41 to 1.07) for bRFS and 0.94 (95% CI, 0.68 to 1.30) for OS. No significant difference was observed in the 3-year incidence of late RT-related grade ≥ 3 GI (2.5% v 3.9%) or genitourinary toxicity (2.9% v 2.9%). CONCLUSION In our study, there was no statistically significant difference in bRFS between the two treatment groups. Similarly, no difference was seen in OS or late RT-related toxicities. On the basis of these results, both neoadjuvant and concurrent initiations of short-term ADT with dose-escalated PRT are reasonable standards of care for LPCa.

Background: Most of breast cancer patients survive for a long-term period. The existing assessment of survivors’ prognosis has had some limitations in breast cancer because it is based on an evaluation at the time of diagnosis. Conditional survival reflects change over time after diagnosis and treatment of cancer. Conditional disease-free survival (CDFS) and conditional overall survival (COS) can provide more accurate prognosis to breast cancer patients. In this study, we aimed to determine 5-years CDFS and COS according to disease-free period after diagnosis and treatment of breast cancer in Korea. Method: We retrospectively reviewed clinical data of 5664 patients aged 16 to 86 who underwent curative surgery for breast cancer between January 2000 and December 2008 at Samsung Medical Center, a single tertiary hospital in Korea. The CDFS and COS rates were based on cumulative DFS and OS estimates up to 15 years using the Kaplan-Meier method. Results: At baseline, each 5-years DFS and OS were 88.0% and 93.8%. For patients who kept disease free status from 1 to 9 years after surgery, the 5-years CDFS rates were calculated as 88.7%, 90.7%, 91.6%, 91.1%, 91.5%, 91.0%, 89.5%, 86.1% and 86.1%, respectively. The 5-year COS rates of the patients who had survived from 1 to 9 years after surgical treatment were calculated as 92.6%, 92.1%, 91.2%, 91.0%, 89.4%, 85.6%, 80.7%, 75.3%, and 73.0%, respectively. Conclusion: Our study showed that 5-years CDFS and COS for most patients who have breast cancer in Korea seemed to be good prognosis for a long time. However, cancer recurrence tended to occur after a long period postoperatively. Further study is required to identify risk factors associated with recurrence after several years in Korean breast cancer patients. Citation Format: Jee Hyun Ahn, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Byung-Joo Chae, Se Kyung Lee, Jai Min Ryu, Jonghan Yu. The 5-years conditional disease free survival and overal survival for breast cancer patients in Korea [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-08-25.

Background: Approximately 40% of patients with stage I-III triple-negative breast cancer (TNBC) recur after standard treatment, while the remaining 60% experience long-term disease-free survival (DFS). There are currently no clinical tests to assess the risk of recurrence in TNBC patients. We previously developed and validated an MHCII Immune Activation assay, which measures a gene expression signature that includes the major histocompatibility complex class II (MHCII) pathway genes and markers of activated tumor infiltrating lymphocytes. The MHCII Immune Activation assay was recently shown to accurately assess the risk of recurrence in Basal-like TNBC patients using FFPE tissues from an institutional cohort. A limitation of the previous study is that the patients’ treatment regimens in the institutional cohort were heterogeneous. The goal of this study was to determine if the MHCII Immune Activation assay can accurately assess the DFS in Basal-like TNBC patients who received uniform chemotherapy regimens in the context of a randomized clinical trial. Methods: The MHCII Immune Activation assay was applied to RNA isolated from 60 Basal-like TNBC FFPE specimens from the GEICAM/9906 clinical trial, a multicenter randomized phase III study evaluating adjuvant chemotherapy in node-positive operable BC patients. Thirty nine (65%) of the patients were treated with fluorouracil, epirubicin, and cyclophosphamide (FEC), and 21 (35%) patients received FEC followed by paclitaxel (FEC-P) (median follow-up 9.7 years). The MHCII Immune Activation Score was calculated from the assay using methods described previously, and patients were categorized into a High Risk of Recurrence (High ROR) group using pre-specified thresholds. The association between the MHCII Immune Activation Score and DFS was assessed using Kaplan-Meier analysis and cox proportional hazards models. Results: Across both arms, 32/60 (53.3%) patients were classified into the High ROR group based on their Low MHCII Immune Activation Scores. Patients in the High ROR group had significantly shorter DFS (Hazard Ratio (HR)=2.9 (CI95%:1.27-6.66), p-value=0.0081). Cox proportional hazard regression of the log10 transformed MHCII Immune Activation Score confirmed that MHCII Immune Activation Score is significantly associated with DFS (Wald Test p=0.0127). In the FEC arm, there were 22/39 (56.41%) patients classified into the High ROR group (Low MHCII Immune Activation Score). Patients in the High ROR group in the FEC arm showed a trend toward shorter DFS (HR=1.99 (CI95%:0.74-5.31)), but it was not significant (p-value=0.1595). In the FEC-P arm, there were 10/21 (47.62%) patients classified into the High ROR group (Low MHCII Immune Activation Score). Patients in the High ROR group in the FEC-P arm had significantly shorter DFS (HR=6.28 (CI95%:1.28-30.73), p-value=0.0111). Larger cohorts will be needed to confirm if the association between DFS and MHCII Immune Activation Score is stronger when patients are treated with chemotherapy regimens that include paclitaxel. Conclusions: The MHCII Immune Activation assay can be applied to RNA from FFPE tumor specimens to assess risk of recurrence in TNBC patients. The MHCII Immune Activation Score is associated with risk of recurrence in TNBC patients treated with uniform adjuvant chemotherapy regimens. Citation Format: Miguel Martín, Katherine L Updike, Alvaro Rodríguez-Lescure, Lourdes Calvo, Jesús Herranz, Nuria Martín, Philip S Bernard, Katherine E Varley. The MHCII immune activation assay is prognostic for disease free survival in basal-like TNBC breast cancer patients in the GEICAM/9906 clinical trial [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-10-09.

Objective: In breast cancer, tumor subtype and disease free survival (DFS) are correlated with prognosis. The aim of this study was to assess whether the effect of tumor subtype on survival was associated with DFS. Methods: The China National Cancer Center database was used to identify 1784 breast cancer women diagnosed between January 1987 to June 2017. Overall survival (OS) was defined as the time from first tumor recurrence or relapse to death due to any cause. Eligibility required metastatic patients with documented ER, PR, and HER2 status. Tumor subtype was classified into four groups: HR+HER2-, HR+HER2+, HR-HER2+ and triple negative breast cancer (TNBC) group. Results: In patients whose DFS < 2 years, we found significant differences between tumor subtype and OS (P=0.007), with HR+HER2- presenting most favorable survival while TNBC showing worst prognosis. A similar pattern was observed in patients whose DFS < 3, 4 and 5 years (all P 0.1). Of note, if DFS was longer than five years, the impact of different tumor subtype on survival was not obvious (P=0.438). Conclusion: No survival differences were found among tumor subtypes when DFS was shorter than one year, indicating particularly poor prognosis even in the HR+HER2- subtype, possibly due to primary treatment resistance. Subsequent more intensive first-line treatment with combined chemotherapy might not help in prolonging survival. Citation Format: Yiqun Li, Binghe Xu, Fei Ma, Qing Li, Pin Zhang, Peng Yuan, Jiayu Wang, Yang Luo, Ruigang Cai, Qiao Li, Hongnan Mo, Xiuwen Guan, Shaoyan Lin, Yimeng Chen, Zijing Wang. The association of disease free survival and the impact of tumor subtype on overall survival in advanced breast cancer patients: A real-world study from the China National Cancer Center [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-08-61.

Introduction: As a tertiary referral cancer centre, 20-30 % of patients seen in our breast clinic present after excision of the primary breast tumour without oncological principles maintained and no details on the excision margins. We evaluated the safety of excision biopsy (ExBx) as a diagnostic procedure by comparing the outcomes against patients who underwent definitive surgery after a core biopsy/FNAC (CxBx) for diagnosis. Methods: We performed a retrospective audit of the case charts of women with breast cancer treated at our institution. We included women with operable breast cancer (OBC) who presented post ExBx of the primary tumour and those who were treatment naïve and operated after only a CxBx for diagnosis. Results: Of the 1022 women included in the analysis, 551 underwent ExBx for primary diagnosis and 471 had CxBx prior to definitive breast surgery. The excision biopsy group were younger women (median age 44 years) with smaller tumours (median T size 2.5cm), lower HR ( hormone receptor) positive (58.3%) and less number were Her2+ve (16.7 %). In this group 17% received NACT, with 66.4% undergoing breast conservation surgery (BCS), and 37.6% node positive. While in the core biopsy group, the women were older women (median age 50 years) had larger tumours, median 3 cm, with 71.3% HR positive, 18.3% Her2 +ve, 72.8% underwent breast conservation surgery with 44.6 % node positive At a median follow up of 46 months, there was no difference in four year disease free survival (DFS) between ExBx group (83.8% versus 86.8%) and non-ExBx (HR=1.29,95%CI=0.93-1.79, p=0.13). When matched for T size, 699/1022 (69%) had T2 tumours and DFS in ExBx group was 80.7% in compared to 85.7% in non ExBx group. (HR=1.46, 95%CI=1.0-2.11, p=0.04). On multivariate cox regression, T size (HR=1.45,95%CI=1.02-2.07, p=0.03), HR negative (HR=1.61,95%CI=1.15-2.26,p=0.006), node positivity (HR=1.82,95%CI=1.31-2.53,p Conclusion: ExBx of the primary tumour as a diagnostic procedure not performed with oncological principles prior to definitive surgery has a detrimental impact on survival in women with operable breast cancer. Citation Format: Nita Sukumar Nair, Rohini W Hawaldar, Quarratulain Chougle, Vani Parmar, Vaibhav Vanmali, Shabina Siddique, Ashwini Devade, Aarti Pandey, Shalaka Joshi, Sudeep Gupta, Rajendra A Badwe. Impact of lumpectomy for diagnosis of primary tumor on disease free survival in women with operable breast cancer: An institutional audit [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P1-20-25.

Background/aim Gastric cancer is the fifth most frequently diagnosed cancer and the second most common cause of cancer-related death. The only potentially curative treatment is surgical resection, which is associated with potentially severe complications, such as anastomotic leakage. The aim of this systematic review was to evaluate the relationship between anastomotic leakage and overall and disease-free survival after surgery for gastric cancer. Materials and methods A systematic literature search was performed and 7 articles published between 2010 and 2019 were included, including a total of 7,167 patients. Results Among the included studies the frequency of anastomotic leakage ranged from 6 to 41%. Patients affected by anastomotic leakage had an overall survival ranging between 4.1 and 97.6 months, whereas patients who did not experience anastomotic leakage had an overall survival between 23 and 109.5 months. Conclusion Closer follow-up or even more aggressive oncological therapy may be considered for patients affected by anastomotic leakage after surgery for gastric cancer.

To determine how small bowel neuroendocrine neoplasms (SBNEN’s) are diagnosed and examine the effect of CT enterography (CTE) on diagnosis and rates of disease-free survival. Histopathologically-confirmed SBNEN’s diagnosed at our institution between 1996 and 2016 were identified. Clinical presentation, radiology, endoscopy, surgery, and pathology reports were reviewed and compared between consecutive 5-year periods. Of the 178 SBNEN initially diagnosed at our institution, the incidence increased 12-fold from 9 (during 1996–2000) to 114 (during 2011–2016). Comparing the first 5 to the last 5 years, GI bleeding and abdominal pain increased significantly as indications (with both increasing from 0 to > 25%, p ≤ 0.023). Initial diagnosis by radiology increased 2-fold [from 33% (n = 3) to 66% (n = 75); p = 0.263]. Detection of a small bowel mass and the suggestion that SBNEN was present varied significantly between imaging modalities (p