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Aim: We reported anatomo-clinical features of brain metastases (BMs) collected in a Tunisian medical oncology department. Patients & methods: We retrospectively identified all cases of BM within a cohort of 7055 patients, treated for a histologically confirmed nonhematological cancer between 2000 and 2016. Data about age, sex and primary tumor were collected. Results: Incidence was 1.9% and mean age was 54 years with a 1.24 sex ratio. BMs were symptomatic in 73.7% of cases after a median time of 16 months. A total of 73.4% patients receiving local therapy, 88% by whole brain radiation therapy and 21.6% had a metastasectomy. Lung and breast cancers were the primary in 80% of the BM. Conclusion: BM showed trends of young with underestimated incidence.

Aim: We aimed to identify a cutoff value of tumor size (TuS) correlated to prognosis of stage II and III colorectal cancer and to evaluate the prognostic significance. Patients & methods: We retrospectively analyzed 257 patients treated for stage II–III colorectal cancer between 2003 and 2014. We used receiver-operating characteristic to evaluate TuS performance accuracy to predict survival. We identified a cutoff value. We used the Kaplan–Meier method and Cox regression analysis to study survival and prognostic factors. Results: Area under the receiver-operating characteristic curve of TuS was 0.62 ± 0.048. A size of 4 cm was identified as a predictor of survival with a sensitivity of 88.2% and a specificity of 59.2%. We observed 98 patients with TuS ≤4 cm and 159 patients with TuS greater than 4 cm. Patients with TuS greater than 4 cm were more likely to have a cancer located in the colon (81.1 vs 70.4%, p = 0.002) and commonly pT4 (44 vs 22.4%, p = 0.0001). There was no difference in terms of gender, insufficient removed lymph nodes number, number of positive lymph nodes, stage and oxaliplatin administration between both groups. 5-year survival rate of patients with TuS ≥4 cm and TuS less than 4 cm was 76 and 84%, respectively (p = 0.008). Age ≥65 years, stage III, venous invasion and pN+ greater than 3 were significant bad prognostic factors in patients with TuS ≥4 cm in univariate analysis. Stage III was the only independent prognostic factor in multivariate analysis. Administration of chemotherapy was the only factor with significant impact on survival in univariate and multivariate analyses in patients with TuS less than 4 cm. Conclusion: TuS had not only an impact on survival but also interfered with other prognostic factors.

Aim: Surgical treatment of hepatic or pulmonary metastases is the optimal therapeutic goal in metastatic colorectal cancer (CRC). Methods: Our retrospective study concerned 70 patients treated for CRC, collected from 2003 to 2015, presenting liver metastases (LM) in 61 cases and pulmonary metastases (PM) in nine cases, treated by surgery for their distant disease. We collected and compared their epidemiologic, anatomoclinical parameters and analyzed several prognostic factors. Results: Metastases were multiple (≥ 4) in 9/61 LM and in 5/9 PM. Patients had synchronous metastases in 32 cases (30 LM/2 PM) and metachronous metastases in 33 cases (32 LM and 11 PM). Surgery for LM consisted of metastasectomy (49/61), segmentectomy (5/61) and hepatectomy for the remaining seven patients; ten patients had also subsequent liver radiofrequency. LM were treated by wedge resection in 6/9 and lobectomy in two cases, radiofrequency was performed in five cases. 56/61 (80%) patients received chemotherapy, mostly FOLFOX protocol as the first-line treatment and targeted therapy in 55% of cases. For the overall population, median OS and PFS were, respectively, 44 and 32 months. We did not observe any significant difference in terms of OS (p = 0.659) and PFS (p = 0.318) between resected LM or/and PM. A better survival was found when there was disease-free interval between the occurrence of the primary and the metastases exceeded 18 months and in patients with less than four metastases. Conclusion: Resection of metastatic disease mostly in liver and lungs improves survival of patients with CRC. The patients with longer disease-free interval and less than four metastases had the best outcomes.

We aimed to review all published literature reporting biological data about inflammatory breast cancer (IBC) in populations from North Africa. Methods: We reviewed all studies that evaluated biological features of IBC in six North African countries between 1990 and 2017. Among 118 screened studies, 13 were included, none about Mauritania/Libya. Results: Across the studies, hormonal receptors were positive in 46–69% of cases, reaching 83% in Algeria. HER2 was overexpressed in 25–39% of cases. Recombinant human C protein expression was the highest in Egyptian patients (87%) compared with other North African populations. Using mRNA expression recombinant human C protein was expressed in 83% of Tunisian patients. WISP3 gene expression showed positive immunohistochemistry staining in 17% and mRNA expression in 26.8% of IBC. Conclusion: Biological aspects of IBC across North Africa show important similarities and differences.