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1. Systemic pro-inflammatory response identifies patients with cancer with adverse outcomes from SARS-CoV-2 infection: the OnCovid Inflammatory Score

Author

Dettorre, Gino M., Dolly, Saoirse, Loizidou, Angela, Chester, John, Jackson, Amanda, Mukherjee, Uma, Zambelli, Alberto, Aguilar Company, Juan, Bower, Mark, Sng, Christopher C. T., Salazar Soler, Ramón, Bertuzzi, Alexia, Brunet, Joan, Mesia, Ricard, Sita-Lumsden, Ailsa, Seguí, Elia, Biello, Federica, Generali, Daniele, Grisanti, Salvatore, Seeva, Pavetha, Rizzo, Gianpiero, Libertini, Michela, Maconi, Antonio, Moss, Charlotte, Russell, Beth, Harbeck, Nadia, Vincenzi, Bruno, Bertulli, Rossella, Ottaviani, Diego, Liñan, Raquel, Marrari, Andrea, Carmona García, M. Carmen, Chopra, Neha, Tondini, Carlo Alberto, Mirallas, Oriol, Tovazzi, Valeria, Fotia, Vittoria, Cruz, Claudia Andrea, Saoudi González, Nadia, Felip, Eudald, Roqué, Ariadna, Lee, Alvin J. X., Newsom-Davis, Tom, García Illescas, David, Reyes, Roxana, Wong, Yien Ning Sophia, Ferrante, Daniela, Scotti, Lorenza, Marco Hernández, Javier, Ruiz Camps, Isabel, Patriarca, Andrea, Rimassa, Lorenza, Chiudinelli, Lorenzo, Franchi, Michela, Santoro, Armando, Prat Aparicio, Aleix, Gennari, Alessandra, Van Hemelrijck, Mieke, Tabernero Caturla, Josep, Diamantis, Nikolaos, Pinato, David J., OnCovid study group, Dettorre, G. M., Dolly, S., Loizidou, A., Chester, J., Jackson, A., Mukherjee, U., Zambelli, A., Aguilar-Company, J., Bower, M., Sng, C. C. T., Salazar, R., Bertuzzi, A., Brunet, J., Mesia, R., Sita-Lumsden, A., Segui, E., Biello, F., Generali, D., Grisanti, S., Seeva, P., Rizzo, G., Libertini, M., Maconi, A., Moss, C., Russell, B., Harbeck, N., Vincenzi, B., Bertulli, R., Ottaviani, D., Linan, R., Marrari, A., Carmen Carmona-Garcia, M., Chopra, N., Tondini, C. A., Mirallas, O., Tovazzi, V., Fotia, V., Cruz, C. A., Saoudi-Gonzalez, N., Felip, E., Roque, A., Lee, A. J. X., Newsom-Davis, T., Garcia-Illescas, D., Reyes, R., Wong, Y. N. S., Ferrante, D., Scotti, L., Marco-Hernandez, J., Ruiz-Camps, I., Patriarca, A., Rimassa, L., Chiudinelli, L., Franchi, M., Santoro, A., Prat, A., Gennari, A., Van Hemelrijck, M., Tabernero, J., Diamantis, N., Pinato, D. J., Wellcome Trust, Institut Català de la Salut, [Dettorre GM] Department of Surgery and Cancer, Imperial College London, Hammersmith Hospital, London, UK. [Dolly S] Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust (GSTT), London, UK. [Loizidou A] Department of Infectious Diseases, Internal Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium. [Chester J] Medical Oncology, School of Medicine, Cardiff University, Cardiff, UK. Medical Oncology, Velindre Cancer Centre, Cardiff, UK. [Jackson A] Clinical Trials, Velindre Cancer Centre, Cardiff, UK. [Mukherjee U] Medical Oncology, Barts Health NHS Trust, London, UK. [Aguilar-Company J] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei de Malalties Infeccioses, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Mirallas O, Saoudi-Gonzalez N, García-Illescas D] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Ruiz-Camps I] Servei de Malalties Infeccioses, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Tabernero J] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. IOB-Quiron, UVic-UCC, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Male, 0301 basic medicine, Oncology, Cancer Research, Comorbidity, Systemic inflammation, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], COVID-19 Testing, 0302 clinical medicine, Neoplasms, Immunotherapy Biomarkers, virosis::infecciones por virus ARN::infecciones por Nidovirales::infecciones por Coronaviridae::infecciones por Coronavirus [ENFERMEDADES], 80 and over, Immunology and Allergy, Medicine, Hypoalbuminemia, Young adult, Càncer, Multivariate Analysi, RC254-282, COVID-19 (Malaltia) - Complicacions, Cancer, Aged, 80 and over, OnCovid study group, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Virus Diseases::RNA Virus Infections::Nidovirales Infections::Coronaviridae Infections::Coronavirus Infections [DISEASES], Middle Aged, Prognosis, Inflamació, Systemic Inflammatory Response Syndrome, 030220 oncology & carcinogenesis, Cohort, Pathological Conditions, Signs and Symptoms::Pathologic Processes::Inflammation::Systemic Inflammatory Response Syndrome [DISEASES], Molecular Medicine, Female, medicine.symptom, Life Sciences & Biomedicine, Human, Adult, medicine.medical_specialty, Prognosi, Càncer - Epidemiologia, Immunology, neoplasias [ENFERMEDADES], inflammation mediator, Young Adult, 03 medical and health sciences, Internal medicine, Humans, afecciones patológicas, signos y síntomas::procesos patológicos::inflamación::síndrome de respuesta inflamatoria sistémica [ENFERMEDADES], Aged, Pharmacology, Science & Technology, business.industry, SARS-CoV-2, COVID-19, medicine.disease, inflammation, inflammation mediators, Blood Cell Count, Multivariate Analysis, Neoplasms [DISEASES], Systemic inflammatory response syndrome, 030104 developmental biology, Neoplasm, Lymphocytopenia, business, Other subheadings::Other subheadings::/complications [Other subheadings]
Abstract

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamació; Mediadors d'inflamació Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamación; Mediadores de la inflamación Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflammation; Inflammation mediators Background Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. Methods In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. Results We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p

Published
2021

2. Prevalence and impact of COVID-19 sequelae on treatment and survival of patients with cancer who recovered from SARS-CoV-2 infection: evidence from the OnCovid retrospective, multicentre registry study

Author

David J Pinato, Josep Tabernero, Mark Bower, Lorenza Scotti, Meera Patel, Emeline Colomba, Saoirse Dolly, Angela Loizidou, John Chester, Uma Mukherjee, Alberto Zambelli, Alessia Dalla Pria, Juan Aguilar-Company, Diego Ottaviani, Amani Chowdhury, Eve Merry, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Matteo Lambertini, Marco Tagliamento, Anna Pous, Ailsa Sita-Lumsden, Krishnie Srikandarajah, Johann Colomba, Fanny Pommeret, Elia Seguí, Daniele Generali, Salvatore Grisanti, Paolo Pedrazzoli, Gianpiero Rizzo, Michela Libertini, Charlotte Moss, Joanne S Evans, Beth Russell, Nadia Harbeck, Bruno Vincenzi, Federica Biello, Rossella Bertulli, Raquel Liñan, Sabrina Rossi, Maria Carmen Carmona-García, Carlo Tondini, Laura Fox, Alice Baggi, Vittoria Fotia, Alessandro Parisi, Giampero Porzio, Maristella Saponara, Claudia Andrea Cruz, David García-Illescas, Eudald Felip, Ariadna Roqué Lloveras, Rachel Sharkey, Elisa Roldán, Roxana Reyes, Irina Earnshaw, Daniela Ferrante, Javier Marco-Hernández, Isabel Ruiz-Camps, Gianluca Gaidano, Andrea Patriarca, Riccardo Bruna, Anna Sureda, Clara Martinez-Vila, Ana Sanchez de Torre, Luca Cantini, Marco Filetti, Lorenza Rimassa, Lorenzo Chiudinelli, Michela Franchi, Marco Krengli, Armando Santoro, Aleix Prat, Mieke Van Hemelrijck, Nikolaos Diamantis, Thomas Newsom-Davis, Alessandra Gennari, Alessio Cortellini, Judith Swallow, Chris Chung, Gino Dettorre, Neha Chopra, Alvin JX Lee, Christopher CT Sng, Yien Ning Sophia Wong, Myria Galazi, Sarah Benafif, Palma Dileo, Grisma Patel, Anjui Wu, Alasdair Sinclair, Gehan Soosaipillai, Eleanor Jones, Amanda Jackson, Martine Piccart, Emeline Colomba-Blameble, Claudia A Cruz, Elia Segui, David Garcia Illescas, Oriol Mirallas, Anna Carbó, Isabel Garcia, Rachel Wuerstlein, Ricard Mesia, Clara Maluquer, Francesca D'Avanzo, Giuseppe Tonini, Salvatore Provenzano, Valeria Tovazzi, Corrado Ficorella, Paola Queirolo, Raffaele Giusti, Francesca Mazzoni, Federica Zoratto, Marco Tucci, Rossana Berardi, Annalisa Guida, Sergio Bracarda, Maria Iglesias, Pinato, D. J., Tabernero, J., Bower, M., Scotti, L., Patel, M., Colomba, E., Dolly, S., Loizidou, A., Chester, J., Mukherjee, U., Zambelli, A., Dalla Pria, A., Aguilar-Company, J., Ottaviani, D., Chowdhury, A., Merry, E., Salazar, R., Bertuzzi, A., Brunet, J., Lambertini, M., Tagliamento, M., Pous, A., Sita-Lumsden, A., Srikandarajah, K., Colomba, J., Pommeret, F., Segui, E., Generali, D., Grisanti, S., Pedrazzoli, P., Rizzo, G., Libertini, M., Moss, C., Evans, J. S., Russell, B., Harbeck, N., Vincenzi, B., Biello, F., Bertulli, R., Linan, R., Rossi, S., Carmona-Garcia, M. C., Tondini, C., Fox, L., Baggi, A., Fotia, V., Parisi, A., Porzio, G., Saponara, M., Cruz, C. A., Garcia-Illescas, D., Felip, E., Roque Lloveras, A., Sharkey, R., Roldan, E., Reyes, R., Earnshaw, I., Ferrante, D., Marco-Hernandez, J., Ruiz-Camps, I., Gaidano, G., Patriarca, A., Bruna, R., Sureda, A., Martinez-Vila, C., Sanchez de Torre, A., Cantini, L., Filetti, M., Rimassa, L., Chiudinelli, L., Franchi, M., Krengli, M., Santoro, A., Prat, A., Van Hemelrijck, M., Diamantis, N., Newsom-Davis, T., Gennari, A., Cortellini, A., Swallow, J., Chung, C., Dettorre, G., Chopra, N., Lee, A. J., Sng, C. C., Wong, Y. N. S., Galazi, M., Benafif, S., Dileo, P., Patel, G., Wu, A., Sinclair, A., Soosaipillai, G., Jones, E., Jackson, A., Piccart, M., Colomba-Blameble, E., Garcia Illescas, D., Mirallas, O., Carbo, A., Garcia, I., Wuerstlein, R., Mesia, R., Maluquer, C., D'Avanzo, F., Tonini, G., Provenzano, S., Tovazzi, V., Ficorella, C., Queirolo, P., Giusti, R., Mazzoni, F., Zoratto, F., Tucci, M., Berardi, R., Guida, A., Bracarda, S., and Iglesias, M.

Subjects
Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Belgium, COVID-19, Disease Progression, Female, France, Germany, Hospitalization, Humans, Italy, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasms, Prevalence, Registries, Retrospective Studies, Spain, United Kingdom, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Registry study, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), OnCovid, cancer treatment, Post-Acute COVID-19 Syndrome, Internal medicine, medicine, 80 and over, In patient, business.industry, Cancer, Retrospective cohort study, Articles, medicine.disease, Oncology, Research centre, Population study, business
Abstract

Background: The medium-term and long-term impact of COVID-19 in patients with cancer is not yet known. In this study, we aimed to describe the prevalence of COVID-19 sequelae and their impact on the survival of patients with cancer. We also aimed to describe patterns of resumption and modifications of systemic anti-cancer therapy following recovery from SARS-CoV-2 infection. Methods: OnCovid is an active European registry study enrolling consecutive patients aged 18 years or older with a history of solid or haematological malignancy and who had a diagnosis of RT-PCR confirmed SARS-CoV-2 infection. For this retrospective study, patients were enrolled from 35 institutions across Belgium, France, Germany, Italy, Spain, and the UK. Patients who were diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, and entered into the registry at the point of data lock (March 1, 2021), were eligible for analysis. The present analysis was focused on COVID-19 survivors who underwent clinical reassessment at each participating institution. We documented prevalence of COVID-19 sequelae and described factors associated with their development and their association with post-COVID-19 survival, which was defined as the interval from post-COVID-19 reassessment to the patients’ death or last follow-up. We also evaluated resumption of systemic anti-cancer therapy in patients treated within 4 weeks of COVID-19 diagnosis. The OnCovid study is registered in ClinicalTrials.gov, NCT04393974. Findings: 2795 patients diagnosed with SARS-CoV-2 infection between Feb 27, 2020, and Feb 14, 2021, were entered into the study by the time of the data lock on March 1, 2021. After the exclusion of ineligible patients, the final study population consisted of 2634 patients. 1557 COVID-19 survivors underwent a formal clinical reassessment after a median of 22·1 months (IQR 8·4–57·8) from cancer diagnosis and 44 days (28–329) from COVID-19 diagnosis. 234 (15·0%) patients reported COVID-19 sequelae, including respiratory symptoms (116 [49·6%]) and residual fatigue (96 [41·0%]). Sequelae were more common in men (vs women; p=0·041), patients aged 65 years or older (vs other age groups; p=0·048), patients with two or more comorbidities (vs one or none; p=0·0006), and patients with a history of smoking (vs no smoking history; p=0·0004). Sequelae were associated with hospitalisation for COVID-19 (p

Published
2021

3. Aggressive Pituitary Macroadenoma Treated With Capecitabine and Temozolomide Chemotherapy Combination in a Patient With Nelson’s Syndrome: A Case Report

Author

Irene Hernandez, J. Hernando, Oriol Mirallas, Elena Martínez-Sáez, Anas Chaachou, A. Garcia-Alvarez, Betina Biagetti, Francesca Filippi-Arriaga, Anton Aubanell, Jaume Capdevila, Institut Català de la Salut, [Mirallas O, Garcia-Alvarez A, Hernando J, Capdevila J] Servei d’Oncologia Mèdica, Unitat de Tumors Gastrointestinals i Endocrins, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Filippi-Arriaga F] Servei de Farmacologia Clínica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Hernandez Hernandez I, Biagetti B] Servei d’Endocrinologia i Nutrició, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Aubanell A] Servei de Radiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Chaachou A, Martínez-Saez E] Servei de Patologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
Hipòfisi - Tumors - Tractament, Adenoma, Male, medicine.medical_specialty, Side effect, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores], Case Report, Disease, temozolomide, aggressive pituitary tumors, Adenoma - Tractament, Other subheadings::Other subheadings::/drug therapy [Other subheadings], Quimioteràpia combinada, Diseases of the endocrine glands. Clinical endocrinology, Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Adenoma [DISEASES], Nelson Syndrome, Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Pituitary Neoplasms::ACTH-Secreting Pituitary Adenoma::Nelson Syndrome [DISEASES], Capecitabine, Endocrinology, Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], Antineoplastic Combined Chemotherapy Protocols, Medicine, Humans, Neoplasm Invasiveness, Pituitary Neoplasms, neoplasias::neoplasias por tipo histológico::neoplasias glandulares y epiteliales::adenoma [ENFERMEDADES], Adverse effect, Chemotherapy, Temozolomide, Nelson’s syndrome, business.industry, capecitabine, Pituitary tumors, Nelson's syndrome, terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Middle Aged, medicine.disease, RC648-665, Surgery, Tumor Burden, Treatment Outcome, neoplasias::neoplasias por localización::neoplasias de las glándulas endocrinas::neoplasias hipofisarias::adenoma hipofisario secretor de ACTH::síndrome de Nelson [ENFERMEDADES], Spain, business, medicine.drug
Abstract

Agressive pituitary tumors; Capecitabine; Temozolomide Tumores hipofisarios agresivos; Capecitabina; Temozolomida Tumors hipofisaris agressius; Capecitabina; Temozolomida Nelson’s syndrome is considered a severe side effect that can occur after a total bilateral adrenalectomy in patients with Cushing’s disease. It usually presents with clinical manifestations of an enlarging pituitary tumor including visual and cranial nerve alterations, and if not treated, can cause death through local brain compression or invasion. The first therapeutic option is surgery but in extreme cases of inaccessible or resistant aggressive pituitary tumors; the off-label use of chemotherapy with capecitabine and temozolomide can be considered. However, the use of this treatment is controversial due to adverse events, lack of complete response, and inability to predict results. We present the case of a 48-year-old man diagnosed with Nelson’s syndrome with prolonged partial response and significant clinical benefit to treatment with capecitabine and temozolomide.

Published
2021

4. Acquired hepatocerebral degeneration in a metastatic neuroendocrine tumor long-term survivor - an update on neuroendocrine neoplasm's treatment: A case report

Author

Mirallas, Oriol, Saoudi, Nadia, Gomez-Puerto, Diego, Riveiro Barciela, Mar, Merino, Xavier, Auger, Cristina, Landolfi, Stefania, Blanco, Laia, Garcia-Burillo, Amparo, Molero, Xavier, Salcedo, Maria-Teresa, Capdevila Castillón, Jaume, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Mirallas O, Saoudi N, Gómez-Puerto D, Capdevila J] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. Vall Hebron Institute of Oncology (VHIO), Barcelona, Spain. [Riveiro-Barciela M] Unitat del Fetge, Servei de Medicina Interna, Hospital Universitari Vall d'Hebron, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Merino X, Auger C] Servei de Radiodiagnòstic, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Landolfi S, Salcedo-Allende MT] Servei de Patologia, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Blanco L, Molero X] Servei de Cirurgia Hepatobiliopancreàtica i Trasplantaments, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Garcia-Burillo A] Servei de Medicina Nuclear, Vall d'Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Peptide radionuclide receptor therapy, Encephalopathy, Digestive System Diseases::Liver Diseases::Hepatolenticular Degeneration [DISEASES], derecho sanitario::bienestar social::sistema de salud unificado::vigilancia sanitaria [SALUD PÚBLICA], Parkinsonism, Somatostatin analogues, Neuroendocrine tumors, Tumors neuroendocrins - Complicacions, Paramagnetic deposits, 03 medical and health sciences, Liver disease, Otros calificadores::Otros calificadores::/complicaciones [Otros calificadores], 0302 clinical medicine, Medicina preventiva, Case report, medicine, Everolimus, Degeneració hepatolenticular - Tractament, Hepatic encephalopathy, Endoscopic retrograde cholangiopancreatography, neoplasias::neoplasias por tipo histológico::neoplasias de células germinales y embrionarias::tumores neuroectodérmicos::tumores neuroendocrinos [ENFERMEDADES], Hepatology, medicine.diagnostic_test, business.industry, Hepatocerebral degeneration, medicine.disease, Health Law::Social Welfare::Unified Health System::Health Surveillance [PUBLIC HEALTH], enfermedades del sistema digestivo::enfermedades hepáticas::degeneración hepatolenticular [ENFERMEDADES], 030220 oncology & carcinogenesis, Hepatic metastases, Neoplasms::Neoplasms by Histologic Type::Neoplasms, Germ Cell and Embryonal::Neuroectodermal Tumors::Neuroendocrine Tumors [DISEASES], 030211 gastroenterology & hepatology, Radiology, Hepatectomy, business, Other subheadings::Other subheadings::/complications [Other subheadings]
Abstract

Metàstasis hepàtiques; Degeneració hepatocerebral; Tumors neuroendocrins Metástasis hepáticas; Degeneración hepatocerebral; Tumores neuroendocrinos Hepatic metastases; Hepatocerebral degeneration; Neuroendocrine tumors BACKGROUND Metastatic small bowel low-grade neuroendocrine tumors (NETs) have a good prognosis. Surgery is the only curative treatment; however, this may induce advanced liver disease, particularly in long-term survivor patients. Acquired hepatocerebral degeneration or Parkinsonism in cirrhosis is characterized by rapidly progressive extrapyramidal symptoms in patients with advanced liver disease. CASE SUMMARY A 70-year-old man presented to the emergency department with diminished consciousness and disorientation, and was diagnosed with hepatic encephalopathy. The patient was diagnosed in 1993 with a metastatic small bowel NET, for which he twice underwent hepatic surgery, with metastatic resection in 1993 and a right hepatectomy in 2002 to remove two hepatic metastases. In 2003, the patient started first-line chemotherapy and in 2004 started the first of three consecutive biological treatments, followed by radio-molecular therapy, achieving stable disease for 14 years. Disease progression was identified and he underwent an endoscopic retrograde cholangiopancreatography. However, in 2019 advanced liver disease was identified. We diagnosed the development of acquired hepatocerebral degeneration, an unusual long-term side effect after multiple hepatic procedures. CONCLUSION The importance of regular and ongoing surveillance in long-term NET survivors who undergo hepatic procedures should be integrated into the therapeutic management plan, as some of these negative outcomes could be prevented.

Published
2021

5. Hepatocellular carcinoma with tumor thrombus extends to the right atrium and portal vein: a case report

Author

Gomez-Puerto, Diego, Mirallas, Oriol, Vidal-González, Judit, Vargas Blasco, Víctor, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Gomez-Puerto D, Mirallas O] Servei d’Oncologia Mèdica, Vall d'Hebron Hospital Universitari, Barcelona, Spain. [Vidal-González J] Servei d’Hepatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBERehd, Barcelona, Spain. [Vargas V] Servei d’Hepatologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBERehd, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus

Subjects
medicine.medical_specialty, Hepatocellular carcinoma, neoplasias::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias hepáticas::carcinoma hepatocelular [ENFERMEDADES], Inferior vena cava, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Cardiac magnetic resonance imaging, Case report, Fetge - Càncer - Prognosi, medicine, Hepatopulmonary syndrome, Vein, Diagnosis::Prognosis [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT], diagnóstico::pronóstico [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS], Portopulmonary hypertension, Right atrium, Hepatology, medicine.diagnostic_test, business.industry, Sorafenib, medicine.disease, digestive system diseases, Pulmonary embolism, Tumor thrombus, medicine.anatomical_structure, Neoplasms::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Liver Neoplasms::Carcinoma, Hepatocellular [DISEASES], medicine.vein, 030220 oncology & carcinogenesis, Alpha-fetoprotein, cardiovascular system, 030211 gastroenterology & hepatology, Radiology, business
Abstract

Alfa-fetoproteïna; Carcinoma hepatocel·lular; Trombe tumoral Alfafetoproteína; Carcinoma hepatocelular; Trombo tumoral Alpha-fetoprotein; Hepatocellular carcinoma; Tumor thrombus BACKGROUND Hepatocellular carcinoma (HCC) is the most important primary malignant liver disease. A large proportion of patients with advanced HCC have macrovascular invasion. HCC tends to infiltrate vascular structures, particularly the portal vein and its branches, and more rarely, the hepatic veins. The intravascular tumor thrombus can affect the inferior vena cava (IVC) or even the right atrium (RA), the latter having a poor prognosis. CASE SUMMARY HCC is one of the most aggressive malignant tumors. Tumor thrombus (TT) formation in advanced HCC stages is common and usually involves the hepatic or portal veins. Herein, we report a 69-year-old woman who presented with dyspnea to the emergency department. A ventilation/perfusion lung scan was performed, ruling out pulmonary embolism. Hepatopulmonary syndrome and portopulmonary hypertension were discarded with contrasted echocardiography, but a mass in the RA was detected and confirmed by cardiac magnetic resonance imaging. Abdominal computed tomography showed a liver mass with a dynamic enhancement pattern compatible with HCC and an intraluminal IVC mass extending from the hepatic vein into the RA. HCC with TT expansion to IVC and RA is rare and indicates poor prognosis. CONCLUSION HCC with TT expansion to IVC and RA is rare and indicates poor prognosis. There is no consensus about anticoagulation or other interventions in these patients. Gomez-Puerto D, Mirallas O, Vidal-González J, Vargas V. Hepatocellular carcinoma with tumor thrombus extends to the right atrium and portal vein: A case report. World J Hepatol 2020; 12(11): 1128-1135 [PMID: 33312435 DOI: 10.4254/wjh.v12.i11.1128]

Published
2020

6. Clinical portrait of the SARS-CoV-2 epidemic in european patients with cancer

Author

David J. Pinato, Alberto Zambelli, Juan Aguilar-Company, Mark Bower, Christopher C.T. Sng, Ramon Salazar, Alexia Bertuzzi, Joan Brunet, Ricard Mesia, Elia Seguí, Federica Biello, Daniele Generali, Salvatore Grisanti, Gianpiero Rizzo, Michela Libertini, Antonio Maconi, Nadia Harbeck, Bruno Vincenzi, Rossella Bertulli, Diego Ottaviani, Anna Carbó, Riccardo Bruna, Sarah Benafif, Andrea Marrari, Rachel Wuerstlein, M. Carmen Carmona-Garcia, Neha Chopra, Carlo Tondini, Oriol Mirallas, Valeria Tovazzi, Marta Betti, Salvatore Provenzano, Vittoria Fotia, Claudia Andrea Cruz, Alessia Dalla Pria, Francesca D'Avanzo, Joanne S. Evans, Nadia Saoudi-Gonzalez, Eudald Felip, Myria Galazi, Isabel Garcia-Fructuoso, Alvin J.X. Lee, Thomas Newsom-Davis, Andrea Patriarca, David García-Illescas, Roxana Reyes, Palma Dileo, Rachel Sharkey, Yien Ning Sophia Wong, Daniela Ferrante, Javier Marco-Hernández, Anna Sureda, Clara Maluquer, Isabel Ruiz-Camps, Gianluca Gaidano, Lorenza Rimassa, Lorenzo Chiudinelli, Macarena Izuzquiza, Alba Cabirta, Michela Franchi, Armando Santoro, Aleix Prat, Josep Tabernero, Alessandra Gennari, Gian Carlo Avanzi, Mattia Bellan, Luigi Mario Castello, Maria Martinez, Meritxell Mollà, Mario Pirisi, Lorenza Scotti, Judith Swallow, Pinato, D. J., Zambelli, A., Aguilar-Company, J., Bower, M., Sng, C. C. T., Salazar, R., Bertuzzi, A., Brunet, J., Mesia, R., Segui, E., Biello, F., Generali, D., Grisanti, S., Rizzo, G., Libertini, M., Maconi, A., Harbeck, N., Vincenzi, B., Bertulli, R., Ottaviani, D., Carbo, A., Bruna, R., Benafif, S., Marrari, A., Wuerstlein, R., Carmona-Garcia, M. C., Chopra, N., Tondini, C., Mirallas, O., Tovazzi, V., Betti, M., Provenzano, S., Fotia, V., Cruz, C. A., Pria, A. D., D'Avanzo, F., Evans, J. S., Saoudi-Gonzalez, N., Felip, E., Galazi, M., Garcia-Fructuoso, I., Lee, A. J. X., Newsom-Davis, T., Patriarca, A., Garcia-Illescas, D., Reyes, R., Dileo, P., Sharkey, R., Wong, Y. N. S., Ferrante, D., Marco-Hernandez, J., Sureda, A., Maluquer, C., Ruiz-Camps, I., Gaidano, G., Rimassa, L., Chiudinelli, L., Izuzquiza, M., Cabirta, A., Franchi, M., Santoro, A., Prat, A., Tabernero, J., and Gennari, A.

Subjects
0301 basic medicine, medicine.medical_specialty, medicine.medical_treatment, Population, MEDLINE, risk stratification, Targeted therapy, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, SARS-CoV-2 pandemic, oncology practice, Internal medicine, Pandemic, medicine, education, education.field_of_study, Chemotherapy, Research Briefs, business.industry, Mortality rate, Cancer, medicine.disease, 3. Good health, 030104 developmental biology, Oncology, 030220 oncology & carcinogenesis, business
Abstract

Higher risk of death from COVID-19 among patients with cancer was correlated with male sex, greater age, presence of multiple comorbidities, advanced-stage disease, and active disease; there was no association between risk and anticancer treatment., The SARS-CoV-2 pandemic significantly affected oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncologic features to severity and mortality from COVID-19 and little guidance as to the role of anticancer and anti–COVID-19 therapy in this population. In a multicenter study of 890 patients with cancer with confirmed COVID-19, we demonstrated a worsening gradient of mortality from breast cancer to hematologic malignancies and showed that male gender, older age, and number of comorbidities identify a subset of patients with significantly worse mortality rates from COVID-19. Provision of chemotherapy, targeted therapy, or immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk stratification of patients and supports further research into emerging anti–COVID-19 therapeutics in SARS-CoV-2–infected patients with cancer. Significance: In this observational study of 890 patients with cancer diagnosed with SARS-CoV-2, mortality was 33.6% and predicted by male gender, age ≥65, and comorbidity burden. Delivery of cancer therapy was not detrimental to severity or mortality from COVID-19. These patients should be the focus of shielding efforts during the SARS-CoV-2 pandemic. This article is highlighted in the In This Issue feature, p. 1426

Published
2020

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