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Background: Esophageal cancer is an invasive tumor with rapid growth and a poor prognosis. The annual incidence of esophageal cancer in the United States is 6 per 100 000 men and 1.6 per 100 000 women. This is different in the case of Iran, and the number of patients in the country is higher than in other countries. In this evaluation, the researchers present the experience with open Transhiatal Esophagectomy (Orringer) technique outcomes. Objectives: This study aimed at evaluating the Orringer technique and its complications in patients with esophageal cancer for 25 years at the Cancer Research Center of Shahid Beheshti University of Medical Sciences. Methods: This is a descriptive study conducted from the beginning of 1988 to 2016. In this study, 114 patients with a mean age of 55 years and a gender classification of 60% male and 40% female were evaluated. Results: After resection, more than 98% of patients were in the T3 N1 - N3 stage. There were 4 mortalities: 2 were due to descending aorta tearing, 1 was due to tracheobronchial tearing, and 1 was pneumonia From 40 cases of pleural effusion, only 5 cases (12.5%) needed a thoracotomy tube. Only 2 patients needed intervention from 30 patients with dysphagia; 1 case was relieved by balloon dilatation and the other needed a free jejunal flap. Five-year survivals were 30% and 20% versus 48% and 23% in the neoadjuvant and non-neoadjuvant groups, respectively. conclusions: The present study and other experiences showed that non-radical surgery such as the Orringer technique is acceptable and compassable compared to radical surgery in 3 fields.

Background: Hepatopancreatobiliary (HPB) malignancies are a relatively rare but important type of cancer with usually poor prognosis. Prompt diagnosis and treatment are crucial to improving the patient’s outcome. For this issue, acknowledgment of epidemiological characteristics is helpful. Objectives: In this study, the epidemiological characteristics of cases with HPB sarcoma among Iranian patients were assessed. Methods: In this epidemiological study, 133 consecutive cases with HPB sarcoma in Iran from 2010 to 2014 were evaluated, including gallbladder, pancreas, hepatic, pancreatic body and head, and other biliary tumors. Results: Nine gallbladder sarcoma cases were reported between 2010 and 2014, accounting for 6.7% of all HPB sarcoma cases, and leiomyosarcoma was the most common. A total of 16 patients of pancreatic origin were reported during this period, with the highest rate of 6 cases in 2011; in this sarcoma category, malignant type spindle cell tumor was the most common type accounting for 12.5% of all cases. Ninety-five cases of liver sarcomas were reported generally. Non-specified and desmoplastic small round cell tumors were the most common types. Five cases of pancreatic head sarcomas were reported during 2010 - 2013. There was no predominant tumor type. Five cases of pancreatic head sarcoma were reported during 2010 - 2013. There was no dominant tumor type. About the other biliary tract sites, six patients were reported. Gastrointestinal stromal sarcoma was the most common type. Conclusions: Hepatopancreatobiliary sarcoma in the Iranian population generally has diverse types, and there are different patterns according to the age and sex distribution in patients according to the initial location of the tumor and also their pathological subtypes.

Breast cancer is one of the most common challenges for women's health. Until now, neoadjuvant chemotherapy is a standard approach in locally advanced breast cancer (LABC), as it increases the probability of breast-conserving surgery (BCS). This study aimed to compare the survival rate in neoadjuvant and adjuvant groups to suggest a better treatment strategy for locally advanced breast cancer.The study was conducted between 2009 and 2019 on 845 LABC patients at the Cancer Research Center of Shahid Beheshti University of Medical Sciences in Iran. All patients with LABC at stages 3A, 3B, and two were evaluated for treatment with adjuvants (n = 520 female patients) and neoadjuvant (n = 320 female patients) treatment strategies. Patients were followed up for at least 120 months. The Kaplan-Meier method calculated the survival rate using SPSS version 23 software.The 5 and 10 years survival rates of neoadjuvant and adjuvant groups were 87 ± 0.04, 80 ± 0.07% and 87 ± 0.02, 83 ± 0.03%, respectively. Statistical analysis results with the mentioned treatment strategies did not show any significant difference in overall survival.The result of this study on LABC patients demonstrated that compared to surgery first following adjuvant chemotherapy, the neoadjuvant chemotherapy has several benefits, including downstaging and more BCS, with no statistically significant difference in the overall survival rate of the patients.

Hematological malignancies including leukemia, multiple myeloma, and lymphoma are known as leading causes of death around the world. Despite all developments in cancer management, current therapeutic methods are still relatively inefficient, leading to the heavy financial burdens for public health systems. Strategic attempts in clinical practice must be based on three serious goals including (1) increasing the efficacy of treatments and decreasing their side-effects; (2) decreasing financial price of treatments and related morbidity and mortality rates; and (3) improving life quality and survival of affected patients. Melatonin, a multipotential neurohormone mainly secreted by the pineal gland, has recently been shown to play essential roles in the treatment of various human diseases. Moreover, it possesses anticancer impacts and acts through regulation of underlying cellular and molecular mechanisms. In this article, we review mechanistic roles and beneficial effects of melatonin against hematological cancers, especially lymphoma.

BACKGROUND Background Recently, a real-time system, named cancer diagnostic probe (CDP), has been developed to diagnose the presence of pre-neoplastic/neoplastic cells in breast cavity side margins. Detecting mechanism is real-time determination of the ROS/H2 O2 released from cancer or atypical cells, through reverse Warburg effect and hypoxia glycolysis pathways. AIMS Here, we designed a human model study based on real-time checking of 387 internal margins (IM) from 39 neoadjuvant breast cancer cases by CDP. MATERIALS & METHODS: Each lesion was checked by entered needle sensor and electrical scores were recorded. The permanent pathology result of each tested lesion was our gold standard to evaluate CDP scoring. CDP results were compared with permanent pathology of tumour side margins (as a conventional margin evaluation procedure). RESULTS Results showed that the sensitivity of CDP in scoring the cavity side margins of those cases is 91%. A total of 18 involved IM which had been detected by CDP were declared as free margins in pathology section of tumour side samples. Just five involved IM were missed by CDP. DISCUSSIONS Such sensitivity revealed that metabolism based (here: hypoxia glycolysis) tracing of cancer cells show distinct electrochemical responses between clear and involved cavity side margin evaluation. CONCLUSION This human study showed the promising role of CDP to achieve clear margins after BCS of neoadjuvant cases.

Background: One of the most important alterations in breast cancer treatment is the change of view in axillary lymph node management. At the moment, sentinel lymph node biopsy (SLNB) is the standard care in axillary lymph node management. However, in patients with clinically positive lymph nodes or in patients, who have no willingness to receive radioactive drugs, axillary lymph node dissection (ALND) must be done. To the best of our knowledge, there is no overall survival (OS) benefit in ALND, especially at the early stage of breast cancer, during which this procedure is not justified. Objectives: Herein, we have reported the results of 27 years of experiments in limited axillary lymph node dissection (LALND) in comparison to ALND as well as the relationship among the number of removed lymph nodes, OS, and disease-free survival (DFS) at the early stage of breast cancer. Methods: OS and DFS for 588 cases, who were at the early stage of breast cancer and treated by LALND between 1984 and 2019, were compared with 1026 patients, who were treated by ALND during the same interval in this study. Notably, SLNB cases were excluded. Results: The results revealed no significant difference among the groups in terms of DFS (P = 0.268, 0.123, and 0.333). Also, there was no difference in terms of OS between the LALND group (1 - 4 nodes, 5 - 6 nodes, and 7 - 8 nodes) and ALND group (≥ 9 nodes) in patients without lymph node involvement (AHR less than 2). However, in the patients with axillary lymph node metastasis (N1, N2), similar results were obtained. Correspondingly, in this group, the best results were observed in those patients, whose 7 - 8 lymph nodes were removed. Conclusions: Regarding the results of the current study; it can be concluded that performing the LALND in the defined anatomic range and removing 7 - 8 lymph nodes instead of removing 10 lymph nodes are not inferior when it is not possible to do SLNB (there is no access to it) and/or being a contraindication to do it for evaluating the status of axillary lymph nodes in the patients at the early stage of breast cancer.

Cancers are serious life-threatening diseases which annually are responsible for millions of deaths across the world. Despite many developments in therapeutic approaches for affected individuals, the rate of morbidity and mortality is high. The survival rate and life quality of cancer patients is still low. In addition, the poor prognosis of patients and side effects of the present treatments underscores that finding novel and effective complementary and alternative therapies is a critical issue. Melatonin is a powerful anticancer agent and its efficiency has been widely documented up to now. Melatonin applies its anticancer abilities through affecting various mechanisms including angiogenesis, apoptosis, autophagy, endoplasmic reticulum stress and oxidative stress. Regarding the implication of mentioned cellular processes in cancer pathogenesis, we aimed to further evaluate the anticancer effects of melatonin via these mechanisms.

Background: The annual religious ritual of Arba’een is the global largest mass gathering of pilgrims from different countries participating in a mass movement on an 80-km pathway to visit the Shrine of Imam Hussein, the grandson of Prophet Muhammad. The provision of health care for such a mass movement has always been an important vital issue for the health care system. Objectives: The current study investigated the common illnesses in addition to the quantity of health care services offered by temporary clinics and health stations located on the way to the shrine to such a mass gathering of on-feet pilgrims in Iraq in Arba’een 2019. Methods: This cross-sectional study was conducted at temporary clinics and health stations where pilgrims in need of nursing, midwifery, and pharmaceutical care were provided with services by general and expert physicians on the way from Najaf to Karbala in Iraq during a week in October 2019. Results: Imam Reza Temporary Clinic offered services to a total of 26,875 patients, including 9,934 females (36.96%) and 16,941 males (63.04%), on all days of the week. The most common chief complaint reported by the patients were musculoskeletal problems (n=11,945; 21.99%), foot blisters (n=11,372; 20.94%), and skin lesions (n=10,662; 19.62%). Conclusions: The present study highlighted the need for providing more organized services, especially in emergency health care, and necessity of paying further and closer attention to the significance of the health history of those pilgrims attending such religious mass gatherings in previous years.

Background: Among different common types of cancer, Gastric cancer (GC) is a worldwide health priority in both developing and developed countries. The aim of this study was to map the distribution of incident cases of GC in Iran to provide a geographical presentation of the incidence of the disease.Methods: This study used the Iranian National Cancer Registry (INCR) data from 2004 to 2014. Excel was used to do the primary analysis including calculation of GC incidence for each province and also to provide a frequency table of the type and location of GC by the provinces. ArcGIS 10.5 (Redlands, CA, USA) mapping software was used to map the provincial age-standardized incidence rates by sex. The type and location of the GC cases were obtained from the NCR dataset.Results: According to the results of the present study, the patients were predominantly male 49,907 (70.0%). During the study period, the highest and lowest age-standardized incidence rates of GC in Iran in 2014 were reported from Ardebil (IR=30.19) and Ghom (IR=1.00) respectively. A significant difference was observed when the distribution of the location of GC tumors was compared between males and females (PConclusions: The results of the current study suggested a lower rate of GC incidence rate was reported in Iran when compared to the global figure in both females and males. The findings suggest involving different factors with different effects in GC among Iranian populations. Further studies are needed to better understand the epidemiology and etiology of the disease.

Background: Gastric cancer has been one of the major causes of death in the past decades. It is the fifth most prevalent cancer and the third leading cause of neoplasm death worldwide. Thus, to know more about this health problem, assessing the burden of this cancer and its association with socioeconomic status of countries is of great importance. In this study, we aimed to evaluate the mean trend of gastric cancer mortality-to-incidence ratio (GCMIR) in different super regions defined by the Institute for Health Metrics and Evaluation (IHME) and investigate the relationship between GCMIR and Human Development Index (HDI) in the period 2000-2016. Methods: We used the data from the Global Burden of Disease (GBD) 2016 study to calculate GCMIR for 185 world countries in the period 2000–2016. We also extracted the HDI data for each year under study from the Updates of the UNDP website. To attain the analytic aims, marginal modeling and generalized estimating equations (GEE) were utilized. Results: Sub-Saharan Africa was the only super region with a positive slope of GCMIR, and high-income countries had the greatest decreasing slope of GCMIR during the study period. Moreover, there was a negative association between GCMIR and HDI in these years. Conclusion: Our findings revealed that gastric cancer could be thought not only as a biological disease but also as a social event that will be more controllable with the improvement of economic status and other social determinants of health.

Introduction. Surgery has been known as the procedure of choice for breast cancer management since 1700 years before Christ. Nowadays, breast-conserving surgery and mastectomy are performed in selected cases with specific clinical criteria. Here, we compare these two procedures for breast cancer patients with variable features in Cancer Research Center, Tehran, as a single institution experience. Methods. In this 25-year follow-up retrospective cohort study, we identified breast cancer patients who had undergone breast-conserving therapy or mastectomy. Disease-free survival and overall survival were evaluated using Kaplan–Meier survival analysis and the log-rank test between the two groups. A p value less than 0.05 was considered statistically significant. Results. A total of 3358 breast cancer patients, including 61% breast-conserving therapy and 39% mastectomy cases were identified, with a mean follow-up time of 94 months. The overall survival and disease-free survival of all cases were significantly better in breast-conserved patients, particularly in early-stage breast cancer with favorable clinical, pathological, and biological features. Ten-year disease-free survival and overall survival in breast-conserving therapy and mastectomy cases were 74%, 88% and 58%, 80%, respectively. Conclusion. Breast-conserving surgery and radiation therapy prove to be an appropriate treatment option for breast cancer patients in terms of overall survival and disease-free survival when indicated.

The current study aimed at the seroepidemiological survey of human cystic echinococcosis (CE) in nomadic people in Boyer-Ahmad District in the southwest of Iran. One thousand and five nomads were selected by cross-sectional sample collection in nomadic tribes of Boyer-Ahmad District in the southwest of Iran. Blood samples were taken from each individual, and the sera were tested for detection of anti-hydatid cyst antibodies using antigen B-ELISA. A predesigned questionnaire which contained basic epidemiological and individual information related to hydatid cyst was filled for each subject during sample collecting. Subjects of the study were 227 males (22.6%) and 778 (77.4%) females. The mean age of the participants was 40.4 years old (±16.6). Anti-hydatid cyst antibodies were detected in 81 (8.1%) of the subjects. Seroprevalence rate for CE in females (9%) was more than males (4.8%). Multivariate logistic regression revealed significant associations between CE seropositivity and sex (odds ratio [OR] = 1.88; 95% confidence interval [CI] = 0.93-3.80) and dog ownership (OR = 8.3; 95% CI = 3.94-16.37). The rate of infection with CE in nomadic people in southwest of Iran is considerable. Treatment of dogs and increasing the level of people awareness may contribute a substantial advancement in the control of the disease in the area.

A 4-year (2008–2011) community-based participatory research was implemented in the Kohgiloyeh and Boyerahmad province, Iran. A steering committee was established from academics, policy makers, health officials, and representatives of health sectors. This committee selected six regions within Boyerahmad and Dena counties based on administrative divisions. Health companions consisting of stakeholders, academics, local leaders, health providers, and public representatives were established to guide the project in each region. The health companion groups were enabled by attending workshops dealing with need assessment, priority setting, and research methodology. Health companion groups adopted a Planned Approach to Community Health (PATCH) methodology including community mobilization for data collection, health priority setting, developing of a comprehensive intervention plan, and evaluation. A list of main health issues and their priorities for each region was provided. Subsequently, research topics were determined and six surveys and intervention programs were planned and implemented. After intervention most of top priority health risk factors were decreased and the preventive programs that targeted risk factors were increased significantly. This project is found to be an effective approach for building stronger partnerships between researchers and community members for the development of effective solutions for local health concerns and promote public health.

Objectives: To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat. Methods: This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly assigned in to three groups by Random Design Method. The first group received single infliximab injection (n=20), the second one received double infliximab injection (n=20) and the third received nothing (n=20), after receiving intra-peritoneal injection of talc for induction of peritoneal adhesions. All the animals were sacrificed after 6 weeks and the peritoneal adhesions were evaluated according to Nair classification. Results: We observed that the mean adhesion grade was lower in those who received double dose of infliximib when compared to single dose and controls. However the difference did not reach a significant value ( p=0.178). The grade of peritoneal adhesion was also comparable between the three study groups ( p=0.103). The mean number of 1st WBC count was also comparable between three study groups ( p=0.382). We observed that 2nd WBC count was also comparable between two study groups ( p=0.317). Conclusion: Administration of intravenous infliximab after intraabdominal surgicalprocedures would not prevent the formation of peritoneal adhesions in animal model of albino rat.