16,458 results on '"METASTASES"'
Search Results
2. Longitudinal Study of Local Ablative Therapy in Oligometastatic Disease (OLIGO-DK)
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Gitte Fredberg Persson MD PhD, Associate Professor, Chief PhysicianGitte Fredberg Persson MD PhD
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- 2024
3. 68Ga-PSMA PET in the Renal Cell Carcinoma
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Qin Weijun, Professor and Director, Department of Urology
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- 2024
4. 68Ga-PSMA PET in the Prostate Cancer
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Qin Weijun, Professor and Director, Department of Urology
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- 2024
5. The molecular basis of the anticancer effect of statins.
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Buccioli, Giovanni, Testa, Carolina, Jacchetti, Emanuela, Pinoli, Pietro, Carelli, Stephana, Ceri, Stefano, and Raimondi, Manuela T.
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ANTINEOPLASTIC agents , *STATINS (Cardiovascular agents) , *DRUG repositioning , *CARDIOVASCULAR agents , *CELL death - Abstract
Statins, widely used cardiovascular drugs that lower cholesterol by inhibiting HMG-CoA reductase, have been increasingly recognized for their potential anticancer properties. This study elucidates the underlying mechanism, revealing that statins exploit Synthetic Lethality, a principle where the co-occurrence of two non-lethal events leads to cell death. Our computational analysis of approximately 37,000 SL pairs identified statins as potential drugs targeting genes involved in SL pairs with metastatic genes. In vitro validation on various cancer cell lines confirmed the anticancer efficacy of statins. This data-driven drug repurposing strategy provides a molecular basis for the anticancer effects of statins, offering translational opportunities in oncology. [ABSTRACT FROM AUTHOR]
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- 2024
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6. Cytologic features of mesenchymal, melanocytic and haematolymphoid tumours of the central nervous system and metastases.
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Bárcena, Carmen and Jiménez‐Heffernan, José A.
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CENTRAL nervous system , *BRAIN tumors , *CELL differentiation , *HISTOGENESIS , *METASTASIS - Abstract
The current World Health Organization (WHO) classification of central nervous system (CNS) tumours includes several neoplasms that, while occurring in this location, are more frequently seen extracranially. These include mesenchymal, melanocytic and haematolymphoid neoplasms, as well as metastases. A few of these entities are exclusive of the CNS and have no extracranial counterpart. Despite their diverse histogenesis, these neoplasms share a peculiar predilection for involving meningeal structures. In fact, in the context of an intraoperative pathologic consultation of a meningeal tumour, virtually all these entities should be considered as potential diagnoses. Metastases in the CNS are very common. Most are carcinomas that cytologically resemble their site of origin. Loss of differentiation with cell dissociation and anaplasia and presence of accompanying fibrillary brain parenchyma can be a source of diagnostic problems. In this review, we intend to show the most relevant cytologic features of these tumours, and it is especially aimed at their analysis during intraoperative studies. [ABSTRACT FROM AUTHOR]
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- 2024
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7. Diagnostic efficacy of image-guided core needle biopsy of suspected malignant osseous lesions: a retrospective cohort study from a single academic institution.
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Winkler, Winston L., Baker, Jonathan C., Tomasian, Anderanik, Vander Velde, Theodore L., Hillen, Travis J., Luo, Chongliang, Imaoka, Resten, Dettorre, Gino M., and Jennings, Jack W.
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CORE needle biopsy , *MULTIVARIATE analysis , *REFERENCE values , *BONE cancer , *ODDS ratio - Abstract
Objectives: To evaluate diagnostic yield and accuracy of image-guided core needle biopsy (ICNB) of suspected malignant osseous lesions in a large cohort of adults, evaluate what factors influence these measures, and offer technical recommendations to optimize yield. Methods: A retrospective analysis of 2321 ICNBs performed from 2010 to 2021 was completed. The diagnostic yield and accuracy of the biopsies as well as a series of patient, lesion-related, and technical factors were retrospectively analyzed. Multivariate statistical analysis was performed to evaluate what factors were associated with yield and accuracy. Different cutoff values of total core length and core number were then tested to determine threshold values in relation to increased diagnostic yield. Results: Diagnostic yield was 98.2% (2279/2321) and accuracy was 97.6% (120/123). Increased total core length (odds ratio [OR] = 2.34, 95% confidence interval [CI] (1.41–3.90), p = 0.001), core number (OR = 1.51, 95% CI (1.06–2.16), p = 0.02) and presence of primary malignancy (OR = 2.81, 95% CI (1.40–5.62), p = 0.004) were associated with improved yield. Lesion location in an extremity (OR = 0.27, 95% CI (0.11–0.68), p = 0.006) and using fluoroscopic imaging guidance (OR = 0.33, 95% CI (0.12–0.90), p = 0.03) were associated with lower yield. Cutoff thresholds in relation to increased diagnostic yield were found to be 20 mm total core length (marginal OR = 4.16, 95% CI = (2.09–9.03), p < 0.001), and three total cores obtained (marginal OR = 2.78, 95% CI (1.34–6.54), p = 0.005). None of the analyzed factors influenced diagnostic accuracy. Conclusions: ICNB has a high rate of diagnostic yield and accuracy. Several factors influence diagnostic yield; 20 mm core length and three total cores optimize yield. Clinical relevance statement: Image-guided core needle biopsy of suspected malignant osseous lesions is a safe procedure with a very high rate of diagnostic yield and accuracy. Obtaining 20 mm total core length and three total cores optimizes diagnostic yield. Key Points: • In a retrospective cohort study, image-guided core needle biopsy of suspected osseous malignant lesions in adults was found to have very high rates of diagnostic yield and accuracy. • Increased total core length and core number of biopsies were each associated with increased diagnostic yield, and these relationships reached thresholds at 20 mm total core length and three total cores obtained. • The presence of a known primary malignancy was also associated with increased yield while using fluoroscopic imaging guidance and lesion location in an extremity were associated with decreased yield. [ABSTRACT FROM AUTHOR]
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- 2024
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8. In situ tumor vaccine with optimized nanoadjuvants and lymph node targeting capacity to treat ovarian cancer and metastases.
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Li, Yuan, Tong, Fan, Wang, Yufan, Wang, Jing, Wu, Manqi, Li, Hanmei, Guo, Hongyan, and Gao, Huile
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Tumor vaccine, a promising modality of tumor immunotherapy, needs to go through the process of tumor antigen generation and loading, antigen drainage to lymph nodes (LNs), antigen internalization by dendritic cells (DCs), DC maturation, and antigen cross-presentation to activate T-cells. However, tumor vaccines are often unable to satisfy all the steps, leading to the limitation of their application and efficacy. Herein, based on a smart nanogel system, an in situ nano-vaccine (CpG@Man-P/Tra/Gel) targeting LNs was constructed to induce potent anti-tumor immune effects and inhibit the recurrence and metastasis of ovarian cancer. The CpG@Man-P/Tra/Gel exhibited MMP-2-sensitive release of trametinib (Tra) and nano-adjuvant CPG@Man-P, which generated abundant in situ depot of whole-cell tumor antigens and formed in situ nano-vaccines with CpG@Man-P. Benefiting from mannose (Man) modification, the nano-vaccines targeted to LNs, promoted the uptake of antigens by DCs, further inducing the maturation of DCs and activation of T cells. Moreover, CpG@Man-P with different particle sizes were prepared and the effective size was selected to evaluate the antitumor effect and immune response in vivo. Notably, combined with PD-1 blocking, the vaccine effectively inhibited primary tumor growth and induced tumor-specific immune response against tumor recurrence and metastasis of ovarian cancer. A smart tumor in situ nano-vaccine Tra/CpG@Man-P/Gel was constructed, and the size of nanoadjuvants was optimixed, to induce potent antitumor immunity and inhibit the primary and metastatic tumors. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2024
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9. Clinico-biological factors predicting the benefit of the LV5FU2 maintenance strategy as a first-line therapy in patients with metastatic pancreatic cancer.
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Boisteau, Emeric, Dahan, Laetitia, Williet, Nicolas, Malicot, Karine Le, Desramé, Jérôme, Bouché, Olivier, Petorin, Caroline, Malka, David, Rebischung, Christine, Aparicio, Thomas, Lecaille, Cédric, Rinaldi, Yves, Turpin, Anthony, Bignon, Anne-Laure, Bachet, Jean-Baptiste, Lepage, Côme, Granger, Victoire, Legoux, Jean-Louis, Deplanque, Gaël, and Baconnier, Mathieu
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IRINOTECAN ,PATIENT selection ,NEUTROPHIL lymphocyte ratio ,ANTINEOPLASTIC agents ,TREATMENT effectiveness ,TUMOR markers ,CANCER patients ,AGE distribution ,RETROSPECTIVE studies ,PANCREATIC tumors ,METASTASIS ,CANCER chemotherapy ,FOLINIC acid ,OXALIPLATIN ,DRUG efficacy ,CLINICAL deterioration ,QUALITY of life ,MEDICAL records ,ACQUISITION of data ,FLUOROURACIL ,PROGRESSION-free survival ,LIVER ,PROPORTIONAL hazards models ,OVERALL survival ,TIME ,EVALUATION - Abstract
Introduction Predictive markers of LV5FU2 maintenance benefit after first-line induction with FOLFIRINOX in patients with metastatic pancreatic cancer are necessary to select patients who will not be harmed by this strategy. Patients and Methods We focused on patients who received 12 cycles of FOLFIRINOX (arm A, N = 88) or 8 cycles of FOLFIRINOX followed by LV5FU2 maintenance in controlled patients (arm B, N = 91) from the PRODIGE-35 trial. Prognostic factors and predictors of efficiency were identified by using Cox regression. Median progression-free survival (PFS), overall survival (OS), and time to deterioration of quality of life (TTD-QoL) were evaluated. Results Poor independent prognostic factors were primary tumor in place, age <65 years and the presence of liver metastases for PFS, a baseline neutrophil/lymphocyte ratio (NLR) ≥5 and CA19.9 ≥500 UI/L for OS, independent of the treatment arm. Patients with one metastatic site had a longer PFS in arm A, whereas patients with ≥2 metastatic sites had a longer PFS in arm B. We also identified predictors of OS and TTD-QoL in arm B but these differences were not statistically significant. Conclusion Except for patients with one metastatic site who benefited more from 12 cycles of FOLFIRINOX, a maintenance strategy with LV5FU2 should be widely offered to mPC patients whose survival and QoL are preserved after 4 months of FOLFIRINOX. (ClinicalTrials.gov: NCT02352337). [ABSTRACT FROM AUTHOR]
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- 2024
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10. Cisplatin Monotherapy as a Treatment Option for Patients with HER-2 Negative Breast Cancer Experiencing Hepatic Visceral Crisis or Impending Visceral Crisis.
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Püsküllüoğlu, Mirosława, Pieniążek, Małgorzata, Rudzińska, Agnieszka, Pietruszka, Agnieszka, Pacholczak-Madej, Renata, Grela-Wojewoda, Aleksandra, and Ziobro, Marek
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BREAST cancer prognosis ,HYPERBILIRUBINEMIA ,CISPLATIN ,BREAST tumors ,LOGISTIC regression analysis ,TREATMENT effectiveness ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,CANCER patients ,LONGITUDINAL method ,CANCER chemotherapy ,ODDS ratio ,METASTASIS ,ONCOGENES ,DRUG efficacy ,MEDICAL records ,ACQUISITION of data ,STATISTICS ,CONFIDENCE intervals ,PROGRESSION-free survival ,EPIDERMAL growth factor receptors ,OVERALL survival - Abstract
Introduction: Hepatic visceral crisis (VC), characterized by a rapid total bilirubin increase with disease progression, poses a life-threatening risk in advanced breast cancer (ABC). International consensus guidelines define VC and touch on impending VC (IVC). Limited data exist on systemic treatments for hepatic VC/IVC. This study explores the safety and efficacy of cisplatin monotherapy in patients with Human Epidermal Growth Factor Receptor 2- negative breast cancer (BC) and hepatic IVC/VC. Methods: In this retrospective single-center cohort study data of patients treated with cisplatin monotherapy (60–80 mg/m
2 , every 3–4 weeks) between 2016 and 2023 at a reference Cancer Centre in Southern Poland were analyzed. Results: 33 female patients (24/33 hormonal-positive) with the mean age 53.84 years were included. Participants progressed on median 2 prior palliative systemic treatment lines. In 10/23 patients hepatic VC and in 23/33 IVC (rapid, symptomatic liver progression; extensive liver involvement; alanine or aspartate aminotransferase > 2 × normal limit; significant increases in lactate dehydrogenase, alkaline phosphatase, or gamma-glutamyl transferase) were identified. Median progression-free survival was 1.87 months and median overall survival 2.67 months. 33% of the patients presented stable disease or partial response. Eight patients experienced adverse events grade ≥ 3: in five the dose of cisplatin was reduced; two stopped the treatment. Conclusion: Due to the hepatotoxicity of BC-active drugs, specific recommendations for systemic treatment are scarce. Our study explored cisplatin's potential use, finding it to be a viable option in patients with performance status 0 or 1 experiencing hepatic IVC/VC, irrespective of liver function parameters and other factors. [ABSTRACT FROM AUTHOR]- Published
- 2024
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11. Surgery for Infrarenal Retroperitoneal Node Metastases from Colon Cancer.
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Dulac, Anne-Sophie, Genova, Pietro, Benoit, Olivier, Neuzillet, Cindy, Hajjam, Mostapha El, Emile, Jean-François, Peschaud, Frédérique, and Lupinacci, Renato Micelli
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Purpose: Treatment of retroperitoneal lymph node metastases (RPN) from colon cancer (CC) is a therapeutic challenge. Available evidence supporting a curative approach is weak and uncertainties remain concerning the extent of the dissection, the optimal timing for surgery, and the role of adjuvant radiotherapy. We report the outcomes of a curative intent strategy in a recent monocentric series of patients. Methods: We did a retrospective review of all curative intent surgical treatment of RPN from CC performed consecutively in a French university hospital from June 2015 to April 2021. Demographics, clinicopathological, and molecular characteristics were evaluated. We describe recurrence-free and overall survival and factors related to recurrence. Results: Records from 18 patients were reviewed. The median age was 69 years. Most of the patients were male (55%), ASA 1–2 (94%), had a left-sided primary colon cancer (73%), and had metachronous RPN (62%). Thirteen patients (72%) experienced recurrence. Recurrence was often limited to RPN (27%) or liver (22%). Four patients underwent a second surgery for RPN recurrence. Median disease-free and overall survival were 22 months and 50 months after RPN surgery. We did not find any factor associated with recurrence. Short-term recurrence (< 6 months) was associated with shorter overall survival (0.031). Conclusion: The current results suggest that RPN resection is feasible and associated with long survival in selected patients. Further studies evaluating the benefit of curative strategies including radical surgery for patients with potentially resectable RPN are warranted. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Factors Predicting Prognosis in Metastatic Grade 1 Gastro-entero-pancreatic Neuroendocrine Tumors.
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Pandrowala, Saneya A., Kapoor, Deeksha, Kunte, Aditya, Chopde, Amit, Puranik, Ameya, Dev, Indraja Devidas, Parghane, Rahul, Basu, Sandip, Ramaswamy, Anant, Ostwal, Vikas, Chaudhari, Vikram A., Bhandare, Manish S., and Shrikhande, Shailesh V.
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Introduction: The incidence of gastroenteropancreatic neuroendocrine tumors (GEP-NET) has steadily increased. These tumors are considered relatively indolent even when metastatic. What determines survival outcomes in such situations is understudied. Materials and Methods: Retrospective analysis of a prospectively maintained NET clinic database, to include patients of metastatic grade 1 GEP-NET, from January 2018 to December 2021, to assess factors affecting progression-free survival (PFS). Results: Of the 589 patients of GEP-NET treated during the study period, 100 were grade 1, with radiological evidence of distant metastasis. The median age was 50 years, with 67% being men. Of these, 15 patients were observed, while 85 patients received treatment in the form of surgery (n = 32), peptide receptor radionuclide therapy (n = 50), octreotide LAR (n = 22), and/or chemotherapy (n = 4), either as a single modality or multi-modality treatment. The median (PFS) was 54.5 months. The estimated 3-year PFS and 3-year overall survival rates were 72.3% (SE 0.048) and 93.4% (SE 0.026), respectively. On Cox regression, a high liver tumor burden was the only independent predictor of PFS (OR 3.443, p = 0.014). The 5-year OS of patients with concomitant extra-hepatic disease was significantly lower than that of patients with liver-limited disease (70.7% vs. 100%, p = 0.017). Conclusion: A higher burden of liver disease is associated with shorter PFS in patients with metastatic grade I GEP-NETs. The OS is significantly lower in patients with associated extrahepatic involvement. These parameters may justify a more aggressive treatment approach in metastatic grade 1 GEP-NETs. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Changes in expression of breast cancer tumor biomarkers between primary tumors and corresponding metastatic sites: common patterns and relationships with survival.
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Schwieger, Lara, Postlewait, Lauren M., Liu, Yi, Jou, Stephanie, Yi, Sha, Peng, Limin, and Li, Xiaoxian
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Purpose: In metastatic breast cancer, differences in expression patterns of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) between the primary tumor (PT) and metastatic site (MET) have been reported. However, there is limited understanding of the relationship of tumor subtype discordance and overall survival (OS). We evaluated patterns of ER/PR/HER2 in PTs and corresponding METs and assessed the relationship between these patterns and OS. Methods: Patients diagnosed at our center with metastatic breast cancer (2011–2020) were included. ER/PR were stratified as < 1%/1–10%/ > 10% by immunohistochemistry and HER2 as positive/negative by immunohistochemistry/FISH. Tumor subtypes were classified as ER or PR + /HER2−, HER2+ , or triple-negative. Biomarker discordance data from PTs to METs were analyzed for expression patterns. OS was assessed. Results: Of 254 patients, 41 (16.1%) had synchronous and 213 (83.9%) had metachronous METs. Category change of ER/PR/HER2 expression was observed in 56 (22.0%), 117 (40.5%), and 30 (11.8%) patients, respectively. Tumor subtype changed in 56 (22.0%) patients. We identified a difference between PT and MET from ER > 10% to ER < 1% (n = 28,16.2% p < 0.01); PR > 10% to PR < 1% (n = 54,48.2%, p < 0.001); PR > 10% to PR 1–10% (n = 18,16.1%, p < 0.001), and ER or PR+/HER2− to triple-negative (n = 19,13.0%, p = 0.03). In log-rank analysis, change from an ER or PR+/HER2− (5-year OS 88.6%) PT to a HER2+(67.5%) or triple-negative (54.6%) MET was associated with decreased survival (p < 0.01); however, in multivariate analysis, discordant biomarker expression was not associated with decreased survival (p > 0.05). Conclusion: Tumor expression of ER/PR/HER2 can differ between the PT and MET. Loss of ER/PR expression is common and may be related to worse survival. Routine assessment of MET tumor markers could inform prognosis and therapeutic decision-making. [ABSTRACT FROM AUTHOR]
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- 2024
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14. Clinical performance of implanted devices used in surgical treatment of patients with spinal tumors: a systematic review.
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De Salvatore, Sergio, Longo, Umile Giuseppe, Vincenzi, Bruno, Pantano, Francesco, Zollo, Giuliano, Calabrese, Giovanni, and Denaro, Vincenzo
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RADIOISOTOPE brachytherapy , *FATIGUE limit , *ARTIFICIAL implants , *COST benefit analysis ,TUMOR surgery - Abstract
Purpose: Implanted devices used in metastatic spine tumor surgery (MSTS) include pedicle screws, fixation plates, fixation rods, and interbody devices. A material to be used to fabricate any of these devices should possess an array of properties, which include biocompatibility, no toxicity, bioactivity, low wear rate, low to moderate incidence of artifacts during imaging, tensile strength and modulus that are comparable to those of cortical bone, high fatigue strength/long fatigue life, minimal or no negative impact on radiotherapy (RT) planning and delivery, and high capability for fusion to the contiguous bone. The shortcomings of Ti6Al4V alloy for these applications with respect to these desirable properties are well recognized, opening the field for an investigation about novel biomaterials that could replace the current gold standard. Previously published reviews on this topic have exhibited significant shortcomings in the studies they included, such as a small, heterogenous sample size and the lack of a cost-benefit analysis, extremely useful to understand the practical possibility of applying a novel material on a large scale. Therefore, this review aims to collect information about the clinical performance of these biomaterials from the most recent literature, with the objective of deliberating which could potentially be better than titanium in the future, with particular attention to safety, artifact production and radiotherapy planning interference. The significant promise showed by analyzing the clinical performance of these devices warrants further research through prospective studies with a larger sample size also taking into account each aspect of the production and use of such materials. Methods: The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The search was performed from March 2022 to September 2023. Results: At the end of the screening process, 20 articles were considered eligible for this study. Polyetheretherketone (PEEK), Carbon-fibre reinforced polyetheretherketone (CFR-PEEK), long carbon fiber reinforced polymer (LCFRP), Polymethylmethacrylate (PMMA), and carbon screw and rods were used in the included studies. Conclusion: CFR-PEEK displays a noninferior safety and efficacy profile to titanium implanted devices. However, it also has other advantages. By decreasing artifact production, it is able to increase detection of local tumor recurrence and decrease radiotherapy dose perturbation, ultimately bettering prognosis for patients necessitating adjuvant treatment. Nonetheless, its drawbacks have not been explored fully and still require further investigation in future studies. This does not exclude the fact that CFR-PEEK could be a valid alternative to titanium in the near future. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Serum Calcium Level at Diagnosis Can Predict Lethal Prostate Cancer Relapse.
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Fekete, Zsolt, Ignat, Patricia, Jakab, Henrietta, Todor, Nicolae, László, István Péter, Muntean, Alina-Simona, Curcean, Sebastian, Nemeș, Adina, Nuțu, Dumitrița, and Kacsó, Gabriel
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PROSTATE cancer prognosis , *BENIGN prostatic hyperplasia , *PROSTATE cancer patients , *CANCER diagnosis , *PROSTATE cancer , *CANCER relapse - Abstract
Background/Objectives: The most important prognostic factors in curatively treated prostate cancer are T and N stage, histology, grade group and initial PSA. A recent study found that men with blood calcium levels at the high end of the normal range are over two-and-a-half times more likely to develop fatal prostate cancer than those with lower calcium levels. However, there is limited evidence regarding the prognostic value of calcium levels at the time of prostate cancer diagnosis. We aimed to determine whether a calcium level in the upper range of normal values has any prognostic value in curatively treated prostate cancer. Methods: We conducted a retrospective analysis of 84 consecutive patients with prostate cancer who underwent curative-intent radiotherapy—either as primary treatment or adjuvant therapy—using external beam radiotherapy with or without brachytherapy. We analyzed all pertinent prognostic factors that could potentially impact disease-free survival. Results: The study revealed that calcium levels at diagnosis significantly predict disease-free survival, whereas the initial PSA level did not hold prognostic significance—likely due to interference from benign prostatic hyperplasia. Conclusions: If our findings are validated, calcium levels at the time of prostate cancer diagnosis could be incorporated into future predictive and prognostic models. [ABSTRACT FROM AUTHOR]
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- 2024
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16. Rationale for the Initiation, Outcomes, and Characteristics of Chemotherapy Following CDK4/6 Inhibitors in Breast Cancer: A Real-World Cohort Study.
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Püsküllüoğlu, Miroslawa, Ziobro, Marek, Lompart, Joanna, Rudzińska, Agnieszka, Zemełka, Tomasz, Jaworska, Justyna, Ochenduszko, Sebastian, and Grela-Wojewoda, Aleksandra
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PROTEIN kinase inhibitors , *DRUG side effects , *BREAST tumors , *ANTINEOPLASTIC agents , *TERMINATION of treatment , *DRUG therapy , *TREATMENT effectiveness , *CANCER patients , *AGE distribution , *TUMOR grading , *TUMOR markers , *RETROSPECTIVE studies , *CANCER chemotherapy , *LONGITUDINAL method , *ADJUVANT chemotherapy , *METASTASIS , *STATISTICS , *PROGRESSION-free survival , *CYCLIN-dependent kinases , *TIME , *OVERALL survival - Abstract
Simple Summary: This study investigated one of the treatment options for advanced breast cancer patients after they completed standard therapy that combines hormone therapy and specific targeted agents called cyclin-dependent kinase 4/6 inhibitors. We wanted to understand why in real-world patients start chemotherapy after finishing standard initial treatment, how they respond to it, and what factors might affect their outcomes. We found that chemotherapy was often used when patients faced dissemination to internal organs with the risk of further progression, but it provided limited benefits. We suggest that modern drugs recommended by guidelines before chemotherapy should be better reimbursed in Poland. This research could help doctors make better treatment decisions and improve future clinical trials. The standard therapy for hormone-receptor-positive, human epidermal growth factor receptor 2-negative advanced breast cancer includes the use of cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) with endocrine therapy. The optimal post-CDK4/6i treatment sequence is unclear. This cohort study evaluated the initiation, characteristics, and outcomes of chemotherapy following CDK4/6i-based treatment. Among the 227 patients who began CDK4/6i therapy, 114 completed it. Seventy-nine female patients received further treatment, including 55 receiving chemotherapy. The average age was 60.1 years. Post-CDK4/6i chemotherapy was typically (69.1%) first-line due to an impending visceral crisis. The median progression-free survival (mPFS) was 3.0 months (range 0.5–18.9), and the median overall survival (mOS) was 8.3 months (0.5–26.1). The median OS from the end of CDK4/6i treatment was 12.4 months (1.5–26.8). In univariate analysis, neither mPFS nor mOS was associated with age, tumor grade, receptor status, Ki67 status, time from diagnosis to CDK4/6i cessation, therapy line, or CDK4/6i type. Dose reduction occurred in 12 patients (21.8%), and chemotherapy was ceased due to adverse events in 8 patients (14.6%). Chemotherapy showed limited benefit regardless of the regimen. The role of chemotherapy may evolve with broader CDK4/6i use in adjuvant treatment. [ABSTRACT FROM AUTHOR]
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- 2024
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17. The Clinical Features and Outcomes of Pseudocirrhosis in Breast Cancer.
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Phillips, Edward, Sethi, Mantegh, Vasanthakumar, Surammiya, Sherpa, Gina, Johnston, Stephen, Parton, Marina, Kipps, Emma, Turner, Nicholas C., Foxton, Matthew, and Okines, Alicia
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BREAST cancer prognosis , *THERAPEUTIC use of antineoplastic agents , *LIVER tumors , *RISK assessment , *CIRRHOSIS of the liver , *ANTIMETABOLITES , *HYDROCARBONS , *BREAST tumors , *SYMPTOMS , *RETROSPECTIVE studies , *DESCRIPTIVE statistics , *TREATMENT effectiveness , *CANCER chemotherapy , *METASTASIS , *CONFIDENCE intervals , *DISEASE risk factors , *DISEASE complications - Abstract
Simple Summary: Pseudocirrhosis is a nodularity in the liver that it is typically associated with breast cancer liver metastases, and may occur as a response to chemotherapy and other systemic anticancer treatments. The types of patients who develop pseudocirrhosis, the treatments that they have received, and their outcomes are not well known. This study reviewed 170 patients with a diagnosis of pseudocirrhosis. A variety of different anticancer treatments were received, with taxanes (74.7%) and capecitabine (67.1%) being the most common. The median time between diagnosis of liver metastases and diagnosis of pseudocirrhosis was 17.1 months. The median overall survival once diagnosed with pseudocirrhosis was 7.6 months and patients with HER2+ disease had a statistically significant longer overall survival. To our knowledge, this is the largest dataset of pseudocirrhotic patients that has been published. It provides information to patients and clinicians on risk factors to develop pseudocirrhosis, and prognosis in different subtypes. Pseudocirrhosis is a diffuse nodularity of the liver that radiologically mimics cirrhosis but is a distinct pathological process. It is seen almost exclusively in patients with liver metastases and may represent a response to systemic treatment. Data on the risk factors for pseudocirrhosis and outcomes are limited. In total, 170 patients with a diagnosis of breast cancer and pseudocirrhosis in a 10-year period were identified and retrospectively analysed. Data were collected on baseline patient characteristics, treatments received, and outcomes. Median time between diagnosis of liver metastases and diagnosis of pseudocirrhosis was 17.1 months (range, 0–149 months). In total, 89.4% of patients received chemotherapy between their diagnosis of breast cancer liver metastases and their diagnosis of pseudocirrhosis, most commonly a taxane (74.7%) or capecitabine (67.1%), and the median treatment lines received was 3. Median OS from first diagnosis of pseudocirrhosis was 7.6 months (95% CI: 6.1–9.6 months) and was longer in patients with HER2+ disease at 16.7 months (95% CI: 6.4–32.9 months), which was statistically significant. In our study, pseudocirrhosis occurred in the presence of liver metastases and was associated with a poor prognosis. HER2+ patients with pseudocirrhosis had a better prognosis than other subtypes, but we did not identify other significant predictors of survival. Chemotherapy was not a prerequisite for pseudocirrhosis development, although the majority of patients had received at least one line of chemotherapy before pseudocirrhosis was diagnosed. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Expressions and clinical significance of CCN5 and E-cadherin in primary and recurrent lesions of breast cancer.
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Guofeng Zhou, Xingxing Gui, Wei Qu, and Xiujuan Zhang
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LYMPH node cancer ,LYMPHATIC metastasis ,CELL adhesion ,BREAST cancer ,IMMUNOSTAINING ,BREAST - Abstract
Background: Breast cancer recurrence and lymph node metastasis significantly impact patient outcomes. Understanding the molecular mechanisms behind these processes is crucial for developing effective treatments. CCN5 and E-cadherin are proteins involved in cell adhesion and epithelial-mesenchymal transition (EMT), playing roles in breast cancer progression. Objective: This study aimed to analyze the expression levels and clinical significance of CCN5 and E-cadherin in primary and recurrent breast cancer lesions. Methods: Immunohistochemical staining using the SP method was performed to detect CCN5 and E-cadherin expression levels in 28 normal breast tissue samples, 52 primary breast cancer lesions, and paired recurrent chest wall lesions. The expression levels of these proteins were compared across different tissue types and correlated with lymph node metastasis. Results: CCN5 and E-cadherin expression levels significantly differed among normal breast tissues, primary breast cancer lesions, and recurrent lesions (χ2 = 18.934 and χ2 = 14.516, p < 0.05). Primary breast cancer lesions exhibited higher CCN5 and E-cadherin expression levels compared with recurrent lesions and normal tissues, although these differences were not statistically significant. Patients without lymph node metastases exhibited significantly higher expression levels of CCN5 and E-cadherin compared with those with lymph node metastases (χ2 = 9.775, χ2 = 9.1479, p < 0.05). A positive correlation between CCN5 and E-cadherin expression levels was found in breast cancer tissues (r = 0.398, p < 0.001). Conclusion: CCN5 and E-cadherin were expressed at lower levels in recurrent breast cancer tissues and those with lymph node metastases, indicating their potential roles in breast cancer recurrence and metastasis. These findings suggest that CCN5 and E-cadherin might work synergistically to influence breast cancer progression. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Safety and efficacy of percutaneous image‐guided ablation for soft tissue sarcoma metastases to the liver.
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Awad, Ahmed, Pal, Koustav, Yevich, Steven, Kuban, Joshua D., Tam, Alda, Odisio, Bruno C., Gupta, Sanjay, Habibollahi, Peiman, Bishop, Andrew J., Conley, Anthony Paul, Somaiah, Neeta, Araujo, Dejka M., Zarzour, Maria Alejandra, Ratan, Ravin, Roland, Christina L., Keung, Emily Z., Huang, Steven Y., and Sheth, Rahul A.
- Subjects
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SARCOMA , *GASTROINTESTINAL stromal tumors , *TREATMENT effectiveness , *PROGRESSION-free survival , *OVERALL survival , *GUIDED tissue regeneration , *LEIOMYOSARCOMA - Abstract
Purpose: To evaluate outcomes following percutaneous image‐guided ablation of soft tissue sarcoma metastases to the liver. Materials and Methods: A single‐institution retrospective analysis of patients with a diagnosis of metastatic soft tissue sarcoma who underwent percutaneous image‐guided ablation of hepatic metastases between January 2011 and December 2021 was performed. Patients with less than 60 days of follow‐up after ablation were excluded. The primary outcome was local tumor progression‐free survival (LPFS). Secondary outcomes included overall survival, liver‐specific progression‐free survival. and chemotherapy‐free survival. Results: Fifty‐five patients who underwent percutaneous ablation for 84 metastatic liver lesions were included. The most common histopathological subtypes were leiomyosarcoma (23/55), followed by gastrointestinal stromal tumor (22/55). The median treated liver lesions was 2 (range, 1–8), whereas the median size of metastases were 1.8 cm (0.3–8.7 cm). Complete response at 2 months was achieved in 90.5% of the treated lesions. LPFS was 83% at 1 year and 80% at 2 years. Liver‐specific progression‐free survival was 66% at 1 year and 40% at 2 years. The overall survival at 1 and 2 years was 98% and 94%. The chemotherapy‐free holiday from the start of ablation was 71.2% at 12 months. The complication rate was 3.6% (2/55); one of the complications was Common Terminology Criteria for Adverse Events grade 3 or higher. LPFS subgroup analysis for leiomyosarcoma versus gastrointestinal stromal tumor suggests histology‐agnostic outcomes (2 years, 89% vs 82%, p =.35). Conclusion: Percutaneous image‐guided liver ablation of soft tissue sarcoma metastases is safe and efficacious. Image‐guided ablation of sarcoma metastasis is a promising modality for treating sarcoma metastases to the liver, with a local tumor progression‐free survival of 83% and 80% at 1 and 2 years. Subgroup analysis demonstrated no significant differences between the local tumor progression‐free survival of gastrointestinal stromal tumor versus leiomyosarcoma, suggesting a histology‐agnostic treatment paradigm. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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20. Postoperative Acute Intracranial Hemorrhage and Venous Thromboembolism in Patients with Brain Metastases Receiving Acetylsalicylic Acid Perioperatively.
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Tonchev, Nikolay, Pinchuk, Anatoli, Dumitru, Claudia A., Neyazi, Belal, Swiatek, Vanessa Magdalena, Stein, Klaus Peter, Sandalcioglu, Ibrahim Erol, and Rashidi, Ali
- Subjects
- *
ASPIRIN , *INTRACRANIAL hemorrhage , *BRAIN surgery , *THROMBOEMBOLISM ,TUMOR surgery - Abstract
Cranial operations are associated with a high risk of postoperative intracranial hemorrhage (pICH) and venous thromboembolic events, along with increased mortality and morbidity. With the use of acetylsalicylic acid (ASA) for prophylaxis becoming more prevalent, the risk of bleeding when ASA is administered preoperatively is unknown, as are the effects of discontinuation upon the occurrence of thromboembolic events, especially in societies with aging demographics. To address these questions, a retrospective analysis was performed using medical records and radiological images of 1862 patients subjected to brain tumor surgery over a decade in our department. The risk of pICH was compared in patients with metastases receiving ASA treatment versus patients not receiving ASA treatment. The occurrence of venous thromboembolic events after surgery was also evaluated. The study group consisted of 365 patients with different types of brain metastases. In total, 20 patients suffered pICH and 7 of these were associated with clinical neurological deterioration postoperatively. Of the 58 patients who took ASA preoperatively, 2 patients experienced pICH, compared with 5 patients in the non-ASA impact group (p = 0.120). Patients who took ASA were not at significantly higher risk of pICH and therefore a worse outcome compared to the group without ASA. Therefore, these data suggest that in patients at high cardiovascular risk, ASA can be safely continued during elective brain tumor surgery. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
21. Area Socioeconomic Status is Associated with Refusal of Recommended Surgery in Patients with Metastatic Bone and Joint Disease.
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Mani, Kyle, Kleinbart, Emily, Schlumprecht, Anne, Golding, Regina, Akioyamen, Noel, Song, Hyun, De La Garza Ramos, Rafael, Eleswarapu, Ananth, Yang, Rui, Geller, David, Hoang, Bang, Yassari, Reza, and Fourman, Mitchell S.
- Abstract
Background: This study sought to identify associations between the Yost Index, a geocoded area neighborhood socioeconomic status (nSES) score, and race/ethnicity with patient refusal of recommended surgery for metastatic bone disease. Methods: Patients with metastatic bone disease were extracted from the Surveillance, Epidemiology, and End Results database. The Yost Index was geocoded using factor analysis and categorized into quintiles using census tract-level American Community Service (ACS) 5-year estimates and seven nSES measures. Multivariable logistic regression models calculated odds ratios (ORs) of refusal of recommended surgery and 95% confidence intervals (CIs), adjusting for clinical covariates. Results: A total of 138,257 patients were included, of which 14,943 (10.8%) were recommended for surgical resection. Patients in the lowest nSES quintile had 57% higher odds of refusing surgical treatment than those in the highest quintile (aOR = 1.57, 95% CI 1.30–1.91, p < 0.001). Patients in the lowest nSES quintile also had a 31.2% higher age-adjusted incidence rate of not being recommended for surgery compared with those in the highest quintile (186.4 vs. 142.1 per 1 million, p < 0.001). Black patients had 34% higher odds of refusing treatment compared with White patients (aOR = 1.34, 95% CI 1.14–1.58, p = 0.003). Advanced age, unmarried status, and patients with aggressive cancer subtypes were associated with higher odds of refusing surgery (p < 0.001). Conclusions: nSES and race/ethnicity are independent predictors of a patient refusing surgery for metastatic cancer to bone, even after adjusting for various clinical covariates. Effective strategies for addressing these inequalities and improving the access and quality of care of patients with a lower nSES and minority backgrounds are needed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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22. Proximal femoral multiple myeloma pathological fractures, impending and actual fractures – a patient survival study.
- Author
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Hershkovich, Oded, Sakhnini, Mojahed, Barkay, Gal, Liberman, Boaz, Friedlander, Alon, and Lotan, Raphael
- Abstract
Introduction: The femur is a common site for Multiple Myeloma (MM) involvement. This study explores the impact of preventive surgery for anticipated femoral pathological fractures (IFF), based on Mirels classification, versus treatment of pathological femur fracture (PFF) on MM patient mortality and morbidity. Methods: Retrospective cohort of 33 patients undergoing surgery due to femoral MM involvement (2004–2015), 18 patients with PFF, 15 patients with IFF, followed up until deceased or to July 2016. Demographic data, oncological, pathological, radiation, surgical reports, outpatient clinical records, and imaging studies were studied. Exclusion criteria included patients who had surgery at other medical centers. Results: The mean age was 70.4 ± 13.6 and 62.6 ± 12.2 years (p = 0.1) in the PFF and the IFF cohorts, respectively, primarily women (55.6% and 46.7%, respectively). The average Mirels' score was 10.4 ± 1.2. Post-operative complications were observed in 25% of patients, with no difference between IFF & PFF. We did not find a difference in mortality between IFF and PFF cohorts (p = 0.59). Conclusion: The femur is commonly involved in MM. This study found that actual fractures, compared to imminent fractures, do not affect MM morbidity or mortality. Our study shows that proximal femoral MM behaves differently from proximal femoral metastatic disease regarding the impact of surgery on life span. Due to the fracture healing potential of MM, an IFF can probably be treated initially conservatively unless it progresses to an actual fracture needing surgery. Future, more extensive studies are required before revolutionizing the proximal femoral Multiple Myeloma-related involvement treatment paradigm. Highlights: The femur is a common site for Multiple Myeloma (MM) involvement. Earlier studies did not assess the impact of preventive surgery for anticipated femoral pathological fractures (IFF) to the treatment of pathological femur fracture (PFF) on MM patient mortality and morbidity. In this retrospective cohort of patients undergoing surgery due to femoral MM involvement, we found that actual fractures, compared to imminent fractures, do not affect morbidity or mortality. Our study shows that proximal femoral Multiple Myeloma behaves differently from proximal femoral metastatic disease regarding the impact of surgery on life span. Due to the fracture healing potential of Multiple Myeloma, an IFF can probably be treated initially conservatively unless it progresses to an actual fracture needing surgery. Future, more extensive studies are required before revolutionizing the proximal femoral Multiple Myeloma -related involvement treatment paradigm. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
23. Skin Malignant Melanoma and Matrix Metalloproteinases: Promising Links to Efficient Therapies.
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Lazar, Angela Madalina, Costea, Daniel Ovidiu, Popp, Cristiana Gabriela, and Mastalier, Bogdan
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- *
MATRIX metalloproteinases , *MELANOMA , *CUTANEOUS malignant melanoma , *GENETIC mutation , *DEATH rate , *SKIN - Abstract
Skin malignant melanoma (MM) is one of the most frequent and aggressive neoplasia worldwide. Its associated high mortality rates are mostly due to its metastases, while diagnosis and treatment of MM in its early stages is of favorable prognostic. Even skin superficial MMs at incipient local stages can already present with lymph node invasion and distant metastases. Therefore, knowledge of the controllable risk factors and pathogenic mechanisms of MM development, spreading, and metastatic pattern, as well as early diagnosis, are essential to decrease the high mortality rates associated with cutaneous malignant melanoma. Genetic factors are incriminated, although lifetime-acquired genetic mutations appear to be even more frequently involved in the development of MM. Skin melanocytes divide only twice per year and have time to accumulate genetic mutations as a consequence of environmental aggressive factors, such as UV exposure. In the search for more promising therapies, matrix metalloproteinases have become of significant interest, such as MMP-1, MMP-2, MMP-9, and MMP-13, which have been linked to more aggressive forms of cancer and earlier metastases. Therefore, the development of specific synthetic inhibitors of MMP secretion or activity could represent a more promising and effective approach to the personalized treatment of MM patients. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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24. Cognitive Dysfunction in Non-CNS Metastatic Cancer: Comparing Brain Metastasis, Non-CNS Metastasis, and Healthy Controls.
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Collette, Christopher, Willhelm, Gabrielle, Del Bene, Victor A., Aita, Stephen L., Marotta, Dario, Myers, Terina, Anderson, Joseph, Gammon, Meredith, Gerstenecker, Adam, Nabors, L. Burt, Fiveash, John, and Triebel, Kristen L.
- Subjects
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BRAIN metastasis , *METASTASIS , *EXECUTIVE function , *BRAIN cancer , *COGNITION disorders - Abstract
AbstractLimited research has compared cognition of people with non-central nervous system metastatic cancer (NCM)
vs. metastatic brain cancer (BM). This prospective cross-sectional study was comprised 37 healthy controls (HC), 40 NCM, and 61 BM completing 10 neuropsychological tests. The NCM performed below HCs on processing speed and executive functioning tasks, while the BM group demonstrated lower performance across tests. Tasks of processing speed, verbal fluency, and verbal memory differentiated the clinical groups (BM < NCM). Nearly 20% of the NCM group was impaired onat least three neuropsychological tests whereas approximately 40% of the BM group demonstrated the same level of impairment. [ABSTRACT FROM AUTHOR]- Published
- 2024
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25. Advances and challenges in organ-on-chip technology: toward mimicking human physiology and disease in vitro.
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Kumar, Dhiraj, Nadda, Rahul, and Repaka, Ramjee
- Abstract
Organs-on-chips have been tissues or three-dimensional (3D) mini-organs that comprise numerous cell types and have been produced on microfluidic chips to imitate the complicated structures and interactions of diverse cell types and organs under controlled circumstances. Several morphological and physiological distinctions exist between traditional 2D cultures, animal models, and the growing popular 3D cultures. On the other hand, animal models might not accurately simulate human toxicity because of physiological variations and interspecies metabolic capability. The on-chip technique allows for observing and understanding the process and alterations occurring in metastases. The present study aimed to briefly overview single and multi-organ-on-chip techniques. The current study addresses each platform's essential benefits and characteristics and highlights recent developments in developing and utilizing technologies for single and multi-organs-on-chips. The study also discusses the drawbacks and constraints associated with these models, which include the requirement for standardized procedures and the difficulties of adding immune cells and other intricate biological elements. Finally, a comprehensive review demonstrated that the organs-on-chips approach has a potential way of investigating organ function and disease. The advancements in single and multi-organ-on-chip structures can potentially increase drug discovery and minimize dependency on animal models, resulting in improved therapies for human diseases. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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26. Inhibition of Histone Deacetylase Activity Increases Cisplatin Efficacy to Eliminate Metastatic Cells in Pediatric Liver Cancers.
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Gulati, Ruhi, Fleifil, Yasmeen, Jennings, Katherine, Bondoc, Alex, Tiao, Greg, Geller, James, Timchenko, Lubov, and Timchenko, Nikolai
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RISK assessment , *CISPLATIN , *CANCER relapse , *CANCER , *ENZYME inhibitors , *ANTINEOPLASTIC agents , *NEURONS , *CELL proliferation , *DISEASE eradication , *HEPATOBLASTOMA , *TRANSCRIPTION factors , *METASTASIS , *CELL lines , *FIBROBLASTS , *DRUG efficacy , *HEPATOCELLULAR carcinoma , *HISTONE deacetylase , *PHARMACODYNAMICS , *DISEASE risk factors , *CHILDREN - Abstract
Simple Summary: Patients with pediatric liver cancers hepatoblastoma and hepatocellular carcinoma very often develop lung metastases. These cancers can present with lung metastases and are at higher risk of relapse. Although cisplatin is very effective at clearing lung metastases, they can still relapse. Therefore, there is an urgent need to develop therapeutic approaches to prevent the development of lung metastases in patients with pediatric liver cancers. In this paper, we show that the metastatic microenvironment of HBL and HCC patients contains a heterogeneous cell population that formed tumor clusters. We found that both fresh primary tumors and generated primary cell cultures had increased the expression of HDAC1, a histone deacetylase, and the transcription factor Sp5. Sp5 and HDAC1 work in tandem by transporting HDAC1 to the promoters of genes and changing their expression. We analyzed the effects of the HDAC inhibitor, SAHA, on the metastasis-initiating cells in combination with cisplatin. We found that HDAC inhibition increases the efficacy of cisplatin to eliminate these metastasis-initiating cells. The pediatric liver cancers, hepatoblastoma and hepatocellular carcinoma, are dangerous cancers which often spread to the lungs. Although treatments with cisplatin significantly improve outcomes, cisplatin may not eliminate metastasis-initiating cells. Our group has recently shown that the metastatic microenvironments of hepatoblastoma contain Cancer Associated Fibroblasts (CAFs) and neuron-like cells, which initiate cancer spread from liver to lungs. In this study, we found that these cells express high levels of HDAC1; therefore, we examined if histone deacetylase inhibition improves cisplatin anti-proliferative effects and reduces the formation of tumor clusters in pediatric liver cancer metastatic microenvironments. Methods: New cell lines were generated from primary hepatoblastoma liver tumors (hbl) and lung metastases (LM) of HBL patients. In addition, cell lines were generated from hepatocellular neoplasm, not otherwise specified (HCN-NOS) tumor samples, and hcc cell lines. Hbl, LM and hcc cells were treated with cisplatin, SAHA or in combination. The effect of these drugs on the number of cells, formation of tumor clusters and HDAC1-Sp5-p21 axis were examined. Results: Both HBL and HCC tissue specimens have increased HDAC1-Sp5 pathway activation, recapitulated in cell lines generated from the tumors. HDAC inhibition with vorinostat (SAHA) increases cisplatin efficacy to eliminate CAFs in hbl and in hcc cell lines. Although the neuron-like cells survive the combined treatments, proliferation was inhibited. Notably, combining SAHA with cisplatin overcame cisplatin resistance in an LM cell line from an aggressive case with multiple metastases. Underlying mechanisms of this enhanced inhibition include suppression of the HDAC1-Sp5 pathway and elevation of an inhibitor of proliferation p21. Similar findings were found with gemcitabine treatments suggesting that elimination of proliferative CAFs cells is a key event in the inhibition of mitotic microenvironment. Conclusions: Our studies demonstrate the synergistic benefits of HDAC inhibition and cisplatin to eliminate metastasis-initiating cells in pediatric liver cancers. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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27. Anticancer Effects of Spiperone in C57BL/6 Mice with Emphysema and Lung Carcinoma.
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Ermakova, N. N., Zhukova, M. A., Pan, E. S., Pan, V. Yu., Morozov, S. G., Kubatiev, A. A., Dygai, A. M., and Skurikhin, E. G.
- Subjects
- *
CANCER stem cells , *CIGARETTE smoke , *LUNG cancer , *LABORATORY mice , *SMOKING - Abstract
The antitumor and antimetastatic activity of dopamine D2 receptor antagonists spiperone was studied in C57BL/6 mice in a model of combined pathology (emphysema and lung cancer). Emphysema was induced by administration of LPS and cigarette smoke extract. Lung cancer was induced by injection of Lewis lung carcinoma cells into the lung. It has been shown that under conditions of combined lung pathology, spiperone prevents inflammatory infiltration and emphysematous expansion of the lungs and reduces the size of the primary tumor node, the number of metastases, and the area of the lungs affected by metastases. Spiperone reduces the number of cancer stem cells (CSCs) in the lungs and blood of mice with combined pathology. CSCs isolated from the lungs and blood of mice with combined pathology treated with spiperone had a significantly lower potential to form a tumorosphere in vitro than CSCs from untreated mice with emphysema and lung carcinoma. Thus, blockade of dopamine D2 receptors is a promising approach for correcting combined lung pathology and can be used in the development of a method for treating lung cancer in patients with emphysema. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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28. The molecular basis of the anticancer effect of statins
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Giovanni Buccioli, Carolina Testa, Emanuela Jacchetti, Pietro Pinoli, Stephana Carelli, Stefano Ceri, and Manuela T. Raimondi
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Statins ,Drug repurposing ,Synthetic lethality ,Metastases ,Big data ,Medicine ,Science - Abstract
Abstract Statins, widely used cardiovascular drugs that lower cholesterol by inhibiting HMG-CoA reductase, have been increasingly recognized for their potential anticancer properties. This study elucidates the underlying mechanism, revealing that statins exploit Synthetic Lethality, a principle where the co-occurrence of two non-lethal events leads to cell death. Our computational analysis of approximately 37,000 SL pairs identified statins as potential drugs targeting genes involved in SL pairs with metastatic genes. In vitro validation on various cancer cell lines confirmed the anticancer efficacy of statins. This data-driven drug repurposing strategy provides a molecular basis for the anticancer effects of statins, offering translational opportunities in oncology.
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- 2024
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29. CT-Guided Microwave Ablation with Vertebral Augmentation for Spinal Metastases with Posterior Wall Defects
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Zhang X, Niu J, Fan J, Hu M, Xing C, Yuan Q, Yang S, Wang B, Li P, Man Q, Ren Y, Wu L, and Zhang K
- Subjects
microwaves ,vertebroplasty ,spinal ,metastases ,Medicine (General) ,R5-920 - Abstract
Xusheng Zhang,1,* Jiacheng Niu,2,* Jing Fan,1 Miaomiao Hu,1 Chao Xing,1 Qianqian Yuan,1 Shen Yang,1 Baohu Wang,1 Peishun Li,1 Qirong Man,1 Yanchen Ren,1 Linlin Wu,1 Kaixian Zhang1 1Department of Oncology, Tengzhou Central People’s Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People’s Republic of China; 2Medical Imaging Center, Tengzhou Central People’s Hospital Affiliated to Jining Medical College, Tengzhou, Shandong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kaixian Zhang, Email kaixianzhangtz@163.comPurpose: To evaluate the efficacy and safety of combined microwave ablation (MWA) and vertebral augmentation (VA) in the treatment of spinal metastases with posterior wall defects.Patients and Methods: A retrospective review was conducted for 67 patients (42 men, 25 women) with painful spine metastases and posterior wall defects who underwent MWA combined with VA. Among these patients, 52 vertebrae had no epidural invasion and 33 had mild invasion but did not compress the spinal cord. Procedural effectiveness was determined by comparing visual analog scale (VAS) scores and Oswestry disability index (ODI) scores before the procedure and during the follow-up period.Results: The procedure was technically successful in all patients. The mean VAS score declined significantly from 6.85 ± 1.81 before the procedure to 3.27 ± 1.97 at 24 h, 1.96 ± 1.56 at 1 week, 1.84 ± 1.50 at 4 weeks, 1.73 ± 1.45 at 12 weeks, and 1.71 ± 1.52 at 24 weeks post-procedure (p < 0.01). The mean ODI score was lower post-procedure than before the procedure (p < 0.001). Transient nerve injury occurred in two patients (SIR classification D), and the incidence of asymptomatic bone cement (SIR classification A) was 43.5% (37/85).Conclusion: MWA combined with VA is an effective and safe treatment for painful spine metastases with posterior wall defects.Keywords: microwaves, vertebroplasty, spinal, metastases
- Published
- 2024
30. Postoperative Acute Intracranial Hemorrhage and Venous Thromboembolism in Patients with Brain Metastases Receiving Acetylsalicylic Acid Perioperatively
- Author
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Nikolay Tonchev, Anatoli Pinchuk, Claudia A. Dumitru, Belal Neyazi, Vanessa Magdalena Swiatek, Klaus Peter Stein, Ibrahim Erol Sandalcioglu, and Ali Rashidi
- Subjects
ASA ,metastases ,craniotomy ,hemorrhage ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Cranial operations are associated with a high risk of postoperative intracranial hemorrhage (pICH) and venous thromboembolic events, along with increased mortality and morbidity. With the use of acetylsalicylic acid (ASA) for prophylaxis becoming more prevalent, the risk of bleeding when ASA is administered preoperatively is unknown, as are the effects of discontinuation upon the occurrence of thromboembolic events, especially in societies with aging demographics. To address these questions, a retrospective analysis was performed using medical records and radiological images of 1862 patients subjected to brain tumor surgery over a decade in our department. The risk of pICH was compared in patients with metastases receiving ASA treatment versus patients not receiving ASA treatment. The occurrence of venous thromboembolic events after surgery was also evaluated. The study group consisted of 365 patients with different types of brain metastases. In total, 20 patients suffered pICH and 7 of these were associated with clinical neurological deterioration postoperatively. Of the 58 patients who took ASA preoperatively, 2 patients experienced pICH, compared with 5 patients in the non-ASA impact group (p = 0.120). Patients who took ASA were not at significantly higher risk of pICH and therefore a worse outcome compared to the group without ASA. Therefore, these data suggest that in patients at high cardiovascular risk, ASA can be safely continued during elective brain tumor surgery.
- Published
- 2024
- Full Text
- View/download PDF
31. Clinical performance of implanted devices used in surgical treatment of patients with spinal tumors: a systematic review
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Sergio De Salvatore, Umile Giuseppe Longo, Bruno Vincenzi, Francesco Pantano, Giuliano Zollo, Giovanni Calabrese, and Vincenzo Denaro
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Spinal tumors ,Metastases ,Spine ,Radiolucent implanted devices ,Radiotherapy ,Coated implant ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Abstract Purpose Implanted devices used in metastatic spine tumor surgery (MSTS) include pedicle screws, fixation plates, fixation rods, and interbody devices. A material to be used to fabricate any of these devices should possess an array of properties, which include biocompatibility, no toxicity, bioactivity, low wear rate, low to moderate incidence of artifacts during imaging, tensile strength and modulus that are comparable to those of cortical bone, high fatigue strength/long fatigue life, minimal or no negative impact on radiotherapy (RT) planning and delivery, and high capability for fusion to the contiguous bone. The shortcomings of Ti6Al4V alloy for these applications with respect to these desirable properties are well recognized, opening the field for an investigation about novel biomaterials that could replace the current gold standard. Previously published reviews on this topic have exhibited significant shortcomings in the studies they included, such as a small, heterogenous sample size and the lack of a cost-benefit analysis, extremely useful to understand the practical possibility of applying a novel material on a large scale. Therefore, this review aims to collect information about the clinical performance of these biomaterials from the most recent literature, with the objective of deliberating which could potentially be better than titanium in the future, with particular attention to safety, artifact production and radiotherapy planning interference. The significant promise showed by analyzing the clinical performance of these devices warrants further research through prospective studies with a larger sample size also taking into account each aspect of the production and use of such materials. Methods The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were used to improve the reporting of the review. The search was performed from March 2022 to September 2023. Results At the end of the screening process, 20 articles were considered eligible for this study. Polyetheretherketone (PEEK), Carbon-fibre reinforced polyetheretherketone (CFR-PEEK), long carbon fiber reinforced polymer (LCFRP), Polymethylmethacrylate (PMMA), and carbon screw and rods were used in the included studies. Conclusion CFR-PEEK displays a noninferior safety and efficacy profile to titanium implanted devices. However, it also has other advantages. By decreasing artifact production, it is able to increase detection of local tumor recurrence and decrease radiotherapy dose perturbation, ultimately bettering prognosis for patients necessitating adjuvant treatment. Nonetheless, its drawbacks have not been explored fully and still require further investigation in future studies. This does not exclude the fact that CFR-PEEK could be a valid alternative to titanium in the near future.
- Published
- 2024
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32. Utilizing non-histological serological markers in the prediction of recurrence and metastasis in head and neck melanoma
- Author
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L. O. Kovtun
- Subjects
melanoma ,biomarkers ,dermatoscopy ,metastases ,calcium-binding protein ,melanoma inhibitory activity ,hepatocyte growth factor ,eosinophil cationic protein ,serum indoleamine 2 ,3-dioxygenase ,vitamin d ,lactate dehydrogenase ,Internal medicine ,RC31-1245 - Abstract
There is a need for the development of additional prognostic melanoma (e.g., head and neck melanoma) biomarkers to stratify melanoma patients and reliably identify high-risk subgroups with the aim of providing effective personalized therapy. Biomarkers play an important role in the diagnosis and prognostic classification of various types of cancer and may be indicators of biological or pathological processes or responses to exposure or intervention, providing a physician with the data helpful for future decision making with regard to patient management. The advent of novel treatments and modalities for treating various stages of the disease with a notable objective response-to-survival ratio gave us good reason, in this review, to emphasize non-histological serological biomarkers for the correction and improvement in the efficacy of treatment as well as the prognosis of survival in patients with head and neck melanoma.
- Published
- 2024
- Full Text
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33. Proximal femoral multiple myeloma pathological fractures, impending and actual fractures – a patient survival study
- Author
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Oded Hershkovich, Mojahed Sakhnini, Gal Barkay, Boaz Liberman, Alon Friedlander, and Raphael Lotan
- Subjects
Femur ,Multiple Myeloma ,Metastases ,Survival ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Introduction The femur is a common site for Multiple Myeloma (MM) involvement. This study explores the impact of preventive surgery for anticipated femoral pathological fractures (IFF), based on Mirels classification, versus treatment of pathological femur fracture (PFF) on MM patient mortality and morbidity. Methods Retrospective cohort of 33 patients undergoing surgery due to femoral MM involvement (2004–2015), 18 patients with PFF, 15 patients with IFF, followed up until deceased or to July 2016. Demographic data, oncological, pathological, radiation, surgical reports, outpatient clinical records, and imaging studies were studied. Exclusion criteria included patients who had surgery at other medical centers. Results The mean age was 70.4 ± 13.6 and 62.6 ± 12.2 years (p = 0.1) in the PFF and the IFF cohorts, respectively, primarily women (55.6% and 46.7%, respectively). The average Mirels' score was 10.4 ± 1.2. Post-operative complications were observed in 25% of patients, with no difference between IFF & PFF. We did not find a difference in mortality between IFF and PFF cohorts (p = 0.59). Conclusion The femur is commonly involved in MM. This study found that actual fractures, compared to imminent fractures, do not affect MM morbidity or mortality. Our study shows that proximal femoral MM behaves differently from proximal femoral metastatic disease regarding the impact of surgery on life span. Due to the fracture healing potential of MM, an IFF can probably be treated initially conservatively unless it progresses to an actual fracture needing surgery. Future, more extensive studies are required before revolutionizing the proximal femoral Multiple Myeloma-related involvement treatment paradigm.
- Published
- 2024
- Full Text
- View/download PDF
34. RECIST 1.1 Target Lesion Categorical Response in Metastatic Renal Cell Carcinoma: A Comparison of Conventional versus Volumetric Assessment.
- Author
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Gong, Amanda, Ruchalski, Kathleen, Kim, Hyun, Douek, Michael, Gutierrez, Antonio, Sai, Victor, Coy, Heidi, Villegas, Bianca, Raman, Steven, Goldin, Jonathan, and Patel, Maitraya
- Subjects
Kidney ,Metastases ,Oncology ,Outcomes Analysis ,Tumor Response ,Urinary ,Volume Analysis ,Humans ,Carcinoma ,Renal Cell ,Response Evaluation Criteria in Solid Tumors ,Retrospective Studies ,Tomography ,X-Ray Computed ,Kidney Neoplasms - Abstract
Purpose To investigate Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) approximations of target lesion tumor burden by comparing categorical treatment response according to conventional RECIST versus actual tumor volume measurements of RECIST target lesions. Materials and Methods This is a retrospective cohort study of individuals with metastatic renal cell carcinoma enrolled in a clinical trial (from 2003 to 2017) and includes individuals who underwent baseline and at least one follow-up chest, abdominal, and pelvic CT study and with at least one target lesion. Target lesion volume was assessed by (a) Vmodel, a spherical model of conventional RECIST 1.1, which was extrapolated from RECIST diameter, and (b) Vactual, manually contoured volume. Volumetric responses were determined by the sum of target lesion volumes (Vmodel-sum TL and Vactual-sum TL, respectively). Categorical volumetric thresholds were extrapolated from RECIST. McNemar tests were used to compare categorical volume responses. Results Target lesions were assessed at baseline (638 participants), week 9 (593 participants), and week 17 (508 participants). Vmodel-sum TL classified more participants as having progressive disease (PD), compared with Vactual-sum TL at week 9 (52 vs 31 participants) and week 17 (57 vs 39 participants), with significant overall response discordance (P < .001). At week 9, 25 (48%) of 52 participants labeled with PD by Vmodel-sum TL were classified as having stable disease by Vactual-sum TL. Conclusion A model of RECIST 1.1 based on a single diameter measurement more frequently classified PD compared with response assessment by actual measured tumor volume. Keywords: Urinary, Kidney, Metastases, Oncology, Tumor Response, Volume Analysis, Outcomes Analysis ClinicalTrials.gov registration no. NCT01865747 © RSNA, 2023 Supplemental material is available for this article.
- Published
- 2023
35. Unusual testicular metastatic localization of Ewing’s sarcoma: case report
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Youness Aboulaich, Youssef Kharbach, and Abdelhak Khallouk
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Metastases ,Ewing’s sarcoma ,Testicles ,Case report ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Abstract Background Ewing’s sarcoma is a rare form of bone cancer that can also affect soft tissues. In some cases, it can spread to other parts of the body, including the testicles, causing testicular metastases. To our knowledge, no testicular metastasis of Ewing’s sarcoma has been reported in the literature. Summary We report an original case of an 18-year-old patient who presented with bilateral testicular masses revealing an exceptional metastasis of metastatic bone Ewing sarcoma under chemotherapy for one year. It was difficult to diagnose synchronous bilateral testicular metastases of Ewing’s sarcoma due to the low frequency of these metastases. However, given the history of metastatic cancer, the data from the clinical examination, and the results of ultrasound, it should be considered and included in the differential diagnosis. Conclusion Despite the uncommon occurrence of secondary testicular metastasis, it should be considered in the differential diagnosis when encountering such a clinical presentation.
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- 2024
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36. Oncologic Outcomes of Incidental Versus Biopsy-diagnosed Grade Group 1 Prostate Cancer: A Multi-institutional Study
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Riccardo Leni, Emily A. Vertosick, Roderick C.N. van den Bergh, Timo F.W. Soeterik, Joris G. Heetman, Harm H.E. van Melick, Marco Roscigno, Giovanni La Croce, Luigi F. Da Pozzo, Jonathan Olivier, Fabio Zattoni, Matteo Facco, Fabrizio Dal Moro, Peter K.F. Chiu, Xiaobo Wu, Isabel Heidegger, Giulia Giannini, Lorenzo Bianchi, Luca Lampariello, Leonardo Quarta, Andrea Salonia, Francesco Montorsi, Alberto Briganti, Umberto Capitanio, Sigrid V. Carlsson, Andrew J. Vickers, and Giorgio Gandaglia
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Active surveillance ,Incidental prostate cancer ,Surveillance biopsies ,Metastases ,Diseases of the genitourinary system. Urology ,RC870-923 ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Background and objective: Patients diagnosed with grade group (GG) 1 prostate cancer (PCa) following treatment for benign disease (“incidental” PCa) are typically managed with active surveillance (AS). It is not known how their outcomes compare with those observed in patients diagnosed with GG1 on biopsy. We aimed at determining whether long-term oncologic outcomes of AS for patients with GG1 PCa differ according to the type of diagnosis: incidental versus biopsy detected. Methods: A retrospective, multi-institutional analysis of PCa patients with GG1 on AS at eight institutions was conducted. Competing risk analyses estimated the incidence of metastases, PCa mortality, and conversion to treatment. As a secondary analysis, we estimated the risk of GG ≥2 on the first follow-up biopsy according to the type of initial diagnosis. Key findings and limitations: A total of 213 versus 1900 patients with incidental versus biopsy-diagnosed GG1 were identified. Patients with incidental cancers were followed with repeated biopsies and multiparametric magnetic resonance imaging less frequently than those diagnosed on biopsy. The 10-yr incidence of treatment was 22% for incidental cancers versus 53% for biopsy (subdistribution hazard ratio [sHR] 0.34, 95% confidence interval [CI] 0.26–0.46, p
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- 2024
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37. Brain metastases from a thymoma: Case report for a rare secondary localization
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Ghassen Gader, Skander Guediche, Ines Moussa, Sinda Ben Zekri, Mohamed Badri, Ahmed Harbaoui, and Ihsèn Zammel
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Metastases ,Thymoma ,Pneumology ,Neurosurgery ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Thymomas are benign epithelial neoplasms originating from the thymus gland and are among the most common primary mediastinal tumors. Malignancy is typically determined by evidence of pathological invasion beyond the capsule, with local invasion being the primary mode of spread to adjacent organs. Distant metastases are exceedingly rare. We present the case of a 63-year-old man who exhibited symptoms suggestive of increased intracranial pressure and motor deficit. Brain imaging revealed multiple intracranial lesions. Surgical intervention was performed to excise the largest lesion. Subsequent body CT scan and pathological examination confirmed that the brain metastases originated from a primary thymoma, classified as B3. The patient was recommended for adjuvant chemotherapy and radiotherapy, but unfortunately passed away at the initiation of therapy. The prognosis for patients with brain metastases from thymomas remains poor. Optimal management strategies typically involve prompt surgical intervention whenever feasible, followed by adjuvant therapy aimed at improving mean survival rates.
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- 2024
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38. Surgical Oncology
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Pantvaidya, Gouri, Kattepur, Abhay, Badwe, Rajendra A., editor, Gupta, Sudeep, editor, Shrikhande, Shailesh V., editor, and Laskar, Siddhartha, editor
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- 2024
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39. 18F-NaF
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Calabria, Ferdinando, Leporace, Mario, Bagnato, Antonio, Schillaci, Orazio, Calabria, Ferdinando, editor, and Schillaci, Orazio, editor
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- 2024
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40. Metastatic Disease of the Extremities
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Kask, Gilber, Laitinen, Minna, Slullitel, Pablo, editor, Rossi, Luciano, editor, and Camino-Willhuber, Gastón, editor
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- 2024
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41. Spinal Metastatic Tumors
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Estefan, Martin, Quraishi, Nasir, Slullitel, Pablo, editor, Rossi, Luciano, editor, and Camino-Willhuber, Gastón, editor
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- 2024
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42. Preoperative Y-90 Radioembolization for Tumor Control and Future Liver Remnant Hypertrophy in Patients With Colorectal Liver Metastases
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Sirtex Medical
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- 2023
43. Cisplatin Monotherapy as a Treatment Option for Patients with HER-2 Negative Breast Cancer Experiencing Hepatic Visceral Crisis or Impending Visceral Crisis
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Mirosława Püsküllüoğlu, Małgorzata Pieniążek, Agnieszka Rudzińska, Agnieszka Pietruszka, Renata Pacholczak-Madej, Aleksandra Grela-Wojewoda, and Marek Ziobro
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Breast cancer ,Visceral crisis ,Overall survival ,Metastases ,Chemotherapy ,Cisplatin ,Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,RC254-282 - Abstract
Abstract Introduction Hepatic visceral crisis (VC), characterized by a rapid total bilirubin increase with disease progression, poses a life-threatening risk in advanced breast cancer (ABC). International consensus guidelines define VC and touch on impending VC (IVC). Limited data exist on systemic treatments for hepatic VC/IVC. This study explores the safety and efficacy of cisplatin monotherapy in patients with Human Epidermal Growth Factor Receptor 2- negative breast cancer (BC) and hepatic IVC/VC. Methods In this retrospective single-center cohort study data of patients treated with cisplatin monotherapy (60–80 mg/m2, every 3–4 weeks) between 2016 and 2023 at a reference Cancer Centre in Southern Poland were analyzed. Results 33 female patients (24/33 hormonal-positive) with the mean age 53.84 years were included. Participants progressed on median 2 prior palliative systemic treatment lines. In 10/23 patients hepatic VC and in 23/33 IVC (rapid, symptomatic liver progression; extensive liver involvement; alanine or aspartate aminotransferase > 2 × normal limit; significant increases in lactate dehydrogenase, alkaline phosphatase, or gamma-glutamyl transferase) were identified. Median progression-free survival was 1.87 months and median overall survival 2.67 months. 33% of the patients presented stable disease or partial response. Eight patients experienced adverse events grade ≥ 3: in five the dose of cisplatin was reduced; two stopped the treatment. Conclusion Due to the hepatotoxicity of BC-active drugs, specific recommendations for systemic treatment are scarce. Our study explored cisplatin's potential use, finding it to be a viable option in patients with performance status 0 or 1 experiencing hepatic IVC/VC, irrespective of liver function parameters and other factors.
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- 2024
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44. The CEA/PCI ratio is a superior prognosticator than mCOREP for colorectal cancer patients with peritoneal carcinomatosis
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Phelopatir Anthony, MD, MS, Shoma Barat, BSc, MSc, Nima Ahmadi, MBBS, FRACS, and David Lawson Morris, MBChB, FRACS
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Carcinoembryonic antigen ,Peritoneal carcinomatosis ,Colorectal cancer ,Metastases ,Prognosis ,Surgery ,RD1-811 - Abstract
Background: The CEA/PCI ratio, which evaluates tumour marker and burden, has been demonstrated as a prognosticator for patients with colorectal cancer with peritoneal carcinomatosis. The aim of this study was to compare the CEA/PCI ratio with the Modified Colorectal Peritoneal Score (mCOREP) for overall survival (OS) and recurrence free survival (RFS). There is no literature currently comparing both markers for RFS. Methods: Data was collected retrospectively for patients undergoing CRS and hyperthermic intraperitoneal chemotherapy (HIPEC) at the Peritonectomy Unit at St. George Hospital, NSW from January 2015 to December 2021. Results: From 187 patients, an increase in CEA/PCI ratio was associated with reduced OS (p 4 illustrated reduced RFS in patients with lower PCIs.
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- 2024
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45. Spinal extradural meningioma: Report of two cases
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Rakesh Redhu and H. N. Pavithra
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extradural meningioma ,metastases ,schwannoma ,Diseases of the musculoskeletal system ,RC925-935 - Abstract
Purely extradural spinal meningiomas are rare and often confused with metastases and schwannomas. Only a few cases have been described in the literature, and they are located mainly in the cervical and dorsal regions. We present two cases of extradural meningiomas, one well-defined nodular growth present at a cervicodorsal junction that was confused with schwannoma preoperatively and the other typical meningioma extending both intra and extradurally in the upper dorsal spine.
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- 2024
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46. Metastatic bone disease – epidemiology, characteristics, and diagnostic possibilities
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Michał Kanak, Ziemowit Żaba, Dawid Ciechanowicz, Natalia Pawłuś, Jędrzej Lesman, and Marcin Domżalski
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bones ,metastases ,neoplasms ,diagnosis ,tumor of unknown origin ,Orthopedic surgery ,RD701-811 - Abstract
Metastatic bone disease (MBD) is a common problem among patients with malignant tumors. Bone tissue is the third most frequent site of metastasis, following the lungs and liver. The risk of bone metastases increases with the duration of the cancer disease. Early diagnosis should be implemented when a patient with malignant tumors reports symptoms such as bone pain, joint mobility disorders, or neurological symptoms. Attention should also be drawn to abnormalities in laboratory tests – elevated calcium levels in serum (hypercalcemia). In the case of fractures in atypical locations or occurring after low-energy trauma, oncological disease should be included in the differential diagnosis. The first-line imaging studies include X-rays and computed tomography. Magnetic resonance imaging is recommended in cases of diagnostic uncertainty or changes in the axial skeleton. Additionally, scintigraphy allows for determining the nature of the lesion and oncological staging (assessment of the number of metastatic lesions to the bones). Hybrid studies are also used, characterized by the best sensitivity and specificity parameters. If dealing with a tumor of unknown origin, the most important diagnostic step is biopsy, which should be performed by an experienced clinician at a bone cancer treatment center. The authors of the publication hope that the review presented below will help expand knowledge about MBD, optimize its diagnostic process, and improve medical care in Poland for patients with metastatic bone disease.
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- 2024
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47. MALIGNANT MELANOMA – METASTASES IN GIT: REPORT OF 4 CASES AND LITERATURE REVIEW
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Vasil Bozhkov and Plamen Chernopolsky
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malignant melanoma ,metastases ,ileus ,intussusception ,immunotherapy ,Dentistry ,RK1-715 ,Medicine (General) ,R5-920 - Abstract
Purpose: We present four cases of malignant melanoma metastases in GIT. The symptoms which led to the hospitalization of the patients were ileus in two cases, hematemesis and hematochezia. Results: We performed operative treatment - small intestinal resection because of intussusception followed by anastomosis in three patients and in one patient, liver resection and bitruncular sigmostomy. The histopathology revealed metastases for malignant melanoma. All of the patients had previous operation for a skin form of malignant melanoma, and chemotherapy or immunotherapy was performed. The patients had a postoperative period without complications. Conclusions: Malignant melanoma is a widely common disease. It is the third neoplastic diseases which give metastases in the small intestine. Malignant melanoma metastases in the GIT are initially asymptomatic, but in time, they manifest with clinical presentation of ileus or bleeding from the GI tract.
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- 2024
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48. Metastatic nose and paranasal sinus masses – A case series
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Latha CS, Begum N, Amaranth SB, Brunda CP, Rao IS, and Subrahmanyam C
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metastases ,paranasal sinuses ,renal cell carcinoma ,breast carcinoma ,non-hodgkin’s lymphoma ,sinus surgery ,Medicine (General) ,R5-920 - Abstract
Metastases to the nose and paranasal sinuses are unusual. These tumors are commonly seen in the 4th to 6th decades of life. The clinical presentation may be analogous to that of primary sino-nasal tumors. They usually present with common nasal and ocular symptoms due to which diagnosis may be missed and delayed. Hence, high level of suspicion is necessary for patients with known malignancies presenting with inconsistent or repeated nasal and ocular symptoms. Otorhinolaryngologists should be familiar with these metastases to paranasal sinuses from unusual primary elsewhere in the body, to evaluate and manage these tumors. Retrospective data was collected from the hospital records from 2020-2023. A total 14 cases of sino-nasal malignancies were identified. On further analysis three cases were found to be having distant metastases from primary sites such as kidney, breast and lymph nodes. We are reporting three metastatic malignancies. Each was systematically evaluated, confirming their origin as metastases from other primary sites. They were then managed appropriately.
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- 2024
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49. Cannonball Pulmonary Metastases as Initial Presentation of Hepatocellular Carcinoma: A Case Report and Literature Review
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Héctor Raúl Ibarra-Sifuentes, Gustavo Abraham Canales-Azcona, Jaqueline Isabel Gómez-Arredondo, and Carlos Javier Rodríguez-Álvarez
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Hepatocellular carcinoma ,Metastases ,Cannonball metastases ,Pulmonary metastases ,Case report ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Hepatocellular carcinoma is a major public health problem, as is considered the fastest growing cause of cancer-related death. Cannonball metastases as an initial finding in hepatocellular carcinoma are considered a rare phenomenon. Case Presentation A 59-year-old man presented to the outpatient clinic for subacute cough, asthenia, and involuntary weight loss. Chest X-ray showed multiple, round, bilateral pulmonary solid lesions. Contrast-enhanced computed tomography of the chest and abdomen revealed multiple bilateral, contrast-enhanced pulmonary nodules known as "cannonball" lesions and a heterogeneous lesion located in the right lobe of the liver with retroperitoneal lymphadenopathy. A biopsy was performed, and the histopathological result was compatible with metastatic poorly differentiated hepatocellular carcinoma. Due to the advanced stage of the disease, the patient received palliative care and expired two months later. Conclusion Cannonball metastases in hepatocellular carcinoma are considered a rare finding and represents a poor prognosis. It is important to awaken the interest of clinicians in a timely diagnosis, as well as a possible suspicion of hepatocellular carcinoma in patients with this radiographic pattern.
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- 2024
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50. Ocular metastases profile in a tertiary hospital in São Paulo, Brazil
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Matheus Senna Pereira Ogata, Guilherme Rodrigues Ferreira, Melina Correia Morales, and Arthur Gustavo Fernandes
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Ocular oncology ,Metastases ,Tumours ,Ophthalmology ,RE1-994 - Abstract
Abstract Objective Ocular metastases are the most common intraocular tumours in adults. Data regarding the occurrence of these tumours in the Brazilian population is scarce. We aimed to investigate the profile of ocular metastases of patients referred to tertiary hospital service in São Paulo, Brazil. Design Retrospective study. Participants Patients referred to the Ocular Oncology service of the Federal University of São Paulo with initial diagnostic hypothesis of ocular metastasis. Methods Data was retrospectively collected from medical records from June 2017 to June 2023. Age, sex, primary tumour site, previous knowledge of the systemic diagnosis, laterality, initial visual acuity (VA), local or systemic treatment and mean follow-up period were obtained. Results A total of 37 cases were referred to the ocular oncology division due to a suspected ocular metastasis, 15 (40.5%) were confirmed. Mean age at diagnosis was 53.47 ± 16.01 years old, the majority (86.7%) of patients already knew the systemic diagnosis. Breast cancer (66.7%) was the most common primary site, followed by Lung cancer (26.7%). Both eyes were affected in 66.67% of the cases, all patients had metastases at the choroid (100.0%), and the mean initial VA was 1.37 ± 1.04 logMAR. Chemotherapy was the main systemic treatment modality (73.3%), and most patients had no ocular treatment (53.3%). The mortality rate along the follow-up period was 30.0%. Conclusions Considering the number of new patients absorbed by the Ocular Oncology service over the study period, the frequency of ocular metastases was relatively low. The patients’ characteristics was comparable to data published in the international literature.
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- 2024
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