Tentorial meningiomas： clinical results in 81 patients treated microsurgically

OBJECTIVE:Even during the microsurgical era, tentorial meningiomas present a formidable surgical challenge when tumor involves critical neurovascular structures. We report our experience with tentorial meningioma with regard to clinical presentation, diagnostic workup, microsurgical technique, complications, and follow-up results. METHODS: In a retrospective study, we reviewed the medical     

Signet ring cell adenocarcinomas: Different clinical–pathological characteristics of oesophageal and gastric locations

AimsThe incidence of oesogastric (OG) signet ring cell adenocarcinoma (SRC) is increasing in Western countries. The differential characteristics between oesophageal and gastric SRC tumours are unknown. We aimed to investigate the role of tumour location on prognosis in OG SRC.MethodsAmong 924 OG SRC resected in 21 centres from 1997 to 2010, consecutive patients who had oesophageal tumours (group OESO, n = 136) were matched to randomly selected patients who had gastric tumours (group GASTRIC, n = 363). Matching variables were gender, age, American Society of Anaesthesiologists score, malnutrition, pretherapeutic clinical TNM stage and neoadjuvant treatment. Patients and tumour characteristics were compared between groups and prognostic factors were identified.ResultsThe two groups were well matched. Tumours in group GASTRIC were more advanced at surgical exploration, with higher rates of linitis plastica (P < 0.001), peritoneal carcinomatosis (P = 0.001), and advanced pTNM stages (P = 0.034). Radicality of resection and recurrence rates were similar (P > 0.480). Recurrences were more frequently distant (P < 0.001) and peritoneal (P < 0.001) in group GASTRIC. After adjustment on confounding variables, gastric location (P = 0.034) was independently associated with a better prognosis than oesophageal location.ConclusionGastric and oesophageal SRC tumours are distinct diseases. Despite similar pretherapeutic factors, gastric tumours were more advanced with a greater propensity for the peritoneal surface at the diagnosis and recurrence and associated with a better prognosis.     

Quantitative analysis of EZH2 expression and its correlations with lung cancer patients’ clinical pathological characteristics

Introduction

Elevated Enhancer of Zeste Homologue 2 (EZH2) expression is involved in many human malignancies through epigenetically silencing related genes. However, the study of the EZH2 protein expression in lung cancer remains at the qualitative or semi-quantitative level. The present study is to elucidate the roles of EZH2 in the progression and metastasis of different subtypes of lung cancer at quantitative level.

Materials and methods

Lung carcinoma tissue microarray was constructed containing 32 normal adult lung tissues, 113 lung carcinomas and 57 lymph-node metastases. EZH2 protein expression was detected by immunohistochemistry and assessed quantitatively with Leica Q500MC image analysis system. Positive unit (PU) value was used to evaluate the protein expression intensity of positive cells from systematically selected fields under the microscope.

Results

Elevated Enhancer of Zeste Homologue 2 PU in lung carcinomas was significantly greater than that in normal lung tissues (p = 0.001). Increased EZH2 expression was correlated with histological subtypes, differentiation, TNM stage, and lymph-node metastases (p < 0.05). EZH2 PU of primary lung carcinomas was smaller than that of lymph-node metastasis (p = 0.002). EZH2 PU was not associated with patients’ gender, age, smoking status, tumor location, and tumor size (p > 0.05).

Conclusions

Elevated Enhancer of Zeste Homologue 2 PU is increased with the development of lung cancer. EZH2 may play an important role in the progression and metastasis of lung cancer.     

Breast cancer in the oldest old (≥ 89 years): Tumor characteristics,treatment choices,clinical outcomes and literature review

IntroductionRisk of breast cancer increases with age and very few data are available in patients older than 89.MethodsA retrospective analysis on patients aged 89 and older treated between 2008 and 2019 at our certified breast center. The aim was to analyze clinical characteristics, decision-making, treatment, outcomes and open questions regarding this subpopulation for which there is a lack of guidelines.Results58 patients included. Tumor characteristics were analyzed, 85% patients underwent surgery of which 44% had a mastectomy. The median follow-up and overall survival were 20 and 76 months, respectively.The median survival of metastatic and non-metastatic patients were 14 and 50 months, respectively. Most patients did not receive any adjuvant treatment and among these 14% had a relapse.ConclusionsElderly patients should not be under or over-treated because of their age; they represent a large heterogeneous group deserving a sub-stratification for a better tailored treatment.     

Effects of neoadjuvant chemotherapy on the quantitative expression of P-gp, LRP, MRP, GST-π in NSCLC and its clinical significance

1 Introduction Lung cancer is the most common and the first le-thal cancer inlarge cities of China with anincreasingmorbidity in recent years . Non-small cell lung cancer(NSCLC) takes up 80 %--85 % of total lung cancersand has a high mortality .Since most of patients werediagnosed at Ⅲor Ⅳof clinic stage ,surgical treat-ment alone showed a poor effect onit .The total five-year survival rate of NSCLC after diagnosis is below15 %[1]. Upto now,systemic therapy becomes an ef-fective treat m…     

Epidemiology of glioma: clinical characteristics,symptoms, and predictors of glioma patients grade I–IV in the the Danish Neuro-Oncology Registry

Bevacizumab (BVZ), a monoclonal antibody directed against vascular endothelial growth factor (VEGF), has been suspected to increase the incidence of ischemic stroke (IS) and intracranial hemorrhage (ICH) in GBM patients. Intracranial vascular events, such as IS and ICH, were retrospectively analyzed in 364 MRI scans of 82 patients with recurrent GBM (1st/2nd/3rd relapse). Out of these 82 patients, 40 were treated with BVZ (178 scans) in addition to basic treatment, whereas 42 patients matching for age and gender received basic treatment (186 scans). Distribution of typical vascular risk factors between both groups was analyzed retrospectively. In seven out of 82 patients (8%) vascular events were detected in MRI. Four vascular events were recorded in the BVZ-group (3 IS and 1 ICH), and 3 vascular events were found in the Control-group (1 IS and 2 ICH; p?>?0.05 between both groups). Likewise, vascular risk factors (arterial hypertension, diabetes mellitus, obesity, former vascular event, hyperlipidemia, tobacco consumption and/or hypercholesterolemia) did not differ significantly between both groups. BVZ treatment does not seem to be associated with an increased risk for vascular events in patients with GBM in recurrence.     

Weekly docetaxel, cisplatin and low dose fluorouracil for advanced gastric carcinoma： a randomized clinical trial

Objective  

The aim of this study was to investigate the efficacy of weekly docetaxel (TXT), cisplatin (DDP) combined with continuous infusion of low dose fluorouracil (FU) on advanced gastric carcinoma.     

Collision tumor of the kidney composed of clear cell carcinoma and collecting duct carcinoma：report of a case with unusual morphology and clinical follow-up

We report the case of a 67-year-old female who presented with a large renal mass. Gross examination of the nephrectomy specimen demonstrated a 6-cm renal mass that invaded into the renal sinus and perinephric fat. Histologic examination revealed two distinct tumor types. The first type was a conventional （clear cell） renal cell carcinoma that was of low nuclear grade and comprised the minority of the overall tumor. The second type was a high-grade collecting duct carcinoma with glandular/tubular differentiation and composed the majority of the tumor. Immunohistochemical studies demonstrated distinctive patterns of the two tumor types, thus confirming two distinct lineages. Five months postoperatively, the patient developed metastasis to the lungs and right hilar lymph node region. A fine needle aspiration of a lung nodule demonstrated a metastatic, poorly differentiated carcinoma, similar to the collecting duct carcinoma component in the kidney. Collision tumors of the kidney are rare with fewer than 10 cases reported in the literature. Our report further expands the spectrum of this rare phenomenon.     

Survival and clinical outcomes in patients with metastatic epidural spinal cord compression after spinal surgery：a prospective,multicenter, observational cohort study

Background: High quality studies have been challenging to undertake in patients with metastatic epidural spinal cord compression. Nonetheless, in the article“Survival and Clinical Outcomes in Surgically Treated Patients With Meta-static Epidural Spinal Cord Compression: Results of the Prospective Multicenter AOSpine Study”recently published in the Journal of Clinical Oncology, our team provided convincing evidence that spinal surgery improves overall quality of life in patients with this potentially devastating complication of cancer. Considering that metastatic spinal lesions treated with surgery have the highest mean cost among all oncological musculo-skeletal issues, it is essential to pro-vide high quality data to optimize the therapeutic approaches and cost-effective use of health care resources. Main body: Although the AOSpine Study provided high quality prospective data, it was primarily limited by the lack of non-operative controls and the relatively small sample size. Given the dearth of medical equipoise and the funda-mental difference between patients deemed to be adequate surgical candidates and those who are not amenable to operative intervention, conducting a randomized controlled trial in this patient population was not felt to be ethi-cally or medically feasible. Consequently, the optimal option to overcome limitations of both the lack of controls and the relatively small sample size is through collection of large prospective datasets through rigorously developed and maintained registries. Conclusions: With the alarming increase in the incidence of cancer in China and China’s parallel growing cancer con-trol efforts, China would offer a fantastic platform to set up a national metastatic spinal lesion registry. Such registry would not only enhance metastatic epidural spinal cord compression translational research but also optimize patient care.     

Phase Ⅲ Clinical Trials of the Cell Differentiation Agent-2 （CDA-2）： Therapeutic Efficacy on Breast Cancer, Non-Small Cell Lung Cancer and Primary Hepatoma

OBJECTIVE The objective of this study was to explore the effect of CDA-2, a selective inhibitor of abnormal methylation enzymes in cancer cells, on the therapeutic efficacy of cytotoxic chemotherapy. METHODS Advanced cancer patients, all of whom had previously undergone chemotherapy, were randomly divided into 2 groups, one receiving chemotherapy only as the control group, and the other receiving CDA-2 in addition to chemotherapy as the combination group. The therapeutic efficacies and the toxic maniestations of the 2 groups were compared based on the WHO criteria. RESULTS Of 454 cancer patients enrolled in phase Ⅲ clinical trials of CDA-2, 80, 188, and 186 were breast cancer, NSCLC, and primary hepatoma patients, respectively. Among them 378 patients completed treatments according to the protocols. The results showed that the overall effective rate of the combination group was 2.6 fold that of the control group, 4.8 fold in the case of breast cancer, 2.3 fold in the case of primary hepatoma, and 2.2 fold in the case of NSCLC. Surprisingly, the combination therapy appeared to work better for stage Ⅳ than stage Ⅲ patients. CDA-2 did not contribute additional toxicity. On the contrary, it reduced toxic manifestations of chemotherapy, particularly regarding white blood cells, nausea and vomiting. CONCLUSION Modulation of abnormal methylation enzymes by CDA-2 is definitely helpful to supplement chemotherapy. It significantly increased the therapeutic efficacy and reduced the toxic manifestation of cytotoxic chemotherapy on breast cancer and NSCLC.