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Nunzia Cinzia Paladino Carole Guérin Aoïfe Lowery Andrea Attard Wassim Essamet Eveline Slotema Isabelle Morange Frédéric Castinetti Thierry Brue Anderson Loundou David Taïeb Frédéric Sebag 《Surgical oncology》2018,27(2):231-235
Background
adrenal tumor-to-liver uptake value (Tmx:Lmx) on 18F-FDG PET/CT is an accurate and reproducible PET parameter in the distinction between benign and malignant adrenal masses. The potential impact of steroid hormone secretion on 18F-FDG uptake is still debatable. The aim of this study was to evaluate this relationship.Methods
2010–2015: 73 patients who underwent adrenalectomy for adrenocortical tumors [49 secreting/(SA) and 24 non-secreting/(NSA)] were retrospectively included in the study. Fourteen were malignant. All patients underwent hormonal evaluation, functional and anatomical imaging, Weiss scoring and Ki 67 evaluation.Results
malignant tumors exhibit higher SUVmax than benign tumors (median 7.75 vs 3.06 respectively, p?<?0.001) and Tmx:Lmx was 2.7 vs 1.17 for benign tumors, p?<?0.001.Tmx:Lmx was positively correlated to Weiss score (p?<?0.001).No significant difference was observed for Tmx:Lmx between SA and NSA overall (p?=?0.851), regardless of the subgroup of tumors analyzed. Tmx:Lmx was not correlated to tumor size (p?<?0.508) or 24?h free urinary cortisol level (p?<?0.522).Conclusions
no correlation was observed between Tmx:Lmx and hormonal status, however the correlation between ratio, malignancy and Weiss score confirm the utility of 18F-FDG PET/CT for the differentiation of benign from malignant adrenal lesions, irrespective of the hormone secretory status of the tumor. 18F-FDG PET/CT is a useful biomarker in the diagnosis of adrenal tumors, regardless of the secretion status. 相似文献3.
J.H. Jeon J.M. Lee D.H. Moon H.C. Yang M.S. Kim G.-K. Lee J.I. Zo 《European journal of surgical oncology》2017,43(2):471-477
Background
The purpose of this study was to analyze the risk factors of recurrence in patients with early stage esophageal squamous cell carcinoma (ESCC).Methods
We retrospectively analyzed the medical records of 190 patients with confirmed T1N0M0 ESCC after curative esophagectomy. The following potential prognostic factors for recurrence were investigated: age, sex, pathologic T category, tumor location, differentiation grade, tumor size, venous invasion, angiolymphatic invasion, perineural invasion and the maximum standardized uptake value (SUVmax) of the primary tumor.Results
There were 174 male and 16 female patients with a median age of 66.0 years (range, 42.0–79.0 years). The pathologic status of the surgically resected ESCCs was T1a in 93 patients (48.9%) and T1b in 97 patients (51.1%). The median number of dissected lymph nodes was 35 (range, 10 to 86), and all lymph nodes were negative for tumors. The multivariate analysis showed presence of venous invasion [HR (hazard ratio), 11.433; P < 0.001) and SUVmax ≥ 3.2 (HR, 2.830; P = 0.011) as independent risk factors for recurrence. The 5-year recurrence-free survival (RFS) was 25.0% for patients with venous invasion and 78.9% for those without (P < 0.001). The 5-year RFS was 67.1% for patients with an SUVmax ≥3.2 and 81.5% for those with an SUVmax <3.2 (P = 0.003).Conclusions
Venous invasion and high SUVmax could be important prognostic factors coupled with the TNM staging system, in patients with early stage ESCC. 相似文献4.
Kazushige Kawai Hiroaki Nozawa Keisuke Hata Toshiaki Tanaka Takeshi Nishikawa Koji Oba Toshiaki Watanabe 《Clinical colorectal cancer》2018,17(2):e163-e170
Introduction
Although 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) has been increasingly used to evaluate the response to preoperative chemoradiotherapy (CRT) in patients with rectal cancer, the optimal intervals between completion of CRT, PET, and surgery have not been fully investigated.Patients and Methods
A total of 148 consecutive patients with rectal adenocarcinoma who received CRT followed by FDG-PET and radical surgery were retrospectively analyzed. The association between the FDG-PET maximum standardized uptake value (SUVmax) and pathological response was assessed using a logistic regression model, with a primary focus on the intervals between CRT and PET as well as between PET and surgery.Results
The baseline SUVmax showed no association with pathological response (P = .201; area under the curve [AUC] = 0.528), whereas the SUVmax after CRT completion showed a strong association (P < .001; AUC = 0.707). Logistic regression analysis revealed that the ability of the SUVmax to accurately predict pathological good responders was significantly associated with a long CRT–PET interval (≥ 7 weeks; P = .027), but was not affected by the length of PET–surgery interval. In patients with a short CRT–PET interval (< 7 weeks), the ability of the SUVmax to predict good responders was poor (P = .201; AUC = 0.669); however, in patients with long intervals (≥ 7 weeks), the predictive ability markedly improved (P < .001; AUC = 0.879).Conclusion
A minimum wait time of 7 weeks is recommended before performing FDG-PET after neoadjuvant CRT for rectal cancer to obtain maximal predictive accuracy for pathological response. 相似文献5.
Angelina Cistaro Laura Cassalia Cinzia Ferrara Natale Quartuccio Laura Evangelista Maurizio Bianchi Franca Fagioli Gianni Bisi Sergio Baldari Alessandro Zanella Marta Pillon Pietro Zucchetta Marta Burei Alessandra Sala Luca Guerra Priscilla Guglielmo Roberta Burnelli Stefano Panareo Giuseppe Rubini 《Clinical Lymphoma, Myeloma & Leukemia》2018,18(6):e267-e273
Introduction
The present study investigated the utility of fluorine-18 (18F) fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in assessing bone marrow involvement (BMI) compared with bone marrow biopsy (BMB) in newly diagnosed pediatric Hodgkin lymphoma (HL).Patients and Methods
A total of 224 pediatric patients with HL underwent 18F-FDG PET/CT at staging. BMB or follow-up imaging was used as the standard of reference for the evaluation of BMI.Results
18F-FDG PET/CT was negative for BMI in 193 cases. Of the 193 patients, the findings for 16 were originally reported as doubtful and later interpreted as negative for BMI, with negative findings on follow-up imaging and BMB. At BMB, 1 of the 16 patients (6.25%) had BMI. Of the 193 patients, 192 (99.48%) had negative BMB findings. Thus, the 18F-FDG PET/CT findings were truly negative for 192 patients and falsely negative for 1 patient for BMI.Conclusion
18F-FDG PET/CT showed high diagnostic performance in the evaluation of BMI in pediatric HL. Thus, BMB should be ideally reserved for patients presenting with doubtful 18F-FDG PET/CT findings for BMI. 相似文献6.
M. Samim I.Q. Molenaar M.F.J. Seesing P.S.N. van Rossum M.A.A.J. van den Bosch T.J.M. Ruers I.H.M. Borel Rinkes R. van Hillegersberg M.G.E.H. Lam H.M. Verkooijen 《Surgical oncology》2017,26(1):37-45
Purpose
Uncertainty exists regarding the optimal imaging modality for timely detection of disease progression (DP) after ablation therapy for colorectal liver metastases. We evaluated the diagnostic accuracy of 18F-FDG PET(/CT), CT and MRI for detection of DP following ablation therapy.Methods
A systematic search was performed on May 18, 2016. The analysis included studies that reported on the diagnostic accuracy of 18F-FDG PET(/CT), CT and/or MRI for post-ablative evaluation of patients with liver metastases. Primary outcome was the diagnostic accuracy of the imaging modalities for detection of DP. Methodological quality was assessed using the QUADAS-2 tool. Pooled sensitivities and specificities were estimated using bivariate random-effects models.Results
Ten studies were included in the meta-analysis, including seven comparative studies. Nine reported data on diagnostic accuracy of 18F-FDG PET(/CT), seven on CT imaging. Only two studies reported the diagnostic accuracy of MRI, hence not included in the meta-analysis. Quality assessment raised concerns about the risk of bias regarding the use of the reference standard, blinding of the index tests and the follow-up time. Pooled sensitivity was respectively 84.6% (75.0–90.6) and 53.4% (29.0–76.4) for 18F-FDG PET(/CT) and CT (P = 0.005). Pooled specificity was respectively 92.4% (86.5–95.9) and 95.7% (87.5–98.6) (P = 0.392).Conclusion
18F-FDG PET/(CT) yields a higher sensitivity for detecting DP after ablation therapy compared with CT and has a comparably high specificity. These findings indicate that the use of 18F-FDG PET(/CT) in this setting particularly allows for minimization of the false-negative rate compared with CT without compromising the low false-positive rate. 相似文献7.
Bianca van Veggel Adrianus J. de Langen Sayed M.S. Hashemi Kim Monkhorst Daniëlle A.M. Heideman Erik Thunnissen Egbert F. Smit 《Journal of thoracic oncology》2018,13(8):1222-1226
Introduction
EGFR exon 20 insertions comprise 4% to 9% of EGFR mutated NSCLC. Despite being an oncogenic driver, they are associated with primary resistance to EGFR tyrosine kinase inhibitors (TKIs). We hypothesized that dual EGFR blockade with afatinib, an irreversible EGFR TKI, and cetuximab, a monoclonal antibody against EGFR, could induce tumor responses.Methods
Four patients with EGFR exon 20 insertion–positive NSCLC were treated with afatinib 40 mg once daily and cetuximab 250 mg/m2 to 500 mg/m2 every 2 weeks.Results
All patients had stage IV adenocarcinoma of the lung harboring an EGFR exon 20 insertion mutation. Previous lines of treatment consisted of platinum doublet chemotherapy (n = 4) and EGFR TKI (n = 2). Three of four patients showed a partial response according to Response Evaluation Criteria in Solid Tumors (RECIST 1.1). Median progression-free survival was 5.4 months (95% confidence interval: 0.0 – 14.2 months; range 2.7 months – 17.6 months). Toxicity was manageable with appropriate skin management and dose reduction being required in two patients.Conclusions
Dual EGFR blockade with afatinib and cetuximab may induce tumor responses in patients with EGFR exon 20 insertion–positive NSCLC. 相似文献8.
Maíra Teixeira Dória Jonathan Yugo Maesaka Raymundo Soares de Azevedo Neto Nestor de Barros Edmund Chada Baracat José Roberto Filassi 《Clinical breast cancer》2018,18(5):e805-e812
Background
Approximately 30% of ductal carcinoma in situ (DCIS) cases have an invasive component discovered on the final analysis that could affect surgical management. The aims of the present study were to determine the risk factors associated with the underestimation of DCIS and to develop a model to predict the probability of invasiveness.Materials and Methods
A retrospective analysis was performed on the data for all patients with a diagnosis of DCIS found by percutaneous biopsy from January 2008 to February 2016. Thirteen potential predictors of invasiveness were examined. The statistical analysis of the present study was improved using Nagelkerke’s R2, the area under the receiving operating characteristic (AUC) curve, and the Hosmer-Lemeshow goodness-of-fit test.Results
Of 354 biopsy specimens deemed to be DCIS on initial biopsy, 100 (28.2%) were recategorized as invasive carcinoma after surgery. On multivariate analysis, the strongest predictors of invasiveness were comedonecrosis, size on mammography, suspected microinvasion, histologic grade, and younger patient age. The model had a good discriminative ability, with an AUC of 0.764. The overall performance of the model was fair, with a Nagelkerke’s R2 of 40.9%. A separate analysis performed on 274 specimens obtained through vacuum-assisted biopsy revealed different variables were associated with underestimation; however, a similar AUC (0.743) and Nagelkerke’s R2 (45.7%) were obtained.Conclusion
Our model had the best AUC for predicting DCIS invasiveness reported to date. However, further statistical analysis showed only a fair overall performance. The currently known clinical, radiographic, and pathologic features might be insufficient to identify which patients with DCIS have underestimated disease. 相似文献9.
Yukihiro Umeda Yoshiki Demura Masaki Anzai Hiroki Matsuoka Tomoyuki Araya Masaru Nishitsuji Koichi Nishi Tatsuro Tsuchida Yasuyuki Sumida Miwa Morikawa Shingo Ameshima Takeshi Ishizaki Kazuo Kasahara Tamotsu Ishizuka 《Lung cancer (Amsterdam, Netherlands)》2014
Objectives
Recent advances in endobronchial ultrasonography with a guide sheath (EBUS-GS) have enabled better visualization of distal airways, while virtual bronchoscopic navigation (VBN) has been shown useful as a guide to navigate the bronchoscope. However, indications for utilizing VBN and EBUS-GS are not always clear. To clarify indications for a bronchoscopic examination using VBN and EBUS-GS, we evaluated factors that predict the diagnostic yield of a transbronchial biopsy (TBB) procedure for peripheral lung cancer (PLC) lesions.Methods
We retrospectively reviewed the charts of 194 patients with 201 PLC lesions (≤3 cm mean diameter), and analyzed the association of diagnostic yield of TBB with [18F]-fluoro-2-deoxy-d-glucose (18F-FDG) positron emission tomography and chest computed tomography (CT) findings.Results
The diagnostic yield of TBB using VBN and EBUS-GS was 66.7%. High maximum standardized uptake value (SUVmax), positive bronchus sign, and ground-glass opacity component shown on CT were all significant predictors of diagnostic yield, while multivariate analysis showed only high 18F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign as significant predictors. Diagnostic yield was higher for PLC lesions with high 18F-FDG uptake (SUVmax ≥2.8) and positive bronchus sign (84.6%) than for those with SUVmax <2.8 and negative bronchus sign (33.3%). High 18F-FDG uptake was also correlated with tumor invasiveness.Conclusions
High 18F-FDG uptake predicted the diagnostic yield of TBB using VBN and EBUS-GS for PLC lesions. 18F-FDG uptake and bronchus sign may indicate for the accurate application of bronchoscopy with those modalities for diagnosing PLC. 相似文献10.
Hang Su Chenyang Dai Huikang Xie Yijiu Ren Yunlang She Xiermaimaiti Kadeer Dong Xie Hui Zheng Gening Jiang Chang Chen 《Clinical lung cancer》2018,19(5):e609-e617
Background
In this study we aimed to identify the risk factors of recurrence in patients with clinical stage IA adenocarcinoma presented as ground glass nodule (GGN) on computed tomography scans.Patients and Methods
The study included 245 patients with clinical stage IA adenocarcinoma presented as GGN who underwent surgery during 2010 to 2013. All patients were divided into 2 subgroups on the basis of consolidation diameter to tumor diameter (C/T) ratio on lung window: (1) ground-glass opacity (GGO)-dominant subgroup (C/T ≤ 0.5; n = 179); (2) solid-dominant subgroup (C/T > 0.5; n = 66). Recurrence-free survival (RFS) was analyzed to identify independent risk factors of recurrence using the Kaplan–Meier approach and multivariable Cox models.Results
Patients in the GGO-dominant subgroup had a better prognosis than those in the solid-dominant subgroup (5-year RFS: 98% vs. 87%; P < .001). Multivariate analysis confirmed that C/T ratio was an independent risk factor for RFS in patients with clinical stage IA adenocarcinoma presented as GGN (hazard ratio [HR], 9.47; 95% confidence interval [CI], 1.75-51.1; P = .009). In the analysis of the solid-dominant group, multivariate analysis showed that limited resection was an independent risk factor of recurrence in this subgroup (HR, 6.86; 95% CI, 1.50-31.42; P = .013). Regarding the GGO-dominant subgroup, surgical type was not a risk factor of recurrence.Conclusion
Patients with clinical stage IA solid-dominant adenocarcinoma (C/T ratio > 0.5) had a higher rate of recurrence after limited resection than lobectomy. Thus, limited resection should be performed cautiously in these patients (C/T ratio > 0.5). 相似文献11.
Introduction
We examined the value of tumor location in predicting the clinicopathologic features, survival, and metastases of pulmonary adenocarcinoma.Patients and Methods
A total of 417 cases of pulmonary adenocarcinoma were included in the present study. The tumors with invasion of the segmental and/or lobar bronchus were classified as central adenocarcinoma and those without as peripheral adenocarcinoma. Histologic grade, cytologic features, and adenocarcinoma type (terminal respiratory unit [TRU] type vs. non-TRU type) were compared between the 2 groups. The prognostic factors for disease-free survival (DFS) were analyzed using univariate and multivariate analyses.Results
Central adenocarcinoma was associated with lymphatic and/or vascular invasion (P = .011), necrosis (P < .001), high histologic grade (P = .004), and advanced stage (P < .001). For lung adenocarcinoma 1 to 4 cm in size, central adenocarcinoma was linked to a greater rate of nodal metastasis than peripheral adenocarcinoma. However, for lung adenocarcinoma of other sizes, central and peripheral adenocarcinoma had no differences in the rates of nodal metastasis. For nuclear features, central adenocarcinoma showed high mitotic counts, advanced nuclear atypia, and larger nuclei (P < .001, P < .001, P < .001, respectively). More peripheral adenocarcinomas than central adenocarcinomas were TRU type (229 of 281 [81.5%] vs. 58 of 136 [42.6%]; P < .001). Multivariate survival analyses of DFS showed that tumor location (central vs. peripheral, hazard ratio, 1.744; P < .001) was a stage-independent prognostic factor.Conclusion
Central adenocarcinoma is associated with a high potential for regional lymph node metastases, even at a small size. The results of our study showed that tumor location is an important factor for choosing treatment strategies and predicting DFS. 相似文献12.
Fangying Xu Si Li Jing Zhang Lili Wang Xuesong Wu Jing Wang Qiong Huang Maode Lai 《Clinical colorectal cancer》2018,17(3):e579-e592
Background
Tumor tissues consist of heterogeneous cancer cells and stroma cells, including cancer stem cells and immune cells. Epithelial–mesenchymal transition (EMT) programs closely associate with acquisition of stemness. We investigated for the first time the clinical significance of combining cancer stem cells, immune cells, and EMT traits.Materials and Methods
In 419 colorectal carcinomas, stem-cell markers (Nanog, Lgr5, CD44v6, ALDH1A1), EMT markers (E-cadherin, Snail), and immune-cell markers (CD3+, CD4+ or CD8+ T lymphocytes, CD20+ B lymphocytes, CD68+ macrophages) were detected in tumor center (TC) and tumor invasive front by an immunohistochemical method. Unsupervised hierarchical clustering analysis was performed to group the data according to correlation analyses. Survival analysis and chi-square test were performed to explore the significance of this clustering.Results
There were correlations among the expression of Nanog, Lgr5, CD44v6, and immune cell counts (P < .05). Nanog, Lgr5, CD44v6, and ALDH1A1 positively related to E-cadherin or Snail (P < .05). A cluster (termed cluster SIE) based on cancer stemness markers (Nanog, Lgr5, CD44v6, ALDH1A1 in TC), EMT markers (E-cadherin, Snail in TC), and immune-cell markers (CD4+ and CD8+ T-lymphocyte counts in TC, and CD68+ macrophages in tumor invasive front) could significantly predict 5-year survival (P = .040). Multivariate Cox proportional hazard model showed that only tumor, node, metastasis classification system stage and cluster SIE were independent prognostic predictors (hazard ratio = 1.920; 95% confidence interval, 1.082-3.407; P = .026).Conclusion
Cancer stemness, immune state, and EMT programs should be considered as a whole. Cluster SIE was an independent predictor for 5-year survival of patients with colorectal cancer. 相似文献13.
Jae-Ryong Shim Seung Duk Lee Sung-Sik Han Sang Jae Lee Dong Eun Lee Seok-Ki Kim Seong Hoon Kim Sang Jae Park Jae-Hwan Oh 《European journal of surgical oncology》2018,44(5):670-676
Introduction
Colorectal cancer liver metastasis (CRLM) can be cured with surgery. To improve survival, optimal selection of CRLM patients should be done cautiously, which may be facilitated by preoperative [F-18] fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT).Methods
A total of 245 patients with CRLM between February 2007 and January 2015 were retrospectively studied. All clinical variables, pathological data, and various PET/CT parameters were correlated with disease-free survival (DFS) and overall survival (OS). Metastatic tumor maximum standardized uptake value (SUVmax) and normal liver mean SUV (SUVmean) ratio was selected for group classification.Results
The median DFS in months were 24.5 months and median OS were 41.7 months. Multivariate analysis found an increased risk of worse prognosis in DFS for primary colon cancer T3～T4, N2 stage, neoadjuvant chemotherapy, synchronous metastasis, multiple metastatic tumor number and metastatic tumor SUVmax/normal liver SUVmean ratio >4.3. The DFS rate of each group classified by SUV ratio was 58.1%, 39.0%, and 33.6% vs. 39.3%, 20.8%, and 15.8% at 1, 3, and 5 years (p = 0.017). Patients with multiple tumors and SUV ratio of >4.3 showed worst survival (OS rate: 74.2%, 41.5%, and 24.2%, p = 0.001 at 1, 3, and 5 years, respectively).Conclusions
PET/CT variables can be a valuable prognostic factor in patients with CRLM for the prediction of recurrence. Preoperative PET/CT may improve risk stratification and optimize outcomes of patients with CRLM. 相似文献14.
Kanae K. Miyake Yuji Nakamoto Shigehira Saji Tomoharu Sugie Kensuke Kurihara Shotaro Kanao Debra M. Ikeda Masakazu Toi Kaori Togashi 《Breast cancer research and treatment》2018,169(3):437-446
Purpose
Premenopausal physiologic steroid levels change cyclically, in contrast to steady state low levels seen in postmenopausal patients. The purpose of this study was to evaluate whether 18F-fluorodeoxyglucose (18F-FDG) uptake in breast cancer is influenced by physiological hormonal fluctuations.Methods
A total of 160 primary invasive breast cancers from 155 females (54 premenopausal, 101 postmenopausal) who underwent 18F-FDG positron emission tomography/computed tomography before therapy were retrospectively analyzed. The maximal standardized uptake values (SUVmax) of tumors were compared with menstrual phases and menopausal status according to the following subgroups: ‘luminal A-like,’ ‘luminal B-like,’ and ‘non-luminal.’ Additionally, the effect of estradiol (E2) on 18F-FDG uptake in breast cancer cells was evaluated in vitro.Results
Among premenopausal patients, SUVmax during the periovulatory-luteal phase was significantly higher than that during the follicular phase in luminal A-like tumors (n = 25, p = 0.004), while it did not differ between the follicular phase and the periovulatory-luteal phase in luminal B-like (n = 24) and non-luminal tumors (n = 7). Multiple regression analysis showed menstrual phase, tumor size, and Ki-67 index are independent predictors for SUVmax in premenopausal luminal A-like tumors. There were no significant differences in SUVmax between pre- and postmenopausal patients in any of the subgroups. In in vitro studies, uptake in estrogen receptor-positive cells was significantly augmented when E2 concentration was increased from 0.01 to ≥ 1 nM.Conclusions
Our data suggest that 18F-FDG uptake may be impacted by physiological hormonal fluctuations during menstrual cycle in luminal A-like cancers, and that E2 could be partly responsible for these events.15.
Stephan Schorn Ihsan Ekin Demir Bernhard Haller Florian Scheufele Carmen Mota Reyes Elke Tieftrunk Mine Sargut Ruediger Goess Helmut Friess Güralp Onur Ceyhan 《Surgical oncology》2017,26(1):105-115
Objectives
To assess the impact of neural invasion/NI on overall survival/OS and tumor recurrence in pancreatic ductal adenocarcinoma/PDAC.Summary background data
NI is a histopathological hallmark of PDAC. Although some studies suggested an important role for NI on OS, disease-free/DFS and progression-free survival/PFS in PDAC, there is still no consensus on the actual role of NI on survival and local recurrence in PDAC.Methods
Pubmed, Cochrane library, Ovid and Google Scholar were screened for the terms “pancreatic ductal adenocarcinoma”, “pancreatic cancer”, “survival”, “tumor recurrence” and “perineural invasion”. The Preferred–Reporting-Items-for-Systematic-review-and-Meta-Analysis/PRISMA-guidelines were used for systematic review and meta-analysis. Articles meeting predefined criteria were critically analysed on relevance, and meta-analyses were performed by pooling univariate and multivariate hazard ratios/HR.Results
A total number of 25 studies on the influence of NI on tumor recurrence, and 121 studies analysing the influence of NI on survival were identified by systematic review. The HR of the univariate (HR 1.88; 95%-CI 1.71–2.07; p < 0.00001) and multivariate meta-analysis (HR 1.68; 95%-CI 1.47–1.92; p < 0.00001) showed a major impact of NI on OS. Likewise, NI was associated with decreased DFS (HR 2.53; 95%-CI: 1.67–3.83; p = 0.0001) and PFS (HR 2.41; 95%-CI: 1.73–3.37: p < 0.00001) multivariate meta-analysis.Conclusions
Although the power of this study is limited by missing pathological procedures to assess the true incidence of NI, NI appears to be an independent prognostic factor for OS, DFS and PFS in PDAC. Therefore, NI should be increasingly considered in patient stratification and in the development of novel therapeutic algorithms. 相似文献16.
Eunhyang Park Soyeon Ahn Hyojin Kim Soo Young Park Jisun Lim Hyun Jung Kwon Yeon Bi Han Choon-Taek Lee Sukki Cho Jin-Haeng Chung 《Journal of thoracic oncology》2018,13(11):1776-1783
Introduction
Lung adenocarcinoma (ADC) with synchronous ground-glass/lepidic (GG/L) nodules is considered a distinct disease entity in multiple synchronous lung cancers. Few studies have performed next-generation sequencing analysis of these synchronous sequential lesions, and genetic alterations of GG/L nodules must be further investigated.Methods
We performed targeted sequencing in ADC with synchronous atypical adenomatous hyperplasia (AAH), ADC in situ, or minimally invasive ADC from 16 patients. Next-generation sequencing was performed by using a customized panel including 154 cancer-associated genes.Results
Multiple synchronous lesions in the same patient showed different mutation profiles, and some shared identically mutated genes. In five patients harboring EGFR-mutant ADC, their synchronous GG/L nodules had EGFR mutation; however, none was observed in EGFR wild-type ADC. The average numbers of exonic mutations were 4.2, 5.4, 4.0, and 5.4 in AAH, ADC in situ, minimally invasive ADC, and ADC, respectively. In each lesion type, various mutations, including LDL receptor related protein 1B gene (LRP1B), KRAS, EGFR, and BRAF were observed in AAH, and EGFR mutations were the most frequently observed in ADC. In all, 80% of mutations with a variant allele frequency of 20% or higher, which contained driver gene mutations, were identified in ADC. Intratumoral heterogeneity of the genetic profile was found between the lepidic and invasive areas of ADC, but the driver gene mutations were similar.Conclusions
This study suggests that ADC and synchronous GG/L nodules are genetically independent tumors. Intratumoral genetic heterogeneity of ADC was present, but driver gene mutations were homogeneously distributed. Driver gene mutations with a high variant allele frequency were identified in the invasive tumor. These findings support the relevance of molecular characterization of lung ADC and synchronous GG/L nodules. 相似文献17.
Toshikazu Ito Shoji Oura Shinji Nagamine Masato Takahashi Naohito Yamamoto Noboru Yamamichi Mitsuharu Earashi Hiroyoshi Doihara Shigeru Imoto Shoshu Mitsuyama Kohei Akazawa 《Clinical breast cancer》2018,18(4):e495-e500
Purpose
To validate the safety and efficacy of percutaneous radiofrequency ablation (RFA) of breast carcinomas.Methods
This retrospective study was conducted by the Breast Cancer Society for Minimally Invasive Therapy following approval from institutional review boards, and with the written informed consent of patients. A total of 386 patients with breast cancer treated with RFA at 10 institutions between July 2003 and June 2009 were identified and included in the analysis. Patients underwent a standard RFA procedure with ultrasound guidance and were followed up every 6 to 12 months. In this study, feasibility of RFA procedure and related safety and ipsilateral breast tumor recurrence (IBTR) were examined. Fisher exact or χ2 test evaluated associations between clinicopathological factors and IBTR, and local recurrence-free survival was estimated using the Kaplan-Meier method.Results
RFA-related adverse events included local pain in 9 patients, skin burns in 15, and nipple retraction in 7. Patients were followed for a median of 50 months. IBTR was more frequently observed in patients with initial tumor sizes > 2 cm (3 of 30, 10%) than in those with initial tumors ≤ 2 cm (8 of 355, 2.3%; P = .015). IBTR-free rates 5 years after RFA were 97%, 94%, and 87% in patients with initial tumor sizes ≤ 1.0 cm, 1.1 to 2.0 cm, and > 2.0 cm, respectively.Conclusions
RFA in breast cancer is a safe and promising minimally invasive treatment for tumors ≤ 2 cm in diameter. Further studies are needed to optimize the technique and evaluate its future role as local therapy. 相似文献18.
Zhihua Gong Junying Chen Jia-Nan Cheng Chengdu Sun Qingzhu Jia Xinwei Diao Bo Zhu 《Clinical lung cancer》2018,19(5):e551-e558
Background
The benefits of immune checkpoint inhibitors for first-line treatment in patients with lung adenocarcinoma harboring EGFR mutations are unclear. The effects of ICIs depend on the tumor microenvironment (TME). Differences in TME properties between mutant and wild-type EGFR have not been fully characterized.Patients and Methods
We collected 105 surgically resected (50 EGFR mutated and 55 EGFR wild-type), treatment-naïve lung adenocarcinoma tissues with clinical data to investigate the landscape and compartmentalization of tumor-infiltrating immune cells with respect to EGFR status by immunohistochemistry. The normalized FPKM values of data for 531 patients were obtained from The Cancer Genome Atlas (TCGA) Data Portal (https://portal.gdc.cancer.gov/).Results
CD68-positive cells within the tumor niche exhibited more intensive infiltration in wild-type EGFR than in mutations, and was related to lymph node invasion. In the RNA-Seq analysis, MMP9 and VEGFA showed higher levels in wild-type EGFR than in mutant cases. The EGFR mutation independently predicted a favorable disease-free survival.Conclusion
The CD68-positive cells play a crucial role in discriminating the TME between different EGFR statuses. 相似文献19.
Zhaohui Jin Mindy L. Hartgers Cristobal T. Sanhueza Christopher R. Shubert Steven R. Alberts Mark J. Truty Prasuna Muppa David M. Nagorney Thomas C. Smyrk Mohamed Hassan Amit Mahipal 《European journal of surgical oncology》2018,44(5):677-683
Introduction
Ampullary adenocarcinoma is a rare entity with limited data on prognostic factors. The aim of this study is to identify prognostic factors and assess the benefit of adjuvant therapy in patients with ampullary adenocarcinoma who underwent pancreatoduodenectomy.Methods
A cohort of 121 consecutive patients underwent pancreatoduodenectomy for ampullary adenocarcinoma from 2006 to 2016 at Mayo Clinic in Rochester, MN. All patients were confirmed by independent pathologic review to have ampullary carcinoma. Patient survival and its correlation with patient and tumor variables were evaluated by univariate and multivariate analysis.Results
Fifty three patients (45%) received adjuvant therapy (34 patients had chemotherapy alone, while 19 patients received both chemotherapy and radiation therapy). Fifty seven percent of the patients were diagnosed with advanced stage disease (Stage IIB or higher). Nearly all patients (98.3%) had negative surgical margins. Median overall survival (OS) was 91.8 months (95% CI:52.6 months-not reached). In multivariate analysis, excellent performance status (ECOG: 0), adjuvant therapy, and advanced stage remained statistically significant. Adjuvant therapy was independently associated with improved disease free survival (Hazard ratio [HR]:0.52, P = 0.04) and overall survival (HR:0.45, P = 0.03) in patients with advanced disease.Conclusions
Adjuvant therapy was associated with improved survival in patients with resected ampullary cancer, especially with advanced stage disease. A multi-institutional randomized trial is needed to further assess the role of adjuvant therapy in ampullary adenocarcinoma. 相似文献20.
Bojan Zaric Luka Brcic Anna Buder Anita Brandstetter Jorun O. Buresch Stefan Traint Tomi Kovacevic Vladimir Stojsic Branislav Perin Robert Pirker Martin Filipits 《Clinical lung cancer》2018,19(6):e957-e963