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Δευτέρα 28 Ιουνίου 2021

Clinical Impact of a Novel Model Predictive of Oncotype DX Recurrence Score in Breast Cancer

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In Vivo. 2021 Jul-Aug;35(4):2439-2444. doi: 10.21873/invivo.12522.

ABSTRACT

BACKGROUND/AIM: Oncotype DX recurrence score (RS) for breast cancer is a useful tool for determining chemotherapy indication but it is expensive and time-consuming. We determined whether four immuno-histochemical markers, namely human epidermal growth factor 2 (HER2), estrogen receptor (ER), progesterone receptor (PgR), and Ki-67, are predictive of an RS ≥26 in Japanese patients.

PATIENTS AND METHODS: The study included 95 Japanese patients evaluated for RS. A predictive model was created using logistic regression analysis.

RESULTS: The discriminant function was calculated as follows: p=1/{1+exp [-(4.611+1.2342×HER2-0.0813×ER- 0.0489 ×PgR+0.0857×Ki67)]}. Using a probability of 0.5 as the cutoff, the accuracy, sensitivity, specificity, positive predictive and negative predictive values were 90.5%, 72.2%, 94.8%, 76.4% and 93.5%, respectively.

CONCLUSION: The model had a high negative predictive value in predicting RS ≥26 in Japanese patients, indicating that Oncotype DX testing may be omitted in patients with a negative result according to the predictive model.

PMID:34182528 | DOI:10.21873/invivo.12522

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Sleep Disorders Before and During the COVID-19 Pandemic in Patients Assigned to Adjuvant Radiotherapy for Breast Cancer

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In Vivo. 2021 Jul-Aug;35(4):2253-2260. doi: 10.21873/invivo.12498.

ABSTRACT

BACKGROUND/AIM: The anticipation of radiotherapy can cause distress and sleep disorders, which may be aggravated by the COVID-19 pandemic. This study investigated sleep disorders in a large cohort of patients with breast cancer before and during the pandemic.

PATIENTS AND METHODS: Twenty-three characteristics were retrospectively analyzed for associations with pre-radiotherapy sleep disorders in 338 patients. Moreover, 163 patients presenting before and 175 patients presenting during the COVID-19 pandemic were compared for sleep disorders.

RESULTS: Sleep disorders were significantly associated with age ≤60 years (p=0.006); high distress score (p<0.0001); more emotional (p<0.0001), physical (p<0.0001) or practical (p<0.0001) problems; psycho-oncological need (p<0.0001); invasive cancer (p=0.003); chemotherapy (p<0.001); and hormon al therapy (p=0.006). Sleep disorders were similarly common in both groups (prior to vs. during the pandemic: 40% vs. 45%, p=0.38).

CONCLUSION: Although additional significant risk factors for sleep disorders were identified, the COVID-19 pandemic appeared to have no significant impact on sleep disorders in patients scheduled for irradiation of breast cancer.

PMID:34182504 | DOI:10.21873/invivo.12498

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Whole-brain Radiation Therapy for Intracranial Metastases as Initial or Late Treatment

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In Vivo. 2021 Jul-Aug;35(4):2445-2450. doi: 10.21873/invivo.12523.

ABSTRACT

BACKGROUND/AIM: We examined the difference between whole-brain radiation therapy (WBRT) for intracranial metastases (IM) from lung cancer as an initial and as a late treatment affecting overall survival (OS).

PATIENTS AND METHODS: Thirty-three patients who presented with IM at initial examination who received WBRT as the initial treatment (initial WBRT group) and 47 patients without IM or with asymptomatic IM at initial examination who received WBRT after systemic therapy, between January 2014 and December 2020, were retrospectively analyzed. Patients' OS after WBRT were compared.

RESULTS: Median OS was significantly longer in patients treated with systemic anticancer therapy after WBRT than in patients who were not (176 vs. 47 days, respectively; p<0.001), and systemic anticancer therapy after WBRT was a significant prognostic factor (p<0.001 ).

CONCLUSION: Treatment with systemic anticancer therapy after WBRT may prolong the survival of patients who present with IM at initial examination.

PMID:34182529 | DOI:10.21873/invivo.12523

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Emergency Management of Obstructive Colorectal Cancer - A Retrospective Study of Efficacy and Safety in Self-expanding Metallic Stents and Trans-anal Tubes

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In Vivo. 2021 Jul-Aug;35(4):2289-2296. doi: 10.21873/invivo.12502.

ABSTRACT

BACKGROUND/AIM: The self-expanding metallic stent (SEMS) has recently been used for obstructive colorectal cancer (OCRC), and reports of its use are increasing. However, the long-term results of OCRC after using SEMS remain unclear. This study investigated the characteristics of SEMS compared to trans-anal tube (TAT) and clarified the long-term results and efficacy of SEMS for OCRC.

PATIENTS AND METHODS: We analyzed 48 patients who required SEMS or TAT for emergent decompression of OCRC and underwent resection for OCRC between 2007 and 2019. The perioperative factors and long-term results in the two groups were evaluated.

RESULTS: Patients with OCRC were divided into the SEMS (n=23) and the TAT group (n=25). No significant differences were seen in background factors, complications and the 5-year overall survival after surgery (p=0.3500) between the two groups. The clinical success of decompression (p=0.0072), oral intake (p<0.0001) and change in serum albumin (p<0.0001) from decompression to surgery were significantly better in the SEMS compares to the TAT group.

CONCLUSION: The long-term outcomes in the SEMS group were not significantly different than in the TAT group, and nutritional status was better in patients with SEMS, suggesting that SEMS is very effective and may be the first-line treatment of OCRC.

PMID:34182508 | DOI:10.21873/invivo.12502

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Factors Associated With Longitudinal QOL Change in Patients With Chronic Liver Diseases

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In Vivo. 2021 Jul-Aug;35(4):2451-2456. doi: 10.21873/invivo.12524.

ABSTRACT

AIM: To examine the relationship between longitudinal quality of life (QOL) change, as assessed by the 36-Item Short Form Health Survey (SF-36), sarcopenia-related factors and body composition in patients with chronic liver diseases (CLDs).

PATIENTS AND METHODS: Data from patients with CLDs (n=184) were retrospectively analyzed, focusing on factors associated with the difference of physical and mental component summary score (PCS and MCS) in SF-36 between the two visits (ΔPCS and ΔMCS). The difference of serum albumin level, body mass index (BMI), arm circumference, arm muscle circumference, grip strength (GS), skeletal muscle index, extracellular to total body water ratio between the two visits were included into the multiple regression analysis.

RESULTS: Δalbumin (p=0.0325) and ΔGS (p<0.0001) were independent factors linked to ΔPCS Δalbumin (p=0.0005) and ΔBMI (p=0.0232) were independent factors linked to ΔMCS Conclusion: Significance of serum albumin level, muscle strength and body composition on health-related QOL in CLD patients should be emphasized.

PMID:34182530 | DOI:10.21873/invivo.12524

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Diabetes Mellitus as a Prognostic Factor for Locally Advanced Rectal Cancer

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In Vivo. 2021 Jul-Aug;35(4):2495-2501. doi: 10.21873/invivo.12530.

ABSTRACT

BACKGROUND/AIM: Currently, the impact of diabetes mellitus (DM) on rectal cancer patients is complex and just partly elucidated. The purpose of this study was to investigate the impact of diabetes mellitus on rectal cancer patients focusing on tumor differentiation grade, neoadjuvant chemoradiotherapy (NACRT) response, disease-free (DFS) and overall (OS) survival.

PATIENTS AND METHODS: Our study's population consisted of a group of 53 patients diagnosed with locally advanced rectal cancer, who underwent NACRT, followed by radical oncological surgery. This patient population was further divided into two groups according to diabetes presence.

RESULTS: Downstaging rates, local control, DFS, and OS were lower in the DM subgroup compared to the non-DM locally advanced rectal cancer patients.

CONCLUSION: The presence of DM at the time of diagnosis o f locally advanced rectal cancer patients may be a negative predictive factor for response to neoadjuvant therapy, distant metastases, and local recurrences rates.

PMID:34182536 | DOI:10.21873/invivo.12530

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Primary Leiomyoma of the Visceral Pleura: An Unexpected Occurrence

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In Vivo. 2021 Jul-Aug;35(4):2457-2463. doi: 10.21873/invivo.12525.

ABSTRACT

BACKGROUND/AIM: Leiomyoma is a rare benign tumor originating from smooth muscle fibres. In the respiratory tract, these tumors are rare and in the pleura, cases are exceptional, with only a few reported so far. This is the main reason we decided to present this case of primary leiomyoma of the visceral pleura.

CASE REPORT: We present a case of a 51-year-old asymptomatic patient who, during a routine medical examination using standard chest radiography, presented with a 3 by 2 cm homogenous mass in the right superior pulmonary area, tangent to the chest wall (same level with the 3rd rib). Further investigation using computed tomography (CT) in the chest confirmed the presence of a 31/18 mm solid mass in the right upper lobe, in contact with the parietal pleura. Surgery was performed for two reasons: i) removal of the tumoral mass and ii) establi shing a histopathological diagnosis. Intraoperatively, a well-defined, homogenous, ivory white non-infiltrating mass was discovered in the right upper lobe on the visceral pleura and in close proximity to the minor fissure. The mass was removed with negative surgical margins and was left with healthy tissue. Histopathological examination and immunohistochemistry came as a surprise, establishing our diagnosis of leiomyoma.

CONCLUSION: Primitive pleural leiomyoma must remain a possibility when considering the differential diagnosis of pleural tumors. The main course of treatment is complete surgical resection. In our case, long-term follow up did not present any local recurrence.

PMID:34182531 | DOI:10.21873/invivo.12525

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Chronic Treatment of an Advanced Prostate-cancer Patient With Oral Methioninase Resulted in Long-term Stabilization of Rapidly Rising PSA Levels

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In Vivo. 2021 Jul-Aug;35(4):2171-2176. doi: 10.21873/invivo.12488.

ABSTRACT

BACKGROUND/AIM: Advanced prostate cancer is a recalcitrant disease with very limited treatment options. Our laboratory discovered methionine addiction, presumably a characteristic of all cancer types, including prostate cancer, which can be targeted by methionine restriction (MR), through treatment with oral recombinant methioninase (o-rMETase).

PATIENTS AND METHODS: o-rMETase was produced by fermentation of recombinant E. coli containing the Pseudomonas putida methioninase gene, and purified by column chromatography. An advanced prostate cancer patient received o-rMETase as a supplement, 500 units per day, divided into two oral doses of 250 units each.

RESULTS: Before treatment, the patient had a rapid rise in PSA levels, from 39 to 56 ng/ml, within 6 weeks. At the 15th week of o-rMETase administration, the PSA levels stabilized at 62 ng /ml. No overt side effects were observed.

CONCLUSION: o-rMETase single treatment can be beneficial for advanced prostate cancer patients.

PMID:34182494 | DOI:10.21873/invivo.12488

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Short-term Outcomes of Liver Resection in Patients With Hemodialysis

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In Vivo. 2021 Jul-Aug;35(4):2465-2468. doi: 10.21873/invivo.12526.

ABSTRACT

BACKGROUND: The number of patients with hemodialysis is increasing increased yearly. Few reports are available on hepatobiliary and gastrointestinal surgery in these patients.

PATIENTS AND METHODS: A total of 222 patients who underwent partial liver resection or segmentectomy in our hospital between January 2015 and September 2019 were included in this study. Patients were divided into the hemodialysis group (n=9) and non-hemodialysis group (n=213).

RESULTS: No significant difference was observed in postoperative complications between the hemodialysis and non-hemodialysis group. The hemodialysis group had a significantly higher infectious complication rates than the non-hemodialysis group (33.3% vs. 8.0%, p=0.009). In logistic regression analysis, hemodialysis was only a significant risk factor for postoperative infectious complications (OR=5.61, 95 % CI=1.12-28.20, p=0.036).

CONCLUSION: Liver resections, at least segmentectomy or smaller, is acceptable in patients on hemodialysis. However, these patients may have a higher risk of postoperative infectious complications than other patients.

PMID:34182532 | DOI:10.21873/invivo.12526

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Multicenter Study of Carbon-ion Radiotherapy for Oropharyngeal Non-squamous Cell Carcinoma

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In Vivo. 2021 Jul-Aug;35(4):2239-2245. doi: 10.21873/invivo.12496.

ABSTRACT

BACKGROUND/AIM: To evaluate treatment outcomes of carbon-ion radiotherapy for oropharyngeal non-squamous cell carcinoma at four carbon-ion facilities in Japan.

PATIENTS AND METHODS: We retrospectively analyzed the cases of 33 patients with oropharyngeal non-squamous cell carcinoma who were treated with carbon-ion radiotherapy between November 2003 and December 2014.

RESULTS: The histology included adenoid cystic carcinoma (n=25) and mucosal malignant melanoma (n=4). No patients had T1 tumors; 23 had T4 tumors. The most-commonly prescribed dose was 57.6 Gy (RBE) in 16 fractions. The median follow-up period was 34.8 months (range=4.2-122.8 months). The 3-year local control and overall survival rates were 94.7% and 90.7%, respectively. There were no grade ≥4 acute adverse events. Only one patient experienced a grade ≥4 late adverse event. No patien ts experienced late adverse events related to swallowing or salivary function.

CONCLUSION: Carbon-ion radiotherapy appears to be a promising treatment option for oropharyngeal non-squamous cell carcinoma.

PMID:34182502 | DOI:10.21873/invivo.12496

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Clinicopathological Characteristics of Microscopic Tubal Intraepithelial Metastases from Adenocarcinoma and Small Cell Neuroendocrine Carcinoma of the Uterine Cervix

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In Vivo. 2021 Jul-Aug;35(4):2469-2481. doi: 10.21873/invivo.12527.

ABSTRACT

BACKGROUND/AIM: Some metastatic tumors that involve the fallopian tube show intraepithelial spread, mimicking primary tubal neoplasm and representing a potential diagnostic pitfall. In this study, we aimed to investigate the clinicopathological characteristics of tubal intraepithelial metastasis (IEM) from cervical carcinoma.

PATIENTS AND METHODS: We analyzed the clinical features, histological features, and immunophenotypes of IEMs in five patients with cervical carcinoma.

RESULTS: This study included usual-type (1/5), mucinous-type (1/5), and gastric-type (2/5) endocervical adenocarcinomas and small cell neuroendocrine carcinoma (1/5) cases. None of the patients had ovarian metastasis, but metastatic tumor cells spread along the tubal mucosal surface and partially replaced the lining epithelium. Histological features of metastatic tumors closely r esembled those of the primary tumors in all cases.

CONCLUSION: Tubal IEM can mimic various tubal lesions including serous tubal intraepithelial carcinoma. Morphological consistency between the primary and metastatic tumors and immunostaining help guide the differential diagnosis of challenging intraepithelial lesions of the fallopian tube.

PMID:34182533 | DOI:10.21873/invivo.12527

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