Prognostic significance of adjuvant radiation therapy in adenocarcinoma of the cecum

PURPOSE: Local recurrence is a common failure pattern in adenocarcinoma of the cecum. This study aimed to investigate the potential role of adjuvant radiation therapy on oncologic outcomes of patients with adenocarcinoma of the cecum. MATERIALS AND METHODS: This retrospective study was carried out at three large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of 162 patients with adenocarcinoma of the cecum that were treated and followed up between 2000 and 2013. All the patients had undergone a right hemicolectomy and received chemotherapy with (n = 48) or without (n = 114) adjuvant radiation therapy. RESULTS: The subjects were 65 females and 97 males with a median age of 56 years (range, 17 to 90 years) at diagnosis. The 5-year local control (LC), disease free survival (DFS), and overall survival (OS) rates were 72.7%, 57.2%, and 62.6% respectively. In a multivariate analysis, age, tumor stage, node stage, and adjuvant radiation therapy were determined to be independent prognostic factors. Age more than 55 years (hazard ratio [HR] = 1.0; 95% confidence interval [CI], 0.06–0.32; p = 0.003], T4 stage (HR = 6.8; 95% CI, 3.07–15.36; p < 0.001), node positive disease (HR = 4.2; 95% CI, 1.94–9.13; p < 0.001), and the absence of adjuvant radiation therapy (HR = 3.0; 95% CI, 1.39–6.46; p = 0.005) had a negative influence on OS. CONCLUSION: Adjuvant radiation therapy significantly improves DFS and OS in patients with adenocarcinoma of the cecum.

Prognostic Significance of Mucinous Histologic Subtype on Oncologic Outcomes in Patients With Colorectal Cancer

PURPOSE: Mucinous adenocarcinomas account for about 10% of all colorectal cancers. This study aimed to investigate the prognostic impact of mucinous histologic subtype on oncologic outcomes in patients with colorectal cancer. METHODS: This retrospective study was performed at two large tertiary university hospitals. We analyzed the characteristics, prognostic factors, and survival of patients with colorectal cancer who were treated and followed up between 2000 and 2013. RESULTS: Totally, 144 of 1,268 patients with a colorectal adenocarcinoma (11.4%) had mucinous histologic subtype. Statistically significant results found in this research are as follows: Mucinous histologic subtype tended to present in younger patients and to have larger tumor size, higher histologic grade, higher node stage, larger number of positive nodes, and higher rate of perineural invasion compared to nonmucinous histologic subtype. On the univariate analysis, mucinous subtype was a prognostic factor for disease-free and overall survival. On the multivariate analysis, primary tumor location, node stage and lymphatic-vascular invasion were independent prognostic factors for the local control rate. Rectal tumor location, higher disease stage, tumor grade II, and presence of lymphatic-vascular invasion had negative influences on disease-free survival, as did rectal tumor location, higher disease stage and presence of lymphatic-vascular invasion on overall survival. CONCLUSION: Mucinous histologic subtype was associated with some adverse pathologic features in patients with colorectal cancer; however, it was not an independent prognostic factor for oncologic outcome.

report of a rare gastric cancer case: leptomeningeal carcinomatosis

Leptomeningeal carcinomatosis [LMC] from gastrointestinal cancer would be rare. A 56-years old man with complaint of dyspepsia and histopathologic examination of the biopsy specimens has shown: adenocarcinoma. At the end of adjuvant chemo radiation therapy, the patient has affected by headache and mild confusion. In cerebrospinal fluid [CSF] cytology, a plenty of malignant cells have seen and unfortunately after a short time for about 4 days after ICU admission, the patient has died. This could be due to heavy burden of disease in central nervous system

Prognostic significance of metastatic lymph node ratio in patients with gastric cancer: an evaluation in north-east of Iran

In this study we have evaluated the prognostic impact of Metastatic Lymph node Ratio [MLR] in gastric cancer patients whose have undergone curative surgical resection. A total of 121 patients with gastric adenocarcinoma undergoing curative surgical resection [R0] in our institutions between 2003 and 2010 have been included in this study. MLR has classified into 3 groups as follows: MLR0; 0, MLR1; >0-0.33 and MLR2; 0.34-1. We have used Kaplan-Meier method to calculate survival rates and log rank test to compare survival curves between groups. Cox proportional hazards model has utilized for multivariate analysis. The median age of patients was 65 [range; 32 to 89] with a male to female ratio of 91/30 [3.03]. 88 patients have undergone total gastrectomy [72.5%] and 33 subtotal gastrectomy [27.5%]. With a median total retrieved lymph node of 11 [range; 6 to 44], the MLR0 to MLR2 has calculated in 28[23.1%], 31[25.6%] and 62 [51.2%] patients respectively. MLR2 [>0.33] has significantly associated with higher Tumor stage [T1-T2: 18.7% vs. T3: 56.2%, p=0.002]. With a median follow up time of 12 months [range; 2-88], the 3-year survival in patients with MLR0, MLR1 and MLR2 was 75.1%, 54.8% and 9.5% respectively [p value<0.001]. Tumor location [p<0.01], tumor stage [p<0.01] and lymph node stage [p<0.001] were also significant predictor of survival. MLR has also significant correlated with survival in 91 patients with less than 15 obtained lymph nodes [p<0.001]. Cox-regression multivariate analysis has shown MLR as the most important and independent predictor of survival [p<0.001]. MLR with cutoff point of 0.33 could be used as an independent prognostic factor in gastric cancer patients whose have undergone curative surgical resection. This factor could effectively predict survival even in cases with insufficient [<15] retrieved lymph nodes

serum C-reactive protein and prooxidant-antioxidant balance in patients with esophageal cancer compared to healthy subjects

Introduction: The molecular mechanisms involved in pathogenesis of esophageal cancer have been the main concern of several studies. In this study, we aimed to investigate the changes of serum prooxidant-antioxidant balance [PAB] values as a redox index, as well as serum C-reactive protein [CRP] compared to healthy control group

Materials and Methods: In a cross-sectional study, blood samples were drawn from 25 patients with esophageal cancer and 25 healthy subjects. Serum CRP and PAB value were measured in all samples according to relevant protocols

Results: Serum CRP was significantly higher in our patients [14.3 +/- 3.2 mg/L] compared to healthy control group [4.6 +/- 1.4 mg/L], with a P-value of less than 0.001. The value of PAB in our patients [133.9 +/- 21.7] was also higher than that of healthy subject [51.3 +/- 11.2], indicating a redox perturbation in favor of oxidants

Conclusion: There was a significant increase in both serum PAB value and CRP in patients with esophageal cancer compared to the control group, which indicated both oxidative stress and inflammatory response in patients with esophageal cancer, respectively

stromal overexpression of CD10 in invasive breast cancer and its association with clincophathologic factors

Breast carcinoma is the most common non-skin malignancy in women. More recently, it has been suggested that extracellular proteinase has also regulated growth factors and cytokines that might contribute to tumor progression. CD10 is a 90-110kd cell surface zinc-dependent metalloproteinase. Since CD10 is structurally similar to matrix metalloproteinase and stromelysin, it might facilitate cancer cell invasion and/or metastasis. The aim of this study was investigation the rate of CD10 expression in the stromal cells of invasive ductal breast carcinomas, Immunohistochemical aspects, then any other aspects to be able to clarify its correlation with other clinicopathological factors of this disease. One hundred patients with histopathologic diagnosis of invasive ductal carcinoma and 50 patients with fibroadenoma of breast [as the control group] have selected, then 150 paraffin blocks have obtained. The stained slides by immunohistochemistry method for CD10 marker have examined separately by two pathologists, and discrepancies have reviewed in common session to get the final result. Stromal CD10 has detected in 28% of the IDC. No kind of immunoreactivity has identified in the stromal cells of normal breast. Stromal CD10 expression in IDC has significantly correlated with increasing tumor size [p<0.001], increasing histologic grade [p<0.001], the presence of nodal metastases [p<0.001] and estrogen receptor negative status [p=0.003]. Stromal CD10 expression in IDC has closely correlated with invasion and metastasis and it might play an important role in the pathogenesis of IDC

Changes in daily activities of cancer patients after diagnosis: how do canadian and Iranian patients perceive the change?

Being diagnosed with cancer has major impacts on a patient's life. This study was conducted to explore how specific daily activities of patients change as a result of cancer diagnosis or its treatment and how these patients feel about such changes. This was a cross-sectional descriptive study. Cancer patients referred to our clinics and by completing a questionnaire, they reported their daily activities and how they changed after diagnosis. A total of 201 patients in Canada and 167 patients in Iran completed the questionnaire. The research setting was the outpatient cancer clinics of the Jewish General Hospital in Montreal, Canada [February to April 2008] and Imam Reza Hospital and Ghaem Hospital in Mashhad, Iran [March to August 2008]. More than 40 percent of the patients reported changes after the diagnosis in at least 8 out of 22 daily activities listed in the questionnaire. While a negative perception towards the changes was more common, some patients also perceived some changes as positive. More than half of the participants [56.9%] who were employed at the time of diagnosis experienced changes in the amount or type of their paid work after being diagnosed with cancer. The impact of a cancer diagnosis and treatment on a patient's daily activities is drastic. There is a need to provide support and interventions to help patients maintain daily activities they need and/or like. Further studies are needed to better understand the nature of such interventions

Incidence of chemotherapy-induced amenorrhea after adjuvant chemotherapy with taxane and anthracyclines in young patients with breast cancer

Chemotherapy-induced amenorrhea is one of long term side effects of adjuvant chemotherapy in patients with breast cancer which may interfere with their future reproductive function. Although amenorrhea is well recognized, the actual incidence following taxanes remains uncertain. In a cross sectional study, we identified breast cancer patients aged 45 years or younger who were treated with adjuvant anthracycline and taxane-based regimens at three different oncology departments from 2001-2008. One hundred and nineteen patients met all eligibility criteria and consented to participate in a regular follow up program. The median age at diagnosis was 33.5 years [range, 25-41]. Seventy [58%] patients developed amenorrhea for at least 12 months following completion of treatment, and regular menses were maintained in another 49 [42%] patients. No statistically significant association was found between age and development of amenorrhea, although those who experienced cessation of menses were older. Although taxane containing chemotherapy was associated with higher rate of amenorrhea compared to FAC, this was not statistically significant [P=0.11]. Also, treatment with tamoxifen and Estrogen Receptor [ER] positive status was significantly correlated with chemotherapy induced amenorrhea