B2 colon cancer: Is there a role for adjuvant chemotherapy? Mansoura experience

To evaluate the benefit of adjuvant 5-fluorouracil-based chemotherapy in .patients with Dukes' B2 colon cancer, using event-free survival [EFS] and overall survival [OS] as primary end points. Patients and Methods: One hundred patients with Dukes' B2 colon cancer, attending the outpatient clinics of Clinical Oncology and Nuclear Medicine Department, Mansoura University Hospitals, during the period from January 1998 to December 2002, were reviewed retrospectively for comparing patients who received adjuvant chemotherapy following radical surgery and those who were under follow-up. With a median follow-up of 79.5 months, the 5-year EFS and OS in the adjuvant chemotherapy arm were 101.6 and 103.3 months respectively, compared to 94.8 and 99.3 months in the control arm respectively, both were statistically insignificant. Our study does not support the routine use of adjuvant 5-fluorouracil plus leucovorin chemotherapy in all patients with Dukes' B2 colon cancer, as true benefit

Prognostic role of matrix metalloproteinase-9 [MMP-9] in patients with osteosarcoma

Osteosarcoma [OS] is a highly malignant bone tumor and is the most frequent malignant bone tumor in children and adolescents. The majority of patients with this disease harbor "micrometastasis" at diagnosis, a fact that demonstrates the need for molecular variables which can predict the presence or absence of micro-metastasis. Matrix metalloproteinases [MMPs] are a class of matrix - and basement membrane-degrading enzymes whose expression is associated with tumor cell invasive and metastatic behavior. One of these enzymes, MMP-9 is expressed in developing and remodeling bone in OS cell lines. The current study investigated the expression of MMP-9 by immunohistochemistry and its correlation with the prognosis in OS patients treated at Mansoura Clinical Oncology and Nuclear Medicine Department. MMP-9 was examined immunohistochemically using a monoclonal antibody in 20 patients with OS. The range of follow-up was 16 to 53 months with a median of 31.5 months. Correlation of the positivity of staining with prognosis was analyzed with Kaplan-Meier method. We found that MMP-9 immunohistochemical expression was positive in 85% of cases [17/20] and increased MMP-9 expression was significantly associated with poor prognosis in overall, metastasis-free and recurrence-free survivals [p=0.001, 0.001, and 0.002 respectively]. These results suggest that MMP-9 expression is common in OS and demonstrate the correlation of MMP-9 expression and the oncological outcome of OS patients

Concomitant boost radiotherapy plus concurrent cisplatin for muscle invasive bladder cancer

To determine the efficacy and toxicity of accelerated concomitant boost radiotherapy [RT] plus concurrent cisplatin in patients with muscle invasive bladder cancer. Sixty four patients with muscle invading transitional cell bladder cancer were entered into a protocol of transurethral resection of the bladder tumor [TURBT] followed by concurrent cisplatin [10mg/m[2] thrice weekly] and accelerated concomitant boost radiotherapy. The whole pelvis was treated by l.8Gy conventional daily fractions up to a total dose of 45Gy. A concomitant boost limited to the bladder was delivered as a second daily fraction [1.4Gy] during the last 3 weeks up to a total dose of 66Gy. The patients were evaluated for local control, toxicity and survival. All but two patients completed the radiotherapy protocol. Fifty eight patients received the full doses of cisplatin. Grade 3 acute urinary toxicity was observed in 10 patients [15.6%]. Also, 6 patients [9.4%] presented with acute grade 3 bowel toxicity. Eight patients [12.6%] experienced late grade 3 toxicity [4 with bladder and 4 with bowel toxicity]. The 3-year actuarial local control, distant disease control and overall survival rates were 60% [95% CI, 50.1-69.3], 65.6% [95% CI, 53.7%-74.3%], and 37.5% [95% CI, 26.1%-45.9%] respectively. The results of our protocol of acclerated concomitant boost radiotherapy with concurrent cisplatin, as regard locoregional control and overall survival, did not appear to be improved in comparison with other studies combining cisplatin and standard conventional fractionation, moreover the observed toxicity was higher