Frequency and clinical features of deficient mismatch repair in ovarian clear cell and endometrioid carcinoma / 부인종양

Objective@#To clarify the frequency of deficient mismatch repair (dMMR) in Japanese ovarian cancer patients, we examined microsatellite instability (MSI) status and immunohistochemistry (IHC) subtypes, including endometrioid carcinoma (EMC), clear cell carcinoma (CCC), or a mixture of both (Mix). @*Methods@#We registered 390 patients who were diagnosed with EMC/CCC/Mix between 2006 and 2015 and treated at seven participating facilities. For 339 patients confirmed eligible by the Central Pathological Review Board, MSI, IHC, and MutL homolog 1 methylation analyses were conducted. The tissues of patients with Lynch syndrome (LS)-related cancer histories, such as colorectal and endometrial cancer, were also investigated. @*Results@#MSI-high (MSI-H) status was observed in 2/217 CCC (0.9%), 10/115 EMC (8.7%), and 1/4 Mix (25%). Additionally, loss of MMR protein expression (LoE-MMR) was observed in 5/219 (2.3%), 16/115 (14.0%), and 1/4 (25%) patients with CCC, EMC, and Mix, respectively. Both MSI-H and LoE-MMR were found significantly more often in EMC (p<0.001). The median (range) ages of patients with MMR expression and LoE-MMR were 54 (30–90) and 46 (22–76) (p=0.002), respectively. In the multivariate analysis, advanced stage and histological type were identified as prognostic factors. @*Conclusion@#The dMMR rate for EMC/CCC was similar to that reported in Western countries. In Japan, it is assumed that the dMMR frequency is higher because of the increased proportion of CCC.

The Healthcare Workers’ Awareness and Support regarding the Sexuality of Cancer Patients, Their Families and Their Partners

<p>Objective: The aim of this study was to investigate the healthcare workers’ awareness and support regarding the sexuality of cancer patients, their families. Methods: A self-reported questionnaire survey was conducted on the healthcare workers in Shikoku Cancer Center on May 2014. Results: Four hundred and fifty-seven (84.9%) workers responded to the questionnaire. It was 29.8% who have communicated about sexual issues with patients and their families, 67.0% acknowledged the necessity of supporting them. In the group which had experience in communicating about sexual issues and participating in study meetings of sexuality, there were more healthcare workers who acknowledged the necessity of support significantly (aware group). In the aware group, the reasons why they hesitated and felt difficulty in communicating about sexual issues were that they had no chances to communicate with patients about sexual issues (93.5%), they didn’t know whether the patients needed intervention of healthcare workers (89.2%), they felt lack of their knowledge of support regarding sexuality (89.2%), and they felt lack of their skill of support regarding sexuality (88.9%). In the aware group, in order to get knowledge and information about sexuality, books and brochures which could be introduced to the patients and their families (96.4%) were considered to be most wanted. Conclusion: We have to make an effort so that all healthcare workers recognize the importance of the necessity of communicating about sexual issues with the patients, their families and their partners.</p>

Predictive ability of [18]F-fluorodeoxyglucose positron emission tomography/computed tomography for pathological complete response and prognosis after neoadjuvant chemotherapy in triple-negative breast cancer patients

Objective The mortality of patients with locally advanced triple-negative breast cancer [TNBC] is high, and pathological complete response [pCR] to neoadjuvant chemotherapy [NAC] is associated with improved prognosis. This retrospective study was designed and powered to investigate the ability of [18]F-fluorodeoxyglucose positron emission tomography/computed tomography [[18]F-FDG-PET/CT] to predict pathological response to NAC and prognosis after NAC

Methods The data of 32 consecutive women with clinical stage II or III TNBC from January 2006 to December 2013 in our institution who underwent FDG-PET/CT at baseline and after NAC were retrospectively analyzed. The maximum standardized uptake value [SUV[max]] in the primary tumor at each examination and the change in SUV[max] [delta SUV[max]] between the two scans were measured. Correlations between PET parameters and pathological response, and correlations between PET parameters and disease-free survival [DFS] were examined

Results At the completion of NAC, surgery showed pCR in 7 patients, while 25 had residual tumor, so-called non-pCR. Median follow-up was 39.0 months. Of the non-pCR patients, 9 relapsed at 3 years. Of all assessed clinical, biological, and PET parameters, N-stage, clinical stage, and delta SUV[max] were predictors of pathological response [p=0.0288, 0.0068, 0.0068; Fischer's exact test]. The cut-off value of delta SUV[max] to differentiate pCR evaluated by the receiver operating characteristic [ROC] curve analysis was 81.3%. Three-year disease-free survival [DFS] was lower in patients with non-pCR than in patients with pCR [p=0.328, log-rank test]. The cut-off value of delta SUV[max] to differentiate 3-year DFS evaluated by the ROC analysis was 15.9%. In all cases, 3-year DFS was lower in patients with delta SUV[max] <15.9% than in patients with delta SUV[max] >/=15.9% [p=0.0078, log-rank test]. In non-pCR patients, 3-year DFS was lower in patients with delta SUV[max] <15.9% than in patients with delta SUV[max] >/=15.9% [p=0.0238, log-rank test]

Conclusions FDG-PET/CT at baseline and after NAC could predict pathological response to NAC before surgery and the clinical outcome after surgery in locally advanced TNBC patients

Peri-orbital electrodes as a supplemental recording for detection of ictal discharges in medial temporal lobe epilepsy

Objective: The feasibility of peri-orbital electrodes, which are not invasive and do not induce pain, as a supplemental electrode for detection of ictal discharges in medial temporal lobe epilepsy (MTLE) was examined. Methods: Patients with MTLE, who underwent video-EEG monitoring with simultaneous peri-orbital and sphenoidal electrodes and obtained good outcome following standard anterior temporal lobectomy, were subjects in this study. Initial ictal discharge amplitudes were compared between sphenoidal (Sp1/ 2), standard anterior temporal in 10-20 system (F7/ 8), peri-orbital (superior orbital lateral: SOL, inferior orbital medial: IOM), frontopolar (Fp1/ 2), frontal (F3/4) and ear (A1/ 2) electrodes. Results: A total of 34 consecutive seizures from 20 patients were analyzed, with a maximum amplitude observed at Sp1/2 (57.57±5.59), followed by F7/8 (54.89±5.59), SOL (50.97±5.59), IOM (46.95±5.59), A1/2 (45.07±5.69), Fp1/2 (44.78±5.62), and F3/4 (37.75±5.66) (mean±standard error, μV). There was no statistical difference between Sp1/2, F7/8, SOL, and IOM values. When the sphenoidal electrode was omitted, 13 seizures (13/34, 38.2%) resulted in the highest amplitude at peri-orbital electrodes and 10 seizures (10/ 34, 29.4%) at F7/8. Conclusions: Peri-orbital electrodes could detect ictal discharges in MTLE as well as sphenoidal and standard anterior temporal electrodes in 10-20 system and are useful for supplemental recording for detecting ictal epileptiform discharges in MTLE.