RESUMEN
Hormone-sensitive prostate cancer with visceral metastasis is a difficulty in clinical diagnosis and treatment. We treated a patient with hormone-sensitive prostate cancer with visceral metastasis and managed it under the multi-disciplinary treatment model (MDT). A 55-year-old man presented to the hospital complaining of increased prostate-specific antigen (PSA) found in the physical examination for 2 days. At admission, the PSA was 389.2ng/ml, and 68Ga-PSMA PET/CT showed metastatic malignant lesions of the prostate, with lymph node metastasis, lumbar vertebral metastases and liver tubercles. Transrectal prostate puncture biopsy: prostate adenocarcinoma, Gleason score of 4+ 5=9. The patient has no history of androgen deprivation therapy (ADT) and diagnosed as metastatic hormone-sensitive prostate cancer (mHSPC). Then the patient received total androgen blockade therapy (CAB regimen). After MDT discussion, metastatic prostate cancer was diagnosed based on the liver histopathology of percutaneous biopsy. After the second MDT discussion, the regimen was changed to abirone plus ADT. After 6 months, the blood PSA was controlled at a level between 0.003 to 0.006 ng/ml, and the testosterone was less than 2.5ng/dl. Re-examination of 68Ga-PSMA PET/CT showed that lower signal of radionuclide in all lesions, especially no more abnormal uptake lesions were identified in the liver.
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Objective: To explore the prognostic factors for the breast cancer patients with spinal metastasis, and establish a prognostic scoring model. Methods: A total of 160 breast cancer patients with spinal metastasis in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2008 to January 2016 were retrospectively identified. The clinical characteristics and prognosis were analyzed by univariate and multivariate survival analysis to explore the prognostic factors. And then a prognostic scoring model was developed according to the regression coefficient for each independent prognostic factor. Results: The 160 breast cancer patients with spinal metastasis whose average age was 56.8 years (range 22-82 years) were identified, and the median follow-up was 40 (24, 55) months. The multivariate Cox analysis showed that the patients' general condition, hormone receptor expression, visceral metastasis, and serum carbohydrate antigen 125 (CA125) level significantly influenced survival (P<0.05). According to the regression coefficients, a survival prediction scoring model comprising these factors was established, which ranged from 0 to 6 points. Three risk groups with different prognoses were identified : low risk group (0-1 point), intermediate risk group (2-4 points), and high risk group (5-6 points). Conclusion: The general condition, hormone receptor expression, visceral metastasis, and serum CA125 level were independent prognostic factors for the breast cancer patients with spinal metastasis. And the prognostic scoring model comprising these four clinical factors can effectively predict the patients' prognoses.
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Cancer of the uterine cervix is one of the leading gynecological malignancies of developing nations including India. A 45-year-old female presented with menstrual irregularities and other nonspecific symptoms. After initial workup, she was diagnosed with carcinoma cervix, Stage IV A, while she was being planned to take up radical concomitant chemoradiotherapy, she developed widespread nodules over various sites over the body, which were histopathologically proven as metastatic lesions. She was treated with a palliative intent by radiotherapy and chemotherapy. Only a few such cases have been reported in the literature with variable outcomes. These rare presentations should be thoroughly worked up and studied to know more about their biological behavior.
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Objective To investigate effects of CO_2 pneumoperitoneum,helium pneumoperitoneum,and laparotomy on(port-)site and visceral metastasis in BALB/c nude mice bearing human colon cancer xenografts.Methods A nude mouse model with human colon cancer LoVo cell line xenografts was used.The mice were randomly divided into four groups: CO_2 Pneumoperitoneum Group,Helium Pneumoperitoneum Group,Open Surgery Group,and Control Group.A biopsy was performed in the former 3 groups,and the Control Group received no surgical intervention. Results All the mice were sacrificed for pathological examinations.Orthotopic tumor xenograft was successfully established in all the mice of the four groups(100%,86/86).The rates of port-site metastasis were 9.5%(2/21) in the CO_2 Pneumoperitoneum Group,9.1%(2/22) in the Helium Pneumoperitoneum Group,and 19.0%(4/21) in the Open Surgery Group,respectively,without significant differences among the three groups(?~2=1.227,P=0.541).The rates of liver metastasis were 38.1%(8/21) in the CO_2 Pneumoperitoneum Group,31.8%(7/22) in the Helium Pneumoperitoneum Group,52.4%(11/21) in the Open Surgery Group,and 31.8%(7/22) in the Control Group,respectively,without significant differences among the four groups(?~2=2.543,P=0.468).Conclusions As compared with laparotomy and control groups,artificial pneumoperitoneum doesn't cause an increase of rates of port-site and visceral metastasis.Moreover,there is no significant difference between CO_2 pneumoperitoneum and helium pneumoperitoneum in rates of port-site and visceral metastasis.