RESUMO
Background: Glioblastoma [GB] is the most common and lethal primary brain tumor in adults representing 25% of primary brain tumors in adults. The objective of our study was to report the epidemiologic, clinical and therapeutic features of GB in Tunisia.
Methods:Our retrospective study included 41 patients with histologically confirmed GB treated between 2006 and 2012 at the medical oncology departments of Abderrahmane Mami hospital in Ariana and the military hospital in Tunis
Results: Median age was 54 years [13 to 72 years] and sex-ratio was 2.3. Karnofsky performance status [KPS] was <70% in 31.7% of cases, while Recursive partitioning analysis radiation therapy oncology group [RTOG-RPA] classification was III in 11 [26.8%], IV in 19 [46.3%], V in 10 [24.3%] and VI in 1 [2.4%] cases. Complete resection [CR] was achieved in 29 patients [70.7%], partial resection [PR] or tumor debulking in 5 patients [12.2%] and biopsy alone [BA] in 7 patients [17.1%]. All patients received brain radiotherapy [RT] at a dose of 60 Gy combined with concurrent temozolomide [TMZ]. Nineteen patients [46.3%] received adjuvant TMZ, 8 of them completed 6 cycles. Median overall survival [OS] was 12 months [2 to 56 months]. Six, 12, 18 and 24-months OS rates were 84.6%, 57.6%, 35.4% and 20.7%, OS being correlated to age, KPS, RPA and quality of resection
Conclusion: Our retrospective study is the first African GB series. Despite it included predominantly poor prognosis patients with impaired neurocognitive function and adjuvant treatment discontinuation, our median OS was comparable to Stupp data
RESUMO
Aim: To evaluate the literature data about diagnostic value, prognosis value and interest in follow-up of Ki-67 antibody after treatment for breast cancer
Methods: We performed a literature search in pubmed using the keywords: Ki-67, anti-Ki-67, breast cancer, prognosis, proliferation, chemotherapy, hormone therapy
Results: Ki-67 is routinely used as a static marker of proliferative activity and in follow-up-monitoring before and after treatment by chemotherapy and more recently hormonotherapy. Ki-67 was also used at a cut-off of 14% to differentiate between luminal A and B breast cancers. A high Ki-67 expression is probably related to a poorer prognosis but also a better response to neoadjuvant chemo and/or targeted therapy. More recently, genomic analysis is more reliable to classify the molecular breast cancer subtypes avoiding the possible cases of discordant Ki-67 rate. Ki-67 is also interesting in predicting histological response to neoadjuvant chemo and hormone therapy
Conclusion: Ki-67 evaluated by immunohistochemistry is important in routine in countries without bimolecular plateforms despite technical insufficiencies. When available, genomic grading is better to classify molecular subtypes and determine breast cancer prognosis in adjuvant and neoadjuvant setting