Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region

Abstract Background: High-risk basal cell carcinoma involves a significant rate of basal cell carcinoma that requires Mohs micrographic surgery for definitive treatment. Staged excision with pathologic margin control is a simple, accessible, and curative procedure suggested for the treatment of high-risk basal cell carcinoma. Objective: To evaluate the results of staged excision of high-risk basal cell carcinoma in the head region. Methods: This interventional study was performed on patients with high-risk basal cell carcinoma, who underwent staged excision until the margins were free of tumor. Results: A total of 122 patients (47 females and 75 males) with mean age of 57.66 ± 9.13 years were recruited in this study. Nasal and nodular types were the most common of both clinical and pathologic forms, respectively. Further, 89.3 % of cases were cured by staged excision after four years of follow-up. There was a significant relationship between treatment outcomes and recurrent lesions, multiplicity of risk factors, long-standing disease, and pathologic type. There was also a significant association between the number of surgical excisions and multiplicity of risk factors, as well as recurrence, location, and size of basal cell carcinoma. Study limitations: Lack of magnetic resonance imaging assessment in cases of suspected perineural invasion. Conclusions: High-risk basal cell carcinoma had a high cure rate by staged excision. Patients with more risk factors and those with nasal and recurrent basal cell carcinoma required more staged excisions. Failure of treatment is more probable in patients with more risk factors, long-standing lesions, and high-risk pathologic and recurrent basal cell carcinomas.

Comparison Of ER-Positive Versus ER-Negative In Breast Cancer Women And Invasive Ductal Carcinoma In The West Of Iran: A Direct Correlation With Vascular Invasion.

Background & Objective: ER expression is the main indicator of potential responses to endocrine therapy, and approximately 70% of human breast cancers are hormone-dependent and ER-positive. The aim of the study is to evaluate the correlation between risk factors with ER status in breast cancer patients in the West of Iran. Methodology: In a retrospective study, 260 breast cancer women were included invasive ductal carcinoma our Clinic. A sufficient sample size was selected from any patient, and the slides were stained by hematoxylin and eosin (H & E) method. Estrogen receptor (ER) and progesterone receptor (PR) positivity were defined as ≥10% positive tumor cells with nuclear staining. Chi-square test and T-test were used to analyze the significance of correlation between the expression of ER and other parameters. Results: The patients were divided into two groups (156 patients with ER-positive group and 104 patients with ER-negative group). There was a significant difference between histological grade, nuclear grade, lymph node metastasis, tumor size and vascular invasion and also tumor markers of HER2, PR, P53 expression with ER status. Based on binary logistic regression analysis, in patients with ER-positive, more patients had vascular invasion and PR-positive, but P53 was negative. Conclusion: There was a direct correlation between vascular invasion and PR, with ER status and a reverse correlation between p53 with ER status.

Frequency of Ki-67 (MIB-1) and P53 expressions among patients with prostate cancer.

Context: Prostate cancer is the most common malignant tumor in men. Tumor grade is one of the most important prognostic factors of prostate cancer. P53 and Ki-67 expressions have also been considered to be prognostic factors. Aims: This study was performed to investigate the frequency of these proteins expression and compare the obtained results with Gleason's grading. Settings and Design: In this cross-sectional study, 49 paraffin blocks of prostate cancers were assessed. Tumor grade was determined according to the Gleason's criteria. Materials and Methods: Ki-67 and P53 expressions were determined by immunohistochemical staining. Statistical Analysis: The obtained results were analyzed and evaluated using Spearman's statistical test (SPSS version 15). Results: Three out of 49 (6.1%) cases were well differentiated, 21 (43%) moderately differentiated and 25 (51%) were poorly differentiated. P53 was negative in all well-differentiated cases. Ki-67 was negative in 14 cases (28%) including all well-differentiated tumors. Among moderately and poorly differentiated tumors Ki-67 was negative in eight (38%) and three (12%) of cases, respectively. A statistically significant relation was observed between the increased Ki-67 labeling index (LI) and increased Gleason's grade. Conversely, no statistically significant relation was found between P53 expression and increased Gleason's grade. Conclusions: According to the findings of this study, it seems that Ki-67 can be used as a prognostic factor for prostate cancer. On the other hand, the probable relation between P-53 and prostate cancer prognosis requires further studies.