ABSTRACT
INTRODUCTION: Somatostatin receptors are expressed in a large number of human tumours. The somatostatin receptors types 1-5 expression in a series including 100 gastro-entero-pancreatic endocrine tumours were analysed. METHODS: From a prospectively built database of patients with gastro-entero-pancreatic endocrine tumours referred from three institutions, 100 cases with clinical and pathological data were selected. Somatostatin receptors expression by immunohistochemistry with somatostatin receptor types 1-5 antibodies in tissue paraffin sections were studied and correlated with the histological diagnosis according to the WHO classification, location and functional status. RESULTS: Of the 100 cases, 67 were gastrointestinal tumours, 25 pancreatic and 8 liver metastasis of unknown origin. Thirty-one of them were functioning tumours: 2 insulinomas, 5 gastrinomas, 1 glucagonoma and 23 carcinoids. Somatostatin receptors expression was observed in 94 tumours. The six negative cases were all non-functioning tumours. Somatostatin receptors 2a and 5 were highly expressed (86 and 62%, respectively), and surprisingly found even in poorly differentiated endocrine carcinomas. Somatostatin receptors expression was less frequent in pancreatic than in gastrointestinal tumours. Well-differentiated neoplasms had a higher density of somatostatin receptors. Only SSTR2a showed membrane staining. CONCLUSIONS: Immunohistochemistry revealed that somatostatin receptors were highly expressed in both primary and metastatic gastro-entero-pancreatic endocrine tumours with heterogeneous staining distribution. It proved to be a reliable technique even in small tumour samples.
Subject(s)
Endocrine Gland Neoplasms/metabolism , Gastrointestinal Neoplasms/metabolism , Receptors, Somatostatin/metabolism , Adult , Databases, Factual , Endocrine Gland Neoplasms/pathology , Endocrine Gland Neoplasms/secondary , Female , Gastrointestinal Neoplasms/pathology , Humans , Immunohistochemistry , Male , Middle Aged , Receptors, Somatostatin/analysisABSTRACT
Anal cancers compromise only 1.5% of all digestive tumors. At present, concurrent radiochemotherapy (RT-CT) is the treatment of choice for most of these lesions. OBJECTIVE: To collect and analyze clinical data from the medical records of all consecutive patients with squamous cell carcinoma of the anal canal (SCCAC) treated by the Oncology Section in 20 years. PATIENTS AND METHODS: The medical records of 108 patients with SCCAC were reviewed: 64% were women, mean age was 57.6 years (27-85), only 1 patient was HIV(+). RESULTS: Initial treatment: 87 patients were treated with RT-CT (81%), 5 CT only, 2 RT only, 8 local resection and 6 abdominoperineal resection (APR). 1) Patients initially treated with RT-CT: cobalt therapy was given to 76% of pts and linear accelerator was used in 24% of patients. 24% of patients received Mitomycin C based CT (modified Nigro), 66% Cisplatin based CT and 10% 5FU alone; 66% had clinical complete response (CCR) (26% of them relapsed). Median follow up was 2.16 years (1 month-15.5 years), median time to progression was 11.8 months and overall survival was 76.7% at 3 years (CI 95%: 65.2-87.7). 2) Patients initially treated with local resection: 6 patients NED and 2 relapsed (1 had CCR after RT-CT). 3) Patients initially treated with APR: 5 with curative intent (4 had local recurrence), and 1 was palliative. 4) Surgical rescue after RT-CT in 6 patients with curative intent (4 APR and 2 local resections), and in 15 patients was palliative (2 APR and other surgeries in 13). CONCLUSIONS: Our group is pioneer in the use of Cisplatin based RT-CT for the treatment of patients with SCCAC. Complete response rate and overall survival at 3 years, were similar to those reported by international data. As this is probably one of the largest series of SCCAC in Argentina, we hope that this analysis of our data would be a starting point to develop prospective clinical trials.
El carcinoma epidermoide del canal anal (CCA) constituye el 1.5% de los cánceres del sistema digestivo. Lamayoría de los pacientes puede acceder a la cura a través de radioquimioterapia (RT-QT) concurrente. Objetivos:evaluar qué ocurrió con todos los pacientes con CCA registrados por la Sección Oncología en 20 años.Pacientes y métodos: se revisaron las fichas de 108 pacientes:64% eran mujeres y la edad media fue de 57.6 años (27-83), sólo 1 paciente tenía confirmación de HIV (+). Resultados: tratamiento inicial: 87 pacientes recibieron RT-QT (81%), 5 QT sola, 2 RT sola, 8 resecciónlocal y 6 resección abdominoperineal (RAP). 1) Grupo con RT-QT de inicio: 76% realizó telecobaltoterapiay 24% acelerador lineal, 24% de los pacientes recibió un esquema con Mitomicina (Nigro modificado),66% esquemas con Cisplatino y 10% 5FU solo; respuesta clínica completa 66% (26% de ellos recidivaron).La mediana de seguimiento fue de 2.16 años (1 mes-15.5 años), la mediana de tiempo a la progresión fue de 11.8 meses y la sobrevida global fue de76.7% a los 3 años (IC 95%: 65.2-87.7). 2) Grupo con resección local de inicio: 6 pacientes sin enfermedada largo plazo y 2 recidivas (1 de ellas rescatada con RT-QT con respuesta completa). 3) RAP de inicio: 5con intención curativa (4 recidivaron localmente) y 1 paliativa. 4) Cirugía luego de RT-QT: en 6 pacientescon intención curativa (4 RAP y 2 resecciones locales), y en 15 pacientes con intención paliativa (2 RAP y 13otras cirugías). Conclusiones: nuestro grupo es pionero en el empleo de RT-QT basada en Cisplatino para eltratamiento de pacientes con CCA. Las tasas de respuesta completa y la de pacientes vivos a 3 años fueronsimilares a las reportadas en la literatura internacional. Dado que esta es probablemente la experiencia actualizada en CCA más grande de nuestro país, confiamos en que la elaboración de los datos que aquí presentamos sea el punto de partida para desarrollar ensayos clínicos prospectivos.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Carcinoma, Squamous Cell/therapy , Anus Neoplasms/therapy , Radiotherapy Dosage , Retrospective Studies , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Neoplasm Recurrence, Local , Treatment Outcome , Follow-Up Studies , Disease-Free Survival , Combined Modality TherapyABSTRACT
Anal cancers compromise only 1.5% of all digestive tumors. At present, concurrent radiochemotherapy (RT-CT) is the treatment of choice for most of these lesions. OBJECTIVE: To collect and analyze clinical data from the medical records of all consecutive patients with squamous cell carcinoma of the anal canal (SCCAC) treated by the Oncology Section in 20 years. PATIENTS AND METHODS: The medical records of 108 patients with SCCAC were reviewed: 64% were women, mean age was 57.6 years (27-85), only 1 patient was HIV(+). RESULTS: Initial treatment: 87 patients were treated with RT-CT (81%), 5 CT only, 2 RT only, 8 local resection and 6 abdominoperineal resection (APR). 1) Patients initially treated with RT-CT: cobalt therapy was given to 76% of pts and linear accelerator was used in 24% of patients. 24% of patients received Mitomycin C based CT (modified Nigro), 66% Cisplatin based CT and 10% 5FU alone; 66% had clinical complete response (CCR) (26% of them relapsed). Median follow up was 2.16 years (1 month-15.5 years), median time to progression was 11.8 months and overall survival was 76.7% at 3 years (CI 95%: 65.2-87.7). 2) Patients initially treated with local resection: 6 patients NED and 2 relapsed (1 had CCR after RT-CT). 3) Patients initially treated with APR: 5 with curative intent (4 had local recurrence), and 1 was palliative. 4) Surgical rescue after RT-CT in 6 patients with curative intent (4 APR and 2 local resections), and in 15 patients was palliative (2 APR and other surgeries in 13). CONCLUSIONS: Our group is pioneer in the use of Cisplatin based RT-CT for the treatment of patients with SCCAC. Complete response rate and overall survival at 3 years, were similar to those reported by international data. As this is probably one of the largest series of SCCAC in Argentina, we hope that this analysis of our data would be a starting point to develop prospective clinical trials.(AU)
El carcinoma epidermoide del canal anal (CCA) constituye el 1.5% de los cánceres del sistema digestivo. Lamayoría de los pacientes puede acceder a la cura a través de radioquimioterapia (RT-QT) concurrente. Objetivos:evaluar qué ocurrió con todos los pacientes con CCA registrados por la Sección Oncología en 20 años.Pacientes y métodos: se revisaron las fichas de 108 pacientes:64% eran mujeres y la edad media fue de 57.6 años (27-83), sólo 1 paciente tenía confirmación de HIV (+). Resultados: tratamiento inicial: 87 pacientes recibieron RT-QT (81%), 5 QT sola, 2 RT sola, 8 resecciónlocal y 6 resección abdominoperineal (RAP). 1) Grupo con RT-QT de inicio: 76% realizó telecobaltoterapiay 24% acelerador lineal, 24% de los pacientes recibió un esquema con Mitomicina (Nigro modificado),66% esquemas con Cisplatino y 10% 5FU solo; respuesta clínica completa 66% (26% de ellos recidivaron).La mediana de seguimiento fue de 2.16 años (1 mes-15.5 años), la mediana de tiempo a la progresión fue de 11.8 meses y la sobrevida global fue de76.7% a los 3 años (IC 95%: 65.2-87.7). 2) Grupo con resección local de inicio: 6 pacientes sin enfermedada largo plazo y 2 recidivas (1 de ellas rescatada con RT-QT con respuesta completa). 3) RAP de inicio: 5con intención curativa (4 recidivaron localmente) y 1 paliativa. 4) Cirugía luego de RT-QT: en 6 pacientescon intención curativa (4 RAP y 2 resecciones locales), y en 15 pacientes con intención paliativa (2 RAP y 13otras cirugías). Conclusiones: nuestro grupo es pionero en el empleo de RT-QT basada en Cisplatino para eltratamiento de pacientes con CCA. Las tasas de respuesta completa y la de pacientes vivos a 3 años fueronsimilares a las reportadas en la literatura internacional. Dado que esta es probablemente la experiencia actualizada en CCA más grande de nuestro país, confiamos en que la elaboración de los datos que aquí presentamos sea el punto de partida para desarrollar ensayos clínicos prospectivos.(AU)
