ABSTRACT
BACKGROUND: Downstaging and pathologic complete response (pCR) after chemoradiotherapy (CRT) may improve progression-free survival and overall survival (OS) after curative therapy of locally advanced adenocarcinoma of rectum. The purpose of this study is to evaluate the pathologic response subsequent to neoadjuvant chemoradiation in locally advanced rectal adenocarcinoma and any impact of response on oncological outcome [disease-free survival (DFS), OS]. METHODS: A total of 127 patients with histologically-proven rectal adenocarcinoma, locally advanced, were treated with preoperative radiotherapy and concurrent 5-fluorouracil (5 FU), and followed by curative surgery. Pathologic response to neoadjuvant treatment was evaluated by comparing pathologic TN (tumour and nodal) staging (yp) with pre-treatment clinical staging. DFS and OS were compared in patients with: pCR, partial pathologic response and no response to neoadjuvant therapy. RESULTS: 14.96% (19 patients) had a pCR, 58.27% [74] showed downstaging and 26.77% [34] had no change in staging. At follow-up (range, 4-9 years, median 6 years 2 months or 74 months), 17.32% [22] showed recurrence: 15.74% [20] distant metastasis, 1.57% [2] pelvic failure. 10.5% [2] of the patients with pCR showed distant metastasis, none showed local recurrence. In the downstaged group, nine developed distant failure and two had local recurrence (14.86%). Distant failure was seen in 26.47% [9] of those with no response to neoadjuvant treatment. DFS and OS rates for all groups were 82.67% and 88.97% respectively. Patients with pCR showed 89.47% DFS and 94.7% OS. In partial responders, DFS was 85.1% and OS was 90.5%. In non-responders, DFS and OS were 73.5% and 82.3% respectively. Patients with pCR had a significantly greater probability of DFS and OS than non-responders. Rectal cancer-related death was 11.02% [14]: one patient (5.26%) with pCR, 9.47% [7] in the downstaged group and 17.64% [6] of non-responders. CONCLUSIONS: The majority of patients showed some response to neoadjuvant treatment. Findings of this study indicate tumour response to neoadjuvant CRT improves the long-term outcome, with a better result in patients with pCR.
ABSTRACT
BACKGROUND: Germ cell tumors are neoplasms that originate from multi potential germ cells and can be intra or extra gonadal. According to pathologic classification, they have different subtypes. They account for 3% of pediatric malignancies and most commonly happen in children before the age of 15 years old. Epidemiologic evidence about pediatric germ cell tumors is scant in our region. OBJECTIVES: The aim of current study was to determine demographic characteristics, recurrence and survival rate of germ cell tumor patients under the age of 21 years. PATIENTS AND METHODS: During a 10-year period (1996 - 2006), 106 patients under the age of 21 years suffering from germ cell tumor were admitted to our centers. We extracted the data needed for our study from patients' medical records in the hospitals. RESULTS: Thirty seven boys and 69 girls with a mean age of 8.4 ± 7.8 years were included. Most tumors were diagnosed before the age of one year (37%). The most common pathologic subtype was mature teratoma (44%). Ovary (35%) was the most common primary site. Surgery plus chemotherapy were used to treat 54 patients and BEP was the most common chemotherapy regimen. Metastasis and recurrent tumor were seen in 22% and 8% of cases, respectively. Four-year overall survival was 89%. CONCLUSIONS: Our study showed that demographic characteristics of GCT patients in our population are similar to patients of other geographic regions in the world. Primary tumor site, histologic subtype and metastasis were significant prognostic factors for survival.
ABSTRACT
BACKGROUND: Maternal infection during pregnancy is a risk factor for some behavioral problems with neurodevelopmental origin. This study aimed to evaluate the effects of exposure of pregnant mice to the bacterial lipopolysaccharide (LPS) on sexual behaviour and serum level of pituitary-gonadal hormones of offspring in adulthood. MATERIALS AND METHODS: In this Expremental study, pregnant NMRI mice (n=7/group) were treated with intra-peritoneal administration of LPS (1, 5 and 10 µg/kg) at day 10 of gestation. Induction of the pro-inflammatory cytokines, Tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1ß) and interleukin-6 (IL-6) were measured in maternal serum 2 hours following the maternal LPS challenge. Behavior in the adult male offspring reproductive activity was investigated using receptive female mice. Concentrations of testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in adult offspring serum were measured using the enzyme-linked immunosorbent assay (ELISA) method (at postnatal day 60, n=10/group). RESULTS: One-way ANOVA showed that LPS administration induces a significant increase in TNF-α, IL-1ß and IL-6 levels of maternal serum. Prenatal LPS exposure reduces sexual behavior and serum concentration of LH and testosterone in adult male offspring. CONCLUSION: The overall results suggest that prenatal exposure to LPS increases pro- inflammatory cytokine levels, affects development of neuroendocrine systems and results in the inhibition of reproductive behaviors and reactivity of hypothalamic-pituitary-gonadal (HPG) axis in adult male offspring.
