Incidence and Mortality of Sarcomas in Shanghai, China, During 2002-2014.

Background: Sarcomas are a heterogeneous group of rare but deadly malignant tumors. The aim of this study was to comprehensively describe the incidence and mortality of sarcomas in Shanghai during 2002-2014. Method: Data were from Shanghai Cancer Registry. All new cases diagnosed with sarcomas and all death records where the cause of death listed as sarcomas were included. The characteristics of sarcomas incidence and mortality were analyzed. Age-standardized rates (ASRs) were adjusted by the world standard population. The trends were assessed by Joinpoint analysis. Results: A total of 9,440 incident cases were identified. The ASR was 3.4/105 for all sarcomas combined. Incidence of sarcomas overall was similar in females (3.5/105) as in males (3.4/105). Except for sarcomas "Not Otherwise Specified" (NOS), the most common histological subtype was gastrointestinal stromal sarcoma (GISS) (14.8%), which was followed by fibrosarcoma (7.2%), lipoblastoma (6.7%), leiomyosarcomas (6.5%), and osteosarcoma (5.3%). Among those incident cases, 87.9% were located in soft tissue sarcomas (STS) and 12.1% in bone and joint (bone sarcomas). The ASRs for STS and bone sarcomas were 2.8/105 and 0.6/105, respectively. Incidence rates for all STS combined rose exponentially with age, while bone sarcomas had the highest incidence at age 0-19. There were 4,279 deaths during 2002-2014 with the ASR of 1.3/105. Age-adjusted mortality due to sarcomas was slightly higher in males (1.5/105) than females (1.2/105). Except for sarcomas NOS, leiomyosarcomas was the most common subtype, comprising 9.9% of deaths due to sarcomas, followed by lipoblastoma (6.4%) and osteosarcoma (6.3%). The ASRs of mortality for STS and bone sarcomas were 1.0/105 and 0.2/105, respectively. For both males and females, the age-standardized incidence for STS and bone sarcomas did not change meaningfully over the study period. In contrast, age-standardized STS mortality in females increased by 2.3% per year (95% CI: 0.3, 4.4%), but was unchanged in males. No meaningful trends in bone sarcomas mortality were observed for either males or females. Conclusion: This population-based study was the first report of epidemiology of sarcomas in Shanghai according to anatomic site and histologic type. The diversity and rarity of sarcomas suggested more detailed data are warranted.

18F-FDG positron emission tomography for the assessment of histological response to neoadjuvant chemotherapy in osteosarcomas: a meta-analysis.

PURPOSE: The purpose of this meta-analysis was to evaluate the predicting value of fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET-CT) in the assessment of histological response to neoadjuvant chemotherapy in patients with osteosarcomas. METHODS: A detailed search was made in MEDLINE, EMBASE and the Web of Knowledge for relevant original articles published in English; methodological quality of the included studies were also assessed. Two reviewers extracted data independently. Sufficient data was presented to construct a 2 × 2 contingency table. Pooled sensitivity and specificity, positive and negative likelihood ratios were estimated. A summary receiver operating characteristic curve (SROC) was constructed with the Moses' constant of linear model. A χ(2) test was performed to test for heterogeneity. RESULTS: Eight studies comprising 178 patients met the inclusion criteria. The pooled sensitivity and specificity for standardized uptake values (SUV) after chemotherapy (SUV2) ≤ 2.5 were 0.734 (95% CI, 0.537-0.867) and 0.864 (95% CI, 0.510-0.975), for the ratio of standardized uptake values after (SUV2) to before (SUV1) chemotherapy SUV 2:1 ≤ 0.5 were 0.690 (95% CI, 0.497-0.833) and 0.653 (95% CI, 0.492-0.786), the positive and negative likelihood ratio (LR+/LR-) for SUV2 ≤ 2.5 were 5.397 (95% CI, 1.169-24.920) and 0.308 (95% CI, 0.165-0.577), for SUV 2:1 ≤ 0.5 were 1.989 (95% CI, 1.145-3.457) and 0.475 (95% CI, 0.247-0.915). There was no significant difference between-study heterogeneity for either LR + or LR- in any of these analyses. The area under the SROC curve for SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 were 0.81 and 0.72, respectively. CONCLUSIONS: The present meta-analysis showed that 18F-FDG PET-CT scan, as measured by the SUV before and after treatment, SUV2 ≤ 2.5 and SUV 2:1 ≤ 0.5 are valuable for predicting the histological response to chemotherapy. SUV2 ≤ 2.5 have better predicting performance than SUV 2:1 ≤ 0.5.

Clinical prospect of research on molecular targeted therapy in soft tissue sarcomas / 国际肿瘤学杂志

It has been suggested that some unusual molecules and genes might be involved in the development of soft tissue sarcomas (STS) and that drugs targeting specific molecules and genes would selectively kill tumor cells, which have been demonstrated to be more effective approach with less side effect than traditional chemotherapy. However, most of the effective targets of STS are currently not elucidated, and the effects of trial-target therapy are mostly not satisfactory, thus multiple targeting drugs might guide a future direction for tumor therapy.

Study of adeno-associated virus carrying the HGFK1 gene(AAV-HGFK1) in treating rat hepatocellular carcinoma / 中国癌症杂志

Background and purpose: Hepatocellular carcinoma (HCC) is a hypervascular tumor associated with a poor prognosis and lack of effective treatments. Consequently, identifying novel therapeutic strategies are urgently needed. We have previously shown that the kringle 1 domain of human hepatocyte growth factor (HGFK1) is a more effective anti-angiogenesis molecule than angiostatin. In this study, we observed the effects and mechanisms of HGFK1 gene on the HCC. Methods: A recombinant adeno-associated vires carrying the HGFK1 gene (rAAV-HGFK1) was constructed.HCC of rat was induced by McA-RH7777. rAAV-HGFK1 was used to treat the rat, median survival time and metastasis rate were observed. Results: Ten days after tumor cell inoculation, surgery were performed to confirm the tumor formation, PBS, rAAV-EGFP or rAAV-HGFK1 was injected directly into the tumor nodule followed by portal vein injection. Results from our study demonstrated that rAAV-HGFK1 treatment significantly prolonged the median survival time of the HCC bearing rats from 30 days (PBS and rAAV-EGFP groups) to 49 days (rAAV-HGFK1 group). More importantly rAAV-HGFK1 inhibited tumor growth and completely prevented liver, lung and peritoneal metastasis. In the controlled PBS and AAV-EGFP group, liver and peritoneal metastasis rate were both 100%, and lung metastasis rate was 100% and 83%, respectively. While there was no metastasis found in treatment group, with only 33% of ascites happened. This was most possibly due to the primary tumor in liver but not due to the metastasis. Moreover, at a higher magnification (1000×), it was clear that the HGFK1 protein was expressed mainly in the cytoplasma of liver cells. In parallel, IHC staining of CD31 also demonstrated a significantly lower level of microvessel density (MVD) (6.21±1.6) in the liver tumor of the AAV-HGFK1 treatment group, as compared to the two control PBS and AAV-EGFP groups (25.1±2.1 and 26.8±2.5, respectively, P<0.01). HE staining showed that AAV-HGFK1 treatment induced large areas of necrosis in the tumor tissues, while minimal areas of necrosis were observed in the tumor tissue in the control groups. In addition, no toxicity appeared when high dosage (4.8× 1012 vg/rat) of rAAV-HGFK1 was administered in rats. Conclusion: Results from this study demonstrated that HGFK1 inhibited the growth and metastasis of HCC and prolonged the survival time of animals with HCC through anti-angiogenesis effects. No obvious toxicity was observed. It might be the novel promising treatment for HCC and other cancers.