Salvage surgery and conversion surgery for patients with non-small cell lung cancer: A narrative review.

Non-small cell lung cancer (NSCLC) remains the leading cause of cancer-related deaths. With the development of screening, patient selection and treatment strategies, patients' survival outcomes and living quality significantly improved. However, some patients still have local recurrence or residual tumors after receiving definitive therapies. Salvage surgery has been regarded as an effective option for recurrent or residual NSCLC, but its effectiveness remains undetermined. Furthermore, conversion surgery is a special type of salvage surgery for tumors converted from "initially unresectable" to "potentially resectable" status due to a favorable response to systemic treatments. Although conversion surgery is a promising curative procedure for advanced NSCLC, its concept and clinical value remain unfamiliar to clinicians. In this narrative review, we provided an overview of the safety and efficacy of salvage surgery, especially salvage surgery after sublobar resection in early-stage NSCLC. More importantly, we highlighted the concept and value of conversion surgery after systemic treatment in advanced NSCLC to gain some insights into its role in the treatment of lung cancer.

Fabrication of alkali lignin-based emulsion electrospun nanofibers for the nanoencapsulation of beta-carotene and the enhanced antioxidant property.

For the greater utilization of ß-carotene in antioxidant material, ß-carotene-loaded emulsion stabilized by alkali lignin (AL) was successfully electrospinning with poly (vinyl alcohol) (PVA) (PVA/AL/ß-carotene nanofiber). Transmission electron microscopy demonstrated the core-shell structure of nanofiber with the average diameter being 356.31 nm, and 85.7 % of ß-carotene was effectively encapsulated into the core section. Fourier transform infrared spectra and differential scanning calorimetry revealed the good compatibility and decreased crystallinity of ß-carotene, favoring its stability and solubility, respectively. As expected, the PVA/AL/ß-carotene nanofiber exhibited higher antioxidant activity than free ß-carotene due to the protection of AL matrix and the special structure of nanofiber, as the DPPH free radical scavenging rate being 90.7 % at 7th day. The sustained release behavior of ß-carotene and AL from fiber followed Fickian diffusion model, contributing to the greater protection for fish oil than that of emulsion. Thus, this study provides an approach to develop hydrophobic compounds-loaded emulsion electrospun antioxidant material with controlled release property and enhanced activity.

Risk of breast cancer-related death in women with a prior cancer.

The overall risk of developing a second primary cancer is increasing. The purpose of this study was to analyze the survival of patients with breast cancer diagnosed after a prior cancer and identify risk factors of breast cancer death in this population. Using the SEER database, we identified 1,310 woman diagnosed with breast cancer between 2010 and 2015 after a prior cancer as the primary cohort. Clinicopathological characteristics were compared using the Student t-test and chi-square test. Fine and Gray's regression was used to evaluate the effect of treatments on breast cancer death. After propensity score matching (PSM), 9,845 pairs of patients with breast cancer as the prior or second cancer diagnosed between 2010 and 2011 were included as a second cohort. PSM-adjusted Kaplan-Meier and Cox hazards models were used to evaluate the impact of prior cancer on survival. The results showed that survivors of gynecologic cancers (e.g., ovarian cancer) had a higher risk of developing breast cancer than survivors of gastrointestinal and urinary tract cancers. More patients died of breast cancer than of prior urinary cancer (53.3% vs. 40%, P < 0.05) and melanoma (66.7% vs. 33.3%, P < 0.05). The ratio of breast cancer deaths to prior cancer deaths was significantly higher in patients with diagnoses interval ≥ 3 years than in those with the interval < 3 years (2.67 vs. 0.69, P < 0.001). Breast cancer-specific survival and overall survival rates were significantly lower in women with breast cancer as the second primary cancer than in those with breast cancer as the prior cancer, especially among hormone receptor-positive women. However, breast cancer treatment decreased the risk of breast cancer -specific death (hazard ratio = 0.695, 95% confidence interval: 0.586-0.725, P < 0.001). Breast cancer patients with prior cancers must be carefully considered for clinical trials.

Downregulation of XBP1 decreases serous ovarian cancer cell viability and enhances sensitivity to oxidative stress by increasing intracellular ROS levels.

Interaction between endoplasmic reticulum (ER) stress and oxidative stress contributes to the occurrence and development of various types of cancer. The X-box-binding protein 1 (XBP1), which is an important transcription factor in ER stress-related pathways, has also been reported to serve a protective role against oxidative stress. However, the role of XBP1 in serous ovarian cancer (SOC) remains elusive. The aim of the present study was to explore the biological function of XBP1 in SOC cells under normal or oxidative stress conditions. The expression of XBP1 was downregulated in the SOC cell lines A2780 and HO8910 by lentivirus-mediated short hairpin RNA (shRNA). Cell proliferative ability was evaluated by cell colony formation and viability assays. The sensitivity of ovarian cancer cells to oxidative stress was evaluated using cell survival rate and apoptotic rate, determined by the Cell Counting Kit-8 assay and flow cytometry, respectively. Reactive oxygen species (ROS) levels were measured by flow cytometry and cell immunofluorescence using a dichlorodihydrofluorescein diacetate probe. The mRNA and protein expression levels were detected by fluorescence quantitative polymerase chain reaction and western blot analysis, respectively. The results demonstrated that XBP1 was overexpressed in SOC compared with normal ovarian epithelial cells, and that downregulation of XBP1 significantly reduced cell proliferative ability. In addition, the downregulation of XBP1 significantly enhanced the sensitivity of SOC cells to H2O2 by increasing the intracellular ROS levels. The phosphorylation level of the mitogen-activated protein kinase (MAPK) p38 decreased in the cells of the XBP1-knockdown group. These results indicated that XBP1 may serve a protective role against oxidative stress in SOC cells, and the underlying molecular mechanism may be associated with the downregulation of phosphorylated p38. Therefore, targeting XBP1 may act synergistically with ROS inducers in the treatment of SOC.

Molecular profiling of mucinous epithelial ovarian cancer by weighted gene co-expression network analysis.

PURPOSE: In order to identify the molecular characteristics and improve the efficacy of early diagnosis of mucinous epithelial ovarian cancer (mEOC), here, the transcriptome profiling by weighted gene co-expression network analysis (WGCNA) has been proposed as an effective method. METHODS: The gene expression dataset GSE26193 was reanalyzed with a systematical approach, WGCNA. mEOC-related gene co-expression modules were detected and the functional enrichments of these modules were performed at GO and KEGG terms. Ten hub genes in the mEOC-related modules were validated using two independent datasets GSE44104 and GSE30274. RESULTS: 11 co-expressed gene modules were identified by WGCNA based on 4917 genes and 99 epithelial ovarian cancer samples. The turquoise module was found to be significantly associated with the subtype of mEOC. KEGG pathway enrichment analysis showed genes in the turquoise module significantly enriched in metabolism of xenobiotics by cytochrome P450 and steroid hormone biosynthesis. Ten hub genes (LIPH, BCAS1, FUT3, ZG16B, PTPRH, SLC4A4, MUC13, TFF1, HNF4G and TFF2) in the turquoise module were validated to be highly expressed in mEOC using two independent gene expression datasets GSE44104 and GSE30274. CONCLUSION: Our work proposed an applicable framework of molecular characteristics for patients with mEOC, which may help us to obtain a precise and comprehensive understanding on the molecular complexities of mEOC. The hub genes identified in our study, as potential specific biomarkers of mEOC, may be applied in the early diagnosis of mEOC in the future.