-
BMC Oral Health Jun 2024Parotid gland carcinoma (PGC) is a rare malignant tumor. The purpose of this study was to investigate the role of immune-inflammatory-nutrition indicators and...
BACKGROUND
Parotid gland carcinoma (PGC) is a rare malignant tumor. The purpose of this study was to investigate the role of immune-inflammatory-nutrition indicators and age-adjusted Charlson comorbidity index score (ACCI) of PGC and develop the nomogram model for predicting prognosis.
METHOD
All patients diagnosed with PGC in two tertiary hospitals, treated with surgical resection, from March 2012 to June 2018 were obtained. Potential prognostic factors were identified by univariate and multivariate Cox regression analyses. The nomogram models were established based on these identified independent prognostic factors. The performance of the developed prognostic model was estimated by related indexes and plots.
RESULT
The study population consisted of 344 patients with PGC who underwent surgical resection, 285 patients without smoking (82.8%), and 225 patients (65.4%) with mucoepidermoid carcinoma, with a median age of 50.0 years. American Joint Committee on Cancer (AJCC) stage (p < 0.001), pathology (p = 0.019), tumor location (p < 0.001), extranodal extension (ENE) (p < 0.001), systemic immune-inflammation index (SII) (p = 0.004), prognostic nutrition index (PNI) (p = 0.003), ACCI (p < 0.001), and Glasgow prognostic Score (GPS) (p = 0.001) were independent indicators for disease free survival (DFS). Additionally, the independent prognostic factors for overall survival (OS) including AJCC stage (p = 0.015), pathology (p = 0.004), tumor location (p < 0.001), perineural invasion (p = 0.009), ENE (p < 0.001), systemic immune-inflammation index (SII) (p = 0.001), PNI (p = 0.001), ACCI (p = 0.003), and GPS (p = 0.033). The nomogram models for predicting DFS and OS in PGC patients were generated based on these independent risk factors. All nomogram models show good discriminative capability with area under curves (AUCs) over 0.8 (DFS 0.802, and OS 0.825, respectively). Decision curve analysis (DCA), integrated discrimination improvement (IDI), and net reclassification index (NRI) show good clinical net benefit of the two nomograms in both training and validation cohorts. Kaplan-Meier survival analyses showed superior discrimination of DFS and OS in the new risk stratification system compared with the AJCC stage system. Finally, postoperative patients with PGC who underwent adjuvant radiotherapy had a better prognosis in the high-, and medium-risk subgroups (p < 0.05), but not for the low-risk subgroup.
CONCLUSION
The immune-inflammatory-nutrition indicators and ACCI played an important role in both DFS and OS of PGC patients. Adjuvant radiotherapy had no benefit in the low-risk subgroup for PGC patients who underwent surgical resection. The newly established nomogram models perform well and can provide an individualized prognostic reference, which may be helpful for patients and surgeons in proper follow-up strategies.
Topics: Humans; Nomograms; Male; Middle Aged; Female; Parotid Neoplasms; Prognosis; Aged; Adult; Comorbidity; Retrospective Studies; Inflammation; Age Factors
PubMed: 38909208
DOI: 10.1186/s12903-024-04490-5 -
Indian Journal of Pathology &... Jun 2024To investigate relationships between microsatellite instability (MSI) and the clinicopathological characteristics of colorectal cancer (CRC) to facilitate the provision...
BACKGROUND
To investigate relationships between microsatellite instability (MSI) and the clinicopathological characteristics of colorectal cancer (CRC) to facilitate the provision of targeted therapy and immunotherapy for CRC related to MSI, and provide a basis for better prognoses.
MATERIALS AND METHODS
Data were obtained from the information system of the Pathology Department of the Fourth Affiliated Hospital of Harbin Medical University, China, from January 01, 2021 to September 30, 2022. Clinicopathological information, including sex, age, tumor size, and associated expression of MSI, was collected.
RESULTS
CRC associated with MSI usually occurred in people aged over 50 years. It was related to tumor diameter, which was 5-10 cm at the most. Most tumors occurred in the right colon and were moderately to poorly differentiated. PCR detected 29 patients, including 24 cases of microsatellite stable (MSS), one case of MSI-low, and four cases of MSI-high. The expression of mismatch repair (MMR) protein in these 29 patients was also investigated via immunohistochemistry (IHC), which detected 25 cases of MSS and four cases of MSI-high. The consistency between IHC and PCR was 96.6%.
CONCLUSION
The expression of MMR is related to age, tumor diameter, tumor location, and tumor differentiation. It was not related to gender, lymphovascular and perineural invasion, lymph node metastasis, TNM stage, or P53 expression. The consistency between IHC and PCR was 96.6%.
PubMed: 38904458
DOI: 10.4103/ijpm.ijpm_651_23 -
Frontiers in Oncology 2024This study analyzed the risk factors associated with positive surgical margins (PSM) and five-year survival after prostate cancer resection to construct a positive...
BACKGROUND
This study analyzed the risk factors associated with positive surgical margins (PSM) and five-year survival after prostate cancer resection to construct a positive margin prediction model.
METHODS
We retrospectively analyzed the clinical data of 148 patients treated with prostatectomy. The patients were divided into PSM group and Negative surgical margins (NSM) group. Several parameters were compared between the groups. All patients were followed up for 60 months. The risk factors for PSM and five-year survival were evaluated by univariate analysis, followed by multifactorial dichotomous logistic regression analysis. Finally, ROC curves were plotted for the risk factors to establish a predictive model for PSM after prostate cancer resection.
RESULTS
(1) Serum PSA, percentage of positive puncture stitches, clinical stage, surgical approach, Gleason score on puncture biopsy, and perineural invasion were significantly associated with the risk of PSM (P < 0.05). Serum PSA, perineural invasion, Gleason score on puncture biopsy, and percentage of positive puncture stitches were independent risk factors for PSM. (2) Total prostate-specific antigen (tPSA) by puncture, nutritional status, lymph node metastasis, bone metastasis, and seminal vesicle invasion may be risk factors for five-year survival. Lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. (3) After plotting the ROC curve, the area under the curve (AUC) [AUC: 0.776, 95%, confidence interval (CI): 0.725 to 0.854] was found to be a valid predictor of PSM; the AUC [AUC: 0.664, 95%, confidence interval (CI): 0.576 to 0.753] was also a valid predictor of five-year survival (P < 0.05). (4) The scoring system had a standard error of 0.02 and a cut-off value of 6. It predicted PSM after prostate cancer resection with moderate efficacy.
CONCLUSIONS
Serum PSA, perineural invasion, puncture biopsy Gleason score, and percentage of positive puncture stitches were independent risk factors for positive surgical margins (PSM). Also, lymph node metastasis and nutritional status were the main risk factors for the five-year survival of patients with prostate cancer. Overall, the prediction efficacy of this scoring system concerning the risk of PSM after prostate cancer resection was moderate.
PubMed: 38903708
DOI: 10.3389/fonc.2024.1360404 -
Frontiers in Veterinary Science 2024Squamous cell carcinoma (SCC) is a malignant neoplasm that accounts for approximately 15-25% and 70-80% of all feline cutaneous and oral tumors, respectively. Similar to...
INTRODUCTION
Squamous cell carcinoma (SCC) is a malignant neoplasm that accounts for approximately 15-25% and 70-80% of all feline cutaneous and oral tumors, respectively. Similar to that in humans, feline SCC can be highly invasive locally; however, its metastasis rate is low. Thus, effective local treatment may be curative for most patients, and includes surgery, electrochemotherapy (ECT), cryosurgery, or a combination of these. However, this neoplasia can manifest more aggressively in some patients, leading to higher recurrence rates. In humans, perineural invasion (PNI) has been described as a relevant tumor dissemination pathway associated with high-risk SCC, resulting in higher recurrence rates, resistance to local treatments, and short survival. However, PNI and its prognostic value have not been described in feline SCC. This study aimed to evaluate the PNI in a feline population with SCC treated with ECT and correlate its presence with the occurrence of local recurrence and other clinical variables.
METHODS
Twenty-four cats histopathologically diagnosed with SCC between 2013 and 2021 were retrospectively selected from the medical records of the Oncological Center Vet Cancer (São Paulo, SP, Brazil). The inclusion criteria were ECT as the sole therapy, histopathological evaluation of PNI, and absence of distant metastatic disease.
RESULTS
The complete response rate was 96% (23/24), and PNI was identified in 33% of the cats (8/24, PNI-positive group), whereas 67% were free of this invasion (16/24, PNI-negative group). All PNI-positive cats developed local recurrence, whereas only five PNI-negative cats experienced recurrence. Local recurrence was significantly associated with PNI ( = 0.03).
DISCUSSION
The results of this study are preliminary but promising. The data obtained are the first regarding PNI occurrence in feline SCC and pave the way for further studies, mainly to correlate the PNI with survival data and better define its prognostic value.
PubMed: 38903688
DOI: 10.3389/fvets.2024.1408260 -
Frontiers in Veterinary Science 2024Potential synovial penetration following palmar digital nerve blocks has not been investigated.
BACKGROUND
Potential synovial penetration following palmar digital nerve blocks has not been investigated.
OBJECTIVES
To evaluate the proximity of needles placed for palmar digital nerve blocks to nearby synovial structures using computed tomography (CT).
STUDY DESIGN
Descriptive observational study.
METHODS
In 18 cadaver forelimbs, sequential injection of the navicular bursa (NB), distal interphalangeal joint (DIPJ) and digital flexor tendon sheath (DFTS) was performed using 3, 5 and 10 mL diluted radiodense contrast medium, respectively. After each synovial injection, 25 gage needles were placed over the palmar digital nerves at the proximal aspect of the ungular cartilages (distal injections) and 1 cm further proximally (proximal injections), and CT examination was performed. Subsequently, needles were removed, and the synovial structures further distended with the same volume as for the first injection. Perineural needle placement and image acquisition were repeated. The distance between the needle tip and adjacent synovial structures was measured (mm) in reconstructed images. Results were analyzed in separate general linear mixed models, to determine the effect of needle position and synovial distension on the distance from the tip of the needle to the NB, DFTS and DIPJ.
RESULTS
Synovial penetration was confirmed following 12/420 (3%) needle placements (NB n = 5, 1 after proximal and 4 after distal injections; DIPJ n = 2, DFTS n = 2, NB or DIPJ n = 3, all after distal injections). The mean distance from the needle tip to the NB and DIPJ was significantly smaller after the second distension (NB: = 0.025; DIPJ: < 0.001) and with the distal needle placements (NB: p < 0.001; DIPJ: p < 0.001). For the DFTS, the distance from the needle tip was significantly smaller with the proximal needle placements ( = 0.001).
MAIN LIMITATIONS
study.
CONCLUSION
There is a small risk of synovial penetration when performing palmar digital nerve blocks, especially when distension of adjacent synovial structures is present.
PubMed: 38895719
DOI: 10.3389/fvets.2024.1404331 -
Iranian Journal of Public Health Feb 2024Today, survivin is known as one of the most specific cancer proteins; provide unique and practical study opportunities. Clinical value of survivin in gastric cancer (GC)...
BACKGROUND
Today, survivin is known as one of the most specific cancer proteins; provide unique and practical study opportunities. Clinical value of survivin in gastric cancer (GC) is not yet appointed. To establish the expression level of survivin and its diagnosis value in Iranian patients with GC, we evaluated the association of survivin expression with clinicopathologic factors.
METHODS
Overall, 60 matched-normal controls with 60 GC samples including 30 cases with evidence of metastasis at time of our study and 30 cases without evidence of metastasis were recruited, in Tehran, Iran during 2008 to 2018. Survivin expression was evaluated by quantitative Real-time polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC) study.
RESULTS
Increased expression of survivin at mRNA and protein levels was found in 86.7% and 71.6% of cases, respectively. Evidence indicated a significant difference in survivin mRNA expression level between tumor and nontumoral (marginal) tissues (<0.001). The difference in expression of survivin mRNA was not significant between metastatic and non-metastatic tumor tissues (=0.171). Positive immunoreactivity of survivin was observed to be predominantly in the nucleus of tumor cells. A significant difference in survivin protein expression was detected between tumor and non-tumoral tissues (<0.001) and between metastatic and non-metastatic tumor tissues (<0.001). There was no significant association between survivin mRNA expression and clinicopathological variables. However, survivin protein expression was significantly correlated with perineural involvement (<0.018).
CONCLUSION
This data could be supportive of using survivin as a useful diagnostic marker in GC. Although, more research is needed in this area.
PubMed: 38894824
DOI: 10.18502/ijph.v53i2.14931 -
Cureus May 2024Adenoid cystic carcinoma (ACC) is a rare type of tumor that usually originates from minor salivary glands in the oral cavity. ACC of the larynx is even rare. This case...
Adenoid cystic carcinoma (ACC) is a rare type of tumor that usually originates from minor salivary glands in the oral cavity. ACC of the larynx is even rare. This case study describes a 36-year-old non-smoking male farmer who initially presented with dyspnea and was misdiagnosed with bronchial asthma. Spirometry revealed fixed airway obstruction. Further evaluation revealed a pedunculated mass obstructing the airway, which was diagnosed as ACC by histopathological examination of the biopsy specimen. The patient was treated with radiation therapy, resulting in clinical improvement after six weeks. ACC is highly invasive and slow-growing, with perineural extension and a higher risk of recurrence. Metastasis in the lungs is common. Adequate preoperative staging, including imaging with computed tomography (CT) and magnetic resonance imaging, is important for planning treatment. The role of radiation therapy with concurrent chemotherapy is still under trial.
PubMed: 38894795
DOI: 10.7759/cureus.60571 -
Therapeutic Advances in Medical Oncology 2024DNA ploidy (P), stroma fraction (S), and nucleotyping (N) collectively known as PSN, have proven prognostic accuracy in stage II colorectal cancer (CRC). However, few...
INTRODUCTION
DNA ploidy (P), stroma fraction (S), and nucleotyping (N) collectively known as PSN, have proven prognostic accuracy in stage II colorectal cancer (CRC). However, few studies have reported on the prognostic value of the PSN panel in stage III colon cancer patients receiving capecitabine and oxaliplatin adjuvant chemotherapy.
OBJECTIVES
This study aimed to validate PSN's prognostic impact on stage III colon cancer, identifying candidates for optimized adjuvant chemotherapy duration.
DESIGN
A retrospective analysis was conducted on a cohort of stage III colon cancer patients from April 2008 to June 2020.
METHODS
Postoperative pathological samples from stage III colon cancer patients who underwent radical surgery and postoperative adjuvant chemotherapy at Sun Yat-sen University Cancer Center were retrospectively collected. Automated digital imaging assessed PSN, categorizing risk groups. Kaplan-Meier, Cox regression, and time-dependent receiver operating characteristic analysis compared model validity.
RESULTS
Significant differences in 5-year disease-free survival (DFS) and overall survival (OS) were noted among PSN-based low-, moderate-, and high-risk groups (DFS: 92.10% 83.62% 79.80%, = 0.029; OS: 96.69% 93.99% 90.12%, = 0.016). PSN emerged as an independent prognostic factor for DFS [hazard ratio (HR) = 1.409, 95% confidence interval (CI): 1.002-1.981, = 0.049] and OS (HR = 1.720, 95% CI: 1.127-2.624, = 0.012). The PSN model, incorporating perineural invasion and tumor location, displayed superior area under the curve for 5-year (0.692 0.553, = 0.020) and 10-year (0.694 0.532, = 0.006) DFS than TNM stage. In the PSN high-risk group, completing eight cycles of adjuvant chemotherapy significantly improved 5-year DFS and OS compared to four to seven cycles (DFS: 89.43% 71.52%, = 0.026; OS: 96.77% 85.46%, = 0.007).
CONCLUSION
The PSN panel effectively stratifies stage III colon cancer, aiding in optimized adjuvant chemotherapy duration determination.
PubMed: 38894737
DOI: 10.1177/17588359241260575 -
Journal of Clinical Medicine Jun 2024: The aim of this study was to establish a histologic baseline for cryoanalgesia of 2 min duration and evaluate the effects of different freeze durations. : A porcine...
: The aim of this study was to establish a histologic baseline for cryoanalgesia of 2 min duration and evaluate the effects of different freeze durations. : A porcine model was used in which the application of bilateral cryoanalgesia from intercostal spaces T3-T7 was completed via partial median sternotomy. The animals were kept alive for 7 days and the ribcages were sent to a specialized center for histopathologic analysis of the freezing injury. : Forty freezing lesions were completed and analyzed histologically. Thirty-eight (95%) of the cryo-lesions presented 100% nerve fiber degeneration at or distal to the ablation site, with preservation of the perineural connective tissue, as intended. The two unaffected nerves were found to be physically located outside of the freezing area. : The complete axonal degeneration with preservation of the perineural tissue opens the possibility to shorter freezing times than the recommended 2 min. Visualization of the nerve and positioning of the probe is important in ensuring the proper effect on the nerve. This histologic analysis confirms the process triggered by cryoanalgesia that, until now, had only been assumed.
PubMed: 38893015
DOI: 10.3390/jcm13113304 -
Journal of Clinical Medicine May 2024Hepatocellular carcinoma (HCC) is widely recognized as the predominant type of primary liver malignancy. Orthotopic liver transplantation (OLT) has emerged as a highly...
Hepatocellular carcinoma (HCC) is widely recognized as the predominant type of primary liver malignancy. Orthotopic liver transplantation (OLT) has emerged as a highly effective treatment option for unresectable HCC. Immunotherapies as neoadjuvant options are now being actively investigated in the transplant oncology era to enhance outcomes in patients with HCC. Here, we report our experience with patients with HCC who had received Immune Checkpoint Inhibitors (ICPI) prior to curative OLT. This was a retrospective cohort that included patients with HCC who received ICPI prior to OLT at a single institution from January 2019 to August 2023. Graft rejection was assessed and reported along with the type of ICPI, malignancy treated, and the timing of ICPI in association with OLT. During this cohort period, six patients with HCC underwent OLT after neoadjuvant ICPI. All patients were male with a median age of 61 (interquartile range: 59-64) years at OLT. Etiology associated with HCC was viral ( = 4) or Non-alcoholic steatohepatitis, NASH ( = 2). Tumor focality was multifocal ( = 4) and unifocal ( = 2). Lymphovascular invasion was identified in four patients. No perineural invasion was identified in any of the patients. All patients received ICPI including atezolizumab/bevacizumab ( = 4), nivolumab/ipilimumab ( = 1), and nivolumab as monotherapy ( = 1). All patients received either single or combined liver-directed/locoregional therapy, including transarterial chemoembolization (TACE), Yttrium-90 (Y90), stereotactic body radiotherapy (SBRT), and radiofrequency ablation (RFA). The median washout period was 5 months. All patients responded to ICPI and achieved a safe and successful OLT. All patients received tacrolimus plus mycophenolate as immunosuppressant (IS) therapy post-OLT and one patient received prednisone as additional IS. No patient had clinical evidence of rejection. This cohort emphasizes the success of tumor downstaging by ICPI for OLT when employed as the neoadjuvant therapy strategy. In addition, this study illustrated the importance of timing for the administration of ICPI before OLT. Given the lack of conclusive evidence in this therapeutic area, we believe that our study lays the groundwork for prospective trials to further examine the impact of ICPI prior to OLT.
PubMed: 38892779
DOI: 10.3390/jcm13113068