-
Cancer Immunology, Immunotherapy : CII Feb 2022Latency-associated peptide (LAP) was identified as crucial immune regulator in tumor microenvironment (TME) in recent researches. In this study, we aimed to estimate the...
BACKGROUND
Latency-associated peptide (LAP) was identified as crucial immune regulator in tumor microenvironment (TME) in recent researches. In this study, we aimed to estimate the predictive value of LAP expression for clinical survival and therapeutic response in muscle-invasive bladder cancer (MIBC).
METHODS
Our study encompassed 140 MIBC patients from Zhongshan Hospital (ZSHS cohort), 401 patients from The Cancer Genome Atlas (TCGA cohort) and 195 patients received PDL1 blockade from IMvigor210 trial. Survival analyses were conducted through Kaplan-Meier curve and Cox regression model. LAP expression and its association with immune contexture were evaluated in ZSHS and TCGA cohort.
RESULTS
We found that high intratumoral LAP cells infiltration anticipated inferior survival and adjuvant chemotherapy (ACT) response, and was closely related to an immunoevasive contexture with increased M2 macrophages, neutrophils and conspicuously a cluster of highly exhausted CD8 T cells. The combinational analysis of LAP cells and CD8 T cells infiltration stratified patients into distinct risk groups with implications for therapeutic sensitivity to PDL1 blockade and refinement of molecular classification in MIBC.
CONCLUSIONS
LAP expression was correlated with patients' inferior prognosis, ACT-tolerance and an immunoevasive TME with exhausted CD8 T cell infiltration, suggesting that LAP could serve as a promising therapeutic target in MIBC. Simultaneously, our novel TME classification based on LAP cells and CD8 T cells infiltration and its potential in appraising PDL1 blockade application for MIBC patients deserved further validation.
Topics: CD8-Positive T-Lymphocytes; Chemotherapy, Adjuvant; Drug Resistance, Neoplasm; Follow-Up Studies; Humans; Immune Checkpoint Inhibitors; Muscle Neoplasms; Peptides; Prognosis; Protein Precursors; Retrospective Studies; Survival Rate; Transforming Growth Factor beta; Tumor Escape; Tumor Microenvironment; Urinary Bladder Neoplasms
PubMed: 34152439
DOI: 10.1007/s00262-021-02987-4 -
Lasers in Surgery and Medicine Mar 2017Sarcomas are rare but highly aggressive tumors, and local recurrence after surgical excision can occur in up to 50% cases. Therefore, there is a strong clinical need for...
BACKGROUND AND OBJECTIVE
Sarcomas are rare but highly aggressive tumors, and local recurrence after surgical excision can occur in up to 50% cases. Therefore, there is a strong clinical need for accurate tissue differentiation and margin assessment to reduce incomplete resection and local recurrence. The purpose of this study was to investigate the use of optical coherence tomography (OCT) and a novel image texture-based processing algorithm to differentiate sarcoma from muscle and adipose tissue.
STUDY DESIGN AND METHODS
In this study, tumor margin delineation in 19 feline and canine veterinary patients was achieved with intraoperative OCT to help validate tumor resection. While differentiation of lower-scattering adipose tissue from higher-scattering muscle and tumor tissue was relatively straightforward, it was more challenging to distinguish between dense highly scattering muscle and tumor tissue types based on scattering intensity and microstructural features alone. To improve tissue-type differentiation in a more objective and automated manner, three descriptive statistical metrics, namely the coefficient of variation (CV), standard deviation (STD), and Range, were implemented in a custom algorithm applied to the OCT images.
RESULTS
Over 22,800 OCT images were collected intraoperatively from over 38 sites on 19 ex vivo tissue specimens removed during sarcoma surgeries. Following the generation of an initial set of OCT images correlated with standard hematoxylin and eosin-stained histopathology, over 760 images were subsequently used for automated analysis. Using texture-based image processing metrics, OCT images of sarcoma, muscle, and adipose tissue were all found to be statistically different from one another (P ≤ 0.001).
CONCLUSION
These results demonstrate the potential of using intraoperative OCT, along with an automated tissue differentiation algorithm, as a guidance tool for soft tissue sarcoma margin delineation in the operating room. Lasers Surg. Med. 49:240-248, 2017. © 2017 Wiley Periodicals, Inc.
Topics: Animals; Biopsy, Needle; Cats; Diagnosis, Differential; Dogs; Image Processing, Computer-Assisted; Immunohistochemistry; Margins of Excision; Monitoring, Intraoperative; Muscle Neoplasms; Neoplasms, Adipose Tissue; Sarcoma; Tomography, Optical Coherence
PubMed: 28319274
DOI: 10.1002/lsm.22633 -
Cancer Jun 2019Delays from the diagnosis of muscle-invasive bladder cancer (MIBC) to radical cystectomy (RC) longer than 12 weeks result in higher mortality and shorter...
BACKGROUND
Delays from the diagnosis of muscle-invasive bladder cancer (MIBC) to radical cystectomy (RC) longer than 12 weeks result in higher mortality and shorter progression-free survival. This study sought to identify factors associated with RC delays and to determine whether delays in care in the current treatment paradigm, which includes neoadjuvant chemotherapy (NAC), affect survival.
METHODS
Subjects with American Joint Committee on Cancer stage II urothelial carcinoma of the bladder who underwent RC from 2004 to 2012 were identified from the linked Surveillance, Epidemiology, and End Results national cancer registry and the Medicare claims database and were stratified into RC groups with or without NAC. Cox multivariable proportional hazard models and multivariable logistic regression models assessed the significance of delays in RC for survival and identified independent characteristics associated with RC delays, respectively.
RESULTS
This study identified 1509 patients with MIBC who underwent RC during the study period. In comparison with timely surgery, delays in RC increased overall mortality, regardless of the use of NAC (hazard ratio [HR] without NAC, 1.34; 95% confidence interval [CI], 1.03-1.76; HR after NAC, 1.63; 95% CI, 1.06-2.52). Patients proceeding to RC without NAC had higher odds of delayed care if they lived in a high-poverty neighborhood (odds ratio [OR], 1.37; 95% CI, 1.01-2.08) or nonmetropolitan area (OR, 1.61; 95% CI, 1.01-2.55), were men (OR, 2.22; 95% CI, 1.25-4.00), or required a provider transfer for bladder cancer care (OR, 1.82; 95% CI, 1.10-3.03).
CONCLUSIONS
Delays in care from the time of either the initial diagnosis or the completion of NAC to RC are associated with worse overall survival among patients with MIBC. Timely surgery is fundamental in the treatment of MIBC, and this necessitates attention to disparities in access to complex surgical care and care coordination.
Topics: Aged; Cystectomy; Female; Follow-Up Studies; Humans; Male; Muscle Neoplasms; Neoplasm Invasiveness; Prognosis; Retrospective Studies; Survival Rate; Time-to-Treatment; Urinary Bladder Neoplasms
PubMed: 30840335
DOI: 10.1002/cncr.32048 -
JAMA Surgery Oct 2018Radical cystectomy is the guidelines-recommended treatment of muscle-invasive bladder cancer, but a resurgence of trimodal therapy has occurred. Limited comparative data... (Comparative Study)
Comparative Study
IMPORTANCE
Radical cystectomy is the guidelines-recommended treatment of muscle-invasive bladder cancer, but a resurgence of trimodal therapy has occurred. Limited comparative data are available on outcomes and costs attributable to these 2 treatments.
OBJECTIVE
To compare the survival outcomes and costs between trimodal therapy and radical cystectomy in older adults with muscle-invasive bladder cancer.
DESIGN, SETTING, AND PARTICIPANTS
This population-based cohort study used data from the Surveillance, Epidemiology, and End Results-Medicare linked database. A total of 3200 older adults (aged ≥66 years) with clinical stage T2 to T4a bladder cancer diagnosed from January 1, 2002, to December 31, 2011, and with claims data available through December 31, 2013, were included in the analysis. Patients who received radical cystectomy underwent either only surgery or surgery in combination with radiotherapy or chemotherapy. Patients who received trimodal therapy underwent transurethral resection of the bladder followed by radiotherapy and chemotherapy. Propensity score matching by sociodemographic and clinical characteristics was used. Data analysis was performed from August 1, 2017, to March 11, 2018.
MAIN OUTCOMES AND MEASURES
Overall survival and cancer-specific survival were evaluated using the Cox proportional hazards regression model and the Fine and Gray competing risk model. All Medicare health care costs for inpatient, outpatient, and physician services within 30, 90, and 180 days of treatment were compared. The total amount spent nationwide was estimated, using 180-day medical costs between treatments, by the total number of new cases of muscle-invasive bladder cancer in the United States in 2011.
RESULTS
Of the 3200 patients who met the inclusion criteria, 2048 (64.0%) were men and 1152 (36.0%) were women, with a mean (SD) age of 75.8 (6.0) years. After propensity score matching, 687 patients (21.5%) underwent trimodal therapy and 687 patients (21.5%) underwent radical cystectomy. Patients who underwent trimodal therapy had significantly decreased overall survival (hazard ratio [HR], 1.49; 95% CI, 1.31-1.69) and cancer-specific survival (HR, 1.55; 95% CI, 1.32-1.83). No differences in costs at 30 days were observed between trimodal therapy ($15 233 in 2002 vs $18 743 in 2011) and radical cystectomy ($17 990 in 2002 vs $21 738 in 2011). However, median total costs were significantly higher with trimodal therapy than with radical cystectomy at 90 days ($80 174 vs $69 181; median difference, $8964; Hodges-Lehmann 95% CI, $3848-$14 079) and at 180 days ($179 891 vs $107 017; median difference, $63 771; Hodges-Lehmann 95% CI, $55 512-$72 029). Extrapolating these figures to the total US population revealed $335 million in excess spending for trimodal therapy compared with the less costly radical cystectomy ($492 million) for patients who received a muscle-invasive bladder cancer diagnosis in 2011.
CONCLUSIONS AND RELEVANCE
Trimodal therapy was associated with significantly decreased overall survival and cancer-specific survival as well as $335 million in excess spending in 2011. These findings have important health policy implications regarding the appropriate use of high value-based care among older adults with invasive bladder cancer who are candidates for either radical cystectomy or trimodal therapy.
Topics: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Chemoradiotherapy; Combined Modality Therapy; Cystectomy; Female; Humans; Kaplan-Meier Estimate; Male; Muscle Neoplasms; Neoplasm Invasiveness; Retrospective Studies; SEER Program; Treatment Outcome; United States; Urinary Bladder Neoplasms
PubMed: 29955780
DOI: 10.1001/jamasurg.2018.1680 -
PET Clinics Oct 2018Soft tissue sarcomas (STSs) account for less than 1% of adult solid tumors and about 7% of pediatric malignancies, causing 2% of cancer-related deaths. With the advent... (Review)
Review
Soft tissue sarcomas (STSs) account for less than 1% of adult solid tumors and about 7% of pediatric malignancies, causing 2% of cancer-related deaths. With the advent of PET-computed tomography (CT), the value of (18) fluorine-2-fluoro-2-deoxy-d-glucose (FDG) PET imaging to improve the management of STSs has been explored. FDG PET imaging has been found useful in restaging and treatment response assessment. This article reviews current knowledge and application of FDG PET-CT in initial diagnosis, staging, restaging, treatment response monitoring, and prognosis, with a brief overview of the most common histologic subtypes of STS.
Topics: Bone Neoplasms; Fluorodeoxyglucose F18; Humans; Muscle Neoplasms; Neoplasm Staging; Neoplasms, Connective and Soft Tissue; Positron Emission Tomography Computed Tomography; Radiopharmaceuticals; Sarcoma; Treatment Outcome
PubMed: 30219191
DOI: 10.1016/j.cpet.2018.05.011 -
European Annals of Otorhinolaryngology,... Sep 2016
Topics: Female; Humans; Masseter Muscle; Middle Aged; Muscle Neoplasms; Neurilemmoma; Parotid Gland
PubMed: 26997569
DOI: 10.1016/j.anorl.2016.02.003 -
Journal of Cancer Research and... Nov 2021Bladder cancer is one of the most common malignancies worldwide. Some studies noted sex differences in the prognosis of bladder cancer, but results are inconsistent.
CONTEXT
Bladder cancer is one of the most common malignancies worldwide. Some studies noted sex differences in the prognosis of bladder cancer, but results are inconsistent.
SUBJECTS AND METHODS
In this study, we assessed whether women with bladder cancer exhibit a worse prognosis, after adjustment for disease stage, age, and body mass index (BMI), using clinical data from The Cancer Genome Atlas. We used a Student's t-test to compare age and BMI in groups with different sexes.
STATISTICAL ANALYSIS USED
The Kaplan-Meier method with log-rank test was used to determine clinical prognosis.
RESULTS
The BMI (30.15 vs. 26.68, P = 0.0035) and age (67.54 years vs. 66.01 years, P = 0.045) of female patients with muscle-invasive bladder cancer (MIBC) were higher than those of male patients. The overall survival (OS) prognosis of female patients was worse than that of male patients. After grouping by disease characteristics, the disease-free survival (DFS) and OS prognoses of female patients under 60 years of age were worse than those of male patients. In the group with BMI >24, the OS prognosis of female patients was worse than that of male patients, but no difference was found in DFS prognosis. In the group with BMI ≤24, the DFS prognosis of female patients was worse than that of male patients, but no difference was found in OS prognosis. Compared to males, female patients with Stage III disease demonstrated a worse DFS prognosis and poorer OS prognosis, women with stage T3 demonstrated a worse DFS prognosis, and women with stage N0 demonstrated a poorer OS prognosis. No difference was found in prognosis between male and female patients in all other groups.
CONCLUSIONS
In patients with MIBC, women tended to exhibit a worse prognosis than men. More specifically, we found a correlation between prognosis and sex after grouping patients by BMI.
Topics: Adult; Aged; Aged, 80 and over; Body Mass Index; Cystectomy; Female; Follow-Up Studies; Humans; Male; Middle Aged; Muscle Neoplasms; Neoplasm Invasiveness; Prognosis; Sex Factors; Survival Rate; Urinary Bladder Neoplasms
PubMed: 34850773
DOI: 10.4103/jcrt.jcrt_875_21 -
Diagnostic and Interventional Imaging Apr 2015MR imaging is currently regarded as a pivotal technique for the assessment of a variety of musculoskeletal conditions. Diffusion-weighted MR imaging (DWI) is a... (Review)
Review
MR imaging is currently regarded as a pivotal technique for the assessment of a variety of musculoskeletal conditions. Diffusion-weighted MR imaging (DWI) is a relatively recent sequence that provides information on the degree of cellularity of lesions. Apparent diffusion coefficient (ADC) value provides information on the movement of water molecules outside the cells. The literature contains many studies that have evaluated the role of DWI in musculoskeletal diseases. However, to date they yielded conflicting results on the use and the diagnostic capabilities of DWI in the area of musculoskeletal diseases. However, many of them have showed that DWI is a useful technique for the evaluation of the extent of the disease in a subset of musculoskeletal cancers. In terms of tissue characterization, DWI may be an adjunct to the more conventional MR imaging techniques but should be interpreted along with the signal of the lesion as observed on conventional sequences, especially in musculoskeletal cancers. Regarding the monitoring of response to therapy in cancer or inflammatory disease, the use of ADC value may represent a more reliable additional tool but must be compared to the initial ADC value of the lesions along with the knowledge of the actual therapy.
Topics: Bone Neoplasms; Diffusion Magnetic Resonance Imaging; Humans; Muscle Neoplasms; Musculoskeletal Diseases
PubMed: 25704147
DOI: 10.1016/j.diii.2014.10.008 -
AJR. American Journal of Roentgenology Jan 2012The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report... (Review)
Review
OBJECTIVE
The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods.
CONCLUSION
Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods.
Topics: Algorithms; Biomarkers, Tumor; Bone Neoplasms; Choline; Contrast Media; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Spectroscopy; Muscle Neoplasms; Protons; Reproducibility of Results; Sensitivity and Specificity
PubMed: 22194493
DOI: 10.2214/AJR.11.6505 -
Pediatric Radiology Jun 2008Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma of childhood. This paper is focuses on imaging for diagnosis, staging, and follow-up of noncraniofacial RMS. (Review)
Review
Rhabdomyosarcoma (RMS) is the most common soft-tissue sarcoma of childhood. This paper is focuses on imaging for diagnosis, staging, and follow-up of noncraniofacial RMS.
Topics: Adult; Child; Humans; Magnetic Resonance Imaging; Muscle Neoplasms; Positron-Emission Tomography; Radiography; Rhabdomyosarcoma; Thoracic Neoplasms; Tomography, X-Ray Computed; Ultrasonography; Urogenital Neoplasms
PubMed: 18324394
DOI: 10.1007/s00247-008-0751-y