scholarly journals Quantification of the spatial distribution of primary tumors in the lung to develop new prognostic biomarkers for locally advanced NSCLC

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Diem Vuong ◽  
Marta Bogowicz ◽  
Leonard Wee ◽  
Oliver Riesterer ◽  
Eugenia Vlaskou Badra ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Permutation Test ◽  
Main Bronchus ◽  
Nsclc Patient ◽  
Locally Advanced ◽  
Tumor Location ◽  
Anatomical Location ◽  
Primary Tumors ◽  
Patient Status ◽  
The Right

AbstractThe anatomical location and extent of primary lung tumors have shown prognostic value for overall survival (OS). However, its manual assessment is prone to interobserver variability. This study aims to use data driven identification of image characteristics for OS in locally advanced non-small cell lung cancer (NSCLC) patients. Five stage IIIA/IIIB NSCLC patient cohorts were retrospectively collected. Patients were treated either with radiochemotherapy (RCT): RCT1* (n = 107), RCT2 (n = 95), RCT3 (n = 37) or with surgery combined with radiotherapy or chemotherapy: S1* (n = 135), S2 (n = 55). Based on a deformable image registration (MIM Vista, 6.9.2.), an in-house developed software transferred each primary tumor to the CT scan of a reference patient while maintaining the original tumor shape. A frequency-weighted cumulative status map was created for both exploratory cohorts (indicated with an asterisk), where the spatial extent of the tumor was uni-labeled with 2 years OS. For the exploratory cohorts, a permutation test with random assignment of patient status was performed to identify regions with statistically significant worse OS, referred to as decreased survival areas (DSA). The minimal Euclidean distance between primary tumor to DSA was extracted from the independent cohorts (negative distance in case of overlap). To account for the tumor volume, the distance was scaled with the radius of the volume-equivalent sphere. For the S1 cohort, DSA were located at the right main bronchus whereas for the RCT1 cohort they further extended in cranio-caudal direction. In the independent cohorts, the model based on distance to DSA achieved performance: AUCRCT2 [95% CI] = 0.67 [0.55–0.78] and AUCRCT3 = 0.59 [0.39–0.79] for RCT patients, but showed bad performance for surgery cohort (AUCS2 = 0.52 [0.30–0.74]). Shorter distance to DSA was associated with worse outcome (p = 0.0074). In conclusion, this explanatory analysis quantifies the value of primary tumor location for OS prediction based on cumulative status maps. Shorter distance of primary tumor to a high-risk region was associated with worse prognosis in the RCT cohort.

scholarly journals Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

2020 ◽  
Author(s):  
Yuanping Zhang ◽  
Yongjin Wang ◽  
Yichuan Yuan ◽  
Jiliang Qiu ◽  
Yuxiong Qiu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Colorectal Liver Metastases ◽  
Tumor Location ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival ◽  
Primary Tumor Location ◽  
Before And After

Abstract Background: Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods: From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis. Results: Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM (P = 0.575; P = 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P = 0.028, P = 0.003). Conclusions: Compared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.

PS02.080: CLINICAL SIGNIFICANCE OF THE NUMBER OF PERITUMORAL LYMPHATIC VESSELS AFTER CHEMOTHERAPY IN ESOPHAGEAL CANCER PATIENTS

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 143-143
Author(s):  
Takeo Hara ◽  
Tomoki Makino ◽  
Makoto Yamasaki ◽  
Koji Tanaka ◽  
Yasuyuki Miyazaki ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Primary Tumor ◽  
Conflicts Of Interest ◽  
Locally Advanced ◽  
Lymphatic Vessels ◽  
Tumor Location ◽  
Resected Specimen ◽  
Long Term Outcome ◽  
Cutoff Value

Abstract Background Neoadjuvant chemotherapy (NAC), a standard treatment for locally-advanced esophageal cancer, often achieves significant antitumor effect as clinically or microscopically confirmed. However, how chemotherapy histologically impacts upon normal tissues, in particular lymphatic vessels, adjacent to a tumor remains unclear. Methods A total of 137 patients who underwent curative esophagectomy with (NAC group n = 62)/without (nonNAC group n = 75) NAC for thoracic esophageal cancer in our department from 2004 to 2012 were analyzed. The number of lymphatic vessels (NLV) adjacent to primary tumor (within 1000μm from the edge of tumor) in lamina propria mucosae layer was assessed by immunostaining of D2–40 and its association with clinico-pathological parameters was analyzed. Results The NLV was significantly lower in the NAC group as compared with the nonNAC group (NAC vs nonNAC; 19.1 ± 9.0 vs 22.8 ± 8.6, P = 0.014). In the nonNAC group, when classified into two (high vs low NLV) groups by using the cutoff value of the median NLV in nonNAC group, NLV did not correlated with any clinico-pathological factors including age, gender, tumor location, pT, pN, pM, ly, v, and overall survival. On the other hand, in the NAC group, high NLV (classified by the same cutoff value as noted above) was significantly associated with good histological response (grade1b-2) (high vs low NLV; 52 vs 26%, P = 0.026) and less development of lymph node recurrence (16 vs 40%, P = 0.029) but not with other parameters including age, gender, tumor location, pT, pN, pM, ly, and v. Notably, the high NLV group showed the more favorable 5-year overall survival compared to the low NLV group (61 vs 49%, P = 0.0041). Multivariate analysis of overall survival further identified low NLV (HR = 3.68, 95%CI 1.54–10.83, P = 0.0005) to be one of independent prognostic factors along with pT(HR = 2.87, 95%CI 1.37–6.35, P = 0.0050) and pN(HR = 4.04, 95%CI 1.53–13.89, P = 0.0034) in the NAC group. Conclusion NAC might decrease the number of lymphatic vessels adjacent to primary tumor in resected specimen, and this number was associated with tumor response to NAC and long-term outcome in patients who underwent NAC plus surgery. Disclosure All authors have declared no conflicts of interest.

Feasibility and efficacy of weekly intraarterial cisplatin in locally advanced (stage III and IV) head and neck cancers.

1988 ◽  
Vol 6 (6) ◽  
pp. 969-975 ◽  
Author(s):  
J E Mortimer ◽  
M E Taylor ◽  
S Schulman ◽  
C Cummings ◽  
E Weymuller ◽  
...  
Keyword(s):  
Head And Neck ◽  
Primary Tumor ◽  
Locally Advanced ◽  
Complete Response ◽  
External Carotid Artery ◽  
Head And Neck Cancers ◽  
External Carotid ◽  
Nodal Disease ◽  
Primary Tumor Site ◽  
Primary Tumors

Thirty-five consecutive patients with primary unresectable head and neck cancers were considered eligible for protocol treatment with neoadjuvant intraarterial cisplatin. External carotid artery catheterizations were technically feasible in 29 patients (83%). Twenty-five patients with 28 primary tumors received intraarterial cisplatin, 100 mg/m2, every seven to 14 days for three cycles. The most common toxicity was nausea and vomiting. Ipsilateral hemialopecia, transient VII nerve palsy, and blurring of vision seem to be unique to this route of administration at this dose. A complete response was seen at the primary tumor site in nine of 28 (32%), with 14 of 28 partial responses (50%). In evaluating both primary tumor and nodal disease, five of 25 patients achieved a complete response and 15 of 25 a partial response. In previous reports, one complete response was observed in 74 patients with head and neck cancer treated with neoadjuvant intravenous (IV) cisplatin every 3 weeks. The overall response of 82% reported here is comparable to that reported with combination chemotherapy and suggests an advantage to the arterial administration of cisplatin when possible in the neoadjuvant setting.

Prognostic impact of PD-L1 and PD-1 expression by primary tumor location in colorectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 628-628 ◽  
Author(s):  
Jonna Berntsson ◽  
Anna Larsson ◽  
Bjorn Nodin ◽  
Jakob Eberhard ◽  
Karin Jirstrom
Keyword(s):  
Colorectal Cancer ◽  
Immune Cells ◽  
Primary Tumor ◽  
Tumor Location ◽  
Left Colon ◽  
Prognostic Impact ◽  
Full Cohort ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Entire Cohort

628 Background: A plethora of studies report abundant expression of programmed death-ligand 1 (PD-L1) on tumors to be associated with poor outcome in several cancer forms, whereas immune cell-specific expression of PD-L1 has been associated with improved prognosis in colorectal cancer. However, none of these studies have investigated the association with prognosis according to primary tumor location. This study aimed to investigate the clinicopathological correlates and prognostic impact of PD-L1 and its receptor PD-1 in colorectal cancer, with particular reference to the anatomical subsite of the primary tumor. Methods: Immunohistochemical expression of PD-L1 and PD-1 was analysed in tissue microarrays with tumors from 557 incident cases of CRC from a prospective population-based cohort. Kaplan-Meier and Cox regression analyses were applied to determine the impact of biomarker expression on 5-year overall survival (OS), in the entire cohort and in subgroup analysis of right colon, left colon, and rectum. Results: High PD-L1 expression on tumor-infiltrating immune cells correlated significantly with an improved 5-year OS in univariable and multivariable analysis, adjusted for age, sex, TNM stage, differentiation grade, and vascular invasion, in the full cohort (HR = 0.49; 95 % CI 0.35-0.68), and in primary tumors of the right (HR = 0.43; 95 % CI 0.25-0.74) and the left colon (HR = 0.28; 95 % CI 0.13-0.61), but not in rectal cancer. High tumor-specific PD-L1-expression was not significantly associated with prognosis in neither the full cohort nor according to primary tumor location. High expression of PD-1 on tumor-infiltrating immune cells was significantly associated with an improved 5-year overall survival in the entire cohort (HR = 0.42; 95 % CI 0.21-0.87), but not in subsite analysis according to primary tumor location. Conclusions: This study is, to the best of our knowledge, the first to investigate the prognostic impact of PD-L1 and PD-1 expression according to primary tumor site in colorectal cancer. Dense infiltration of PD-L1+ immune cells was found to be an independent favorable prognostic factor in primary tumors of the right and left colon, but not in the rectum.

Outcomes by tumor location in patients with metastatic colorectal cancer (mCRC) treated with regorafenib (REG): Final analysis from the prospective, observational CORRELATE study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 539-539 ◽  
Author(s):  
Michel Ducreux ◽  
Lone Nørgård Petersen ◽  
Leopold Öhler ◽  
Francesca Bergamo ◽  
Jean-Philippe Metges ◽  
...  
Keyword(s):  
Observational Study ◽  
Progression Free Survival ◽  
Final Analysis ◽  
Tumor Location ◽  
Local Health Authority ◽  
Anatomical Location ◽  
Local Health ◽  
Primary Tumors ◽  
Kaplan Meier ◽  
Ecog Ps

539 Background: The anatomical location of the primary tumor has been associated with different prognosis and outcomes in mCRC. REG significantly improved overall survival (OS) versus placebo in patients with mCRC who progressed on standard therapies in phase 3 trials. We report the final results of outcomes in patients with mCRC with left-sided (L) or right-sided (R) primary tumors who were treated with REG in the real-world CORRELATE study. Methods: CORRELATE (NCT02042144) was a prospective, observational study designed to characterize the safety and effectiveness of REG in patients previously treated with approved therapies and for whom the decision to treat with REG was made by the treating physician according to the local health authority label. Patients with tumor location unknown or tumors in both regions were excluded (n = 62). OS was analyzed using the Kaplan–Meier method. Results: Overall, 975 patients were included in the analysis: L = 768 (79%) and R = 207 (21%). Most patients were ECOG PS 0–1 (L: 86%; R: 87%). Median time from initial diagnosis and from diagnosis of metastatic disease to REG treatment was slightly longer in L versus R tumors (34 vs 30 months and 27 vs 23 months, respectively). A higher proportion of patients with L versus R tumors, respectively, had prior radiotherapy (34% vs 15%) and a lower proportion had a partial colectomy (44% vs 75%). Both groups received a median of three prior regimens. REG treatment duration was similar in the two groups (median duration: L 2.6 months vs R 2.3 months), as was median progression-free survival (95% CI): 2.8 months (2.6, 2.9) for L tumors versus 2.7 months (2.5, 3.1) for R tumors. Median OS (95% CI) was 7.4 months (6.7, 8.0) for L tumors versus 8.2 months (6.6, 9.3) for R tumors; one-year OS rates were 32% versus 34%, respectively. Conclusions: Results from this observational study suggest that OS is similar in patients with L and R tumors treated with REG. Clinical trial information: NCT02042144.

The prognostic significance of extra-intestinal tumor location for primary nonmetastatic gastrointestinal stromal tumors.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 2-2
Author(s):  
Mary Lydon Guye ◽  
Rebecca A. Nelson ◽  
Amanda Kathleen Arrington ◽  
Steven L. Chen ◽  
Warren Allen Chow ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Primary Tumor ◽  
Gastrointestinal Stromal Tumors ◽  
Tumor Location ◽  
Gi Tract ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Stromal Tumors ◽  
Mesenchymal Neoplasm

2 Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the GI tract. Tumor size, tumor location, and mitotic index are established factors that risk stratify recurrence and survival. Extra-intestinal GISTs are infrequently observed and our objective was to investigate the outcomes of patients with primary GISTs found outside the GI tract. Methods: The Surveillance Epidemiology and End Results registry was used to identify patients with GIST treated with surgery between 1996 and 2008. Patients were evaluated by standard clinical and pathological indices including: age, primary tumor location (extra−intestinal vs. GI tract), tumor size, tumor grade, and extent of disease. Overall survival differences between primary site groups were assessed by Kaplan-Meier method. Univariate and stepwise multivariate Cox proportional hazards analyses were performed. Results: Of the 2812 patients with surgically treated GIST, 2489 (88.5%) had a primary tumor location in the GI tract and 323 (11.5%) were located in extra-intestinal sites. Comparison of patients by primary tumor location demonstrated more locally advanced cancers with lymph node involvement (40.2% vs. 18.4%; p<.0001) and a higher occurrence of distant metastatic disease (22.3% vs. 16.6%; p<.0001) among the extra-intestinal GISTs. When comparing overall survival, patients with extra-intestinal GISTs had significantly worse 5 year survival (62% vs. 70%, respectively; p=0.002) than patients with primary tumors within the GI tract. Stepwise multivariate analysis showed that non-intestinal site was an independent predictor of poorer survival (HR 1.29, 95% CI [1.05-1.59], p=0.015). Conclusions: Our data indicates that extra-intestinal location for primary non-metastatic GIST is an independent poor prognostic factor, with worse overall survival, compared to GISTs located within the GI tract. Risk stratification for prognosis should account for these rare GIST locations.

Clinical impact of primary tumor location in patients with metastatic colorectal cancer (mCRC) treated with regorafenib or trifluridine/tipiracil as later-line.

2020 ◽  
Vol 38 (4_suppl) ◽  
pp. 105-105
Author(s):  
Hiromichi Nakajima ◽  
Shota Fukuoka ◽  
Toshikazu Moriwaki ◽  
Toshiki Masuishi ◽  
Atsuo Takashima ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Prognostic Factor ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Primary Tumor ◽  
Univariate Analysis ◽  
Tumor Location ◽  
Primary Tumor Location ◽  
The Right ◽  
The Impact

105 Background: In the recent years, primary tumor location (PTL) is considered as an important prognostic and predictive factor in first-line treatment of mCRC. Although regorafenib (REG) and trifluridine/tipiracil (TFTD) have been available recently, the prognostic value of PTL in later-line with these agents is not well understood. TFTD improved survival regardless of PTL in the RECOURSE trial, while REG did not show survival benefit in the patients (pts) with rectal cancer in the CORRECT trial. Methods: We retrospectively evaluated pts with mCRC who were registered in a multicenter observational study (the REGOTAS study). The main inclusion criteria were ECOG PS of 0–2, refractory or intolerant to fluoropyrimidines, oxaliplatin, irinotecan, and anti-VEGF and anti-EGFR therapy (if KRAS wild type), and no prior use of REG and TFTD. The impact of PTL on overall survival (OS) were evaluated using Cox proportional hazards models based on baseline characteristics and propensity score matching. Results: A total of 550 pts (223 pts in the REG group, 327 pts in the TFTD group; 122 pts in the right-sided, 428 pts in the left-sided) were included in this study. Although the right-sided pts was significantly shorter OS compared with the left-sided pts by univariate analysis (hazard ratio [HR] 0.79, 95% confidence interval [CI] 0.63-0.99, P = 0.04), multivariate analysis revealed that PTL was not an independent prognostic factor (HR 0.88, 95% CI 0.69-1.1, P = 0.26). The similar results were obtained in each treatment group. In subgroup analysis according to PTL, OS were comparable between REG and TFTD groups regardless of PTL (HR 0.93, 95% CI 0.62-1.39 in the right-sided; HR 1.08, 95% CI 0.83-1.39 in the left-sided [excluding rectum]; and HR 1.01, 95% CI 0.62-1.62 in the rectal cancer pts). These results were similar in sensitivity analysis using propensity score-matching. Conclusions: In the present study, PTL is not a prognostic factor in patient with mCRC treated with either REG or TFTD as later-line. No difference in OS was observed between REG and TFTD groups irrespective of PTL.

The importance of maintenance chemotherapy in the first and second lines of treatment of metastatic colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15583-e15583
Author(s):  
Danila Gridnev ◽  
Anatoly Popov ◽  
Dina Islamova ◽  
Vladislav Makarov ◽  
Edouard Vozny ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Metastatic Colorectal Cancer ◽  
Primary Tumor ◽  
Locally Advanced ◽  
Long Term Results ◽  
Maintenance Chemotherapy ◽  
Group A ◽  
Group B ◽  
The Right

e15583 Background: The first and second lines of CT is decisive in the treatment of colorectal cancer. Choosing the right one allows you to increase PFS and improve long-term results. Surgical treatment and maintenance chemotherapy (MT) increase PFS and OS, as they can be prescribed at any stage of treatment. Methods: The analysis included 192 patients diagnosed with metastatic colorectal cancer (mCRC) who received treatment between 2014 and 2019. The average age of the patients was 62 years. At the beginning of treatment, the overall condition of all patients was ECOG1. Primary mCRC had 129 (67%) patients. In 63 (33%) patients, locally advanced disease was first diagnosed, which were included in the study after progression. PFS and OS for all patients were calculated from the start of the 1st line. Localization of the primary tumor in 42 (22%) patients was on the right side of the colon and on the left side in 149 (78%) and 1 patient did not show primary tumor. Among the patients with primary metastatic disease, 100 (52%) had isolated metastases, while the remaining 92 (48%) had 2 or more localizations. Different types of surgical treatment of metastases in the liver occurred in 41 (21%) patients. 119 patients never received MT (with any number of lines) and made a comparison group(A). 73 patients received MT in at least one of the CT lines (B). 12 patients received MT in the 1st and 2nd CT (C). These groups were homogeneous in terms of gender, age, ECOG, accessibility of surgical treatment of distant metastasis, mutational status of the tumor, and accessibility of biotherapy. Evaluation of the effect was performed using RECIST criteria, at intervals of 3 months or the appearance of clinical symptoms of progression. The treatment was carried out before the progression. At the time of analysis, 94 patients are alive and continue to receive treatment. Results: We compared in all three groups: In group A: OS - 12.9 months, PFS 1-line CT - 9.5 months, PFS 2-line CT - 4.5 months In group B: OS - 27.6 months, PFS 1-line CT - 13.6 months, PFS 2-line CT - 9.1 months In group C: OS - 38.3 months, PFS 1-line CT - 14.2 months, PFS 2-line CT - 9.1 months. “Five-year” survival (In those patients who were observed from the start of the study for all 5 years) in group A was 5,8 %, in group B 15 %, and in group C 16 %. Conclusions: Increase of PFS and OS in patients who received MT at least at one of the stages of treatment, and continues to increase in patients receiving MT in the first two lines CT. Thus, MT is a necessary component of the treatment of mCRC.

748 Myeloid cell infiltration correlates with prognosis and varies based on tumor location in cholangiocarcinoma

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A796-A797
Author(s):  
Paul Kunk ◽  
Sean Dougherty
Keyword(s):  
Primary Tumor ◽  
Myeloid Cells ◽  
Tumor Location ◽  
P Value ◽  
M2 Macrophages ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Metastatic Lesions ◽  
Higher Power ◽  
Mesothelin Expression

BackgroundCholangiocarcinoma (CC) is a rare malignancy with an increasing incidence and poor prognosis. Immunotherapy represents one potential treatment for CC, however identification of immunotherapeutic targets requires a thorough characterization of the tumor immune microenvironment (TIME). Mesothelin, a tumor associated antigen, is abundantly expressed in other malignancies, though its expression in CC has not been well characterized. We hypothesized that (1) the TIME of CC would vary by primary tumor location and between primary and metastatic lesions, (2) high tumor infiltration by CD8+ T cells and low infiltration by M2 macrophages would be associated with improved survival, and (3) most CC would express mesothelin.Methods99 CC tumors from unique stage I-IV patients were included, of which 89 were primary tumors (24 intrahepatic (ICC), 65 extrahepatic (ECC - 30 hilar (H-ECC) and 35 distal (D-ECC))) and 10 were metastatic lesions. Tissue microarrays were constructed and immunohistochemistry (IHC) was performed for lymphoid and myeloid markers, as well as for PD-L1 and mesothelin. IHC+ cells were quantified by automated image analysis. Expression of mesothelin and PD-L1 by tumors cells were evaluated on a semiquantitative scale (0, +1, +2, or +3). Hypothesis testing was performed using Kruskal-Wallis test and survival analyses were performed with Univariate and Multivariate Cox Hazard Models.ResultsMost tumors were infiltrated by myeloid cells in addition to CD4+, CD8+, and FoxP3+ T-cells. Mesothelin was expressed (≥1+) in 68% of tumors (figure 1), while PD-L1 was expressed (≥1%) in only 16% of tumors. Higher densities of M1 macrophages (CD68+) were present in D-ECC relative to ICC and H-ECC (figure 2). M1 macropahges were also found in higher densities in metastatic tumors. Mesothelin and granzyme-B expression was significantly higher in D-ECC. Increasing density of myeloid cells (CD14+) and M2 macrophages (CD163+) was associated with worse survival (p= 0.02, 0.03, respectively) (figure 3). Intraepithelial and intratumoral T cell infiltration did not correlate with OS.Abstract 748 Figure 1Mesothelin expression by primary tumor locationA+C) Representative low Mesothelin expression at low (X10) (A) and higher power (X20) (C). B+D) Representative high Mesothelin expression at low (X10)(B) and higher power (X20)(D). E) Log(x+1) transformed Mesothelin Expression as determined by automated cell counting, median and IQR, all data points shown. Median: 5.5, 79.5, 146.0 for ICC, H-ECC, D-ECC, respective, p-value = 0.025. F-H) Mesothelin Expression determined by visual inspection and scoring for ICC (F), H-ICC (G), and D-ECC (D).Abstract 748 Figure 2Immune infiltration based on primary tumor locationIncrease in immune infiltrate in primary tumors as distance from liver increases. P-values determined by Jonckheere-Terpstra Test with FDR correctionsAbstract 748 Figure 3CD14 and CD163 Correlate with OSA+C) Kaplan Meier Curve of OS for (A) CD14 (Median OS: 20 vs. 90 months, log-rank p-value <0.01) and (C) CD163 (Median OS: 15 vs. 32 months, log-rank p-value<0.01). B+D) Multivariate Cox Hazard Models. Assumptions of Cox Hazard Model were checked with Schoenfeld residual values, significance level <0.01ConclusionsThe TIME of CC varies significantly by primary tumor location and between primary and metastatic lesions. D-ECC has a favorable immune profile compared to ICC and H-ECC, with a better milieu for antigen presentation including increased mesothelin and less suppressive macrophages, which may support better response to checkpoint blockade. The data supported the hypothesis that higher densities of intra-tumoral M2 macrophages and myeloid cells correlated with worse OS, even after controlling for clinical variables, suggesting that these cell populations may represent promising immunotherapeutic targets in CC.

scholarly journals Clinicopathological Characteristics and Prognostic Factors in Ovarian Metastases from Right- and Left-Sided Colorectal Cancer

2021 ◽  
Vol 28 (4) ◽  
pp. 2914-2927
Author(s):  
Ondřej Kubeček ◽  
Jan Laco ◽  
Jiří Špaček ◽  
Alena Kubečková ◽  
Jiří Petera ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Prognostic Factors ◽  
Primary Tumor ◽  
Residual Disease ◽  
Menopausal Status ◽  
Clinicopathological Characteristics ◽  
Primary Tumors ◽  
Imaging Methods ◽  
Secondary Tumors ◽  
The Right

Background: Secondary tumors of the ovary (STOs) account for 10–25% of all ovarian malignancies, including metastases from primary gynecological tumors. Colorectal cancer (CRC) has been recognized as one of the most common causes of STOs in Western countries. Despite it being well-known that CRC originating from the right versus left side of the colon/rectum differ substantially, there is a paucity of information regarding the effect of the primary tumor sidedness on the clinicopathological characteristics of STOs. Methods: This retrospective, observational chart review study included patients with histologically confirmed STOs of CRC origin diagnosed between January 2000 and December 2019. The clinicopathological characteristics of STOs originating from left-sided and right-sided CRC were compared. Univariable and multivariable analyses employing elastic net Cox proportional hazard models were used to evaluate potential prognostic factors. Further, the role of imaging methods in STOs diagnostics was evaluated. Results: Fifty-one patients with STOs of colorectal origin were identified. The primary tumor originated in the right and left colon/rectum in 39% and 61% of the cases, respectively. STOs originating from right-sided primary tumors were more frequently bilateral, associated with peritoneal carcinomatosis, had the ovarian surface affected by the tumor, and contained a mucinous component. The independent prognostic factors for overall survival in the whole cohort included: the presence of macroscopic residual disease after cytoreductive surgery, menopausal status, the application of systemic therapy, and the application of targeted therapy. In 54% of cases, the imaging methods failed to determine the laterality of the STOs correctly as compared to pathological reports and/or intraoperative findings. Conclusion: STOs originating from left-sided and right-sided CRC show distinct clinicopathological characteristics. Moreover, different metastatic pathways might be employed according to the primary tumor sidedness. Considering the discrepancies between radiological assessment and histopathological findings regarding the laterality of STOs, bilateral adnexectomy should be advised whenever feasible.

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