scholarly journals Pathology-proven extradural ('distant') metastases of gliomas in adults in the Netherlands between 1971-2018: a systematic case series

2021 ◽  
Author(s):  
Sanne J den Hartog ◽  
Anja van der Kolk ◽  
Annette Bruggink ◽  
Tatjana Seute ◽  
Pieter Wesseling ◽  
...  
Keyword(s):  
The Netherlands ◽  
Lymph Nodes ◽  
Survival Data ◽  
Case Series ◽  
Distant Metastases ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Primary Tumors ◽  
Paraffin Block ◽  
Diffuse Gliomas

Abstract Background Diffuse gliomas are the most frequent primary tumors originating in the central nervous system parenchyma. Although the majority of these tumors are highly malignant, extradural metastases (EDM) are extremely rare. We aimed to perform a systematic review of patients with pathology-proven EDM of diffuse gliomas in the Netherlands. Methods From the Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands information on all cases with EDM between 1971 and October 2018 was retrieved. Patients aged < 18 years or with a diagnosis of ependymoma or continuous tumor growth from intra- to extradural were excluded. Demographics, initial tumor diagnosis, treatment characteristics, location of the EDM and survival data were collected. IDH1 R132H immunohistochemistry was performed on cases of which a paraffin block of the metastatic tumor could be retrieved. Results Twenty-five patients with diffuse glioma and pathology-proven EDM were identified. Median age at diagnosis of glioma was 46 years (IQR;35-59); 21 patients (84%) were male. Histopathologic diagnosis was glioblastoma in 17 patients (68%) and lower grade tumor in eight patients. In three out of 12 patients of which a paraffin block could be retrieved immunohistochemistry revealed an IDH1-mutant glioma. Most frequent EDM locations were bone/bone marrow (14/25 patients;56%), and lymph nodes (6/25 patients;24%). Conclusion EDM of diffuse glioma are rare. They occur most frequently in patients with glioblastoma, however they can also originate from lower grade, IDH-mutant gliomas. In daily practice, EDM of diffuse glioma should be considered in patients with tumefactive lesions of the bone or lymph nodes.

EPID-17. COMPARATIVE EPIDEMIOLOGY OF PRIMARY BRAIN TUMORS AMONG ADOLESCENTS AND YOUNG ADULTS (AYA)

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi89-vi89
Author(s):  
Nayan Lamba ◽  
Bryan Iorgulescu
Keyword(s):  
Brain Tumor ◽  
Brain Tumors ◽  
Cox Regression ◽  
Adolescent And Young Adult ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Tumor Type ◽  
Primary Brain Tumors ◽  
Diffuse Gliomas ◽  
Hiv Aids

Abstract INTRODUCTION We utilized national registry data to evaluate the unique epidemiology of primary adolescent and young adult (AYA) brain tumors according to the WHO2016 classification. METHODS AYA patients (15≤age≤39) presenting between 2004-2017 with a brain tumor were identified by ICD-O-3 coding from the National Cancer Database (comprising >70% of newly-diagnosed cancers in the U.S.), and compared to pediatric and adult populations. Epidemiology and overall survival (estimated by Kaplan-Meier techniques and multivariable Cox regression) were assessed by WHO2016 tumor type. RESULTS 108,705 AYA brain tumor patients were identified (56.9% female), compared to 23,928 pediatric (46.8% female) and 748,272 adult (55.6% female) patients. Among the 69.4% of AYA brain tumors with pathological diagnosis, diffuse gliomas (31.4%), sellar tumors (19.2%), and meningiomas (15.3%) predominated in both sexes. Diffuse glioma (31.4%), sellar (19.2%), cranial nerve (7.3%), and mesenchymal non-meningothelial (4.1%) tumors represented a greater proportion of AYA brain tumors than in either pediatric or adult populations. A majority of all intracranial GCTs (59.2%) and neuronal & mixed neuronal-glial tumors (51.6%) presented during AYA. Although the prevalence of diffuse gliomas was similar between AYAs and adults, AYA gliomas were more likely to be grade 2-3 astrocytomas (38.9% vs 14.3%) and oligodendrogliomas (19.3% vs 4.3%) than in adults. GBMs represented 76.0% of adult diffuse gliomas vs. only 25.7% of AYA diffuse gliomas, but with a similar prevalence of MGMT promoter methylation (40.8% vs 38.4%). Notably, 50.7% of AYA PCNSLs were associated with HIV/AIDS, vs only 7.1% in adults (p< 0.001). CONCLUSIONS The distribution, epidemiology, and survival outcomes of primary brain tumors in the AYA population are distinct from their pediatric and adult counterparts. Notably, AYA infiltrative gliomas were more often of lower grade than adults and AYA PCNSL were far more likely to be associated with HIV/AIDS. Primary brain tumors in AYA patients require specialized management.

scholarly journals Neurotensin Receptor-1 Expression in Human Prostate Cancer: A Pilot Study on Primary Tumors and Lymph Node Metastases

2019 ◽  
Vol 20 (7) ◽  
pp. 1721 ◽  
Author(s):  
Clément Morgat ◽  
Adrien Chastel ◽  
Vincent Molinie ◽  
Romain Schollhammer ◽  
Gaétan Macgrogan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lymph Nodes ◽  
Distant Metastases ◽  
Human Prostate ◽  
Normal Prostate ◽  
Tissue Samples ◽  
Primary Tumors ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Prostate Cancers

Neurotensin and its high-affinity receptor, NTR1, are involved in the growth of various tumors. Few data are available regarding NTR1 expression in normal and tumoral human prostate tissue samples. NTR1 expression was assessed using immunohistochemistry in 12 normal prostate tissues, 11 benign prostatic hyperplasia (BPH), 44 prostate cancers, and 15 related metastatic lymph nodes (one per patient, when available). NTR1-staining was negative in normal prostate and BPH samples. NTR1 was overexpressed in four out of 44 (9.1%) primary tumors. There was no clear association between NTR1 overexpression and age, PSA-values, Gleason score, pT-status, nodal-status, or margin. NTR1 was expressed at a high level of five out of 15 (33.3%) metastatic lymph nodes. NTR1 overexpression was thus more frequent in metastatic lymph nodes than in primary tumors (p = 0.038). In this limited series of samples, NTR1 overexpression was observed in few primary prostate cancers. Upregulation was more frequent in related lymph nodes. The presence of this target in metastatic lymph nodes may open new perspectives for imaging and radionuclide therapy of prostate cancer. Factors driving NTR1 expression in primary prostate cancer and in nodal and distant metastases still need to be characterized.

scholarly journals Short-term comparative results of segmental resection versus radical resection in two patients with myxofibrosarcoma of the limbs - case series

2020 ◽  
Vol 3 (1) ◽  
pp. 9-14
Author(s):  
Sergiu-Andrei Iordache ◽  
Bogdan Şerban ◽  
Andreea Vlad ◽  
Adrian Cursaru
Keyword(s):  
Adjuvant Radiotherapy ◽  
Therapeutic Option ◽  
Case Series ◽  
Distant Metastases ◽  
Radical Resection ◽  
Segmental Resection ◽  
Lower Grade ◽  
Short Term ◽  
Comparative Results ◽  
Challenging Situation

AbstractIntroduction: Myxofibrosarcoma is a rare subtype of soft tissue sarcoma with a locally infiltrative behavior and ability to determine distant metastases.Materials and methods: We presented two myxofibrosarcoma cases who benefited from segmental or radical resection.Management and outcome: In the case of the 80-year-old woman, with grade 3 myxofibrosarcoma, we practiced radical surgery with scapulohumeral disarticulation followed by adjuvant radiotherapy.The therapeutic option for the 77-year-old man with grade 2 myxofibrosarcoma was segmental resection followed by adjuvant radiotherapy. After three months, the patient was in a good clinical condition with no sign of local recurrence, but with the presence of pulmonary metastases for the patient who benefited of segmental resection.Discussion: The radical resection had better short-term results, with no local or distant metastases at three months after surgery, although the tumor had a higher grade (G3), compared to segmental resection practiced for a lower grade tumor (G2), in which case the patient developed pulmonary metastasis at three months follow up.Conclusion: Myxofibrosarcoma represents a challenging situation regarding the management due to its unpredictive clinical course. Our cases raised the following question: should we consider treating it more aggressively in order to obtain good local control and reduce the risk of metastasis?

scholarly journals Mediterranean fever (PYRIN) is differentially expressed and up-regulated in the bone metastases of patients with metastatic breast cancer.

2021 ◽  
Author(s):  
Shahan Mamoor
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Survival Data ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Metastatic Breast ◽  
Secretion Systems ◽  
Primary Tumors ◽  
Mediterranean Fever

To understand the transcriptional nature of metastasis to disparate sites in human breast cancer, we mined published microarray data (1), comparing global gene expression profiles of metastasis to the bones and to the lymph nodes. We discovered that the pattern recognition receptor PYRIN, also known as Mediterranean fever (MEFV), was among the genes whose expression was most different, transcriptome-wide, in bone and lymph node metastases. PYRIN mRNA was present at significantly higher quantities in metastasis to the bone as compared to metastasis to the lymph nodes. Analysis of patient survival data revealed that expression of PYRIN in primary tumors of the breast was correlated with distant metastasis-free survival, in lymph node positive patients but not in lymph node negative patients. PYRIN has functions in innate immune sensing of modifications of RhoGTP and the cytoskeleton by bacterial Type III secretion systems (2, 3) and is modulated by Yersinia pestis (4, 5).

scholarly journals Overcoming the Odds: Toward a Molecular Profile of Long-Term Survival in Glioblastoma

2020 ◽  
Vol 79 (10) ◽  
pp. 1031-1037
Author(s):  
Timothy E Richardson ◽  
Ashwani Kumar ◽  
Chao Xing ◽  
Kimmo J Hatanpaa ◽  
Jamie M Walker
Keyword(s):  
Overall Survival ◽  
Case Series ◽  
Molecular Profile ◽  
Lower Grade ◽  
Diffuse Glioma ◽  
Term Survival ◽  
Total N ◽  
Long Term Survival ◽  
Prognostic Features

Abstract For over a century, gliomas were characterized solely by histologic features. With the publication of the WHO Classification of Tumours of the Central Nervous System, Revised 4th Edition in 2016, integrated histologic and molecular diagnosis became the norm, providing improved tumor grading and prognosis with IDH1/2 (isocitrate dehydrogenase 1 and 2) mutation being the most significant prognostic feature in all grades of adult diffuse glioma. Since then, much work has been done to identify additional molecular prognostic features, but the bulk of the progress has been made in defining aggressive features in lower grade astrocytoma. Although there have been several large case series of glioblastomas with long-term survival (LTS; overall survival ≥36 months), less is known about the clinical and molecular features of these cases. Herein, we review 19 studies examining LTS glioblastoma patients from 2009 to 2020 that include variable molecular analysis, including 465 cases with survival of 36 months or more (total n = 2328). These studies suggest that while there is no definitive molecular signature of long survival, younger age, IDH mutation, and MGMT (methyl guanine methyl transferase) promoter hypermethylation are associated with longer overall survival, and in IDH-wildtype tumors, chromosome 19/20 co-gain and lack of EGFR amplification, chromosome 7 gain/10 loss, and TERT promoter mutation are associated with LTS.

scholarly journals A Head-to-Head Comparison of 68Ga-DOTA-FAPI-04 and 18F-FDG PET/MR in Patients with Nasopharyngeal Carcinoma: A Prospective Study

2021 ◽  
Author(s):  
Chunxia Qin ◽  
Fang Liu ◽  
Jing Huang ◽  
Weiwei Ruan ◽  
Qingyao Liu ◽  
...  
Keyword(s):  
Lymph Node ◽  
Nasopharyngeal Carcinoma ◽  
Lymph Nodes ◽  
Skull Base ◽  
Primary Tumor ◽  
Fdg Pet ◽  
Distant Metastases ◽  
Tracer Uptake ◽  
Visual Evaluation ◽  
Primary Tumors

Abstract PurposeTo conduct a head-to-head comparison of the diagnostic ability of 68Ga-DOTA-FAPI-04 (68Ga-FAPI) and 18F-FDG PET/MR in nasopharyngeal carcinoma (NPC) patients.MethodsPatients diagnosed with NPC were prospectively enrolled. All patients underwent head-and-neck 68Ga-FAPI PET/MR and 18F-FDG PET/MR within one week. Primary tumor, lymph node numbers, and tracer uptake were compared by SUVmax and visual evaluation. The primary tumor volumes derived from 68Ga-FAPI, 18F-FDG PET, and MRI were also compared.ResultsFifteen patients were enrolled from June to August 2020. Both 68Ga-FAPI and 18F-FDG PET had 100% detection rate of the primary tumor. The 68Ga-FAPI SUVmax of primary tumors (13.87±5.13) was lower than that of 18F-FDG (17.73±6.84), but the difference was not significant (p=0.078). Compared with 18F-FDG, 68Ga-FAPI PET improved the delineation of skull-base invasion in eight out of eight patients and intracranial invasion in four out of four patients. When 25%SUVmax of 68Ga-FAPI or 20%SUVmax of 18F-FDG was utilized as a threshold for determining tumor volume, it was highly consistent with MRI. 18F-FDG PET detected much more positive lymph nodes than 68Ga-FAPI (100 vs 48). The SUVmax of 48 paired lymph nodes was significantly lower on 68Ga-FAPI than 18F-FDG (8.67±3.88 vs 11.79±6.17, p<0.001). Additionally, 68Ga-FAPI further detected four highly suspected small, distant metastases in three patients. Compared with 18F-FDG, 68Ga-FAPI changed overall staging in six of fifteen patients, with three patients being up-staged, and three down-staged.Conclusion68Ga-FAPI outperforms 18F-FDG in delineating the primary tumor and detecting suspected distant metastases, particularly in the evaluation of skull-base and intracranial invasion, suggesting 68Ga-FAPI hybrid PET/MR has the potential to serve as a single-step staging modality for patients with NPC. However, its value regarding lymph node and distant metastases evaluation needs further study.Trial registration: NCT04554719. Registered September 8, 2020 - retrospectively registered, http://clinicaltrails.gov/show/ NCT04554719

PATH-24. COPY NUMBER ALTERATIONS IN NOTCH PATHWAY GENES ARE PROGNOSTIC IN A SUBSET OF DIFFUSE ASTROCYTIC GLIOMAS

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi120-vi120
Author(s):  
Nicholas Nuechterlein ◽  
Patrick Cimino
Keyword(s):  
Copy Number ◽  
Notch Pathway ◽  
Progression Free Survival ◽  
Lower Grade ◽  
Copy Number Loss ◽  
Diffuse Glioma ◽  
Single Nucleotide Variants ◽  
Diffuse Gliomas ◽  
Astrocytic Gliomas ◽  
Inactivating Mutations

Abstract Inactivating mutations in NOTCH1 occur in many cancer types and are frequently observed in IDH-mutant, 1p/19q-codeleted oligodendroglioma. Although the role of NOTCH1 as a tumor suppressor in diffuse glioma has become appreciated in human tissue and small animal models, the spectrum of inactivating mutations in Notch pathway genes in diffuse astrocytic gliomas has not been well described. To address this, we queried the TCGA lower-grade glioma and glioblastoma datasets to establish the extent of inactivation of Notch pathway genes, specifically by cataloging single nucleotide variants and those with copy number loss or deletion. Key alteration frequencies were found to be similar in two-independent glioma cohorts (Col, MSK). Notch pathway genes with inactivating alterations (overwhelmingly copy number loss) were present in 77% of TCGA diffuse gliomas. Across all diffuse gliomas, DLL3 loss was the most common alteration (TCGA 31%). For IDH-mutant diffuse astrocytic gliomas, JAG2 loss was the most common alteration (TCGA 23.0%, Col 35%, MSK 27%). DLL1 loss and MAML1 loss were mutually exclusive (p&lt; 0.001) in TCGA IDH-mutant astrocytomas with a combined frequency of 39% (Col 47%, MSK 56%). The presence of any alteration in the top 10 altered Notch pathway genes indicated a shorter progression-free survival (p = 0.028) for TCGA IDH-mutant diffuse astrocytomas. For IDH-wildtype diffuse astrocytic gliomas, EP300 loss was the most common inactivating alteration (TCGA 35.4%, Col 49%, MSK 38%). EP300 loss, DLL1 loss, DLL4 loss were mutually exclusive (p = 0.006) in TCGA IDH-wildtype diffuse astrocytic gliomas with a combined frequency of 61% (Col 72%, MSK 66%). The presence of alterations in any of these three genes indicated a decreased overall survival (p = 0.045) in TCGA IDH-wildtype diffuse astrocytic gliomas. Overall, loss of differential Notch pathway genes has prognostic implications in both IDH-wildtype and IDH-mutant diffuse astrocytic gliomas.

scholarly journals Evaluation of Androgen Receptor in Relation to Estrogen Receptor (AR/ER) and Progesterone Receptor (AR/PgR): A New Must in Breast Cancer?

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Giuseppe Bronte ◽  
Andrea Rocca ◽  
Sara Ravaioli ◽  
Emanuela Scarpi ◽  
Massimiliano Bonafè ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Androgen Receptor ◽  
Survival Data ◽  
Epithelial Mesenchymal Transition ◽  
Case Series ◽  
Transition Process ◽  
Primary Tumors ◽  
Mesenchymal Transition ◽  
Early Primary ◽  
Patient Prognosis

Steroid nuclear receptors are known to be involved in the regulation of epithelial-mesenchymal transition process with important roles in invasion and metastasis initiation. Androgen receptor (AR) has been extensively studied, but its role in relation to breast cancer patient prognosis remains to be clarified. AR/ER ratio has been reported to be an unfavorable prognostic marker in early primary breast cancer, but its role in the patients with advanced disease has to be cleared. We retrospectively analyzed ER, PgR, and AR expression on a case series of 159 specimens of primary BC samples by using immunohistochemistry and 89 patients of these had luminal tumors for which AR and ER expression and survival data were available. For twenty-four patients both primary and metastatic tumors were available. A significantly shorter overall survival was observed in primary tumors with AR/PgR ratio ≥ 1.54 (HR = 2.27; 95% CI 1.30-3.97; p = 0.004). Similarly OS was significantly shorter when ER/PgR ratio ≥2 in primary tumors (HR = 1.89; 95% CI 1.10-3.24; p = 0.021). The analysis of the 24 patients who had biomarker determinations both in primary tumors and metastasis showed a better OS when AR/ER ratio in the metastasis was ≥ 0.90 (p = 0.022). Patients with a high AR/ER ratio in primary tumor that remained high in the metastasis had better prognosis in terms of OS (p = 0.011). Despite we suggested that the ratios AR/ER and AR/PgR could be used to identify patients with different prognosis, their real value needs to be better clarified in different BC settings through prospective studies.

scholarly journals Origins of lymphatic and distant metastases in human colorectal cancer

Science ◽  
2017 ◽  
Vol 357 (6346) ◽  
pp. 55-60 ◽  
Author(s):  
Kamila Naxerova ◽  
Johannes G. Reiter ◽  
Elena Brachtel ◽  
Jochen K. Lennerz ◽  
Marc van de Wetering ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Primary Tumor ◽  
Phylogenetic Trees ◽  
Evolutionary Relationship ◽  
Distant Metastases ◽  
Human Colorectal Cancer ◽  
Regional Lymph Nodes ◽  
Primary Tumors

The spread of cancer cells from primary tumors to regional lymph nodes is often associated with reduced survival. One prevailing model to explain this association posits that fatal, distant metastases are seeded by lymph node metastases. This view provides a mechanistic basis for the TNM staging system and is the rationale for surgical resection of tumor-draining lymph nodes. Here we examine the evolutionary relationship between primary tumor, lymph node, and distant metastases in human colorectal cancer. Studying 213 archival biopsy samples from 17 patients, we used somatic variants in hypermutable DNA regions to reconstruct high-confidence phylogenetic trees. We found that in 65% of cases, lymphatic and distant metastases arose from independent subclones in the primary tumor, whereas in 35% of cases they shared common subclonal origin. Therefore, two different lineage relationships between lymphatic and distant metastases exist in colorectal cancer.

Pancreatic neuroendocrine tumors: Twenty years’ experience of 100 patients at a single center.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 179-179
Author(s):  
Satoshi Shiba ◽  
Chigusa Morizane ◽  
Shunsuke Kondo ◽  
Hideki Ueno ◽  
Masafumi Ikeda ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Neuroendocrine Tumors ◽  
Survival Rates ◽  
Case Series ◽  
Distant Metastases ◽  
World Health ◽  
Endocrine Tumors ◽  
Pancreatic Neuroendocrine Tumors ◽  
Primary Tumors ◽  
Pancreatic Endocrine Tumors

179 Background: Pancreatic neuroendocrine tumors (NETs) are rare neoplasms that exhibit a variety of diverse morphological, functional and behavioral characteristics. However, only a few reports have evaluated large case series of pancreatic endocrine tumors. Methods: We conducted a retrospective review of 100 consecutive patients with pancreatic NETs diagnosed pathologically and treated at the National Cancer Center Hospital between 1991 and 2010. Results: The characteristics of the 100 patients were as follows: male, 49; female, 51; median age, 55 years. Fourteen patients gave a history of endocrine symptoms at the time of diagnosis. The primary tumors arose in the head, body and tail of the pancreas in 54, 25 and 21 patients, respectively. According to the 2010 grading classification of the World Health Organization, 11 patients were classified as having NET G1, 44 as having NET G2 and 29 as having NEC. The five-year survival rates of the patients with NET G1, NET G2 and NEC were 91%, 78% and 12%, respectively. The five-year survival rates of the patients with stage I, II and III, and IV disease classified according to the American Joint Committee on Cancer (AJCC) were 100%, 68% and 9%, respectively. Distant metastases occurred in 18% percent of the NET G1 patients, 39% of the NET G2 patients and 83% of the NEC patients. Treatment was undertaken by surgical resection in 82%, 59% and 24% of patients with NET G1, NET G2 and NEC, respectively. The five-year survival rates of the patients with NET G1, NET G2 and NEC after radical surgery were 100%, 91% and 36%, respectively. Among the 33 patients treated by systemic chemotherapy, the median survival period was 22.9 months in the patients with NET G1/G2 and 6.6 months in those with NEC. A multivariate analysis identified lower age, good performance status (PS) and lower histopathologic grade as independent favorable prognostic factors. Conclusions: Patients with NET G1, G2 treated by surgical resection had a good prognosis. Most patients with NEC exhibited distant metastases and had a poor prognosis. Histopathologic grade is an important factor for selecting the appropriate treatment strategy and predicting the prognosis in patients with pancreatic NETs.

Sign in / Sign up

Export Citation Format

Share Document