Toxicity of PD-1/CTLA-4 inhibitor immunotherapy among elderly patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14139-e14139 ◽  
Author(s):  
Vidit Kapoor ◽  
Olivier Rixe
Keyword(s):  
Side Effects ◽  
Metastatic Melanoma ◽  
Population Group ◽  
The Elderly ◽  
Fisher Exact Test ◽  
Check Point ◽  
Exact Test ◽  
Increased Risk ◽  
Significant Difference ◽  
Check Point Inhibitors

e14139 Background: The use of Immune check point inhibitors in advanced metastatic melanoma is becoming increasingly common especially in the elderly population. With metastatic melanoma being mostly a disease of the elderly, the safety and toxicity profile of immune check point inhibitors in this population group continues to remain controversial. Prior studies have hypothesized that due to reduced immune responses in the elderly, toxicity to immune check point inhibitors is expected to be low. In this study we aim to analyze the association of check point inhibitor induced immuno-toxicity with age. Methods: We analyzed 108 patients with stage 4 metastatic melanoma who were treated with anti-PD1 and/or anti-CTLA-4 immunotherapy. Out of these patients, 58 (53.7%) were 65 or more years old and 50 (46.3%) were < 65 years old. Overall, 64 (59.3%) patients had autoimmune side effects; 35 (60.3%) were 65 years or older and 29 (48%) were < 65 years old. The most common side effects were dermatitis (n = 22, 20.4%) and colitis (n = 21, 19.4%). Incidences of various autoimmune side effects were calculated in both groups (65 years or older and < 65 years old). Fisher exact test was used to calculate p values Results: There was a significant difference between the incidence of dermatitis between the two groups. (51.4% in 65 years or older and 24.1% in < 65 years old group, p = 0.04). The incidence of colitis was more in the 65 years or older group (37.1%) as compared to < 65 years group (31.1%) however results were not statistically significant (p = 0.79). Similarly, there was no significant difference in other autoimmune side effects including hepatitis, arthritis, pneumonitis, thyroiditis, hypophysitis, adrenalitis, anemia and thrombocytopenia between the two groups. Also, there was no significant difference in the incidence of different grades of side effects (1 to 4) between the two groups. Conclusions: Patients who are 65 years or older can safely tolerate immunotherapy as compared to patients < 65 years old but with an increased risk of dermatitis. These data should be validated by a larger study population.

Molecular features for selecting Asian metastatic melanoma patients who benefit from check-point inhibitors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e22011-e22011
Author(s):  
Seonggyu Byeon ◽  
Hyera Kim ◽  
Ja Hyun Yeo ◽  
Jinchul Kim ◽  
Minsuk Kwon ◽  
...  
Keyword(s):  
Metastatic Melanoma ◽  
Tumor Response ◽  
Univariate Analysis ◽  
Molecular Characteristics ◽  
Check Point ◽  
Asian Patients ◽  
Molecular Features ◽  
Significant Difference ◽  
Check Point Inhibitors ◽  
Melanoma Patients

e22011 Background: There was few data for molecular characteristics of Asian metastatic melanoma patients with distinct clinical features as compared to West patients with metastatic melanoma. We conducted the molecular profiling for Asian metastatic melanoma patients with check-point inhibitors (CPIs) to find novel biomarkers to CPIs. Methods: 164 Asian patients with metastatic melanoma who received CPIs were simultaneously tested by the next generation sequencing (NGS) in tumor samples. We collected all NGS data and clinic-pathologic factors and also analyzed biomarkers for tumor response to CPIs. Results: The most common subtype was acral melanoma (39.6%) followed by cutaneous melanoma (32.3%), mucosal melanoma (26.2%) and others (1.8%). 163 pts are evaluable for efficacy; we observed 40 complete response (24.4 %), 34 confirmed partial responses (20.7%), 41 stable disease (25.0%) and 48 disease progression (29.3%). The overall confirmed response rate from the dose escalation is 45.1%. There was no significant difference of tumor response among subtypes of melanoma (p = 0.295). NRAS and TP53 mutation and NF2 deletion were significantly related to patients without the response to CPIs (p < 0.05). Meanwhile, MYC and RPS6KB1 amplification were found with those with the response (p < 0.05). The median progression free survival (PFS) to ICIS was 5.9 months (95% CI 3.8 - 8.05 months). Univariate analysis showed that TP53 and BRAF mutation, NF2 deletion, and BIRC2 amplification were poor prognostic values for PFS (p < 0.05). Conclusions: This study reported molecular characteristics of 164 Asian patients with metastatic melanoma. The specific molecular alterations influenced on the tumor response and PFS to CPIs in those.

scholarly journals AB0009 ASSOCIATION OF STAT4 RS7574865, RUNX1 RS9979383, IL6 RS1800795, IL6R RS2228145, IL6R RS4845618 WITH SYSTEMIC LUPUS ERYTHEMATOSUS SUSCEPTIBILITY AND SOME LUPUS MANIFESTATIONS IN BELARUSIAN POPULATION

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1039.2-1040
Author(s):  
N. Dostanko ◽  
V. Yagur ◽  
R. Goncharova ◽  
E. Siniauskaya ◽  
T. Zybalova
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Diagnostic Odds Ratio ◽  
Protective Role ◽  
Fisher Exact Test ◽  
Systemic Lupus ◽  
Exact Test ◽  
American College Of Rheumatology ◽  
Healthy Donors ◽  
Significant Difference

Background:Systemic lupus erythematosus (SLE) has a significant genetic predisposition. Many genetic variants of susceptibility to SLE have been published and analyzed, but the clinical and functional significance of the various genotypes has not yet been clearly defined [1].Objectives:To estimate the association between some of non-HLA gene polymorphisms such as STAT4 rs7574865, RUNX1 rs9979383, IL6 rs1800795, IL6R rs2228145, IL6R rs4845618 and susceptibility to SLE in Belarusian population as well as some disease manifestations.Methods:We examined 383 healthy blood donors and 54 SLE patients (18-72 years old, median age 35) classified according to the 1997 American College of Rheumatology (ACR) revised classification criteria [2]. Deoxyribonucleic acid was extracted from peripheral blood samples by phenol-chloroform method. Genotyping was performed by real-time PCR with fluorescent probes. Differences of distribution of all the single nucleotide polymorphism (SNP) genotypes and their associations with secondary antiphospholipid syndrom (APS) and lupus arthritis were analyzed using Pearson χ2 (χ2) and two-way Fisher exact test (F, p2-t). Diagnostic odds ratio (dOR), likelihood ratio of positive (LR +) and negative (LR –) tests and corresponding 95% confidence intervals (CI) were also calculated.Results:We revealed significant difference in STAT4 rs7574865 genotypes in SLE patients and healthy donors (χ2=8,27, р=0,016) with significant increase of ТТ genotype frequency in SLE patients vs healthy donors (χ2=6.83 p=0.009; p2-t =0.020; dOR=3.78 (CI95% 1.36-10.55); LR+ =3.44 (CI95% 1.35-8.71); LR– =0.91 (CI95% 0.83-0.98)). Lupus arthritis was more common in risk TT-genotype SLE carriers than in other SLE patients (χ2=5.902 p=0.015; p2-t =0.027).We revealed significant increase of СТ genotype (RUNX1 rs9979383) in healthy donors vs SLE patients (χ2=4.14; p=0.042; dOR=0.53 (CI95% 0.29-0.98); LR+ =0.69 (CI95% 0.45-0.99); LR– =1.3 (CI95% 1.01-1,56)). Lupus arthritis was more common in SLE СТ-genotype carriers than in other SLE patients (χ2=4.66 p=0.031; p2-t =0.058).Significant differences in IL6 rs1800795, IL6R rs2228145 and IL6R rs4845618 genotypes distribution between studied groups were not found (χ2, p=0.427, p=0.559 and p=0.407, correspondingly) but GG-genotype (IL6 rs1800795) carriership in SLE patients was associated with increased APS frequency (χ2=4.45, p=0.035; dOR=0.19 (CI95% 0.04-0.9); LR+ =0.28 (CI95% 0.07-0.93); LR– =1.41 (CI95% 1.03-1.64).Conclusion:Our data suggest the susceptibility to SLE in ТТ genotype of STAT4 rs7574865 polymorphism, protective role of СТ genotype of RUNX1 rs9979383 for SLE and association between GG-genotype of IL6 rs1800795 and APS in SLE patients in Belarusian population. Lupus arthritis was associated with ТТ genotype of STAT4 rs7574865 and СТ genotype of RUNX1 rs9979383.References:[1]Chen L, Morris DL, Vyse TJ. Genetic advances in systemic lupus erythematosus: an update. Curr Opin Rheumatol 2017;29:423–33.[2]Hochberg MC. Updating the American College of Rheumatology Revised Criteria for the classification of Systemic Lupus Erythematosus. Arthritis Rheum 1997;40:1725.Disclosure of Interests:None declared

Percepção da atratividade mentual feminina por cirurgiões bucomaxilofaciais, ortodontistas e leigos

2021 ◽  
Vol 14 (53) ◽  
pp. 86-91
Author(s):  
Alípio Miguel Rocha Neto ◽  
Emerson Filipe de Carvalho Nogueira ◽  
Laísa Brenda de Holanda Cavalcanti ◽  
Patrícia Mendonça Borba ◽  
Guaracy Fonseca Junior ◽  
...  
Keyword(s):  
Profile Analysis ◽  
Great Majority ◽  
Class Ii ◽  
Lateral Face ◽  
Vertical Line ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Lay People ◽  
The People ◽  
Significant Difference

Objectives- Evaluate the perception of the female chin attractiveness by maxillofacial surgeons, orthodontists and lay people through simulations of mentoplasty performed with the aid of a software. Profile photography along with lateral face teleradiography were manipulated using Dolphin Imaging Software version 11.8, and different clinical situations were designed. Methods: The alterations were performed with anteroposterior movements, with images of mentoplasty of advancement (+2, +3 and +4), and recoil (-2, -3, -4). The reference of the movement was given in relation to the True Vertical Line (TVL). Ninety people were interviewed. 30 orthodontists, 30 maxillofacial surgeons and 30 lay people. They observed the photos and classified the profile according to extremely pleasant, pleasant, unpleasant and extremely pleasant. To evaluate the presence of significant difference between the groups in relation to the profile analysis, the Fisher Exact test was used. Results: Most lay people, surgeons and orthodontists (46%) considered the chin at the limit of the TVL as an extremely attractive profile. 34.4% considered the chin 2 mm before the TVL as an attractive profile; chin 3 mm beyond the TVL as unattractive (45.5%), and the most unattractive ones were 4 mm beyond the TVL (75.6%). Conclusion: So the great majority of the people interviewed showed a preference for the positioning of the chin in the TVL or slightly Class II profile in female patients, which can guide professionals in a better planning.

scholarly journals A profile and treatment outcome of seasonal hyper-acute panuveitis

1970 ◽  
Vol 2 (1) ◽  
pp. 35-38 ◽  
Author(s):  
E Shrestha
Keyword(s):  
Visual Acuity ◽  
Medical Treatment ◽  
Visual Outcome ◽  
P Value ◽  
Fisher Exact Test ◽  
Mean Values ◽  
Exact Test ◽  
Pediatric Age Group ◽  
Significant Difference ◽  
The Mean

Introduction: Seasonal hyper-acute panuveitis (SHAPU) is a sight-threatening disease and its management is challenging. Objective: To study the profile and evaluate the visual outcome of the patients of clinicallydiagnosed cases of SHAPU after treatment. Subjects and methods: A retrospective interventional hospital-based study was carried out involving 21 subjects with clinically-diagnosed SHAPU. The data were retrieved from the record section of the hospital and analyzed. The variables studied were demographic pattern, clinical condition, duration of presentation and visual acuity before and after the treatment. Statistics: The data were analyzed using Epi Info version 2000. Percentage prevalence, mean values with standard deviation, relative risk, 95% CI and p value were calculated. P value of < 0.05 was considered to be significant. Results: Among the 21 cases, the numbers of male and female were 11 (52.4 %) and 10 (46.7 %) respectively. A comparative analysis of gender in children and adults did not show any significant difference (RR=0.47, 95% CI = 0.22 - 1.01, Fisher exact test: p = 0.14). The mean for all ages was 7 ± 12.68 years, while the mean age in pediatric cases was 4.5 ± 3.91 years. Thirteen (61.9%) cases occurred in children below fifteen years. Fifteen (71.4 %) cases reported during September and October. Presenting visual acuity of all cases was less than 3/60. All of them received medical treatment. By the end of the 4th week, seven (33.3 %) patients regained vision to 6/18. Conclusion: SHAPU is more prevalent in pediatric age group. It is equally prevalent among males and females. The visual acuity can improve with early medical treatment. Keywords: SHAPU; panuveitis; steroid; phthisis bulbi DOI: 10.3126/nepjoph.v2i1.3702 Nep J Oph 2010;2(1) 35-38

The Predictive Value of Thromboelastogram in the Evaluation of Patients with Suspected Acute Venous Thromboembolism

2019 ◽  
Vol 143 (3) ◽  
pp. 272-278
Author(s):  
Tareq Abu Assab ◽  
David Raveh-Brawer ◽  
Julia Abramowitz ◽  
Mira Naamad ◽  
Chezi Ganzel
Keyword(s):  
Venous Thromboembolism ◽  
Emergency Room ◽  
Alpha Angle ◽  
Categorical Variables ◽  
Clot Lysis ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Exact Test ◽  
Significant Difference ◽  
D Dimer

Introduction: The objective of this prospective study was to examine whether thromboelastogram (TEG) can predict the presence of venous thromboembolism (VTE) in patients who arrive at the emergency room with signs/symptoms that raise the suspicion of acute VTE. Methods: Every patient was tested for D-dimer and all TEG parameters, including: reaction time, clot time formation, alpha-angle, maximal amplitude, clot viscoelasticity, coagulation index, and clot lysis at 30 min. For categorical variables, χ2 or the Fisher exact test were used, and for continuous variables the t test or other non-parametric tests were used. Results: During 2016, a total of 109 patients were enrolled with a median age of 55.7 (21–89) years. Eighteen patients were diagnosed with VTE. Analyzing the different TEG parameters, both as continuous and categorical variables, did not reveal a statistically significant difference between VTE-positive and VTE-negative patients. Combining different TEG parameters or dividing the cohort according to gender, clinical suspicion of VTE (Well’s criteria), or different levels of D-dimer did not change the results of the analysis. Conclusion: The current study could not demonstrate a significant value of any TEG parameter as a predictor of VTE among patients who came to the emergency room with signs/symptoms that raise the suspicion of VTE.

scholarly journals Prevalence of Joint Hypermobility and Patterns of Articular Manifestations in Patients with Inflammatory Bowel Disease

2009 ◽  
Vol 2009 ◽  
pp. 1-5 ◽  
Author(s):  
P. Vounotrypidis ◽  
E. Efremidou ◽  
P. Zezos ◽  
M. Pitiakoudis ◽  
E. Maltezos ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Study Groups ◽  
Joint Hypermobility ◽  
Fisher Exact Test ◽  
Hypermobility Syndrome ◽  
Exact Test ◽  
Significant Difference ◽  
Healthy Control ◽  
Inflammatory Bowel

Objective. The objective is the investigation of Joint Hypermobility (JH) and the Hypermobility Syndrome (HMS) in patients with inflammatory bowel disease (IBD).Methods. We examined 83 patients with IBD and 67 healthy individuals for the presence of JH. Patients were excluded if they were under 18 or over 50 years of age and if they had other conditions which affect joint mobility. Thex2and the Fisher exact test were used appropriately between study groups. Odds ratios (ORs) for the risk of JH and HMS in IBD groups were calculated.Results. A total of 150 individuals (83 IBD patients and 67 healthy controls) participated in the study. 69 IBD patients, 41 with Crohn's Disease (CD) and 28 with ulcerative colitis (UC), were finally eligible. JH was detected in 29 CD patients (70.7%), in 10 UC patients (35.7%), and in 17 healthy control subjects (25.4%). Significant difference was detected on JH in CD patients as compared to UC patients (P=.0063) and controls (P<.0001). The estimated OR for JH was 7.108 (95% CI: 2.98–16.95) in CD and 1.634 (95% CI: 0.63–4.22) in UC patients. HMS was detected in 5 (12.2%) CD and in 1 (3.57%) UC patients. The OR for HMS in CD was 3.75 (95% CI: 0.41–34.007), while 7 (17.1%) CD patients had overlapping symptoms for both HMS and early spondylarthropathy.Conclusions. JH and the HMS are common in CD patients, thus articular manifestations should be carefully interpreted. This implies an involvement of collagen varieties in the pathogenesis of IBD.

scholarly journals Determination of Clopidogrel Resistance by Whole Blood Platelet Aggregometry and Inhibitors of the P2Y12 Receptor

2006 ◽  
Vol 52 (3) ◽  
pp. 383-388 ◽  
Author(s):  
Boris T Ivandic ◽  
Philipp Schlick ◽  
Peter Staritz ◽  
Kerstin Kurz ◽  
Hugo A Katus ◽  
...  
Keyword(s):  
Whole Blood ◽  
Adenosine Monophosphate ◽  
Blood Platelet ◽  
P2y12 Receptor ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Clopidogrel Resistance ◽  
Impedance Aggregometry ◽  
Platelet Aggregometry ◽  
Increased Risk

Abstract Background: Inhibition of platelet aggregation by clopidogrel may be insufficient in up to 30% of users. These nonresponders carry an increased risk of cardiovascular events. We reported here a simple assay to study clopidogrel responsiveness. Methods: Electrical impedance aggregometry was performed in diluted whole blood in the presence of 5 and 20 μmol/L ADP. Some samples were incubated with 0.1 mmol/L methyl-S-adenosine monophosphate (MeSAMP), a P2Y12 receptor blocker, to maximize inhibition of aggregation before aggregometry. To validate the assay, we analyzed 6-min impedance in 21 healthy probands and 244 patients with coronary artery disease (CAD). Results: At 5 μmol/L ADP, the imprecision of the assay was 11%. Mean (SD) impedance of the healthy cohort was 12.2 (2.2) Ω. The mean − 3 SD was used to define the cutoff for clopidogrel responsiveness: responders and nonresponders exhibited a 6-min impedance ≤5 Ω and &gt;5 Ω, respectively. Samples from nonresponders were incubated with MeSAMP and analyzed again to distinguish pharmacokinetic and pharmacodynamic types of resistance. Sixteen percent of CAD patients were classified as nonresponders (38 and 2 cases of pharmacokinetic and pharmacodynamic resistance, respectively). Female sex was strongly associated with clopidogrel resistance (P = 0.0002, Fisher exact test). A higher clopidogrel loading dose (P = 0.0353, Mann–Whitney U-test) was given to responders (median, 450 mg) than nonresponders (median, 300 mg). Age and cardiovascular diagnosis showed no significant associations. Conclusions: Impedance aggregometry using 5 μmol/L ADP is a useful tool for studying clopidogrel responsiveness. MeSAMP allows characterization of responsiveness “on treatment” and may be useful for optimizing clopidogrel dosing.

scholarly journals Granisetron versus Granisetron-Dexamethasone for Prevention of Postoperative Nausea and Vomiting in Pediatric Strabismus Surgery: A Randomized Double-Blind Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Renu Sinha ◽  
Dilip Shende ◽  
Souvik Maitra ◽  
Neeraj Kumar ◽  
Bikash Ranjan Ray ◽  
...  
Keyword(s):  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Complete Response ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Fisher Exact Test ◽  
Double Blind ◽  
Exact Test ◽  
Oculocardiac Reflex ◽  
Significant Difference

Aim.Efficacy of granisetron and combination of granisetron and dexamethasone was evaluated for prevention of postoperative nausea and vomiting (PONV) in children undergoing elective strabismus surgery.Methods.A total of 136 children (1–15 years) were included. Children received either granisetron (40 mcg/kg) [group G] or combination of granisetron (40 mcg/kg) and dexamethasone (150 mcg/kg) [group GD]. Intraoperative fentanyl requirement and incidence and severity of oculocardiac reflex were assessed. PONV severity was assessed for first 24 hours and if score was >2, it was treated with metoclopramide. Postoperative analgesia was administered with intravenous fentanyl and ibuprofen.Results.The demographic profile, muscles operated, and fentanyl requirement were comparable. Complete response to PONV in first 24 hours was observed in 75% (51/68) of children in group G and 76.9% (50/65) of children in group GD, which was comparable statistically (p=0.96, Fisher exact test; OR 1.11, 95% CI 0.50, 2.46). Incidence of PONV between 0 and 24 hours was comparable. One child in group G required rescue antiemetic in first 24 hours and none of the children had severe PONV in group GD. There was no significant difference in incidence or severity of oculocardiac reflex.Conclusion.Dexamethasone did not increase efficacy of granisetron for prevention of PONV in elective pediatric strabismus surgery. Registration number of clinical trial wasCTRI/2009/091/001000.

scholarly journals Comparison of Complications between Total and Subtotal Thyroidectomy in Simple Multinodular Goitre

2018 ◽  
Vol 9 (2) ◽  
pp. 55-59
Author(s):  
Nadim Ahmed ◽  
Sami Ahmad ◽  
Farhad Uddin Ahmed ◽  
Muhammad Anwar Hossain ◽  
Krishna Pada Saha ◽  
...  
Keyword(s):  
Total Thyroidectomy ◽  
Subtotal Thyroidectomy ◽  
Fisher Exact Test ◽  
Multinodular Goitre ◽  
Chi Square ◽  
College Hospital ◽  
Nodular Goitre ◽  
Exact Test ◽  
Postoperative Haemorrhage ◽  
Significant Difference

Background: Multinodular goitre is one of the most common endocrine surgical problems. Because controversy still continues to surround the use of total thyroidectomy for management of simple nodular goitre, the present study was conducted to compare the complications between total and subtotal thyroidectomy for management of simple multinodular goitre.Materials & methods: The experimental study was conducted in the department of Surgery and ENT, Rajshahi Medical College Hospital over a period of 2 years from July 2011 to June 2013. Of the total 83 simple multinodular goitre patients – 38 were assigned to total and 45 to subtotal thyroidectomy groups. Student’s t-test was done to analyze the means of quantitative variables & Chi-square (X2) and Fisher Exact test was applied to analyze categorical variables.Results: Most (88.9%) of patients in subtotal thyroidectomy (STT) group and 86.8% in total thyroidectomy (TT) group did not receive any blood transfusion during operation. Only 1(2.2%) patient in STT group experienced significant intraoperative haemorrhage. All patients were successfully operated. However, few patients of either group experienced some complications. Tetany was developed in 7.89% patients of TT and 4.44% patients of STT group. The other complication was recurrent laryngeal nerve (RLN) palsy (5.3% in TT and 2.2% in STT groups). No case of postoperative haemorrhage (haematoma) or wound infection was occured in either group. In TT group 5 (13.16%) patients and in STT group 4 (8.89%) patients developed different complications with no significant difference between the groups (p=0.533). The mean postoperative hospital stay was higher in TT group than In STT group (6.21 ± 0.99 vs. 5.96 ± 0.79 days), though the difference is not statistically significant (p= 0.206).Conclusions: The study shows that total thyroidectomy can be performed without increasing risk of complications and is a better alternative to subtotal thyroidectomy for the treatment of simple multinodular goitre.J Shaheed Suhrawardy Med Coll, December 2017, Vol.9(2); 55-59

Increased risk for abnormalities on perioperative colon screening in patients with microsatellite instability–positive endometrial carcinoma

2006 ◽  
Vol 16 (6) ◽  
pp. 1980-1986 ◽  
Author(s):  
B. M. Buttin ◽  
M. A. Powell ◽  
P. J. Goodfellow ◽  
S. N. Lewin ◽  
R. K. Gibb ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Microsatellite Instability ◽  
Medical Records ◽  
Fisher Exact Test ◽  
Exact Test ◽  
Molecular Stratification ◽  
Colon Cancers ◽  
Increased Risk ◽  
Primary Colon ◽  
Endometrial Cancers

Microsatellite instability (MSI) is a feature of certain hereditary and sporadic endometrial and colon cancers. We set out to determine whether molecular stratification of endometrial cancers based on tumor MSI status could help identify patients at increased risk for abnormalities found on perioperative colon screening. From a prospectively accrued series of 413 patients, medical records were reviewed from 94 patients with MSI positive (MSI+) and 94 patients with MSI negative (MSI−) endometrial cancers, matched by year of diagnosis. We reviewed clinicopathologic data and results of perioperative colon screening. Differences were analyzed using Fisher exact test and logistic regression analysis. There were no significant clinicopathologic differences between the two cohorts. Sixty-five percent of patients in each group underwent perioperative colon screening. However, patients with MSI+ cancers had a twofold increase in the frequency of colonic abnormalities (30% versus 14.8%, P= 0.044) over those with MSI− cancers. Furthermore, the only primary colon cancers (N= 2) were found in women with MSI+ endometrial cancers that were unmethylated at the MLH1 promoter. Our data suggest that patients with MSI+ endometrial cancers are at increased risk for abnormalities on perioperative colon screening. Those with MSI+MLH1 unmethylated cancers appear to be at highest risk.

Sign in / Sign up

Export Citation Format

Share Document