scholarly journals Prognostic Role of the Removed Vaginal Cuff and Its Correlation with L1CAM in Low-Risk Endometrial Adenocarcinoma

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 34
Author(s):  
Enrico Vizza ◽  
Valentina Bruno ◽  
Giuseppe Cutillo ◽  
Emanuela Mancini ◽  
Isabella Sperduti ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Endometrial Adenocarcinoma ◽  
Low Risk ◽  
Consensus Guidelines ◽  
Prognostic Role ◽  
Vaginal Cuff ◽  
Number Of Patients ◽  
Significant Difference ◽  
Retrospective Data Collection

Objective: The aim of our study was to investigate the role of the excised vaginal cuff length as a prognostic factor in terms of DFS and recurrence rate/site, in low-risk endometrial cancer (EC) patients. Moreover, we correlated the recurrence with the expression of L1CAM. Material and Methods: From March 2001 to November 2016, a retrospective data collection was conducted of women undergoing surgical treatment for low-risk EC according to ESMO-ESGO-ESTRO consensus guidelines. Patients were divided into three groups according to their vaginal cuff length: V0 without vaginal cuff, V1 with a vaginal cuff shorter than 1.5 cm and V2 with a vaginal cuff longer than or equal to 1.5 cm. Results: 344 patients were included in the study: 100 in the V0 group, 179 in the V1 group and 65 in the V2 group. The total recurrence rate was 6.1%: the number of patients with recurrence was 8 (8%), 10 (5.6%) and 3 (4.6%), in the V0, V1 and V2 group, respectively. No statistically significant difference was found in the recurrence rate among the three groups. Although the DFS was higher in the V2 group, the result was not significant. L1CAM was positive in 71.4% of recurrences and in 82% of the distant recurrences. Conclusions: The rate of recurrence in patients with EC at low risk of recurrence does not decrease as the length of the vaginal cuff removed increases. Furthermore, the size of the removed vaginal cuff does not affect either the site of recurrence or the likelihood of survival.

S-Adenosylmethionine Supplementation May Reduce Cancer-Related Fatigue: A Prospective Evaluation Using the FACIT-F Questionnaire in Colon Cancer Patients Undergoing Oxaliplatin-Based Chemotherapy Regimens

Chemotherapy ◽  
2021 ◽  
pp. 1-8
Author(s):  
Angelo Onorato ◽  
Andrea Napolitano ◽  
Silvia Spoto ◽  
Lorena Incorvaia ◽  
Antonio Russo ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Cancer Patients ◽  
Chronic Fatigue ◽  
University Campus ◽  
Cancer Related Fatigue ◽  
Number Of Patients ◽  
Significant Difference ◽  
The University ◽  
Oncologic Treatment

<b><i>Background:</i></b> Fatigue is a common distressing symptom for patients living with chronic or acute diseases, including liver disorders and cancer (<i>Cancer-Related Fatigue</i>, CRF). Its etiology is multifactorial, and some hypotheses regarding the pathogenesis are summarized, with possible shared mechanisms both in cancer and in chronic liver diseases. A deal of work has investigated the role of a multifunctional molecule in improving symptoms and outcomes in different liver dysfunctions and associated symptoms, including chronic fatigue: S-adenosylmethionine (SAM; AdoMet). The aim of this work is actually to consider its role also in oncologic settings. <b><i>Patients and Methods:</i></b> Between January 2006 and December 2009, at the University Campus Bio-Medico of Rome, 145 patients affected by colorectal cancer in adjuvant (<i>n</i> = 91) or metastatic (<i>n</i> = 54; <i>n</i> = 40 with liver metastases) setting and treated with oxaliplatin-based regimen (FOLFOX for adjuvant and bevacizumab + XELOX for metastatic ones), 76 of which with the supplementation of S-adenosylmethionine (AdoMet; 400 mg b.i.d.) (57% of adjuvant patients and 44% of metastatic ones) and 69 without AdoMet supplementation, were evaluated for fatigue prevalence using the Functional Assessment of Chronic Illnesses Therapy-Fatigue (FACIT-F) questionnaire, at 3 and 6 months after the beginning of oncologic treatment. Notably, the number of patients with liver metastases was well balanced between the group of patients treated with AdoMet and those who were not. <b><i>Results:</i></b> Among patients receiving oxaliplatin-based chemotherapy, both in adjuvant and in metastatic settings, after just 3 months from the beginning of chemotherapy, mean scores from questionnaire domains like FACIT-F subscale (7.9 vs. 3.1, <i>p</i> = 0.006), FACIT physical (6.25 vs. 3.32, <i>p</i> = 0.020), FACIT emotional (4.65 vs. 2.19, <i>p</i> = 0.045), and FACIT-F total score (16.5 vs. 8.27, <i>p</i> = 0.021) were higher in those receiving supplementation of AdoMet, resulting in reduced fatigue; a significant difference was maintained even after 6 months of treatment. <b><i>Discussion and Conclusions:</i></b> Mechanisms and strategies for managing CRF are not fully understood. This work aimed at investigating the possible role of S-adenosylmethionine supplementation in improving fatigue scores in a specific setting of cancer patients, using a FACIT-F questionnaire, a well-validated quality of life instrument widely used for the assessment of CRF in clinical trials.

An Update on the Role of Thalidomide (THAL) in Total Therapy 2 (TT2) for Newly Diagnosed Patients with Multiple Myeloma (MM): Analysis of Subgroups Defined by Standard Prognostic Factors (SPF) and Gene Expression Profiling (GEP)-Derived Subgroups.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3389-3389 ◽  
Author(s):  
John D. Shaughnessy ◽  
Jeffrey Haessler ◽  
Jerry Zeldis ◽  
Yongsheng Huang ◽  
Fenghuang Zhan ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Risk Groups ◽  
Complete Response ◽  
Low Risk ◽  
Phase Iii ◽  
Significant Difference ◽  
And Control ◽  
Standard Risk

Abstract Background: THAL, whose activity in MM was discovered in the setting of advanced and refractory disease in the late 1990’s (Singhal, NEJM, 2000), has become the standard front-line therapy in combination with dexamethasone (DEX). In a randomized phase III tandem transplant trial, TT2, a higher complete response (CR) rate and longer event-free survival (EFS) had been observed on the THAL arm (Barlogie, NEJM, 2006). The similar overall survival (OS) on THAL and control arms had been attributed to the routine use of THAL as salvage therapy for the patients randomized to the No-THAL arm and the shorter post-relapse OS among patients randomized to the THAL arm. Patients and Methods: With a median follow-up on TT2 of 53mo, 107 patients have relapsed and 219 died. Subset analyses were performed to determine whether THAL confers an OS advantage in any subgroup of patients. Results: 6-yr EFS and OS rates are 48%/63% on THAL and 38%/58% on control arm (p=0.01/0.67). Post-relapse OS is now similar with median durations of 5.3mo/4.3mo among control/THAL arms (p=0.11). According to multivariate analyses of 11 standard prognostic factors, EFS was shorter among patients treated without THAL, in the presence of cytogenetic abnormalities (CA), B2M and LDH elevations and low albumin, whereas CR was favorable; OS was inferior with CA, high LDH, low albumin and in patients not receiving 2nd transplant or not achieving CR. Randomization to THAL was beneficial only in the >2 risk factor group: 6-yr OS was 47% in 31 patients on THAL and 12% in 31 control patients (Figure 1, p=0.01). When examined in the context of GEP (70 gene model-based high versus low risk groups) and inter-phase FISH data (amp1q21), available in 260 patients, the 57 with GEP low risk and absence of amp1q21 receiving THAL had 5-yr OS of 90% compared to 74% among 73 controls (p=0.13). Conclusion: With longer follow-up of 53mo on TT2, EFS remains superior among patients randomized to THAL; post-relapse survival is no longer inferior among those randomized to THAL; THAL benefited a high-risk subgroup with >2 standard risk factors, whereas no significant `difference has yet emerged among genetically defined subgroups. Figure Figure

Correlation between expression of MCM6, a new proliferative marker, and treatment outcome in patients with Hodgkin's disease

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e19547-e19547
Author(s):  
K. Khodadad ◽  
S. Karimi ◽  
Z. Esfahani Monfared
Keyword(s):  
Treatment Outcome ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Univariate Analysis ◽  
Response To Treatment ◽  
G1 Arrest ◽  
Number Of Patients ◽  
Significant Difference ◽  
Proliferative Marker

e19547 Background: MCM6 is a proliferative marker, which in contrary to Ki67, is involved in all cell cycle phases, including early G1. We evaluated MCM6 expression in Hodgkin's disease (HD) patients in order to find any correlation between MCM6 expression and treatment outcome. Methods: Formalin-fixed paraffin-embedded lymph node specimens of 55 patients with HD treated with ABVD regimen (± radiotherapy) were assessed for MCM6 expression by IHC. The percentage of nuclear positivity in RS and mononuclear Hodgkin cells was evaluated in each case. Clinical data, response to treatment and relapse rates were obtained from patients’ medical records. These data were analyzed by SPSS software. Results: Mean MCM6 expression was 80.7% (ranging 35%-99%) with no significant difference between histology subtypes. In univariate analysis, MCM6 expression was not statistically significant for B-symptoms (P=0.27), sex (P=0.91), stage (P=0.18) and response to treatment (P=0.53), but was significant for age (P=0.008) (≤23 vs >23 yrs old). The MCM6 mean expression between relapsed and non-relapsed groups was marginally significant (21% vs 29.4%, P=0.057). In multivariate analysis, we evaluated MCM6 expression, B-symptoms, stage, response rate and age for relapse. None of risk factors were statistically significant predictor for relapse, including MCM6 expression (P=0.238), however, were significant regarding to response (P<0.001) and stage (P=0.048). We divided patients in 4 quartiles based on their MCM6 expression (Q1<74.25%, N=13, Q2=74.26–85.5%, N=14, Q3=85.6–91.75%, N=13, Q4>91.75%, N=12). Relapse and PFS were not significantly different between these quartiles (P=0.27 and P=0.83, respectively). Conclusions: Our study on a limited number of patients revealed MCM6 is not a strong predictor for treatment outcome in patients with HD. Our findings can be possibly explained by early G1 arrest of tumor cells and the role of cytokine production in pathogenesis of HD. We believe determining the accurate predictive role of proliferative markers needs to be focused on the markers which are exclusively involved in S phase. No significant financial relationships to disclose.

Prevalence and predictors of active surveillance management for black males diagnosed with low risk prostate cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18019-e18019
Author(s):  
Nicolette Taku ◽  
Vivek Narayan ◽  
Scarlett Bellamy ◽  
Neha Vapiwala
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Private Insurance ◽  
Univariate Analysis ◽  
Low Risk ◽  
Consensus Guidelines ◽  
Pathologic Features ◽  
Significant Difference ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

e18019 Background: Consensus guidelines recommend that active surveillance (AS) be considered in the management of men with low risk prostate cancer (LRPC). The evidence supporting this recommendation is largely derived from studies in which men of African descent were underrepresented; thus, the appropriate implementation of AS in this population remains controversial. The objective of our study was to evaluate the prevalence and clinical predictors of an AS approach in black men (BM) diagnosed with LRPC following the 2010 inclusion of AS in LRPC management consensus guidelines. Methods: BM (N = 15,242) and non-Hispanic white men (WM) (N = 86,655) diagnosed with LRPC (as defined by PSA ≤ 10 ng/ml, Gleason score ≤ 6, clinical stage T1 – T2a) between 2010 and 2013 were identified from the National Cancer Database. Logistic regression models were used to assess the likelihood of pursuing an AS strategy over time, as well as to examine associations between sociodemographic characteristics (SDCs) and the receipt of AS. Results: Overall, 9% of BM with LRPC were managed with AS. On univariate analysis, the likelihood of BM undergoing AS increased from 2010 and was statistically significant ( p < 0.001) for all subsequent years (2011: OR = 1.54, 95% CI 1.30-1.82; 2012: OR = 2.19, 95% CI 1.82-2.60; 2013: OR = 2.55, 95% CI 2.15-3.02). Uninsured BM were twice as likely as those with private insurance to pursue AS (OR 1.97, 95% CI 1.51-2.58, p < 0.001). BM seen at academic cancer programs were also more likely to be managed with AS, when compared to those seen at community cancer centers (OR 1.47, 95% CI 1.37-1.60, p < 0.001). BM were less likely than WM to receive AS (OR = 0.82, 95% CI 0.77 to 0.87, p < 0.001). On multivariate analysis adjusted for SDCs, there was no significant difference in AS utilization between the two ethnic groups. Conclusions: The utilization of AS for BM with LRPC appears to be increasing, may be influenced by SDCs, and may not differ from the AS utilization for WM with LRPC. Given the observed elevated rates of post-prostatectomy adverse pathologic features among BM, further evaluation of the determinants of AS utilization and scrutinous consideration of the appropriateness of AS in this population is warranted.

scholarly journals The Comparison of ISUP Grades Between Prostate Biopsy and Radical Prostatectomy: The Incoherence and Related Factors

Acta Medica ◽  
2021 ◽  
Vol 52 (3) ◽  
pp. 213-218
Author(s):  
Erman Ceyhan ◽  
Burak Yılmaz ◽  
Bülent Öztürk
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
International Society ◽  
Prostate Biopsy ◽  
Low Risk ◽  
Related Factors ◽  
Number Of Patients ◽  
Significant Difference ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

Objective: To assess the incoherence rates between prostate biopsies and radical prostatectomy specimens with the use of the International Society of Urological Pathology grading system and to identify the related factors. Materials and Methods: 89 radical prostatectomy patients were analyzed retrospectively. Patients with Gleason score≥6 were included to the study. Patients’ prostate spesific antigen levels, digital rectal examination, prostate biopsy parameters, prostate cancer risk groups and final prostatectomy pathologies were examined. Gleason scores and International Society of Urological Pathology grades of prostate biopsy and prostatectomy specimens were compared. The coherence, upgrading and downgrading rates of pathologies assessed and related factors were identified. Results: Patients’ mean age was 63.1±6.0 years. Prostate spesific antigen levels ranged from 2.8 to 114.0ng/mL(mean:14.8±16.7). The mean number of cores biopsied was 10.9±3.1. Number of patients in low, intermediate and high risk group were 27(30.3%), 34(38.2%) and 28(31.5%) respectively. The coherence, upgrading and downgrading rates according to International Society of Urological Pathology grading were 49.4%, 33.7% and 16.9% respectively. The low risk prostate cancer group showed the most coherent pathologies with the rate of 70.4%(p<0.05, both for International Society of Urological Pathology grading and Gleason scoring). There was no significant relation between prostate spesific antigen level, number of cores biopsied, percentage of cancer involvement, presence of perineural invasion coherence, upgrading and downgrading. Also no significant difference found between coherent, upgrading and downgrading pathologies with respect to the time to radical prostatectomy. Conclusion: The incoherence between prostate biopsy and radical prostatectomy is challenging. Risk of upgrading and downgrading should be considered in decision making. Low risk prostate cancer shows the most coherent pathology between prostate biopsy and radical prostatectomy.

scholarly journals The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Balázs Sági ◽  
István Késői ◽  
Tibor Vas ◽  
Botond Csiky ◽  
Judit Nagy ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Heart Rate ◽  
Iga Nephropathy ◽  
Heart Rate Recovery ◽  
Stress Test ◽  
Prognostic Role ◽  
Cox Regression Analysis ◽  
Ckd Stage ◽  
Significant Difference

Abstract Background Cardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients. Methods One hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1–4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal). Results Patients with reduced HRR (< 23 bpm) had significantly more end point events (22/62 patients vs. 9/53 patients, p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012). Conclusion Our results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.

scholarly journals Role of cytohormonal study in normal pregnancy and in threatened abortion

2018 ◽  
Vol 7 (5) ◽  
pp. 1735
Author(s):  
Shailesh B. Patil ◽  
Milind B. Patil
Keyword(s):  
Normal Pregnancy ◽  
Fetal Outcome ◽  
Control Group ◽  
Vaginal Smear ◽  
Age Group ◽  
Number Of Patients ◽  
Significant Difference ◽  
Parity Number ◽  
Threatened Abortion

Background: It is certain from clinical experience of many that one or more hemorrhages in early pregnancy can still end up in good fetal outcome. So, our study deals with comparison of cytohormonal study in pregnancy and threatened abortion. The study was conducted with the aim of utilizing colpocytogram as a tool in assessing and treating cases of threatened abortion and comparing them with normal pregnant women.Methods: Patients attending antenatal care unit on outdoor basis and labelled as normal pregnancy cases were considered as control group. The patients of threatened abortion were studied when they were admitted in Gynecology department for indoor treatment. Patients were studied taking into consideration their age, parity, number of abortions, complaints (P/V bleeding, pain in abdomen), gestational age, per abdomen and per vaginal findings and also USG findings and vaginal smear pattern.Results: Maximum number of patients was present in the age group of 21-25 years in both the groups. While only 13.33% had normal smear pattern in threatened abortion group. 86.67% patients in threatened abortion group showed abnormal smear pattern. There is statistically significant difference was found (p<0.05). There is statistically significant was found (P<0.01) and indicates good effects of the drug on the vaginal epithelium.Conclusions: The cytohormonal study acts as a simple, reliable, good, noninvasive method for evaluation of hormonal pattern in normal pregnancy and threatened abortion. 

scholarly journals Varicocele treatment: A 2-centers comparison between non microsurgical open correction, laparoscopic approach and retrograde percutaneous sclerotization on 463 cases

2013 ◽  
Vol 85 (3) ◽  
pp. 143 ◽  
Author(s):  
Giangiacomo Ollandini ◽  
Giovanni Liguori ◽  
Stanislav Ziaran ◽  
Tomáš Málek ◽  
Giorgio Mazzon ◽  
...  
Keyword(s):  
Sperm Count ◽  
Laparoscopic Approach ◽  
Sperm Parameters ◽  
Age Related ◽  
Number Of Patients ◽  
Significant Difference ◽  
Bivariate Regression ◽  
Open Surgical Procedure ◽  
Bivariate Regression Analysis

Objectives: To determine whether there are differences in sperm parameters improvement after different varicocele correction techniques. To determine the role of age in sperm parameters improvement. Methods: 2 different European centers collected pre- and postoperative sperm parameters of patients undergoing varicocele correction. Among 463 evaluated patients, 367 were included. Patients were divided in procedure-related and age-related groups. Ivanissevich inguinal open surgical procedure (OS), lymphatic-sparing laparoscopic approach (LSL) and retrograde percutaneous transfemoral sclerotization (RPS) were performed. As outcome measurements sperm count (millions/mL, SC) and percentage of mobile sperms were analyzed. Univariate and multivariate regression between the defined groups; bivariate regression analysis between age and sperm count and motility. Results: Number of patients: OS 78; LSL 85; RPS 204. Mean age 30.2 (SD 6.83); postoperative SC increased from 18.2 to 30.1 (CI 95% 27.3-32.9; p &lt; 0,001); motility from 25.6 to 32.56% (30.9-34.2; p &lt; 0.001). OS: SC varied from 16.9 to 18.2 (p &lt; 0.001); sperm motility from 29% to 33% (p &lt; 0.001). LSL: SC from 15.5 to 17.2 (p &lt; 0.001); motility from 27 to 31% (p &lt; 0.001). RPS: SC from 18.9 to 36.2 (p &lt; 0.001); motility from 24% to 32% (p &lt; 0.001). Univariate and multivariate analysis confirmed the significant difference of SC variation in RPS, compared to the other groups (p &lt; 0.001). No significance between LSL and OS (p = 0.826). No significant differences regarding motility (p = 0.8). Conclusions: Varicocele correction is confirmed useful in improving sperm parameters; sclerotization technique leads to a better sperm improvement compared to other studied procedures; improvement in seminal parameters is not affected by age of the patients treated.

scholarly journals The Role of HE4 in Ovarian Cancer Follow-up: A Review

2014 ◽  
Vol 24 (8) ◽  
pp. 1359-1365 ◽  
Author(s):  
Elisa Piovano ◽  
Lorenza Attamante ◽  
Chiara Macchi ◽  
Camilla Cavallero ◽  
Cesare Romagnolo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Recurrence ◽  
Ca 125 ◽  
Prognostic Role ◽  
Independent Predictive Factor ◽  
Secondary Cytoreductive Surgery ◽  
Number Of Patients ◽  
Predictive Role

ObjectiveThe aim of this review was to analyze the state of the art about HE4 and follow-up in patients treated for ovarian cancer.MethodsA literature search was conducted in the MEDLINE database using the key words “HE4” and “ovarian cancer” and “recurrence” or “relapse” or “follow up.”ResultsSeven of 28 clinical studies were selected. Four studies were prospective, and all of them were based on a small number of patients (8–73 women). A failure of HE4 levels to normalize at completion of standard therapy may indicate a poor prognosis, thus suggesting the need of a closer follow-up. Moreover, HE4 showed better sensibility and specificity in the diagnosis of ovarian cancer recurrence with respect to CA-125, being also an earlier indicator of the relapse with a lead time of 5 to 8 months. HE4 showed a better performance in this setting if performed in association with other markers (CA-125, CA-72.4). HE4 seems to be an independent predictive factor for the surgical outcome at secondary cytoreductive surgery and to maintain its prognostic role even after the recurrence.ConclusionsThese preliminary data start to suggest a superiority of HE4 over CA-125 in the detection of ovarian cancer recurrence. Moreover, the prognostic role of HE4 could help clinicians to personalize the follow-up program, whereas its predictive role could be useful to plan the treatment of the relapse. The role of HE4 in ovarian cancer follow-up deserves to be further investigated in prospective randomized multicentric studies.

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