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BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Benyamin Hoseini ◽  
Zahra Rahmatinejad ◽  
Ladan Goshayeshi ◽  
Robert Bergquist ◽  
Amin Golabpour ◽  
...  

Abstract Background The incidence rate of colorectal cancer (CRC) is increasing among patients below 50 years of age. The reason for this is unclear, but could have to do with the fact that indicative variables, such as tumour location, gender preference and genetic preponderance have not been followed up in a consistent mann er. The current study was primarily conducted to improve the hereditary CRC screening programme by assessing the demographic and clinicopathological characteristics of early-onset CRC compared to late-onset CRC in northeast Iran. Methods This retrospective study, carried out over a three-year follow-up period (2014–2017), included 562 consecutive CRCs diagnosed in three Mashhad city hospital laboratories in north-eastern Iran. We applied comparative analysis of pathological and hereditary features together with information on the presence of mismatch repair (MMR) gene deficiency with respect to recovery versus mortality. Patients with mutations resulting in absence of the MMR gene MLH1 protein product and normal BRAF status were considered to be at high risk of Lynch syndrome (LS). Analyses using R studio software were performed on early-onset CRC (n = 222) and late-onset CRC (n = 340), corresponding to patients ≤50 years of age and patients > 50 years. Results From an age-of-onset point of view, the distribution between the genders differed with females showing a higher proportion of early-onset CRC than men (56% vs. 44%), while the late-onset CRC disparity was less pronounced (48% vs. 52%). The mean age of all participants was 55.6 ± 14.8 years, with 40.3 ± 7.3 years for early-onset CRC and 65.1 ± 9.3 years for late-onset CRC. With respect to anatomical tumour location (distal, rectal and proximal), the frequencies were 61, 28 and 11%, respectively, but the variation did not reach statistical significance. However, there was a dramatic difference with regard to the history of CRC in second-degree relatives between two age categories, with much higher numbers of family-related CRCs in the early-onset group. Expression of the MLH1 and PMS2 genes were significantly different between recovered and deceased, while this finding was not observed with regard to the MSH6 and the MSH2 genes. Mortality was significantly higher in those at high risk of LS. Conclusion The variation of demographic, pathological and genetic characteristics between early-onset and late-onset CRC emphasizes the need for a well-defined algorithm to identify high-risk patients.


2021 ◽  
pp. 201010582110507
Author(s):  
Muhammad Syafiek Mohd Razali ◽  
Muhammad Amin Ibrahim ◽  
Adli Azam Mohammad Razi ◽  
Mohammed Fauzi Abdul Rani

We present a 70-year-old gentleman with chronic cough with haemoptysis found to have left lower zone collapse on imaging. The bronchoscopy showed an endobronchial mass histologically of a non-secreting atypical carcinoid. Poor baseline lung function excluded surgical resection, and instead, he successfully underwent a bronchoscopic debulking procedure which improved his FEV1 to 84% and DLCO 83% predicted. Unfortunately, the tumour regrew, but the calculated percentage predicted postoperative for FEV1 (64%), and DLCO (65%) enabled definitive surgical resection to take place. Surgical resection remains the definite curative option for localised endobronchial atypical carcinoid tumours. Achieving this in proximal endobronchial carcinoid tumour is a challenge. We described an endoscopic tumour debulking procedure as a bridge for curative surgical resection in a patient with an inoperable proximal atypical carcinoid tumour due to poor predicted postoperative lung function. We highlighted the need to assess predicted postoperative lung function with functional and quantitative perfusion methods to aid surgical planning. Debulking the tumour by endoscopy can be used as a conduit to curative surgical resection in bronchial carcinoid tumour. The choice of calculating the percentage predicted values by either or both methods must be individualised based on tumour location and the probability of converting a lobectomy to a pneumonectomy. This precautionary approach could evaluate the postoperative lung function and morbidity and mortality risk if considering a pneumonectomy. Endoscopic debulking can be a successful bridge to a curative surgical resection aided by comprehensive preoperative lung function tests to predict postoperative lung values


2021 ◽  
Author(s):  
Thomas Layton

AbstractBasal cell carcinoma (BCC) is the most common malignancy in humans. Incomplete excision following conventional surgical excision requires careful consideration given the potential for disease recurrence. We performed a retrospective study analyzing facial BCC treated by conventional surgical excision to investigate factors influencing the likelihood of tumour clearance. In total, 456 cases of facial BCC were reviewed to collect a dataset of 50 tumours with involved margins and these compared to 50 completely excised tumours from the same cohort. Statistical comparison between incomplete and complete excision cases was performed using several metrics including tumour location, histology, grade, surgeon experience and method of wound reconstruction. Interestingly, our results demonstrated that only tumour location and histological type had a statistically significant impact on the completeness of resection. Infiltrative, morphoeic and mixed tumours had a higher chance of incomplete excision, as did tumours located on the inner canthus and ala nasi. In addition, the overall incomplete excision rate was 10.96% in line with previous studies. Our results help inform surgical practice and support consideration of extending the recommended macroscopic surgical margin for higher risk tumours. More research is needed to further categorize facial BCC to optimize surgical management.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Jakub Chmelo ◽  
Maziar Navidi ◽  
Alexander W Phillips ◽  
Alastair Greystoke ◽  
Rhona CF Sinclair

Abstract Background Sarcopenia characterised as a loss of muscle mass and function is prevalent in cancer populations. It is known to occur in patients receiving neoadjuvant treatment and is associated with poorer outcomes. Thus, minimizing sarcopenia may lead to improved patient prognosis. It has been suggested that exercise can reverse and prevent sarcopenia. Little is known as to whether prehabilitation as an intervention to enhance patients’ functional capacity prior to surgery can lead to sarcopenia prevention. Methods Patients enrolled into a prospective prehabilitation study (ChemoFit) during neoadjuvant chemotherapy (NAC) for oesophagogastric adenocarcinoma (OGA) had their radiological sarcopenia measured before and after neoadjuvant chemotherapy (NAC). Radiological sarcopenia and lean body mass (LBM) were measured from computed tomography scans at the level of the L3 vertebra. ChemoFit patients were compared with an historical cohort (NO-PREHAB) which did not undergo prehabilitation and which had their radiological sarcopenia evaluated prospectively prior to and after NAC for OGA. Results Patients in the ChemoFit group were younger compared to the NO-PREHAB group (median age 70 vs 65, p = 0.04). Otherwise there were no differences in gender, BMI, smoking status, comorbidities, tumour location and clinical stage of the disease. Radiological sarcopenia was present prior to NAC in 17/36 (47%) which increased to 26/36 (72%) after NAC amongst ChemoFit patients. Sarcopenia prior to NAC in the NO-PREHAB cohort was 12/28 (43%) which increased to 16/28 (57%) post NAC. Intergroup difference (p = 0.291). Median (IQR) ΔLBM at two time points was in ChemoFit -2.6kg (-5.2;-0.6) and in NO-PREHAB -3.1kg (-4.7;-1.0) (p = 0.730). Conclusions Radiological sarcopenia increased in both groups during NAC for OGA. Prehabilitation did not prevent this from happening. Other strategies must be explored in order to mitigate against sarcopenia.


2021 ◽  
Vol 14 (12) ◽  
pp. e246889
Author(s):  
Masaya Suematsu ◽  
Shigeki Yagyu ◽  
Hajime Hosoi ◽  
Tomoko Iehara

We reported two infantile cases of mediastinal neuroblastoma with life-threatening tracheal obstructions presenting as oncologic emergencies that were successfully treated per tentative risk classification using serum-based MYCN gene amplification (MNA) analysis. Tentative risk stratification based on age, tumour location and serum-based MNA status may be useful in patients with neuroblastoma presenting as oncologic emergencies who require urgent therapy stratification but for whom tumor-based molecular diagnoses cannot be established.


Author(s):  
Saeid Jafarzadeh Ghoushchi ◽  
Ramin Ranjbarzadeh ◽  
Saeed Aghasoleimani Najafabadi ◽  
Elnaz Osgooei ◽  
Erfan Babaee Tirkolaee

Impact ◽  
2021 ◽  
Vol 2021 (8) ◽  
pp. 19-21
Author(s):  
Sachie Kusaka

Boron neutron capture therapy (BNCT) has the potential to kill tumours without harming normal cells and could therefore prove revolutionary in cancer treatment. BNCT is a treatment that focuses on how the chemical element boron has a high likelihood of causing nuclear reactions with neutrons. A key focus for some researchers is the idea that the nuclear reaction of boron occurs in proportion to the number of optimal energy neutrons and the concentration of boron at the tumour location and they believe that if this could be properly harnessed, the treatment would be dramatically improved. Dr Sachie Kusaka, Graduate School of Engineering, Osaka University, Japan, is part of a team of researchers working to improve the effectiveness of BNCT for brain tumour. Kusaka has identified an alternative route to deliver the boron drug BPA efficiently to the brain by avoiding the blood-brain barrier, and named the route "boron cerebrospinal fluid administration method". "Administering the drug into the cerebrospinal fluid could enable more boron to be efficiently delivered to the brain tumour,' says Kusaka.


2021 ◽  
pp. flgastro-2021-101959
Author(s):  
Orouba Almilaji ◽  
Sally D Parry ◽  
Sharon Docherty ◽  
Jonathon Snook

BackgroundFaecal occult blood (FOB) positivity and iron deficiency anaemia (IDA) are common manifestations of colorectal cancer (CRC) and both potentially facilitate diagnosis at an earlier, more treatable stage. It has been assumed that both are the consequence of low-grade blood loss from the tumour bed.MethodA retrospective analysis of 1121 cases of CRC diagnosed at a single centre between 2010 and 2016, comparing cases presenting via FOB-based Bowel Cancer Screening Programme (BCSP) and IDA pathways for a series of variables including age, sex, tumour location and prevalence of anaemia.ResultsThe BCSP and IDA pathways each accounted for about 15% of the total case load. There were significant differences between the BCSP and IDA sub-groups in median age (68 vs 78 years: p<0.001), median haemoglobin (138 vs 89 g/L: p<0.001) and proportion of lesions in right colon (31.1% vs 82.5%: p<0.001). The major disparity in the prevalence of anaemia (overall 20.0% vs 98.2%: p<0.001) persisted when controlled for tumour location.ConclusionParadoxically, CRC screening through the detection of FOB positivity and IDA identifies distinctly different sub-populations of cases. The theoretical implication is that an additional mechanism may be required to explain the development of IDA in CRC. The practical implication is that detection of IDA may have a complementary role to the BCSP in population screening for CRC.


Author(s):  
Omer M. Farhan-Alanie ◽  
Taegyeong Tina Ha ◽  
James Doonan ◽  
Ashish Mahendra ◽  
Sanjay Gupta

Abstract Introduction Limb-sparing surgery with negative margins is possible in most soft tissue sarcoma (STS) resections and focuses on maximising function and minimising morbidity. Various risk factors for surgical site infections (SSIs) have been reported in the literature specific to sarcoma surgery. The aim of this study is to determine whether systemic inflammatory response prognostic scoring systems can predict post-operative SSI in patients undergoing potentially curative resection of STS. Methods Patients who had a planned curative resection of a primary STS at a single centre between January 2010 and December 2019 with a minimum follow-up of 6 months were included. Data were extracted on patient and tumour characteristics, and pre-operative blood results were used to calculate inflammatory prognostic scores based on published thresholds and correlated with risk of developing SSI or debridement procedures. Results A total of 187 cases were included. There were 60 SSIs. On univariate analysis, there was a statistically significant increased risk of SSI in patients who are diabetic, increasing specimen diameter, American Society of Anaesthesiology (ASA) grade 3, use of endoprosthetic replacement, blood loss greater than 1 L, and junctional tumour location. Modified Glasgow prognostic score, C-reactive protein/albumin ratio and neutrophil–platelet score (NPS) were statistically associated with the risk of SSI. On multivariate analysis, ASA grade 3, junctional tumour location and NPS were independently associated with the risk of developing a SSI. Conclusion This study supports the routine use of simple inflammation-based prognostic scores in identifying patients at increased risk of developing infectious complications in patients undergoing potentially curative resection of STS.


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