Prognostic Relevance of Thyroid-Hormone-Associated Proteins in Adenoid Cystic Carcinoma of the Head and Neck

The proteins sodium iodide symporter (NIS), μ-crystallin (CRYM), and thyroid hormone receptor beta (THRB) have been associated with prognosis in various cancer entities. While NIS and THRB may serve as possible therapeutic targets, the role of CRYM in cancer is still unclear. Protein levels of 44 patients with adenoid cystic carcinoma of the head and neck were analyzed using immunohistochemistry and correlated with clinicopathological data and outcome. NIS was positive in 72%, CRYM was positive in 55%, and THRB was positive in 39% of the patients. CRYM-positive adenoid cystic carcinomas were associated with a better cause-specific survival. Thus, our data indicate that CRYM might be a suitable positive prognostic marker in adenoid cystic carcinoma of the head and neck. Furthermore, expression of NIS was present in most patients and therefore evaluation of the use of radioiodine treatment is recommended.

Association Between the Extent of Resection and Prognosis in Adult Patients With WHO Grade III Gliomas: a Population-based Study

PurposeThe role of surgical resection in the treatment of anaplastic glioma is poorly understood. The aim of the present retrospective study was to clarify the survival of patients with anaplastic gliomas.MethodsWe utilized the SEER database to assess the association between prognostic and demographic data, tumor characteristics, and treatment factors in adult patients with anaplastic glioma. Overall survival and cause-specific survival were analyzed using multivariable Cox regression and competing risk regression, respectively.ResultsA total of 3979 patients with anaplastic glioma who had undergone surgical intervention were included in the analysis. Patients who underwent gross total resection (GTR) had significantly better 5-year and 10-year overall survival (OS) (59.9% vs. 44.0%, 45.0% vs. 29.4%, p < 0.001) than those who did not. The 5-year and 10-year cumulative incidence rates of cancer-specific death in the GTR group were lower than those in the corresponding N-GTR group (36.6% vs.51.9%, 49.9% vs. 65.5%, p < 0.001). Multivariable analysis identified GTR as an independent significant predictor for prolonged OS (HR:0.72; 95% confidence interval [CI] 0.65-0.79, P<0.05) and cause-specific survival (CSS) (HR:0.72, 95% CI 0.65-0.80, P<0.05).Further subgroup analysis revealed a stable association between the extent of resection and OS (P values for interaction >0.05), except for tumor location and histologic type groups.ConclusionsWhile the survival of patients with anaplastic glioma remains poor, GTR is associated with increased OS and CSS compared to N-GTR.

Comparing Prognosis Associated with Partial Cystectomy and Trimodal Therapy for Muscle-Invasive Bladder Cancer Patients

<b><i>Objective:</i></b> This study aimed to compare the survival outcomes between trimodal therapy (TT) and partial cystectomy (PC) in muscle-invasive bladder cancer (MIBC) patients. <b><i>Methods:</i></b> The data of 13,096 patients with MIBC diagnosed between 2004 and 2015 were retrieved from the Surveillance, Epidemiology, and End Results database. Among them, 4,041 patients underwent TT and 1,670 patients underwent PC. Propensity score matching was performed to balance the characteristics between the 2 treatment groups. A multivariate Cox regression analysis model and a competing risk model were used to evaluate overall survival (OS) and cancer-specific survival. Cumulative incidence survival curves were obtained using the Kaplan-Meier method. <b><i>Results:</i></b> Results of multivariate Cox analysis before propensity score matching showed that the TT group had a 31% reduction in cause-specific survival relative to the PC group (HR: 0.69, 95% CI: 0.61–0.78, <i>p</i> &#x3c; 0.001) and a 28% reduction in OS (HR: 0.72, 95% CI: 0.66–0.79, <i>p</i> &#x3c; 0.001). After propensity score matching, the 2 groups yielded 972 patients, with 3-year cause-specific survival rates of 54.1% and 68.5% in the TT group and the PC group, respectively. <b><i>Conclusions:</i></b> Patients who underwent PC had a better prognosis than those who received TT. In addition, for MIBC patients who required bladder-sparing therapy, advanced age (≥80 years), pathological type of squamous cell carcinoma, and tumor stage of T3–4, N2–3, and M1 were independent poor prognostic factors.

333 THE LONG-TERM TREATMENT OUTCOMES OF ESOPHAGEAL SCC WITH MM/SM1 INVASION AFTER ENDOSCOPIC RESECTION

Resent advances in endoscopic resection (ER) provide us increasing chances for resecting esophageal SCC with muscularis mucosae (MM) and submucosal (SM) invasion. We perform additional therapy such as chemoradiotherapy (CRT) or esophagectomy considering the risk of metastasis and patient’s condition. However, there is only a few reports about long-term outcome after ER for such cases. Methods We retrospectively studied 188 case of esophageal SCC with pathological MM invasion resected by ER (161 cases) and SM1(27 cases) from 2005 to 2016 in Cancer Institute Hospital. We recommended CRT or esophagectomy as additional treatment for the cases which had lymphovascular invasion (LVI) or DI (droplet infiltration) considering patients’ conditions. Median observation period of them were 71 months. Results The SM1 cases had significantly higher rate of LVI than the MM cases. Of 161 MM cases, 2 cases had recurrence, however, they are alive after CRT or CRT following esophagectomy. Of 27 SM1 cases, 3 cases had LN recurrence, underwent RT or CRT or CRT following esophagectomy, one case died of esophageal SCC and the others survive. The rate of metastatic cases was higher in SM1 than that in MM. Overall survival rate in 5 years were 89.8% in MM and 81.8% in SM1. Cause specific survival rate in 5 years were 100% in both MM and SM1. Conclusion The long-term outcomes of ER for MM/SM1 invasive esophageal SCC was good with appropriate additional therapy which we should perform in high risk cases for LN metastasis considering patients’ condition.

Patterns of Lymph Node Metastasis in Patients With T1/T2 Gastroduodenal Neuroendocrine Neoplasms: Implications for Endoscopic Treatment

Guidelines have differed in their opinion regarding the indications for endoscopic resection of gastric-neuroendocrine neoplasms (g-NENs) and duodenal-NENs (d-NENs). We examined the association between size and lymph node metastasis (LNM) to identify candidates most suitable for endoscopic resection. We identified 706 patients with T1/T2 g-NENs and 621 patients with T1/T2 d-NENs from the SEER database. The prevalence of LNM and risk factors associated with LNM were analyzed. LNM was present in 8.1% of patients with gastroduodenal neuroendocrine tumors (NETs) and 31.6% of patients with neuroendocrine carcinomas (NECs). Multivariate logistic regression indicated that tumor size &gt;10mm, greater invasion depth, and poor differentiation were independently associated with LNM. In addition, the percentage of g-NETs invading submucosa with LNM increased with tumor size (≤10 mm,3.9%;11–20 mm,8.6%;&gt;20 mm,16.1%). However, in contrast to the low LNM risk in patients with small g-NETs (≤10 mm), we found that LNM rate exceeded 5% even for patients with small submucosal-infiltrating d-NETs. Among patients with nodal-negative g-NETs, the cause specific survival (CSS) was similar for those who received surgical resection and endoscopic resection. Among patients with d-NETs, the CSS was better for those who received endoscopic resection. In conclusion, patients with d-NETs had a higher probability of LNM than those with g-NETs. Endoscopic resection can be utilized for curative treatment of submucosa-infiltrating g-NETs and intramucosal d-NETs when the size is 10 mm or less. These results reinforce the need to search for LNM in lesions that are larger than 10 mm.