Prognostic Value of Tumour Size in Colon Cancer – Smaller is Better?

Background: The prognostic value of tumour size in colon cancer remains controversial. This study aimed to reveal the correlation between tumour size and prognosis of colon cancer.Methods: A total of 498 patients with colon cancer were included in this study. The correlation of tumour size with prognosis, mismatch repair status and other clinicopathological characteristics as well as tumour microenvironment was analysed.Results: For stage IIA microsatellite stable (MSS) colon cancer, tumours sized <3.5 cm and ≥5 cm were associated with a poorer disease free survival (DFS) compared with tumours sized between 3.5 and 5 cm (p=0.002). Small tumour size (HR=5.098, p=0.001) and large tumour size (HR=2.749, p=0.029) were found to be independent prognostic factors for stage IIA MSS colon cancer. Moreover, high expression of transgelin (TAGLN), a marker of cancer-associated fibroblasts (CAFs), was found to be an independent prognostic factor for poorer DFS (HR=9.651, p=0.009), which was also associated with smaller tumour size (p=0.027).Conclusion: Small (<3.5 cm) and large (≥5 cm) tumour sizes are associated with decreased DFS in stage IIA MSS colon cancer. Enrichment of TAGLN+ CAFs is associated with decreased DFS and small tumour size.

Risk factors for the local recurrence of giant cell tumours of the sacrum treated with nerve-sparing surgery

Aims There is a lack of evidence about the risk factors for local recurrence of a giant cell tumour (GCT) of the sacrum treated with nerve-sparing surgery, probably because of the rarity of the disease. This study aimed to answer two questions: first, what is the rate of local recurrence of sacral GCT treated with nerve-sparing surgery and second, what are the risk factors for its local recurrence? Methods A total of 114 patients with a sacral GCT who underwent nerve-sparing surgery at our hospital between July 2005 and August 2017 were reviewed. The rate of local recurrence was determined, and Kaplan-Meier survival analysis carried out to evaluate the mean recurrence-free survival. Possible risks factors including demographics, tumour characteristics, adjuvant therapy, operation, and laboratory indices were analyzed using univariate analysis. Variables with p < 0.100 in the univariate analysis were further considered in a multivariate Cox regression analysis to identify the risk factors. Results The rate of local recurrence of sacral GCT treated with nerve-sparing surgery was 28.95% (33/114). Multivariate Cox regression analysis showed that large tumour size (> 8.80 cm) (hazard ratio (HR) 3.16; 95% confidence interval (CI) 1.27 to 7.87; p = 0.014), high neutrophil-to-lymphocyte ratio (NLR) (> 2.09) (HR 3.13; 95% CI 1.28 to 7.62; p = 0.012), involvement of a sacroiliac joint (HR 3.09; 95% CI 1.06 to 9.04; p = 0.039), and massive intraoperative blood loss (> 1,550 ml) (HR 2.47; 95% CI 1.14 to 5.36; p = 0.022) were independent risk factors for local recurrence. Conclusion Patients with a sacral GCT who undergo nerve-sparing surgery have a local recurrence rate of 29%. Large tumour size, high NLR, involvement of a sacroiliac joint, and massive intraoperative blood loss are independent risk factors. Cite this article: Bone Joint J 2020;102-B(10):1392–1398.

Untreated Giant Ameloblastoma of Jaw - Diagnostic and Management Dilemma

Ameloblastoma is a benign locally aggressive odontogenic epithelial neoplasm. It is slow growing tumour and mostly of benign behaviour. The most frequent location is at lower molar region and rarely involve upper jaw or maxillary sinus. Patients are usually asymptomatic until reaching a certain large size. Delayedtreatment is relatively common in our society. Patients mostly seek for treatment when a large tumour size is achieved. Herein we report a case due to its rarity, giant size, imaging challenge and management, which involves radical resection and free flap reconstruction.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 313-318

Breast cancer incidence: Decreasing trend in large tumours in women aged 50–74

Objective A decrease in advanced breast cancer incidence is considered an early indicator of breast cancer mortality reduction in a screening programme. We describe trends in breast cancer incidence according to tumour size and age in three French administrative areas, where an organized screening programme was implemented during the 1990s. Methods Our study included all 28,092 invasive breast cancers diagnosed from 2000 to 2010 in women living in three areas (Hérault, Isère, Loire-Atlantique). Age, year of diagnosis, and size of tumour at diagnosis was provided by the three area cancer registries. Poisson regression models were fitted to estimate changes in incidence over time, after adjustment for age and administrative area. Results From 2000 to 2010, the incidence rate of large (tumour size >20 mm) breast cancer linearly decreased in women aged 50–74 (target age of the screening programme) from 108.4 to 84.1/100,000 (annual percent change = −1.9%, p < 0.001). No change in large breast cancer incidence rate was found in women aged 20–49, or older than 74. Conclusions A decreasing trend in incidence of large tumour size breast cancer in the target age of the screening programme is demonstrated for the first time in France. The overall 20.9% linear decrease over 11 years in these three areas is encouraging and should be closely monitored and extended to other areas of France, where the screening programme was generally implemented only in 2004.

Primary pure carcinoid tumour of the testis: A case report and review of the literature

Primary testicular carcinoid tumours (TCT) are very rare, and a large tumour size and the presence of carcinoid syndrome predict a malignant course. Histologically, it is difficult to differentiate between benign and malignant TCTs. We report a case of a primary pure TCT with an unusual presentation in a 23- year-old man, who had an asymptomatic, enlarged scrotum on the right side for 7 years. On gross examination, the tumour was 9.6 cm in diameter. The Ki-67 labelling index was 19.8%. High inguinal orchidectomy was performed, and 30 months after surgery the patient remains asymptomatic.