Prognostic Role of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in the Survival of Patients with Esophageal Cancer

Background: Different factors can affect the future of a person with cancer. The patient’s systemic inflammatory response is an important factor. Several inflammatory markers have been evaluated for measuring the patient’s response to cancer. We evaluated neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as prognostic factors for survival in patients with pathologically proven esophageal cancer. Methods: In this retrospective cohort study, patients with pathologically approved esophageal cancer, who underwent surgical treatment in the cancer institute of Iran, were included. Demographic, pathological, and laboratory data of patients were obtained from the archive of medical records. Results: In this study, 135 patients with esophageal cancer with a mean age of 60 were studied. The median time of the follow-up period was 21 months. Mean NLR and PLR were 7.05 and 898, respectively. Patients’ survival had a significant relationship with their age, gender, tumor differentiation, receiving chemotherapy, absolute neutrophil count, total bilirubin, direct bilirubin, and NLR. Conclusion: According to the results, in a multivariable investigation, it was demonstrated that a high NLR has a direct effect on patients’ poor survival.

Preoperative Axillary Ultrasound-guided Wire Localization and Lymphoscintigraphy for Sentinel Lymph Node Biopsy in Breast Cancer Patients

Background: Breast cancer has the highest incidence and mortality among female malignant tumors. Breast cancer with negative axillary lymph nodes has been diag- nosed mainly at an early stage. Sentinel lymph node biopsy (SLNB) is a standard screening technique for patients with early-stage breast cancer and clinically nega- tive lymph nodes. Lymphoscintigraphy (sentinel lymph node mapping) has been reg- ularly used as the standard method for SLNB. Today, ultrasound-guided wire locali- zation (USGWL) is a well-established technique with superior outcomes. Therefore, we attempted to determine whether preoperative UGWL and lymphoscintigraphy (blue dye and isotope injection) improve SLN detection and false-negative rate in breast cancer patients undergoing SLNB and identify clinical factors that may affect the diagnostic accuracy of axillary ultrasound (AUS). Methods: Between December 2018 and June 2019, 55 patients with clinical T1- 3N0 breast cancer eligible for an SLNB at Imam Khomeini Hospital in Tehran were included in our study. Tumor characteristics and demographic data were collect- ed by reviewing medical records and questionnaires prepared by our surgical team. The day before SLNB, all patients underwent ultrasound-guided wire localization of SLN. Lymphoscintigraphy was performed with an unfiltered 99mTc-labelled sulfur colloid peritumoral injection followed by methylene blue dye injection. The results were analyzed based on the permanent pathology report. Results: Among the 55 patients, 71.8% of SLNs were detected by wire localization, while 57.8% were found by methylene blue mapping and 59.6% by gamma probe detection. Compared with wire localization and isotope injection, the methylene blue dye technique had a low sensitivity (72.2%), while both wire localization and isotope injection reached 77.8%. The sensitivity, specificity, and accuracy of UGWL were 77.8%, 42.1%, and 65.4%, respectively. Otherwise, methylene blue dye and isotope injection accuracy was 47.3% and 50.1%, respectively. Furthermore, there was a significant relationship between BMI, tumor size, laterality, reactive ALN, and the accuracy of preoperative AUS. But there was no significant correlation between age, weight, height, tumor biopsy, tumor location, the time interval between methylene blue dye and isotope injection to surgery, and also the type of surgery to the accuracy of preoperative AUS. Conclusion: Preoperative UGWL can effectively identify SLNs compared to lym- phoscintigraphy (blue dye and isotope injection) in early breast cancer patients un- dergoing SLNB.

Fibrolamellar Hepatocellular Carcinoma: Report of a Rare Case with Rapid Progression and Unusual Metastatic Sites

Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare primary liver cancer that occurs in young adults, and its biology is not well known. We present a 21-year-old woman with metastatic liver cancer 6 months after undergoing embolization procedures for a typical hemangioma. The pathological investigation confirmed metastatic FLHCC. Despite liver mass resection and lung metastasectomy, after 3 months, the tumor recurred. In 18F-FDG PET-CT scan, lung, ovary, colon, and peritoneal invasions were reported. Unfortunately, the patient died a year after diagnosis due to a rapid progression and multiple unusual metastatic sites.

The Role of Cancer Charities in Breast Cancer Prevention in Iran

Background: Cancer is a significant public health problem, and its burden is increasing globally, especially in low- and middle-income countries. Cancer charities, alongside the government, could address health issues based on their goals. We studied the activities of cancer charities related to breast cancer (BC) prevention in Iran. Methods: We designed a situational analysis study. We abstracted the cancer charities’ objectives that were members of the “Iran Cancer National Network of NGOs and Charities (IRCNNC).” We also searched for their international activities. We reviewed the BC prevention programs conducted by Iranian cancer charities and collected their data and information regarding BC awareness and screening. Results: Overall, 43 charities were an active member of the IRCNNC and were engaged in 6 areas, including 1) financial and non-financial supports, 2) providing medical services, 3) providing accommodation to companions of the patients traveling from other cities, 4) supplying infrastructure and medical equipment to cancer hospitals, 5) conducting scientific and research activities, and 6) running educational and awareness campaigns. Most actions were on financial and non-financial supports. Seven charities are a member of the Union for International Cancer Control (UICC). Five charities reported their movement on BC prevention. Conclusion: Most charities did not document their prevention programs and did not follow an organized screening program. Training and capacity building is needed to support the cancer charities for the evidence-based cancer prevention program.

Cancer Statistics in I.R. Iran in 2020

The article's abstract is not available.

A Study on the Relationship Between Tumor Size, Tumor Grade and Lymph Node Involvement in Canine Mammary Cancer: Simulation of Tumor Behavior in Human Breast Cancer

Background: In the last two decades, canine mammary cancer has played an essential role in human breast cancer research. There are various similarities between biological and clinical features of canine breast cancer and female breast cancer in many cases. Clinical studies and evaluation of prognostic factors in canine mammary cancer can increase reliability in generalizing results to human cancers. This study was performed in the direction of comparative oncology. Methods: We collected clinicopathological data of an invasive type of canine mammary carcinoma from clinical records and pathology reports. Age, tumor laterality, tumor size, lymph node status, and tumor grade were recorded, and the relationships between the parameters were evaluated using linear regression analysis. Results: Ninety-seven patients were included in the study, and the mean age was 10.06 ± 2.73 years. The left mammary gland was involved in 51% of cases, and pT2 was the most common tumor size. Lymph nodes were involved in 27% of patients, and 43% of tumors were grade I. Statistical analysis showed no relationship between tumor size and laterality with other clinicopathological features. However, there was a statistically significant relationship between tumor size and tumor grade, and lymph node status. As the tumor size increased, tumor grade and the risk of lymph node involvement raised. Conclusion: Similar results of this study to breast cancer in women show that canine mammary carcinoma is a suitable model in comparative oncology research. Dogs live shorter than humans so that researchers can get the results of treatment and perform survival rate assessments faster in clinical trials. By considering ethical principles, dogs with breast cancer may replace phases I and II of human clinical trials in some cancer types soon.

The Effects of Individual Diet Therapy on Food Intake, Quality of Life, and Related Serum Proteins in Patients with Breast Cancer: A Randomized Clinical Trial

Background: In cancer patients, weight loss due to malnutrition has a significant impact on the patients’ treatment and quality of life. This study aimed to determine the appropriate therapeutic strategy to control the side effects of chemotherapy in patients with breast cancer to improve their health, quality of life, and nutritional status. Methods: In our prospective study, we examined gastric cancer patients who were Seventy patients undergoing chemotherapy were included and randomly divided into intervention (n=35) and control groups (n=35). The intervention group received an individualized diet according to their nutritional needs for eight weeks, and the control group received dietary advice on the side effects of chemotherapy. Malnutrition, nutritional barriers, and patients’ quality of life were evaluated by PG-SGA, nutritional barriers, and QLQ-C30 questionnaires. Serum proteins were also assessed at the beginning and the end of the study. Results: The patients’ mean age was 50.91±1.72 years in the intervention group and 51±1.35 in the control group. According to the PG-SGA questionnaire classification, 68.5% of patients had malnutrition at baseline. In the intervention group, the mean score of PG-SGA decreased, which indicated an improvement in patients’ nutritional status. Increased scores in the functional section of QLQC30 and a decrease in the symptom section of this questionnaire indicated the improved quality of life in patients undergoing treatment at the end of the intervention. Albumin (P<0.001) and hemoglobin (P<0.001) levels increased in the intervention group, while there were no significant changes in these variables of the control group. Serum levels of ferritin did not show significant changes in either the intervention or the control group. Conclusion: Identifying nutritional barriers in breast cancer patients and individual diet therapy based on these barriers and nutritional needs reduces nutritional barriers. Consequently, malnutrition would decline, and the quality of life may enhance in these patients.

Giant Cell Variant of Glioblastoma Multiforme: Report of a Rare Variant in a Child

Malignant glial tumors are rare in children. Giant cell variant is a rare subtype of glioblastoma, accounting for about 0.8% of brain tumors and 5% of glioblastoma tumors. Giant cell glioblastoma is a male predominant tumor in children and adults. Due to the low prevalence of this variant, available information is limited. An 11-year-old female child was referred with a chief complaint of a progressive persistent headache. MRI showed a well-defined cystic lesion with a solid mural component in the right parietal lobe with a compression effect on the ipsilateral ventricular system. Surgery was done. After the pathologist reported glioblastoma multiforme, a giant cell variant, the patient received 30 sessions of radiation therapy. The patient was readmitted 18 months later with a headache, and the pathologist confirmed the recurrence of the tumor. Based on radiology, the giant cell glioblastoma cannot be distinguished from the common subtype glioblastoma. The pathologists must be aware of this entity, and histologic differential diagnoses are warranted for diagnostic, prognostic, and therapeutic purposes.

Evaluation of Different Types of Pain in Patients with Breast Cancer

Background: Cancer, a common disease in the world, is considered the second cause of mortality in developed countries. In the management of symptoms created by breast cancer (BC), pain is the most important. So, this study aimed to evaluate different dimensions of pain in patients using the McGill Pain Questionnaire. In this way, physicians could perform effective treatment for patients. Methods: This case study was done on BC patients aged 30-60 years old in some specialized cancer hospitals in Tehran. The utilized research instrument in this study was the McGill Pain Questionnaire. Data were analyzed by SPSS Software. Conclusion: According to these results, it is possible to use effective and better treatment to reduce BC patients’ pain.

Evaluation of Peritoneal Lavage for Gastric Cancer Staging in Patients Without Ascites Based on Cytology and Carcinoembryonic Antigen

Background: Imaging, cytological examination of ascites (if present), laparosco- py, and peritoneal lavage are performed before surgery for gastric cancer staging. Peritoneal lavage aims to diagnose the microscopic presence of tumor cells on the peritoneal surface. Positive cytology may have a prognostic value that classifies the disorder as stage IV, in which the patient is no longer an elective surgical candidate. Thus, our study was designed to assess the ability of peritoneal lavage to stage gastric cancer in non-ascitic patients based on cytological evaluation and carcinoembryonic antigen (CEA) level measurement. Methods: In our prospective study, we examined gastric cancer patients who were candidates for elective surgery. Upon entering the abdominal cavity and before tu- mor manipulation, normal saline (500 ml) was applied, and the abdominal cavity was thoroughly dispersed. After three minutes, the fluid was drained and addressed to cytological analysis and CEA measurement by radioimmunoassay (RIA). Study var- iables including age, sex, family history, tumor position, pathology, staging, grading, the original tumor size, regional lymph node involvement, and distant metastases were recorded during the pre- and postoperative staging. The association between positive peritoneal lavage cytology and various patients’ characteristics was investigated. Results: In this study, 94 patients were screened. Due to lymphoma and gastrointes- tinal stromal tumor (GIST), two patients were excluded. We examined 92 patients, including 63 males (68.5 %) and 29 females (31.5 %). The mean age of patients was 58.52 ± 11.87 years. The most common tumor location was the esophagogastric junction. Moderately differentiated adenocarcinoma was the most frequent micro- scopic diagnosis. T3 was the most prevalent primary tumor size in 51 patients. Sev- enty-two patients (78.26%) were operable, of whom 18 (19.6 %) were positive for peritoneal lavage cytology. Positive cytology of peritoneal lavage was significantly related to tumor size, tumor grade, serosa/adjacent organ invasion (T4), laparoscopic staging findings, locally advanced disease (R0), and stage of the disease (P < 0.05). In the peritoneal lavage fluid, elevated CEA titers were significantly related to the high-grade tumor (P = 0.012). Conclusion: Our study demonstrated that positive cytology and high CEA titers in peritoneal lavage fluid of gastric cancer patients without ascites are significantly correlated to the advanced stages.