• Title/Summary/Keyword: Pathologic response

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Pathologic Risk Factors and Oncologic Outcomes in Early-stage Cervical Cancer Patients Treated by Radical Hysterectomy and Pelvic Lymphadenectomy at a Thai University Hospital: A 7 year Retrospective Review

  • Ruengkhachorn, Irene;Therasakvichya, Suwanit;Warnnissorn, Malee;Leelaphatanadit, Chairat;Sangkarat, Suthi;Srisombat, Jutatip
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5951-5956
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    • 2015
  • Background: To evaluate the rate of pathologic high-risk factors, intermediate-risk factors, and treatment outcomes in early-stage cervical cancer patients undergoing radical hysterectomy and pelvic lymphadenectomy (RHPL). Materials and Methods: Medical records of stage IA-IIA1 cervical cancer patients who underwent RHPL during the 2006 to 2012 time period and patient follow-up data until December 2013 were reviewed. Results: Of 331 patients, 52 women (15.7%) had pathologic high-risk factors and 59 women (17.8%) had intermediate-risk factors without high-risk factors. All studied patients had an initial complete response. At median follow-up time of 40.9 months (range 1-103.3 months) and mean follow-up time of$ 43.3{\pm}25.3$ months, 37 women had disease recurrence and 4 women had died of disease. The most common site of recurrence was the pelvis (64.8%). Five-year and 10-year disease free survival rates were 96.1% and 91.5%, respectively. Five-year and 10-year overall survival rates were 100% and 99.4%, respectively. Independent factors related to recurrence were pelvic node metastasis (odds ratio [OR], 2.670; 95%CI, 1.001-7.119), and >1/3 cervical stromal invasion (OR, 3.763; 95%CI, 1.483-9.549). Conclusions: The rates of pathologic high-risk and intermediate-risk factors should be considered and disclosed when counseling patients regarding primary treatment by RHPL. Oncologic outcomes of primary surgical treatment for early-stage cervical carcinoma were found to be excellent.

Nationwide Survey of the Database System on Gastric Cancer Patients (전국 위암 환자 데이터 관리에 관한 설문조사 결과)

  • Yang Han-Kwang
    • Journal of Gastric Cancer
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    • v.4 no.1
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    • pp.15-26
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    • 2004
  • This nationwide survey was conducted to evaluate the current status of the database system on gastric cancer patients in Korea. The Information Committee of Korean Gastric Cancer Association (KGCA) sent questionnaires about the database management to all 402 KGCA members in 110 institutes. In addition, we asked them to send the gastric cancer sheet and the pathologic report of gastric cancer used in their institutes. Response rates were $18.9\%$ (76/402) for individuals and $51.8\%$ (57/110) for institutes, respectively. Most of the university hospitals responded to the questionnaire (response rate of university hospital: $74.6\%$, 44/59). A regular conference of gastric cancer and a digitalization of the database on gastric cancer patients were performed in 29 ($50.9\%$) and 43 ($75.4\%$) out of 57 institutes, respectively. MS excel was most commonly used for the digitalization of the database, followed by MS access and SPSS. A regularly formed gastric cancer sheet and pathologic report were used in 38 ($66.7\%$) and 49 ($86.0\%$) institutes, respectively. Hospital computerization, such as an Order Communicating System, an Electric Medical Record, and a Picture Archiving/Communicating System had been set up previously or would be set up in the near future in most institutes. In 25 gastric cancer sheets collected, the mean number of total items was 72.9 ($15\∼177$). Identification datafor the patients, surgical data, and pathologic data were included on most of the sheets, but preoperative status, preoperative diagnostic data, and postoperative hospital course were not.

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Soft Tissue Response of Rabbit Larynx to Implanted Foley Catheter for Short Duration (토끼 후두내 삽입한 풍선도관에 대한 단기 조직 반응)

  • Yoo, Young-Sam;Choi, Chan;Kim, Dong-Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.34-39
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    • 2011
  • Objectives : This study was aimed to investigate soft tissue reaction such as inflammation, immune reaction of rabbit larynx to implanted foley catheter. Methods : After 8 rabbits were anesthetized, their thyroid cartilage and trachea were exposed through a skin incision and a 6 French foley catheter was inserted into the thyroid cartilage via cricothyroid membrane and ballooned with normal saline (0.1 mL). The other end of catheters were ligated and cut. The wound was closed keeping catheter under the skin. Two rabbits were used as normal control Larynges were removed for pathologic examination at 4weeks and 8 weeks of the study respectively, Results : Ten rabbits were euthanized for gross and pathologic examination (5 rabbits after 4 weeks and 5 rabbits after 8 weeks). All rabbits survived the study periods and inflammations or foreign body reactions were minimally found on pathologic examinations. Conclusions : Foley catheter could be useful and safe material for vocal fold medialization in rabbit models.

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Clonazepam Treatment of Pathologic Aerophagia in Children with Mental Retardation

  • Lee, Ga-Hyun;Jang, Hyo-Jeong;Hwang, Jin-Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.17 no.4
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    • pp.209-213
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    • 2014
  • Purpose: Pathologic aerophagia (PA) may lead to bowel perforation or volvulus in mentally retarded patients. The authors investigated the effects of clonazepam on the management of PA in children with severe to profound mental retardation (MR). Methods: This study was undertaken as a retrospective case analysis of 21 PA patients with MR who were followed for over 12 months and diagnosed as having PA. Patients were assigned to two management groups, that is, to a clonazepam randomized open-labeled, treatment group or a reassurance group. The following were recorded and analyzed; age, response, remission rate to clonazepam treatment, and the side effect of clonazepam. It was defined positive response (response+) as being symptom-free for a whole week within 1 month of commencing treatment and remission(+) as being symptom-free for a whole month within 6 months of treatment. Results: The average age of the 21 PA children with MR was 10 years and 13 patients were female. Symptom duration before diagnosis of PA was 7 months. Clinical features of the clonazepam-trial group (n=11) and the reassurance group (n=10) were non-significantly different. Response(+) was achieved by 2 patients (18.2%) in the clonazepamtrial group and by no patient in the reassurance group. Remission(+) was achieved by 6 patients (54.5%) in the clonazepam-trial group and by one patient (10%) in the reassurance group (p=0.040). Conclusion: When PA children with MR with severe bowel distention are considered for surgical treatment to prevent acute abdomen, a trial of clonazepam could be recommended.

Molecular Types and Neoadjuvant Chemotherapy in Patients with Breast Cancer- While Molecular Shifting is More Common in Luminal a Tumors, The Pathologic Complete Response is Most Frequently Observed in Her-2 Like Tumors

  • Salim, Derya Kivrak;Mutlu, Hasan;Eryilmaz, Melek Karakurt;Musri, Fatma Yalcin;Tural, Deniz;Gunduz, Seyda;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9379-9383
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    • 2014
  • Background: Pathologic complete response (pCR) is one of the most important target end-points of neoadjuvant chemotherapy (NACT) in patients with breast cancer (BC). In present study, we aimed to investigate the relationship between molecular subtypes and NACT in patients with BC. Materials and Methods: Using the Akdeniz University database, 106 patients who received NACT for operable breast cancer were retrospectively identified. Prognostic factors before and after NACT were assessed. According to the molecular subtypes, molecular shifting after NACT and tumoral and nodal response to NACT were analyzed. Results: The distribution of subtypes was: Luminal A, 28.3% (n=30); Luminal B, 31.1% (n=33); HER2-like, 24.5% (n=26); and basal like/triple negative (BL/TN), 16.0% (n=17). According to molecular subtypes, pCR rates in both breast and axillary were 0%, 21.4%, 36.4% and 27.3% for luminal A, luminal B, HER2-like and BL/TN, respectively (p=0.018). Molecular subtype shifting was mostly seen in luminal A type (28.6%) after the NACT. The pCR rate in breast and axillary was significantly higher in patients with HER2-like type BC. Conclusions: In patients with HER-2 like type BC, NACT may be offered in early stages. Additionally, due to molecular shifting, adjuvant treatment schedule should be reviewed again, especially in the luminal A group.

Pituitary Apoplexy due to Pituitary Adenoma Infarction

  • Kim, Joo-Pyung;Park, Bong-Jin;Kim, Sung-Bum;Lim, Young-Jin
    • Journal of Korean Neurosurgical Society
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    • v.43 no.5
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    • pp.246-249
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    • 2008
  • Cause of pituitary apoplexy has been known as hemorrhage, hemorrhagic infarction or infarction of pituitary adenoma or adjacent tissues of pituitary gland. However, pituitary apoplexy caused by pure infarction of pituitary adenoma has been rarely reported. Here, we present the two cases pituitary apoplexies caused by pituitary adenoma infarction that were confirmed by transsphenoidal approach (TSA) and pathologic reports. Pathologic report of first case revealed total tumor infarction of a nonfunctioning pituitary macroadenoma and second case partial tumor infarction of ACTH secreting pituitary macroadenoma. Patients with pituitary apoplexy which was caused by pituitary adenoma infarction unrelated to hemorrhage or hemorrhagic infarction showed good response to TSA treatment. Further study on the predisposing factors of pituitary apoplexy and the mechanism of infarction in pituitary adenoma is necessary.

Cellular senescence in cancer

  • Kim, Young Hwa;Park, Tae Jun
    • BMB Reports
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    • v.52 no.1
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    • pp.42-46
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    • 2019
  • Cellular senescence, a process of cell proliferation arrest in response to various stressors, has been considered to be important factor in age-related disease. Identification of senescent cells in tissues is limited and the role of senescent cells is poorly understood. Recently however, several studies showed the characterization of senescent cells in various pathologic conditions and the role of senescent cells in disease progression is becoming important. Senescent cells are growth-arrested cells, however, the senescence associated secretory phenotype (SASP) of senescent cells could modify the tissues' microenvironment. Here, we discuss the progress and understanding of the role of senescent cells in tissues of pathologic conditions and discuss the development of new therapeutic paradigms, such as senescent cells-targeted therapy.

The Neutrophil to Lymphocyte Ratio has a High Negative Predictive Value for Pathologic Complete Response in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

  • Eryilmaz, Melek Karakurt;Mutlu, Hasan;Salim, Derya Kivrak;Musri, Fatma Yalcin;Tural, Deniz;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7737-7740
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    • 2014
  • Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with pancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine the relationship between pathological complete response (pCR) and pretreatment NLR values in locally advanced breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and Methods: Datawere collected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BC patients treated with NACT between January 2000-December 2013. Results: A total of 78 patients were analyzed. Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR-cases (p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patients with PCR+ was 2.33 (AUC:0.544, 95%CI [0.401-0.688], p=0.586) with sensitivity, specificity, positive predictive value and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively. Conclusions: This study showed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV, in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatment may not be recommended.

Preoperative short course radiotherapy with concurrent and consolidation chemotherapies followed by delayed surgery in locally advanced rectal cancer: preliminary results

  • Aghili, Mahdi;Sotoudeh, Sarvazad;Ghalehtaki, Reza;Babaei, Mohammad;Farazmand, Borna;Fazeli, Mohammad-Sadegh;Keshvari, Amir;Haddad, Peiman;Farhan, Farshid
    • Radiation Oncology Journal
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    • v.36 no.1
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    • pp.17-24
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    • 2018
  • Purpose: This study aimed to assess complications and outcomes of a new approach, that is, combining short course radiotherapy (SRT), concurrent and consolidative chemotherapies, and delayed surgery. Materials and Methods: In this single arm phase II prospective clinical trial, patients with T3-4 or N+ M0 rectal adenocarcinoma were enrolled. Patients who received induction chemotherapy or previous pelvic radiotherapy were excluded. Study protocol consisted of three-dimensional conformal SRT (25 Gy in 5 fractions in 1 week) with concurrent and consolidation chemotherapies including capecitabine and oxaliplatin. Total mesorectal excision was done at least 8 weeks after the last fraction of radiotherapy. Primary outcome was complete pathologic response and secondary outcomes were treatment related complications. Results: Thirty-three patients completed the planned preoperative chemoradiation and 26 of them underwent surgery (24 low anterior resection and 2 abdominoperineal resection). Acute proctitis grades 2 and 3 were seen in 11 (33.3%) and 7 (21.2%) patients, respectively. There were no grades 3 and 4 subacute hematologic and non-hematologic (genitourinary and peripheral neuropathy) toxicities and perioperative morbidities such as anastomose leakage. Grade 2 or higher late toxicities were observed among 29.6% of the patients. Complete pathologic response was achieved in 8 (30.8%) patients who underwent surgery. The 3-year overall survival and local control rates were 65% and 94%, respectively. Conclusion: This study showed that SRT combined with concurrent and consolidation chemotherapies followed by delayed surgery is not only feasible and tolerable without significant toxicity but also, associated with promising complete pathologic response rates.

Artificial Intelligence in the Pathology of Gastric Cancer

  • Sangjoon Choi;Seokhwi Kim
    • Journal of Gastric Cancer
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    • v.23 no.3
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    • pp.410-427
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    • 2023
  • Recent advances in artificial intelligence (AI) have provided novel tools for rapid and precise pathologic diagnosis. The introduction of digital pathology has enabled the acquisition of scanned slide images that are essential for the application of AI. The application of AI for improved pathologic diagnosis includes the error-free detection of potentially negligible lesions, such as a minute focus of metastatic tumor cells in lymph nodes, the accurate diagnosis of potentially controversial histologic findings, such as very well-differentiated carcinomas mimicking normal epithelial tissues, and the pathological subtyping of the cancers. Additionally, the utilization of AI algorithms enables the precise decision of the score of immunohistochemical markers for targeted therapies, such as human epidermal growth factor receptor 2 and programmed death-ligand 1. Studies have revealed that AI assistance can reduce the discordance of interpretation between pathologists and more accurately predict clinical outcomes. Several approaches have been employed to develop novel biomarkers from histologic images using AI. Moreover, AI-assisted analysis of the cancer microenvironment showed that the distribution of tumor-infiltrating lymphocytes was related to the response to the immune checkpoint inhibitor therapy, emphasizing its value as a biomarker. As numerous studies have demonstrated the significance of AI-assisted interpretation and biomarker development, the AI-based approach will advance diagnostic pathology.