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Clinicopathologic Features and Prognosis of Osteosarcoma in Turkish Adults

  • Seker, Mehmet Metin;Seker, Ayse;Aksoy, Sercan;Ozdemir, Nuriye;Uncu, Dogan;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3537-3540
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    • 2014
  • Background: Osteosarcomas are the most common solid malignancies of bone. In the last two decades there have been no concrete developments in their systemic treatment. In this trial we aimed to present our osteosarcoma patient clinical and demographic outcomes. Materials and Methods: Patients treated and followed up for osteosarcoma in Ankara Numune Education and Research Hospital from 2002 to 2012 were reviewed retrospectively. Results: A total of 21 patients (15 male, 6 female) were diagnosed with osteosarcoma. The disease was located at extremities in 76% and in 14% was metastatic at the time of diagnosis. Median disease free survival (DFS) was 36 months in non-metastatic patients and median progression free survival (PFS) was 2 months in metastatic patients (p<0.0001). Median overall survival (OS) was 80 months and 4 months, respectively (p=0.012). There were no survival differences in terms of presentation with pathological fracture, tumor size, tumor grade, alkaline phosphatase and lactate dehydrogenase level and type of chemotherapy regimen. Conclusions: Tumor site and stages are the most important prognostic factors for osteosarcoma. Extremity primary tumors have beter survival rates than non-extremity tumors. As a result of the use of effective chemotherapy the long term survival rates have improved from 10-20% to 60-70% in the last decades but we need more active agents, especially for metastatic cases.

Relationship Between Prognosis and Neutrophil: Lymphocyte and Platelet:Lymphocyte Ratios in Patients with Malignant Pleural Mesotheliomas

  • Cihan, Yasemin Benderli;Ozturk, Ahmet;Mutlu, Hasan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2061-2067
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    • 2014
  • Background: It has been demonstrated that neutrophil:lymphocyte (NLR) and platelet:lymphocyte (PLR) ratios are associated with prognosis in cancer patients. The aim of this study was to investigate whether pretreatment white blood cell (WBC), neutrophil, lymphocyte, monocyte, platelet, basophil and eosinophil counts, LDH level, NLR and PLR are associated with prognosis in patients with malignant pleural mesothelioma (MPM). Materials and Methods: We retrospectively reviewed files of 50 patients who were managed with a diagnosis of MPM between 2005 and 2010. Demographic and clinical characteristics, treatments, response to treatment and prognostic factors were evaluated, along with relationships between pretreatment blood parameters and prognosis. Results: Overall, 38 men and 12 women were included to the study. Mean age was $61.5{\pm}9.4$ years (range: 39-83 years). There was advanced disease in 86% (n=43) and the histological type was epithelial mesothelioma in the majority (82%). Of the cases, 17 (34%) received radiotherapy, while 42 cases underwent first- and second-line chemotherapy, with cisplatin plus pemetrexed as the most commonly used regimen. In the assessment after therapy, it was found that there was complete response in 4 cases (8%), partial response in 10 cases (20%), stable disease in 17 cases (34%) and progression in 19 cases (38%). Median follow-up was 10 months (range: 10 day-30 months). Median overall survival was found to be 20.7 months while median progression-free survival as 10 months. In univariate and multivariate analyses, it was found that factors significantly affecting overall survival included stage (p=0.030), response to treatment (p=0.026) and monocyte count (p=0.004), while factors affecting disease-free survival included NLR (p=0.018), response to treatment (p=0.001), and PLR score (p=0.003). Conclusions: Overall and disease-free survival was found to be better in cases with a WBC count<8.000, platelet count<300,000, and low NLR and PLR scores in malignant pleural mesothelioma.

Survival Analysis in Advanced Non Small Cell Lung Cancer Treated with Platinum Based Chemotherapy in Combination with Paclitaxel, Gemcitabine and Etoposide

  • Natukula, Kirmani;Jamil, Kaiser;Pingali, Usha Rani;Attili, Venkata Satya Suresh;Madireddy, Umamaheshwar Rao Naidu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4661-4666
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    • 2013
  • Background: The wide spectrum of clinical features in advanced stages of non-small cell lung cancer (NSCLC) probably contributes to disparities in outcomes because of different prognostic variables significant for stage IIIB/IV patients. Hence the aim of this study was to check for favorable response of patients to various chemotherapeutic combinations with respect to patient survival in stage IIIB and stage IV NSCLC disease. We selected those patients for our study who were receiving treatment with paclitaxel, gemcitabine or etoposide in combination with platinum based drugs. Materials and Methods: Seventy-two patients who visited the hospital from June 2009 to November 2012 with confirmed diagnosis of lung cancer were included, and data were collected for follow up and classified according to treatment received with respect to patients' regimen and response, and overall survival. This study analyzed tumor variables that were associated with clinical outcome in advanced NSCLC patients who were undergoing first-line chemotherapy for stage IIIB/IV NSCLC. Results: Comparative data on various parameters like age, gender, stage, histology, site of disease, metastatic site and chemo-regimens was analyzed; these parameters predicted variable significant improvement for overall survival ($p{\geq}0.05$). One and two year survival rates were 20.8% and 15.3%. Conclusions: In this study we found slight improvement in survival rates in NSCLC and clinical outcomes with one combination (carboplatin+paclitaxel). Overall there were only marginal differences in survival rates for other chemo-regimens evaluated in this study.

Concurrent Chemoradiation with Weekly Paclitaxel and Cisplatin for Locally Advanced Cervical Cancer

  • Kalaghchi, Bita;Abdi, Robab;Amouzegar-Hashemi, Farnaz;Esmati, Ebrahim;Alikhasi, Afsaneh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.sup3
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    • pp.287-291
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    • 2016
  • Cervical cancer is one of the most common gynecological cancers in Iranian women. This study was initiated to assess whether the combination of paclitaxel and cisplatin with radiation might feasible for these patients. The aim was to assess tumor response and toxicity of weekly cisplatin and paclitaxel along with radiotherapy in the treatment of cervical cancer. Women with primary untreated squamous cell carcinoma of the cervix with FIGO stages IB2 to IIIB were treated with weekly injections of cisplatin 30 mg/m2 and paclitaxel 35 mg/m2 for 5-6 weeks along with radiotherapy. A total of 25 patients were enrolled in this study who completed the intended treatment. Disease was assessed prior to treatment by pelvic examination and contrast enhanced MRI of the abdomen and pelvis. Response was assessed 1 month after completion of treatment by physical examination and 3 months after also by MRI.Toxicity was assessed and was graded using RTOG grading. There was a complete response rate of 84% after 3 months. The major toxicity was grade 1 and 2 anemia (92%). The mean duration of treatment was 58 days. In conclusion, combination chemotherapy with cisplatin and paclitaxel along with radiotherapy in patients with locally advanced squamous cell carcinoma of cervixwas well tolerated, in contrast to other studies, but it seems that there was no increase in tumor response and progression free survival with this treatment regimen.

Informational Needs of Women with Breast Cancer Treated with Chemotherapy

  • Abi Nader, Elie;Kourie, Hampig Raphael;Ghosn, Marwan;El Karak, Fadi;Kattan, Joseph;Chahine, Georges;Nasr, Fadi
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1797-1800
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    • 2016
  • Background: Research in the field of informational needs of breast cancer patients is scarce. In the few published articles, these needs were usually not satisfied. The main objective of this study was to evaluate satisfaction regarding informational needs in women with breast cancer. The long-term goal was to guide physician-patient communication to meet these needs. Materials and Methods: A survey with 21 questions was completed by 84 female patients receiving chemotherapy in a one-day hospital in Beirut, Lebanon. All patients were aware of their disease and agreed to participate in the survey. Results: The doctor was the major source of information for patients followed by media (radio and television). The level of knowledge of patients concerning their disease was proportional to the number of information sources. Women aged younger than 45 years, diagnosed during the last three months before the survey and certified from high school were less satisfied with information given by the oncologist. The missing information was in relation with the steps of the treatment after the chemotherapy regimen, the risk of a family member (sisters and daughters) of developing the disease and management of lymphedema. Conclusions: This study generated a scale for the degree of satisfaction of information received by women with breast cancer from their oncologist. The physician can use this scale to improve his or her skills of communication to patients and diminish their level of fear and anxiety.

Predictors of Outcome in Patients with Advanced Nonseminomatous Germ Cell Testicular Tumors

  • Yetisyigit, Tarkan;Babacan, Nalan;Urun, Yuksel;Seber, Erdogan Selcuk;Cihan, Sener;Arpaci, Erkan;Yildirim, Nuriye;Aksoy, Sercan;Budakoglu, Burcin;Zengin, Nurullah;Oksuzoglu, Berna;Yalcin, Banu Cicek;Alkis, Necati
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.831-835
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    • 2014
  • Background: Predictor factors determining complete response to treatment are still not clearly defined. We aimed to evaluate clinicopathological features, risk factors, treatment responses, and survival analysis of patient with advanced nonseminomatous GCTs (NSGCTs). Materials and Methods: Between November 1999 and September 2011, 140 patients with stage II and III NSGCTs were referred to our institutions and 125 patients with complete clinical data were included in this retrospective study. Four cycles of BEP regimen were applied as a first-line treatment. Salvage chemotherapy and/or high-dose chemotherapy (HDCT) with autologous stem cell transplantation were given in patients who progressed after BEP chemotherapy. Post-chemotherapy surgery was performed in selected patients with incomplete radiographic response and normal tumor markers. Results: The median age was 28 years. For the good, intermediate and poor risk groups, compete response rates (CRR) were, 84.6%, 67.9% and 59.4%, respectively. Extragonadal tumors, stage 3 disease, intermediate and poor risk factors, rete testis invasion were associated with worse outcomes. There were 32 patients (25.6%) with non-CR who were treated with salvage treatment. Thirty-one patients died from GCTs and 94% of them had stage III disease. Conclusions: Even though response rates are high, some patients with GCTs still need salvage treatment and cure cannot be achieved. Non-complete response to platinium-based first-line treatment is a negative prognostic factor. Our study confirmed the need for a prognostic and predictive model and more effective salvage approaches.

Association of Immunohistochemically Defined Molecular Subtypes with Clinical Response to Presurgical Chemotherapy in Patients with Advanced Breast Cancer

  • Khokher, Samina;Qureshi, Muhammad Usman;Mahmood, Saqib;Nagi, Abdul Hannan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3223-3228
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    • 2013
  • Gene expression profiling (GEP) has identified several molecular subtypes of breast cancer, with different clinico-pathologic features and exhibiting different responses to chemotherapy. However, GEP is expensive and not available in the developing countries where the majority of patients present at advanced stage. The St Gallen Consensus in 2011 proposed use of a simplified, four immunohistochemical (IHC) biomarker panel (ER, PR, HER2, Ki67/Tumor Grade) for molecular classification. The present study was conducted in 75 newly diagnosed patients of breast cancer with large (>5cm) tumors to evaluate the association of IHC surrogate molecular subtype with the clinical response to presurgical chemotherapy, evaluated by the WHO criteria, 3 weeks after the third cycle of 5 flourouracil, adriamycin, cyclophosphamide (FAC regimen). The subtypes of luminal, basal-like and HER2 enriched were found to account for 36.0 % (27/75), 34.7 % (26/75) and 29.3% (22/75) of patients respectively. Ten were luminal A and 14 luminal B (8 HER2 negative and 6HER2 positive). The triple negative breast cancer (TNBC) was most sensitive to chemotherapy with 19% achieving clinical-complete-response (cCR) followed by HER2 enriched (2/22 (9%) cCR), luminal B (1/6 (7%) cCR) and luminal A (0/10 (0%) cCR). Heterogeneity was observed within each subgroup, being most marked in the TNBC although the most responding tumors, 8% developing clinical-progressive-disease. The study supports association of molecular subtypes with response to chemotherapy in patients with advanced breast cancer and the existence of further heterogeneity within subtypes.

Effect of feeding diet containing Cordyceps with fly pupa on blood lipid, fatty acid and TBARS in broiler chickens (브로일러의 혈액지질, 닭고기의 지방산 및 지방산패도에 관한 파리번데기 동충하초 급여효과)

  • Park, Byung-Sung
    • Journal of the Korean Applied Science and Technology
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    • v.28 no.3
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    • pp.273-283
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    • 2011
  • The objective of this study was to determine the feeding effect of a diet containing Cordyceps with fly pupa on the changes in blood lipid profile from broiler chickens, fatty acids and thiobarbituric acid reactive substances (TBARS) in chicken meat. A total of 360 chicks (Ross strain 308) were divided on hatch day into four treated groups with respect to a 35-day feeding regimen: T1 (control group), T2 (2.0% Cordyceps with fly pupa), T3 (3.5% Corceps with fly pupa) and T3 (5.0% Cordyceps with fly pupa). Blood triacylglyceride and total cholesterol level was significantly decreased by 5.32-10.63% and 9.23-12.62%, respectively, in groups T2, T3 and T4 when compared to T1 (p<0.05). Water holding capacity was significantly highest in T2 (p<0.05), while there were no significant differences among groups T2, T3 and T. In chicken meat, the ratio of saturated fatty acid to unsaturated fatty acid was high in the T3 and T4 groups, the ratio of n-6 to n-3 fatty acid was low in the T2, T3 and T4 groups and oleic acid (18:1n-9) was high in the T2, T3 and T4 groups, when compared to T1 (p<0.05). TBARS tended to increase according to the storage time (in days), and was significantly lower in the chicken thigh muscles with skin in groups T2, T3 and T4 as compared to T1 (p<0.05). These results suggest that a diet containing 2.0-3.5% of Cordyceps with fly pupa may decrease blood lipid and improve both the shelf-life and quality of broiler chicken meat.

Successful treatment of tubulointerstitial nephritis and uveitis with steroid and azathioprine in a 12-year-old boy

  • Kim, Ji Eun;Park, Se Jin;Oh, Ji Young;Jeong, Hyeon Joo;Kim, Ji Hong;Shin, Jae Il
    • Clinical and Experimental Pediatrics
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    • v.59 no.sup1
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    • pp.99-102
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    • 2016
  • Tubulointerstitial nephritis and uveitis (TINU) syndrome is a rare disease, often underdiagnosed or misdiagnosed in children. We describe the case of a 12-year-old boy who presented to Severance Hospital with a 1-month history of bilateral conjunctival injection. He was first evaluated by an Ophthalmologist in another hospital and diagnosed with panuveitis. Laboratory tests indicated renal failure, and a renal biopsy confirmed the diagnosis of acute tubulointerstitial nephritis. An extensive exclusion of all possible causes allowed a diagnosis of TINU syndrome. The patient was treated with a systemic corticosteroid (initially prednisolone, 2 mg/kg and later deflazacort 1 mg/kg) and topical steroid drops for 1 month. Azathioprine was later added to the treatment regimen and the systemic steroid was slowly tapered. The final outcome of renal-ocular disease was favorable in the patient. However, long-term follow-up is necessary to properly manage frequent relapses and incomplete renal recovery. TINU should be considered as a differential diagnosis in children with uveitis or acute renal failure.

Changes in in vivo Lipid Peroxidation and Antioxidant Defense System in Streptozotocin-Induced Diabetic Rats: a Time Course Study (스트렙토조토신-당뇨쥐에서 지질과산화 및 항산화계의 경시적 변화)

  • 이수자;박수현;이혜성
    • Journal of Nutrition and Health
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    • v.34 no.3
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    • pp.253-264
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    • 2001
  • This study was carried out to examine a part of the mechanism for the etiology of diabetic complications. Thirty normal and forty streptozotocin(STZ)-induced diabetic rats were used as the animal models. The animals were sacrificed at the time points of 3 days, 1,2,4 and 6 weeks after STZ-injection and a time course changes in the concentrations of thiobarbituric acid-reactive substances(TBARS) in blood, urine, and tissues, along with the levels of conjugated dienes in tissues were measured as indices of in vivo lipid peroxidation. The activities of antioxidant enzymes, catalase, superoxide dismutase, glutathione peroxidase and the levels of blood retinol and alpha-tocopherol were also measured. The diabetic rats maintained a slightly higher plasma TBARS level throughout the experiment. The urinary TBARS level was significantly higher in diabetic group and gradually increased with time. Concentrations of TBARS in liver, heart, and kidney tissues from diabetic animals were higher than those from the normal group. An increase of conjugated dienes was also observed in the all tissues examined. The kidney tissue of diabetic animals revealed more significant lipid peroxidation state than any other organ tissues. The activities of hepatic antioxidant enzymes such as catalase, superoxide dismutase, glutathione peroxidase were higher in diabetic animals compared to the control ones and increased with the duration of diabetes mellitus. The plasma levels of vitamin A and E were loser in diabetic animals than in normal controls throughout the experimental period. The level of vitamin E in diabetic animals was significantly decreased with the duration of the disease. The results of this study suggest that an effective regimen to suppress the adverse changes in lipid peroxidation and antioxidant defense system is required from the early stage of the disease to prevent the development of diabetic complications. (Korean J Nutrition 34(3) : 253∼264, 2001)

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