Current Issue : October-December
Volume : 2021
Issue Number : 4
Articles : 5 Articles
Background: Pancreatic head adenocarcinoma (PHAC), a malignant tumour, has a very poor prognosis, and the
existing prognostic tools lack good predictive power. This study aimed to develop a better nomogram to predict
overall survival after resection of non-metastatic PHAC.
Methods: Patients with non-metastatic PHAC were collected from the Surveillance, Epidemiology, and End Results
(SEER) database and divided randomly into training and validation cohorts at a ratio of 7:3. Cox regression analysis
was used to screen prognostic factors and construct the nomogram. Net reclassification improvement (NRI) and
integrated discrimination improvement (IDI) were calculated to evaluate the performance of the model. The
predictive accuracy and clinical benefits of the nomogram were validated using the area under the curve (AUC),
calibration curves, and decision curve analysis (DCA).
Results: From 2010 to 2016, 6419 patients with non-metastatic PHAC who underwent surgery were collected from
the SEER database. A model including T stage, N stage, grade, radiotherapy, and chemotherapy was constructed.
The concordance index of the nomogram was 0.676, and the AUCs of the model assessing survival at multiple
timepoints within 60 months were significantly higher than those of the American Joint Committee on Cancer
(AJCC) 8th staging system in the training cohort. Calibration curves showed that the nomogram had ability to
predict the actual survival. The NRI, IDI, and DCA curves also indicated that our nomogram had higher predictive
capability and clinical utility than the AJCC staging system.
Conclusions: Our nomogram has an ability to predict overall survival after resection of non-metastatic PHAC and
includes prognostic factors that are easy to obtain in clinical practice. It would help assist clinicians to conduct
Background: Osimertinib is a third generation tyrosine kinase inhibitor (TKI) that targets the epidermal growth
factor receptor (EGFR) in lung cancer. However, although this molecule is not subject to some of the resistance
mechanisms observed in response to first generation TKIs, ultimately, patients relapse because of unknown
resistance mechanisms. New relevant non-small cell lung cancer (NSCLC) mice models are therefore required to
allow the analysis of these resistance mechanisms and to evaluate the efficacy of new therapeutic strategies.
Methods: Briefly, PC-9 cells, previously modified for luciferase expression, were injected into the tail vein of mice.
Tumor implantation and longitudinal growth, almost exclusively localized in the lung, were evaluated by
bioluminescence. Once established, the tumor was treated with osimertinib until tumor escape and development
of bone metastases.
Results: Micro-metastases were detected by bioluminescence and collected for further analysis.
Conclusion: We describe an orthotopic model of NSCLC protocol that led to lung primary tumor nesting and, after
osimertinib treatment, by metastases dissemination, and that allow the isolation of these small osimertinib-resistant
micro-metastases. This model provides new biological tools to study tumor progression from the establishment of a
lung tumor to the generation of drug-resistant micro-metastases, mimicking the natural course of the disease in
human NSCLC patients....
Background: The purpose of this study was to explore clinicalpathology features, molecular features and outcome
of male breast cancer patients who expressed ER, PR as well as HER-2, namely triple-positive male breast cancer (TPMBC),
and compared them with triple-positive female breast cancer patients (TP-FBC).
Methods: TP-MBC and TP-FBC from 2010 to 2017 were selected from the Surveillance, Epidemiology, and End
Results database (SEER). Kaplan-Meier plotter and multivariable Cox regression model were applied to analyse the
difference between TP-MBC and TP-FBC on cancer-specific survival (CSS) and overall survival (OS). Propensity score
matched (PSM) analysis was used to ensure well-balanced characteristics. 7 cases TP-MBC and 174 cases TP-FBC
patients with the genomic and clinical information were identified from the cohort of The Cancer Genome Atlas
(TCGA) and the Memorial Sloan Kettering (MSK).
Result: 336 TP-MBC and 33,339 TP-FBC patients were taken into the study. The percentages of TP-MBC in MBC
patients were higher than the rates of TP-FBC in FBC patients from 2010 to 2017 except 2012. Compared with TPFBC,
more TP-MBC were staged III (17.9% vs. 13.5%) or stage IV (11.0% vs. 6.9%). TP-MBC were more frequently to
be older than 65-years-old (47.0% vs. 29.3%), Balck (15.2% vs. 10.8%), ductal carcinoma (91.7% vs. 84.4%) and
metastases to lung (4.5% vs. 2.1%) or bone (8.6% vs. 4.7%). TP-MBC had worse OS and CSS than TP-FBC in all stages
(P < 0.001). In multivariable prediction model of TPBC, male patients had a higher risk than female. Lastly, the worse
OS (P < 0.001) and CSS (P = 0.013) were seen in the 1:3 PSM analysis between TP-MBC and TP-FBC. Genomic analysis
revealed that TP-MBCs have some notable rare mutations, like ERBB2, ERBB3, RB1, CDK12, FGFR2, IDH1, AGO2,
GATA3, and some of them are not discovered in TP-FBC.
Conclusion: TP-MBC had a worse survival than TP-FBC, and there were different genomic features between two
groups. Current knowledge and treatment to TP-MBC maybe inadequate and remain to be explored....
Background: Neoadjuvant chemotherapy (NACT) was initially applied to locally advanced breast cancer to convert
advanced lesions to an operable status. Currently, its application has been expanded to enhance overall oncological results,
especially in patients with triple-negative or HER-2-positive breast cancer. With more NACT being applied, the role and
impact of this approach on breast reconstruction needs to be determined. This study aimed to perform a complete
reconstructive outcome analysis of patients receiving NACT who underwent immediate breast reconstruction.
Methods: A retrospective review of a single reconstructive surgeon’s immediate breast reconstructions performed from July
2008 to December 2018 was undertaken. The results were stratified by the use of NACT. Patient demographics, delivery of
NACT, adjuvant treatment, incidence of surgical complications, and postoperative photographs were analyzed.
Results: A total of 269 patients were included. The mean follow-up was 46.3 months. Forty-six out of 269 patients received
NACT and were included in the NACT group. The other patients were included in the non-NACT group. When implantbased
reconstruction was planned, the NACT group had a higher rate of two-stage tissue expander-implant reconstruction
than direct-to-implant reconstruction (p < 0.001). The requirement for postmastectomy radiotherapy was higher in the NACT
group (p < 0.001). The surgical complication rates were similar between groups after adjusting for confounding factors. The
objective aesthetic outcomes assessed by 6 plastic surgeons were also similar between groups.
Conclusions: Immediate breast reconstruction is a safe and reliable procedure, with an acceptable reconstructive
complication rate and satisfactory aesthetic outcomes, for patients treated with NACT....
Background: Nasopharyngeal carcinoma (NPC) is a malignancy predominantly associated with infection by the
Epstein-Barr virus (EBV). Approximately 12,900 new cases of NPC occur each year, with more than 70% of cases
occurring in the east and southeast Asia. NPC is different from ordinary head and neck squamous cell carcinoma
due to its particular biological properties and it is highly sensitive to radiotherapy. With the development of RT
technology, the 3-year local control rate and survival rates of non-metastatic NPC reached 80–90% in the intensitymodulated
RT (IMRT) era. However, whether distant metastatic NPC (de novo mNPC, dmNPC) should receive
locoregional RT (LRRT) needs to be clarified.
Results: Multivariate analysis identified three independent prognostic factors: Epstein-Barr virus (EBV) DNA, number
of metastatic lesions, and number of metastatic organs. Through these factors, all patients were successfully divided
into 3 subgroups: low-risk (single metastatic organ, EBV DNA ≤ 25,000 copies/ml, and ≤ 5 metastatic lesions),
intermediate-risk (single metastatic organ, EBV DNA > 25,000 copies/ml, and ≤ 5 metastatic lesions), and high-risk
(multiple metastatic organs or > 5 metastatic lesions or both). By comparing LRRT and non-LRRT groups, statistical
differences were found in OS in the low-risk and intermediate-risk subgroups (p = 0.039 and p = 0.010, respectively)
but no significant difference was found in OS in the high-risk subgroup (p = 0.076). Further multivariate analysis of
different risk stratifications revealed that LRRT can improve OS of low- and intermediate-risk subgroups....................
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