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Zahi I Mitri, Swapnil Parmar, Brett Johnson, Annette Kolodzie, Jamie M Keck, Max Morris, Alexander R Guimaraes, Brooke R Beckett, Uma Borate, Charles D Lopez, Kathleen A Kemmer, Joshi J Alumkal, Tomasz M Beer, Christopher L Corless, Gordon B Mills, Joe W Gray, Raymond C Bergan
BACKGROUND: In order to establish the workflows required to implement a real-time process involving multi-omic analysis of patient samples to support precision-guided therapeutic intervention, a tissue acquisition and analysis trial was implemented. This report describes our findings to date, including the frequency with which mutational testing led to precision-guided therapy and outcome for those patients. METHODS: Eligible patients presenting to Oregon Health and Science University Knight Cancer Institute were enrolled on the study...
December 14, 2018: Journal of Translational Medicine
Kurian Joseph, Khalifa Alkaabi, Heather Warkentin, Sunita Ghosh, Naresh Jha, Michael Smylie, John Walker
INTRODUCTION: We report the outcomes of using a combination of cetuximab with radiation therapy (Cetux-RT) to treat a selected group of patients with locally advanced (unresectable) cutaneous squamous cell carcinoma (LA-cSCC). This study presents two-year efficacy and safety data for 8 patients with LA-cSCC treated within a single institution. METHODS: Between 2014 and 2017 a total of eight patients (seven males, one female) with LA-cSCC received curative intent treatment with Cetux-RT...
December 14, 2018: Journal of Medical Imaging and Radiation Oncology
Bo Wang, Wenwei Pan, Meihua Yang, Wenjuan Yang, Wang He, Xu Chen, Junming Bi, Ning Jiang, Jian Huang, Tianxin Lin
Drugs blocking programmed death ligand-1 (PD-L1) have shown unprecedented activity in metastatic and unresectable bladder cancer. The purpose of the present study was to investigate the expression, clinical significance and association of PD-L1 with tumor-infiltrating lymphocytes (TIL) in resectable urothelial cell carcinoma of the bladder (UCB). In this retrospective study, 248 UCB patients who received radical cystectomy or transurethral resection were examined. Immunohistochemistry was used to evaluate PD-L1 expression and stromal CD8+ TIL, Th1 orientation T cell (T-bet+ ) and PD-1+ TIL densities within the intratumoral regions and associated stromal regions...
December 12, 2018: Cancer Science
Tomonari Suetsugu, Nobuhisa Matsuhashi, Takao Takahashi, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Kazuhiro Yoshida
Pathological complete response is achievable with mFOLFOX6 plus cetuximab therapy for unresectable colorectal cancer with multiple paraaortic lymph node metastases (mCRC) despite right-sided colonic origin. A 62-year-old woman with synchronous paraaortic lymph node metastases of transverse colon cancer was treated with mFOLFOX6 plus cetuximab as first-line therapy. The tumor size was markedly decreased following 6 courses of chemotherapy, and all lymph node metastases had disappeared. The patient then underwent conventional right hemicolectomy with D3 lymph node dissection plus sampling excision of the paraaortic lymph nodes...
December 2018: Molecular and Clinical Oncology
A Hawasli, L Camero, T Williams, G Ambrosi, M Sahly, D Demos, S Harrington
BACKGROUND: Esophagectomy has high cardiac and pulmonary complication rates that can reach 43% and 58% respectively. The original Ivor Lewis esophagectomy was a two-stage procedure. We revisited this procedure using a hybrid minimally-invasive approach. METHODS: Thirty-five consecutive patients with esophageal cancer were operated on over an eight-year period. The first stage used laparoscopic mobilization of the stomach, while the second stage used open thoracotomy...
December 4, 2018: American Journal of Surgery
Daquan Wang, Nan Bi, Dongfu Chen, Luhua Wang
RATIONALE: Tracheobronchial adenoid cystic carcinoma (TACC) is a rare malignancy. Surgical resection remains the standard treatment of choice. But it is frequently unresectable due to its local extension. The practicability and safety of hypofractionated radiotherapy (HRT) for TACC remains unknown since most of the TACCs are centrally located. PATIENT CONCERNS: A 57-year-old female presented with paroxysmal cough, expectoration, and hemoptysis. DIAGNOSES: Computed tomography (CT) scan of the chest revealed a nodule originating from the wall of right primary bronchus, with 1...
December 2018: Medicine (Baltimore)
Li-Ye Wang, Shuai Gong, Li-Ping Gao, Li-Xia Hou, Wei He
RATIONALE: Intrahepatic cholangiocarcinoma (ICC) originates from the secondary branch of the bile duct and the intrahepatic bile duct epithelial cells, and is a rare pathological type of primary liver cancer. Recently, apatinib has been successfully used for a variety of malignancies. PATIENT CONCERNS: A 23-year-old female was noted with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than 1 month. The enhanced CT scan revealed multiple intrahepatic lesions, portal vein and right branch tumor emboli were present...
December 2018: Medicine (Baltimore)
Emmanuel Ii Uy Hao, Ho Kyung Hwang, Dong-Sub Yoon, Woo Jung Lee, Chang Moo Kang
BACKGROUND: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare tumors considered to be benign although 10% to 15% of SPNs have been reported to be aggressive. Due to its rarity, there have only been a few cases reported regarding the clinical course of patients with aggressive SPNs. The goal of this study is to describe the clinical course of patients diagnosed with aggressive SPNs. METHODS: A PubMed search was done looking for articles describing the clinical course of patients diagnosed with SPN that locally invaded, recurred, or metastasized...
December 2018: Medicine (Baltimore)
Gyu Sang Yoo, Dongryul Oh, Hongryull Pyo, Yong Chan Ahn, Jae Myung Noh, Hee Chul Park, Do Hoon Lim
We performed a retrospective analysis to evaluate treatment outcomes and the risk of fatal hemorrhage by tumor regression when definitive concurrent chemo-radiotherapy (CCRT) was delivered to patients with non-small cell lung cancer (NSCLC) invading adjacent great vessels on radiological findings. We selected 37 unresectable NSCLC patients with adjacent great vessel invasion (GVI) by carefully reviewing each patient's images. The criteria of definite GVI were as follows: irregular indentation at the tumor-vessel contact border, slit-like narrowing of adjacent great vessels by the tumor, presence of intra-luminal mass formation, tumors contacting >5 cm of adjacent great vessel and obliteration of the intervening fat plane between tumor and adjacent great vessel, and/or tumors contacting more than half of the circumference of the aortic wall...
December 13, 2018: Journal of Radiation Research
Steven D Criss, Meghan J Mooradian, Deirdre F Sheehan, Leyre Zubiri, Melissa A Lumish, Justin F Gainor, Kerry L Reynolds, Chung Yin Kong
Importance: In early 2018, durvalumab became the first immunotherapy to be approved for adjuvant treatment of patients with unresectable stage III non-small cell lung cancer (NSCLC) whose cancer has not progressed after definitive chemoradiotherapy. However, the cost-effectiveness and potential economic implications of using this high-priced therapy in this indication are unknown to date. Objective: To explore the cost-effectiveness and potential budgetary consequences of durvalumab consolidation therapy vs no consolidation therapy after chemoradiotherapy in stage III NSCLC in the context of the US health care system...
December 13, 2018: JAMA Oncology
Shinsuke Takeno, Yukinori Tanoue, Roko Hamada, Fumiaki Kawano, Kosei Tashiro, Takashi Wada, Atsushi Nanashima
Approximately half of the patients with esophageal cancer are diagnosed at an advanced stage with inoperable disease. The technique of bypass surgery, which is one of the palliative procedures for esophageal cancer, usually requires the insertion of a drainage tube for clearing secretions from the blind remnant esophagus. Since the artificial drainage tube is sometimes problematic for the patient after discharge from the hospital, drainage tubeless (DRESS) surgery might be preferable. The authors demonstrated the utility of DRESS bypass surgery by adding esophagostomy in the right supraclavicular region in three patients with unresectable esophageal cancer with and without esophago-respiratory fistula...
December 11, 2018: Annals of Thoracic and Cardiovascular Surgery
Man Hu, Liyang Jiang, Xiangli Cui, Jianguang Zhang, Jinming Yu
Precision radiotherapy, which accurately delivers the dose on a tumor and confers little or no irradiation to the surrounding normal tissue and organs, results in maximum tumor control and decreases the toxicity to the utmost extent. Proton beam therapy (PBT) provides superior dose distributions and has a dosimetric advantage over photon beam therapy. Initially, the clinical practice and study of proton beam therapy focused on ocular tumor, skull base, paraspinal tumors (chondrosarcoma and chordoma), and unresectable sarcomas, which responded poorly when treated with photon radiotherapy...
December 12, 2018: Journal of Hematology & Oncology
Azusa Tanimoto, Shinji Takeuchi, Hiroshi Kotani, Kaname Yamashita, Tadaaki Yamada, Koushiro Ohtsubo, Hiromichi Ebi, Hiroko Ikeda, Seiji Yano
BACKGROUND: Pulmonary carcinosarcoma (PCS) is a rare primary lung malignancy and has a poor prognosis among lung tumor histological subtypes. However, an appropriate treatment strategy has not been developed for unresectable PCS. CASE PRESENTATION: A 65-year-old man who was diagnosed with PCS was treated by surgical removal of the primary lung lesion, followed by six cycles of adjuvant chemotherapy with cisplatin plus irinotecan. Following the chemotherapy, he experienced a relapse with brain metastasis, which induced the rapid onset of left leg paralysis...
December 12, 2018: BMC Pulmonary Medicine
Binyi Xiao, Jianhong Peng, Jinghua Tang, Rongxin Zhang, Cong Li, Junzhong Lin, Peirong Ding, Desen Wan, Zhizhong Pan, Xiaojun Wu
Objectives: Gastrointestinal stromal tumor (GIST) liver metastasis (GLM) is a special subset of advanced GIST, because its lesions are easier to define and assess. We aim to determine the role of liver metastasectomy for patients with GLM in the era of tyrosine kinase inhibitor (TKI) therapy. Methods: We reviewed patients with metastatic GIST who received surgery or other treatments in Sun Yat-sen University Cancer Center between January 1991 and December 2017. Patients with metastases confined to the liver and with no previous metastasis to other locations were included into the study and were classified into surgical and non-surgical groups...
2018: Cancer Management and Research
Kazuhiro Togasaki, Yasutaka Sukawa, Takanori Kanai, Hiromasa Takaishi
Standard treatment options for patients with advanced gastric cancer (GC) offer limited efficacy and are associated with some toxicity, which necessitates the development of more effective therapies for improving the treatment outcomes for this disease. Immunotherapy involving immune checkpoint inhibitors (ICIs) which inhibit the programmed death 1 (PD-1)/programmed death ligand 1 interaction has emerged as a new treatment option. Nivolumab, a human IgG4 monoclonal antibody inhibitor of PD-1, has demonstrated promising clinical activity and induced durable responses in patients with advanced GC...
2018: OncoTargets and Therapy
Ravi Gupta, Akshay Anand, Manoj Kumar, Mlb Bhatt, Sudhir Singh, Abhinav Arun Sonkar
Gallbladder cancer (CaGB) in the subcontinent belongs to low socioeconomic status, and at the time of diagnosis, a large number is unresectable or inoperable so the palliative treatment remains the only option. In the present study, attempt was made to see the effect and safety profile of single-agent oral capecitabine in inoperable CaGB in presence of low levels of jaundice post-single-catheter transhepatic external biliary drainage. In N  = 35 of inoperable jaundiced CaGB, post-biliary drainage capecitabine in low dose was started when their total bilirubin levels fell to 10 mg% or below...
December 2018: Indian Journal of Surgical Oncology
Avanish Saklani, P Sugoor, A Chaturvedi, R Bhamre, S Jatal, V Ostwal, R Engineer
The multimodal treatment for advanced rectal adenocarcinoma mandates accurate preoperative staging with contrast-enhanced computed tomography (CECT) of the thorax, abdomen, and pelvis, and magnetic resonance imaging (MRI) of the pelvis. Unlike gastric cancer, the role of staging laparoscopy (SL) in advanced colorectal cancer has not been evaluated. This study aims to evaluate the clinical value of SL in treatment decision-making for advanced rectal cancer (RC) with near or complete obstructing tumors. Observational review of colorectal database at Tata Memorial Hospital from January 2013 to December 2016 identified 562 patients diagnosed and treated for advanced RC...
December 2018: Indian Journal of Surgical Oncology
Bulent Cetin, Irem Bilgetekin, Mustafa Cengiz, Ahmet Ozet
The most common site of blood-borne metastases from colorectal cancers (CRC) is the liver. Resection of (liver) metastases is a part of standard treatment of metastatic colorectal cancer. Hepatic resection is the first-line treatment of liver metastases, with 5-year survival rates between 25 and 58%. The enhanced efficacy of systemic chemotherapeutic regimens has increased tumor response rates and improved the progression-free and overall survival of patients with these malignancies. In approximately 20% of patients with initially unresectable liver metastases, the metastases may become resectable after administration of neoadjuvant chemotherapy...
December 2018: Indian Journal of Surgical Oncology
Yves Collin, Alex Paré, Assia Belblidia, Richard Létourneau, Marylène Plasse, Michel Dagenais, Simon Turcotte, Guillaume Martel, André Roy, Real Lapointe, Frank Vandenbroucke-Menu
BACKGROUND: Previous studies comparing the survival outcomes of liver resections with and without preoperative portal vein embolization (PVE) for colorectal liver metastases (CLM) have linked PVE to higher rate of tumor progression, lower overall survival (OS) and lower disease-free survival (DFS). The lack of adjusted models to compare these outcomes is a limitation of these studies since patients requiring PVE may differ significantly from the ones receiving upfront surgery. MATERIALS AND METHODS: Prospective cohort study of 128 patients undergoing CLM resection...
December 8, 2018: International Journal of Surgery
Jenny X Chen, Elliott D Kozin, Jennifer O'Malley, Ivan Chebib, E Tessa Hedley-Whyte, William Faquin, Joseph Nadol, Alicia M Quesnel
OBJECTIVES/HYPOTHESIS: Investigate the otopathology of angiosarcoma of the temporal bone, which has not been previously described in the literature. STUDY DESIGN: Postmortem evaluation and literature review. METHODS: Postmortem histological evaluation of the temporal bones and review of the literature for the treatment and prognosis of this rare disease were performed. RESULTS: A 50-year-old male with right chronic otitis media presented with progressive hearing loss, disequilibrium, otalgia, and acute facial paresis...
December 11, 2018: Laryngoscope
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