Influence of tumor characteristics on the outcome of liver transplantation among

Hepatocellular carcinoma (HCC) may recur after liver transplantation (LT), mainly in patients with multinodular and large tumors. However, factors predictive of outcome after LT in patients with small tumors remain ill defined. We investigated which factors were related to mortality or tumor recurrence among 47 liver transplant recipients with liver cirrhosis and HCC and compared them with 107 patients with liver cirrhosis without tumor who underwent LT in the same period. Patients with HCC were older (P <.001), more frequently had cirrhosis of a viral origin (P <.001), and had lower Child-Pugh scores (P <.001) than patients without tumor. Survival of patients with and without tumor was not significantly different (P =.20). Among patients with HCC, those with lower recurrence-free survival rates had liver cirrhosis of a viral origin, vascular invasion, bilobar disease, and tumor-node-metastasis (TNM) stage IV. At multivariate analysis, the only factor associated with mortality or recurrence was TNM stage IV (P =.02). Our results suggest that in patients with HCC and TNM stage IV, LT might be contraindicate

Assessment of Operative Risk in Colorectal Oncologic Surgery

The objective of the present study is to elaborate a prognostic index for qualitative assessment of the operative risk in the surgical treatment of colorectal cancer (CRC).The documentation of 150 CRC patients, 91 males and 59 females, operated on in the Clinic of Surgery, Marko A. Markov Specialized Hospital of Oncological Diseases of Varna during the period from June 2008 till April 2009 was analyzed. Mean patients` age was 64,2 years (range, 34-84 years).Seventy patients presented with colon cancer, 76 - with rectum cancer while 4 patients presented with multiple tumour localizations. The risk factors included the following: patient`s age and gender; ASA stage; CRC localization according to ICD of WHO; surgical procedure according to OPCS4 system; emergency; CRC stage according to TNM classification; resection type, and hematocrit level. There were 55 patients with TNM stage I, 80 patients with TNM stages II-III, and 15 patients with TNM stage IV. The most common interventions were anterior resection (in 48 patients), right hemicolectomy (in 41 patients), and sigmoidectomy (in 23 patients). Thirty-day operative lethality rate was zero.The created data-base can successfully be used for the purposes of CRC prognostication with the patients forwarded to operative treatment

Assessment of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio and platelet count as predictors of long-term outcome after R0 resection for colorectal cancer

Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and platelet count (PC) were shown to be prognostic in several solid malignancies. We analysed 603 R0 resected patients to assess whether NLR, PLR and PC correlate with other well-known prognostic factors and survival of patients with colorectal cancer (CRC). Receiver operating characteristic (ROC) curve analysis was performed to define cut-off values for high and low ratios of these indices. Univariate and multivariate analysis were used to determine the prognostic value of NLR, PLR and PC for overall and cancer-related survival. The distribution of NLR, PLR and PC in CRC patients was compared with 5270 healthy blood donors. The distribution of NLR, PLR and PC was significantly different between CRC patients and controls (all p\u2009&lt;\u20090.05). A significant but heterogeneous association was found between the main CRC prognostic factors and high values of NLR, PLR and PC. Survival appeared to be worse in patients with high NLR with cancers in AJCC/UICC TNM Stages I-IV; nonetheless its prognostic value was not confirmed for cancer-related survival in multivariate analysis. After stratification of patients according to AJCC/UICC TNM stages, high PC value was significantly correlated with overall and cancer-related survival in TNM stage IV patients

Evaluation of Retinoblastoma According to Histological Grading, TNM Staging and Age at Presentation

Objective: To evaluate retinoblastoma, according to histological grades, TNM staging and age at presentation.Materials and Methods: This cross sectional study was conducted in Department of Pathology BMSI- JPMC Karachi from1st January 2009 to 31st December 2013 during which a total of 80 cases of retinoblastoma were received. Out of which 68 werereviewed and morphological diagnosis was done on H&amp;E staining. Histological grades and TNM staging were categorized.The data was analyzed by using SPSS version 22.Results: In 80 cases of retinoblastoma the mean age of patients was 3.64 years with 3-4 years (53.75%) of age being thecommonest. Amongst 68 cases, well differentiated retinoblastoma were seen in 7.35%, moderately differentiated 11.76%, poorlydifferentiated 26.47% and undifferentiated 51.41% cases. Varied pattern of TNM staging were observed. Majority (60.29%)in stage IV followed by 19.11% in stage I and 10.29% each in TNM stage II and III. Regional lymph node metastasis was seenin 4/68 cases (5.88%) while 3/68 (4.41%) showed distant (CNS) metastasis. All these cases (7/7) were in TNM stage IV withmajority showing grade 4 (75%) and grade 3 (25%) histology.Conclusion: Evaluation of retinoblastoma showed that commonest age group was 3-4 years. Majority of retinoblastoma caseswere undifferentiated (G4) followed by poorly differentiated (G3). While in TNM staging system varied pattern was observed,majority were in stage IV followed by Stage I. Majority of lymph node and distant metastasis were seen in grade 4 histologyand all of them were in TNM stage IV.Evaluation of Retinoblastoma According to HistologicalGrading, TNM Staging and Age at Presentatio

MMP-2 and MMP-9 in normal mucosa are independently associated with outcome of colorectal cancer patients.

BackgroundUpregulation of the matrix metalloproteinases MMP-2 and MMP-9 in various cancers has been associated with worse survival of the patients.MethodsWe assessed MMP-2 and MMP-9 levels in normal colorectal mucosa from colorectal cancer patients in relation to the course of the disease.ResultsA high protein expression of MMP-2 as well as MMP-9 in normal mucosa was found to be correlated with worse 5-year survival. The combination of both parameters was an even stronger prognostic factor. These protein levels were found not to be related to the corresponding single nucleotide polymorphisms of MMP-2 (-1306C&gt;T) and MMP-9 (-1562C&gt;T). Multivariate analyses indicated that the MMP-2 and MMP-9 levels in normal mucosa are prognostic for survival, independent of TNM classification.ConclusionMMP-2 and MMP-9 levels in normal mucosa are indicative of the course of disease in colorectal cancer patients

Female breast cancer treatment and survival in South Australia: Results from linked health data.

Objective We investigated treatment and survival by clinical and sociodemographic characteristics for service evaluation using linked data. Method Data on invasive female breast cancers (n = 13,494) from the South Australian Cancer Registry (2000–2014 diagnoses) were linked to hospital inpatient, radiotherapy and universal health insurance data. Treatments ≤12 months from diagnosis and survival were analysed, using adjusted odds ratios (aORs) from logistic regression, and adjusted sub-hazard ratios (aSHRs) from competing risk regression. Results and conclusion Five-year disease-specific survival increased to 91% for 2010–2014. Most women had breast surgery (90%), systemic therapy (72%) and radiotherapy (60%). Less treatment applied for ages 80+ vs <50 years (aOR 0.10, 95% CI 0.05–0.20) and TNM stage IV vs stage I (aOR 0.13, 95% CI 0.08–0.22). Surgical treatment increased during the study period and strongly predicted higher survival. Compared with no surgery, aSHRs were 0.31 (95% CI 0.26–0.36) for women having breast-conserving surgery, 0.49 (95% CI 0.41–0.57) for mastectomy and 0.42 (95% CI 0.33–0.52) when both surgery types were received. Patients aged 80+ years had lower survival and less treatment. More trial evidence is needed to optimise trade-offs between benefits and harms in these older women. Survival differences were not found by residential remoteness and were marginal by socioeconomic status

First interim analysis of the GIDEON (Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib) non‐interventional study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92068/1/j.1742-1241.2012.02940.x.pd

Which interval is most crucial to presentation and survival in gastroesophageal cancer: a systematic review

Aim: The aim of this study was to identify the most crucial interval to encourage earlier diagnosis in with gastroesophageal cancer and to identify potential factors effecting this interval. Background: Gastroesophageal malignancy is the eighth most commonly presenting cancer with one of the worst survival rates. Identifying the most crucial period for intervention to inform earlier diagnosis is an important step towards improving survival. Design: Mixed methods literature review. Data Sources: CINAHL, MEDLINE and Academic search primer online databases were searched using keywords and inclusion/exclusion criteria. Empirical evidence published between 2000–2016 with a focus on gastroesophageal cancer presentation and survival was reviewed to inform this study. Review methods: Twelve studies were extracted for further review. Selected studies were appraised and presented through Olensen's “delay interval” framework to inform the most crucial interval to survival in gastroesophageal cancer. Results: The findings identify the patient interval as the most critical period for encouraging earlier presentation and reducing advanced stage presentation in gastroesophageal cancer. The article also highlighted some methodological limitations to cancer research, such as a lack of consensus in definitions which prevent statistical meta-analysis of cancer data, survivor bias in gastroesophageal cancer studies and a significant lack of qualitative evidence to reveal patient experience in presenting with this cancer. Conclusion: Further research into the patient interval is required to elicit information on how and why patients present with their cancer symptoms