PD-L1 expression in immune cells is a favorable prognostic factor for nasopharyngeal carcinoma

Background: Programmed death-ligand 1 (PD-L1) has been determined as a reliable prognostic factor for various malignancies. In this study, we aimed to determine the prognostic effect of PD-L1 expression in tumor-infiltrating immune cells (TIICs) of nasopharyngeal carcinoma (NPC) patients.Methods: Seventy patients diagnosed with non-metastatic NPC were included in the study. PD-L1 expression on immune cells was analyzed by immunohistochemical method. Patients were categorized into two groups according to the PD-L1 expression level in TIICs (level of PD-L1 staining ≥5% positive vs <5% negative).Results: Median follow-up period was 34 months (range = 1 - 188). 1 and 2 years survival rate were found as 75% and 63% in PD-L1 negative TIICs group (47%), and 85% and 83% in PD-L1 positive TIICs group (53%), respectively. PD-L1 positivity in immune cells (ICs) was detected in 53% of the patients. The survival rate was found better in the PD- L1 positive group compared to the negative group (P = 0.049).Discussion: In conclusion, the survival rate was found significantly better in the PD-L1 positive TIICs group, compared to the negative group

Predictive factor for lymph node metastasis in non-metastatic colorectal adenocarcinomas

Objectives: To evaluate the predictive factors of lymph node involvement in non-metastatic colorectal adenocarcinomas (nmCRC). Methods: A total of 453 patients diagnosed with nmCRC were analyzed regarding T stage, lymphovascular invasion status, tumor grade and proposed risk score (RS), determined by the combination of these three factors for lymph node metastasis. Results: The median age was 62 (25-90 years), M/F ratio was 1.4:1 and majority of the patients had tumors localized on the left colon (70.6%). The number of excised lymph nodes was ≥12 in 77% of the cases. The postoperative pathological assessments revealed that 57.2% of patie,nts had N0 disease, 29.1% had N1 disease, and 13.7% had N2 disease. The T stages (p=0.007), grade (p<0.001), lymphovascular invasion (p=0.002), RS (p<0.001), and number of excised lymph nodes (p=0.029) were significantly different between N0, N1, and N2 patients. Higher RS was associated with lymph node metastasis (p<0.001). Conclusion: The risk score may predict lymph node metastasis in patients with nmCRC and if validated may be helpful in the decision-making of adjuvant chemotherapy, especially in the elderly and patients with inadequate lymph node dissection

Necrotizing Fasciitis Secondary To Bevacizumab Treatment For Metastatic Rectal Adenocarcinoma

Bevacizumab is a recombinant humanized monoclonal antibody that selectively blocks the activity of vascular endothelial growth factor (VEGF) receptor and it is used in metastatic colorectal patients. We present here a case of fatal necrotizing fasciitis in a patient during bevacizumab treatment for colorectal cancer. In our review of the literature, necrotizing fasciitis was not reported before or during bevacizumab treatment.PubMedWo

Serum 25-Hydroxy Vitamin D Status Is Not Related To Osteopenia/Osteoporosis Risk in Colorectal Cancer Survivors

Background: The incidence of colorectal cancer increases with vitamin D deficiency as shown in recently published studies. In addition, prospective investigations have indicated that low vitamin D levels may be associated with increased mortality of colorectal cancer, especially in stage III and IV cases. However, the exact incidence of vitamin D deficiency and the relation between vitamin D deficiency and osteopenia/osteporosis is still not known. The aim of this study is to identify severity of vitamin D deficiency and absolute risk factors of osteopenia/osteoporosis in colorectal cancer survivors. Materials and Methods: A total of 113 colorectal cancer survivors treated with surgery and/or chemotherapy +/- radiotherapy were recruited from medical oncology outpatient clinics during routine follow-up visits in 2012-2013. Bone mineral densitometry (BMD) was performed, and serum 25-OH vitamin D levels were also checked on the same day of the questionnaire. The patients was divided into 2 groups, group A with normal BMD and group B with osteopenia/osteoporosis. Results: The median age of the study population was 58 (40-76). Thirty (30.0%) were female, whereas 79 (70.0%) were male. The median follow-up was 48 months (14-120 months). Vitamin D deficiency was found in 109 (96.5%); mild deficiency (20-30 ng/ml) in 19 (16.8%), moderate deficiency (10-20 ng/ml) in 54 (47.8%) and severe deficiency (< 10 ng/ml) in 36 (31.9%). Osteopenia was evident in 58 (51.4%) patients whereas osteoporosis was noted in 17 (15.0%). Normal BMD was observed in 38 (33.6%). No apparent effects of type of surgery, presence of stoma, chemotherapy, radiotherapy and TNM stage were found regarding the risk of osteopenia and osteoporosis. Also, the severity of the vitamin D deficiency had no effect in the risk of osteopenia and osteporosis (p=0.93). In female patients, osteopenia/osteoporosis were observed in 79.5% patients as compared to 60.7% of male patients (p=0.04). Conclusions: In our study, vitamin D deficiency and osteopenia/osteoporosis was observed in 96.5% and 66.4% of colorectal cancer survivors, respectively. There is no defined absolute risk factor of osteopenia and osteoporosis in colorectal cancer survivors. To our knowledge, in the literature, our study is the first to evaluateall the risk factors of osteopenia and osteoporosis in colorectal cancer survivors.WoSScopu

Turkish Oncology Group

Background: An association between the ABO blood group and the risk of certain malignancies, including pancreatic and gastric cancer, has been reported previously. However, it is unclear whether this association is valid for gastrointestinal stromal tumors (GIST). In this study, ABO blood groups and the Rh factor were investigated in a series of GIST cases. Material and Methods: In 162 patients with GIST, blood group and Rh factor were examined and compared with a control group of 3,022,883 healthy volunteer blood donors of the Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with tumor size, mitotic activity, and age were also evaluated. Results: Overall, the ABO blood group and Rh factor distributions of the 162 patients with GIST were similar to those of the general population. There were no significant differences between both ABO blood types and Rh factor in terms of tumor size, mitotic activity, and age. Conclusion: This is the first study reported on this issue. In our study, we didn't find any relationship between GIST and ABO blood group and Rh factor. However further studies with larger number of patients are needed to establish the role of blood groups in this population.WoSScopu

Clinical predictive factors associated with pathologic complete response in locally advanced rectal cancer

Objective: In this study, our aim was to identify the main predictive factors associated with pathologic complete response (pCR) to neoadjuvantchemoradiotherapy (nCRT) in patients with locally advanced rectal cancer. Methods: The patients who had locally advanced rectal cancer and underwent a long-course nCRT, followed by curative surgery between January 2009 and December 2015 at two-center were included. The clinical factors associated with pCR or non-pCR were analyzed by Logistic regression. Results: Two hundred and three patients were included in this study. Forty-six patients (22.7%) had pCR and 157 patients (77.3%) had non-pCR. In the univariate analysis, no smoking history, clinically negative lymp node (cN-), well-differentiated tumor, tumor size of ≤5 cm, pre-nCRT CEA level of ≤5 (ng/mL) and median interval to surgery>8 week were associated with an increased rate of pCR. No smoking history [odds ratio (OR) = 3.382, P = .008], endoscopic tumor size of ≤5 [OR = 2.608, P = .03], cN- [OR = 3.800, P = .002], well-differentiated tumor [OR = 3.566, P = .002], median interval to surgery of >8 week [OR = 2.981, P = .014], and pre-nCRT CEA level of ≤5 (ng/mL) [OR = 3.067, P = .008] were determined to be independent predictive factors of pCR with logistic regression model analysis. Conclusion: No smoking history, cN-, tumor size of ≤5 cm, well-differentiated tumor, pre-nCRT CEA level of ≤5 (ng/mL) and median interval to surgery of >8 weeks were independent clinical predictors for pCR in rectal cancer patients treated with long course of nCRT. This factors may help clinicians predict the prognosis of patients and develop proper treatment approach. Keywords: Pathologic complete response, Neoadjuvant chemoradiotherapy, Locally advanced rectal cancer, Leukocyte/lymphocyte ratio, Platelet/lymphocyte rati

Evaluation of prognostic factors and treatment in advanced small bowel adenocarcinoma: report of a multi-institutional experience of anatolian Society of medical oncology (ASMO)

WOS: 000388782200027PubMed ID: 27837629Purpose: Small bowel adenocarcinoma (SBA) is a rare tumor of the gastrointestinal system with poor prognosis. Since these are rarely encountered tumors, there are limited numbers of studies investigating systemic treatment in advanced SBA. The purpose of this study was to evaluate the prognostic factors and systemic treatments in patients with advance SBA. Methods: Seventy-one patients from 18 Centers with advanced SBA were included in the study. Fifty-six patients received one of the four different chemotherapy regimens as first-line therapy and 15 patients were treated with best supportive care (BSC). Results: Of the 71 patients, 42 (59%) were male and 29 (41%) female with a median age of 56 years. Median follow-up duration was 14.3 months. The median progression free survival (PFS) and overall survival (OS) were 7 and 13 months, respectively (N=71). In patients treated with FOLFOX (N=18), FOLFIRI (N=11), cisplatin-5-fluoroura-cil/5-FU (N=17) and gemcitabine alone (N=10), median PFS was 7, 8, 8 and 5 months, respectively, while median OS was 15, 16, 15 and 11 months, respectively. No significant differences between chemotherapy groups were noticed in terms of PFS and OS. Univariate analysis revealed that chemotherapy administration, de novo metastatic disease, ECOG PS 0 and 1, and overall response to therapy were significantly related to improved outcome. Only overall response to treatment was found to be significantly prognostic in multivariate analysis (p = 0.001). Conclusions: In this study, overall response to chemotherapy emerged as the single significant prognostic factor for advanced SBAs. Platin and irinotecan based regimens achieved similar survival outcomes in advanced SBA patients