Real-life experience of patients with sarcomatoid renal cell carcinoma: a multicenter retrospective study

Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant

Survival results according to Oncotype Dx recurrence score in patients with hormone receptor positive HER-2 negative early-stage breast cancer: first multicenter Oncotype Dx recurrence score survival data of Turkey

Background: The Oncotype Dx recurrence score (ODx-RS) guides the adjuvant chemotherapy decision-making process for patients with early-stage hormone receptor-positive, HER-2 receptor-negative breast cancer. This study aimed to evaluate survival and its correlation with ODx-RS in pT1-2, N0-N1mic patients treated with adjuvant therapy based on tumor board decisions. Patients and methods: Estrogen-positive HER-2 negative early-stage breast cancer patients (pT1-2 N0, N1mic) with known ODx-RS, operated on between 2010 and 2014, were included in this study. The primary aim was to evaluate 5-year disease-free survival (DFS) rates according to ODX-RS. Results: A total of 203 eligible patients were included in the study, with a median age of 48 (range 26-75) and median follow-up of 84 (range 23-138) months. ROC curve analysis for all patients revealed a recurrence cut-off age of 45 years, prompting evaluation by grouping patients as ≤45 years vs. >45 years. No significant difference in five-year DFS rates was observed between the endocrine-only (ET) and chemo-endocrine (CE) groups. However, among the ET group, DFS was higher in patients over 45 years compared to those aged ≤45 years. When stratifying by ODx-RS as 0-17 and ≥18, DFS was significantly higher in the former group within the ET group. However, such differences were not seen in the CE group. In the ET group, an ODx-RS ≥18 and menopausal status were identified as independent factors affecting survival, with only an ODx-RS ≥18 impacting DFS in patients aged ≤45 years. The ROC curve analysis for this subgroup found the ODx-RS cut-off to be 18. Conclusion: This first multicenter Oncotype Dx survival analysis in Turkey demonstrates the importance of Oncotype Dx recurrence score and age in determining treatment strategies for early-stage breast cancer patients. As a different aproach to the literature, our findings suggest that the addition of chemotherapy to endocrine therapy in young patients (≤45 years) with Oncotype Dx recurrence scores of ≥18 improves DFS. Copyright © 2023 Ünal, Özmen, Ordu, Pilanci, İlgün, Gökmen, Almuradova, Özdoğan, Güler, Uras, Kara, Demircan, Işık, Alço, Saip, Aydın, Duymaz, Çelebi, Yararbaş, Soybir and Ozmen

METASTATIC BREAST CANCER

Breast cancer is the most common cause of death among women from malignant tumors. Metastatic breast cancer is not currently a curable disease. According to most authors, especially in developing countries, from 50 to 70% of patients already have advanced forms of the disease upon admission (locally common forms, in the form of lesions of regional lymph nodes and distant metastases to various organs). The nature and frequency of distant breast cancer metastases is very diverse. In 40-80% of cases, breast cancer metastasizes to bone. However, it can metastasize other organs and systems, for example, to the liver, lungs, ovaries, brain, and others. Diagnosis and treatment of distant breast cancer metastases is an urgent problem in oncammammology, since mortality in these forms remains very high, and the long-term and immediate results of treatment are still very unsatisfactory. The conducted therapy, being palliative, is aimed at improving quality and prolonging life. The most effective for conducting palliative therapy for this group of patients is various chemotherapy regimens. But traditionally used chemotherapy regimens do not always turn out to be effective; on the contrary, cytostatics weaken the body’s resistance and deplete the body’s immunobiological reserve, sometimes they worsen not only the quality of life, but also shorten the duration

Metastatic Pancreatic Cancer Second-Line Treatment Options: Is the Difference Only in Cost?

WOS:000605102700001PubMed: 33400209Introduction Although pancreatic cancer ranks seventh in cancer-related deaths, it is an extremely fatal disease, and more than 330,000 people die from this disease worldwide. Although there are many first-line treatment studies in the literature, there are almost no prospective studies regarding second-line therapy. Therefore, there is no standard approach in the second-line treatment of pancreatic cancer. We decided to conduct this study to investigate second-line treatments with problems such as cost, treatment efficacy, and toxicity. Methods Patients older than 18 years old who applied to Ege University Hospital medical oncology department with a diagnosis of metastatic pancreatic cancer, who received first-line chemotherapy due to their illness, and who had progressed afterwards were included in the study. The files of the patients who applied between 2013 and 2017 were examined. Results Our study's primary endpoint was progression-free survival, and it was found that the median progression-free survival was 3.2 months in the Xelox patients, 3.7 months in the gemcitabine-nab paclitaxel patients, and 3.5 months in the other regimens. When the secondary endpoint was evaluated, overall survival, the median overall survival was 5.9 months in the Xelox patients, 5.3 months in the gemcitabine-nab paclitaxel patients, and 4.8 months in the other regimens. Conclusion As a result, second-line treatments were compared, and no statistically significant difference was found between them. For this reason, the side effects of previously used drugs and the side effects of new drugs to be used, as well as their costs, should be evaluated when choosing a treatment

Importance of p53, bcl-2 genes in uterine body cancer and their role in prediction

Uterine body cancer (UBC) makes up 7.1% of malignant tumors in women and ranks 6th in the structure of the incidence of malignant tumors in women in the world after breast cancer, cervical cancer, colorectal cancer, lung and thyroid cancer. In developed countries, it is the most common malignant tumor of the female genital organs. The study included 105 patients with a diagnosis of stage I uterine body cancer, the patients were divided into 2 groups: I - the main group consists of 60 patients who received preoperative brachytherapy (Total focal dose (TFD) = 16-20Gy). Control group II consisted of 45 patients who, after curettage of the uterine cavity, were immediately operated on in the volume of extirpation of the uterus with appendages and routinely received combined radiation therapy: from distance gamma therapy (DGT) TFD = 44 Gy, from brachytherapy TFD = 20 Gy. All biological materials obtained during curettage of the uterine cavity and as a result of surgery in both groups were subjected to immunohistochemistry. The mutant p53 gene and the apoptosis regulator bcl-2 were studied by immunohistochemical method.&nbsp

Клинический случай хирургического лечения злокачественной опухоли из оболочек периферических нервов забрюшинной локализации

Clinical case. The article presents a clinical case of malignant retroperitoneal schwannoma, which was a diagnostic finding. The clinical picture of the disease was dominated by pain in the lower abdomen and lower back, frequent urination. After a diagnostic examination and preliminary preparation, the patient was operated on in a hospital at the oncogynecology department of the Tashkent City branch of the Republican Specialized Scientific and practical Medical Center of Oncology and Radiology with a preliminary diagnosis of an ovarian tumor. Interrooperatively, a tumor of the retroperitoneal space with lesions of the obturator nerve was revealed. Subsequently, immunohistochemical analysis clarified the histological type of the tumor, which turned out to be a malignant schwannoma of the retroperitoneal space.Conclusion. These data may help in the management of patients with this pathology and improve the diagnosis of patients with small pelvic tumors.В статье представлен клинический случай злокачественной шванномы забрюшинного пространства, которая явилась диагностической находкой. После обследования и предварительной подготовки больная прооперирована в стационарных условиях отделения онкогинекологии Ташкентского городского филиала Республиканского специализированного научно-практического медицинского центра онкологии и радиологии с предварительном диагнозом по поводу опухоли яичника. Интраоперационно выявлена опухоль забрюшинного пространства с поражением обтураторного нерва. В дальнейшем с помощью иммуногистохимического анализа уточнен гистологический тип опухоли: злокачественная шваннома ретроперитонеального пространства.Заключение. Эти данные могут помочь при ведении больных с данной патологией и улучшить диагностику больных c опухолями малого таза