The Use of Neutrophil/Lymphocyte Ratio (Nlr), Platelet/Lymphocyte Ratio (Plr), and Mean Platelet Volume (Mpv) As Inflammatory Biomarkers in the Prognosis of Patients with Early-Stage Colorectal Adenocarcinoma

WOS: 000419586300003Colorectal cancer (CRC) represents the most prevalent cancer of the gastrointestinal system in adults. Despite long-term survival rates achieved by early resection and adjuvant therapies, relapse is a significant problem for those patients. The present study aims to investigate the possibility of using neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) as biomarkers for postoperative relapse in patients with CRC. We retrospectively analyzed 188 non-metastatic CRC patients followed up and treated at Dokuz Eylul University, Faculty of Medicine Hospital, Medical Oncology Clinic. We recorded demographic, laboratory and histopathological data from patient files and we calculated NLR, PLR and MPV, which were recorded as preoperative, postoperative and relapse values. This study classified patients into two groups: relapsed and relapse-free patients. Twenty-five patients (13.3%) developed a relapse during the follow-up period. The relapsed group had a higher NLR prior to tumor resection compared to the relapse-free patients, whereas PLR and MPV were not high. Despite the absence of any significant change in NLR or MPV after tumor resection, PLR displayed an upwards trend. At the time of relapse, CEA and MPV increased as PLR fell (compared to the postoperative period). The relapse-free group exhibited a significant decrease in CEA and MPV after tumor resection, and other parameters did not change. Comparing the results based on disease stages, stage III patients had significantly higher MPV levels than the stage II. NLR, MPV and PLR may help physicians identify prognosis after tumor resection in patients with CRC

The role of BRAF mutation in patients with high-risk malignant melanoma treated with high-dose adjuvant interferon therapy

Data regarding the prognostic importance of BRAFV600 tumor mutations in high-risk, non-metastatic, stage 2 and 3 malignant melanoma (MM) patients are controversial. There is not sufficient information in the medical literature regarding the reliability of BRAF mutations as a predictive factor in prognosis and adjuvant treatment decision issues in this patient group. The data of 50 operated high-risk, non-metastatic, stage 2B/2C and 3 MM patients who received high-dose interferon alfa-2b therapy were evaluated retrospectively. BRAF mutations were analyzed by using microarray-based molecular methods. The associations between BRAF mutations and both clinicopathological characteristics and survival were assessed. Of the 50 patients, 52 % was female and 48 % was male, and the median age was 51.5 years. Twenty-three (46 %) and 27 (54 %) patients had stage 2B/2C and stage 3 disease, respectively. BRAF mutation was detected in 21 patients. The median overall survival (OS) was 58.1 months, whereas the median disease-free survival (DFS) was 22.7 months. When the OS and DFS were compared according to the BRAF mutation status, no difference was detected between the two groups. BRAF mutations were detected more frequently in tumors with mitosis and ulceration; however, no statistically significant difference was observed in other clinicopathological parameters. In conclusion, it is not appropriate to use BRAF mutations as a prognostic and predictive marker for selecting the treatment and assessing its outcomes in patients with early stage, high-risk MM

Is monitoring mean platelet volume necessary in breast cancer patients?

Background: Mean platelet volume (MPV) is a parameter that increases during thrombotic and cardiovascular events. Tamoxifen (Tmx) and aromatase inhibitors (AIs), which are adjuvant endocrine therapies, may cause serious side effects, such as vascular thrombosis. The present study investigated the changes in MPV values of breast cancer patients receiving long-term adjuvant hormone therapy and the relationship of MPV with adverse effects of hormonotherapy

Case report of a renal cell carcinoma patient with acute pancreatitis under both sunitinib and axitinib treatment

Sunitinib and axitinib are oral tyrosine kinase inhibitors (TKI) that is commonly used in the treatment of metastatic renal cell carcinoma (RCC) as it has been shown to improve the progression-free survival of patients compared with sorafenib. Hypertension, palmar-plantar erythrodysesthesia, diarrhea, decreased appetite, nausea, and fatigue are common adverse events associated with them. We declared the first case report of a RCC patient with acute pancreatitis both under sunitinib and axitinib treatment. A 63-year-old male RCC patient who had been previously treated with interferon alfa 2b, sunitinib, everolimus and axitinib was hospitalized for acute pancreatitis four months after the onset of sunitinib therapy and five months after the onset of axitinib treatment. Symptoms and levels of serum lipase were normalized within one week after drug was withheld. Acute pancreatitis is a rare side effect of TKI and because of this, in patients under TKI treatment abdominal pain should be considered as a possible symptom of acute pancreatitis

Prevalence and related factors of sarcopenia in newly diagnosed cancer patients

Introduction Sarcopenia is defined as the loss of muscle mass and muscular functioning. Although sarcopenia prevalence is highly variable in the literature, pre-chemotherapy sarcopenia prevalence was not well studied in newly diagnosed cancer patients. In this context, the present study aims to determine the prevalence of sarcopenia and its related factors in this population. Material and methods Prospectively, newly diagnosed cancer patients were evaluated for body composition measurement and muscle strength by employing the bioelectric impedance analysis method and handgrip dynamometer tool. Results A total of 461 patients were included in the study. The median age of patients was 59 years (range 18-83) and 258 patients (56%) were women. Sarcopenia was present in 77 patients (16.7%) and was at significantly higher frequencies in men (p = 0.015), advanced age (>= 65 years, p = 0.014), lower body mass index (BMI 0, p = 0.026). In multivariate analyses, advanced age (over 65 years), gender (men), and lower body mass index (BMI < 25) were significantly associated with sarcopenia (p values 0.033, < 0.001, and < 0.001, respectively). Conclusions Our study is the first prevalence study conducted with bioelectric impedance analysis on Turkish cancer patients and sarcopenia was detected to be notably prevalent among our patients with newly diagnosed cancer. Given the likely negative outcomes of sarcopenia reported in the literature (treatment failure, increased complications, and impaired survival), it is important to know the presence of sarcopenia before treatment and take preventive precautions

The role of FOLFOXIRI in chemorefractory metastatic colorectal cancer patients

Introduction: The use of FOLFOXIRI (oxaliplatin, irinotecan, leucovorin, and 5-fluorouracil) as first-line therapy for metastatic colorectal cancer (mCRC) is well-established. However, there is no data about the effectiveness of this regimen in pretreated patients in the current literature. In this case report, we aim to evaluate the efficacy and benefit of FOLFOXIRI in patients who received standard regimens. Case report: 3 patients were treated with FOLFOXIRI and 1 patient received FOLFOXIRI + bevasizumab. Three patients had a partial response to FOLFOXIRI; one of these patients showed disease progression on this chemotherapy regimen and died. Progression free survival (PFS) of three patients was 5.5, 9 and 7.5 months respectively. One patient showed progression without any response to treatment. Conclusion: We observed a partial response in 3 patients who were treated with FOLFOXİRİ and their progression-free survival was more than 3 months. These patients were treated with FOLFOXİRİ as a third or fourth line therapy. FOLFOXIRI should be considered as an alternative option in patients who have received standard treatments with good performance status. Keywords: Colorectal cancer, FOLFOXIRI, Metastatic, Chemorefractor

Chemotherapy-induced sarcopenia in newly diagnosed cancer patients: Izmir Oncology Group (IZOG) study

BackgroundSarcopenia is associated with physical disability, increased post-operative complications, poorer tolerance to chemotherapy, and reduced survival outcome. However, little is known about the changes in body composition during chemotherapy treatment. We aimed to determine whether adjuvant or palliative chemotherapy causes the development of sarcopenia in newly diagnosed cancer patients and to reveal the relationship of sarcopenia with the duration of chemotherapy.MethodsThe study included newly diagnosed cancer patients who underwent curative surgery for primary tumor and also cancer patients who were metastatic at diagnosis. Body composition and handgrip strength were assessed by bio-electric impedance analysis (BIA) and handgrip dynamometer tools, respectively. Measurement tests were performed prior to chemotherapy, in the third and sixth months of chemotherapy.ResultsThe median age of a total of 276 patients was 57.5 years (range 18-83), and majority of them (55.8%) were women. Among the pre-chemotherapy factors that could be associated with sarcopenia, male gender >= 65 years of age, body mass ndex (BMI) < 25, and nutritional risk screening 2002 score < 3 were found to be positively associated with sarcopenia (p < 0.001, p = 0.036, p < 0.001, and p < 0.001, respectively). In the multivariate analysis, male gender (p < 0.001) and BMI < 25 (p = 0.047) were found to be significant. Of 276 patients, 14.5% were sarcopenic prior to chemotherapy. After chemotherapy, 21.4% of them were sarcopenic at the end of the third month and 23.9% were sarcopenic at the end of the sixth month.ConclusionThe incidence of sarcopenia was found to be increased with chemotherapy itself and its duration in both non-metastatic and metastatic cancer patients which has to be evaluated in detail in disease-specific prospective and randomized studies

HALP score and GNRI: Simple and easily accessible indexes for predicting prognosis in advanced stage NSCLC patients. The Izmir oncology group (IZOG) study

ObjectiveThe Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) Score and the Geriatric Nutrition Risk Index (GNRI) are used as prognostic factors in different types of cancers. In this study we analyzed the prognostic value of the HALP Score and the GNRI calculated prior to first-line treatment in patients diagnosed with de novo metastatic non-small cell lung cancer (mNSCLC). Materials and methodsDe novo mNSCLC patients were retrospectively evaluated from January 2016 to December 2019. Patients with Driver's mutation, severe comorbidities, active infection, or insufficient organ function, and those receiving anti-inflammatory treatment were excluded from the study. Optimal cut-off points for the HALP score and the GNRI were calculated with the receiver operating characteristic (ROC) curve analysis. Predictive factors for overall survival (OS) were assessed with univariate and multivariate Cox proportional hazard analyses, and OS was studied with the Kaplan-Meier analysis. ResultsThe study included 401 patients in total. In the ROC curve analysis, the cut-off points were found 23.24 (AUC = 0.928; 95% CI: 0.901-0.955, p < 0.001) for HALP, and 53.60 (AUC = 0.932; 95% CI: 0.908-0.955, p < 0.001) for GNRI. Groups with lower HALP scores and lower GNRI had significantly shorter OS compared to those with higher HALP scores and GNRIs. Univariate analysis showed that male gender, smoking, high ECOG score, low HALP score and low GNRI were associated with worse survival rates. Multivariate analysis showed that low HALP score (HR = 2.988, 95% CI: 2.065-4.324, p < 0.001); low GNRI score (HR = 2.901, 95% CI: 2.045-4.114, p < 0.001) and smoking history (HR = 1.447, 95% CI: 1.046-2.001, p = 0.025) were independent factors associated with worse OS rates. ConclusionOur study showed the HALP score and the GNRI to be of prognostic value as simple, cost-effective, and useful markers that predict OS in de novo mNSCLC patients

Prognostic role of De Ritis and basal neutrophil to lymphocyte ratio in patients with advanced stage pancreatic cancer [Izmir Oncology Group (IZOG) Study]

Purpose: We aimed to investigate the prognostic significance of neutrophil/lymphocyte ratio (NLR), an indirect indicator for the immune response and AST/ALT ratio (De Ritis), liver enzymes that are commonly used in various clinical fields, in patients with advanced-stage pancreatic cancer

Is adjuvant chemotherapy necessary for Luminal A-like breast cancer?

Purpose: Patients with breast cancer with Luminal-A subtype have a better prognosis but poor chemotherapy response. Chemotherapy is controversial in lymph node-positive patients with Luminal-A subtype. In this retrospective study, we aimed to evaluate the efficacy and benefit of chemotherapy in the Luminal A-like subtype of breast cancer