Prospective transGEICAM study of the impact of the 21-gene recurrence score assay and traditional clinicopathological factors on adjuvant clinical decision making in women with estrogen receptor-positive (ER+) node-negative breast cancer
Albanell J.,Hospital del Mar |
Albanell J.,IMIM Hospital del Mar Research Institute |
Albanell J.,Autonomous University of Barcelona |
Gonzalez A.,Medical Oncology Service |
And 22 more authors.
Annals of Oncology | Year: 2012
Background: This study examined the impact of the Recurrence Score (RS) in Spanish breast cancer patients and explored the associations between clinicopathological markers and likelihood of change in treatment recommendations. Patients and methods: Enrollment was offered consecutively to eligible women with estrogen receptor-positive; human epidermal growth factor receptor 2-negative, node-negative breast cancer. Oncologists recorded treatment recommendation and confidence in it before and after knowing the patient's RS. Results: Treatment recommendation changed in 32% of 107 patients enrolled: in 21% from chemohormonal (CHT) to hormonal therapy (HT) and in 11% from HT to CHT. RS was associated with the likelihood of change from HT to CHT (P < 0.001) and from CHT to HT (P < 0.001). Confidence of oncologists in treatment recommendations increased for 60% of cases. Higher tumor grade (P = 0.007) and a high proliferative index (Ki-67) (P = 0.023) were significantly associated with a greater chance of changing from HT to CHT, while positive progesterone receptor status (P = 0.002) with a greater probability of changing from CHT to HT. Conclusions: Results from the first prospective European study are consistent with published experience and use of the RS as proposed in European clinical practice guidelines and provide evidence on how Oncotype DX and clinicopathological factors are complementary and patient selection may be improved. © The Author 2011. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
Sepulveda I.,General Hospital of Concepcion |
Sepulveda I.,Finis Terrae University |
Sepulveda I.,General Hospital Guillermo Grant Benavente |
Platin E.,University of North Carolina at Chapel Hill |
And 5 more authors.
Case Reports in Oncology | Year: 2014
We report the case of a patient who presented to the ENT service with left facial swelling of 5 months duration. Imaging studies revealed a dense expansive mass confined to the inside of the left deep parotid lobule and moderate enhancement following contrast media injection. Subsequently, a biopsy confirmed the presence of an oncocytoma. The patient was treated with total parotidectomy, complete tumor resection and sparing facial nerve surgery. Today, the patient is disease free and has no complications. © 2014 S. Karger AG, Basel.
Cheng L.,Indiana University |
Comperat E.,Pathology Service |
Rouprt M.,Hospital Pitie Salpetriere |
Menendez C.L.,Hospital of Cabuees |
Montironi R.,Marche Polytechnic University
Pathology | Year: 2010
We present the clinicopathological features of eight cases of large cell undifferentiated bladder carcinoma not otherwise specified (LCUBC). LCUBC was characterised by sheets of large polygonal or round cells with moderate to abundant cytoplasm and distinct cell borders. The LCUBC component varied from 90 to 100 of the tumour specimen with five cases showing pure LCUBC. The architectural pattern of the tumour varied from infiltrating tumour to solid expansile nests with focal (<5%) discohesive growth pattern in two cases. Immunohistochemical staining demonstrated that LCUBC cases were positive for cytokeratins AE1/AE3 and 7; CAM 5.2, CK20, thrombomodulin and uroplakin III were positive in six, three, three and two cases, respectively. Other immunohistochemical markers performed in the differential diagnosis context included alpha-fetoprotein, beta human chorionic gonadotrophin (βhCG), prostate specific antigen (PSA), vimentin, synaptophysin and chromogranin and all were negative. Ki-67 and p53 labelling indexes were 50-90% and 40-90%, respectively. All patients had advanced stage cancer (≥pT3) and seven (87.5%) had lymph node metastases. Follow-up information was available in all cases, with a range of 626 months (mean 10.6 months). Six patients died of disease between 5 and 26 months and two patients were alive with metastases at 6 and 14 months. The prognosis of LCUBC was compared with conventional urothelial carcinoma of similar stages showing survival differences (p=0.0004). In summary, LCUBC is an aggressive variant of urothelial carcinoma that presents at an advanced stage. © 2010 Royal College of Pathologists of Australasia.
Rached Palermo M.H.,Hospital Regional Of Franca |
Pinto M.B.,Pathology Service |
Zanetti J.S.,University of Sao Paulo |
Ribeiro-Silva A.,University of Sao Paulo
Polish Journal of Pathology | Year: 2013
Mucoepidermoid carcinomas in mammary glands represent 0.3% of all breast tumors. Features of salivary gland mucoepidermoid carcinoma have been used in studies concerning mucoepidermoid carcinomas of the breast because both share similar morphologic and molecular features. We report a case of primary mucoepidermoid carcinoma of the breast with an immunohistochemistry staining panel. We verified that MUC5AC occurs in more than 50% of high-grade tumors, and MUC1 correlates with shorter disease-free survival. The comparative analysis of mucin profiles may provide further insights into the clinical behavior of these tumors.
PubMed | Elea Laboratories, Pathology Service, National University of Quilmes, Chemo Romikin and 3 more.
Type: | Journal: SpringerPlus | Year: 2015
Desmopressin (dDAVP) is a well-known peptide analog of the antidiuretic hormone vasopressin, used to prevent excessive bleeding during surgical procedures. dDAVP increases hemostatic mediators, such as the von Willebrand factor (vWF), recently considered a key element in resistance to metastasis. Studies in mouse models and veterinary trials in dogs with locally-advanced mammary tumors demonstrated that high doses of perioperative dDAVP inhibited lymph node and early blood-borne metastasis and significantly prolonged survival. We conducteda phase II dose-escalation trial in patients with breast cancer, administering a lyophilized formulation of dDAVP by intravenous infusion in saline, 30-60min before and 24h after surgical resection. Primary endpoints were safety and tolerability, as well as selection of the best dose for cancer surgery. Secondary endpoints included surgical bleeding, plasma levels of vWF, and circulating tumor cells (CTCs) as measured by quantitative PCR of cytokeratin-19 transcripts. Only 2 of a total of 20 patients experienced reversible adverse events, including hyponatremia (grade 4) and hypersensitivity reaction (grade 2). Reactions were adequately managed by slowing the infusion rate. A reduced intraoperative bleeding was noted with increasing doses of dDAVP. Treatment was associated with higher vWF plasma levels and a postoperative drop in CTC counts. At the highest dose level evaluated (2g/kg) dDAVP appeared safe when administered in two slow infusions of 1g/kg, before and after surgery. Clinical trials to establish the effectiveness of adjunctive perioperative dDAVP therapy are warranted. This trial is registered on www.clinicaltrials.gov (NCT01606072).
Trape J.,Laboratory Medicine Service |
Montesinos J.,Medical Oncology Service |
Catot S.,Medical Oncology Service |
Buxo J.,Medical Oncology Service |
And 6 more authors.
International Journal of Biological Markers | Year: 2012
Aims: The objective of the present study is to determine the prognostic value of clinical variables and biomarkers in patients with advanced stages of NSCLC and establish a prognostic classification of these patients. Methods: For 135 patients with advanced NSCLC we determined their clinical variables and their levels of CEA, CA 125, CYFRA 21-1, albumin, LDH, erythrosedimentation and leukocytes. Results: Multivariate analysis identified PS (ECOG) >1, metastases, no anti-neoplastic treatment, CA 125 >35 U/mL, CYFRA 21-1 >3.3 ng/mL and leukocytes >10'000/μL, as independent prognostic factors for survival. Patients were classified into 3 groups according to the number of adverse prognostic factors (APF). One point was assigned for each APF, except for chemotherapy treatment. Patients with 0-1 APF represented our reference group: patients with 2-3 APF had HR=2.7 (95% CI: 1.5-4.6), while patients with 4-5 APF had HR=8.8 (95% CI: 4.6-16.8). This "score" maintained the differences between risk groups both in patients who received antineoplastic treatment and in those who did not. Conclusion: The application of a score that includes clinical data and biomarkers may improve the prognostic classification of NSCLC patients. © 2012 Wichtig Editore.
PubMed | Pathology Service, Glaucoma Service, Ophthalmology Service and Retina and Vitreous Service
Type: Journal Article | Journal: International journal of ophthalmology | Year: 2016
To determine whether different intravitreal doses of quinupristin/dalfopristin lead to electroretinographic or histological changes in the rabbit retina over one month period after injection.Eighteen New Zealand white rabbits were divided into three treatment groups (groups 1 to 3) and different intravitreal doses of quinupristin/dalfopristin were tested in each group. The right eye was injected with the drug and the left eye received intravitreal injection of 5% dextrose water and served as control eye. The doses delivered to each group were 0.1 mg/0.1 mL, 1 mg/0.1 mL and 10 mg/0.1 mL. Simultaneous, bilateral, dark-adapted electroretinography and clinical images of both eyes were obtained in all groups before injection (baseline) and after 7, 14, 21 and 28d, followed by enucleation for histological examination.Subjects in the group 1 showed no signs of toxicity in the electroretinogram when compared with groups 2 and 3 (Kruskall-Wallis test, P=0.000). By day 7, no electrical response to light stimuli was recorded in the treated eyes in groups 2 and 3, consistent with severe damage due to retinal toxicity. Light microscopy revealed no significant histopathological changes in the group 1, while rabbits in groups 2 and 3 had signs of granulomatous inflammation in most cases.Intravitreal 0.1 mg/0.1 mL doses of quinupristin/dalfopristin do not lead to electroretinographic or histological signs of retinal toxicity compared with 1 mg/0.1 mL and 10 mg/0.1 mL in this rabbit model.
Paparo F.,E.O. Ospedali Galliera |
Bacigalupo L.,E.O. Ospedali Galliera |
Garello I.,University of Genoa |
Biscaldi E.,E.O. Ospedali Galliera |
And 3 more authors.
Abdominal Imaging | Year: 2012
Background: Computed tomography enterography (CTE) may detect the presence, severity, and extent of bowel inflammation in patients with Crohn's disease (CD). The aim of our study was to assess, among a cohort of 22 histologically proven CD patients, the prevalence of disease distribution, behavior, anastomotic recurrence and extraintestinal manifestations detected by an original CTE technique. Methods: Two radiologists reviewed 221 CTEs performed providing both small and large bowel distension by oral administration of neutral contrast material and trans-rectal introduction of a water enema (CTE-WE). Results: Ileal CD was detected in 116 CTE-WEs (52.4%), including 71/116 (61.2%) non-stricturing/non-penetrating, 17/116 (14.6%) stricturing, and 28/116 (24.1%) penetrating forms. Colonic CD was appreciable in 35 (15.8%) patients, including 18/35 (51.4%) non-stricturing/ non-penetrating, 6/35 (17.1%) stricturing, and 11/35 (31.4%) penetrating forms. Ileocolic CD was present in 52 (23.5%) CTE-WEs, including 30/52 (57.7%) nonstricturing/ non-penetrating; 3/52 (5.7%) stricturing, and 19/52 (36.5%) penetrating forms. In 10/221 patients (4.5%), upper gastrointestinal involvement (UGI) was present. Perianal disease was observed in 17/221 patients (7.7%). Fistulas were present in 52 (23.5%) and abscesses in 24 (10.8%) CTE-WEs, respectively. Among 57/221 (25.8%) patients who had undergone a disease-related intestinal resection, in 30/57 cases (52.6%) CD recurrence at the anastomosis was present. 4/221 patients (1.8%) with a histologically confirmed intestinal neoplastic stenosis were observed. Sacroiliitis (24%) was found to be prevalent over hepatic steatosis (10.8%), cholelithiasis (8.6%), and nephrolithiasis (4%). Conclusions: CTE-WE represents a comprehensive imaging technique which may demonstrate bowel inflammation and CD extraintestinal manifestations. A peculiar prevalence of UGI involvement and neoplastic strictures were observed. In our study the prevalence of sacroiliitis resulted higher than previously reported. © Springer Science+Business Media, LLC 2011.
PubMed | Oncology Service, University Pompeu Fabra, Pathology Service, Hospital Universitari Of Bellvitge and 3 more.
Type: Journal Article | Journal: Oncotarget | Year: 2016
Brain metastasis is a devastating problem in patients with breast, lung and melanoma tumors. GRP94 and FN14 are predictive biomarkers over-expressed in primary breast carcinomas that metastasized in brain. To further validate these brain metastasis biomarkers, we performed a multicenter study including 318 patients with breast carcinomas. Among these patients, there were 138 patients with metastasis, of whom 84 had brain metastasis. The likelihood of developing brain metastasis increased by 5.24-fold (95%CI 2.83-9.71) and 2.55- (95%CI 1.52-4.3) in the presence of FN14 and GRP94, respectively. Moreover, FN14 was more sensitive than ErbB2 (38.27 vs. 24.68) with similar specificity (89.43 vs. 89.55) to predict brain metastasis and had identical prognostic value than triple negative patients (p < 0.0001). Furthermore, we used GRP94 and FN14 pathways and GUILD, a network-based disease-gene prioritization program, to pinpoint the genes likely to be therapeutic targets, which resulted in FN14 as the main modulator and thalidomide as the best scored drug. The treatment of mice with brain metastasis improves survival decreasing reactive astrocytes and angiogenesis, and down-regulate FN14 and its ligand TWEAK. In conclusion our results indicate that FN14 and GRP94 are prediction/prognosis markers which open up new possibilities for preventing/treating brain metastasis.
Tonni G.,Guastalla Civil Hospital |
Lituania M.,Galliera Hospital |
Bonasoni M.P.,Pathology Service |
De Felice C.,University of Siena
Archives of Gynecology and Obstetrics | Year: 2011
Introduction: Nasal glioma is a rare, benign congenital midline facial lesion. Materials and methods: Prenatal ultrasound diagnosis performed at 2nd trimester of pregnancy revealed a right-sided mass at the level of the fetal face extending from the right internal canthus to the nasal bridge. Conclusion: Differential diagnosis of facial mass in the fetus represents a critical issue because is essential in guiding the prenatal counselling of the couple and in guiding the prenatal and/or postnatal management. Alternative diagnoses such as dacryocystocele, dermoid cyst, retinoblastoma or teratoma, hemangioma, and encephalocele that can not completely be excluded prenatally are discussed. Embryology, pathology, prenatal ultrasound diagnostic clusters of the lesion as well as MR imaging findings are discussed together with review of the literature. © 2011 Springer-Verlag.