Editorial

2 pages, 233 KiB

Open AccessEditorial

by Valentin Titus Grigorean and Daniel Alin Cristian

Medicina 2023, 59(1), 98; https://doi.org/10.3390/medicina59010098 - 31 Dec 2022

Cited by 2 | Viewed by 1332

The COVID-19 pandemic has brought infectious and contagious diseases back to the forefront of medical concerns worldwide [...] Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

Research

Jump to: Editorial, Review, Other

15 pages, 2393 KiB

Open AccessArticle

Human Papillomavirus Is Rare and Does Not Correlate with p16^INK4A Expression in Non-Small-Cell Lung Cancer in a Jordanian Subpopulation

by Ola Abu Al Karsaneh, Arwa Al Anber, Sahar AlMustafa, Hussien AlMa’aitah, Batool AlQadri, Abir Igbaria, Rama Tayem, Mustafa Khasawneh, Shaima Batayha, Tareq Saleh, Mohammad ALQudah and Maher Sughayer

Medicina 2024, 60(4), 660; https://doi.org/10.3390/medicina60040660 - 19 Apr 2024

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Abstract

Background and Objectives: Human papillomavirus (HPV) was previously investigated in lung cancer with wide inter-geographic discrepancies. p16^INK4a has been used as a surrogate for detecting high-risk HPV (HR-HPV) in some cancer types. This study assessed the evidence of HPV in non-small-cell [...] Read more.

Background and Objectives: Human papillomavirus (HPV) was previously investigated in lung cancer with wide inter-geographic discrepancies. p16^INK4a has been used as a surrogate for detecting high-risk HPV (HR-HPV) in some cancer types. This study assessed the evidence of HPV in non-small-cell lung cancer (NSCLC) among Jordanian patients, investigated the expression of p16^INK4a, and evaluated its prognostic value and association with HPV status. Materials and Methods: The archived samples of 100 patients were used. HPV DNA detection was performed by real-time polymerase chain reaction (RT-PCR). p16^INK4a expression was assessed by immunohistochemistry (IHC). The Eighth American Joint Committee on Cancer protocol (AJCC) of head and neck cancer criteria were applied to evaluate p16^INK4a positivity considering a moderate/strong nuclear/cytoplasmic expression intensity with a distribution in ≥75% of cells as positive. Results: HPV DNA was detected in 5% of NSCLC cases. Three positive cases showed HR-HPV subtypes (16, 18, 52), and two cases showed the probable HR-HPV 26 subtype. p16^INK4a expression was positive in 20 (20%) NSCLC cases. None of the HPV-positive tumors were positive for p16^INK4a expression. A statistically significant association was identified between p16^INK4a expression and the pathological stage (p = 0.029) but not with other variables. No survival impact of p16^INK4a expression was detected in NSCLC cases as a group; however, it showed a statistically significant association with overall survival (OS) in squamous cell carcinoma (SqCC) cases (p = 0.033). Conclusions: This is the first study to assess HPV and p16^INK4a expression in a Jordanian population. HPV positivity is rare in NSCLC among a Jordanian subpopulation. P16 ^INK4a reliability as a surrogate marker for HPV infection in lung cancer must be revisited. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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15 pages, 1810 KiB

Open AccessArticle

Retrospective Evaluation of the Efficacy of Total Neoadjuvant Therapy and Chemoradiotherapy Neoadjuvant Treatment in Relation to Surgery in Patients with Rectal Cancer

by Lucian Dragoș Bratu, Michael Schenker, Puiu Olivian Stovicek, Ramona Adriana Schenker, Alina Maria Mehedințeanu, Tradian Ciprian Berisha, Andreas Donoiu and Stelian Ștefăniță Mogoantă

Medicina 2024, 60(4), 656; https://doi.org/10.3390/medicina60040656 - 19 Apr 2024

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Abstract

Background and Objective: In the therapeutic strategy of rectal cancer, radiotherapy has consolidated its important position and frequent use in current practice due to its indications as neoadjuvant, adjuvant, definitive, or palliative treatment. In recent years, total neoadjuvant therapy (TNT) has been [...] Read more.

Background and Objective: In the therapeutic strategy of rectal cancer, radiotherapy has consolidated its important position and frequent use in current practice due to its indications as neoadjuvant, adjuvant, definitive, or palliative treatment. In recent years, total neoadjuvant therapy (TNT) has been established as the preferred regimen compared to concurrent neoadjuvant chemoradiotherapy (CRT). In relation to better outcomes, the percentage of patients who achieved pathological complete response (pCR) after neoadjuvant treatment is higher in the case of TNT. This study aimed to analyze the response to TNT compared to neoadjuvant CRT regarding pCR rate and the change in staging after surgical intervention. Materials and Methods: We performed a retrospective study on 323 patients with rectal cancer and finally analyzed the data of 201 patients with neoadjuvant treatment, selected based on the inclusion and exclusion criteria. Patients received CRT neoadjuvant therapy or TNT neoadjuvant therapy with FOLFOX or CAPEOX. Results: Out of 157 patients who underwent TNT treatment, 19.74% had pathological complete response, whereas in the group with CRT (n = 44), those with pCR were 13.64%. After neoadjuvant treatment, the most frequent TNM classifications were ypT2 (40.30%) and ypN0 (79.10%). The statistical analysis of the postoperative disease stage, after neoadjuvant therapy, showed that the most frequent changes were downstaging (71.14%) and complete response (18.41%). Only four patients (1.99%) had an upstaging change. The majority of patients (88.56%) initially presented clinical evidence of nodal involvement whereas only 20.9% of the patients still presented regional disease at the time of surgical intervention. Conclusions: By using TNT, a higher rate of stage reduction is obtained compared to the neoadjuvant CRT treatment. The post-neoadjuvant-treatment imagistic evaluation fails to accurately evaluate the response. A better response to TNT was observed in young patients. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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11 pages, 1717 KiB

Open AccessArticle

A Potential Radiomics–Clinical Model for Predicting Failure of Lymph Node Control after Definite Radiotherapy in Locally Advanced Head and Neck Cancer

by Seunghak Lee, Sunmin Park, Chai Hong Rim, Young Hen Lee, Soon Young Kwon, Kyung Ho Oh and Won Sup Yoon

Medicina 2024, 60(1), 92; https://doi.org/10.3390/medicina60010092 - 03 Jan 2024

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Abstract

Background and Objectives: To optimally predict lymph node (LN) failure after definite radiotherapy (RT) in head and neck cancer (HNC) with LN metastases, this study examined radiomics models extracted from CT images of different periods during RT. Materials and Methods: This [...] Read more.

Background and Objectives: To optimally predict lymph node (LN) failure after definite radiotherapy (RT) in head and neck cancer (HNC) with LN metastases, this study examined radiomics models extracted from CT images of different periods during RT. Materials and Methods: This study retrospectively collected radiologic and clinical information from patients undergoing definite RT over 60 Gy for HNC with LN metastases from January 2010 to August 2021. The same largest LNs in each patient from the initial simulation CT (CTpre) and the following simulation CT (CTmid) at approximately 40 Gy were indicated as regions of interest. LN failure was defined as residual or recurrent LN within 3 years after the end of RT. After the radiomics features were extracted, the radiomics alone model and the radiomics plus clinical parameters model from the set of CTpre and CTmid were compared. The LASSO method was applied to select features associated with LN failure. Results: Among 66 patients, 17 LN failures were observed. In the radiomics alone model, CTpre and CTmid had similar mean accuracies (0.681 and 0.697, respectively) and mean areas under the curve (AUC) (0.521 and 0.568, respectively). Radiomics features of spherical disproportion, size zone variance, and log minimum 2 were selected for CTpre plus clinical parameters. Volume, energy, homogeneity, and log minimum 1 were selected for CTmid plus clinical parameters. Clinical parameters including smoking, T-stage, ECE, and regression rate of LN were important for both CTpre and CTmid. In the radiomics plus clinical parameters models, the mean accuracy and mean AUC of CTmid (0.790 and 0.662, respectively) were more improved than those of CTpre (0.731 and 0.582, respectively). Conclusions: Both models using CTpre and CTmid were improved by adding clinical parameters. The radiomics model using CTmid plus clinical parameters was the best in predicting LN failure in our preliminary analyses. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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9 pages, 1651 KiB

Open AccessArticle

Germline DNA Damage Response Gene Mutations in Localized Prostate Cancer

by Tomas Januskevicius, Ieva Vaicekauskaite, Rasa Sabaliauskaite, Augustinas Matulevicius, Alvydas Vezelis, Albertas Ulys, Sonata Jarmalaite and Feliksas Jankevicius

Medicina 2024, 60(1), 73; https://doi.org/10.3390/medicina60010073 - 30 Dec 2023

Viewed by 966

Abstract

Background and Objectives: Germline DNA damage response (DDR) gene mutations correlate with increased prostate cancer (PCa) risk and a more aggressive form of the disease. DDR mutation testing is recommended for metastatic PCa cases, while eligible information about the mutations’ burden in [...] Read more.

Background and Objectives: Germline DNA damage response (DDR) gene mutations correlate with increased prostate cancer (PCa) risk and a more aggressive form of the disease. DDR mutation testing is recommended for metastatic PCa cases, while eligible information about the mutations’ burden in the early-stage localized PCa is still limited. This study is aimed at the prospective detection of DDR pathway mutations in cases with localized PCa and correlation with clinical, histopathological, and radiological data. A comparison to the previously assessed cohort of the advanced PCa was performed. Materials and Methods: Germline DDR gene mutations were assessed prospectively in DNA samples from 139 patients, using a five-gene panel (BRCA1, BRCA2, ATM, CHEK2, and NBN) targeted next-generation sequencing. Results: This study revealed an almost three-fold higher risk of localized PCa among mutation carriers as compared to non-carriers (OR 2.84 and 95% CI: 0.75–20.23, p = 0.16). The prevalence of germline DDR gene mutations in PCa cases was 16.8% (18/107) and they were detected only in cases with PI-RADS 4/5 lesions. BRCA1/BRCA2/ATM mutation carriers were 2.6 times more likely to have a higher (>1) cISUP grade group compared to those with a CHEK2 mutation (p = 0.27). However, the number of cISUP > 1-grade patients with a CHEK2 mutation was significantly higher in advanced PCa than in localized PCa: 66.67% vs. 23.08% (p = 0.047). Conclusions: The results of our study suggest the potential of genetic screening for selected DDR gene mutations for early identification of cases at risk of aggressive PCa. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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12 pages, 1583 KiB

Open AccessArticle

Evaluation of Changes in Circulating Cell-Free DNA as an Early Predictor of Response to Chemoradiation in Rectal Cancer—A Pilot Study

by Wee Liam Ong, Sorinel Lunca, Stefan Morarasu, Ana-Maria Musina, Alina Puscasu, Stefan Iacob, Irina Iftincai, Andreea Marinca, Iuliu Ivanov, Cristian Ena Roata, Natalia Velenciuc and Gabriel Dimofte

Medicina 2023, 59(10), 1742; https://doi.org/10.3390/medicina59101742 - 28 Sep 2023

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Abstract

Background and Objectives: The objective of this study was to investigate quantitative changes in cell-free DNA (cfDNA) found in the bloodstream of patients with locally advanced rectal cancer who received neoadjuvant long-course chemoradiation, assuming a change in DNA fragments release during therapeutic stress. [...] Read more.

Background and Objectives: The objective of this study was to investigate quantitative changes in cell-free DNA (cfDNA) found in the bloodstream of patients with locally advanced rectal cancer who received neoadjuvant long-course chemoradiation, assuming a change in DNA fragments release during therapeutic stress. Materials and Methods: This was a prospective observational study that involved 49 patients who had three distinct pathologies requiring neoadjuvant chemoradiation: 18 patients with breast cancer, 18 patients with cervical cancer, and 13 patients with rectal cancer. Both breast cancer and cervical cancer patients were used as a control groups. Breast cancer patients were used as a control group as irradiation targeted healthy tissue after the tumor resection (R0), while cervical cancer patients were used as a control group to evaluate the effect of chemoradiation regarding cfDNA in a different setting (squamous cell carcinomas) and a different tumor burden. Rectal cancer patients were the study group, and were prospectively evaluated for a correlation between fragmentation of cfDNA and late response to chemoradiation. Blood samples were collected before the initiation of treatment and after the fifth radiation dose delivery. cfDNA was quantified in peripheral blood and compared with the patients’ clinicopathological characteristics and tumor volume. Conclusion: Thirteen patients with locally advanced rectal cancer (T3/T4/N+/M0) were included in the study, and all of them had their samples analyzed. Eight were male (61.54%) and five were female (38.46%), with an average age of 70.85 years. Most of the patients had cT3 (53.85%) or cT4 (46.15%) tumors, and 92.31% had positive lymph nodes (N2–3). Of the thirteen patients, only six underwent surgery, and one of them achieved a pathological complete response (pCR). The mean size of the tumor was 122.60 mm³ [35.33–662.60 mm³]. No significant correlation was found between cfDNA, tumor volume, and tumor regression grade. cfDNA does not seem to predict response to neoadjuvant chemoradiotherapy and it is not correlated to tumor volume or tumor regression grade. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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10 pages, 946 KiB

Open AccessArticle

Comparison of Open versus Laparoscopic Approaches in Salvage Hepatectomy for Recurrent Hepatocellular Carcinoma after Radiofrequency Ablation

by Yeshong Park, Jai Young Cho, Ho-Seong Han, Yoo-Seok Yoon, Hae Won Lee, Boram Lee, MeeYoung Kang and Jinju Kim

Medicina 2023, 59(7), 1243; https://doi.org/10.3390/medicina59071243 - 04 Jul 2023

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Abstract

Background and Objectives: Although radiofrequency ablation (RFA) is widely used as an effective local treatment for hepatocellular carcinoma (HCC), evidence on salvage hepatectomy for local recurrence after RFA is limited. This study aims to compare open and laparoscopic approaches in salvage hepatectomy [...] Read more.

Background and Objectives: Although radiofrequency ablation (RFA) is widely used as an effective local treatment for hepatocellular carcinoma (HCC), evidence on salvage hepatectomy for local recurrence after RFA is limited. This study aims to compare open and laparoscopic approaches in salvage hepatectomy for recurrent HCC after RFA. Materials and Methods: Among patients who underwent hepatectomy between January 2004 and August 2022 at a single tertiary referral center, 55 patients who underwent salvage hepatectomy for marginal recurrence after RFA were selected. An open approach was used in 23 (41.8%) patients, while 32 (58.2%) patients underwent laparoscopic surgery. Short-term and long-term outcomes were compared between the two groups. Results: Major hepatectomy was more often performed in the open group (9 [39.1%] vs. 4 [12.5%], p = 0.022). Intraoperative blood loss was also greater in the open group (450 (325–750) vs. 300 (200–600), p = 0.034). Operation time (p = 0.144) and postoperative morbidity rates (p = 0.639) were similar, and there was no postoperative mortality in either group. Postoperative hospital stay was significantly longer in the open group compared to the laparoscopy group (8 (6–11) days vs. 5 (4–7) days, p = 0.028). The 1-, 3-, and 5-year disease-free survival rates showed no difference between the two groups (44.6% vs. 62.5%, 16.5% vs. 13.5%, and 8.3% vs. 13.5%, respectively; p = 0.154). The 1-, 3-, and 5-year overall survival rates between the two groups were also similar (85.7% vs. 96.8%, 79.6% vs. 86.0%, and 79.6% vs. 79.4%, respectively; p = 0.480). Conclusions: Laparoscopic salvage hepatectomy shows oncologic outcomes comparable to the open approach with faster postoperative recovery rates. Considering that recurrence rates are high after RFA, the laparoscopic approach should be considered as a first-line option in selected patients. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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17 pages, 8658 KiB

Open AccessArticle

The Conditioning of Adjuvant Chemotherapy for Stage II and III Rectal Cancer Determined by Postoperative Pathological Characteristics in Romania

by Horia-Dan Liscu, Bogdan-Radu Liscu, Ruxandra Mitre, Ioana-Valentina Anghel, Ionut-Lucian Antone-Iordache, Andrei Balan, Simona Coniac, Andreea-Iuliana Miron and Georgian Halcu

Medicina 2023, 59(7), 1224; https://doi.org/10.3390/medicina59071224 - 29 Jun 2023

Cited by 3 | Viewed by 1476

Abstract

The management of locally advanced rectal cancer (LARC) suffered changes thanks to the development of improved surgical procedures, radiation delivery, and chemotherapy. Although treatment options improved individually, the optimal order is still debated. Neoadjuvant chemo-radiotherapy followed by total mesorectal excision (TME) has been [...] Read more.

The management of locally advanced rectal cancer (LARC) suffered changes thanks to the development of improved surgical procedures, radiation delivery, and chemotherapy. Although treatment options improved individually, the optimal order is still debated. Neoadjuvant chemo-radiotherapy followed by total mesorectal excision (TME) has been the “golden standard” for locally advanced rectal cancer. There is no common ground in international guidelines on the indications of adjuvant chemotherapy (ADJCHT), with differences between the American, European, and Japanese guidelines. This paper studies the preferences of Romanian oncologists in prescribing ADJCHT. We conducted a single-institution, retrospective study of all nonmetastatic, ECOG 0-1 LARC patients staged II-III who underwent TME and were admitted to the Oncology or Radiotherapy Department of Colțea Clinical Hospital, Bucharest between January 2017 and March 2021. A total of 186 patients were included in the study. A positive correlation was found between ADJCHT and each of the following: (y)pT > 2, (y)pN > 0, and the presence of perineural invasion (PNI+). A strong positive correlation was found between ADJCHT and the presence of at least one risk factor: (y)pT > 2, (y)pN > 0, PNI+, lymphovascular invasion, positive margins, or tumor grade > 1. Tumor downstaging decreased the risk of metastases in the first 2 years and was associated with the use of neoadjuvant radiotherapy, while adding neoadjuvant chemotherapy increased the chance of nodal downstaging. ADJCHT practice for LARC in Romania follows either NCCN or ESMO guidelines, at the discretion of the oncologist, due to the lack of national guideline. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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13 pages, 2694 KiB

Open AccessArticle

Parathyroid Cancer—A Rare Finding during Parathyroidectomy in High Volume Surgery Centre

by Petru Radu, Dragos Garofil, Anca Tigora, Mihai Zurzu, Vlad Paic, Mircea Bratucu, Mircea Litescu, Virgil Prunoiu, Valentin Georgescu, Florian Popa, Valeriu Surlin and Victor Strambu

Medicina 2023, 59(3), 448; https://doi.org/10.3390/medicina59030448 - 23 Feb 2023

Cited by 3 | Viewed by 1476

Abstract

Background and Objectives: Parathyroid cancer is a very rare endocrine tumor, especially in patients with secondary hyperparathyroidism due to end stage renal disease failure. This pathology is difficult to diagnose preoperatively because it has nonspecific clinical manifestations and paraclinical aspects. Our study [...] Read more.

Background and Objectives: Parathyroid cancer is a very rare endocrine tumor, especially in patients with secondary hyperparathyroidism due to end stage renal disease failure. This pathology is difficult to diagnose preoperatively because it has nonspecific clinical manifestations and paraclinical aspects. Our study of the literature identified 34 reported cases of parathyroid carcinoma over the last 40 years in patients undergoing dialysis. We present our experience as illustrative of the features of clinical presentation and histopathological findings of parathyroid carcinoma and assess its management considering the recent relevant literature. Materials and Methods: From January 2012 to November 2022, 650 patients with secondary hyperparathyroidism undergoing dialysis were treated at our academic Department of General Surgery and only two cases of parathyroid carcinoma were diagnosed on histopathological examination. Results: All patients presented with symptomatic hypercalcemia, with no clinical or imaging suspicion of malignant disease and were surgically treated by total parathyroidectomy. Histopathological examination revealed morphologic aspects of parathyroid carcinoma in two cases and immunostaining of Ki-67 was performed for diagnostic confirmation. Postoperative follow-up showed no signs of recurrence and no oncological adjuvant treatment or surgical reinterventions were needed. Conclusions: Parathyroid neoplasia is a particularly rare disease, that remains a challenge when it comes to diagnosis and proper management. Surgical approach is the only valid treatment to remove the malignant tissue and thus improve the patient’s prognosis. Medical and oncologic treatment may be beneficial to control hypercalcemia in case of tumor recurrence. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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12 pages, 2446 KiB

Open AccessArticle

Evaluating the Magnolol Anticancer Potential in MKN-45 Gastric Cancer Cells

by Mahsa Naghashpour, Dian Dayer, Hadi Karami, Mahshid Naghashpour, Mahin Taheri Moghadam, Seyed Mohammad Jafar Haeri and Katsuhiko Suzuki

Medicina 2023, 59(2), 286; https://doi.org/10.3390/medicina59020286 - 01 Feb 2023

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Abstract

Background and Objectives: Combination therapy improves the effect of chemotherapy on tumor cells. Magnolol, used in treating gastrointestinal disorders, has been shown to have anti-cancer properties. We investigated the synergistic effect of cisplatin and magnolol on the viability and maintenance of MKN-45 gastric [...] Read more.

Background and Objectives: Combination therapy improves the effect of chemotherapy on tumor cells. Magnolol, used in treating gastrointestinal disorders, has been shown to have anti-cancer properties. We investigated the synergistic effect of cisplatin and magnolol on the viability and maintenance of MKN-45 gastric cancer cells. Materials and Methods: The toxicity of magnolol and/or cisplatin was determined using the MTT technique. The trypan blue method was used to test magnolol and/or cisplatin’s effect on MKN-45 cell growth. Crystal violet staining was used to assess the treated cells’ tendency for colony formation. The expression of genes linked to apoptosis, cell cycle arrest, and cell migration was examined using the qPCR method. Results: According to MTT data, using magnolol and/or cisplatin significantly reduced cell viability. The ability of the treated cells to proliferate and form colonies was also reduced considerably. Magnolol and/or cisplatin treatment resulted in a considerable elevation in Bax expression. However, the level of Bcl2 expression was dramatically reduced. p21 and p53 expression levels were significantly increased in the treated cells, while MMP-9 expression was significantly reduced. Conclusions: These findings show that magnolol has a remarkable anti-tumor effect on MKN-45 cells. In combination with cisplatin, magnolol may be utilized to overcome cisplatin resistance in gastric cancer cells. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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12 pages, 797 KiB

Open AccessArticle

Validation of a New Prognostic Score in Patients with Ovarian Adenocarcinoma

by Oana Gabriela Trifanescu, Radu Iulian Mitrica, Laurentia Nicoleta Gales, Serban Andrei Marinescu, Natalia Motas, Raluca Alexandra Trifanescu, Laura Rebegea, Mirela Gherghe, Dragos Eugen Georgescu, Georgia Luiza Serbanescu, Haj Hamoud Bashar, Serban Dragosloveanu, Daniel Alin Cristian and Rodica Maricela Anghel

Medicina 2023, 59(2), 229; https://doi.org/10.3390/medicina59020229 - 26 Jan 2023

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Abstract

Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with [...] Read more.

Background and Objectives: This study aimed to assess the impact of clinical prognostic factors and propose a prognostic score that aids the clinician’s decision in estimating the risk for patients in clinical practice. Materials and Methods: The study included 195 patients diagnosed with ovarian adenocarcinoma. The therapeutic strategy involved multidisciplinary decisions: surgery followed by adjuvant chemotherapy (80%), neoadjuvant chemotherapy followed by surgery (16.4%), and only chemotherapy in selected cases (3.6%). Results: After a median follow-up of 68 months, in terms of progression-free survival (PFS) and overall survival (OS), Eastern Cooperative Oncology Group (ECOG) performance status of 1 and 2 vs. 0 (hazard ratio—HR = 2.71, 95% confidence interval—CI, 1.96–3.73, p < 0.001 for PFS and HR = 3.19, 95%CI, 2.20–4.64, p < 0.001 for OS), menopausal vs. premenopausal status (HR = 2.02, 95%CI, 1.35–3,0 p < 0.001 and HR = 2.25, 95%CI = 1.41–3.59, p < 0.001), ascites (HR = 1.95, 95%CI 1.35–2.80, p = 0.03, HR = 2.31, 95%CI = 1.52–3.5, p < 0.007), residual disease (HR = 5.12, 95%CI 3.43–7.65, p < 0.0001 and HR = 4.07, 95%CI = 2.59–6.39, p < 0.0001), and thrombocytosis (HR = 2.48 95%CI = 1.72–3.58, p < 0.0001, HR = 3.33, 95%CI = 2.16–5.13, p < 0.0001) were associated with a poor prognosis. An original prognostic score including these characteristics was validated using receiver operating characteristic (ROC) curves (area under the curve—AUC = 0.799 for PFS and AUC = 0.726 for OS, p < 0.001). The median PFS for patients with none, one, two, three, or four (or more) prognostic factors was not reached, 70, 36, 20, and 12 months, respectively. The corresponding median overall survival (OS) was not reached, 108, 77, 60, and 34 months, respectively. Conclusions: Several negative prognostic factors were identified: ECOG performance status ≥ 1, the presence of ascites and residual disease after surgery, thrombocytosis, and menopausal status. These led to the development of an original prognostic score that can be helpful in clinical practice. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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11 pages, 1048 KiB

Open AccessArticle

Cancer-Oriented Comprehensive Nursing Services in Republic of Korea: Lessons from an Oncologist’s Perspective

by Suk Hun Ha, Moonho Kim, Hyojin Kim, Boram No, Ara Go, Miso Choi, Seol Lee and Yongchel Ahn

Medicina 2023, 59(1), 144; https://doi.org/10.3390/medicina59010144 - 11 Jan 2023

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Abstract

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better [...] Read more.

Background and objectives: As is well known, cancer patients require extensive medical attention as they undergo surgery, chemotherapy, radiotherapy, and supportive care. The importance of high-quality cancer-directed nursing, combined with precision medicine, to maximize their survival outcomes and help them achieve a better quality of life cannot be overemphasized. In this context, we offered a new cancer-oriented comprehensive nursing system to our inpatients and reviewed its clinical outcomes in comparison with those from the preexisting general cancer ward. Materials and Methods: From March 2019 to February 2020, a total of 102 cancer patients and 42 nurses were enrolled in this pilot study. We aimed to analyze their performance in three main categories: structure, process, and patient/nurse outcomes. Results: First, structural (nurse staffing and environment) upgrades were installed in the cancer-oriented comprehensive nursing ward, including an improved nurse-patient ratio (1:8 in the comprehensive ward as compared with 1:14 in the general ward), wider space between beds (1.5 m versus 1.0 m), fully automatic beds with fall prevention sensors, etc. Second, the nursing process was improved (missed care 0.1 event/month vs. 1.3 event/month). Third, both patient and nurse outcomes showed preferable results in the comprehensive ward. The patient satisfaction level was higher in the comprehensive nursing ward than in the general ward (willing to revisit: 91.7% and 78.4%, respectively; willing to recommend to others: 95.0% and 76.8%, respectively). Pressure ulcers, as a patient safety indicator, were also decreased (0.3 events/month vs. 0.8 events/month). However, the fall incidence was similar in both groups (1.6 events/month vs. 1.5 events/month). In terms of nurse outcomes, turnover intention was stabilized and nurses’ job satisfaction in the comprehensive ward was superior to that of their counterparts. Conclusions: Our study was a pilot study to demonstrate that cancer patient-oriented comprehensive nursing services can be helpful in improving the quality of cancer treatment and nurses’ job satisfaction. Continued interest in and efforts to improve nursing care delivery are also crucial in achieving and maintaining the best possible cancer patient care. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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Review

Jump to: Editorial, Research, Other

27 pages, 1555 KiB

Open AccessReview

Exploring Biomarkers in Breast Cancer: Hallmarks of Diagnosis, Treatment, and Follow-Up in Clinical Practice

by Laura Lopez-Gonzalez, Alicia Sanchez Cendra, Cristina Sanchez Cendra, Eduardo David Roberts Cervantes, Javier Cassinello Espinosa, Tatiana Pekarek, Oscar Fraile-Martinez, Cielo García-Montero, Ana María Rodriguez-Slocker, Laura Jiménez-Álvarez, Luis G. Guijarro, Soledad Aguado-Henche, Jorge Monserrat, Melchor Alvarez-Mon, Leonel Pekarek, Miguel A. Ortega and Raul Diaz-Pedrero

Medicina 2024, 60(1), 168; https://doi.org/10.3390/medicina60010168 - 17 Jan 2024

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Abstract

Breast cancer is a prevalent malignancy in the present day, particularly affecting women as one of the most common forms of cancer. A significant portion of patients initially present with localized disease, for which curative treatments are pursued. Conversely, another substantial segment is [...] Read more.

Breast cancer is a prevalent malignancy in the present day, particularly affecting women as one of the most common forms of cancer. A significant portion of patients initially present with localized disease, for which curative treatments are pursued. Conversely, another substantial segment is diagnosed with metastatic disease, which has a worse prognosis. Recent years have witnessed a profound transformation in the prognosis for this latter group, primarily due to the discovery of various biomarkers and the emergence of targeted therapies. These biomarkers, encompassing serological, histological, and genetic indicators, have demonstrated their value across multiple aspects of breast cancer management. They play crucial roles in initial diagnosis, aiding in the detection of relapses during follow-up, guiding the application of targeted treatments, and offering valuable insights for prognostic stratification, especially for highly aggressive tumor types. Molecular markers have now become the keystone of metastatic breast cancer diagnosis, given the diverse array of chemotherapy options and treatment modalities available. These markers signify a transformative shift in the arsenal of therapeutic options against breast cancer. Their diagnostic precision enables the categorization of tumors with elevated risks of recurrence, increased aggressiveness, and heightened mortality. Furthermore, the existence of therapies tailored to target specific molecular anomalies triggers a cascade of changes in tumor behavior. Therefore, the primary objective of this article is to offer a comprehensive review of the clinical, diagnostic, prognostic, and therapeutic utility of the principal biomarkers currently in use, as well as of their clinical impact on metastatic breast cancer. In doing so, our goal is to contribute to a more profound comprehension of this complex disease and, ultimately, to enhance patient outcomes through more precise and effective treatment strategies. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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22 pages, 680 KiB

Open AccessReview

Cancer Pain and Non-Invasive Brain Stimulation—A Narrative Review

by Valentina-Fineta Chiriac, Daniel Ciurescu and Daniela-Viorica Moșoiu

Medicina 2023, 59(11), 1957; https://doi.org/10.3390/medicina59111957 - 06 Nov 2023

Viewed by 1364

Abstract

Background and Objectives: Pain is the most prevalent symptom in cancer patients. There is a paucity of data regarding non-invasive brain stimulation (NIBS) for the treatment of chronic pain in patients with cancer. The purpose of this article is to review the [...] Read more.

Background and Objectives: Pain is the most prevalent symptom in cancer patients. There is a paucity of data regarding non-invasive brain stimulation (NIBS) for the treatment of chronic pain in patients with cancer. The purpose of this article is to review the techniques of NIBS and present the published experiences of the oncological population. Materials and Methods: Databases including MEDLINE, Scopus, Web of Science, and the Cochrane Library were searched for articles on cancer patients with pain that was managed with non-invasive brain stimulation techniques. We included articles in English that were published from inception to January 2023. As studies were limited in number and had different designs and methodologies, a narrative review was considered as the best option to integrate data. Results: Four studies focusing on transcranial magnetic stimulation, six articles on transcranial direct current stimulation, and three articles regarding cranial electric stimulation were found and reviewed. Conclusions: Data are limited and not robust. Further studies in this field are required. Guidelines on NIBS for non-malignant chronic pain conditions provide good premises for cancer-related chronic pain. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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14 pages, 578 KiB

Open AccessReview

CD34—Structure, Functions and Relationship with Cancer Stem Cells

by Petru Radu, Mihai Zurzu, Vlad Paic, Mircea Bratucu, Dragos Garofil, Anca Tigora, Valentin Georgescu, Virgiliu Prunoiu, Costin Pasnicu, Florian Popa, Petra Surlin, Valeriu Surlin and Victor Strambu

Medicina 2023, 59(5), 938; https://doi.org/10.3390/medicina59050938 - 12 May 2023

Cited by 3 | Viewed by 2665

Abstract

The CD34 protein was identified almost four decades ago as a biomarker for hematopoietic stem cell progenitors. CD34 expression of these stem cells has been exploited for therapeutic purposes in various hematological disorders. In the last few decades, studies have revealed the presence [...] Read more.

The CD34 protein was identified almost four decades ago as a biomarker for hematopoietic stem cell progenitors. CD34 expression of these stem cells has been exploited for therapeutic purposes in various hematological disorders. In the last few decades, studies have revealed the presence of CD34 expression on other types of cells with non-hematopoietic origins, such as interstitial cells, endothelial cells, fibrocytes, and muscle satellite cells. Furthermore, CD34 expression may also be found on a variety of cancer stem cells. Nowadays, the molecular functions of this protein have been involved in a variety of cellular functions, such as enhancing proliferation and blocking cell differentiation, enhanced lymphocyte adhesion, and cell morphogenesis. Although a complete understanding of this transmembrane protein, including its developmental origins, its stem cell connections, and other functions, is yet to be achieved. In this paper, we aimed to carry out a systematic analysis of the structure, functions, and relationship with cancer stem cells of CD34 based on the literature overview. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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19 pages, 3174 KiB

Open AccessReview

Challenges in the Diagnosis and Individualized Treatment of Cervical Cancer

by Melanie Schubert, Dirk Olaf Bauerschlag, Mustafa Zelal Muallem, Nicolai Maass and Ibrahim Alkatout

Medicina 2023, 59(5), 925; https://doi.org/10.3390/medicina59050925 - 11 May 2023

Cited by 4 | Viewed by 7015

Abstract

Cervical cancer is still the fourth most common cancer in women throughout the world; an estimated 604,000 new cases were observed in 2020. Better knowledge of its pathogenesis, gained in recent years, has introduced new preventive and diagnostic approaches. Knowledge of its pathogenesis [...] Read more.

Cervical cancer is still the fourth most common cancer in women throughout the world; an estimated 604,000 new cases were observed in 2020. Better knowledge of its pathogenesis, gained in recent years, has introduced new preventive and diagnostic approaches. Knowledge of its pathogenesis has made it possible to provide individualized surgical and drug treatment. In industrialized countries, cervical cancer has become a less frequent tumor entity due to the accessibility of the human papilloma virus vaccination, systematic preventive programs/early detection programs, health care infrastructure and the availability of effective therapy options. Nevertheless, globally, neither mortality nor morbidity has been significantly reduced over the past 10 years, and therapy approaches differ widely. The aim of this review is to address recent advances in the prevention, diagnostic investigation and treatment of cervical cancer globally, focusing on advances in Germany, with a view toward providing an updated overview for clinicians. The following aspects are addressed in detail: (a) the prevalence and causes of cervical cancer, (b) diagnostic tools using imaging techniques, cytology and pathology, (c) pathomechanisms and clinical symptoms of cervical cancer and (d) different treatment approaches (pharmacological, surgical and others) and their impact on outcomes. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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11 pages, 1034 KiB

Open AccessReview

Colorectal Cancer—The “Parent” of Low Bowel Obstruction

by Valentin Titus Grigorean, Anwar Erchid, Ionuţ Simion Coman and Mircea Liţescu

Medicina 2023, 59(5), 875; https://doi.org/10.3390/medicina59050875 - 02 May 2023

Cited by 2 | Viewed by 2565

Abstract

Introduction: Despite the improvement of early diagnosis methods for multiple pathological entities belonging to the digestive tract, bowel obstruction determined by multiple etiologies represents an important percentage of surgical emergencies. General data: Although sometimes obstructive episodes are possible in the early [...] Read more.

Introduction: Despite the improvement of early diagnosis methods for multiple pathological entities belonging to the digestive tract, bowel obstruction determined by multiple etiologies represents an important percentage of surgical emergencies. General data: Although sometimes obstructive episodes are possible in the early stages of colorectal cancer, the most commonly installed intestinal obstruction has the significance of an advanced evolutionary stage of neoplastic disease. Development of Obstructive Mechanism: The spontaneous evolution of colorectal cancer is always burdened by complications. The most common complication is low bowel obstruction, found in approximately 20% of the cases of colorectal cancer, and it can occur either relatively abruptly, or is preceded by initially discrete premonitory symptoms, non-specific (until advanced evolutionary stages) and generally neglected or incorrectly interpreted. Success in the complex treatment of a low neoplastic obstruction is conditioned by a complete diagnosis, adequate pre-operative preparation, a surgical act adapted to the case (in one, two or three successive stages), and dynamic postoperative care. The moment of surgery should be chosen with great care and is the result of the experience of the anesthetic-surgical team. The operative act must be adapted to the case and has as its main objective the resolution of intestinal obstruction and only in a secondary way the resolution of the generating disease. Conclusions: The therapeutic measures adopted (medical-surgical) must have a dynamic character in accordance with the particular situation of the patient. Except for certain or probably benign etiologies, the possibility of colorectal neoplasia should always be considered, in low obstructions, regardless of the patient’s age. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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22 pages, 1460 KiB

Open AccessReview

Mass Spectrometry Contribution to Pediatric Cancers Research

by Marco Agostini, Pietro Traldi and Mahmoud Hamdan

Medicina 2023, 59(3), 612; https://doi.org/10.3390/medicina59030612 - 20 Mar 2023

Cited by 1 | Viewed by 1662

Abstract

For over four decades, mass spectrometry-based methods have provided a wealth of information relevant to various challenges in the field of cancers research. These challenges included identification and validation of novel biomarkers for various diseases, in particular for various forms of cancer. These [...] Read more.

For over four decades, mass spectrometry-based methods have provided a wealth of information relevant to various challenges in the field of cancers research. These challenges included identification and validation of novel biomarkers for various diseases, in particular for various forms of cancer. These biomarkers serve various objectives including monitoring patient response to the various forms of therapy, differentiating subgroups of the same type of cancer, and providing proteomic data to complement datasets generated by genomic, epigenetic, and transcriptomic methods. The same proteomic data can be used to provide prognostic information and could guide scientists and medics to new and innovative targeted therapies The past decade has seen a rapid emergence of epigenetics as a major contributor to carcinogenesis. This development has given a fresh momentum to MS-based proteomics, which demonstrated to be an unrivalled tool for the analyses of protein post-translational modifications associated with chromatin modifications. In particular, high-resolution mass spectrometry has been recently used for systematic quantification of chromatin modifications. Data generated by this approach are central in the search for new therapies for various forms of cancer and will help in attempts to decipher antitumor drug resistance. To appreciate the contribution of mass spectrometry-based proteomics to biomarkers discovery and to our understanding of mechanisms behind the initiation and progression of various forms of cancer, a number of recent investigations are discussed. These investigations also include results provided by two-dimensional gel electrophoresis combined with mass spectrometry. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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7 pages, 647 KiB

Open AccessFeature PaperReview

Interstitial Cells of Cajal—Origin, Distribution and Relationship with Gastrointestinal Tumors

by Petru Radu, Mihai Zurzu, Vlad Paic, Mircea Bratucu, Dragos Garofil, Anca Tigora, Valentin Georgescu, Virgiliu Prunoiu, Florian Popa, Valeriu Surlin and Victor Strambu

Medicina 2023, 59(1), 63; https://doi.org/10.3390/medicina59010063 - 28 Dec 2022

Cited by 2 | Viewed by 4758

Abstract

The interstitial cells of Cajal (ICC) represent a particular network formed by some peculiar cells that were first described by the great neuroanatomist, S. Ramon y Cajal. Nowadays, the ICC have become a fascinating topic for scientists, arousing their curiosity; as a result, [...] Read more.

The interstitial cells of Cajal (ICC) represent a particular network formed by some peculiar cells that were first described by the great neuroanatomist, S. Ramon y Cajal. Nowadays, the ICC have become a fascinating topic for scientists, arousing their curiosity; as a result, there is a vast number of published articles related to the ICC. Today, everybody widely accepts that the ICC represent the pacemaker of the gastrointestinal tract and are highly probable to be the origin cells for gastrointestinal tumors (GISTs). Recently, Cajal-like cells (ICLC) were described, which are found in different organs but with an as yet unknown physiological role that needs further study. New information regarding intestinal development indicates that the ICC (fibroblast-like and muscle-like) and intestinal muscle cells have the same common embryonic cells, thereby presenting the same cellular ultrastructure. Nowadays, there is a vast quantity of information that proves the connection of the ICC and GISTs. Both of them are known to present c-kit expression and the same ultrastructural cell features, which includes minimal myoid differentiation that is noticed in GISTs, therefore, supporting the hypothesis that GISTs are ICC-related tumors. In this review, we have tried to highlight the origin and distribution of Cajal interstitial cells based on their ultrastructural features as well as their relationship with gastrointestinal stromal tumors. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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14 pages, 1054 KiB

Open AccessSystematic Review

Assessing the Predictive Power of the Hemoglobin/Red Cell Distribution Width Ratio in Cancer: A Systematic Review and Future Directions

by Donatella Coradduzza, Serenella Medici, Carla Chessa, Angelo Zinellu, Massimo Madonia, Andrea Angius, Ciriaco Carru and Maria Rosaria De Miglio

Medicina 2023, 59(12), 2124; https://doi.org/10.3390/medicina59122124 - 05 Dec 2023

Cited by 1 | Viewed by 1227

Abstract

Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the [...] Read more.

Background and Objectives: The hemoglobin (Hb)/red cell distribution width (RDW) ratio has emerged as an accessible, repeatable, and inexpensive prognostic factor that may predict survival in cancer patients. The focus of this systematic review is to investigate the prognostic role of the Hb/RDW ratio in cancer and the implications for clinical practice. Materials and Methods: A literature search of PubMed, Scopus, and Web of Science databases was performed by an independent author between 18 March and 30 March 2023 to collect relevant literature that assessed the prognostic value of the Hb/RDW ratio in cancer. Overall survival (OS), progression-free survival (PFS), and the association of these with the Hb/RDW ratio were considered to be the main endpoints. Results: Thirteen retrospective studies, including 3818 cancer patients, were identified and involved in this review. It was observed that, when patients with a high vs. low Hb/RDW ratio were compared, those with a lower Hb/RDW ratio had significantly poorer outcomes (p < 0.05). In lung cancer patients, a one-unit increase in the Hb/RDW ratio reduces mortality by 1.6 times, whilst in esophageal squamous-cell carcinoma patients, a lower Hb/RDW ratio results in a 1.416-times greater risk of mortality. Conclusions: A low Hb/RDW ratio was associated with poor OS and disease progression in patients with cancer. This blood parameter should be considered a standard biomarker in clinical practice for predicting OS and PFS in cancer patients. Future searches will be necessary to determine and standardize the Hb/RDW cut-off value and to assess whether the Hb/RDW ratio is optimal as an independent prognostic factor or if it requires incorporation into risk assessment models for predicting outcomes in cancer patients. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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12 pages, 3418 KiB

Open AccessCase Report

Spindle Cell Rhabdomyosarcoma of the Inguinal Region Mimicking a Complicated Hernia in the Adult—An Unexpected Finding

by Valentin Titus Grigorean, Radu Serescu, Andrei Anica, Violeta Elena Coman, Ştefan Iulian Bedereag, Roxana Corina Sfetea, Mircea Liţescu, Iancu Emil Pleşea, Costin George Florea, Cosmin Burleanu, Anwar Erchid and Ionuţ Simion Coman

Medicina 2023, 59(9), 1515; https://doi.org/10.3390/medicina59091515 - 23 Aug 2023

Viewed by 1159

Abstract

Rhabdomyosarcoma is a rare tumor that is diagnosed mostly in children and adolescents, rarely in adults, representing 2–5% of all soft tissue sarcomas. It has four subtypes that are recognized: embryonal (50%), alveolar (20%), pleomorphic (20%), and spindle cell/sclerosing (10%). The diagnosis of [...] Read more.

Rhabdomyosarcoma is a rare tumor that is diagnosed mostly in children and adolescents, rarely in adults, representing 2–5% of all soft tissue sarcomas. It has four subtypes that are recognized: embryonal (50%), alveolar (20%), pleomorphic (20%), and spindle cell/sclerosing (10%). The diagnosis of rhabdomyosarcoma is based on the histological detection of rhabdomyoblasts and the expression of muscle-related biomarkers. Spindle cell/sclerosing rhabdomyosarcoma consists morphologically of fusiform cells with vesicular chromatin arranged in a storiform pattern or long fascicles, with occasional rhabdomyoblasts. Also, dense, collagenous, sclerotic stroma may be seen more commonly in adults. We present a rare case of an adult who presented to the hospital with a tumor in the left inguinal area, was first diagnosed with a left strangulated inguinal hernia and was operated on as an emergency, although the diagnosis was ultimately a spindle cell rhabdomyosarcoma of the inguinal region. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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7 pages, 661 KiB

Open AccessCase Report

The Philadelphia Chromosome, from Negative to Positive: A Case Report of Relapsed Acute Lymphoblastic Leukemia Following Allogeneic Stem Cell Transplantation

by Elena-Cristina Marinescu, Horia Bumbea, Iuliana Iordan, Ion Dumitru, Dan Soare, Cristina Ciufu and Mihaela Gaman

Medicina 2023, 59(4), 671; https://doi.org/10.3390/medicina59040671 - 28 Mar 2023

Viewed by 1601

Abstract

Relapsed acute lymphoblastic leukemia (ALL) represents a continuous challenge for the clinician. Despite recent advances in treatment, the risk of relapse remains significant. The clinical, biological, cytogenetic, and molecular characteristics may be different at the time of relapse. Current comprehensive genome sequencing studies [...] Read more.

Relapsed acute lymphoblastic leukemia (ALL) represents a continuous challenge for the clinician. Despite recent advances in treatment, the risk of relapse remains significant. The clinical, biological, cytogenetic, and molecular characteristics may be different at the time of relapse. Current comprehensive genome sequencing studies suggest that most relapsed patients, especially those with late relapses, acquire new genetic abnormalities, usually within a minor clone that emerges after ALL diagnosis. We report the case of a 23-year-old young woman diagnosed with Philadelphia chromosome-negative B cell acute lymphoblastic leukemia. The patient underwent allogeneic stem cell transplantation (allo-HSCT) after complete remission. Despite having favorable prognostic factors at diagnosis, the disease relapsed early after allo-HSCT. The cytogenetic and molecular exams at relapse were positive for the Philadelphia chromosome, respectively for the Bcr-Abl transcript. What exactly led to the recurrence of this disease in a more aggressive cytogenetic and molecular form, although there were no predictive elements at diagnosis? Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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7 pages, 4772 KiB

Open AccessCase Report

The Use of Liquid Biopsy in the Molecular Analysis of Plasma Compared to the Tumour Tissue from a Patient with Brain Metastasis: A Case Report

by Veronica Aran, Vinicius Mansur Zogbi, Renan Lyra Miranda, Felipe Andreiuolo, Nathalie Henriques Silva Canedo, Carolina Victor Nazaré, Paulo Niemeyer Filho and Vivaldo Moura Neto

Medicina 2023, 59(3), 459; https://doi.org/10.3390/medicina59030459 - 25 Feb 2023

Cited by 1 | Viewed by 1356

Abstract

Different cancers have multiple genetic mutations, which vary depending on the affected tumour tissue. Small biopsies may not always represent all the genetic landscape of the tumour. To improve the chances of identifying mutations at different disease stages (early, during the disease course, [...] Read more.

Different cancers have multiple genetic mutations, which vary depending on the affected tumour tissue. Small biopsies may not always represent all the genetic landscape of the tumour. To improve the chances of identifying mutations at different disease stages (early, during the disease course, and refractory stage), liquid biopsies offer an advantage to traditional tissue biopsy. In addition, it is possible to detect mutations related to metastatic events depending on the cancer types analysed as will be discussed in this case report, which describes a patient with brain metastasis and lung cancer that harboured K-RAS mutations both in the brain tumour and in the ctDNA present in the bloodstream. Full article

(This article belongs to the Special Issue Advances in Cancer Multimodal Approach: Biomarkers, Mechanisms, Surgical Procedures and Oncological Therapies)

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