What is the real prognostic value of close margins in oral oncology? Publication date: Available online 30 August 2019 Source: Current Problems in Cancer Author(s): Paolo Cariati, Almudena Cabello Serrano, Fernando Mosalve Iglesias, Pablo Torné Poyatos, Jose Fernandez Solis, Silvano Ferrari, Ildefonso Martinez Lara Abstract Aim: The surgical margin is usually considered an important prognostic factor in oral oncology. However, the real value of a close surgical margin and its relationship with survival is still unclear. Thus, the present report sought to identify the relationship between close surgical margins and overall 3-year survival, whilst also analyzing the association between such margins and recurrence. Materials and Methods: The medical records of 200 patients affected by oral squamous cell carcinoma were retrospectively reviewed. The patients were divided into three groups: positive margin (0-2 mm), close margin (2-5 mm), and negative margin (>5 mm). The relationship between surgical margins and overall survival and recurrence rate was analyzed. Results: Surgical margins and reoperation were found to have no significant association with overall survival (P > 0.05). Overall survival was 63% in our sample. Specifically, this was 50%, 64.7% and 66.2% in patients with positive, close and free margins, respectively. Perineural invasion, pN, and locoregional or cervical recurrences were the factors most directly related to overall survival. Discussion: The results of this study indicate that surgical margins are not directly related to overall survival and other factors might significantly influence patient outcomes. Advanced T stage, node involvement, perineural invasion, and ECS are strongly linked with patient survival (P < 0.05). These findings should be carefully evaluated in patients with close surgical margins. Our results indicate that an aggressive adjuvant treatment of patients with close surgical margins could help in obtaining a similar pattern of overall survival with patients with negative margins.

Erythroderma as a paraneoplastic manifestation of small cell lung cancer Publication date: Available online 30 August 2019 Source: Current Problems in Cancer Author(s): Stylianos G. Zervakis, Nikolaos Spernovasilis, Erasmia Boutakoglou, Simeon Panagiotakis, Konstantina Thomopoulou, George Samonis Abstract Erythroderma is a rare clinical entity characterized by generalized erythema affecting the whole or most of the body's skin surface. It is associated with a variety of underlying conditions, including preexisting dermatoses, infections, connective tissue disorders, drugs, malignancies, or it may be idiopathic. A case of a 73-year-old man, with a 5-month history of erythroderma, eventually diagnosed with small cell lung cancer is presented. This is the first reported case indicating an association between erythroderma and small cell lung cancer, extending, thus, current knowledge regarding small cell lung cancer-related paraneoplastic manifestations as well as erythroderma's causative factors.

Usefulness of serum M30 and M65 levels to predict response to neoadjuvant chemotherapy in patients with breast cancer Publication date: Available online 29 July 2019 Source: Current Problems in Cancer Author(s): H. Mehmet Turk, Altay Aliyev, Rabia Sevda Celik, Mesut Seker, Ezgi Coban, Tarık Demir, Tuba Baydas, Abdurrahim Kocyigit Abstract Objective M30 and M65 levels reflect tumor cell activity in patients with epithelial cancer. Cytokeratin 18 is one of the cell skeletal elements. M30 is a apoptotic marker of cytokeratin 18. M65 levels are both an apoptosis and a necrosis marker. The aim of our study was to determine the predictive value of M30 and M65 levels in neoadjuvant treatment of breast cancer. Materials and methods In this prospective study, 41 patients with breast cancer who underwent neoadjuvant chemotherapy were included. Following 4 cycles of chemotherapy with anthracycline containing regimen, patients received paclitaxel treatment for 12 weeks. Blood was collected from the patients before chemotherapy and on day 21, after the 2nd, 4th, and 8th cycles. M30 and M65 levels were measured with the ELISA method. Results While there was an increase in M30 and M65 levels at the 4th cycle (P < 0.05), levels were decreased after the 8th cycle. In addition, there was no significant relationship among M30, M65 levels, and prognostic factors such as ER, PR, c-Erb-2, Ki-67, pathologic-T, pathologic-N, and chemotherapy responses. Conclusion M30 and M65 levels are not of predictive values of response to breast cancer patients receiving neoadjuvant chemotherapy. Nevertheless, M30 and M65 levels increased when patients kept receiving anthracycline containing chemotherapy.

Do estrogen, progesterone, P53 and Ki67 receptor ratios determined from curettage materials in endometrioid-type endometrial carcinoma predict lymph node metastasis? Publication date: Available online 26 July 2019 Source: Current Problems in Cancer Author(s): Varol Gülseren, Mustafa Kocaer, İsa Aykut Özdemir, İlker Çakır, Muzaffer Sancı, Kemal Güngördük Abstract Aim: Estrogen receptor (ER), progesterone receptor (PR), and Ki-67 and P53 receptor levels in endometrial curettage material were investigated for their ability to predict lymph node (LN) involvement in patients with endometrioid-type endometrial cancer (EEC). Methods: This retrospective study was based on a review of the records of patients who were diagnosed with EEC and underwent both hysterectomy and systematic retroperitoneal lymphadenectomy at the Gynecologic Oncology Clinic of Tepecik Training and Research Hospital, Turkey, between January 2008 and August 2017. Results: The curettage materials of 138 EEC patients were analyzed for ER, PR and P53 and Ki-67 receptor levels. According to the pathology results, the median pelvic LN count was 20 (range: 12-49) and the para-aortic LN count was 14 (10-46). Retroperitoneal LN involvement was present in 18 patients (13.0%). The association of LN involvement with all receptors was significant. The combined ratio of the 2 groups of markers ([P53 + Ki67]/[ER + PR]) (≥0.71) was an independent risk factor for LN involvement. In addition, in a univariate logistic regression analysis all receptors were significant predictors of LN involvement. Conclusions: In the detection of LN involvement, determination of the receptor status in curettage material has a high sensitivity and specificity. In EEC patients, receptor levels in curettage materials can be evaluated to detect LN involvement preoperatively.

Radiological and histological findings of an asymptomatic ever-increasing neoplasm: The small bowel neuroendocrine tumor (NET) Publication date: Available online 26 July 2019 Source: Current Problems in Cancer Author(s): Simona Picchia, Monica Terlizzo, Maria Antonietta Bali Abstract The small bowel neuroendocrine tumor is a rare but ever-increasing tumor, most of the time asymptomatic and found incidentally. An early diagnosis can consistently change the prognosis.

Atypical PRES with diffusion restriction or neurotoxicity– ? part of same spectrum—after oxaliplatin (FOLFOX-4 regimen) for colonic cancer Publication date: Available online 4 July 2019 Source: Current Problems in Cancer Author(s): Anitha Sen, V. Jiji, S. Roshni, Anil Prahladan, M. Venugopal, K. Ramachandran Abstract Atypical features of Posterior reversible encephalopathy syndrome (PRES) (diffusion restriction, involvement of corpus callosum & white matter tracts along posterior limbs of internal capsule) were seen in a patient after oxaliplatin administration (FOLFOX- 4 regimen). Findings were most obvious on diffusion weighted images, similar to acute methotrexate neurotoxicity, and resolved completely on follow up.

A phase II multicenter randomized controlled trial to compare standard chemoradiation with or without recombinant human endostatin injection (Endostar) therapy for the treatment of locally advanced nasopharyngeal carcinoma: Long-term outcomes update Publication date: Available online 2 July 2019 Source: Current Problems in Cancer Author(s): Yuanyuan Li, Ye Tian, Feng Jin, Weili Wu, Jinhua Long, Jinlin Ouyang, Yan Zhou Abstract Purpose: This study aimed to observe the feasibility and safety of addition of recombinant human endostatin injection to standard chemoradiation for the locally advanced nasopharyngeal carcinoma. Current follow-up results updated long-term efficacy and late toxicity of the trial. Methods: Between July 2012 and December 2013, we enrolled 114 patients that are older than 18 years with stage Ⅲ-Ⅳb nasopharyngeal carcinoma from 3 centers in Guizhou, China. Fifty six patients who received standard chemoradiation combined with recombinant human endostatin injection (Endostar) were included in the study group. Another 58 patients were randomly assigned to the control group without using Endostar. Patients in both groups received the same 2 cycles of induction chemotherapy (Docetaxel 75 mg/m2, cisplatin 80 mg/m2), followed by 2 cycles of concurrent intensity-modulated radiation therapy with cisplatin (DDP; 80 mg/m2 on days 1 and 22). The patients in the experimental group received 2 cycles Endostar (7.5 mg/m2 d8-d21 during induction chemotherapy and d1-d14 during concurrent chemoradiation). Results: There were no significant differences of toxicities between the 2 groups. Chemotherapy and radiotherapy compliance between the 2 groups was similar. No hemorrhage and coagulation dysfunction in the experimental group were observed. There was a median follow-up of 67.1 months. Comparing the short-time effect of 3 months to the completion of chemoradiotherapy, there was a little higher objective response rate in the experimental group. Compared with the control group, the experimental group improved in the complete remission rate of cervical lymph node metastasis (91.1% vs 72.4%, χ2 = 3.897, P = 0.048). However, there was no significant difference in the curative effect of nasopharyngeal lesions between the 2 groups. (78.6% vs 74.1%, χ2 = 0.310, P = 0.578). The 5-year overall survival, progression-free of survival, metastasis-free survival, and locoregional failure-free survival rates in the 2 groups were 69.6%, 67.8%, 78.75, and 83.0%, respectively, for the experimental group, these rates were 73.2%, 80.1%, 81.7%, and 91.0%, respectively, and for the control group, no significant difference was found (P > 0.05). Conclusions: Patients show good tolerance and compliance with a manageable toxicity profile to the regimen of chemoradiation plus Endostar. There was a little higher objective response rate in the study group. A phase 3 randomized study is needed to substantiate our findings.

Correlation of human papillomavirus 16 and 18 with cervical cancer and their diagnosis methods in Iranian women: A systematic review and meta-analysis Publication date: Available online 2 July 2019 Source: Current Problems in Cancer Author(s): Mona Fani, Pegah Mahmoodi, Maryam Emadzadeh, Amir Avan, Ehsan Karimi, Gordon A. Ferns, Majid Rezayi, Iraj S Amiri Abstract Background Human papillomavirus (HPV) is a sexually transmitted virus and related to the development of cervical cancer (CC). To determine the association between high-risk HPV types and CC, we undertook a systematic review and meta-analysis of recently reported prevalence of HPV16 and 18 in Iranian women identified with cervical infections. Materials and Methods Prevalence studies were identified between 2002 and 2018 using several databases including Medline, Web of Science, Embase, Google Scholar, Iranmedex, and Scientific Information Database. Results For patients with CC, 57% (95% confidence interval [95% CI] = 43.7%-70.4%) were HPV positive, 48.5% (95% CI = 31.8%-65.2%) were HPV16 and 12.5% (95% CI = 8.8%-16.2%) were HPV18 positive. Conclusion The results from meta-analysis indicate a relatively high prevalence of high-risk HPV among women infected with CC.

NAT10 upregulation indicates a poor prognosis in acute myeloid leukemia Publication date: Available online 2 July 2019 Source: Current Problems in Cancer Author(s): Peiqi Liang, Rong Hu, Zhuogang Liu, Miao Miao, Huinan Jiang, Chuan Li Abstract Background: N-acetyltransferase 10 (NAT10) is considered as an oncogene in many tumors. This study investigated the NAT10 expression in Chinese acute myeloid leukemia (AML) patients and evaluated the predictive significance of NAT10 with a single-center retrospective study. Methods: The Oncomine was used to analyze NAT10 expression in AML. We also collected bone marrow samples of 48 newly diagnosed AML patients and 20 benign individuals in our center. NAT10 mRNA expression levels were detected by real-time qPCR. Clinical data was obtained from inpatient medical records. Results: Two microarrays in Oncomine showed that NAT10 was upregulated in AML. Our data revealed that AML patients had higher NAT10 expression levels than the normal controls (P < 0.01). NPM1-mutant patients had higher NAT10 mRNA levels than NPM1-wt patients. NAT10 expression level was higher in nonremission group than in overall remission group (P < 0.05). High NAT10 expression indicated a poor progression-free survival and overall survival. Conclusions: The results support NAT10 as a potential prognostic and therapeutic biomarker for AML.

Future directions in soft tissue sarcoma treatment Publication date: Available online 20 June 2019 Source: Current Problems in Cancer Author(s): Francis Hall, Victor Villalobos, Breelyn Wilky Abstract Sarcoma is a broad term for mesenchymal malignancies that arise from soft tissue or bone. Despite classification by histologic subtype, clinical behavior and response to therapy have great variability. Modern genetic sequencing techniques have been able to identify additional genetic variability and subsequently new targeted therapies. In this review, we discuss the current state of STS diagnostics and treatment and explore some of the more promising areas in which progress is being made. We discuss therapies targeting PDGFRα/KIT, β-Catenin/APC/NOTCH, IDH-1/2 mutations, MDM2 amplifications, EZH2/INI1 expression loss, ALK fusion, and ASPSCR1-TFE3 fusion. We also discuss the progress that has been made within immunotherapies. While soft tissue sarcomas still portend a poor prognosis, these targeted therapies and immunotherapies provide treatment with less toxic side effects.