The diagnostic and prognostic roles of serum irisin in bladder cancer Publication date: Available online 20 November 2019 Source: Current Problems in Cancer Author(s): Marwa M. Esawy, Khalid M. Abdel-Samd Abstract Background: Egypt is among the countries with the highest incidence of bladder cancer (BC). Adipokines involved in BC development. This study aimed to examine the diagnostic and prognostic roles of irisin in BC through its function as an adipokine. Patients and methods: This study included 150 subjects; 75 patients newly diagnosed as BC and 75 apparently healthy subjects. Serum irisin levels were quantified by enzyme-linked immunosorbent assay. Results: Serum irisin levels exhibited significantly lower levels in BC patients compared to controls (1.07 [0.51-1.96] and 1.8 [0.5-2.44] µg/mL), respectively (P < 0.001). Serum irisin was positively correlated with BMI (r = 0.386, P = 0.001) and negatively correlated with serum cholesterol (r = −0.58, P < 0.0001). Irisin had 74.7% sensitivity and 90.7% specificity at a cutoff point of ≤1.2 µg/mL. Serum irisin levels reduction can predict the BC stages, when adjusted for BMI and serum cholesterol level, serum irisin had an adjusted odds ratio of 14 (P = 0.001). Low serum irisin patients had a higher mortality rate when compared to those with high levels (38.2% vs 5%). Conclusion: BC patients had significantly lower levels of serum irisin. Serum irisin showed acceptable performance criteria in BC diagnosis. It had a limited role in BC grading but showed a decreasing trend in different BC stages. Serum irisin seems to be an excellent diagnostic and prognostic marker for BC.

NSCLC patient "migration" for treatment: A retrospective analysis of patient characteristics, travel patterns, and survival differences Publication date: Available online 19 November 2019 Source: Current Problems in Cancer Author(s): Danh Pham, Shruti Bhandari, Christina Pinkston, Malgorzata Oechsli, Goetz Kloecker Abstract Purpose: Every year a significant population exists of those diagnosed with nonsmall cell lung cancer (NSCLC) who do not receive initial treatment upon diagnosis and then “migrate” to additional hospital before ultimately getting treatment. Migration to different hospitals may play a role in the decision to treat or not-to-treat, and we aimed to evaluate the potential factors that lead to treatment. Methods: A retrospective review of 6212 patients with NSCLC from 29 Kentucky hospital registries from 2012 to 2014 was performed. Variables collected included hospital accreditation status, age at diagnosis, stage, overall survival (OS), and insurance status. Hospital records were matched to Kentucky Cancer Registry records to determine the number of hospitals visited for treatment. Results: Most patients were treated at their initial hospital (73%). Of the remaining patients, 36% migrated to a different hospital where most received treatment (93%). Migrating to another hospital was associated with Stage I-III disease, younger age (66.4 vs 72.2 years), and longer OS (561 vs 157 days). Notably, migration was also associated with private insurance status and missing treatment modalities at the initial hospital. Treatment after migrating was associated with Stage I-II disease, younger age (65.8 vs 72.8 years), and longer OS (595 vs 153 days). After adjusting for confounders, treated migrating patients lived longer than initially treated patients (591 vs 505 days), especially among those with stage III (563 vs 495 days) and IV (379 vs 300 days) disease. Conclusion: This analysis demonstrates a survival benefit for initially untreated patients with advanced disease who migrate to another hospital for treatment. Migration was associated with having private insurance, thus making it noteworthy of the relationship between NSCLC survival benefit and insurance status.

Tumor Board Report: The value of tissue diagnosis Publication date: Available online 19 November 2019 Source: Current Problems in Cancer Author(s): Adham Hijab, Ayelet Eran, Tzahala Tzuck-Shina, Orit Kaidar-Person Summary Intracranial lesions in the presence of a known cancer are highly suspicious for brain metastases. Lung cancer is the most common solid tumor responsible for brain metastases. This case emphasizes the importance of multidisciplinary tumor boards including a dedicated neuroradiologist in the management of patients with cancer.

ctDNA/CTCs and the applicability in different causes induced HCC Publication date: Available online 18 November 2019 Source: Current Problems in Cancer Author(s): Xuemei Li, Huihui Wang, Tao Li, Lianzi Wang, Xian Wu, Jiaqing Liu, Yuanhong Xu, Wei Wei Abstract In 2015, liquid biopsy was rated one of the top 10 breakthrough technologies of the year by «MIT Technology Review». Liquid biopsy is a type of in vitro diagnostic using a noninvasive blood test. It is also a breakthrough technology used to detect tumors and cancers and assist therapeutic strategies. The most widely used markers are circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA). Primary carcinoma of the liver is a malignancy of hepatocytes or intrahepatic biliary epithelial cells. The most common type of liver cancer is hepatocellular carcinoma (HCC). The causes of HCC mainly include infection with Hepatitis B and/or Hepatitis C, alcohol abuse, and aflatoxicosis. HCC lacks typical clinical characteristics during the early stage, so early diagnosis is very challenging. However, CTCs and ctDNA carry tumor-specific information. Therefore, the detection and analysis of CTCs and ctDNA can provide evidence for early diagnosis of HCC and guide treatment. Furthermore, several studies have indicated that different inducers of HCC would cause different DNA mutations, so detecting specific mutations will facilitate determination of HCC type and help physicians provide distinctive therapies.

Review on meta-analysis of functional expression and mutational analysis of c-Met in various cancers Publication date: Available online 18 November 2019 Source: Current Problems in Cancer Author(s): Murugesan Sivakumar, Palaniappan Seedevi, Palaniappan Sivasankar, Muthu Ravikumar, Sundharaiyya Surendar, Shahid S. Siddiqui, Sivakumar Loganathan Abstract Comprehensive genomic profiling is expected to revolutionize cancer therapy. Met signaling is responsible for tumorigenesis in various cancers. In this prospective, we present the prevalence of cMet mutations and copy-number alterations across various solid tumors. We used major databases like cBioportal, Pubmed, and COSMIC for c-Met mutation and amplification data collection from various cancers. Our result shows complete details about cMet mutation and its clinical data of various cancers. Hotspot mutation of human c-Met protein reveals that repeatedly and most mutated regions and these hotspots may be a diagnostic tool for cancer confirmation. Amino acid and nucleotide changes and their prevalence were reported in a number of individual cancers However, we collectively present the amino acid and nucleotide changes in various cancers in this review. Our collection of data for c-Met mutation and its distribution in different cancer tissue is showing that the missense mutation is the major one in all type of cancers. Copy number variation data showing amplification and deletion of human c-Met from various tumor types, lung, and central nervous system tumors showing high amplification comparatively other types.

The prognostic role of peritoneal cytology in stage IA endometrial endometrioid carcinomas Publication date: Available online 14 November 2019 Source: Current Problems in Cancer Author(s): Lili Wang, Lei Li, Ming Wu, Jinghe Lang Abstract Introduction: Debates exist about the effects of peritoneal cytology and its treatment on the survival of early endometrial cancer. This study is to explore the prognostic role of peritoneal cytology and relevant therapy in patients with stage IA endometrial endometrioid carcinomas in a retrospective cohort study. Material and methods: From June 1, 2010, to June 1, 2017, in a teaching hospital, all the cases of pathologically confirmed stage IA endometrioid endometrial cancer were reviewed. Patients were followed up to February 1, 2019. The survival outcomes were compared among patients with negative peritoneal cytology, positive peritoneal cytology and no peritoneal cytology outcomes. Results: In total, 1284 patients were included in the study, and 754 (58.7%) had peritoneal cytology evaluations with 22 (2.9%) of positive peritoneal cytology. After a median follow-up of 57.4 months, 1257 patients (97.9%) had definite survival outcomes. None of the patients with positive peritoneal cytology had recurrence or mortality. The appearance of positive peritoneal cytology had no impact on the disease-free, overall and cancer-specific overall survivals in univariate and multivariate analyses. No risk factors, including the adjuvant therapy, were found to be relevant with the appearance and survival in patients with positive peritoneal cytology. Conclusions: In patients with stage IA endometrial endometrioid carcinoma, the prevalence of positive peritoneal cytology was very low without know risk factor. Positive peritoneal cytology did not influence the survival outcomes of whole population, and adjuvant therapy did not influence the survival outcomes of patients with positive peritoneal cytology in such population. Mini Abstract The appearance of positive peritoneal cytology in stage IA endometrial endometrioid carcinomas had no clinical significance and need no adjuvant therapy.

Changes in body composition during neoadjuvant therapy can affect prognosis in rectal cancer patients: An exploratory study Publication date: Available online 1 November 2019 Source: Current Problems in Cancer Author(s): Paola De Nardi, Mariachiara Salandini, Damiano Chiari, Nicolò Pecorelli, Giulia Cristel, Anna Damascelli, Monica Ronzoni, Luca Massimino, Francesco De Cobelli, Marco Braga Abstract Aim: To establish the correlation between changes in body composition after neoadjuvant chemoradiotherapy (nCRT) and postoperative outcomes, in patients with advanced low rectal cancer. Methods: Patients with clinical stage T≥3 or N+ rectal cancer who underwent nCRT and surgical resection were studied. Skeletal muscle, visceral, and subcutaneous fat cross-sectional area were measured by computed tomography before and after nCRT. Postoperative morbidity, pathologic response to nCRT, overall and disease-free survival was assessed. Results: Fifty-two patients, median age 62 (range 32-79) were studied. A skeletal muscle loss >2% significantly correlated with a shorter disease-free survival both in the overall population (P = 0.048) and in the subgroup of N0 patients (P = 0.048). A subcutaneous fat loss >5% was also associated with a shorter disease-free survival (P = 0.012) in the whole population. Conclusions: Skeletal muscle loss, after neoadjuvant chemoradiotherapy, negatively impacts on disease-free survival in surgically treated rectal cancer patients.

Harlequin sign in Pancoast tumor Publication date: Available online 1 November 2019 Source: Current Problems in Cancer Author(s): Rohit Kumar, Shruti Bhandari, Goetz H Kloecker

Factors associated with mortality from lung cancer in India Publication date: Available online 1 November 2019 Source: Current Problems in Cancer Author(s): Manas Pratim Roy. Abstract Objective: Lung cancer is the most common cancer in the world. There is scarcity of research papers at national level on its sociodemographic dimensions. The present paper aims to correlate death from lung cancer with certain demographic factors. Methods: Retrieved data from National Family Health Survey 4, Global Adult Tobacco Survey 2: India 2016-2017 and India: Health of the Nation's States were analyzed, as state and/or Union Territories unit of analysis. Spearman correlation coefficient and multivariate linear regression were used for finding out association with smoking, smokeless tobacco, alcohol consumption, second hand smoking, per capita income and use of clean fuel. Results: Except Kerala, most of the states with higher death rate were confined to north India. Smoking (r = 0.575, P= 0.001), SHS at home and work (r = 0.476, P= 0.008 and r = 0.374, P= 0.042, respectively) were significantly related to deaths from ca lung. On regression, clean fuel was found significantly associated with ca lung mortality. Conclusion: There is need to put emphasis on tobacco cessation and primary prevention of smoking.

Radiation oncologists' perspectives on reducing radiation-induced heart disease in early breast cancer Publication date: Available online 1 November 2019 Source: Current Problems in Cancer Author(s): Hoda Mahdavi Abstract Radiotherapy (RT) as an adjuvant treatment for breast cancer (BC), has caused a reduction of recurrences and BC-related deaths. But it has also induced cardiovascular mortality. Oxidative stress is the principle mediator of RT-induced heart disease, similar to many conventional cardiovascular risk factors. The aggregate effect of cardiovascular conditions, RT of heart substructures, implied techniques, and population cardiac mortality rates is not well understood. Due to uncertainties in this field, this article aims to briefly review the recommended strategies for risk assessment, plan optimization, and screening for prevention of RT-induced heart disease in BC patients.