electronic cigarette news

Background: Image-guided transcatheter hepatic chemoembolization (TACE) is accepted worldwide as an effective treatment for patients with unresectable hepatocellular carcinoma (HCC) and for adequate preservation of liver function. Although considered relatively safe, TACE has been associated with several complications. The aim of this study was to determine the prevalence of the complications associated with TACE therapy and to correlate it with certain risk factors, either well-known or not yet evaluated. Patients and Methods: A total of 330 chemoembolization procedures performed in 170 patients (117 males and 53 females) over a period of 64 months were retrospectively analysed. Among the patients, 123 had hepatocellular carcinoma, 10 had intrahepatic cholangiocarcinoma and 37 had hepatic metastases. The variables considered were: tumour histotype, bilioenteric anastomosis, previous or combined treatment with radiofrequency thermal ablation, antibiotic prophylaxis, chemotherapeutic agents, use of new drug-eluting microspheres, comorbidities such as diabetes, patient age and the presence of vascular anatomical variations. Results: A total of 30 complications occurred in 27 procedures. The total complication rate per procedure was 9.1% and approximately 75% of patients had postembolization syndrome. The difference in the prevalence of complications was statistically significant in the group of diabetic patients (13.3%) compared to the remaining patients (6.3%) (p=0.002) and in patients with biliary stents (25%) compared to those without stents (7.75%) (p=0.027). Conclusion: These data show that diabetes mellitus and the presence of bilioenteric anastomosis are risk factors for developing complications after TACE. The use of new drug-eluting microspheres did not increase the risk of complications.

No Comments »

Aim: This study aimed to determine the prevalence of excess dopamine in relation to clinical symptoms and nuclear imaging in head and neck paraganglioma (PGL) patients. Patients and Methods: Thirty-six consecutive patients with head and neck PGLs, evaluated between 1993 and 2009, were included. Clinical symptoms, dopamine excess (urinary 3-methoxytyramine (3-MT) or dopamine and/or plasma dopamine or 3-MT) and (nor)epinephrine excess (urinary (nor)metanephrine) as well as 111In-octreotide and 123I-metaiodobenzylguanide (MIBG) scintigraphy were documented. Results: Dopamine excess was found in seven patients (19.4%), but was unrelated to clinical signs and symptoms. Excretion of other catecholamines was unremarkable, except in one patient with adrenal pheochromocytoma. 123I-MIBG uptake (present in 36.1% of patients) was associated with dopamine excess (p=0.03). Conclusion: Dopamine excess is present in a considerable percentage of patients with head and neck PGL, and its measurement may be useful in follow-up. Measurement of other catecholamines is necessary to rule out co-existent pheochromocytoma.

No Comments »

Background and Aims: This study examined the efficacy of arabinoxylan rice bran (MGN-3) in conjunction with an interventional therapy (IT) for the treatment of hepatocellular carcinoma patients. Patients and Methods: A total of sixty-eight patients with hepatocellular carcinoma (stages I and II) participated in the study. Patients were randomized to receive IT (30 patients, control group) or IT+MGN-3 (38 patients), and randomly divided into two groups using a computer-generated randomization list. Patients and investigators were blinded. IT included transarterial oily chemoembolization (TOCE) or a combination of TOCE and percutaneous ethanol injection treatment (PEIT). Results: Patients in the IT+MGN-3 group showed: (i) lower recurrence of the disease, 31.6% (12/38), as compared to 46.7% (14/30) for the control; (ii) higher survival after the second year, 35%, as compared to 6.7% for the control; (iii) significantly lower alpha-fetoprotein level, a 38% decrease (p=0.0001), as compared to baseline value, while the control showed no significant change; and (iv) a significant decrease in tumor volume, in contrast to the control, which showed no significant change. When the results were analyzed according to each IT modality, MGN-3+IT sub-groups displayed a greater response to treatment, in every aspect examined, than the IT sub-groups alone. However, the patients in the MGN-3+TOCE+PEIT sub-group demonstrated greater reduction in AFP levels and longer survival time than the MGN-3+TOCE sub-group. Conclusion: MGN-3 in conjunction with IT may be useful for the treatment of hepatocellular carcinoma and warrants further investigation in multiple clinical trials.

No Comments »

Background: Treatment decisions in breast cancer depend on TNM classification and the assessment of additional variables with have an impact on survival. We examined whether histological subtyping breast cancer as either ductal or lobular is related to disease outcome. Patients and Methods: We examined a large data base of 14198 breast cancer patients. Results: Histological sub-classification of invasive breast cancer as either ductal or lobular is not correlated with disease outcome. However, the data further showed that invasive lobular carcinomas have a higher probability of being oestrogen receptor (ER)- and progesterone receptor (PR)-positive and a lower probability of being c-erbB2-positive. They also showed a higher average age at the time of diagnosis in comparison with invasive ductal carcinoma. Local recurrence rates were lower in invasive lobular carcinoma in comparison with invasive ductal carcinoma (3.5% vs. 6.2%; p=0.031). The multivariable Cox regression analysis showed that ER, PR, nodal status, grade and tumour size predicted disease outcome with statistical significance, while the histological subtype (invasive ductal or lobular) was not a significant predictor of disease outcome. Conclusion: Histological sub-classification of invasive breast cancer as either ductal or lobular is not correlated with disease outcome. On the other hand our data gives some indication that lobular and ductal breast cancer appear to be different biological entities.

No Comments »

Background: Systemic inflammation before surgery, as evidenced by the Glasgow prognostic score (GPS), predicts postoperative complications and cancer-specific survival in various types of cancer. The aim of this study was to evaluate the significance GPS in hepatic resection for hepatocellular carcinoma (HCC). Patients and Methods: Sixty-six patients who underwent elective hepatic resections for HCC were include in the study. Patients were classified into three groups: GPS 0 [C-reactive protein (CRP)≤1.0 mg/dl and serum albumin ≥3.5 g/dl, n=54], GPS 1 [CRP >1.0 mg/dl or serum albumin <3.5 g/dl, n=11], and GPS 2 [CRP>1.0 mg/dl and serum albumin <3.5 g/dl, n=1]. We retrospectively examined the association between GPS (0 or 1) and perioperative clinical variables and outcome. Results: In univariate analysis, GPS 0 patients had significantly better preoperative the retention rate of indocyanine green at 15 minutes (ICGR15) (p=0.0418), Child-Pugh classification (p=0.0075) and model for end-stage liver disease score (p=0.0007) than did GPS 1 patients. In multivariate analysis, blood loss and GPS 1 were independent risk factors for pulmonary complications (p=0.0118 for blood loss, p=0.0143 for GPS 1), red blood cell concentration transfusion (p=0.0036 for blood loss, p=0.0117 for GPS 1) and flesh frozen plasma transfusion (p=0.0020 for blood loss, p=0.0044 for GPS 1). Albumin product transfusion, duration of operation (p=0.0478), blood loss (p=0.0420) and GPS 1 (p=0.0111) were independent risk factors. Disease-free and overall survival of GPS 0 and GPS 1 patients were comparable. Conclusion: GPS reflects preoperative patient status, and is associated with blood transfusion and pulmonary complications in elective hepatic resection for HCC.

No Comments »

Background/Aim: Gefitinib and erlotinib were shown to be particularly effective in a clinically selected subpopulation of non-small cell lung cancer patients (NSCLC): adenocarcinoma histology, non-smoking status, Asian origin and female gender have been associated with improved clinical benefit compared to the unselected NSCLC population. The aim of the present study was to investigate the prognostic and predictive role of EGFR and KRAS analysis in advanced lung adenocarcinomas, selected according to clinical features associated to better response to EGFR tyrosine kinase inhibitors (TKIs), namely female gender and non-smoker or former light smoker status. Patients and Methods: EGFR and KRAS mutations and EGFR FISH status were assessed in 67 surgical samples. Results: EGFR and KRAS mutations were found in 16 (26.7%) and 12 (17.9%) patients, respectively. FISH analysis was positive in 34 (56.7%) patients. EGFR-mutated patients showed significantly longer survival when treated with EGFR TKIs (p=0.002, hazard ratio (HR)=0.036, 95% confidence interval (CI): 0.004 -0.303). KRAS mutations was found to be an independent negative prognostic factor in multivariate analysis (p=0.008, HR=3.52, 95%CI: 1.39-8.9). The prognostic value of EGFR FISH status was not confirmed in multivariate analysis (p=0.048, HR=0.47, 95%CI: 0.22-0.99). Conclusion: In a group of clinically selected patients, EGFR and KRAS analysis was able to define distinct molecular subsets of lung adenocarcinoma.

No Comments »

Rhabdomyosarcoma in the mediastinum coexisting with metastatic non-seminomatous germ cell tumor, so-called somatic-type malignancy, is a rare carcinoma and has poor survival. This study reports a case of diffuse and huge hepatic metastasis of non-seminomatous germ cell tumor associated with coexisting embryonal rhabdomyosarcoma in the mediastinum. A 31-year-old man presented with abdominal pain and was found to have multiple abnormal hepatic masses on abdominal computed tomography (CT). Concomitantly, an anterior mediastinal mass was found on chest CT. Chemotherapy was initiated because the hepatic lesion was diagnosed as choriocarcinoma, based on histological findings and the elevation of chorionic gonadotropin β-subunit and α-fetoprotein. After six cycles of bleomycin, etoposide and cisplatin chemotherapy the metastatic liver tumors showed complete response. The remaining mediastinal tumor was completely and successfully resected. The histological findings revealed mature teratoma with embryonal rhabdomyosarcoma. The patient has remained well for over six years after the treatment without any signs of disease recurrence.

No Comments »

Background: Drug-induced pancreatitis is less common compared to other causes of acute pancreatitis; the incidence ranges from between 0.1% to 2% of acute pancreatitis cases. Among alkylating agents, oxaliplatin has not been reported to be associated with acute pancreatitis. Patients and Methods: This case study presents a series of six cases of acute pancreatitis presumably related to exposure to oxaliplatin which had different gastrointestinal malignancies and were being treated with oxaliplatin in combination with other chemotherapeutic drugs. All other related causes of acute pancreatitis were excluded before implicating oxaliplatin as a possible cause. Results: In all cases, oxaliplatin was stopped and patients had resolution of their signs and symptoms, along with a decrease in serum amylase and lipase levels. Conclusion: Knowledge regarding acute pancreatitis related to oxaliplatin is of paramount importance in order to diagnose cases early and institute effective treatment in patients who are undergoing chemotherapy with this drug.

No Comments »

Background/Aim: Carbon ion radiotherapy is expected to be suitable to treat localized prostate cancer because it yields great biological and physical effects. The aim of this study was to examine long-term results and subsequent outcomes after biochemical failure. Patients and Methods: A total of 254 patients were treated from the beginning of 2003 and followed through 2009. Long-term hormone therapy was also used for some intermediate-risk and high-risk patients. Results: Among the patients examined, 54 patients experienced biochemical failure. Failure-free survival was 76%, 91% and 76% at eight years in low-risk, intermediate-risk and high-risk patients, respectively. Clinical progression occurred only in high-risk patients, with 89% progression-free survival at eight years. After biochemical failure, diseases of most patients were well controlled by salvage therapy but twelve high-risk patients (5%) died of prostate cancer. Conclusion: Carbon ion radiotherapy had an excellent effect on localized prostate cancer. Factors influencing salvage therapy included PSA kinetics and duration between radiation and failure.

No Comments »

Background: Molecular and epidemiologic evidence indicates that human papillomavirus (HPV) is involved in the etiology of oral and oropharyngeal squamous cell carcinomas (SCCs). HPV+ tumors appear to be clinically distinct from HPV– tumors, conferring improved survival outcomes for patients. Determination of the HPV status of tumors may assist in patient risk-stratification and ultimately guide optimum treatment. The primary aim of this study was to examine the distribution of HPV in oral and oropharyngeal SCCs as assessed using seven different in vitro amplification assays. The secondary aim was to correlate the distribution of HPV in tumors with clinical and demographic patient data. Materials and Methods: Sixty-eight invasive oral/oropharyngeal SCCs were tested for HPV using four laboratory-developed PCR assays for HPV16 or 18 and three commercial tests, INNO-LiPA® HPV Genotyping Extra (Innogenetics), Linear Array® HPV Genotyping Test (Roche Diagnostics), and Invader® HPV16/18 ASRs (Hologic Corp.). Results: Consensus results between tests revealed that 71.9% of tumors were HPV+, primarily with HPV16 (63.2%). Other genotypes were uncommon and generally occurred coincidently with HPV16. HPV-positivity was significantly higher in oropharyngeal tumors (76.9%), particularly of the tonsils (91.7%), versus oral cavity tumors (20.0%). HPV+ tumors occurred in younger patients (average 54.4 years versus 61.1 years) and were significantly associated with lower histological differentiation (poorly, 100.0%; moderately, 65.6%; well-differentiated, 42.9%). Conclusion: A high rate of HPV-positivity, especially involving HPV16, occurred in oropharyngeal tumors, with a lower rate in oral cavity SCCs; however, solitary infections with HPV18, 33 or 45 in a minority of cases signified the potential oncogenicity of these additional genotypes and the likely need to screen for these less common genotypes in clinical specimens.

No Comments »