{"title":"Health-Related Quality of Life in a Real-World Cohort of Patients with Advanced Urothelial Carcinoma Treated with Immune Checkpoint Inhibitors.","authors":"Hiroki Kobayashi, Nobuki Furubayashi, Kaede Morihara, Motonobu Nakamura, Takahito Negishi","doi":"10.1159/000543541","DOIUrl":"10.1159/000543541","url":null,"abstract":"<p><strong>Introduction: </strong>Health-related quality of life (HRQOL) has been reported in clinical trials of pembrolizumab and avelumab treatment of locally advanced or metastatic urothelial carcinoma. However, few studies have investigated the effect of immune checkpoint inhibitors (ICIs) on HRQOL in patients with urothelial carcinoma in a real-world setting.</p><p><strong>Methods: </strong>We included 44 patients with advanced urothelial cancer who were treated with pembrolizumab or avelumab from January 2018 to November 2023. When patients visited our hospital for treatment, we evaluated their HRQOL using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care. We retrospectively reviewed the interview sheets.</p><p><strong>Results: </strong>The median time to deterioration in global health status was 19.1 weeks. The mean scores of emotional functioning were improved in weeks 18 and 36 compared with baseline. The mean scores for fatigue and appetite loss were also improved in weeks 18 and 36.</p><p><strong>Conclusion: </strong>ICI treatment for advanced urothelial carcinoma did not worsen HRQOL over time in a real-world setting. Tolerability of ICIs for advanced urothelial carcinoma appears good in those who received long-term treatment.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-9"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncologyPub Date : 2025-01-14DOI: 10.1159/000543163
Otto Manninen, Sanna Iivanainen, Martti Arffman, Jussi Pekka Koivunen
{"title":"Non-Small Cell Lung Cancer Treated with Epidermal Growth Factor Receptor Inhibitors: The Effect of Concurrent Medications on Patient Outcomes.","authors":"Otto Manninen, Sanna Iivanainen, Martti Arffman, Jussi Pekka Koivunen","doi":"10.1159/000543163","DOIUrl":"10.1159/000543163","url":null,"abstract":"<p><strong>Introduction: </strong>EGFR-tyrosine kinase inhibitor (TKI)-induced rash can be alleviated with tetracyclines (TCN) and topical corticosteroids (TCS), whereas drugs for acid-related disorders (DARDs) can affect EGFR-TKI absorption. The present study investigated the concomitant use of TCNs, TCSs, and DARDs with EGFR-TKIs in non-small cell lung cancer (NSCLC) and whether these affect patient outcomes.</p><p><strong>Methods: </strong>We retrospectively collected data from all patients (n = 1,498) who had purchased for EGFR-TKIs (erlotinib, gefitinib, and afatinib) in Finland between 2011 and 2020. Overall survival (OS) and time-on-treatment (ToT) were analyzed from the first EGFR-TKI purchase.</p><p><strong>Results: </strong>Early TCN purchases were registered in 298 (19.6%) patients; early TCS and DARD purchases were observed in 154 (10.1%) and 192 (12.9%), while similar percentages were detected in the EGFR mutant cohort. In the entire cohort, early purchase of TCSs and TCNs was associated with improved ToT, OS, and DARDs with inferior outcomes. In the multivariate analysis, TCSs retained their significance in ToT (HR: 0.78; 95% CI: 0.66-0.94), TCNs in OS (HR: 0.73; 95% CI: 0.63-0.84), and DARDs in both (HR: 1.28; 95% CI: 1.091-1.495; HR: 1.19; 95% CI: 1.01-1.41). In the EGFR mutant cohort, similar nonsignificant trends were observed for TCNs, TCSs and DARDs. In the analysis according to EGFR-TKI, erlotinib users had improved outcomes when early TCN or TCS purchases were registered, whereas DARDs were associated with worse outcomes among gefitinib users.</p><p><strong>Conclusions: </strong>Among EGFR-TKI-treated NSCLCs, the use of TCN, TCS, and DARD can affect treatment outcomes that should be considered in optimal patient care.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Comparative Study on the Progression of Neuroendocrine Carcinomas and Mixed Neuroendocrine-Non-Neuroendocrine Neoplasms.","authors":"Xiaoling Duan, Man Zhao, Xiaolei Yin, Lili Mi, Jianfei Shi, Ning Li, Xin Han, Guangjie Han, Jinfeng Wang, Jiaojiao Hou, Fei Yin","doi":"10.1159/000542893","DOIUrl":"10.1159/000542893","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic differences between neuroendocrine carcinoma (NEC) and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) remain unclear.</p><p><strong>Methods: </strong>This study aimed to compare the prognostic outcomes of NEC and MiNEN by analyzing the clinicopathological features of these diseases and exploring factors affecting progression after radical surgery. Additionally, we employed whole-exome sequencing to investigate the molecular mechanisms influencing the prognosis of both conditions.</p><p><strong>Results: </strong>Among the 252 patients followed, 163 underwent surgical treatment. The median time to tumor progression was 16 months (range: 9-56 months). Tumor pathology type (p = 0.007), lymph node metastasis (p < 0.0001), and distant metastasis (p < 0.0001) were identified as independent factors affecting disease progression in NEC and MiNEN patients. MiNEN patients without lymph node or distant metastasis generally had a better prognosis. First-line chemotherapy regimens did not show a significant impact on disease progression (p = 0.160, median progression-free survival [mPFS]: 36 vs. 13 vs. 23 vs. 15 months). However, the etoposide plus cisplatin (EP) regimen has shown good efficacy in gastric neuroendocrine neoplasms (NENs) (p = 0.048, mPFS: 45 vs. 12 vs. 32 vs. 16 months), especially in gastric MiNENs (p = 0.022, mPFS: Undefined vs. 11 vs. 52 vs. 37 months). Further investigation into the genetic mutation differences between NECs and MiNENs revealed that among previously sequenced data, rectal NECs commonly exhibited mutations in MUC16, SPTA1, ATM, PDGFB, NF1, FAT4, AR, APC, ANTXR2, and ADGRA2. In contrast, rectal MiNENs showed common mutations in NOTCH2, ZNRF3, CARD11, TP53, OBSCN, FPR1, APC, ANGPT2, ARID1A, and AR. Mutations in ANGPT2 and OBSCN were present in two rectal MiNEN cases, while NF1 and PDGFB mutations were found in two rectal NEC cases but not in MiNENs. The JAK-STAT signaling pathway appears to be specific to rectal NECs and may be involved in tumor progression.</p><p><strong>Conclusion: </strong>EP regimen remains the most effective chemotherapy option for neuroendocrine tumor patients. There were prognostic differences between NECs and MiNENs, as well as differences in genetic mutations and signaling pathways. This study provided new insights into the prognosis assessment and treatment strategies for NENs, particularly highlighting the importance of personalized treatments and the development of novel targeted therapies.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Predictive Value of Preoperative Peak Oxygen Uptake for Postoperative Pulmonary Complications in Lung Cancer Patients with Chronic Obstructive Pulmonary Disease: A Single-Center Retrospective Cohort Study.","authors":"Masaya Noguchi, Toshiki Takemoto, Masashi Shiraishi, Ryuji Sugiya, Hiroki Mizusawa, Tamotsu Kimura, Akira Tamaki, Yasuhiro Tsutani, Yuji Higashimoto","doi":"10.1159/000543370","DOIUrl":"10.1159/000543370","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between preoperative peak oxygen uptake/weight (VO2/W) and postoperative pulmonary complications (PPC) in lobectomies, including video-assisted thoracoscopic surgery, remains unclear. Traditional pulmonary function tests are often unreliable in this group, necessitating alternative predictive methods. Therefore, this study aimed to clarify the predictive value of preoperative peak VO2/W for PPC and explore factors related to PPC in lung cancer patients with chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 40 patients with lung cancer complicated by COPD who underwent a preoperative cardiopulmonary exercise test between January 2017 and March 2024. Patients were divided into those with and without PPC (PPC and non-PPC groups, respectively). Clinical parameters such as surgical approach, pulmonary function, low attenuation area, and peak VO2/W were compared between the groups. The association between these parameters and PPC was analyzed using multivariate logistic regression.</p><p><strong>Results: </strong>The preoperative % diffusing capacity of the lung for carbon monoxide (%DLCO) and peak VO2/W were significantly lower in the PPC group than in the non-PPC group (p < 0.01 and p < 0.001, respectively), while the ventilatory equivalent/ventilatory carbon dioxide (VE/VCO2) slope was significantly higher in the PPC group than in the non-PPC group (p < 0.05). In the multivariate logistic analysis including the %DLCO, peak VO2/W, VE/VCO2 slope, and forced expiratory volume in 1 s, only peak VO2/W was identified as a significant independent factor for predicting PPC. The area under the receiver operating characteristic curve of peak VO2/W to predict PPC was 0.93, with a cutoff value of 14.6 mL/min/kg, sensitivity of 78%, and specificity of 95%.</p><p><strong>Conclusions: </strong>This study revealed that peak VO2/W was the most important parameter for predicting PPC in lung cancer patients with COPD. Incorporating cardiopulmonary exercise tests into preoperative assessments could improve risk stratification and perioperative management, potentially reducing the incidence of PPC in this high-risk population.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prognostic Value of a Novel Index Combining the Prognostic Nutritional Index and D-Dimer Levels for Gastric Cancer after Gastrectomy.","authors":"Masaaki Yamamoto, Takeshi Omori, Naoki Shinno, Hisashi Hara, Yosuke Mukai, Takahito Sugase, Tomohira Takeoka, Takashi Kanemura, Manabu Mikamori, Shinichiro Hasegawa, Hirofumi Akita, Naotsugu Haraguchi, Junichi Nishimura, Hiroshi Wada, Chu Matsuda, Masayoshi Yasui, Hiroshi Miyata, Masayuki Ohue","doi":"10.1159/000533150","DOIUrl":"10.1159/000533150","url":null,"abstract":"<p><strong>Introduction: </strong>The prognostic nutritional index (PNI) and D-dimer level are two useful measures for gastric cancer prognosis. As they each comprise different factors, it is possible to employ a more useful combined indicator. This study therefore aimed to establish a PNI-D score - which combines the PNI and D-dimer level - and validate its usefulness as a prognostic marker.</p><p><strong>Methods: </strong>We collected data from 1,218 patients with gastric cancer who had undergone radical gastrectomy (R0) between January 2004 and December 2015. Patients were divided into three PNI-D score groups based on the following criteria: score 2, low-PNI (≤46) and high D-dimer levels (>1.0 µg/mL); score 1, either low-PNI or high D-dimer levels; and score 0, no abnormality. We defined the PNI-D score as low (score 0 or 1) and high (score 2), respectively.</p><p><strong>Results: </strong>The PNI-D score was significantly associated with overall, recurrence-free, and disease-specific survival (all log-rank p < 0.0001). The 5-year overall survival rates of patients with PNI-D scores of low and high were 88.1% and 64.7%, respectively; their 5-year recurrence-free survival rates were 86.7% and 61.3%, respectively; and their 5-year disease-specific survival rates were 99.3% and 76.5%, respectively. Cox multivariate analysis revealed that a high-PNI-D score was an independent, statistically significant prognostic factor for poor overall (p = 0.01) survival in patients with gastric cancer.</p><p><strong>Conclusions: </strong>The PNI-D is an independent prognostic factor for patients with gastric cancer.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"1-10"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139074769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to Prevent Local Recurrence of Sacral Chordoma Treated with Carbon-Ion Radiotherapy: An Analysis of the Risk Factors of Local Failure and an Adequate Disease Margin.","authors":"Takashi Yanagawa, Masahiko Okamoto, Tatsuya Ohno, Hirotaka Chikuda","doi":"10.1159/000540649","DOIUrl":"10.1159/000540649","url":null,"abstract":"<p><strong>Introduction: </strong>Recent reports have described the usefulness of carbon ion radiotherapy (CIRT) for inoperable sacral chordomas. However, its long-term local control rate needs to be improved. The present study identified the risk factors that affect the local relapse of sacral chordomas and the appropriate margins from the tumors.</p><p><strong>Methods: </strong>Forty-nine patients with sacral chordoma treated with CIRT between 2011 and 2022 were retrospectively analyzed. Factors predicting the risk of local recurrence were evaluated, including age, sex, tumor size, muscle invaded with tumor, and surgery before CIRT. To determine the appropriate margin, the distance between the clinical target volume (CTV) and the out-field recurrent lesions was analyzed.</p><p><strong>Results: </strong>The patients included 37 males and 12 females with a mean age of 67.1 years. A multivariate analysis showed that a tumor size >8 cm and invasion into the gluteus maximus muscle were significant risk factors with hazard ratios of 5.56 and 15.20 (p = 0.02 and 0.01), respectively. Out-field recurrence occurred in 13 cases, with 6, 3, and 4 relapses occurring in the muscle, bone, and both, respectively. The tumor occurred within 20 mm from the CTV in 60% of relapses in the muscles.</p><p><strong>Conclusion: </strong>The current study presented novel findings on CIRT for sacral chordomas, although there were several limitations, such as a short follow-up period to investigate slow-growth tumors and a small number of tumor specimens owing to inoperative cases. A tumor size >8 cm and invasion into the gluteus maximus muscle were shown to be risk factors for recurrence in the treatment of sacral chordoma with CIRT. Our findings further suggest that an additional 2-cm margin from the CTV in the muscle fiber direction is recommended during CIRT.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"30-36"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Experience and Prognostic Analysis with Avelumab Switch Maintenance Treatment in Metastatic Urothelial Carcinoma.","authors":"Teruki Isobe, Taku Naiki, Yosuke Sugiyama, Aya Naiki-Ito, Takashi Nagai, Toshiki Etani, Keitaro Iida, Yusuke Noda, Nobuhiko Shimizu, Maria Aoki, Masakazu Gonda, Toshiharu Morikawa, Rika Banno, Hiroki Kubota, Ryosuke Ando, Noriyasu Kawai, Takahiro Yasui","doi":"10.1159/000539795","DOIUrl":"10.1159/000539795","url":null,"abstract":"<p><strong>Introduction: </strong>Avelumab (Ave) is approved for metastatic urothelial carcinoma (mUC) maintenance therapy and prolongs overall survival (OS). We explored trends related to Ave treatment of mUC patients.</p><p><strong>Methods: </strong>A total of 72 patients with mUC treated with first-line chemotherapy, from January 2019 to November 2022, at our affiliated institutions, were analyzed. We compared clinical parameters and the prognosis of patients treated with Ave (n = 43) because of progression during first-line chemotherapy, with untreated patients (Ave-untreated; n = 29). Among the Ave-treated group, we classified patients showing a complete or partial response or stable disease in their best response to Ave maintenance therapy as Ave-suitable patients; these were retrospectively analyzed. Potential prognostic factors, including the Geriatric Nutritional Risk Index (GNRI) for determining patients suitable for Ave, were evaluated.</p><p><strong>Results: </strong>The basic clinical parameters of patients when first-line treatment was initiated were not statistically different between the two groups. The Ave-suitable group (median 26.6 months, 95% confidence interval [CI]: 19.4-not reached [NR]) showed significantly longer median OS after first-line treatment than the Ave-untreated group (median 12.0 months, 95% CI: 7.5-NR) with tolerable adverse events. The cut-off values of prognostic factors were set by the receiver operating characteristic curve. Low age and GNRI sustainability were revealed as significant prognostic factors for being Ave-suitable both in univariate and multivariate analysis.</p><p><strong>Conclusion: </strong>In mUC, Ave maintenance prolonged OS within tolerable safety profiles. GNRI sustainability may be used as a biomarker to predict being Ave-suitable.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"11-21"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncologyPub Date : 2025-01-01Epub Date: 2024-08-26DOI: 10.1159/000541004
Deeksheetha Prabhuvenkatesh, Pratibha Ramani, Monal B Yuwanati, Gheena Sukumaran
{"title":"Association of Insulin Receptor Substrate 1 Expression in the Prognosis of Head and Neck Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Deeksheetha Prabhuvenkatesh, Pratibha Ramani, Monal B Yuwanati, Gheena Sukumaran","doi":"10.1159/000541004","DOIUrl":"10.1159/000541004","url":null,"abstract":"<p><strong>Introduction: </strong>Head and neck squamous cell carcinoma (HNSCC) is the most common mucosal neoplasm that affects the head and neck region. It is the 6th most common cancer globally, most commonly seen in South Asian countries. Insulin receptor substrate 1 (IRS-1), like insulin receptor, is an adapter protein that integrates multiple transmembrane signals from growth factors and hormones, to regulate cell growth, survival, differentiation, and metabolism. Evidence suggests that IRS-1 plays a vital role in cancer progression and nodal metastasis. The aim was to assess the prognostic implications of the IRS-1 expression in HNSCC from evidence-based results.</p><p><strong>Methods: </strong>A systematic literature search was done to identify articles describing IRS-1 and HNSCC carried out for PubMed, Cochrane, and Google Scholar, using MeSH terms.</p><p><strong>Results: </strong>A total of 486 cases of HNSCC were included in this systematic review. Out of 3 studies, increased/high expression of IRS-1 was 67%. 64% of the cases in stage I and stage II (TNM staging) showed higher expression of IRS-1, whereas 70% of stage III and stage IV cases showed upregulation of IRS-1. IRS-1 was equally upregulated in cases with lymph node metastasis as well as in cases without any lymph node metastasis. 74% of the patients who showed high expression of IRS-1 showed high mortality during the follow-up period of 13 months.</p><p><strong>Conclusion: </strong>This review concluded that elevated levels of IRS-1 expression were associated with poor prognosis and increased lymph node metastasis.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"253-264"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncologyPub Date : 2025-01-01Epub Date: 2024-08-19DOI: 10.1159/000540363
Yuri Oyama, Nobuyoshi Kittaka, Ayako Higuchi, Yusa Togashi, Azusa Taniguchi, Yukiko Seto, Ai Soma, Sungae Park, Jun Okuno, Noriyuki Watanabe, Saki Matsui, Mikiya Ishihara, Minako Nishio, Keiichiro Honma, Takahiro Nakayama
{"title":"Long-Term Survival Outcomes and Risk Factors for Axillary and Locoregional Recurrence in Japanese Patients with Sentinel Node-Positive Breast Cancer Treated in Accordance with the ACOSOG Z0011 Strategy.","authors":"Yuri Oyama, Nobuyoshi Kittaka, Ayako Higuchi, Yusa Togashi, Azusa Taniguchi, Yukiko Seto, Ai Soma, Sungae Park, Jun Okuno, Noriyuki Watanabe, Saki Matsui, Mikiya Ishihara, Minako Nishio, Keiichiro Honma, Takahiro Nakayama","doi":"10.1159/000540363","DOIUrl":"10.1159/000540363","url":null,"abstract":"<p><strong>Introduction: </strong>In 2018, we reported the results of a study to assess the feasibility of applying the ACOSOG Z0011 criteria to Japanese patients with early-stage breast cancer (median follow-up, 3 years). Their results over the longer term can now be presented. Risk factors for axillary and locoregional recurrence in Z0011-eligible patients are unknown.</p><p><strong>Methods: </strong>Long-term survival outcomes were investigated by analyzing data from patients enrolled in the feasibility study. Data from the feasibility study patients, and from patients eligible for the Z0011 strategy after its introduction into clinical practice, were subjected to multivariate logistic regression analysis to identify risk factors for axillary and locoregional recurrence.</p><p><strong>Results: </strong>Regarding long-term outcomes for the feasibility study patients (n = 189), distant disease-free survival rates at 5 and 7 years were 90.4 ± 2.1% and 85.9 ± 2.6%, respectively, and overall survival rates at 5 and 7 years were 97.3 ± 1.2% and 95.3 ± 1.7%, respectively. Analysis of data from these patients plus the 93 who received Z0011 in clinical practice (total, n = 282) identified the following independent risk factors for axillary recurrence: absence of high axillary tangential irradiation (OR, 5.87 [95% CI, 1.09-31.35], p = 0.04) and number of positive sentinel lymph nodes (OR, 4.65 [95% CI, 1.11-19.48], p = 0.04). Only high Ki67 labeling index (OR, 5.92 [95% CI, 1.31-26.70], p = 0.02) was identified as an independent risk factor for locoregional recurrence.</p><p><strong>Conclusion: </strong>Long-term survival outcome results of the feasibility study show that the Z0011 strategy can be used to treat Japanese patients with early-stage breast cancer. Our findings regarding risk factors suggest that high axillary tangent irradiation is necessary for the prevention of axillary recurrence and that irradiation, including of the regional lymph nodes, should be considered, especially in patients with high Ki67 index values.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"143-155"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncologyPub Date : 2025-01-01Epub Date: 2024-07-30DOI: 10.1159/000540517
Gökhan Uçar, Serhat Sekmek, İrfan Karahan, Yakup Ergün, Özlem Aydın İsak, Sezai Tunç, Mutlu Doğan, Fatih Gürler, Doğan Bayram, Yusuf Açıkgöz, Selin Aktürk Esen, Burak Civelek, Fahriye Tuğba Köş, Öznur Bal, Efnan Algın, Tülay Eren, Gökşen İnanç İmamoğlu, Zuhat Urakçı, Ozan Yazıcı, Nuriye Özdemir, Doğan Uncu
{"title":"The Comparison of FLOT and DCF Regimens as Perioperative Treatment for Gastric Cancer.","authors":"Gökhan Uçar, Serhat Sekmek, İrfan Karahan, Yakup Ergün, Özlem Aydın İsak, Sezai Tunç, Mutlu Doğan, Fatih Gürler, Doğan Bayram, Yusuf Açıkgöz, Selin Aktürk Esen, Burak Civelek, Fahriye Tuğba Köş, Öznur Bal, Efnan Algın, Tülay Eren, Gökşen İnanç İmamoğlu, Zuhat Urakçı, Ozan Yazıcı, Nuriye Özdemir, Doğan Uncu","doi":"10.1159/000540517","DOIUrl":"10.1159/000540517","url":null,"abstract":"<p><strong>Introduction: </strong>Locoregional gastric cancer is a still serious problem and perioperative treatments may improve the success of management. Different regimens were examined. The present study purposed to compare the efficacy of fluorouracil-leucovorin-oxaliplatin-docetaxel (FLOT) and docetaxel-cisplatin-fluorouracil (DCF) regimens.</p><p><strong>Methods: </strong>A retrospective multicenter study assessed the patients with locoregional gastric cancer. There are 240 patients (137 DCF, 103 FLOT). Survival rates were compared.</p><p><strong>Results: </strong>Demographic features were similar between the two groups, but the time period was different. The FLOT group had 7.8% pathological complete response, while the DCF group did not. Disease-free survival was longer in the FLOT than in the DCF group (median not reached - 13.94 months, respectively). Median overall survival was similar (30.9 vs. 37.8 months), but median follow-up affected the analysis. Survival for 36 months was 63% for the FLOT group and 40% for the DCF group (log-rank; p = 0.015).</p><p><strong>Conclusion: </strong>FLOT regimen was superior to DCF regimen for response and survival rates. DCF is a historical approach. Long-term follow-up period is needed for FLOT treatment.</p>","PeriodicalId":19497,"journal":{"name":"Oncology","volume":" ","pages":"128-133"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}