International Journal of Surgical Oncology最新文献

{"title":"Total Mesorectal Excision with or without Lateral Pelvic Lymph Node Dissection in Rectal Cancer.","authors":"Mohamed Yehia Elbarmelgi, Ahmed Mohamed Abdelaal, Osama Refaie, Mohamed Tamer, Ali Ahmed Shafik","doi":"10.1155/2023/6653624","DOIUrl":"10.1155/2023/6653624","url":null,"abstract":"<p><strong>Results: </strong>Incidence of local recurrence was slightly higher in Group A (8.7%) than in Group B (4.3%) but was not statistically significant. There was no statistical significance between both groups regarding distant metastasis (8.7% in Group A and 13% in Group B). Urinary and sexual dysfunctions were higher in Group B (26.1%) compared to those in Group A (21.7%) but were not statistically significant. The incidence of lateral pelvic lymph node metastasis was 30.4%. Also, intraoperative blood loss was higher and operative time was longer in Group B which was statistically significant (<i>P</i> value <0.001).</p><p><strong>Conclusion: </strong>Our conclusion was that prophylactic addition of LPLD to TME was not associated with a statistically significant decrease in the risk of local recurrence or distant metastasis in patients with rectal cancer, although it was numerically better. LPLD is associated with longer operative time and higher intraoperative blood loss.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2023 ","pages":"6653624"},"PeriodicalIF":1.5,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10761226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139088930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors of Thyroid Malignancy in Patients with Toxic Nodular Goiter","authors":"T. Mohamed, A. Sultan, M. Tag El-Din, Ahmed A. Elfattah Mostafa, M. Nafea, Abd-Elfattah Kalmoush, Mohammed Shaaban Nassar, Mohamad Adel Abdalgaleel, A. Hegab, A. H. Ibrahim, Mohamad Baheeg","doi":"10.1155/2022/1054297","DOIUrl":"https://doi.org/10.1155/2022/1054297","url":null,"abstract":"Background Although hyperfunctioning thyroid disorders were thought to be protective against malignancy, some recent studies reported a high incidence of incidentally discovered cancer in patients with hyperfunctioning benign thyroid disorders. We performed this study to estimate the incidence and predictors of malignant thyroid disease in patients with toxic nodular goiter (TNG). Patients and Methods. The data of 98 patients diagnosed with TNG were reviewed (including toxic multinodular goiter SMNG and single toxic nodule STN). The collected data included patients age, gender, systemic comorbidities, family history of thyroid malignancy, previous neck radiation, type of disease (multinodular or single), size of the dominant nodule by the US, operative time, and detection of significant lymph nodes during operation. Based on the histopathological analysis, the cases were allocated into benign and malignant groups. Results Malignancy was detected in 21 patients (21.43%). Although age distribution was comparable between the two groups, males showed a significant increase in association with malignancy. Medical comorbidities and family history of cancer did not differ between the two groups. However, TMNG showed a statistically higher prevalence in the malignant group. Operative data, including operative time and lymph node detection, were comparable between the two groups. On regression analysis, both male gender and TMNG were significant predictors of malignancy. Conclusion The presence of thyroid hyperfunction is not a protective factor against malignancy, as malignancy was detected in about 1/5 of cases. Male gender and TMNG were significant risk factors of malignancy in such patients.","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2022-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48926219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High CD44 Immunoexpression Correlates with Poor Overall Survival: Assessing the Role of Cancer Stem Cell Markers in Oral Squamous Cell Carcinoma Patients from the High-Risk Population of Pakistan","authors":"Y. Adnan, S. M. A. Ali, H. Farooqui, H. A. Kayani, Romana Idrees, M. S. Awan","doi":"10.1155/2022/9990489","DOIUrl":"https://doi.org/10.1155/2022/9990489","url":null,"abstract":"Oral squamous cell carcinoma (OSCC) is a top-ranked cancer in the Pakistani population, and patient survival has remained unchanged at ∼50% for several decades. Recent advances have claimed that a subset of tumour cells, called cancer stem cells (CSCs), are responsible for tumour progression, treatment resistance, and metastasis, which leads to a poor prognosis. This study investigated the impact of CSC markers expression on overall survival (OS) and disease-free survival (DFS) of OSCC patients. Materials and Methods. Immunohistochemistry was used to evaluate CD44, CD133, L1CAM, and SOX2 expression in a well-characterized cohort of 100 Pakistani patients with primary treatment naïve OSCC. The immunoreactivity for each marker was correlated with patient clinicopathologic characteristics, oral cancer risk chewing habits, and survival. The minimum follow-up time for all patients was five years, and survival estimates were calculated using the Kaplan–Meier method and Cox proportional hazards model. Results. In this cohort of 100 patients, there were 57 males and 43 females. The median OS and DFS time durations observed were 64 and 52.5 months, respectively. Positive expression for CD44, CD133, L1CAM, and SOX2 was observed in 33%, 23%, 41%, and 63% of patients. High CD44 expression correlated with decreased OS (P=0.047) but did not influence DFS. However, CD133, L1CAM, and SOX2 had no effect on either OS or DFS. Tonsils, nodal involvement, and AJCC stage were independent predictors of worse OS and DFS both. Conclusion. Of the CSC markers investigated here, only CD44 was a predictor for poor OS. CD44 was also associated with advanced AJCC and T stages. Interestingly, CD133 was significantly lower in patients who habitually consumed oral cancer risk factors.","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2022 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42541242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Beneficial Impact of Intraoperative Ultrasound on Resection Margin Status during Breast Conserving Surgery.","authors":"Osama Almezaien,&nbsp;Ahmed Mohamed Eldeeb,&nbsp;Abdelfattah Kalmoush,&nbsp;Mohamed Shaaban Nassar,&nbsp;Tarek Zaghlol Mohamed,&nbsp;Mohamed Sobhy Shaaban,&nbsp;Mohamed Ibrahim Henish,&nbsp;Sobhy Teama,&nbsp;Saed Abdolmonem Elgohary Khalafallah,&nbsp;Lofty A Ibrahim","doi":"10.1155/2022/2268821","DOIUrl":"https://doi.org/10.1155/2022/2268821","url":null,"abstract":"<p><strong>Background: </strong>Surgical resection with clear surgical cut margins is the mainstay of managing malignant breast neoplasms. Multiple techniques have been suggested to enhance resection status during breast-conserving surgery (BCS), including intraoperative ultrasonography (IOUS). Herein, we conducted the current investigation to reveal the benefit of IOUS on the achievement of R0 resection. <i>Patients and Methods</i>. This retrospective investigation included 140 patients who underwent BCS. They were divided into two groups: the IOUS group (40 cases) and the control group (100 cases). Our primary objective was to determine the free resection margin status (R0).</p><p><strong>Results: </strong>Both study groups expressed statistically comparable demographic and clinical data. Additionally, histopathological examination revealed no significant difference between the two groups regarding the tumor type, stage, or grade. Nonetheless, the R0 resection margin was more frequently encountered in association with IOUS application (97.5% compared to 79% in the control group), and that difference was statistically significant (<i>p</i>=0.007).</p><p><strong>Conclusion: </strong>The application of IOUS has a significant beneficial impact on the outcomes of BCS. It is associated with a marked decline in positive resection margins, and its application should be encouraged in the breast oncological practice.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2022 ","pages":"2268821"},"PeriodicalIF":1.5,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9750786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10749212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Emergent and Elective Colectomy Outcomes in Elderly Patients: A NSQIP Study.","authors":"Mostapha El Edelbi,&nbsp;Ibrahim Abdallah,&nbsp;Rola F Jaafar,&nbsp;Hani Tamim,&nbsp;Samer Deeba,&nbsp;Samer Doughan","doi":"10.1155/2021/9990434","DOIUrl":"https://doi.org/10.1155/2021/9990434","url":null,"abstract":"<p><strong>Introduction: </strong>With the increasing prevalence of colorectal cancer (CRC) worldwide, especially in the elderly, and the variability between physiological and chronological age and its impact on functional status, acute symptoms leading to emergent surgery due to colorectal malignancy may lead to increased morbidity and mortality. The aim of this study is to identify the outcome differences of elective vs. emergent open colectomy in patients above 80 years.</p><p><strong>Methods: </strong>The National Surgical Quality Improvement Program (NSQIP) database was reviewed from 2010 to 2014 for open colectomy based on CPT codes. Comparison between groups was done based on the clinical context at presentation as elective or emergent surgery. Data were analyzed using SAS.</p><p><strong>Results: </strong>Elective colectomies were performed in 8289 (70.8%) vs. emergent colectomies in 3409 (29.1%). Emergent colectomy patients had higher American Society of Anesthesiologists (ASA) preoperative classification III-IV, 1429 (42.0%) and 224 (6.6%), vs. 1238 (14.9%) and 21 (0.2%) in elective colectomy patients (<i>p</i> < 0.0001). Emergent colectomy patients had more comorbidities such as chronic obstructive pulmonary disorder (493 (14.5%) vs. 796 (9.6%)), congestive heart failure (206 (6.0%) vs. 310 (3.8%)), dialysis (106 (3.1%) vs. 56 (0.7%)), and acute renal failure (166 (4.9%) vs. 46 (0.6%)) (<i>p</i> < 0.0001), respectively. Postoperative morbidity and mortality were significantly higher in emergent colectomy (1651 (48.4%) and 872 (25.6%)) vs. elective colectomy (1859 (22.4%) and 567 (6.8%)) (<i>p</i> < 0.0001), respectively.</p><p><strong>Conclusion: </strong>Emergent open colectomy in elderly patients carries a higher risk of morbidity and mortality when compared to elective open colectomy with risk factors being higher ASA classification and more comorbidities.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"9990434"},"PeriodicalIF":1.5,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39729396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological Analysis of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review of 9 Cases.","authors":"Saliha Sağnıç,&nbsp;Özer Birge,&nbsp;Mehmet Sait Bakır,&nbsp;Ceyda Karadag,&nbsp;Tayup Şimşek","doi":"10.1155/2021/8290659","DOIUrl":"https://doi.org/10.1155/2021/8290659","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the clinicopathological features affecting the recurrence and survival of 9 cases of neuroendocrine cancer of the cervix.</p><p><strong>Method: </strong>We retrospectively analyzed 9 cervical neuroendocrine cancer cases identified among 453 cervical cancer patients between 2004 and 2021 at Akdeniz University Gynecological Oncology Outpatient Clinic. Kaplan-Meier survival analysis was used for progression-free survival (PFS) and overall survival (OS). Mathematical functions of mean, standard deviation, median, Min-Max values, and frequencies were used for descriptive statistics. The categorical data were expressed in numbers and percentages (%).</p><p><strong>Results: </strong>Nine patients with neuroendocrine histological subtype were selected out of 453 patients diagnosed with cervical cancer (1.98%). The average overall survival time of the patients was 26 months. The 5-year survival rate was 53.3%, while the PFS was 62.5%. The most common subtype was small cell neuroendocrine cancer. Tumours were mostly locally advanced at the time of diagnosis. 3 patients' stage was 1b2, while 4 patients were 2b, 1 patient was 3c2r, and 1 patient was 4b. All tumours showed the immunohistochemical staining properties of neuroendocrine cancer. The main treatment modality applied to our patients was surgery + adjuvant CRT. The most used chemotherapeutic agents were cisplatin/carboplatin and etoposide. Recurrence was found in 3 cases, including 5 deaths.</p><p><strong>Conclusion: </strong>Neuroendocrine tumour of the cervix is a rare subtype with a poor prognosis. Unfortunately, there is not yet a standard treatment protocol due to the limited number of comparative studies of surgery, chemotherapy, and radiotherapy based treatment schemes.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"8290659"},"PeriodicalIF":1.5,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8463196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39452544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of SOX2 and AGR2 Biomarkers as Early Predictors of Tamoxifen Resistance in ER-Positive Breast Cancer Patients.","authors":"Yomna Zamzam,&nbsp;Yosra Abdelmonem Zamzam,&nbsp;Marwa Aboalsoud,&nbsp;Heba Harras","doi":"10.1155/2021/9947540","DOIUrl":"10.1155/2021/9947540","url":null,"abstract":"<p><strong>Background: </strong>Despite the undeniable benefit of tamoxifen therapy for ER-positive breast cancer patients, approximately one-third of those patients either do not respond to tamoxifen or develop resistance. Thus, it is a crucial step to identify novel, reliable, and easily detectable biomarkers indicating resistance to this drug.</p><p><strong>Objective: </strong>The aim of this work is to explore SOX2 and AGR2 biomarker expression in the tumor tissue of ER-positive breast cancer patients in combination with the evaluation of serum AGR2 level of these patients in order to validate these biomarkers as early predictors of tamoxifen resistance.</p><p><strong>Methods: </strong>This study was conducted on 224 ER-positive breast cancer patients. All patients were primarily subjected to serum AGR2 levelling by ELISA and their breast cancer tissue immunostained for SOX2 and AGR2. After 5 years of follow-up, the patients were divided into 3 groups: group 1 was tamoxifen sensitive and groups 2 and 3 were tamoxifen resistant. Time to failure of tamoxifen treatment was considered the time from the beginning of tamoxifen therapy to the time of discovery of breast cancer recurrence or metastases (in months).</p><p><strong>Results: </strong>SOX2 and AGR2 biomarkers expression and serum AGR2 level were significantly higher in groups 2 and 3 in comparison to group 1, while the relationship between Her2 neu expression and Ki67 index in the 3 different groups was statistically nonsignificant. Lower SOX2 and AGR2 expression and low AGR2 serum levels in the studied patients of groups 2 and 3 were significantly associated with longer time-to-failure of tamoxifen treatment. According to the ROC curve, the combined use of studied markers validity was with a sensitivity of 100%, specificity of 96%, PPV 96%, and NPV 100% (<i>p</i> < 0.001; AUC: 0.984).</p><p><strong>Conclusions: </strong>Integrated use of SOX2 and AGR2 biomarkers with serum AGR2 assay holds a promising hope for their future use as predictive markers for early detection of tamoxifen resistance in ER-positive breast cancer patients.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"9947540"},"PeriodicalIF":1.5,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8460385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39452545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Value of KRAS Gene Mutation on Survival of Patients with Peritoneal Metastases of Colorectal Adenocarcinoma.","authors":"Manuel Díez-Alonso,&nbsp;Fernando Mendoza-Moreno,&nbsp;Remedios Gómez-Sanz,&nbsp;Belén Matías-García,&nbsp;Enrique Ovejero-Merino,&nbsp;Raquel Molina,&nbsp;Sonia Soto-Schütte,&nbsp;Alberto San Juan,&nbsp;Alberto Gutierrez-Calvo","doi":"10.1155/2021/3946875","DOIUrl":"https://doi.org/10.1155/2021/3946875","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of the study was to determine the effect of the presence of mutation in the KRAS gene on the survival in patients with colorectal cancer (CRC) and peritoneal metastases (PM).</p><p><strong>Materials and methods: </strong>A retrospective cohort study was performed. Patients diagnosed with CRC with synchronous or metachronous PM between January 2006 and December 2019 were included. Data on the histopathological, clinical, and treatment factors were collected. The effect of each variable on survival was evaluated by Cox regression.</p><p><strong>Results: </strong>A total of 149 patients were included (64 women (43%) and 85 men (57%); mean age, 63 years). The long-term survival rate at 36 months was 24% (median, 21 months). KRAS mutation was detected in 75 patients (50.3%). Kaplan-Meier analysis estimated that likelihood of survival was higher in patients with wild-type KRAS tumours (35%) than in mutated-type KRAS (14%) (median: 28 vs. 15, respectively) (<i>P</i>=0.001). Within the categories into which the peritoneal cancer index (PCI) was classified, survival at 36 months depended on the KRAS status. Survival in wild-type KRAS tumours with PCI 1-10 was 71% and with PCI 11-20 was 26%, while in mutant-type KRAS tumours, survival was 41% and 4%, respectively (<i>P</i>=0.025). In the multiple regression analysis, the KRAS mutation was revealed to have an independent prognostic value (HR: 2.144; 95% CI: 1.342-3.424).</p><p><strong>Conclusion: </strong>The mutational status of the KRAS gene has demonstrated a strong association with survival and prognostic utility in patients with CRC with PM.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"3946875"},"PeriodicalIF":1.5,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39443833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal Stromal Tumor (GIST) and Synchronous Intra-Abdominal Liposarcoma: A Report of Two Rare Cases and Literature Review.","authors":"Alexandros Diamantis,&nbsp;Athina A Samara,&nbsp;Ioannis Baloyiannis,&nbsp;Dimitrios Symeonidis,&nbsp;Andreas-Marios Diamantis,&nbsp;Maria Tolia,&nbsp;Konstantinos Bouliaris,&nbsp;Georgios Koukoulis,&nbsp;Konstantinos Tepetes","doi":"10.1155/2021/2626635","DOIUrl":"https://doi.org/10.1155/2021/2626635","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare.</p><p><strong>Methods: </strong>We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma.</p><p><strong>Results: </strong>A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study.</p><p><strong>Conclusion: </strong>Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"2626635"},"PeriodicalIF":1.5,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8434899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39416375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transition to Targeted Therapies Improved the Prognosis and Increased the Utilization of Medical Treatments among Patients with Synchronous Metastatic Renal Cell Cancer.","authors":"Lauri Laru,&nbsp;Hanna Ronkainen,&nbsp;Markku H Vaarala","doi":"10.1155/2021/5237695","DOIUrl":"https://doi.org/10.1155/2021/5237695","url":null,"abstract":"<p><p>Since the introduction of targeted therapies (TTs) for metastatic renal cell cancer (mRCC) in 2005, a limited amount of epidemiological data on efficacy of modern drug therapies for synchronous mRCC has been published. We present a comprehensive nationwide cohort including all cases of primarily metastasized renal cell cancer among adults diagnosed between 2005 and 2010, based on data from the Finnish Cancer Registry and patient records from treating hospitals. Applied treatment protocols and survival outcomes were analyzed. A total of 977 patients were included in the analysis; 499 patients were diagnosed between 2005 and 2007 and 478 patients were diagnosed between 2008 and 2010. The median overall survival (OS) was 8.80 months (95% confidence interval (CI): 7.60-10.02). The median OS of the patients diagnosed at the latter era was significantly better (11.1; 95% CI: 8.8-13.4 vs. 7.0; 95% CI: 5.7-8.3 months, <i>p</i> ≤ 0.001). A total number of 524 (53.8%) patients received drug therapy. Altogether, TTs including tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors (mTORi), and vascular endothelial growth factor inhibitor covered 331 (63.2%) of first-line treatments, whereas interferon and its combinations with chemotherapy were used for 186 (35.5%) patients. The median OS rates for TT and interferon as first-line therapy groups were 19.9 (16.9-22.8) and 14.9 (12.3-17.4) months, respectively. The OS for patients who did not receive drug therapy after cytoreductive nephrectomy was dismal. We found that the OS estimate of mRCC patients in Finland has improved since the introduction of tyrosine kinase inhibitors. However, the prognosis remains poor for frail, elderly patients with an impaired performance status.</p>","PeriodicalId":45960,"journal":{"name":"International Journal of Surgical Oncology","volume":"2021 ","pages":"5237695"},"PeriodicalIF":1.5,"publicationDate":"2021-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39334829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}