Cancer diagnosis & prognosis最新文献

{"title":"Aggressive Orbital Dedifferentiated Liposarcoma With Osseus Components in a Young Woman.","authors":"Satoru Kase, Taku Maeda, Noriyuki Otsuka, Yuka Suimon, Susumu Ishida","doi":"10.21873/cdp.10453","DOIUrl":"https://doi.org/10.21873/cdp.10453","url":null,"abstract":"<p><strong>Background/aim: </strong>Dedifferentiated liposarcoma (DDLS) is a rare but aggressive subtype of liposarcoma that arises in soft tissues. In orbital liposarcoma, malignant transformation from well-differentiated to DDLS typically takes at least a year. We herein report a case of a young female with an aggressive DDLS, that developed from an orbital lipoma within one year.</p><p><strong>Case report: </strong>A 25-year-old woman presented with left upper eyelid swelling. MRI revealed abnormal adipose tissue in the medial orbit. The excised tissue was diagnosed as an orbital lipoma. The eyelid swelling recurred three months later, and the orbital tumor enlarged. An additional resection was performed, which again revealed a lipoma without malignant features. Three months later, the swelling worsened, and tumor resection confirmed well differentiated liposarcoma with a Ki-67 labeling index of 10%. Two months later, CT imaging depicted calcified lesions within the tumor. The patient subsequently underwent orbital exenteration followed by proton beam radiation. Histopathological examination of the exenterated tissue revealed DDLS with extensive osseous components. The Ki-67 labeling index exceeded 50%.</p><p><strong>Conclusion: </strong>Ocular oncologists should pay attention to the possibility of rapid malignant transformation in DDLS in primary orbital liposarcoma.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"404-409"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024776","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 Two Gene Expression Profile Tests to Standard of Care for Identifying Patients With Cutaneous Melanoma at Low Risk of Sentinel Lymph Node Positivity.","authors":"Peter A Prieto, Laura K Ferris, Michael J Guenther","doi":"10.21873/cdp.10438","DOIUrl":"https://doi.org/10.21873/cdp.10438","url":null,"abstract":"<p><strong>Background/aim: </strong>The National Comprehensive Cancer Network (NCCN) Guidelines for cutaneous melanoma (CM) recommend avoiding sentinel lymph node biopsy (SLNB) when the positivity risk is <5%, considering SLNB when the risk is 5-10%, or offering SLNB when the risk is >10%. Most patients undergoing SLNB have a negative result, showing that reliance upon the American Joint Committee on Cancer (AJCC) T-stage alone results in most patients undergoing an unnecessary, negative, unreliable, invasive procedure.</p><p><strong>Materials and methods: </strong>Two gene expression profile (GEP) tests, the CP-GEP and the 31-GEP, have been developed to identify patients at low risk of SLN positivity who may consider avoiding SLNB. We analyzed the accuracy of the CP-GEP and 31-GEP in identifying patients with <5% risk of SLN positivity across the five validation studies of the CP-GEP and four validation studies of the 31-GEP in T1-T2 tumors.</p><p><strong>Results: </strong>Patients considered low risk by the CP-GEP had an SLN positivity rate of 6.2%, higher than the risk threshold of 5% used by the NCCN to guide SLNB decisions. In contrast, patients considered low risk by the 31-GEP or i31-SLNB had a 2.8% SLN positivity rate, a substantial improvement over AJCC-staging guidance.</p><p><strong>Conclusion: </strong>Overall, the CP-GEP did not perform as well as AJCC, while the 31-GEP performed better than AJCC.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"261-267"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060308","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":"Facial Diffuse Plexiform Neurofibroma-associated Mandibular Deformities: Surgical Interventions and Monitoring of Treatment Results in a Patient for Over 40 Years.","authors":"Reinhard E Friedrich, Felix K Kohlrusch, Christian Hagel","doi":"10.21873/cdp.10444","DOIUrl":"https://doi.org/10.21873/cdp.10444","url":null,"abstract":"<p><strong>Background/aim: </strong>Neurofibromatosis type 1 (NF1) is an autosomal dominant hereditary tumor-predisposition syndrome and a genetic bone disease. The case report describes tumor-associated mandibular changes, their therapy and follow-up over several decades. The aim of the presentation is to highlight the tumorous and hamartomatous components of the facial skeleton and to examine the stability of surgical measures over the long term.</p><p><strong>Case report: </strong>A 13-year-old male patient had developed an extensive diffuse plexiform neurofibroma of the left cheek and neck region. Radiological examination showed a mandibular defect, which enlarged over time. Surgical treatment consisted of a corrective procedure for the asymmetrical bony chin and augmentation osteoplasty of mandibular defect. The transplant was an integral part of a functionally stable bone for decades.</p><p><strong>Conclusion: </strong>Head and neck diffuse plexiform neurofibroma can be associated with craniofacial bone malformations. Distinction between deformity-related bone changes from an infiltrating and destructive tumor can be difficult, especially in cases of rapidly progressive local bone loss. Presumably, both tumor-associated functional lesions of the masticatory muscles and tumor-related effects on the bone influence the shape of the affected bone. Diagnosis of tumor-associated bone lesions can be challenging in NF1. Reconstructive bone surgery of the jaw provides options for functional and esthetic improvement of the affected individual. However, long-term follow-up checks are advisable to assess treatment results. An exact assessment of the tumor type and long-term monitoring of the findings are the basis of a viable surgical therapy.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"319-329"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021793","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 Factors in EGFR Mutation-positive Patients With Bone Metastases from Lung Adenocarcinoma.","authors":"Shunzo Osaka, Junzo Kawashima, Ryoma Kaguchi, Naoki Toda, Akira Kisohara, Shumei Kan, Kohei Tagawa, Toshio Kojima, Takako Nagai, Eiji Osaka, Kazuyoshi Nakanishi, Yoshiaki Tanaka","doi":"10.21873/cdp.10451","DOIUrl":"https://doi.org/10.21873/cdp.10451","url":null,"abstract":"<p><strong>Background/aim: </strong>This study analyzed prognostic factors in patients with lung adenocarcinoma and bone metastases who tested positive for epidermal growth factor receptor (EGFR) mutations.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed the records of 117 patients with lung adenocarcinoma and bone metastases who were followed up at a single institution for 0.2 months to 66 months. Of these 117 patients, 45 were EGFR mutation-positive and further analysis was performed for these patients. Median survival times and five-year survival rates were investigated according to performance status (PS), oligometastatic status, radiotherapy and EGFR-tyrosine kinase inhibitor (TKI) administration.</p><p><strong>Results: </strong>The five-year survival rate of EGFR mutation-positive patients was 9.2%, and median survival time was 22.7 months; their mean age was 69.5 years. Many EGFR mutation-positive patients had a PS of 2, and the median survival time showed significant differences according to PS (0/1/2 vs. 3/4) and oligometastatic status.</p><p><strong>Conclusion: </strong>Although there was no difference in the mean survival time between patients receiving or not receiving bone radiotherapy, the treatment effectively reduced pain and prevented paralysis. As a first-line treatment in EGFR mutation-positive patients, first- or second-generation TKIs followed by third-generation TKIs showed favorable outcomes.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"386-395"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022048","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":"Analysis of Early Progression in Advanced Renal Cell Carcinoma Treated With Nivolumab Plus Ipilimumab.","authors":"Naoki Ito, Kosuke Ueda, Satoshi Ohnishi, Hiroki Suekane, Tasuku Hiroshige, Kouta Watanabe, Katsuaki Chikui, Keiichiro Uemura, Kiyoaki Nishihara, Makoto Nakiri, Shigetaka Suekane, Tsukasa Igawa","doi":"10.21873/cdp.10446","DOIUrl":"https://doi.org/10.21873/cdp.10446","url":null,"abstract":"<p><strong>Background/aim: </strong>In the CheckMate 214 trial, approximately 40% of patients with advanced renal cell carcinoma (aRCC) treated with nivolumab plus ipilimumab (NIVO + IPI) achieved long-term survival and a durable response to treatment. However, about 20% of patients experienced early disease progression (EDP). This retrospective study aimed to identify predictive factors for EDP among patients with aRCC treated with NIVO + IPI.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed clinical information from patients with aRCC, 19 patients in the EDP group and 40 patients in the control disease group, all of whom were treated with NIVO + IPI at Kurume University Hospital between September 2018 and February 2024.</p><p><strong>Results: </strong>The EDP group exhibited significantly worse progression-free survival and overall survival compared to the control disease group. Multivariate analyses revealed that a performance states (PS) ≥2 (p=0.0312) and the presence of bone metastases (p=0.0374) were independent predictors of EDP.</p><p><strong>Conclusion: </strong>Treatment with NIVO + IPI in patients with aRCC who have a poor PS or bone metastases may be linked to a high risk of EDP.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"344-352"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999222","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":"Dosimetric Comparison of Coplanar, Non-coplanar, and Mixed-Arc VMAT for Head and Face Skin Cancers: A Multi-scenario Analysis.","authors":"Valentina Zagardo, Denis LA Fauci, Giuseppe Emmanuele Umana, Salvatore Lavalle, Paolo Palmisciano, Manfredi Noto, Andrea Boncoraglio, Gianluca Scalia, Gianluca Ferini","doi":"10.21873/cdp.10442","DOIUrl":"https://doi.org/10.21873/cdp.10442","url":null,"abstract":"<p><strong>Background/aim: </strong>This study compared dosimetric differences in target coverage and organs-at-risk (OARs) sparing among coplanar (co-VMAT), non-coplanar (nonco-VMAT), and mixed-arc (mxd-VMAT) volumetric modulated arc therapy (VMAT) for stereotactic radiation treatment of head and face skin cancers (HFSC).</p><p><strong>Patients and methods: </strong>Five patients with HFSC, presenting with tumors located in critical areas near OARs were selected to represent distinct clinical scenarios. At least three competing VMAT plans per case (up to five for extensive tumors) were generated. The planning target volume (PTV) was obtained by applying a 1 mm isotropic expansion to the clinical target volume (CTV), except for portions extending beyond the body contour. Dosimetric parameters, including PTV indices [Dmax, D2%, D98%, V95%, conformity index (CI), and homogeneity index (HI)], dose to surrounding healthy tissues, beam-on time (BOT), and monitor units (MU) were evaluated and compared under identical optimization conditions.</p><p><strong>Results: </strong>Nonco-VMAT improved CI, HI, and OAR sparing for the first (left temporal-zygomatic) and third (nasal pyramid) patients. For the second patient (right frontal and zygomatic targets), mxd-VMAT was optimal for the frontal target, while nonco-VMAT was superior for the zygomatic target. Co-VMAT provided the highest plan quality for the fourth (occipital) patient, though mxd-VMAT slightly reduced OAR doses. For the fifth patient (scalp and vertex), co-VMAT achieved the best balance between target coverage and OAR sparing.</p><p><strong>Conclusion: </strong>This study highlights the potential benefits of non-coplanar arcs in HFSC treatment. VMAT arc arrangement should be tailored to tumor location, as the inclusion of non-coplanar arcs can enhance plan quality for both target coverage and OAR protection in specific cases. However, non-coplanar techniques may prolong treatment duration due to couch rotations and increased MU, potentially reducing patient tolerability.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"300-312"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021778","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 Role of p300 and TMPRSS2 in Prostate Cancer: Immunohistochemical Perspectives and Gleason Correlations.","authors":"Charitomeni Gioukaki, Alexandros Georgiou, Panagiotis Sarantis, Kostas Palamaris, Andreas C Lazaris, Christos Alamanis, Georgia Eleni Thomopoulou","doi":"10.21873/cdp.10439","DOIUrl":"https://doi.org/10.21873/cdp.10439","url":null,"abstract":"<p><strong>Background/aim: </strong>Transmembrane protease, serine 2 (TMPRSS2), and E1A-associated protein (p300) are important factors in prostate cancer (PCa) pathogenesis, playing significant roles in androgen receptor (AR) signaling and tumor progression. Despite their established role in PCa biology, their immunohistochemical alterations across different Gleason patterns and histological grades remain unclear. This experimental study aimed to assess TMPRSS2 and p300 expression in non-malignant and cancerous prostate tissues, correlating their localization and intensity with Gleason scores and tumor aggressiveness.</p><p><strong>Materials and methods: </strong>A total of 58 paraffin-embedded prostate adenocarcinoma (PRAD) tissue sections from male patients who underwent radical prostatectomy, including low- and high-grade tumors and high-grade prostatic intraepithelial neoplasia (HGPIN), were analyzed. Immunohistochemistry (IHC) for TMPRSS2 and p300 was performed. Two independent pathologists conducted H-score assessments with complete interobserver concordance, evaluating staining intensity, localization, and expression patterns, correlating findings with Gleason scores and cancer stage.</p><p><strong>Results: </strong>TMPRSS2 and p300 exhibited variable expression levels across all tissue samples. While TMPRSS2 expression increased in aggressive tumors, its staining intensity did not change significantly across different Gleason grades. p300 over-expression was significantly associated with aggressive tumors, particularly Gleason pattern 5 (p=0.011). High-grade tumors [Gleason ≥7(4+3)] demonstrated higher p300 expression compared to low-grade tumors [Gleason ≤7(3+4)], with minimal staining observed in Gleason score 6.</p><p><strong>Conclusion: </strong>Expression patterns of TMPRSS2 and p300 correlate with PCa aggressiveness. These findings support the growing evidence suggesting their potential role as prognostic markers and therapeutic targets. The implementation of well-designed studies on a larger scale is of utmost importance, to draw safer conclusions.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"268-279"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060318","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":"Factors Influencing Severe Hematologic Toxicity Following Niraparib Therapy in Patients With Ovarian Cancer.","authors":"Michio Kimura, Shiori Yamada, Rina Matsuyama, Makiko Go, Eiseki Usami","doi":"10.21873/cdp.10450","DOIUrl":"https://doi.org/10.21873/cdp.10450","url":null,"abstract":"<p><strong>Background/aim: </strong>Niraparib is a poly ADP ribose polymerase (PARP) inhibitor indicated for the maintenance therapy of ovarian cancer and the treatment of recurrent ovarian cancer. This study aimed to identify an indicator to predict severe hematologic toxicity after niraparib therapy.</p><p><strong>Patients and methods: </strong>We retrospectively included 32 patients with advanced ovarian cancer who were administered niraparib at Ogaki Municipal Hospital (Ogaki, Japan) between January 2020 and December 2024. Univariate analyses were performed to evaluate the relationship between the patients' baseline characteristics and the development of severe hematologic toxicity. Significant variables in the univariate analysis, as well as age, were entered into the multivariate logistic regression model. The optimal cutoff values for significant variables were determined using receiver-operating characteristic (ROC) curve analyses.</p><p><strong>Results: </strong>Severe hematologic toxicity was independently associated with pre-treatment creatinine clearance (odds ratio=0.920; 95% confidence interval=0.823-0.998; p=0.045). The areas under the ROC curves of creatinine clearance at the time of the worst-grade hematologic toxicity before and during niraparib administration were assessed for their ability to predict severe hematologic toxicity. The area under the curves of creatinine clearance at the time of ≥grade 3 hematologic toxicity during niraparib therapy showed high accuracy, with a value of 0.809 (95% confidence interval=0.659-0.958). The calculated cutoff value using the creatinine clearance curve was 47.0 ml/min.</p><p><strong>Conclusion: </strong>Creatinine clearance is a risk factor for severe hematologic toxicity. A creatinine clearance value <47.0 ml/min may slightly increase the risk of this toxicity in patients with ovarian cancer receiving niraparib.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"378-385"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060451","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":"Recurrent Diffuse Neurofibroma of the Mandibular Anterior Lingual Alveolar Process Associated With Dental and Skeletal Changes in Neurofibromatosis Type 1.","authors":"Reinhard E Friedrich, Felix K Kohlrusch, Christian Hagel","doi":"10.21873/cdp.10445","DOIUrl":"https://doi.org/10.21873/cdp.10445","url":null,"abstract":"<p><strong>Background/aim: </strong>Neurofibromatosis type 1 (NF1) is a tumor predisposition syndrome and a bone disease. Dystrophic facial skull often is topographically related to diffuse neurofibromas (DNFs). The report traces the diagnosis and treatment of an oral DNF that was registered in adolescence and describes associated bone findings. The aim of the investigation was to illustrate and specify the interplay of tumor-associated and dysmorphic changes of the facial skull in NF1.</p><p><strong>Case report: </strong>This 14-year-old patient with NF1 had developed a solid tumor arising from the mandibular anterior lingual alveolar process. Histological examination of the tumor identified a DNF. Imaging showed a funnel-shaped vertical defect of the alveolar process between incisors, asymmetry of bony chin and vertical position of mental foramina. The chin showed irregular, bi-cortical connected bone canals suspected to indicate enlarged neurovascular channels. Thirteen years later, the patient developed a local tumor recurrence (DNF). Meanwhile, the anterior bone defect had become larger. However, the bony chin appeared considerably sclerosed. In contrast, mandibular shape and surface were unchanged.</p><p><strong>Conclusion: </strong>DNF can affect the position of teeth, invade the bone, and cause enlarged bone channels. Surface erosion and trophic effects of the mandible may arise adjacent to the neurogenic lesion. DNF of the oral cavity can recur. It is becoming apparent that the tumor-associated skeletal and dental changes in the mandible correlate with the time of development of the peripheral nerve sheath tumor. The findings could be useful as indications for an expanded tumor search in the affected area.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"330-343"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051120","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":"Perspective on an Innovative Curative Strategy for Peritoneal Metastasis Involving Peritonectomy, Hyperthermic Intraperitoneal Chemotherapy, and Adjuvant Chemotherapy Identified as Effective in the Histoculture Drug Response Assay (HDRA).","authors":"Yohei Asano, Yutaka Yonemura, Chihiro Hozumi, Kohei Mizuta, Byung Mo Kang, Jin Soo Kim, Norio Yamamoto, Katsuhiro Hayashi, Hiroaki Kimura, Shinji Miwa, Kentaro Igarashi, Takashi Higuchi, Sei Morinaga, Hiroyuki Tsuchiya, Satoru Demura, Robert M Hoffman","doi":"10.21873/cdp.10440","DOIUrl":"https://doi.org/10.21873/cdp.10440","url":null,"abstract":"<p><strong>Background/aim: </strong>Peritoneal carcinomatosis is the end stage for patients with gastrointestinal cancer, with survival ranging between 2 and 9 months. Pancreatic acinar cell carcinoma (PACC) is rare and can result in peritoneal metastases. The efficacy of chemotherapy for patients with PACC is unknown, and a systemic treatment strategy has not been established. The aim of the present perspective is to discuss a potential curative strategy combining surgery, heated intraperitoneal chemotherapy (HIPEC), and the histoculture drug response assay (HDRA) to identify effective adjuvant chemotherapy for PACC with peritoneal metastases, based on a published case report.</p><p><strong>Case report: </strong>A 31-year-old man with a 20 cm epigastric mass, diagnosed as PACC, had curative-intent resection of a tumor on the distal stomach and pancreas tail. The patient recurred after four courses of adjuvant oral S-1 treatment. Laparotomy demonstrated peritoneal metastases with a peritoneal cancer index of 18. Ascites or other cancer cells in the peritoneal wash were not found. Peritonectomy, combined with HIPEC with gemcitabine and docetaxel, was performed intraoperatively. Postoperative 3-dimensional histoculture of fragments of the resected tumor with drug response testing with the histoculture drug response assay (HDRA) showed gemcitabine had the highest tumor inhibitory rate (70%) among six drugs tested. Based on the HDRA results, the patient was treated with adjuvant systemic gemcitabine chemotherapy. The patient did not have a recurrence within 18 months after surgery.</p><p><strong>Conclusion: </strong>The present innovative treatment of PACC with peritoneal metastases used laparotomy to determine the extent of peritoneal metastases, peritonectomy to attempt to completely remove the tumor, HIPEC for intraoperative hyperthermic-chemotherapy, and the HDRA to determine the most effective drug for adjuvant chemotherapy. These procedures can be individualized for each patient's cancer, and the HDRA is most critical for individualization.</p>","PeriodicalId":72510,"journal":{"name":"Cancer diagnosis & prognosis","volume":"5 3","pages":"280-284"},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059320","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}