Monday, June 28, 2021

Identification of an Optimal Population for Allogeneic Hematopoietic Stem Cell Transplantation in Patients With Mature T and NK Cell Neoplasms

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In Vivo. 2021 Jul-Aug;35(4):2379-2390. doi: 10.21873/invivo.12515.

ABSTRACT

BACKGROUND/AIM: The prognosis of mature T and natural killer (NK) cell neoplasms still remains dismal, despite the advancements in the understanding of the heterogeneous features of these diseases. As allogeneic stem cell transplantation (alloSCT) is an attractive salvage option for relapsed/refractory patients, we conducted this study to identify those who might benefit the most from alloSCT.

PATIENTS AND METHODS: This was a retrospective, single-center, longitudinal cohort study of patients who received alloSCT between December 2019 and January 2000.

RESULTS: The median relapse-free survival and overall survival were 4.4 and 10.0 months, respectively. Disease control status at alloSCT and number of previous treatments were associated with survival outcomes. The conditioning intensity did not significantly alter survival.

CONCLUSION: AlloSCT offers a cure chance for selected relapsed or refractory T and NK cell neoplasms, especially when used early and the disease is well controlled prior to transplantation.

PMID:34182521 | DOI:10.21873/invivo.12515

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Palliative Radiotherapy for Cutaneous Squamous Cell Carcinoma of the Head-and-Neck Region

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In Vivo. 2021 Jul-Aug;35(4):2283-2288. doi: 10.21873/invivo.12501.

ABSTRACT

BACKGROUND/AIM: Cutaneous squamous cell carcinoma (cSCC) is a common type of skin cancer. Options for palliative treatment include systemic agents and radiotherapy. Selection of a radiation regimen should consider the patient's survival prognosis. This study aimed to identify prognostic factors of survival after palliative radiotherapy for cSCC of the head-and-neck.

PATIENTS AND METHODS: Ten factors were analyzed for survival in 12 patients including age, gender, tumor site, histological grade, primary tumor stage, lymph node involvement, distant metastases, upfront surgery, radiation dose and completion of radiotherapy.

RESULTS: On univariate analysis, improved survival was significantly associated with lower histological grade (better differentiation) (p=0.022), no distant metastases (p=0.040) and completion of radiotherapy (p=0.014). In the multi variate analysis, lower histological grade (risk ratio=6.05, p=0.100) and completion of radiotherapy (risk ratio=4.87, p=0.115) showed trends.

CONCLUSION: Predictors of survival were identified that can help design individual treatments. Patients require optimal supportive care as completion of radiotherapy was associated with better survival.

PMID:34182507 | DOI:10.21873/invivo.12501

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Systemic Inflammatory Response to Different Sclerosing Agents as a Predictor of Pleurodesis Outcome

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In Vivo. 2021 Jul-Aug;35(4):2391-2398. doi: 10.21873/invivo.12516.

ABSTRACT

BACKGROUND/AIM: The objectives of this study were to evaluate systemic inflammation using different sclerosing agents and to estimate the prediction of systemic inflammation for the efficacy of pleurodesis.

PATIENTS AND METHODS: Ninety-six patients with recurrent and symptomatic malignant pleural effusion were enrolled in this retrospective study. We used serum C-reactive protein (CRP) levels, serum leukocyte counts and neutrophil-to-lymphocyte ratios (NLRs) as parameters of systemic inflammatory reactions. Evaluations of these parameters were performed before and 24 h after pleurodesis.

RESULTS: Pleurodesis was successful in 81 (84.4%) patients. The non-graded talc induced the highest changes in serum CRP levels, total white blood cell and neutrophil counts compared to other agents, while mitoxantrone induced the lowest. Graded talc and bleomycin i nduced the same levels of changes in serum CRP levels and serum leukocyte counts. The change in serum NLR was the same for all agent groups. Logistic regression confirmed that a change in serum CRP levels [odds ratio (OR)=0.92, p=0.002] and previous chemotherapy (OR=3.31, p=0.012) were independent predictors of pleurodesis efficacy.

CONCLUSION: Pleurodesis agents induced a systemic inflammatory response at different levels. The change in serum CRP levels could be useful for predicting the success of pleurodesis.

PMID:34182522 | DOI:10.21873/invivo.12516

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Human Epidermal Growth Factor Receptor 2-positive Primary Adenocarcinoma in the Cervical Oesophagus: A Case Report

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In Vivo. 2021 Jul-Aug;35(4):2297-2303. doi: 10.21873/invivo.12503.

ABSTRACT

BACKGROUND/AIM: Cervical oesophageal adenocarcinoma (COA) is extremely rare. We present a case of human epidermal growth factor receptor 2 (HER2)-positive COA that showed repeated recurrences despite multidisciplinary treatments.

CASE REPORT: A 49-year-old male was diagnosed with clinical stage IVA COA that originated from ectopic gastric mucosa. He initially underwent definitive chemoradiotherapy (CRT) (60.0 Gy/30 fractions, 5-fluorouracil, and cisplatin). Two months after CRT, the right supraclavicular lymph node (LN) reenlarged and salvage lymphadenectomy was performed. Immunohistochemical staining revealed a HER2-positive adenocarcinoma. Four months after lymphadenectomy, multiple metastases in the mediastinal LNs and lungs were detected, and S-1, oxaliplatin and trastuzumab were administered. Four months after chemotherapy, the patient presented with new liver metastasis. Further metastasis was prevented by Nivolumab treatment for four months.

CONCLUSION: HER2-positive COA may be more aggressive and may require further intensive treatments. This literature review may be helpful in determining treatment strategies for COA.

PMID:34182509 | DOI:10.21873/invivo.12503

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Areas to Improve Quality of Life After Ovarian Tumor Surgery and Adjuvant Treatment

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In Vivo. 2021 Jul-Aug;35(4):2399-2408. doi: 10.21873/invivo.12517.

ABSTRACT

BACKGROUND/AIM: To evaluate quality of life (QoL) in women treated for ovarian tumors one year after laparotomy.

PATIENTS AND METHODS: The validated quality of life questionnaires (EORTC QLQ-C30 and QLQ-OV28) were sent to women who had undergone laparotomy due to ovarian tumors 12 months after surgery. The answers were analyzed and grouped according to the ovarian tumor histology (benign, borderline and cancer).

RESULTS: A total of 621 patients (87.5% out of 710) agreed to participate in the study. Ovarian cancer patients experienced statistically worse QoL one year after laparotomy in several analyzed parameters, including financial difficulties, compared to patients treated for benign and borderline tumors.

CONCLUSION: Women with ovarian cancer still need further cancer rehabilitation and support one year after diagnosis to improve their QoL . The novel finding was that ovarian cancer patients suffered from financial difficulties even in a free of charge health care system.

PMID:34182523 | DOI:10.21873/invivo.12517

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Non-melanoma Skin Cancer Treated by Contact High-dose-rate Radiotherapy (Brachytherapy): A Mono-institutional Series and Literature Review

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In Vivo. 2021 Jul-Aug;35(4):2313-2319. doi: 10.21873/invivo.12505.

ABSTRACT

BACKGROUND/AIM: Non-melanoma skin cancers (NMSC) are the most common neoplasms worldwide and their incidence has been proven to increase in recent years and their treatment should aim at cancer cure as well as cosmetic and functional results. The aim of the study was to report the results of our mono-institutional series of high-dose-rate radiotherapy (cHDR-RT) in NMSC, based on a homogenous technique and two different treatment schedules.

PATIENTS AND METHODS: All patients affected by NMSC who were consecutively evaluated and treated at our Interventional Oncology Center from October 2018 to August 2020, were included. Patients underwent cHDR-RT using flap applicators and remotely afterloaded Ir-192 sources.

RESULTS: Overall, 51 patients were treated for a total of 67 lesions. Local control (LC) and disease-specific survival (DSS) were 94.0% and 10 0%, respectively. Grade 1, grade 2, grade 3 and grade 4 acute toxicity rates were 24.6%, 3.5%, 3.5%, and 0.0%, respectively. The cosmetic results were graded as excellent/good, fair, and poor in 73.7%, 19.3%, and 7.0%.

CONCLUSION: cHDR-RT of NMSC is an effective alternative to surgery due to excellent outcomes both in terms of local control and aesthetic results especially in the face.

PMID:34182511 | DOI:10.21873/invivo.12505

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Low Diagnostic Value of Synovial Aspiration Culture Prior to Reimplantation in Periprosthetic Joint Infection

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In Vivo. 2021 Jul-Aug;35(4):2409-2416. doi: 10.21873/invivo.12518.

ABSTRACT

BACKGROUND/AIM: We aimed to determine the diagnostic value of the synovial aspiration culture prior to reimplantation in two- (or more) stage exchange of periprosthetic joint infection.

PATIENTS AND METHODS: This was a retrospective study, spanning over ten years including all synovial cultures of patients with two- (or more) stage exchange due to periprosthetic joint infection.

RESULTS: A total of 183 patients were included, mean age was 66.6 years (range=12.8-93.4 years). Overall sensitivity of synovial aspiration cultures before reimplantation was 56.6%, specificity 84.6%, negative predictive value (NPV) 63.8%, positive predictive value (PPV) 80.2%, area under the curve (AUC) 70.6%. Sensitivity of the knee in comparison to the hip culture was significantly higher, as well as the NPV and the AUC (p=0.038). In case of complete removal of prosthesis , the sensitivity and AUC were significantly reduced, whereas the specificity was comparable with prosthesis in situ, partial removal or complete removal.

CONCLUSION: Due to the low sensitivity, obtaining several synovial cultures in the prosthesis-free interval to exclude persistence of infection, does not seem reasonable.

PMID:34182524 | DOI:10.21873/invivo.12518

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Integrin α5β1 Mediated Cellular Reorganization in Human Mesenchymal Stem Cells During Neuronal Differentiation

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In Vivo. 2021 Jul-Aug;35(4):2127-2134. doi: 10.21873/invivo.12482.

ABSTRACT

BACKGROUND/AIM: Mesenchymal stem cells (MSCs) have been widely used for yielding neurons in culture to study nervous system pathologies and develop regenerative approaches. In this study, cellular rearrangements of human MSCs related to the expression of the fibronectin common receptor integrin α5β1 and its cell surface localization during neuronal differentiation, were examined.

MATERIALS AND METHODS: Proliferation kinetics of neuronal induced hMSCs (hMd-Neurons) were quantified by BrdU assay, and hMd-Neurons were immunostained for neuronal marker expression. Additionally, cDNA and protein samples were collected at different time points for integrin α5β1 expression analysis.

RESULTS: Endogenous integrin α5β1 expression was significantly upregulated by day 6 and maintained until day 12. Cell surface localization of α5β1 integrin was increase d by day 6; the integrin was internalized into the cytosol by day 12.

CONCLUSION: Integrin dynamics around day 6 of differentiation might be involved in neuronal differentiation and maturation or specification of hMd-Neurons.

PMID:34182488 | DOI:10.21873/invivo.12482

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Clinical Significance of Composition Changes in T-cell Subpopulations After Chemotherapy in Patients With Gastric Cancer

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In Vivo. 2021 Jul-Aug;35(4):2417-2424. doi: 10.21873/invivo.12519.

ABSTRACT

BACKGROUND/AIM: New therapeutic agents and prognostic biomarkers for gastric cancer are needed. We analyzed the composition of peripheral blood T-cell subpopulations in response to chemotherapy in patients with gastric cancer.

PATIENTS AND METHODS: Peripheral blood samples were collected from patients diagnosed with gastric cancer before and after chemotherapy (FOLFOX; oxaliplatin, 5-fluorouracil, and leucovorin). Peripheral blood mononuclear cells were isolated. Patients were divided into responder (n=5) and non-responder groups (n=2) based on their chemotherapy outcomes.

RESULTS: Non-responders showed lower numbers of CD4+/total cells and CD8+/total cells after chemotherapy compared to the responder group, but the difference was not significant (p=0.905, p=0.095). Naïve T, central memory T, effector memory T and effector T-cell counts differed in both groups after chemotherapy.

CONCLUSION: Changes in peripheral T-cell subpopulations after chemotherapy were confirmed in patients with gastric cancer, which may be a prognostic predictor and development of therapeutic agents.

PMID:34182525 | DOI:10.21873/invivo.12519

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Ureteric Bud-derivatives in Wilms Tumor and Nephrogenic Rest

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In Vivo. 2021 Jul-Aug;35(4):2159-2162. doi: 10.21873/invivo.12486.

ABSTRACT

BACKGROUND/AIM: Recent studies suggest that not only the nephrogenic blastema but also the ureteric bud is involved in oncogenesis of Wilms' tumor (WT). However, the occurrence of ureteric bud (UB) derivatives in nephrogenic rest is not yet known. The aim of our study was to find UB derivatives in WT.

MATERIALS AND METHODS: Keratin 17 (KRT17) is expressed exclusively in UB in foetal kidneys. In this study KRT17 immunohistochemistry was used to detect UB-derivatives in 21 triphasic, 2 stromal and 3 epithelial predominant WTs and 9 nephrogenic rests.

RESULTS: We have detected KRT17 positive tubular structures resembling UB in 3 of 9 nephrogenic rests and 15 of 26 WTs.

CONCLUSION: Not only the metanephric blastema but also the UB is involved in the histogenesis of nephrogenic rest and WT.

PMID:34182492 | DOI:10.21873/invivo.12486

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Expression of LAT1 and 4F2hc in Gastroenteropancreatic Neuroendocrine Neoplasms

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In Vivo. 2021 Jul-Aug;35(4):2425-2432. doi: 10.21873/invivo.12520.

ABSTRACT

BACKGROUND/AIM: Little is known about the expression of L-type amino acid transporter 1 (LAT1) and 4F2hc in gastroenteropancreatic-neuroendocrine neoplasms (GEP-NENs). Hence, we conducted a study to verify the clinicopathological significance of LAT1 and 4F2hc.

PATIENTS AND METHODS: Tissues from 126 patients with GEP-NENs were collected between August 2007 and September 2019 at our institution. We evaluated LAT1 and 4F2hc expression by immunohistochemistry, and examined their clinical significance.

RESULTS: No statistically significant associations were observed between LAT1 expression and the different NENs. Expression of 4F2hc was significantly different between neuroendocrine tumour (NET)-G1, NET-G2, and NET-G3 (p=0.029), and was significantly associated with vascular invasion (p=0.044) and the Ki-67 index (p=0.042).

CONCLUSION: No associat ion between LAT1 expression and malignant features in GEP-NENs was observed. However, an association between 4F2hc expression and the potential of malignancy in GEP-NENs was evident.

PMID:34182526 | DOI:10.21873/invivo.12520

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