Clinical manifestations in patients with alpha-fetoprotein producing gastric cancer

Size: px
Start display at page:

Download "Clinical manifestations in patients with alpha-fetoprotein producing gastric cancer"

Transcription

1 Curr Oncol, Vol. 21, pp. e ; doi: CLINICAL MANIFESTATIONS IN AFP PRODUCING GASTRIC CANCER ORIGINAL ARTICLE Clinicl mnifesttions in ptients with lph-fetoprotein producing gstric cncer H.J. Lin md,* Y.H. Hsieh md, W.L. Fng md, # K.H. Hung md, # nd A.F.Y. Li md # ** ABSTRACT Bckground Ptients with lph-fetoprotein (fp) producing gstric cncer hve high incidence of liver metstsis nd poor prognosis. There is some controversy bout clinicl mnifesttions in these ptients. Methods Our study enrolled ptients who, before surgery, hd gstric cncer with serum fp exceeding 20 ng/ [fp>20 (n = 58)] nd with serum fp 20 ng/ or less [fp 20 (n = 1236)]. Clinicl mnifesttions were compred between the groups. Results Erly gstric cncer ws more frequent (30.1% vs. 4%) nd dvnced gstric cncer ws less frequent (69.9% vs. 96%) in the fp 20 group thn the fp>20 group (p < 0.001). Liver nd lymph node metstsis occurred less frequently in the fp 20 group (4.4% vs. 27.6%, p < 0.001, nd 60.7% vs. 91.4%, p < 0.001, respectively). The 1-, 3-, 5-, nd 10-yer survivl rtes of fp 20 ptients were 75.2%, 53.4%, 45.8%, nd 34.6% respectively. The 1-, 3-, 5-, nd 10-yer survivl rtes of ptients with fp greter thn 20 ng/, but 300 ng/ or less, were 46.7%, 28.9%, 17.8%, nd 13.3% respectively. The 1-, 3-, nd 5-yer survivl rtes of ptients with serum fp greter thn 300 ng/ were 15.4%, 7.7%, nd 0% respectively. The independent predictors for survivl time were fp concentrtion, ge, peritonel seeding, liver metstsis, lymph node metstsis, vsculr invsion, TNM stge, curtive surgery, serosl invsion, nd Luren clssifiction. Conclusions Ptients with high serum fp hd high frequency of liver nd lymph node metstsis nd very poor prognosis. More ggressive mngement with multimodl therpy (for exmple, chemotherpy, rdiotherpy) might be needed when treting such ptients. KEY WORDS Gstric cncer, lph-fetoprotein, erly gstric cncer, metstsis 1. INTRODUCTION Alph-fetoprotein (fp) is glycoprotein tht is normlly produced during gesttion by the fetl liver nd yolk sc 1. Elevtion of serum fp is considered to be bnorml in dults nd is often used s tumour mrker in heptocellulr crcinom nd tumours of gondl origin 2. However, vriety of other mlignncies lso produce fp, of which gstric cncer is the most common 3. Elevted serum fp cn occur in ptients without heptocellulr crcinom but with chronic liver disese such s virl heptitis or cirrhosis 4,5. The influence of serum fp on the prognosis of ptients with gstric cncer remins uncler. Alph-fetoprotein producing gstric cncer (fpgc) is rre, constituting only bout 1% 6% of ll gstric cncers 6. Poor prognosis is usully ssocited with fpgc becuse of liver nd lymph node metstsis 3,7. Few studies to dte hve ddressed the clinicopthologic fetures nd long-term survivl of ptients with fpgc. Controversy exists bout the clinicl mnifesttions in these ptients. Therefore, in this retrospective study, we reviewed clinicopthologic findings for 58 Chinese ptients with fpgc nd 1236 ptients with norml serum fp ttending single centre. We lso correlted survivl time with serum fp concentrtion. 2. METHODS We reviewed the medicl records of 3172 consecutive ptients with gstric denocrcinom who received surgicl intervention t the Veterns Generl e394

2 LIN et l. Hospitl Tipei between June 1988 nd December Preopertive serum fp ws ssessed by rdioimmunossy (norml vlue: <20 ng/) in 1331 ptients. The nlysis excluded 37 ptients with cute or chronic heptitis, cirrhosis, or heptocellulr crcinom. Surgicl nd pthologic findings for the remining 1294 ptients were recorded using the Jpnese clssifiction of gstric crcinom nd the Luren clssifiction 8,9. Nodl sttus nd disese stge were ssessed using the tumour node metstsis (TNM) system of the Union for Interntionl Cncer Control 10. Sex, ge, tumour size (mucosl size of the tumour), peritonel seeding, liver metstsis, lymph node metstsis, loction of the min tumour, lymphtic nd vsculr invsion, clinicl stging, curtive surgery, cuse of deth, morphologic ppernce nd depth of cncer involvement, cncer cell differentition, nd survivl time were recorded. Sttisticl nlysis ws performed using the SPSS softwre ppliction (SPSS for Windows, version 10.0: SPSS, Chicgo, IL, U.S.A.). The chi-squre test with Ytes correction for continuity ws used in comprisons of ctegoricl dt. The Fisher exct test ws used when the numbers were less thn 5. Survivl curves were estimted by the Kpln Meier method, nd differences were exmined using the log-rnk test. A multivrite nlysis of prognostic fctors ws evluted using the Cox proportionl hzrds model (forwrd stepwise method). Differences were considered significnt when the p vlue ws less thn RESULTS Of the 1294 eligible ptients, 58 (4.5%) were found to hve high serum fp (>20 ng/), with preopertive concentrtions rnging from 20.6 ng/ to ng/ (medin: 90.4 ng/). Medin followup ws 43.2 months. Tble i compres the clinicopthologic fetures of ptients with serum fp of 20 ng/ or less [fp 20 (n = 1236)] nd those with serum fp exceeding 20 ng/ [fp>20 (n = 58)]. Sex, ge, tumour size, peritonel seeding, nd tumour loction were similr in the two groups. Compred with the fp 20 group, the fp>20 group hd higher incidences of vsculr invsion (17.2% vs. 3.8%, p < 0.001), lymphtic invsion (70.7% vs. 59.7%, p < 0.001), liver metstsis (27.6% vs. 4.4%, p < 0.001), nd lymph node metstsis (91.4% vs. 60.7%, p < 0.001). Compred with ptients hving norml serum fp, those in the fp>20 group hd more stge iv disese nd less stge i or ii disese (p < 0.001). Fewer ptients in the fp>20 group received curtive surgery (10.3% vs. 37.9% in the fp 20 group, p < 0.001). More ptients in the fp>20 group died of their gstric cncer (58.6% vs. 27.1% in the fp 20 group, p < 0.001). Tble ii nlyzes the depth of cncer involvement in the gstric wll. The fp>20 group included fewer tble i Serum lph-fetoprotein (fp) nd clinicopthologic fetures in ptients with gstric cncer Vrible fp concentrtion p Vlue 20 ng/ >20 ng/ Ptients (n) Sex [n (%) men] 976 (78.2) 51 (87.9) Men ge (yers) 66.2± ± Men tumour size (cm) 5.7± ± Peritonel seeding [n (%) yes] 179 (14.5) 8 (13.8) Peritonel seeding present [n (%)] b Proximl to trnsverse colon 83 (46.4) 3 (37.5) Distl to trnsverse colon 96 (53.6) 5 (62.5) Metstsis [n (%) yes] Liver 53 (4.4) 16 (27.6) <0.001 Lymph nodes 750 (60.7) 53 (91.4) <0.001 Loction of min tumour Crdi 195 (15.8) 10 (17.2) Body 395 (32.0) 19 (32.8) Antrum 646 (52.3) 29 (50.0) Invsion [n (%) yes] Lymphtic 738 (59.7) 41 (70.7) <0.001 Vsculr 47 (3.8) 10 (17.2) <0.001 Stge <0.001 i 319 (25.2) 2 (3.3) ib 114 (9.0) 1 (1.6) ii 158 (12.5) 3 (4.9) iii 190 (15.0) 12 (19.7) iiib 153 (12.1) 11 (18.0) iv 333 (26.3) 32 (52.5) Curtive surgery [n (%)] 468 (37.9) 6 (10.3) <0.001 Cuse of deth [n (%) cncer] 330 (27.1) 34 (58.6) <0.001 By chi-squre test. b By Fisher exct test. cses of erly gstric cncer (egc: 4% vs. 30.1%; p < 0.001) nd more cses of dvnced gstric cncer (96% vs. 69.9%, p < 0.001). In the 2 egc ptients of the fp>20 group, cncer cells hd involved the intrmucosl nd musculris mucos lyers. In the fp 20 group, 349 ptients (30.1%) hd egc, with cncer cells confined to the intrmucos in 97 cses (27.8%), to the musculris mucos in 94 cses (26.9%), nd to the submucosl lyer in 158 cses (45.3%). Cncer cells penetrted to serosl lyer nd beyond in more ptients of the fp>20 group [40 ptients (80%) vs. 628 ptients (54.2%) in the fp 20 group, p < 0.001]. Tble iii summrizes the histologic clssifiction of cncer cells in the two groups. Poorly differentited cncers (por 1, por 2, signet-ring cell, mucinous denocrcinom) were not sttisticlly different between the groups (fp 20: n = 558, 48.7%; fp>20: n = 23, 50%; p = 0.87). The Luren clssifiction ws e395

3 CLINICAL MANIFESTATIONS IN AFP PRODUCING GASTRIC CANCER tble ii Serum lph-fetoprotein (fp) nd depth of cncer involvement of the gstric wll Vrible fp concentrtion [n (%)] p Vlue 20 ng/ >20 ng/ Ptients <0.001 b Gstric cncer Erly 349 (30.1) 2 (4.0) Advnced 809 (69.9) 48 (96.0) Depth of involvement <0.001 c Intrmucos 97 (8.4) 1 (2.0) Musculris mucos 94 (8.1) 1 (2.0) Submucos 158 (13.6) 0 (0) Musculris propri 133 (11.5) 2 (4.0) Subseros α 10 (0.9) 2 (4.0) Subseros β 18 (1.6) 3 (6.0) Subseros γ 20 (1.7) 1 (2.0) Serosl penetrtion 518 (44.7) 32 (62.7) Invsion of djcent structures 110 (9.5) 8 (16) Dt not vilble for 78 ptients in the 20 ng/ group, nd 7 in the >20 ng/ group. b By Fisher exct test. c By chi-squre test. tble iii Serum lph-fetoprotein (fp) nd cell differentition in gstric cncer Vrible fp concentrtion [n (%)] p Vlue 20 ng/ >20 ng/ not sttisticlly significntly different between the fp 20 nd fp>20 groups. Survivl time ws further nlyzed by vrious levels of high serum fp. In 45 ptients, serum fp ws greter thn 20 ng/ but less thn or equl to 300 ng/ (20<fp 300); in 13 ptients, serum fp exceeded 300 ng/ (fp>300). The 1-, 3-, 5-, nd 10-yer survivl rtes for ptients in the fp 20 group were 75.2%, 53.4%, 45.8%, nd 34.6% respectively. The 1-, 3-, 5-, nd 10-yer survivl rtes for 20<fp 300 ptients were 46.7%, 28.9%, 17.8%, nd 13.3% respectively. The 1-, 3-, nd 5-yer survivl rtes for ptients with fp>300 were 15.4%, 7.7%, nd 0% respectively. The ptients in the fp 20 group hd the best survivl time, nd the ptients in the 20<fp 300 group hd the poorest survivl (p < 0.001, Figure 1). In univrite nlysis, serum fp greter thn 20 ng/, mle sex, ge greter thn 60, tumour size greter thn 7 cm, peritonel seeding, liver metstsis, lymph node metstsis, lymphtic nd vsculr invsion, tumour stge iv, no curtive surgery, serosl invsion, nd poorly differentited nd diffuse cell types were ssocited with poor survivl time (Tble iv). In multivrite nlysis, the independent prognostic fctors for survivl were serum fp, ptient ge, peritonel seeding, liver metstsis, lymph node metstsis, vsculr invsion, TNM stge, curtive surgery, serosl invsion, nd Luren clssifiction (Tble v). 4. DISCUSSION In our study, 58 ptients with fpgc hd high percentge of lymph node nd liver metstsis nd poor prognosis. The prevlence of fpgc is reported to be Ptients b Ppillry denocrcinom 19 (1.7) 1 (2.2) Tubulr denocrcinom Well-differentited 113 (9.9) 1 (2.2) Modertely differentited 446 (39.0) 18 (39.1) Adenocrcinom, poorly differentited Solid type 43 (3.8) 4 (8.7) Non-solid type 387 (33.8) 16 (34.8) Signet-ring cell crcinom 89 (7.8) 3 (6.5) Mucinous denocrcinom 39 (3.4) 0 (0) Adenosqumous crcinom 1 (0.1) 1 (2.2) Undifferentited 3 (0.3) 1 (2.21) Miscellneous 5 (0.4) 1 (2.2) Luren clssifiction b Intestinl 590 (51.5) 25 (54.3) Diffuse 350 (30.6) 16 (34.8) Mixed 205 (17.9) 5 (10.9) Dt not vilble for 91 ptients in the 20 ng/ group, nd 12 in the >20 ng/ group. b By chi-squre test. figure 1 Overll survivl by serum lph-fetoprotein (fp) concentrtion in nnogrms per milliliter. e396

4 LIN et l. tble iv Univrite nlysis of ll ptients by the Kpln Meier method Vrible Pts (n) 5-Yer survivl Log-rnk p vlue Alph-fetoprotein 20 ng/ <0.001 >20 ng/ Sex Men <0.001 Women Age <60 Yers < Yers Tumour size <7 cm < cm Peritonel seeding Yes <0.001 No Liver metstsis Yes <0.001 No Lymph node metstsis Yes <0.001 No Loction of min tumour Crdi Body Antrum Lymphtic invsion Yes <0.001 No Vsculr invsion Yes < No TNM stge i <0.001 ii iii iv Curtive surgery Yes <0.001 No Serosl invsion Yes <0.001 No Differentition Ppillry denocrcinom <0.001 Tubulr denocrcinom Poorly differentited Mucinous Luren clssifiction Intestinl Diffuse Mixed Includes signet-ring cell crcinom. Pts = ptients. tble v Independent prognostic fctors by Cox modelling Vrible Coefficient hr 95% ci p Vlue fp group <0.001 to Sex to Age <0.001 to Tumour size to Peritonel seeding <0.001 to Liver metstsis to Lymph node metstsis to Lymphtic invsion to Vsculr invsion to TNM stge <0.001 to Curtive surgery to Serosl invsion to Differentition to Luren clssifiction to hr = hzrd rtio; ci = confidence intervl; fp = lph-fetoprotein. 0.17% 8.4% in ptients with gstric cncer 3,6, Clinicl mnifesttions in ptients with fpgc hve rrely been observed becuse of tht smll incidence 15. Furthermore, controversy exists bout those mnifesttions. We observed tht 4.5% of gstric cncer ptients (58 of 1294) hd n bnorml serum fp reding (>20 ng/), proportion tht is comprble with those in other reports. To void confounding fctors in ptients with fpgc, we excluded 37 ptients with liver disese (cirrhosis, heptom, cute heptitis) from the nlysis. Liver metstsis (14.3% 75.6%) is one of the min fetures of fpgc or heptoid denocrcinom of the stomch (hs) 12 14,16. In our series, 16 ptients (27.6%) in the fpgc group were found to hve liver metstsis during follow-up. Tht group more frequently hd liver metstsis thn did ptients with norml serum fp (n = 53, 4.4%, p < 0.001). However, the relted literture describes some different observtions. Nkjim et l. 17 reported tht there ws no correltion between preopertive fp vlues nd histopthology, lymph node metstsis, vessel invsion, nd liver metstsis. e397

5 CLINICAL MANIFESTATIONS IN AFP PRODUCING GASTRIC CANCER Lymph node involvement hs been reported to be present in 62.9% 100% ptients with fpgc Lymph node metstsis ws found more often in our fpgc ptients thn in ptients with norml serum fp (91.4% vs. 60.7%, p < 0.001). Vsculr invsion is very common in fpgc, occurring in 63.5% 75.6% ptients with fpgc or hs 3,6,11,16. In our series, it occurred in 10 ptients (17.2%) with fpgc nd in 47 ptients (3.8%) with norml serum fp (p < 0.001). Lymphtic invsion hs been reported to occur in 71.4% 86.7% of ptients with fpgc or hs 11,12,16,18. In our series, it occurred in 41 ptients (70.7%) with fpgc nd in 738 (59.7%) ptients with norml serum fp (p < 0.001). The lower one third of the stomch is most common loction for fpgc or hs, in the rnge 40% 61.5% 3,6,11 13,16. Our observtion ws similr. In our series, the primry cncer ws bove the ntrum in 29 ptients with fpgc (50%) nd in 646 ptients (52.3%) with norml serum fp. With respect to clinicl stging, the literture reports number of different observtions. In one lrge series (270 ptients), Adchi et l. 15 showed tht most ptients with fpgc hd serosl invsion, lymph node metstsis, nd liver metstsis; three qurters hd stge iii or iv disese. Those uthors found tht the 5-yer survivl rte fter gstrectomy ws only 22%. The poor prognosis ws ttributble mostly to simultneous metstses or erly recurrence in the liver. However, Chun et l. 13 reported tht 74% (n = 26) of their fpgc ptients hd stge i or ii disese. In our study, ptients with norml serum fp were observed to hve more stge i disese (25.2% vs. 3.3% in ptients with fpgc) nd less stge iv disese (27.1% vs. 58.6% in ptients with fpgc, p < 0.001). In our study, more ptients died of gstric cncer in the fpgc group thn in the fp 20 group (58.6% vs. 27.1%, p < 0.001), n observtion tht might be explined by low rte of curtive surgery nd greter rtes of recurrent gstric cncer nd liver metstsis in the ptients with fpgc. In ptients with hs or fpgc, the rte of egc hs been reported to be 0% 42.9% 3,6,11 14,16,19, with most publictions reporting rtes of less thn 10% 6,12,14. However, different observtions hve lso been published. Chun et l. 13 found tht 42.9% of their ptients with fpgc (n = 15) hd erly-stge disese. In our series, egc ws found in 4% of ptients with fpgc (2 of 50), which is rte lower thn tht seen in the ptients with norml fp (349 of 1158, 30.1%, p < 0.001). Our finding is comptible with those in most other reports (0% 19.4%) 6,11,14, which found tht dvnced gstric cncer ws present in most ptients with hs or fpgc 3,6,12,14. In our study, ptients with fpgc more often hd dvnced gstric cncer thn did ptients with norml serum fp (96% vs. 69.9%, p < 0.001). Poorly differentited cncer cells hve been reported to predominte in ptients with fpgc or hs (48.6% 64.4%) 3,12,13,16 ; however, different findings hve lso been reported. In one lrge nlysis of pooled dt from Jpn, Adchi et l. 15 found tht well-differentited cncers ws predominted in ptients with fpgc (n = 218, 87.2%). In our study, the incidence of poorly differentited cncer cells (por 1, por 2, signet-ring cells, mucinous denocrcinom) ws similr in both ptient groups [50% in the fpgc group (n = 23) nd 48.7% in the norml serum fp group (n = 558), p = 0.87]. Surgery is the currently the min therpy for gstric cncer. However, rdicl surgery ws successful in only 6 ptients of our fpgc group (10.3%). In contrst, rdicl surgery ws much more successful in ptients with norml serum fp (n = 468, 37.9%, p < 0.001). Tht difference might explin why the fpgc group hd more liver metstsis nd worse prognosis thn did ptients with norml serum fp. The 5-yer survivl rte in ptients with fpgc hs been reported to be 9% 66% 6,12,13,16. However, there hs been some controversy bout the link between fp nd survivl durtion. Survivl durtion fter surgery hs been found not to be linked to preopertive serum fp 6. Inoue nd collegues observed tht 1 ptient with high serum fp (25,400 ng/) ws still living 12 yers fter dignosis of gstric cncer 6. The lrge Jpnese study using pooled dt lso showed similr results: Adchi et l. 15 found tht 5-yer survivl rtes were not different for ptients with gstric cncer nd serum fp less thn 1000 ng/ (42.7%) or greter thn 1000 ng/ (39.4%). Ngi et l. 20 lso reported tht the 5-yer survivl rte ws 40% in ptients with lower fp nd 38% in ptients with higher fp. Other uthors found tht ptients with fpgc hd shorter survivl durtion. In one lrge series, Liu et l. 3 found tht the 1-, 3-, nd 5-yer survivl rtes for ptients with fpgc were 53%, 35%, nd 28% respectively. Those uthors lso found tht ptients with fpgc or hs hd poorer prognosis thn did ptients who hd lower fp concentrtions (p < 0.01) or non-hs disese (p < 0.05) 3. Chun et l. 13 found tht the 5-yer survivl rte in ptients with fp-producing disese ws significntly poorer thn tht in non-fp-producing group (66% vs. 80%, p = 0.002); however, their reported 5-yer survivl rte ws extremely high compred with tht in other reports. In our study, we found tht 1-, 3-, 5-, nd 10-yer survivl rtes for 20<fp 300 ptients were 46.7%, 28.9%, 17.8%, nd 13.3% respectively. The 1-, 3-, nd 5-yer survivl rtes for fp>300 ptients were 15.4%, 7.7%, nd 0% respectively. Ptients in the fp 20 group hd the best survivl time, nd ptients in the 20<fp 300 group hd the poorest survivl time (p < 0.001, Figure 1). 5. CONCLUSIONS Ptients with fp-producing gstric cncer hd low rte of successful surgery, high rte of liver e398

6 LIN et l. nd lymph node metstsis, nd very poor prognosis. More ggressive mngement with multimodl therpy (for exmple, chemotherpy, rdiotherpy) might be needed when treting such ptients. 6. ACKNOWLEDGMENT This study ws supported by the Tomorrow Medicl Foundtion (grnt no ) nd ws presented s poster during Digestive Disese Week t Orlndo, Florid, U.S.A., in My The uthors express their grtitude to Miss Betty Tzu-En Lin, Mr. Austin Jen- Ling Lin, nd Mr. Alex Jen-Ho Lin for their ssistnce. 7. CONFLICT OF INTEREST DISCLOSURES The uthors declre tht they hve no finncil conflicts of interest. 8. REFERENCES 1. Bergstrnd CG, Czr B. Demonstrtion of new protein frction in serum from the humn fetus. Scnd J Clin Lb Invest 1956;8: El-Bhrwy M. Alph-fetoprotein producing non-germ cell tumours of the femle genitl trct. Eur J Cncer 2010;46: Liu X, Cheng Y, Sheng W, et l. Clinicopthologic fetures nd prognostic fctors in lph-fetoprotein-producing gstric cncers: nlysis of 104 cses. J Surg Oncol 2010;102: Sterling RK, Wright EC, Morgn TR, et l. Frequency of elevted heptocellulr crcinom (hcc) biomrkers in ptients with dvnced heptitis C. Am J Gstroenterol 2012;107: Collier J, Shermn M. Screening for heptocellulr crcinom. Heptology 1998;27: Inoue M, Sno T, Kuchib A, Tniguchi H, Fukgw T, Kti H. Long-term results of gstrectomy for lph-fetoproteinproducing gstric cncer. Br J Surg 2010;97: Chng YC, Ngsue N, Kohno H, et l. Clinicopthologic fetures nd long-term results of lph-fetoprotein-producing gstric cncer. Am J Gstroenterol 1990;85: Jpnese Gstric Cncer Assocition. Jpnese clssifiction of gstric crcinom: 3rd English edition. Gstric Cncer 2011;14: Luren PA, Nevlinen TJ. Epidemiology of intestinl nd diffuse types of gstric crcinom. A time-trend study in Finlnd with comprison between studies from high- nd low-risk res. Cncer 1993;71: Sobin LH, Wittekind C, eds. TNM Clssifiction of Mlignnt Tumours. 6th ed. Hoboken, NJ: John Wiley nd Sons; Bek SK, Hn SW, Oh DY, Im SA, Kim TY, Bng YJ. Clinicopthologic chrcteristics nd tretment outcomes of heptoid denocrcinom of the stomch, rre but unique subtype of gstric cncer. BMC Gstroenterol 2011;11: Zhng JF, Shi SS, Sho YF, Zhng HZ. Clinicopthologicl nd prognostic fetures of heptoid denocrcinom of the stomch. Chin Med J (Engl) 2011;124: Chun H, Kwon SJ. Clinicopthologicl chrcteristics of lph-fetoprotein producing gstric cncer. J Gstric Cncer 2011;11: Ucr E, Semerci E, Ustun H, Yetim T, Huzmeli C, Gullu M. Prognostic vlue of preopertive ce, c 19-9, c 72-4 nd fp levels in gstric cncer. Adv Ther 2008;25: Adchi Y, Tsuchihshi J, Shirishi N, Ysud K, Etoh T, Kitno S. fp-producing gstric crcinom: multivrite nlysis of prognostic fctors in 270 ptients. Oncology 2003;65: Liu X, Cheng Y, Sheng W, et l. Anlysis of clinicopthologic fetures nd prognostic fctors in heptoid denocrcinom of the stomch. Am J Surg Pthol 2010;34: Nkjim K, Ochii T, Suzuki T, et l. Impct of preopertive serum crcinoembryonic ntigen, c 19-9 nd lphfetoprotein levels in gstric cncer ptients. Tumor Biol 1998;19: Ishikur H, Fuksw Y, Ogswr K, Ntori T, Tsukd Y, Aizw M. An fp-producing gstric crcinom with fetures of heptic differentition. A cse report. Cncer 1985;56: Kinjo T, Tniguchi H, Kushim R, et l. Histologic nd immunohistochemicl nlyses of α-fetoprotein producing cncer of the stomch. Am J Surg Pthol 2012;36: Ngi E, Ueym T, Yo T, Tsuneyoshi M. Heptoid denocrcinom of the stomch. A clinicopthologic nd immunohistochemicl nlysis. Cncer 1993;72: Correspondence to: Hwi-Jeng Lin, Division of Gstroenterology nd Heptology, Deprtment of Internl Medicine, Tipei Medicl University Hospitl, Tipei Medicl University, No. 252 Wuxing Street, Tipei Tiwn. E-mil: buddhistlerning@gmil.com * Division of Gstroenterology nd Heptology, Deprtment of Internl Medicine, Tipei Medicl University Hospitl, Tipei City, Tiwn. School of Medicine, Tipei Medicl University, Tipei City, Tiwn. Division of Gstroenterology, Deprtment of Medicine, Buddhist Dlin Tzu Chi Generl Hospitl, Chi-Yi, Tiwn. Buddhist Tzu Chi University, School of Medicine, Hulien City, Tiwn. Division of Generl Surgery, Veterns Generl Hospitl Tipei, Tipei City, Tiwn. # School of Medicine, Ntionl Yng-Ming University, Tipei City, Tiwn. ** Deprtment of Pthology, Veterns Generl Hospitl Tipei, Tipei City, Tiwn. e399

Efficacy of Pembrolizumab in Patients With Advanced Melanoma With Stable Brain Metastases at Baseline: A Pooled Retrospective Analysis

Efficacy of Pembrolizumab in Patients With Advanced Melanoma With Stable Brain Metastases at Baseline: A Pooled Retrospective Analysis Efficcy of Pembrolizumb in Ptients With Advnced Melnom With Stble Brin Metstses t Bseline: A Pooled Retrospective Anlysis Abstrct 1248PD Hmid O, Ribs A, Dud A, Butler MO, Crlino MS, Hwu WJ, Long GV, Ancell

More information

Impact of Positive Nodal Metastases in Patients with Thymic Carcinoma and Thymic Neuroendocrine Tumors

Impact of Positive Nodal Metastases in Patients with Thymic Carcinoma and Thymic Neuroendocrine Tumors Originl Article Impct of Positive Nodl Metstses in Ptients with Thymic Crcinom nd Thymic Neuroendocrine Tumors Benny Weksler, MD, Anthony Holden, MD, nd Jennifer L. Sullivn, MD Introduction: Thymic crcinoms

More information

Esophageal carcinoma is the eighth most common cancer

Esophageal carcinoma is the eighth most common cancer ORIGINAL ARTICLE Tumor-Strom Rtio Is n Independent Predictor for Survivl in Esophgel Squmous Cell Crcinom Ki Wng, MD,* Wei M, MD,* Jinbo Wng, MD,* Ling Yu, MD, Xiomei Zhng, MD, Zhenbo Wng, MD, Bingxu Tn,

More information

American Joint Committee on Cancer Staging and Clinicopathological High-Risk Predictors of Ocular Surface Squamous Neoplasia

American Joint Committee on Cancer Staging and Clinicopathological High-Risk Predictors of Ocular Surface Squamous Neoplasia Americn Joint Committee on Cncer Stging nd Clinicopthologicl High-Risk Predictors of Oculr Surfce Squmous Neoplsi A Study From Tertiry Eye Center in Indi Sheetl Chuhn, MSc; Seem Sen, MD; Anjn Shrm, PhD;

More information

CheckMate 153: Randomized Results of Continuous vs 1-Year Fixed-Duration Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer

CheckMate 153: Randomized Results of Continuous vs 1-Year Fixed-Duration Nivolumab in Patients With Advanced Non-Small Cell Lung Cancer CheckMte 53: Rndomized Results of Continuous vs -Yer Fixed-Durtion Nivolumb in Ptients With Advnced Non-Smll Cell Lung Cncer Abstrct 297O Spigel DR, McCleod M, Hussein MA, Wterhouse DM, Einhorn L, Horn

More information

Classic Papillary Thyroid Carcinoma with Tall Cell Features and Tall Cell Variant Have Similar Clinicopathologic Features

Classic Papillary Thyroid Carcinoma with Tall Cell Features and Tall Cell Variant Have Similar Clinicopathologic Features The Koren Journl of Pthology 2014; 48: 201-208 ORIGINAL ARTICLE Clssic Ppillry Thyroid Crcinom with Tll Cell Fetures nd Tll Cell Vrint Hve Similr Clinicopthologic Fetures Woo Jin Oh 1 Young Sub Lee 1 Uiju

More information

Neutrophil lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors

Neutrophil lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors 2454 Neutrophil lymphocyte rtio predicts survivl in pncretic neuroendocrine tumors GUOPEI LUO 1 3*, CHEN LIU 1 3*, HE CHENG 1 3*, KAIZHOU JIN 1 3, MENG GUO 1 3, YU LU 1 3, JIANG LONG 1 3, JIN XU 1 3, QUANXING

More information

Lung cancer is the leading cause of cancer death worldwide, EGFR Mutation and Brain Metastasis in Pulmonary Adenocarcinomas

Lung cancer is the leading cause of cancer death worldwide, EGFR Mutation and Brain Metastasis in Pulmonary Adenocarcinomas Originl Article EGFR Muttion nd Brin Metstsis in Pulmonry Adenocrcinoms Dong-Yeop Shin, MD,* Im Il N, MD,* Cheol Hyeon Kim, MD, PhD, Sunhoo Prk, MD, PhD, HeeJong Bek, MD, PhD, nd Sung Hyun Yng, MD, PhD*

More information

Prognostic significance of pretreatment serum levels of albumin, LDH and total bilirubin in patients with nonmetastatic

Prognostic significance of pretreatment serum levels of albumin, LDH and total bilirubin in patients with nonmetastatic Crcinogenesis, 2015, Vol. 36, No. 2, 243 248 doi:10.1093/crcin/bgu247 Advnce Access publiction December 18, 2014 Originl Mnuscript originl mnuscript Prognostic significnce of pretretment serum levels of

More information

ONCOLOGY LETTERS 14: , China Medical University, Shenyang, Liaoning , P.R. China

ONCOLOGY LETTERS 14: , China Medical University, Shenyang, Liaoning , P.R. China 4890 Expression of vsculr endothelil growth fctor nd cspse 3 in mucinous brest crcinom nd infiltrting ductl crcinom not otherwise specified, nd the correltion with disese free survivl QIULI WANG 1, LISHA

More information

Original Article Prognostic and clinicopathologic significance of AEG-1/MTDH and E-cadherin expression in human gallbladder carcinoma

Original Article Prognostic and clinicopathologic significance of AEG-1/MTDH and E-cadherin expression in human gallbladder carcinoma Int J Clin Exp Pthol 2018;11(12):6025-6031 www.ijcep.com /ISSN:1936-2625/IJCEP0086349 Originl Article Prognostic nd clinicopthologic significnce of AEG-1/MTDH nd E-cdherin expression in humn gllbldder

More information

CHEST. Thyroid transcription factor 1 (TTF-1) is an important. Original Research

CHEST. Thyroid transcription factor 1 (TTF-1) is an important. Original Research CHEST Originl Reserch Clinicl Significnce of Thyroid Trnscription Fctor-1 in Advnced Lung Adenocrcinom Under Epiderml Growth Fctor Receptor Tyrosine Kinse Inhibitor Tretment Kuei-Pin Chung, MD; Yen-Tsung

More information

BENIGN ulceration along the greater curvature of the pars media of the

BENIGN ulceration along the greater curvature of the pars media of the BENIGN ULCERS OF THE GREATER CURVATURE OF THE STOMACH Report of Two Cses CHARLES H. BROWN, M.D. Deprtment of Gstroenterology nd ANTHONY D. INTRIERE, M.D.* BENIGN ulcertion long the greter curvture of the

More information

DA XU *, XIAOFENG LIU *, LIJUN WANG and BAOCAI XING

DA XU *, XIAOFENG LIU *, LIJUN WANG and BAOCAI XING ONCOLOGY LETTERS Heptectomy plus djuvnt trnsctheter rteril chemoemboliztion improves the survivl rte of ptients with multicentric occurrence of heptocellulr crcinom DA XU *, XIAOFENG LIU *, LIJUN WANG

More information

Case Report INTRODUCTION CASE REPORT. pissn eissn X

Case Report INTRODUCTION CASE REPORT. pissn eissn X pissn 2287-2728 eissn 2287-285X Cse Report Clinicl nd Moleculr Heptology 2018;24:424-429 Complete cure of dvnced heptocellulr crcinom with right drenl glnd metstsis nd portl vein thrombosis by multiple

More information

Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications

Prophylactic effect of neoadjuvant chemotherapy in gastric cancer patients with postoperative complications Gstric Cncer (2018) 21:703 709 https://doi.org/10.1007/s10120-017-0781-y ORIGINAL ARTICLE Prophylctic effect of neodjuvnt chemotherpy in gstric cncer ptients with postopertive complictions Kojiro Eto 1

More information

ORIGINAL ARTICLE ABSTRACT INTRODUCTION

ORIGINAL ARTICLE ABSTRACT INTRODUCTION ORIGINAL ARTICLE LOSS OF EPCAM STAINING CORRELATES WITH POOR OUTCOME IN CRC, Wng et l. Reduction in membrnous immunohistochemicl stining for the intrcellulr domin of epithelil cell dhesion molecule correltes

More information

Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan

Biliary tract cancer treatment: 5,584 results from the Biliary Tract Cancer Statistics Registry from 1998 to 2004 in Japan J Heptoiliry Pncret Surg (2009) 16:1 7 DOI 10.1007/s00534-008-0015-0 TOPICS Biliry trct cncer sttistics registry in Jpn Biliry trct cncer tretment: 5,584 results from the Biliry Trct Cncer Sttistics Registry

More information

Original Article Serum tumor markers used for predicting esophagogastric junction adenocarcinoma in esophageal malignancy

Original Article Serum tumor markers used for predicting esophagogastric junction adenocarcinoma in esophageal malignancy Int J Clin Exp Med 2016;9(6):11859-11864 www.ijcem.com /ISSN:1940-5901/IJCEM0025330 Originl Article Serum tumor mrkers used for predicting esophgogstric junction denocrcinom in esophgel mlignncy Yongkng

More information

P (RCC) was first done in the late 1930s and reported in

P (RCC) was first done in the late 1930s and reported in Pulmonry Resection of Metsttic Renl Cell Crcinom Robert J. Cerfolio, MD, Mrk S. Allen, MD, Clude Deschmps, MD, Richrd C. Dly, MD, Steven L. Wllrichs, BS, Victor F. Trstek, MD, nd Peter C. Pirolero, MD

More information

Improved prognosis of postoperative hepatocellular carcinoma patients when treated with functional foods: a prospective cohort study

Improved prognosis of postoperative hepatocellular carcinoma patients when treated with functional foods: a prospective cohort study Journl of Heptology 37 (2002) 78 86 www.elsevier.com/locte/jhep Improved prognosis of postopertive heptocellulr crcinom ptients when treted with functionl foods: prospective cohort study Yoichi Mtsui*,

More information

Supplementary Online Content

Supplementary Online Content Supplementry Online Content Zulmn DM, Pl Chee C, Ezeji-Okoye SC, et l. Effect of n intensive outptient progrm to ugment primry cre for high-need Veterns Affirs ptients: rndomized clinicl tril. JAMA Intern

More information

Comparative effectiveness of the tumour diagnostics,

Comparative effectiveness of the tumour diagnostics, Gut, 1987, 28, 323-329 Comprtive effectiveness of the tumour dignostics, C 19-9, C 125 nd crcinoembryonic ntigen in ptients with diseses of the digestive system K SKMOTO, Y HG, R YOSHIMR, H GMI, Y YOKOYM,

More information

Clinical significance of zinc finger E box binding homeobox 1 mrna levels in peritoneal washing for gastric cancer

Clinical significance of zinc finger E box binding homeobox 1 mrna levels in peritoneal washing for gastric cancer MOLECULAR AND CLINICAL ONCOLOGY 3: 435-441, 2015 Clinicl significnce of zinc finger E box binding homeobox 1 mrna levels in peritonel wshing for gstric cncer NORIMITSU YABUSAKI, SUGURU YAMADA, TOSHIFUMI

More information

Prognostic factors in tongue cancer relative importance of demographic, clinical and histopathological factors

Prognostic factors in tongue cancer relative importance of demographic, clinical and histopathological factors British Journl of Cncer (2000) 83(5), 614 619 doi: 10.1054/ bjoc.2000.1323, vilble online t http://www.idelibrry.com on Prognostic fctors in tongue cncer reltive importnce of demogrphic, clinicl nd histopthologicl

More information

The College of American Pathologists offers these

The College of American Pathologists offers these Protocol for the Exmintion of Specimens From Ptients With Neuroendocrine Tumors (Crcinoid Tumors) of the Stomch Mry Ky Wshington, MD, PhD; Lur H. Tng, MD, PhD; Jordn Berlin, MD; Philip A. Brnton, MD; Lwrence

More information

Systematic review of actual 10-year survival following resection for hepatocellular carcinoma

Systematic review of actual 10-year survival following resection for hepatocellular carcinoma DOI:10.1111/j.1477-2574.2012.00446.x HPB SYSTEMATIC REVIEW Systemtic review of ctul 10-yer survivl following resection for heptocellulr crcinom Annelise M. Gluer 1, Nichols Cocco 1, Jerome M. Lurence 1,2,

More information

IMpower133: Primary PFS, OS, and safety in a Ph1/3 study of 1L atezolizumab + carboplatin + etoposide in extensive-stage SCLC

IMpower133: Primary PFS, OS, and safety in a Ph1/3 study of 1L atezolizumab + carboplatin + etoposide in extensive-stage SCLC IMpower133: Primry PFS, OS, nd sfety in Ph1/3 study of 1L tezolizumb + crbopltin + etoposide in extensive-stge SCLC S. V. Liu, 1 A. S. Mnsfield, 2 A. Szczesn, 3 L. Hvel, 4 M. Krzkowski, 5 M. J. Hochmir,

More information

One of the most important biological mechanisms of

One of the most important biological mechanisms of Brief Report Serum Thymidine Kinse 1 Activity in the Prognosis nd Monitoring of Chemotherpy in Lung Cncer Ptients: A Brief Report Benjmin Nismn, PhD,* Hovv Nechushtn, MD, PhD,* Him Birn, MD, Hds Gntz-Sorotsky,

More information

Significance of Expression of TGF- in Pulmonary Metastasis in Non-small Cell Lung Cancer Tissues

Significance of Expression of TGF- in Pulmonary Metastasis in Non-small Cell Lung Cancer Tissues Originl Article Significnce of Expression of in Pulmonry Metstsis in Non-smll Cell Lung Cncer Tissues Hisshi Sji, Hruhiko Nkmur, Idiris Awut, Norihito Kwski, Msru Hgiwr, Akihiko Ogt, Mkoto Hosk, Tkmoto

More information

Asian Journal of Andrology (2017) 19,

Asian Journal of Andrology (2017) 19, (2017) 19, 20 25 2017 AJA, SIMM & SJTU. All rights reserved 1008-682X www.sindro.com; www.jndrology.com Prostte Cncer Open Access ORIGINAL ARTICLE Refining the Americn Urologicl Assocition nd Americn Society

More information

CME/SAM. Study on Hyperuricemia in HBV-Associated Glomerulonephritis

CME/SAM. Study on Hyperuricemia in HBV-Associated Glomerulonephritis AJCP / Originl Article Study on Hyperuricemi in HBV-Associted Glomerulonephritis Yongze Zhung, MD, PhD, 1 Yingho Yu, MD, PhD, 2 Yingfng Hung, MD, 3 nd Xiorong Zhong, MD 1 From the 1 Deprtment of Nephrology,

More information

Age related differences in prognosis and prognostic factors among patients with epithelial ovarian cancer

Age related differences in prognosis and prognostic factors among patients with epithelial ovarian cancer MOLECULAR AND CLINICAL ONCOLOGY 9: 329-334, 2018 Age relted differences in prognosis nd prognostic fctors mong ptients with epithelil ovrin cncer KENJI YOSHIKAWA, TAKESHI FUKUDA, RYO UEMURA, HIROAKI MATSUBARA,

More information

Adjuvant chemotherapy for colon carcinoma with positive lymph nodes: use and benefit in routine health care practice

Adjuvant chemotherapy for colon carcinoma with positive lymph nodes: use and benefit in routine health care practice doi: 10.1054/ bjoc.2001.2035, vilble online t http://www.idelibrry.com on http://www.bjcncer.com Adjuvnt chemotherpy for colon crcinom with positive lymph nodes: use nd benefit in routine helth cre prctice

More information

A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital

A review of the patterns of docetaxel use for hormone-resistant prostate cancer at the Princess Margaret Hospital MEDICAL ONCOLOGY A review of the ptterns of docetxel use for hormone-resistnt prostte cncer t the Princess Mrgret Hospitl S.N. Chin MD,* L. Wng MSc, M. Moore MD,* nd S.S. Sridhr MD MSc* ABSTRACT Bckground

More information

Association between LAPTM4B gene polymorphism and susceptibility to and prognosis of diffuse large B cell lymphoma

Association between LAPTM4B gene polymorphism and susceptibility to and prognosis of diffuse large B cell lymphoma 264 Assocition between LAPTM4B gene polymorphism nd susceptibility to nd prognosis of diffuse lrge B cell lymphom HUIRONG DING 1*, XIAOJING CHENG 2*, NING DING 3*, ZHIHUA TIAN 1, JUN ZHU 3, CHUNLIAN ZHOU

More information

EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 89-94, 2013

EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 89-94, 2013 EXPERIMENTAL AND THERAPEUTIC MEDICINE 5: 89-94, 2013 Combined nlysis of serum γ-glutmyl trnsferse isoenzyme II, α-l-fucosidse nd α-fetoprotein detected using commercil kit in the dignosis of heptocellulr

More information

Factors affecting screening for hepatocellular carcinoma

Factors affecting screening for hepatocellular carcinoma 204 Al Hsni F, et l., 2014; 13 (2): 204-210 ORIGINAL ARTICLE Mrch-April, Vol. 13 No. 2, 2014: 204-210 Fctors ffecting screening for heptocellulr crcinom Frh Al Hsni,* Mrin Knoepfli, Armin Gemperli, Attil

More information

A retrospective, single center cohort study on 65 patients with primary retroperitoneal liposarcoma

A retrospective, single center cohort study on 65 patients with primary retroperitoneal liposarcoma ONCOLOGY LETTERS 15: 1799-1810, 2018 A retrospective, single center cohort study on 65 ptients with primry retroperitonel liposrcom YI XI WU 1, JUN YAN LIU 1*, JIA JIA LIU 1*, PENG YAN 1, BO TANG 1, YOU

More information

MOLECULAR AND CLINICAL ONCOLOGY 7: , 2017

MOLECULAR AND CLINICAL ONCOLOGY 7: , 2017 MOLECULAR AND CLINICAL ONCOLOGY 7: 787-797, 2017 Evlution of epiderml growth fctor receptor serum levels nd their ssocition with clinicopthologicl chrcteristics in ptients with colorectl cncer MEHMET KARABULUT

More information

Study on the association between PI3K/AKT/mTOR signaling pathway gene polymorphism and susceptibility to gastric

Study on the association between PI3K/AKT/mTOR signaling pathway gene polymorphism and susceptibility to gastric JBUON 2017; 22(6): 1488-1493 ISSN: 1107-0625, online ISSN: 2241-6293 www.jbuon.com E-mil: editoril_office@jbuon.com ORIGINAL ARTICLE Study on the ssocition between PI3K/AKT/mTOR signling pthwy gene polymorphism

More information

A cross-sectional and follow-up study of leukopenia in tuberculosis patients: prevalence, risk factors and impact of anti-tuberculosis

A cross-sectional and follow-up study of leukopenia in tuberculosis patients: prevalence, risk factors and impact of anti-tuberculosis Originl Article A cross-sectionl nd follow-up study of leukopeni in tuberculosis ptients: prevlence, risk fctors nd impct of nti-tuberculosis tretment Fei-Shen Lin 1 *, Mei-Ying Wu 2 *, Wen-Jun Tu 3, Hong-Qiu

More information

Opioid Use and Survival at the End of Life: A Survey of a Hospice Population

Opioid Use and Survival at the End of Life: A Survey of a Hospice Population 532 Journl of Pin nd Symptom Mngement Vol. 32 No. 6 December 2006 NHPCO Originl Article Opioid Use nd Survivl t the End of Life: A Survey of Hospice Popultion Russell K. Portenoy, MD, Un Sibircev, BA,

More information

Clinical Study Report Synopsis Drug Substance Naloxegol Study Code D3820C00018 Edition Number 1 Date 01 February 2013 EudraCT Number

Clinical Study Report Synopsis Drug Substance Naloxegol Study Code D3820C00018 Edition Number 1 Date 01 February 2013 EudraCT Number EudrCT Number 2012-001531-31 A Phse I, Rndomised, Open-lbel, 3-wy Cross-over Study in Helthy Volunteers to Demonstrte the Bioequivlence of the Nloxegol 25 mg Commercil nd Phse III Formultions nd to Assess

More information

Journal of Hainan Medical University.

Journal of Hainan Medical University. 132 Journl of Hinn Medicl University 2017; 23(11): 132-136 Journl of Hinn Medicl University http://www.hnykdxxb.com Assessment of the efficcy nd sfety of bronchil rtery perfusion chemotherpy combined with

More information

Analysis of Risk Factors for the Development of Incisional and Parastomal Hernias in Patients after Colorectal Surgery

Analysis of Risk Factors for the Development of Incisional and Parastomal Hernias in Patients after Colorectal Surgery Originl Article Journl of the Koren Society of J Koren Soc Coloproctol 2012;28(6):299-303 http://dx.doi.org/10.3393/jksc.2012.28.6.299 pissn 2093-7822 eissn 2093-7830 Anlysis of Risk Fctors for the Development

More information

Patient Survival After Surgical Treatment of Rectal Cancer

Patient Survival After Surgical Treatment of Rectal Cancer Originl Article Ptient Survivl After Surgicl Tretment of Rectl Cncer Impct of Surgeon nd Hospitl Chrcteristics Dvid A. Etzioni, MD, MSHS 1,2 ; Toni M. Young-Fdok, MD, MS 1 ; Robert R. Cim, MD, MA 2,3 ;

More information

Rheumatoid-susceptible alleles of HLA-DRB 1 are genetically recessive to non-susceptible alleles in the progression of bone destruction in the wrists

Rheumatoid-susceptible alleles of HLA-DRB 1 are genetically recessive to non-susceptible alleles in the progression of bone destruction in the wrists Annls of the Rheumtic Diseses 1994; 53: 587-592 587 Deprtment of Orthopedic Surgery, Knsi Medicl University, Otokoym Hospitl, Kyoto, Jpn Y Tod Y Mori Deprtment of Orthopedic Surgery, Knsi Medicl University,

More information

Completion pneumonectomy (CP) refers to the complete

Completion pneumonectomy (CP) refers to the complete ORIGINAL ARTICLE Completion Pneumonectomy in Ptients with Cncer Postopertive Survivl nd Mortlity Fctors Myeul Tbutin, MD, MSc,* Sébstien Courud, MD, MSc, Benoit Guibert, MD, Pierre Mulsnt, MD, Pierre-Jen

More information

Using proliferative markers and Oncotype DX in therapeutic decision-making for breast cancer: the B.C. experience

Using proliferative markers and Oncotype DX in therapeutic decision-making for breast cancer: the B.C. experience ORIGINAL ARTICLE Using prolifertive mrkers nd Oncotype DX in therpeutic decision-mking for brest cncer: the B.C. experience E. Bxter bsc,* L. Gondr btech pdc, C. Lohrisch md, S. Chi md, K. Gelmon md, M.

More information

Clinicopathological analysis and prognosis of extrahepatic bile duct cancer with a microscopic positive ductal margin

Clinicopathological analysis and prognosis of extrahepatic bile duct cancer with a microscopic positive ductal margin DOI:10.1111/hpb.12193 HPB ORIGINAL ARTICLE Clinicopthologicl nlysis nd prognosis of extrheptic bile duct cncer with microscopic positive ductl mrgin In Woong Hn 1 *, Jin-Young Jng 2 *, Kyoung Bun Lee 3,

More information

The Role of Intraoperative Radiation Therapy (IORT) in the Treatment of Locally Advanced Gynecologic Malignancies

The Role of Intraoperative Radiation Therapy (IORT) in the Treatment of Locally Advanced Gynecologic Malignancies The Role of Intropertive Rdition Therpy (IORT) in the Tretment of Loclly Advnced Gynecologic Mlignncies MARCELA G. DEL CARMEN, JAMES F. MCINTYRE, b ANNEKATHRYN GOODMAN Vincent Gynecologic Oncology Service,

More information

Synovial sarcoma. Evaluation of prognosis with emphasis on the study of DNA ploidy and proliferation (PCNA and Ki-67) markers

Synovial sarcoma. Evaluation of prognosis with emphasis on the study of DNA ploidy and proliferation (PCNA and Ki-67) markers Anlyticl Cellulr Pthology 16 (1998) 45 62 45 IOS Press Synovil srcom. Evlution of prognosis with emphsis on the study of DNA ploidy nd prolifertion (PCNA nd Ki-67) mrkers José M. Lopes,, Einr Hnnisdl b,

More information

Relation of Tumor Size, Lymph Node Status, and Survival in

Relation of Tumor Size, Lymph Node Status, and Survival in Reltion of Tumor Size, Lymph Node Sttus, nd Survivl in 24,74 Brest Cncer Cses CHRISTINE L. CARTER, PHD, MPH,* CAROL ALLEN, PHD,t AND DONALD E. HENSON, MD* Two of the most importnt prognostic indictors

More information

Correlation between CT features and liver function and p53 expression in hepatitis, cirrhosis and hepatocellular carcinoma

Correlation between CT features and liver function and p53 expression in hepatitis, cirrhosis and hepatocellular carcinoma ONCOLOGY LETTERS Correltion between CT fetures nd liver function nd p53 expression in heptitis, cirrhosis nd heptocellulr crcinom YAHUI HU, JING WU, SHA LI nd XIAOXIAO ZHAO Deprtment of Nucler Medicine,

More information

Oral UFT (uracil plus futrafur) for neoadjuvant chemotherapy of gastric cancer

Oral UFT (uracil plus futrafur) for neoadjuvant chemotherapy of gastric cancer 64 Gstric Cncer (1999) 2: 64 73 Y. Nio et l.: Neodjuvnt UFT for gstric cncer 1999 by Interntionl nd Jpnese Gstric Cncer Associtions Originl rticle Orl UFT (urcil plus futrfur) for neodjuvnt chemotherpy

More information

*Department of Radiology, Shinshu University School of Medicine **PET Center, Departments of ***Pathology and ****Radiology, Aizawa Hospital

*Department of Radiology, Shinshu University School of Medicine **PET Center, Departments of ***Pathology and ****Radiology, Aizawa Hospital ORIGINAL ARTICLE Annls of Nucler Medicine Vol. 20, No. 9, 597 604, 2006 Evlution of 2-deoxy-2-[ 18 F]fluoro-D-glucose positron emission tomogrphy in gstric crcinom: reltion to histologicl subtypes, depth

More information

High EGFR mrna expression is a prognostic factor for reduced survival in pancreatic cancer after gemcitabine-based adjuvant chemotherapy

High EGFR mrna expression is a prognostic factor for reduced survival in pancreatic cancer after gemcitabine-based adjuvant chemotherapy INTERNATIONAL JOURNAL OF ONCOLOGY 38: 629-641, 2011 High EGFR mrna expression is prognostic fctor for reduced survivl in pncretic cncer fter gemcitbine-bsed djuvnt chemotherpy Hyto Fujit 1, Kenoki Ohuchid

More information

A Case of Intraductal Papillary Mucinous Carcinoma in the Head of the Pancreas Associated With Absence of the Duct of Wirsung

A Case of Intraductal Papillary Mucinous Carcinoma in the Head of the Pancreas Associated With Absence of the Duct of Wirsung CASE REPORT A Cse of Intrductl Ppillry Mucinous Crcinom in the Hed of the Pncres Associted With Asence of the Duct of Wirsung Ismu Mkino, Tkhis Ymguchi, Mitsuyoshi Okzki, Tomohru Miyshit, Hidehiro Tjim,

More information

Community. Profile Yellowstone County. Public Health and Safety Division

Community. Profile Yellowstone County. Public Health and Safety Division Community Helth Profile 2015 Yellowstone County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Community. Profile Lewis & Clark County. Public Health and Safety Division

Community. Profile Lewis & Clark County. Public Health and Safety Division Community Helth Profile 2015 Lewis & Clrk County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Community. Profile Missoula County. Public Health and Safety Division

Community. Profile Missoula County. Public Health and Safety Division Community Helth Profile 2015 Missoul County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk

More information

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health

Body mass index, waist-to-hip ratio, and metabolic syndrome as predictors of middle-aged men's health Originl Article - Sexul Dysfunction/Infertility pissn 2005-6737 eissn 2005-6745 Body mss index, wist-to-hip rtio, nd metbolic syndrome s predictors of middle-ged men's helth Jung Hyun Prk *, In-Chng Cho

More information

Original Article. Breast Care 2016;11: DOI: /

Original Article. Breast Care 2016;11: DOI: / Originl Article Brest Cre 2016;11:323 327 DOI: 10.1159/000452079 Published online: October 24, 2016 Neodjuvnt Chemotherpy with Docetxel, Crbopltin nd Weekly Trstuzumb Is Active in HER2-Positive Erly Brest

More information

Community. Profile Big Horn County. Public Health and Safety Division

Community. Profile Big Horn County. Public Health and Safety Division Community Helth Profile 2015 Big Horn County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl

More information

Risk of Colorectal Cancer by Subsite in a Swedish Prostate Cancer Cohort

Risk of Colorectal Cancer by Subsite in a Swedish Prostate Cancer Cohort Specil Report Risk of Colorectl Cncer by Subsite in Swedish Prostte Cncer Cohort Yunxi Lu, MD, PhD, Rickrd Ljung, MD, PhD, Ann Mrtling, MD, PhD, nd Mts Lindbld, MD, PhD Bckground: The reltionship between

More information

Community. Profile Powell County. Public Health and Safety Division

Community. Profile Powell County. Public Health and Safety Division Community Helth Profile 2015 Powell County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12 Behviorl Risk

More information

The College of American Pathologists offers these

The College of American Pathologists offers these Protocol for the Exmintion of Specimens From Ptients With Neuroendocrine Tumors (Crcinoid Tumors) of the Colon nd Rectum Mry Ky Wshington, MD, PhD; Lur H. Tng, MD, PhD; Jordn Berlin, MD; Philip A. Brnton,

More information

Effects of modified FOLFOX-6 chemotherapy on cellular immune function in patients with gastric cancer

Effects of modified FOLFOX-6 chemotherapy on cellular immune function in patients with gastric cancer ONCOLOGY LETTERS 15: 8635-8640, 2018 Effects of modified FOLFOX-6 chemotherpy on cellulr immune function in ptients with gstric cncer LIANG WANG 1, DONGER ZHOU 1, HAITAO REN 2 nd YAN CHEN 3 Deprtments

More information

General Microscopic Changes

General Microscopic Changes Generl Microscopic Chnges 2 This chpter covers collection of microscopic chnges tht lck dignostic specificity ut occur in different specific diseses, s will ecome pprent in susequent chpters. Almost ll

More information

A genetic variant in ERCC2 is associated with gastric cancer prognosis in a Chinese population

A genetic variant in ERCC2 is associated with gastric cancer prognosis in a Chinese population Mutgenesis vol. 28 no. 4 pp. 441 446 Advnce Access puliction 16 My 2013 doi:10.1093/mutge/get023 A genetic vrint in ERCC2 is ssocited with gstric cncer prognosis in Chinese popultion Hiyn Chu 1,2,, Dongying

More information

Apoptosis and p53 status predict the efficacy of postoperative administration of UFT in non-small cell lung cancer

Apoptosis and p53 status predict the efficacy of postoperative administration of UFT in non-small cell lung cancer doi: 10.1054/ bjoc.2000.1579, vilble online t http://www.idelibrry.com on http://www.bjcncer.com Apoptosis nd p53 sttus predict the efficcy of postopertive dministrtion of UFT in non-smll cell lung cncer

More information

Inhaled Corticosteroid Is Associated With an Increased Risk of TB in Patients With COPD

Inhaled Corticosteroid Is Associated With an Increased Risk of TB in Patients With COPD CHEST Originl Reserch Inhled Corticosteroid Is Associted With n Incresed Risk of TB in Ptients With COPD Jung-Hyun Kim, MD ; Ji-Soo Prk, MD ; Kyung-Ho Kim, MD ; Hye-Cheol Jeong, MD ; Eun-Kyung Kim, MD

More information

Assessment of Depression in Multiple Sclerosis. Validity of Including Somatic Items on the Beck Depression Inventory II

Assessment of Depression in Multiple Sclerosis. Validity of Including Somatic Items on the Beck Depression Inventory II Assessment of Depression in Multiple Sclerosis Vlidity of Including Somtic Items on the Beck Depression Inventory II Peggy Crwford, PhD; Noh J. Webster, MA Signs nd symptoms of multiple sclerosis (MS)

More information

Natural History of Left Anterior Descending Coronary Artery Obstruction: Significance of Location of Stenoses in Medically Treated Patients

Natural History of Left Anterior Descending Coronary Artery Obstruction: Significance of Location of Stenoses in Medically Treated Patients Clin. Crdiol. 8, 415-422 (1985) 0 Clinicl Crdiology Publishing Co., Inc. Originl Contributions Nturl History of Left Anterior Descending Coronry Artery Obstruction: Significnce of Loction of Stenoses in

More information

Association of PTEN expression with liver function and inflammatory changes in patients with liver cancer after chemotherapy

Association of PTEN expression with liver function and inflammatory changes in patients with liver cancer after chemotherapy ONCOLOGY LETTERS Assocition of PTEN expression with liver function nd inflmmtory chnges in ptients with liver cncer fter chemotherpy JIXIANG ZHOU nd XIAOLI LI Deprtment of Heptobiliry Surgery, Xingy Hospitl,

More information

Introduction. These patients benefit less from conventional chemotherapy than patients identified as MMR proficient or microsatellite stable 3-5

Introduction. These patients benefit less from conventional chemotherapy than patients identified as MMR proficient or microsatellite stable 3-5 Nivolumb + Ipilimumb Combintion in Ptients With DNA Mismtch Repir-Deficient/Microstellite Instbility-High Metsttic Colorectl Cncer: First Report of the Full Cohort From CheckMte-142 Abstrct 553 André T,

More information

Anemia in pediatric hemodialysis patients: Results from the 2001 ESRD Clinical Performance Measures Project

Anemia in pediatric hemodialysis patients: Results from the 2001 ESRD Clinical Performance Measures Project Kidney Interntionl, Vol. 64 (2003), pp. 1120 1124 Anemi in peditric hemodilysis ptients: Results from the 2001 ESRD Clinicl Performnce Mesures Project DIANE L. FRANKENFIELD, ALICA M. NEU, BRADLEY A. WARADY,

More information

R Martino 1, P Romero 1, M Subirá 1, M Bellido 1, A Altés 1, A Sureda 1, S Brunet 1, I Badell 2, J Cubells 2 and J Sierra 1

R Martino 1, P Romero 1, M Subirá 1, M Bellido 1, A Altés 1, A Sureda 1, S Brunet 1, I Badell 2, J Cubells 2 and J Sierra 1 Bone Mrrow Trnsplnttion, (1999) 24, 283 287 1999 Stockton Press All rights reserved 0268 3369/99 $12.00 http://www.stockton-press.co.uk/bmt Comprison of the clssic Glucksberg criteri nd the IBMTR Severity

More information

Efficacy of Sonidegib in Patients With Metastatic BCC (mbcc)

Efficacy of Sonidegib in Patients With Metastatic BCC (mbcc) AAD 216 eposter 3368 Efficcy of Sonidegib in Ptients With Metsttic BCC (mbcc) Colin Morton, 1 Michel Migden, 2 Tingting Yi, 3 Mnish Mone, 3 Dlil Sellmi, 3 Reinhrd Dummer 4 1 Stirling Community Hospitl,

More information

Supplementary Online Content

Supplementary Online Content Supplementry Online Content Rieckmnn N, Kronish IM, Shpiro PA, Whng W, Dvidson KW. Serotonin reuptke inhibitor use, depression, nd long-term outcomes fter n cute coronry : prospective cohort study. JAMA

More information

Community. Profile Anaconda- Deer Lodge County. Public Health and Safety Division

Community. Profile Anaconda- Deer Lodge County. Public Health and Safety Division Community Helth Profile 2015 Ancond- Deer Lodge County Public Helth nd Sfety Division Tble of Contents Demogrphic Informtion 1 Communicble Disese 3 Chronic Disese 4 Mternl nd Child Helth 10 Mortlity 12

More information

MOLECULAR AND CLINICAL ONCOLOGY 5: , 2016

MOLECULAR AND CLINICAL ONCOLOGY 5: , 2016 MOLECULAR AND CLINICAL ONCOLOGY 5: 429-436, 2016 Improvement of survivl with postmstectomy rdiotherpy in ptients with 1-3 positive xillry lymph nodes: A systemtic review nd met-nlysis of the current literture

More information

Neuroendocrine Carcinoma with an Adenocarcinoma Component on the Ampulla of Vater Causing Acute Pancreatitis: A Case Report

Neuroendocrine Carcinoma with an Adenocarcinoma Component on the Ampulla of Vater Causing Acute Pancreatitis: A Case Report CASE REPORT Neuroendocrine Crcinom with n Adenocrcinom Component on the Ampull of Vter Cusing Acute Pncretitis: A Cse Report Reiko Ymd 1, Kenichiro Nishikw 2, Msshi Kishiwd 3, Hiroyuki Inoue 1, Tkshi Skuno

More information

Impact of left ventricular hypertrophy on survival in end-stage renal disease

Impact of left ventricular hypertrophy on survival in end-stage renal disease Kidney Interntionl, Vol. 36 (1989), pp. 286 290 Impct of left ventriculr hypertrophy on survivl in end-stge renl disese JONATHAN S. SILBERBERG, PAUL E. BARRE, SARAH S. PRICHARD, nd ALLAN D. SNIDERMAN Divisions

More information

WSU Tree Fruit Research and Extension Center, Wenatchee (509) ext. 265;

WSU Tree Fruit Research and Extension Center, Wenatchee (509) ext. 265; FINAL REPORT WTFRC Project # AH-1-5 WSU Project # 13C-355-3 Project title: PI: Orgniztion: Coopertors: of Sunburn in Apples with RAYNOX Lrry Schrder, Horticulturist WSU Tree Fruit Reserch nd Extension

More information

27 June Bmnly L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION

27 June Bmnly L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION 27 June 1964 Bmnly MEDICAL JOURNAL L. WALTER ET AL.: RESPONSE OF CERVICAL CANCERS TO IRRADIATION x 1,638.) FIG. 2.-Foci of sme tumour s in Fig. 1 contining vible tumour cells with scnty cytoplsm, reltively

More information

Breast-Conserving Surgery Under Local Anesthesia in Elderly Patients with Severe Cardiorespiratory Comorbidities: A Hospital-Based Case-Control Study

Breast-Conserving Surgery Under Local Anesthesia in Elderly Patients with Severe Cardiorespiratory Comorbidities: A Hospital-Based Case-Control Study Originl Article Brest Cre 2017;12:29 33 DOI: 10.1159/000455003 Published online: Februry 8, 2017 Brest-Conserving Surgery Under Locl in Elderly Ptients with Severe Crdiorespirtory Comorbidities: A Hospitl-Bsed

More information

Comparison of three simple methods for the

Comparison of three simple methods for the J. clin. Pth. (1967), 2, 5 Comprison of three simple methods for the ssessment of 'free' thyroid hormone T. M. D. GIMLETTE1 From the Rdio-Isotope Lbortory, St. Thoms's Hospitl, London SYNOPSIS A dilysis

More information

Invasive Pneumococcal Disease Quarterly Report. July September 2017

Invasive Pneumococcal Disease Quarterly Report. July September 2017 Invsive Pneumococcl Disese Qurterly Report July September 2017 Prepred s prt of Ministry of Helth contrct for scientific services by Rebekh Roos Helen Heffernn October 2017 Acknowledgements This report

More information

Lung cancer is the leading cause of cancer-related deaths in

Lung cancer is the leading cause of cancer-related deaths in ORIGINAL ARTICLE Resection Rte nd Outcome of Pulmonry Resections for Non Smll-Cell Lung Cncer A Ntionwide Study From Icelnd Hunbogi Thorsteinsson, MD,* Asgeir Alexndersson, MD,* Gudrun N. Oskrsdottir,

More information

The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study

The burden of cirrhosis and impact of universal coverage public health care system in Thailand: Nationwide study 862 Poovorwn K, et l., 2015; 14 (6): 862-868 ORIGINAL ARTICLE November-December, Vol. 14 No. 6, 2015: 862-868 The burden of cirrhosis nd impct of universl coverge public helth cre system in Thilnd: Ntionwide

More information

Overexpression of FOXM1 Is a Potential Prognostic Marker in Male Breast Cancer

Overexpression of FOXM1 Is a Potential Prognostic Marker in Male Breast Cancer Originl Article Oncol Res Tret 2017;40:167 172 DOI: 10.1159/000458156 Received: September 13, 2016 Accepted: Jnury 26, 2017 Published online: Mrch 15, 2017 Overexpression of FOXM1 Is Potentil Prognostic

More information

Osteosarcoma in patients below 25 years of age: An observational study of incidence, metastasis, treatment and outcomes

Osteosarcoma in patients below 25 years of age: An observational study of incidence, metastasis, treatment and outcomes ONCOLOGY LETTERS Osteosrcom in ptients below 25 yers of ge: An observtionl study of incidence, metstsis, tretment nd outcomes ZHIGANG NIE nd HAO PENG Deprtment of Orthopedics, Renmin Hospitl of Wuhn University,

More information

Abstract. Background. Aim. Patients and Methods. Patients. Study Design

Abstract. Background. Aim. Patients and Methods. Patients. Study Design Impct of the Use of Drugs nd Substitution Tretments on the Antivirl Tretment of Chronic Heptitis C: Anlysis of Complince, Virologicl Response nd Qulity of Life (CHEOBS). Melin, 1 J.-. Lng, D. Ouzn, 3 M.

More information

Relationship between bronchial anthracofibrosis and endobronchial tuberculosis

Relationship between bronchial anthracofibrosis and endobronchial tuberculosis ORIGINAL ARTICLE Koren J Intern Med 2013;28:330-338 Reltionship between bronchil nthrcofibrosis nd endobronchil tuberculosis Hyun Ji Kim, Sng Dong Kim, Dong Woo Shin, Soo Hyun Be, Ah Lim Kim, Ji N Kim,

More information

Impact of Pharmacist Intervention on Diabetes Patients in an Ambulatory Setting

Impact of Pharmacist Intervention on Diabetes Patients in an Ambulatory Setting Impct of Phrmcist Intervention on Dibetes Ptients in n Ambultory Setting Julie Stding, PhrmD, CDE, Jmie Herrmnn, PhrmD, Ryn Wlters, MS, Chris Destche, PhrmD, nd Aln Chock, PhrmD Dibetes is the seventh-leding

More information

Fertility in Norwegian testicular cancer patients

Fertility in Norwegian testicular cancer patients DOI: 0.054/ bjoc.999.0989, vilble online t http://www.idelibrry.com on Fertility in Norwegin testiculr cncer ptients SD Fosså nd Ø Krvdl 2 The Norwegin Rdium Hospitl, Montebello, N-030 Oslo, Norwy; 2 The

More information

RESEARCH ARTICLE. Wen Li 1, Jing Deng 2 *, Shuang-Shuang Wang 1, Liang Ma 1, Jiang Pei 1, Xiao-Xi Zeng 1, Jian-Xin Tang 1. Abstract.

RESEARCH ARTICLE. Wen Li 1, Jing Deng 2 *, Shuang-Shuang Wang 1, Liang Ma 1, Jiang Pei 1, Xiao-Xi Zeng 1, Jian-Xin Tang 1. Abstract. DOI:http://dx.doi.org/10.7314/APJCP.2014.15.24.10937 Methyltion of the RAR-β Gene nd Cigrette Smoking in NSCLC in Southern-Centrl Chinese RESEARCH ARTICLE Assocition of Methyltion of the RAR-β Gene with

More information