Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
Research in Oncology
2357-0687
2357-0695
16
1
2020
06
01
The Role of Radiological Parameters in Assessing Response to Neoadjuvant Therapy in Borderline Resectable Pancreatic Cancer
1
5
EN
Nervana
Hussien
Department of Clinical Oncology, Faculty of Medicine, Helwan University, Cairo, Egypt
hassannervana5455@yahoo.com
Kareem
Sallam
Department of Surgery, Faculty of Medicine, Helwan University, Cairo, Egypt
kareemsallam@yahoo.com
Mostafa
Abdel-Kawi
Department of Radiology, Faculty of Medicine, Helwan University, Cairo, Egypt
moustafa.abdelkawi@helwan.edu.eg
Mai
Ezz El Din
0000-0002-2109-606X
Department of Clinical Oncology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
maiooyaz@yahoo.com
10.21608/resoncol.2020.18938.1088
<strong>Background</strong>: Surgery in pancreatic cancer remains the curative option, consequently drawing attention to the importance of an indeterminate group of patients potentially curable by undergoing this procedure, Borderline Resectable Pancreatic Cancer (BRPC). Despite this seemingly positive outlook the outcome of these patients remains undefined.<br /> <strong>Aim</strong>: To assess the response of BRPC patients to neoadjuvant treatment and the accuracy of radiological constraints in their selection.<br /> <strong>Methods</strong>: Data extraction from a university hospital filing system from September 2015 to September 2018 was performed to select patients with BRPC. The National Comprehensive Cancer Network (NCCN) criteria to define BRPC were used. Clinical, surgical and radiological parameters were collected pre/ post-operative for all cases and correlated to outcome.<br /> <strong>Results</strong>: Sixty patients with BRPC were identified. The outcome of neoadjuvant treatment was partial response in 6 (10%) patients, stable disease in 49 (81.7%) and progressive disease in 5 (8.3%). The majority (78.3%) of patients underwent pancreatectomy. In patients who underwent resection a median overall survival of 31 months (95% CI: 29.180 - 32.820) was achieved vs. 17 months (95% CI: 15.625 - 18.375) in non-resected cases (p < 0.001). Response to neoadjuvant therapy was found to be favorable for overall survival (p = 0.014) and progression-free survival (p = 0.006). Response Evaluation Criteria in Solid Tumors (RECIST) criteria did not predict operative potential.<br /> <strong>Conclusion</strong>: RECIST criteria lacked predictive potentiality for surgical intervention after neoadjuvant chemotherapy in a cohort of BRPC patients. The significant positive outcome observed in BRPC patients who underwent surgery emphasizes that the decision for this procedure should not depend on the response to neoadjuvant treatment per se.
Borderline resectable pancreatic cancer,Neoadjuvant chemotherapy,Radiological assessment,RECIST criteria
https://resoncol.journals.ekb.eg/article_69647.html
https://resoncol.journals.ekb.eg/article_69647_ee0ad0c4f0824e1db7d589f83f7833dd.pdf
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
Research in Oncology
2357-0687
2357-0695
16
1
2020
06
01
Prognostic Value of CD56 Expression in Multiple Myeloma
6
10
EN
Salah
M.
Khallaf
0000-0002-5189-9525
Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
salahmab76@yahoo.com
Eman
A.
Yousof
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
d.emo24@yahoo.com
Eman
H.
Ahmed
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
ehasan888@gmail.com
Shymaa
G.
Mansor
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
shymaagafar@yahoo.com
Hanan
O.
Mohamed
Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
hannahomar@yahoo.com
Sahar
Elgammal
Clinical Pathology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
s.elgammal@aun.edu.eg
Sawsan
M.
Moeen
Internal Medicine Department, Clinical Hematology Unit, Faculty of Medicine, Assiut University, Assiut, Egypt
sawsan.moeen@yahoo.com
Doaa
M.
Sayed
Clinical Pathology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
doaa.sayed123@gmail.com
10.21608/resoncol.2020.24758.1091
<strong>Background:</strong> Understanding the prognostic markers of multiple myeloma (MM) helps in optimizing therapeutic approaches. CD56 is frequently expressed by malignant plasma cells and its use as a prognostic marker in MM is promising.<br /> <strong>Aim:</strong> To evaluate prognostic value of CD56 expression in patients with MM.<br /> <strong>Methods:</strong> This study included 50 newly diagnosed patients with MM. Bone marrow samples were analyzed for CD56 expression by flow cytometry. All patients received bortezomib-based therapy for at least 3-4 months.<br /> <strong>Results:</strong> The median age of patients was 52 years (range 32-75) and 54% of them were males. The stage according to the International Staging System was I in 15 (30%) patients, II in 18 (36%) and III in 17 (34%). CD56 positivity was detected in 84% of enrolled patients. Multivariate analysis revealed that the lack of CD56 expression was an independent predictor of worse overall survival (HR = 4.31 [95% Confidence Interval: 1.23 – 15.13], p = 0.002).<br /> <strong>Conclusion:</strong> The present study suggests that CD56 negativity is associated with poor prognosis in patients with MM and that its incorporation in the risk panel of MM may be considered. Further studies with larger sample size to validate its prognostic value are needed.
Multiple myeloma,Flow cytometry,CD56,prognosis
https://resoncol.journals.ekb.eg/article_79331.html
https://resoncol.journals.ekb.eg/article_79331_69ca01f154c3a1077f8194f5b2f09ef0.pdf
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
Research in Oncology
2357-0687
2357-0695
16
1
2020
06
01
The Impact of Obesity on Surgical Complications and Disease Recurrence in Endometrial Cancer: A Retrospective Study of 267 Patients
11
14
EN
Khaled
Gaballa
0000-0001-7103-4521
Department of Surgery, Oncology Center-Mansoura University, Mansoura, Egypt
khaledgaballah85@gmail.com
Mohamed
Abdelkhalek
Department of Surgery, Oncology Center-Mansoura University, Mansoura, Egypt
mskhalek1@hotmail.com
Basel
Refky
Department of Surgery, Oncology Center-Mansoura University, Mansoura, Egypt
dr.basel@hotmail.com
Basma
Gadelhak
Department of Radiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
basmagadelhak@hotmail.com
Engy
M.
Aboelnaga
0000-0002-5950-6650
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
engyms2007@gmail.com
Wafaa
El-Beshbishi
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
wafaanagah@mans.edu.eg
10.21608/resoncol.2020.23506.1089
<strong>Background</strong>: Obesity is a well-known risk factor for many health problems including endometrial cancer. In addition, it may act as an obstacle to achieving optimal treatment of endometrial cancer and may be associated with disease recurrence.<br /> <strong>Aim</strong>: To explore the impact of obesity on the operative procedure, recurrence of disease and survival in patients with endometrial cancer.<br /> <strong>Methods</strong>: A retrospective study of 267 patients with endometrial carcinoma who underwent surgery at the Oncology Center-Mansoura University from January 2011 to December 2017. Patients were divided according to their body mass index (BMI) into two groups, Group 1 with a BMI <strong>Results</strong>: Group 1 included 46 patients and Group 2 included 221. The mean operative time was longer in Group 2 without statistically significant difference. Twenty-two (47.8%) patients in Group 1 and 71 (32.1%) in Group 2 underwent lymphadenectomy (p = 0.062). The estimated blood loss was significantly higher in Group 2 (p < 0.05). No statistically significant difference was found between the two groups regarding the intra or post-operative complications, despite the high incidence of complications in Group 2. The median disease-free survival (DFS) was 74 months in Group 1 vs. 66 months in Group 2. Obesity did not have a statistically significant impact on DFS among the studied cases (p=0.24).<br /> <strong>Conclusion</strong>: In the current study, obesity did not significantly impact the operative procedure, surgical complications or DFS in patient with endometrial cancer.
Endometrial cancer,Obesity,Surgery,Complications,Disease recurrence,Survival
https://resoncol.journals.ekb.eg/article_80015.html
https://resoncol.journals.ekb.eg/article_80015_8191a2789c07a2edf0e78bd95389f538.pdf
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
Research in Oncology
2357-0687
2357-0695
16
1
2020
06
01
CyberKnife Boost in Pediatric Ependymoma of the Fourth Ventricle
15
21
EN
Amr
Mousa
0000-0002-7564-077X
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
amrgabermousa@yahoo.com
Yasser
Khafaga
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
ykhafaga@gmail.com
Mohamed
N.
Elbeltagi
Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
msnazmy@gmail.com
Abdullah
M.
Al Kafi
Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
mal-kafi@kfshrc.edu.sa
Amani
Al-Kofide
Department of Pediatric Hematology/ Oncology King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
kofide@kfshrc.edu.sa
Ahmed
Elashwah
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
aelashwah@kfshrc.edu.sa
10.21608/resoncol.2020.29443.1096
<strong>Background</strong>: Ependymoma of the fourth ventricle is a challenging disease. Brain stem tolerance dose usually hinders the delivery of adequate radiation dose to target volumes.<br /> <strong>Aim</strong>: To present the treatment outcome of pediatric ependymoma of the fourth ventricle using combined CyberKnife and volumetric modulated arc therapy (VMAT) and compare it to VMAT plans.<br /> <strong>Methods</strong>: The medical charts of 15 patients were retrospectively reviewed. All patients underwent surgery and received radiotherapy in 2 phases using combined plans of VMAT and CyberKnife boost aiming for a total prescription dose of 59.4 Gy in 33 fractions. These plans were compared to a cone-down two-phase VMAT plans. At least 95% of the target volume was required to be encompassed by the 95% isodose level of prescription dose.<br /> <strong>Results</strong>: It was not feasible to achieve adequate target coverage using VMAT without exceeding the brain stem tolerance doses in all but one case. Brain stem maximum point dose, V59 Gy, V55.8 Gy and mean doses were 60.46 ± 0.3 Gy, 1.62 ± 0.42 cc, 37.49 ± 5.78% and 54.79 ± 0.64 Gy in VMAT plans compared to 59.67 ± 0.21 Gy, 0.55 ± 0.22 cc, 25.49 ± 3.84% and 52.86 ± 0.88 Gy in combined technique plans (p = 0.002, 0.001, 0.001 and 0.001; respectively). The estimated 5-year progression-free and overall survival rates were 53.3% and 63.6%. Performance status and extent of surgery significantly influenced overall survival. None of the patients had serious toxicities.<br /> <strong>Conclusion</strong>: On the contrary to VMAT cone-down plans, it was possible to achieve adequate target coverage without violating brain stem constraints using the combination of VMAT and CyberKnife techniques in pediatric ependymoma of the fourth ventricle. The treatment protocol was well tolerated with no reported serious radiation toxicities.
CyberKnife,Ependymoma,Fourth ventricle,Pediatric,Volumetric modulated arc therapy
https://resoncol.journals.ekb.eg/article_94710.html
https://resoncol.journals.ekb.eg/article_94710_2eb1940e9d90191d37d986f07885da27.pdf
Cairo University, Faculty of Medicine, Kasr Al-Ainy Center of Clinical Oncology & Nuclear Medicine
Research in Oncology
2357-0687
2357-0695
16
1
2020
06
01
Prognostic Significance of Lymph Node Ratio after Cervical Lymph Node Dissection in Head and Neck Squamous Cell Carcinoma
22
30
EN
Wafaa
El-beshbeshi
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
wafaanagah@mans.edu.eg
Amir
M.
Zaid
Department of Surgical Oncology, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
ameirmsdzaid@gmail.com
Osama
Eldamshety
Department of Surgical Oncology, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
dr_osama_85@mans.edu.eg
Islam
H.
Metwally
Department of Surgical Oncology, Oncology Center, Faculty of Medicine, Mansoura University, Mansoura, Egypt
dr.islamo@hotmail.co
Entsar
Eladl
Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura, Egypt
entsaraladl@yahoo.com
Engy
M.
Aboelnaga
0000-0002-5950-6650
Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
engyms2007@gmail.com
10.21608/resoncol.2020.25204.1092
<strong>Background:</strong> Lymph node ratio (LNR) is the number of positive lymph nodes (LNs) divided by the total number of excised nodes. It has been shown to be of prognostic significance in a number of cancers.<br /> <strong>Aim</strong>: To investigate the relation between LNR and survival of patients with head and neck squamous cell carcinoma (HNSCC).<br /> <strong>Methods:</strong> A retrospective study of 115 patients with HNSCC treated with curative surgery including neck dissection ± adjuvant treatment from January 2013 to December 2017.<br /> <strong>Results: </strong>The median LNR among node-positive patients was 0.14 which was used as a cutoff point to divide patients into two risk groups. Male gender, N2 stage, high grade and extranodal extension were significantly associated with high (≥0.14) LNR. In multivariate analysis, high LNR, higher TNM nodal stage and larger absolute number of positive LNs associated significantly with worse overall and disease-free survival. In a subgroup analysis of node-positive cases (<em>n</em>=54), LNR associated significantly with disease-free survival but not overall survival. On the other hand, the absolute number of positive LNs and N stage had a significant effect on both overall and disease-free survival.<br /> <strong>Conclusion: </strong>The LNR is of prognostic significance for survival and disease failure in HNSCC. This is also true for the absolute number of positive LNs. Standardization of LN status assessment and determination of an agreed upon cutoff value for LNR are needed before considering its incorporation in the staging system and treatment strategy.
Head and Neck,Lymph node ratio,Lymph node stage,prognosis,Squamous cell carcinoma
https://resoncol.journals.ekb.eg/article_98945.html
https://resoncol.journals.ekb.eg/article_98945_4dd94acb6cc07b8ed5e56fd4c359cfd3.pdf