Adenocarcinoma In Women Research Articles

S2861 Serum β-hCG as a Prognostic Marker for Colorectal Adenocarcinoma in Women of Reproductive Age: A Case Report and Literature Review

S2861 Serum β-hCG as a Prognostic Marker for Colorectal Adenocarcinoma in Women of Reproductive Age: A Case Report and Literature Review

Late Cervical And Vaginal Clear Cell Adenocarcinoma In Women Exposed In Utero To Diethylstilbestrol: Evaluation And Screening.

We aimed to evaluate the risk of cervical and vaginal clear cell adenocarcinoma (CCA) in women, aged 50 years or more, exposed in utero to diethylstilbestrol (DES) and contribute to a reevaluation of the recommendations for cervical and vaginal cancer and pre-cancer screening for these women. We carried out a retrospective review for patients received in a cancer institute. Two cohorts were consecutively studied, the first from 1970 to 2003 and the second from 2004 to 2021, and then linked. During the first period, we observed 61 CCA cases, with a mean age at diagnosis of 23 years (7-42), 36 (59%) following DES exposure in utero. During the second period, we found 27 cases, with one case of DES exposure (4%) for a women diagnosed at the age of 40 years. The mean age of the second cohort was 38 years (14-79). For the seven women aged 50 years or more at the time of CCA diagnosis, DES exposure was excluded for five and considered unlikely for the other two. In total, 88 cases of cervical or vaginal CCA were observed over a period of 51 years in a cancer center. The 37 cases associated with DES exposure represented approximatively one third of the CCA related to DES expected in France. DES exposure was improbable for the seven cases of CCA for women aged 50 years or more. These results do not support the hypothesis of late cervical or vaginal CCA in women exposed to DES in utero and indicate the need for larger multicentric studies. For the present, we propose specific screening for women exposed to DES in utero in terms of : 1) methods: association of cytology and hrHPV testing, with cervical and vaginal sampling, 2) timing : annual, or without exceeding a three-year interval, continuing after 65 years of age and after hysterectomy.

Outcomes of organ-preserving treatment of atypical hyperplasia and early stage endometrial cancer in reproductive age: A prospective and retrospective study

Aim. To evaluate the effectiveness of the intrauterine levonorgestrel-releasing device (LNG-IUD) in the treatment of atypical hyperplasia and the use of LNG-IUD in combination with a gonadotropin-releasing hormone analog (3.6 mg goserelin depot) in the treatment of stage Ia highly differentiated endometrial adenocarcinoma in women wishing to preserve childbearing function, and to assess reproductive outcomes after treatment in these women.
 Materials and methods. A prospective and retrospective series of cases included all patients treated with LNG-IUD or LNG-IUD combined with goserelin 3.2 for atypical hyperplasia or early endometrial cancer (EC) treated in the Department of Innovative Oncology and Gynecology of the Institute of Oncogynecology and Mammology of the Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology from January 2018 to March 2022. Response rates and the relationship of the response with clinical and pathological factors were calculated.
 Results. Fifty-six patients diagnosed with atypical hyperplasia or stage Ia highly differentiated endometrial adenocarcinoma were treated with LNG-IUD and LNG-IUD combined with 3.2 mg of goserelin. Of the 56 patients who completed a 6-month course of hormonal treatment, 42 (82%) showed a complete response: 22 (91.7%) with atypical endometrial hyperplasia (AEH) and 20 (74.1%) with EC. In 4 (7.8%) patients, a partial response was reported: 2 (8.3%) with AEH and 2 (7.4%) with EC. No response was noted in 5 (9.8%) patients in the EC group only. Childbirth was reported in 13 (23.2%) women: 8 (29.6%) with AEH and 5 (17.2%) with EC. Two (3.6%) women were in the second trimester of pregnancy, and 17 (30.4%) women had an early pregnancy loss; 7 (25.9%) of them had AEH, and 10 (34.5%) had EC. The positive response rate was 90.2% at 6 months: 24 (100%) patients with atypical hyperplasia and 22 (81.5%) with EC. Patients with EC in combination with polycystic ovary syndrome and obesity and patients with the non-obese EC phenotype had a lower therapy efficacy.
 Conclusion. LNG-IUD therapy for the conservative treatment of atypical hyperplasia and LNG-IUD therapy combined with goserelin 3.2 for early EC led to a morphological cure in most patients and can be considered for women planning pregnancy.

Gaps in the screening process for women diagnosed with cervical cancer in four diverse US health care settings.

Potential care gaps in the cervical cancer screening process among women diagnosed with cervical cancer in an era with increased human papillomavirus (HPV) testing have not been extensively evaluated. Women diagnosed with cervical cancer between ages 21 and 65 at four study sites between 2010 and 2014 were included. Screening histories were ascertained from 0.5 to 4 years prior to cervical cancer diagnosis. We identified potential care gaps in the screening history for each woman and classified them into one of three mutually exclusive types: lack of a screening test, screening test failure, and diagnostic/treatment care gap. Distributions of care gaps were tabulated by stage, histology, and study site. Multivariable nominal logistic regression was used to examine the associations between demographic and cancer characteristics and type of care gap. Of 499 women evaluated, 46% lacked a screening test in the time window examined, 31% experienced a screening test failure, and 22% experienced a diagnostic/treatment care gap. More than half of the women with advanced cancer and squamous cell carcinoma lacked a screening test compared to 31% and 24% of women with localized cancer and adenocarcinoma, respectively. Women aged 21-29 at diagnosis were more likely to experience screening test failure and diagnostic/treatment care gap, while those aged 50-65 were more likely to lack a screening test, compared to women aged 30-39. Our findings demonstrate a continuing need to develop interventions targeting unscreened and under-screened women and improve detection and diagnosis of adenocarcinoma in women undergoing cervical cancer screening and diagnostic follow-up.

PM2.5 exposure and risk of lung adenocarcinoma in women of Taiwan: A case-control study with density sampling.

The prevalence of smoking among women in Taiwan is <5%, but the incidence of lung cancer remains high. This study determined the association between PM2.5 (fine particulate matter with an aerodynamic diameter of ≤2.5μm) exposure and lung cancer among women in Taiwan. In total, 21,301 female lung cancer cases nationwide were newly diagnosed between 2012 and 2017. Each case was age-, sex- and calendar year-matched with four controls randomly selected from the general population. Allowing a latent period of 5 years, we estimated the PM2.5 and nitrogen dioxide (NO2 ) exposures for each individual according to the residential changes from 2000. We adopted self-reported smoking statuses for the cases, while those of controls were estimated using annual surveys in each residential county. We performed multiple logistic regression analyses to examine the associations between PM2.5 and NO2 exposures and incident lung cancer cases. The ORs of lung adenocarcinoma for the third (30.5-35.1μg/m3 ), fourth (35.1-39.3μg/m3 ) and fifth PM2.5 exposure quintiles (39.3-48.1μg/m3 ) relative to the first quintile were 1.10 (95% CI: 1.04-1.16), 1.12 (95% CI: 1.06-1.19) and 1.10 (95% CI: 1.04-1.16), respectively, after adjusting for smoking, residence and comorbidities. A dose-response relationship (p=0.004) was found. The associations persisted with a 10-year latency and were not detected for small-cell and squamous cell carcinoma after control for smoking. We did not observe a similar effect for NO2 exposure. Residential PM2.5 exposure higher than 30 μg/m3 was associated with an increased risk of lung adenocarcinoma in women of Taiwan.

Potential surrogates for performance status and survival in metastatic non-small cell lung cancer (NSCLC).

170 Background: Performance status (PS), a physician-based, subjective assessment of a patient’s symptoms and ambulatory state, is an eligibility criterion for most clinical trials and a key clinical decision tool for treatment of NSCLC. Methods: Patients with metastatic NSCLC were asked to participate in a prospective, observational study of potential prognostic factors that includes demographics, laboratory, patient reported outcomes (PROs) by the patient reported outcomes measurement information system (PROMIS), PS reported by patient, PS assessed by physician, FitBit tracker (includes steps, distance, heart rate (HR), calories, METs), physical challenge and proteomics (Veristratâ). Correlation and regression analyses were performed for the initial 55 patients enrolled prior to COVID restrictions. Tracker data was collected and averaged over the first 7 days with wear &gt; 500 minutes/day. Other data were collected at baseline. Results: We enrolled 55 patients with metastatic NSCLC. There were 35 females and 20 males with a median age of 67 years. A majority of patients were never (38%, n = 21) or former smokers (40%, n = 22); adenocarcinoma (83%, n = 83%) was the most common histology. 30% (n = 17) patients were 2nd or greater line of therapy. 52 were included for survival analysis and 21 expired with median survival 226 days (149, NA). There were minimal gender related differences in the study population except a higher incidence of adenocarcinoma in women (94% vs 65%, p = 0.012 and longer FiTBit assessed daily “very active minutes” (defined as METs &gt; = 6) in men compared to women (4.21 vs 0.43, p = 0.036). Patient- and physician assessed PS were not statistically different, although patients tended underestimated their PS relative to physicians. Physician assessed PS, patient assessed PS, two-minute walk distance, proteomics by Veristratâ, total daily steps, total daily distance covered, and heart rate/activity mismatch were independent predictors of survival. Age, gender, smoking, BMI, histology, and various CBC-based indices were not prognostic. Conclusions: Patient- and physician-assessment of PS do not always match, many alternate measures to PS are prognostic of survival and tracker-based methods are objective and feasible in clinical practice.

Improvement in lung cancer survival: Six-year survival analysis of patients diagnosed between 2011 and 2016 in Hungary.

e21582 Background: Lung cancer is one of the most common cancers worldwide, however, 5-year survival is poor, only 10-20% of pataients survive this period. To date, no long-term study has been conducted to evaluate long-term survival rates in Hungary. Therefore, the objective of our study was to assess the 6-year survival of lung cancer patients (ICD-10 C34) based on a nationwide review of the National Health Insurance Fund (NHIF) database. Methods: Our retrospective, longitudinal study included patients aged ≥20 years who were diagnosed with lung cancer (ICD-10 C34) between 1 January 2011 and 31 December 2016. Screening period was set for 2009-2010. Patients with other cancer-related ICD-10 codes 6 months before or 12 months after lung cancer diagnosis and those who received any anticancer treatment different from lung cancer protocols were excluded. Survival rates were evaluated according to year of diagnosis, patient gender and age, and morphology of lung cancer and main treatment type. Results: 41,854 newly diagnosed lung cancer patients were recorded. Mean age at diagnosis varied between 64.66 and 65.88 years during study period. One- and 5-year crude survival rates for the total population were 42.23% and 17.85%, respectively. Survival was significantly associated with gender, age and type of lung cancer based on statistical association. Female patients (n = 16,362) had 23% better survival (HR: 0.77 CI95% 0.75-0.79; p &lt; 0.001) than males (n = 25,492). The highest survival rates were found in the 20–49 age cohort (5Y = 31.3%) and if the cancer type was adenocarcinoma (5Y = 20.48%). We measured 5.3 % improvement in lung cancer survival between cases diagnosed in 2015-2016 vs. 2011-2012 (HR: 0.947 CI95% 0.92-0.97; p = 0.003). Survival of those lung cancer patients, whom had surgery in first line treatment without adjuvant therapy (3,120) reached 64.18%, those with adjuvant treatment (n = 2,675) 54.47% 5 year survival, while patients with chemotherapy (n = 11,780) had only 7.9% crude survival. Conclusions: Our study provided long-term LC survival data in Hungary for the first time. We found a 6% improvement in survival by the end of the study period in females and in the younger age groups. Survival rates were comparable to – and at the higher end of – rates registered in other East-Central European countries. Better survival rate of females could be attributed to a higher incidence rate of adenocarcinoma in women. Lung cancer patients diagnosed in early stage had 7-8 times better survival than those found in late stage.

Sex-biased ceRNA networks reveal that OSCAR can promote proliferation and migration of lung adenocarcinoma in women.

Lung adenocarcinoma (LUAD) is one of several malignant tumours with the highest incidence rates. Currently, there is an urgent need for effective diagnostic and therapeutic targets for LUAD in clinical practice. Numerous studies have shown that there may be differences in the development pattern of LUAD between male and female patients, leading to the need for differential treatment. At the same time, previous studies have shown that competitive endogenous (ce)RNA plays an important role in the development of LUAD, but there is no relevant research on whether there is a gender difference in the ceRNA network of LUAD. In this study, we constructed gender-independent, male-specific, and female-specific ceRNA networks using RNA sequencing results from TCGA database. Subsequently, through analysis of the core genes of the ceRNA network, we determined that the male and female ceRNA networks indeed display different features. In addition, we also found that the osteoclast-associated receptor (OSCAR) gene was a potential diagnostic target for detecting LUAD in females, and that increased expression of this gene promoted the proliferation and migration of A549 and H1975 LUAD cell lines; more specifically, A549 and H1975 are male and female LUAD cell lines, respectively. This suggests that the OSCAR gene has the potential to serve as target molecule for the diagnosis and treatment of female-specific LUADs.

Importance of serous intraepithelial ovarian tubal carcinomas in the occurrence of "high-grade" serous carcinomas and / or peritoneal serous carcinomas of unknown primary origin.

Studies of the recent decades on serous pelvic adenocarcinomas in women have set the goal of distinguishing between two diagnostic units: "low-grade" and "high-grade" carcinomas. The predecessor of the "low-grade" variant (type I) is considered to be a borderline serous tumor / atypical proliferative serous tumor (8442/1), which according to the International Classification of Diseases for Oncology ICD-O 2013 of the female reproductive system refers to non-specific, borderline tumors and tumors with unpredictable clinical behavior. The predecessors of the “high-grade” variant (type II) are serous tubular intraepithelial carcinomas (in situ) or “high-grade” serous invasive tubal carcinomas, since they have the TP53 mutation identical to “high-grade” ovarian carcinoma, an aberrant p53 protein expression, high proliferative activity, and significant genomic instability. In addition, according to the carcinogenesis of "high-grade" serous ovarian carcinoma with metastases to the peritoneum, it can also be interpreted as "pelvic high-grade serous carcinoma". A retrospective analysis of the histological, morphometric and immunohistochemical characteristics of the biopsy material of 31 women aged from 28 to 76 years (mean 57.32±11.54; median 57), divided into 3 groups, was carried out. Group 1: 14 observations of the tubal epithelium (8 tubes without pathological changes (subgroup 1a) and 6 with signs of intraepithelial neoplasia (subgroup 1b); group 2: 12 cases of serous adenocarcinoma of the ovary of the “high-grade” variant; group 3: 6 metastatic peritoneal serous carcinoma without a known primary site. Results. Group immunophenotypes showed uniformity in the expression of markers CK7 (+, +/-), CK20 (-), WT-1 (+), CA125 (+, +/-), with an affinity to distal uterine tube fragments. The expression of p53 in all groups with signs of carcinomas (compared with the control subgroup 1a without atypia) was divided into two options - negative samples and samples with overexpression, where no statistically significant difference was found (p&gt;0.05), which is possibly a single way of carcinogenesis. The morphometric study revealed a significant difference in the area of the nuclei between group 3 and the first three groups (1a, 1b, 2), which indicates the similarity of ovarian and tubal neoplasias and uterine tube epithelium. The number of intranuclear reactions with ER and PGR progressively decreased from group 1 to group 3, with an increase in cases with ER (+/-) / PGR (+/- or -) to 50% in group 3, which greatly complicated the diagnostic search for unknown carcinomas of primary localization. HER-2-new expression revealed a possible amplification (gradation 2 + / 3 +) only in group 2 at the level of 16.67% and in group 3 at the level of 33.33%.

Primary urethra adenocarcinoma in women: case report and review of the literature

The female urethra cancer is rare that accounts for less than 0.02% of all women´s cancers. The di-agnosis is often late and is made in more than 50% of cases at the metastatic stage. We report a case of primary urethra adenocarcinoma in a 35-year-old woman diagnosed at the localized stage. Seg-mental resection and meatoplasty had made. The patient had no adjuvant therapy. She was conti-nent without recurrence oncologic.

Krukenburg Tumour Presented as Multiple Abdominal Lumps - A Case Report

Krukenberg tumour is metastatic ovarian involvement of adenocarcinoma in women of reproductive age group. The primary site is commonly in stomach but less commonly from other parts of gastrointestinal tract and uncommonly from other organs. The route of metastasis of this tumour is still not proven though the raw ovarian surface and transperitoneal invitation of malignant cell is one of the postulations. As is the etiology so is the resection of either ovarian or gastric tumour failed to show any improvement of this condition. Ovarian resection can be done in the form of salphingo-oophorectomy with or without hysterectomy. Gastric resection is also done in the same or subsequent sitting according to stage and presentation. We report such an uncommon entity in a 33 year old lady presenting with lower abdominal lump.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 38-40

Prognostic Significance of Comparison of Clinical Indicators with Manifestations of Genetic Polymorphism of Glutathione-S-Transferases in Non-Small Cell Lung Cancer

The article presented the results of comparison of polymorphic variants of the genes GSTM1, GSTT1, GSTP1 and clinical manifestations of non-small cell lung carcinoma. The association of the genotype GSTT1 (del) with the risk of developing squamous cell lung cancer has been revealed (OR = 2.54 CI: 1.13 - 5.72, p = 0.035). Analysis of patient survival rate (n = 173) in groups of various histological types of lung cancer showed that in the group of squamous cell lung cancer (n = 91) in patients with genotype GSTT1 (del), the survival rate median was significantly higher—84 months (95% CI 12.4 - 155.7) than in patients with the genotype GSTT1 (+)—36 months (95% CI 25.2 - 46.8, p = 0.045). In contrast, in the adenocarcinoma group (n = 82), the survival rate median in patients with the genotype GSTT1 (del) was 19 months. (95% CI 6.2 - 33.5), and in patients with genotype GSTT1 (+)—67 months (95% CI 50.1 - 84.0), which is the basis for continuing this comparison in an additional group of testees, as the sampling did not achieve the reliability of p = 0.12. Hypothetically, these differences may be due to differences in the gender composition of squamous cell lung cancer and adenocarcinoma and the involvement of GST enzymes in the metabolism of estrogens in adenocarcinoma in women and other hormonal background and reactivity of the male body with squamous cell carcinoma. Further research and subsequent analysis of the results will be aimed at confirming this hypothesis.

The Evolving Landscape of Invasive Cervical Cancer: A 40-Year Population Based Analysis of Age-Specific and Histology-Specific Incidence and Survival Trends

Patterns of incidence, stage at presentation, and overall survival by age and histologic subtype were explored using population-based registry data to help guide and inform future research and screening recommendations for women with cervical cancer. Data from 18 cancer registries participating in the U.S. Surveillance, Epidemiology, and End Results (SEER) program were used to compute age-adjusted incidence rates of invasive adenocarcinoma (ACA), squamous cell carcinoma (SCC) and adenosquamous cell carcinoma (ASC) between the year 1973 and 2013. Further information on age at diagnosis and stage at presentation were also extracted. Age-specific incidence rates, overall survival, and stage at presentation were calculated for each SCC, ACA, and ASC using the following age groupings: 20-34 years, 35-49 years, 50-64 years, and 65 years and older. In women less than 50 years of age, the age-specific incidence rates of ACA have increased, whereas the age-specific incidence rates of ACA in women 50 years of age and greater have decreased or remained stable. The age-specific increase in ACA has been most dramatic in women between 35 and 49 years old from 1.8 per 100,000 to 3.0 per 100,000 from 1973 to 1979 and 2000 to 2013. This is in contrast to SCC for which the age-specific incidence rates have decreased across all age groups from 1973 to 2013 or ASC for which the age-specific incidence rates have remained stable from 1973 to 2013. In both ACA and SCC, increasing age has been associated with a more advanced stage at presentation. For ACA, the proportion of local compared to regionally advanced disease and metastatic disease at presentation has remained stable over the analyzed time period. By contrast, in more recent years, across all age groups compared, women with SCC have presented with more regionally advanced or metastatic disease. Previous studies have established that the overall incidence of invasive cervical cancer has decreased over the past 30 years. Our analysis has revealed that the decreased incidence of invasive cervical cancer is primarily among women age 50 and greater. In women less than 50 years of age, however, the incidence has remained largely the same. The decreased incidence of SCC in this age group has been offset by a rise in the incidence of ACA. Our findings present a potential paradigm shift in our approach to cervical cancer screening and evaluation. Further research investigating ACA of the cervix-specific etiologies and the potential role of additional and different screening and evaluation methodology is warranted.

THE ASSOCIATION OF THE APOLIPOPROTEIN E4 ALLELE (RS 429358) WITH OVARIAN SEROUS ADENOCARCINOMA

The distribution of APOE 4 allele (rs 429358, C) was analyzed in healthy women (N=454) and patients with ovarian serous adenocarcinoma (N=114) in order to identify genetic predisposition to the disease. We determined the prognostic indicators of the E4 allele as a marker: odds ratio (OR) and AUC (Area Under Curve) - an area under the ROC curve. It was shown that APOE 4 allele was significantly associated with ovarian serous adenocarcinoma (p = 0,003; 0R=1,94; AUC=0,55). The Е4 genotypes frequency was significantly increased among patients (p = 0.02; 0R=1,8). Separate analysis of the two age subgroups (over 46 years and younger) found that the chance of developing ovarian serous adenocarcinoma was significantly increased for older women (p = 0,006; OR = 2,24, AUC = 0,76). Possible associations of APOE 4 with the ovarian serous adenocarcinoma in women of reproductive age deserve further studying.

Incidence trends in oesophageal cancer by histological type: An updated analysis in Sweden

BackgroundWe aimed to update incidence trends of oesophageal cancer by histological type in Sweden. MethodsUsing data from the Swedish Cancer Registry, we examined incidence trends of oesophageal cancer by histological types in individuals aged ≥50 years in 1970–2014 using log-linear joinpoint regressions. ResultsThe age-standardised incidence rate of oesophageal adenocarcinoma in men increased on average by 3.0% per year in 1970–1994, followed by a more rapid increase of 13.7% per year in 1994–2000, and a slower increase of 2.6% per year in 2010–2014. The rate of oesophageal adenocarcinoma in women increased on average by 4.2% per year during the entire period. The rate of squamous cell carcinoma generally decreased over the past 2–3 decades in both sexes. ConclusionsThe incidence of oesophageal adenocarcinoma continues to rise in Sweden, although the increase seems to have slowed down in men since 2000. The incidence of oesophageal squamous cell carcinoma is decreasing.

P1.01-053 Lung Cancer in Brazil: Men and Women Differences

The objective of this study was to describe the trends of histology and age of patients with non-small cell lung cancer (NSCLC) treated with lung resection according to gender. The histology of lung cancer is changing in developed countries and there is still little information available for developing countries. Retrospective analysis of all patients (N=1030) with resected NSCLC between 1986 and 2015 in a university hospital of Southern Brazil. Differences in histology, stage and type of surgery were analyzed by sex and period (1986-1995, 1996-2005 and 2006-2015). Most patients were males (64.5%), main histologic types were adenocarcinoma (44.5%) and squamous cell carcinoma (40.6%). Mean age at surgery was 56.5 years for women and 58.9 years for men in first period, and 62.2 for women and 64.6 for men in the last period (p<0.001), suggesting that it was approximately 2.4 years higher for men (p<0.001), in spite of the period. The proportion of histologic types were different by gender (p<0.001), showing that overall squamous cells carcinoma was more frequent in men (46.9%) than in women (29%), and the opposite occurred for adenocarcinoma (40.4% versus 51.8% for men and women, respectively). Analyses by period showed squamous cells carcinoma declined from around 38.9% in the first period to 23.2% in 2005-2015 for men, virtually equaling the proportion of adenocarcinoma in the last period. The proportion of adenocarcinoma in women increased from 11.9% in the first period to 24% in the last. Considering all NSCLC patients, females with adenocarcinoma represented 11.9% in the first and 24% in the last period. As seen in developed countries, rates of lung cancer in females are rising over the last three decades, but have not surpassed men rates yet. Adenocarcinoma is consistently the most frequent histological type in women. In men squamous cell rate has decreased.

Outcomes and Prognostic Factors of Primary Urethral Cancer

To identify prognostic and treatment factors for primary urethral cancer using a nationwide database. The National Cancer Database was queried for all cases of primary urethral cancer from 2004 to 2013. Patients with other cancer diagnoses, metastasis, or diagnosis on autopsy were excluded. Proportional hazards regression was used to identify independent predictors of overall survival in patients with primary urethral cancer. Because we hypothesized that predictors may covary by sex, we also performed regression analysis stratified by sex. We identified 1268 men and 869 women with primary urethral cancer. Women tended to have more advanced tumors and adenocarcinoma histology. Median survival for the entire cohort was 49 months (43-55), with 5- and 10-year survival rates of 46% and 31%, respectively. On multivariate analysis, age, race, stage, grade, and Charlson comorbidity index were independent predictors of overall survival. Histology was not a predictor of overall survival in the combined model; however, adenocarcinoma in women increased hazards of death, whereas it decreased hazards of death in men when compared with squamous cell carcinoma. Men and women with primary urethral cancer had significant differences in histology, grade, and nodal status. In addition to several expected disease-related factors, black race was associated with increased mortality for patients with primary urethral cancer.

Prognostic factors for long term survival in patients with advanced non-small cell lung cancer.

Non-small cell lung cancer (NSCLC) represents 85% of all lung cancers. It is estimated that 60% of patients with NSCLC at time of diagnosis have advanced disease. The aim of this study was to investigate clinical and demographic prognostic factors of long term survival in patients with unresectable NSCLC. We retrospectively reviewed data of 1,156 patients with NSCLC stage IIIB or IV who survived more than 60 days from the time of diagnosis and treated from August 1987 until March 2013 in the Oncology Department of Pulmonary Clinic of the General Hospital Papanikolaou. Initially univariate analysis using the log-rank test was conducted and then multivariate analysis using the proportional hazards model of Cox. Also Kaplan Meier curves were used to describe the distribution of survival times of patients. The level of significance was set at 0.05. The mean age at diagnosis was 62 years. About 11.9% of patients were women and 88.1% were male. The majority of cases were adenocarcinomas (42.2%), followed squamous (33%) and finally the large cell (6%). Unlike men, most common histological type among women was adenocarcinoma rather than squamous (63% vs. 10.9%). In univariate analysis statistically significant factors in the progression free survival (PFS) and overall survival (OS) were: weight loss ≥5%, histological type, line 1 drugs, line 1 combination, line 1 cycles and radio lung. Specifically radio lung gives clear survival benefit in the PFS and OS in stage IIIB (P=0.002) and IV (P<0.001). On the other hand, the number of distant metastases in stage IV patients did not affect OS, neither PFS. In addition patients who received platinum and taxane had better PFS (P=0.001) and OS (P<0.001) than those who received platinum without taxane. Also the third drug administration proved futile, since survival (682.06±34.9) (P=0.023) and PFS (434.93±26.93) (P=0.012) of patients who received less than three drugs was significantly larger. Finally, large cell carcinoma recorded the shortest OS and PFS compared with adenocarcinoma (P=0.043 and P=0.016 respectively) and squamous cell carcinoma (P=0.021 and P=0.004 respectively). In multivariate analysis the same predictors were statistically significant except for line 1 drugs. This study confirms the increased incidence of adenocarcinoma in women than in men and the aggressiveness of large cell carcinoma. It also underlines the vitality of factors such as weight loss, radio lung and doublet platinum-based. On the other hand, it excludes significant factors such as gender, age and smoking.

Update on our investigation of malignant tumors associated with Peutz-Jeghers syndrome in Japan.

To investigate the recent incidence of malignant tumors associated with Peutz-Jeghers syndrome (PJS) in Japan to clarify if there are any differences in malignant tumor risk and the spectrum of malignancies by reviewing the literature on this subject. We reviewed PJS cases reported in 1115 papers in Japan between January, 1989 and December, 2014. Malignant tumors were identified in 186 of the total 583 PJS cases from 523 evaluable studies. The estimated cumulative risk of a malignant tumor was 83.0% at 70years of age. Compared with a previous study, on a collective 91 cases reported up until 1988 in Japan, the reported proportion of gastrointestinal malignancies decreased, from 82.4 to 48.3%, whereas that of gynecological malignancies increased, from 8.8 to 34.3% (P<0.01). Moreover, breast cancers were occasionally reported (4.8%), even though none were reported in the previous study. Adenocarcinoma of the uterine cervix was the most common malignant tumor (46.8%) among women with PJS. The increased number of reports of cervical adenocarcinoma in women with PJS is the prominent trend in Japan, and a subject of concern among gynecologists. The risk of breast cancer seems to be increasing, but confirmation of this trend will require further investigation.

Эндометриоидная аденокарцинома при беременности: клинический случай

Malignant tumors are encountered in pregnancy in cases of 0.07-0.1% of all pregnancies. Endometriod adenokratsinoma is an extremely rare disease in pregnancy. However there is the urgency of oncological vigilance against endometrial adenocarcinoma in women of reproductive age, including the background of pregnancy.