Comparison Of Clinicopathological Features Research Articles

Clinical and Genetic Characteristics of Early and Advanced Gastric Cancer.

Gastric cancer (GC) persists as the fourth most prevalent cause of global cancer-related mortality, presenting a challenge due to the scarcity of available therapeutic strategies. Precision medicine is crucial not only in the treatment but also in the management of GC. We performed gene panel sequencing with Oncomine focus assay comprising 52 cancer-associated genes and MSI analysis in 100 case-matched gastric cancer cases. A comprehensive analysis of clinical and genetic characteristics was conducted on these genetic results and clinicopathological findings. Upon comparison of clinicopathological characteristics, significant differences between early gastric cancer (EGC) and advanced gastric cancer (AGC) were observed in tumor location (p = 0.003), Lauren classification (p = 0.015), T stage (p = 0.000), and N stage (p = 0.015). The six most frequently mutated genes were PIK3CA (29%, 10/35), ERBB2 (17%, 6/35), KRAS (14%, 5/35), ALK (6%, 2/35), ESR1 (6%, 2/35), and FGFR3 (6%, 2/35). Regarding genetic variation, there was a tendency for the N stage to be higher in GC patients with mutated genes (p = 0.014). The frequency of mutations in GC patients was statistically significantly higher in AGC (n = 24) compared to EGC (n = 11) (odds ratio, 2.792; 95% confidence interval, 1.113 to 7.007; p = 0.026). Six of the ten GC patients carrying mutated genes and exhibiting MSI were classified into intestinal-type and undifferentiated GC, with the location of the tumor being in the lower-third. Among these patients, five harbored mutated PIK3CA, while the remaining patient had a mutation in ALK. Conclusions: AGC patients more frequently exhibited alterations of PIK3CA, KRAS, and ERBB2 as somatic oncogenic drivers, and displayed a higher prevalence of cumulative genetic events, including increased rates of PIK3CA mutations, enhanced detection of immunotherapy biomarkers, and mutations of the ESR1 gene.

Comparison of clinicopathological features and survival analysis between esophageal neuroendocrine carcinoma and esophageal squamous cell carcinoma based on the SEER database, alongside nomogram analysis for esophageal neuroendocrine carcinoma.

Esophageal neuroendocrine carcinoma (ENEC) is a rare subtype of esophageal cancer (EC). It presents distinctive clinical and pathological features in comparison to esophageal squamous cell carcinoma (ESCC). To better elucidate the disparities between the two and establish a prognostic prediction model for ENEC, we conducted this study. Data of ENEC and ESCC patients (1975 to 2016) were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Patients with a confirmed pathological diagnosis of ENEC and ESCC were enrolled in the study. The Chi-square test was employed to compare categorical variables, and the median survival time was analyzed using the Kaplan-Meier curve. Training and validation groups were randomly assigned at a ratio of 7:3. Factors with a significance level of <0.05 in the multifactor regression model as well as age were integrated into the nomogram model. Concordance index (C-index), calibration curves, and decision curve analyses (DCA) were generated for model validation. This study encompassed a total of 737 ENEC patients and 29,420 ESCC. Compared to ESCC, ENEC patients had higher probability of liver metastasis (13.8% vs. 1.9%, P<0.001), poor differentiation (68.0% vs. 37.1%, P<0.001), and late SEER stage (52.8% vs. 26.9%, P<0.001). Patients who received either surgery, radiotherapy (RT), or chemotherapy had a significantly longer disease-specific survival (DSS) and overall survival (OS) (all P<0.001). After propensity score matching (PSM), ENEC patients were associated with shorter DSS (7.0 months vs. not reached, P<0.0001) and OS (7.0 vs. 12.0 months, P<0.0001) compared to ESCC. Race, SEER stage, surgery, RT, and chemotherapy were identified as predictors of DSS and were incorporated into the nomogram model together with age. The validation of the model using C-index (0.751 and 0.706, respectively) and calibration curves reflected the better discrimination power of the model. In addition, DCA supported the favorable potential clinical effect of the predictive model. Lastly, a risk classification based on the nomogram also verified the reliability of the model. ENEC and ESCC exhibit distinct clinicopathological features. Patients with ENEC experience significantly poorer survival outcomes compared to those with ESCC. Surgical intervention, radiation therapy, and chemotherapy significantly improve OS and DSS for ENEC patients. The nomogram prediction model, constructed based on age, race, stage, and treatment regimen, demonstrates accurate and effective predictive capabilities for prognostic factors in ENEC patients.

Comparison of clinicopathological features between children and adults with differentiated thyroid carcinoma

Objective: To compare the clinicopathological features between children ( 18 years) and ≤ adults with differentiated thyroid carcinoma (DTC). Subject and method: A descriptive study on 50 children and 158 adults with DTC at the 108 Military Central Hospital from January 2015 to March 2022. We collected the clinicopathological features and evaluated the difference in these features between children and adult groups. Result: The rate of DTC in children was 0.65% of all DTC patients. In both groups, female patients accounted for the majority (66% and 84.2%, respectively). Papillary thyroid carcinoma (PTC) was the most common subtype (92% and 97.5%). The pediatric DTC patients had higher rates of large tumor size, extrathyroidal extension, vascular invasion, intrathyroidal spread, and lymph node metastasis (LNM). There was no difference between the two groups regarding bilaterality, multifocality, tumor necrosis, and chronic thyroiditis. Conclusion: DTC in the children group revealed more aggressive patterns than DTC in the adults group, with larger tumor size, higher rate of multifocality, extrathyroidal invasion, and LNM.

Comparison of Clinicopathological Features and Prognosis of Mucinous Gastric Carcinoma and other Gastric Cancers: A Retrospective Study of 4,417 Patients

BackgroundMucinous gastric carcinoma (MGC) is a distinct histologic subtype of gastric cancer (GC) that is often diagnosed at an advanced stage. The clinicopathological characteristics and prognosis of MGC, when compared to adenocarcinoma and signet-ring cell carcinoma (SRCC), are currently subjects of debate and require further investigation. MethodsIn this study, we conducted an investigation on 4,417 patients who were hospitalized with GC at Zhejiang Cancer Hospital between April 2008 and December 2019. The objective was to compare the prognosis and clinicopathological characteristics of MGC with other types of GC. ResultsIn comparison to adenocarcinoma, MGC patients exhibited more advanced tumor infiltration (p < 0.001), lower tumor differentiation (p < 0.001), and higher rates of preoperative tumor marker positivity (except for AFP and CA125) (all p < 0.05). However, after propensity score matching (PSM) to eliminate confounding factors, MGC patients surprisingly exhibited a better prognosis than adenocarcinoma patients (p = 0.008), and the results in multifactorial COX regression were similar (HR = 0.792, 95% CI 0.629–0.997, p = 0.047). Among patients with MGC, age, pN stage, as well as preoperative levels of CA125 and CA724 (all p < 0.05), emerged as independent prognostic markers. While overall survival did not significantly differ between MGC and SRCC (p = 0.196), significant survival disparities emerged in advanced-stage patients (p = 0.009), with MGC showing better survival rates. Furthermore, a nomogram was developed to predict 1-, 3-, and 5-year survival in gastric cancer patients based on various factors, achieving a C-index of 0.772 (95% CI: 0.745–0.799). ConclusionsWhile the poorer prognosis associated with MGC may be linked to its advanced stage and lower degree of differentiation, its biological behavior could contribute to improved survival.

Comparison of clinicopathologic characteristics among patients with HBV-positive, HCV-positive and Non-B Non-C hepatocellular carcinoma after hepatectomy: a systematic review and meta-analysis

BackgroundThe incidence of HBV-negative and HCV-negative hepatocellular carcinoma (NBNC-HCC) is significantly increasing. However, their clinicopathologic features and prognosis remain elucidated. Our study aimed to compare the clinicopathologic characteristics and survival outcomes of NBNC-HCC with hepatitis virus-related HCC.MethodA literature review was performed in several databases, including PubMed, Embase, Cochrane Library and Web of Science, to identify the studies comparing NBNC-HCC with HBV-positive HCV-negative HCC (B-HCC), HBV-negative HCV-positive (C-HCC) and/or HBV-positive HCV-positive HCC (BC-HCC). The clinicopathologic characteristics and survival outcomes were extracted and pooled to access the difference.ResultsThirty-two studies with 26,297 patients were included: 5390 patients in NBNC-HCC group, 9873 patients in B-HCC group, 10,848 patients in C-HCC group and 186 patients in BC-HCC group. Patients in NBNC-HCC group were more liable to be diagnosed at higher ages, but with better liver functions and lighter liver cirrhosis. Comparing to B-HCC and C-HCC groups, although NBNC-HCC group was prone to have larger tumor sizes, it did not have more advanced tumors. Meanwhile, there were no significant differences in both 5-year and 10-year disease-free survival and overall survival between NBNC-HCC group and B-HCC or C-HCC group.ConclusionsOur meta-analysis revealed patients with NBNC-HCC had as worse prognosis as those with hepatitis virus-related HCC. More attention should be paid on patients with non-alcoholic steatohepatitis or metabolic syndromes to prevent the incidence of NBNC-HCC.

Comparison of clinicopathological characteristics and survival outcomes between gallbladder mucinous adenocarcinoma and gallbladder adenocarcinoma: A propensity score-matched study.

Gallbladder mucinous adenocarcinoma (GBMAC) is a rare subtype of gallbladder adenocarcinoma (GBAC), with limited knowledge of its survival outcomes from small case series and single-center retrospective analysis. To compare the clinicopathological characteristics of GBMAC with typical GBAC and its prognostic factors to gain insights into this field. This study was conducted using data from the Surveillance, Epidemiology, and End Results database, including cases of GBMAC and typical GBAC diagnosed from 2010 to 2017. The Pearson chi-square test or Fisher exact test was used to examine the differences in clinicopathological features between these two cohorts. In addition, propensity score matching (PSM) analysis was performed to balance the selection biases. Univariate and multivariate Cox hazards regression analyses were performed to determine independent prognostic factors for cancer-specific survival (CSS) and overall survival (OS). The Kaplan-Meier curves and log-rank tests were used to assess the OS and CSS of GBMAC and typical GBAC patients. The clinicopathological and demographic characteristics of GBMAC were different from typical GBAC. They included a larger proportion of patients with unmarried status, advanced American Joint Committee on Cancer (AJCC) stage, higher T stage, higher N1 stage rate and lower N0 and N2 stage rates (P < 0.05). Multivariate analyses demonstrated that surgery [OS: Hazard ratio (HR) = 2.27, P = 0.0037; CSS: HR = 2.05, P = 0.0151], chemotherapy (OS: HR = 6.41, P < 0.001; CSS: HR = 5.24, P < 0.001) and advanced AJCC stage (OS: Stage IV: HR = 28.99, P = 0.0046; CSS: Stage III: HR = 12.31, P = 0.015; stage IV: HR = 32.69, P = 0.0015) were independent prognostic indicators for OS and CSS of GBMAC patients. Furthermore, after PSM analysis, there was no significant difference between GBMAC and matched typical GBAC patients regarding OS (P = 0.82) and CSS (P = 0.69). The biological behaviors of GBMAC are aggressive and significantly different from that of typical GBAC. However, they show similar survival prognoses. Surgery, chemotherapy, and lower AJCC stage were associated with better survival outcomes. Further research is needed in the future to verify these results.

Comparison of Clinico-pathologic features and outcomes of ANCA negative and ANCA positive pauci immune crescentic glomerulonephritis: A single centre study.

Pauci-immune crescentic glomerulonephritis (PICN) is an important cause of rapidly progressive renal failure. 10-40% of PICN cases have ANCA (antineutrophil cytoplasmic antibody) negative serology. The present study compared clinico-pathologic features, Brix's renal risk score, Berden's histopathological classes and differences in outcome between ANCAnegative vs ANCA positive PICN patients. Sixty-one patients of biopsy-proven PICN were studied. Biochemical findings and ANCA serology were recorded. Renal biopsy slides were reviewed along with direct immunofluorescence. Clinical and histological features were compared between ANCA negative and positive PICN using the Man Whitney U test and Chi-square test. Patients were compared for distribution in Berden's histological classes and Brix's renal risk categories. Patient and renal survival were compared using Kaplan-Meier survival analysis. ANCA negative PICN patients were younger (44.9 ± 16.5 years vs 53.6 ± 15.1 years, P = 0.049). Nasal (0 vs 18%, P = 0.035) and pulmonary involvement (9% vs 38%, P = 0.014) were lower in ANCA negative group. Both ANCA groups had similar renal biochemical profiles, percentage normal glomeruli, 16.3 ± 18.2 vs 21.7 ± 20.4 and percentage glomeruli with crescents, 64.5 ± 28.1 vs 64.3 ± 27.1. Twenty-seven per cent of ANCA negative cases fell in the sclerotic class in Berden's classification vs just 2.5% in ANCA positive group (p = 0.037) without significant difference in Brix's renal risk categories (p = 0.329). Thirteen per cent of ANCA negative patients achieved complete remission on treatment compared to 33% in ANCA positive patients. Patient survival and overall probability of progressing to ESRD were similar in the two groups. ANCA negative PICN cases present at younger ages. Nasal and pulmonary involvement is uncommon in these patients. Patient survival and progression to ESRD are similar in both ANCA groups.

Comparison of Clinicopathologic Features and Outcomes Between Synchronous and Metachronous Bilateral Breast Cancer

Purpose: Bilateral breast cancer (BBC) can be divided into two concurrent lesions, depending on the time of occurrence of primary cancer and secondary tumors after treatment of the primary cancer. This study aimed to compare the clinicopathological characteristics and results of synchronous BBC (SBBC) and metachronous BBC (MBBC).Methods: Data of patients diagnosed with breast cancer at Wonkwang university Hospital between October 1991 and October 2021 were retrospectively reviewed. Data of 3,259 patients who were diagnosed with malignant neoplasm of the right or left breast were reviewed. The tumor was defined as SBBC when another cancer was identified as BBC simultaneously or within six months after the primary breast cancer, and as MBBC when another cancer was identified after six months. Among patients with BBC, 31 had SBBC and 32 had MBBC.Results: In SBBC patients, the median age was 59.9 years, and the condition was diagnosed 3.3 years later compared with MBBC. The primary and secondary tumors of SBBC had lower disease stage, even when diagnosed late. Except for tumor, node, and metastasis stage, MBBC showed more invasive ductal carcinoma, while SBBC showed relatively more ductal carcinoma &lt;i&gt;in situ&lt;/i&gt; in both primary and secondary tumors compared with MBBC. In addition, SBBC showed lower hormone receptor positivity rates and Ki-67 levels compared with MBBC. MBBC patients showed a higher survival rate compared with SBBC patients. MBBC is associated with higher overall survival rate compared with SBBC, and its prognosis is not worse compared with that of unilateral breast cancer. In the case of secondary tumor that develops in the contralateral breast without evidence of metastasis, the survival rate is similar to that of unilateral breast cancer, while the treatment is similar to that of primary tumor.Conclusion: As those with SBBC have a worse survival, these patients will require more medical attention; meanwhile, MBBC requires an active treatment approach that is equivalent to that for unilateral breast cancer.

Comparison of clinicopathological characteristics and long-term survival between patients with gallbladder adenosquamous carcinoma and pure gallbladder adenocarcinoma after curative-intent surgery: a single-center experience in China and a meta-analysis.

The aim of the study was to evaluate the similarities and differences between gallbladder adenosquamous carcinoma (GBASC) and pure gallbladder adenocarcinoma (GBAC). Patients with GBASC and GBAC from 2010 to 2020 were analyzed in terms of clinicopathological features and long-term survival. Moreover, a meta-analysis was also performed for further validation. Our experience: A total of 304 patients with resected GBC were identified, including 34 patients with GBASC and 270 patients with GBAC. Patients with GBASC had a significantly higher preoperative CA199 level (P <0.0001), a significantly higher incidence of liver invasion (P <0.0001), a relatively larger tumor size (P = 0.060), and a significantly higher proportion of patients with T3-4 (P <0.0001) or III-IV disease (P = 0.003). A comparable R0 rate was obtained between two groups (P = 0.328). A significantly worse overall survival (OS) (P = 0.0002) or disease-free survival (DFS) (P = 0.0002) was observed in the GBASC. After propensity score matching, comparable OS (P = 0.9093) and DFS (P = 0.1494) were obtained. Clear margin (P = 0.001), node metastasis (P <0.0001), T stage (P <0.0001), and postoperative adjuvant chemoradiotherapy (P <0.0001) were independent prognostic factors for OS for the entire cohort. Adjuvant chemoradiotherapy had a survival benefit for patients with GBAC, while the survival benefit was still being validated in patients with GBASC. Meta-analysis: With our cohort incorporated, a total of seven studies involving 1,434 patients with GBASC/squamous carcinoma (SC) were identified. GBASC/SC shared a worse prognosis (P <0.00001) and more aggressive tumor biological features than GBAC. GBASC/SC shared more aggressive tumor biological features and a much worse prognosis than those with pure GBAC.

Comparison of clinicopathologic features, survival, and demographics in sebaceous carcinoma patients with and without Muir-Torre syndrome

Visceral malignancies in patients with Lynch syndrome behave less aggressively than in those without Lynch syndrome. The behavior of sebaceous carcinoma (SC) in Muir-Torre syndrome (MTS), a variant of Lynch syndrome, is incompletely investigated. To investigate features and survival of SC patients with and without MTS. Retrospective cohort study in the Surveillance, Epidemiology, and End Results 17 database from 2000 to 2019 of patients with SC. Patients were classified as MTS or non-MTS cases based on a threshold score of 2 on the Mayo MTS risk score. We identified 105 (2.8%) MTS cases and 3677 (97.2%) non-MTS cases. On univariate analysis, MTS patients were younger, had a higher proportion of tumors outside the head/neck, and had fewer high-grade tumors. On Kaplan-Meier analysis, MTS patients trended toward having better SC-specific survival. On multivariate Cox proportional hazards analysis adjusting for other covariates, MTS status was an independent predictor of worse overall survival. However, there was no association between MTS status and SC-specific survival. Given relatively high disease-specific survival in SC, our study may have been underpowered to detect a difference on Kaplan-Meier analysis. Our study suggests SC does not behave more aggressively in patients with MTS.

Comparison of clinicopathological characteristics and survival between symptomatic and asymptomatic anaplastic thyroid carcinoma

Although anaplastic thyroid carcinoma (ATC) is a fatal form of thyroid cancer with an overall survival of only a few months, there are some factors associated with longer survival. However, it remains unknown whether asymptomatic ATC differs from symptomatic ATC in terms of characteristics and overall prognosis. Therefore, we aimed to examine the clinicopathological characteristics and prognosis of asymptomatic ATC compared with those of symptomatic ATC. We retrospectively reviewed the medical records of 113 patients with ATC who were registered at our institution between November 1994 and July 2020. A total of 86 patients (59 women and 27 men; mean age, 66.9 ± 11.1 years) were enrolled for analysis. The clinicopathological characteristics of the ATC cohort were evaluated, and prognostic factors associated with disease-specific mortality were assessed. Of the 86 patients with ATC, 78 were symptomatic and eight were asymptomatic. Compared with the symptomatic group, the asymptomatic group had a younger age at diagnosis (59.3 ± 10.3 vs. 67.7 ± 11.0 years, p = 0.045), smaller tumor size (2.8 ± 1.2 vs. 5.8 ± 2.0 cm, p < 0.001), and longer survival period (37.5 ± 46.4, 9.5 ± 16.8 months, p < 0.001). However, the ATC component (%) of the tumor, sex, ultrasonographic risk category, and distant metastasis at diagnosis did not differ significantly between the two groups. In the multivariate Cox regression analysis, asymptomatic ATC (HR: 0.33, 95% CI 0.11–0.99, p = 0.045) and absence of distant metastasis (hazard ratio (HR): 0.56, 95% Confidence interval (CI) 0.35–0.88, p = 0.012) were associated with longer survival. Patients with asymptomatic ATC have a smaller tumor size, a longer survival period, and a younger age than those with symptomatic ATC. Being asymptomatic and having no distant metastasis were associated with longer survival in patients with ATC in a clinical setting.

Comparison of clinicopathological characteristics, gene expression profiles, mutational analysis, and clinical outcomes of pure and mixed small-cell carcinoma of thebladder.

Small cell bladder carcinoma (SCBC) is a rare, divergent form of urothelial carcinoma (UC). We aimed to determine whether pure (n=16) and mixed (SCBC and UC; n=30) tumours differed in pathology, gene expression characteristics, genetic alterations, and clinical outcomes. Forty (87%) patients received first-line chemotherapy. Twenty-nine patients had no metastatic disease at diagnosis and underwent radical cystectomy. There were no differences in age, sex, race distribution, tumour size, stage at presentation, therapy response with pathological downstaging to ≤ypT1N0, or overall or progression-free survival (PFS) between pure and mixed tumours. There was a longer PFS among downstaged chemotherapy-responding tumours ≤ypT2N0M0 than among unresponsive tumours ≥ypT2 ≥ yN1M1 (P=0.001). Patients who achieved pathological downstaging with neoadjuvant chemotherapy (n=10) were stage cT2N0M0 at the time of diagnosis and were alive at the last follow-up (median 37months), while 46% of patients who failed to achieve pathological downstaging were alive at the last follow-up (median 38months; P=0.008). RNA sequencing showed that the UC of mixed SCBC had similar neural expression signatures to pure SCBC. DNA sequencing revealed alterations in TERT (83%), P53 (56%), ARID1A (28%), RB1 (22%), and BRCA2 (11%). Immunohistochemistry for RB1 showed loss of expression in 18/19 (95%) patients, suggesting frequent pathway downregulation despite a low prevalence of RB1 mutation. Patients with pure and mixed SCBC have similar outcomes and these outcomes are determined by the pathological stage at RC and are best among patients who have pathological downstaging after NAC.

Comparison of clinicopathological characteristics and response to neoadjuvant systemic therapy in patients with HER2-low-positive and HER2-zero breast cancer.

Previous studies have observed that human epidermal growth factor receptor 2 (HER2)-low-positive patients and HER2-zero patients have different prognoses. This study was conducted to investigate whether there are differences in clinicopathological characteristics and the response to neoadjuvant systemic therapy (NST) defined as systemic treatment prior to surgery between HER2-low-positive patients and HER2-zero patients. We retrospectively analyzed the data of patients with HER2-negative breast cancer who received NST at the First Affiliated Hospital of Nanjing Medical University from 2014 to 2021. There were 238 patients with HER2-low-positive status and 198 patients with HER2-zero status. The proportion of hormone receptor (HR)-positive patients in the HER2-low-positive group was significantly higher than that in the HER2-zero group (82.8% vs 52.0%, p < 0.001). The HER2-low-positive group had more patients with low Ki67 expression (23.9% vs 16.2%, p = 0.045), higher mastectomy rate (94.5% vs 88.9%, p = 0.031), and larger pathological tumor size (21.6 vs 17.8 mm, p = 0.028) than the HER2-zero group. However, no significant differences were found in pathologic complete response (pCR) rates between the two groups. We draw a conclusion that patients with HER2-low status and HER2-zero status were not found to have different pCR rates after NST, irrespective of HR status. However, differences were observed in some clinicopathological characteristics between the two groups.

Comparison of clinicopathological characteristics, disease free survival and recurrence in triple negative breast cancer(TNBC) with Non-TNBC

Introduction: TNBC is associated with high mortality, morbidity and low survival rates. This study is aimed to study difference in pathological characteristics, disease free survival and recurrence between TNBC and Non-TNBC. Materials and Methods: Total 208 patients, who are diagnosed cases of breast carcinoma visiting our out patient department between August 2020 and July 2022 were enrolled. Demographic details, details during the presentation, pathological characterstics including the HPE, grade and receptor status, modality of treatment were taken. Enrolled patients were followed up. At the end of the study period, 2 year disease free survival, overall survival, recurrence of malignancy were noted. 102 patients who lost followup, status unknown or who has not completed a period of 2 years after diagnosis of Breast carcinoma were excluded. 106 patients were nalised, details were entered in excel sheet. Patients were divided into TNBC and Non-TNBC group and compared. Results: Prevalence of TNBC in our study was 22.6. Tumor size is more at presentation in TNBC compared to Non TNBC. All patients with TNBC had positive nodes during presentation (100%Vs78%). Presence of metastasis at the time of diagnosis is more in TNBC group(20.8%Vs 8.5%). Both groups has Intraductal Carcinoma as the predominant variant. Most of the TNBC had poorly differentiated grade tumors when compared to Non-TNBC. TNBC has more local(38.8% Vs 18.7%) and metastatic(22.22% Vs 4%) recurrences. 2 year Diseases free survival was more in Non-TNBC group(77.33% Vs 38.88%). Conclusions: TNBC has overall lesser disease survival period, more local and metastatic recurrences. Stage at diagnosis in TNBC is more advanced. Hence TNBC has got poor prognosis and high mortality. Early diagnosis and treatment is the key in reducing the mortality and better prognosis.

Comparison of clinicopathological characteristics and response to neoadjuvant chemotherapy between HER2-low and HER2-zero breast cancer

Novel anti-HER2 antibody-drug conjugates trastuzumab deruxtecan (DS-8201a) showed its effect in previously-treated HER2-low metastatic breast cancer, suggesting a promising future in HER2-low breast cancer. We retrospectively reviewed the clinicopathological data of 325 patients with stage I–III HER2 negative breast cancer who received neoadjuvant chemotherapy in the First Affiliated Hospital of Sun Yat-sen University from January 2016 to June 2021. In general, 91 patients (28.0%) were HER2-zero, and 234 patients (72.0%) were HER2-low. The pathological complete response (pCR) rate of the entire cohort was 17.3%. The pCR rate was 16.7% in HER2-low group, and 18.9% in HER2-zero group, showing no significant difference. Patients with HER2-low tumors had significantly longer overall survival (OS) than patients with HER2-zero tumors. ER status was the affecting factor of OS in HER2-low patients in both univariate and multivariate analysis. In conclusion, evidence for HER2-low BC as a distinct entity is insufficient, and more efforts are needed to standardize the scoring of HER2-low breast cancer.

Comparison of clinicopathological characteristics between resected ampullary carcinoma and carcinoma of the second portion of the duodenum.

Few studies compared the oncological and biological characteristics between ampullary carcinoma (AC) and cancer of the second portion of the duodenum (DC-II), although both tumors arise from anatomically close locations. To elucidate differences in clinicopathological characteristics, especially the patterns of lymph node metastasis (LNM), between AC and DC-II. This was a retrospective cohort study of 80 patients with AC and 27 patients with DC-II who underwent pancreaticoduodenectomy between January 1998 and December 2018 in two institutions. Clinicopathological factors, LNM patterns, and prognosis were compared between the two groups. The patients with AC and DC-II did not exhibit significant differences in 5-year overall survival (66.0% and 67.1%, respectively) and 5-year relapse-free survival (63.5% and 62.2%, respectively). Compared to the patients with DC-II, the rate of preoperative biliary drainage was higher (P = 0.042) and the rates of digestive symptoms (P = 0.0158), ulcerative-type cancer (P < 0.0001), large tumor diameter (P < 0.0001), and advanced tumor stage (P = 0.0019) were lower in the patients with AC. The LNM rates were 27.5% and 40.7% in patients with AC and DC-II, respectively, without significant difference (P = 0.23). The rates of LNM to hepatic nodes (N-He) and pyloric nodes (N-Py) were significantly higher in patients with DC-II than in those with AC (metastasis to N-HE: 18.5% and 5% in patients with DC-II and AC, respectively; P = 0.0432; metastasis to N-Py: 11.1% and 0% in patients with DC-II and AC, respectively; P = 0.0186). Although there were no significant differences in the prognosis and recurrence rates between the two groups, metastases to N-He and N-Py were more frequent in patients with DC-II than in those with AC.

Comparison of clinicopathological features and prognostic significance between synchronous multiple primary and solitary esophageal squamous cell carcinomas

BackgroundSynchronous multiple primary esophageal squamous cell carcinoma (S-MPESCC) refers to more than one primary esophageal carcinoma detected in a solitary patient at the time of initial presentation. The purpose of this study was to evaluate the clinicopathological features, appropriate surgical approaches and long-term survival in patients with S-MPESCC by comparing with those with solitary esophageal squamous cell carcinoma (SESCC).MethodsIn total, 567 patients with esophageal squamous cell carcinoma surgically resected in Tianjin Medical University Cancer Institute and Hospital from January 2012 to December 2018 were screened for retrospective analysis (50 in the S-MPESCC group and 516 in the SESCC group).ResultsNo significant difference was observed in terms of other characteristics except total alcohol consumption (P = 0.029). S-MPESCC had higher lymph node rate than SESCC (62.0% and 44.1%, respectively; P = 0.015) especially in upper mediastinal (32.0% and 18.6%, respectively; P = 0.023) and abdominal (38.0% and 22.8%, respectively; P = 0.017) regions. The survival was not different between the two groups, and the 5-year survival rates of S-MPESCC and SESCC were 46.2% and 50.8%, respectively (P = 0.507). But for patients with pT3-4 cancers, the survival in S-MPESCC was worse than that in SESCC (P = 0.033). In the multivariate analysis, pT stage of primary cancer was an important independent predictor of prognosis in patients with S-MPESCC (hazard ratio [HR], 3.968; 95% confidence interval [CI], 1.031 to 15.268; P = 0.045).ConclusionsS-MPESCC was significantly different from SESCC in terms of clinicopathological characteristics include alcohol intake and pattern of lymphatic metastasis. Furthermore, S-MPESCC showed worse long-term survival than SESCC with increasing depth of primary cancer infiltration.

Comparison of Clinico-Pathological Features Between Epithelial Ovarian Cancer Patients With and Without Endometriosis: A Cross-Sectional Study

Objectives: Women with endometriosis have a high risk of developing ovarian carcinoma that may occur due to endometriosis lesions. There is few research have so far focused on the clinical factors in patients with endometriosis-associated ovarian cancer (EAOC). Accordingly, this study aimed at comparing the demographic and obstetric characteristics between ovarian cancer with and without endometriosis Materials and Methods: This cross-sectional study was conducted on 20 EAOC patients and 140 non-EAOC individuals who had gone under surgery from 2011-17 at Al-Zahra hospital. Clinico-pathological characteristics of the two groups including first group only had malignant epithelial ovarian tumor (non-EAOC) and second group had both malignant epithelial ovarian tumor and endometriosis (EAOC). P value less than 0.05 was considered statistically significant. Results: EAOC cases were significantly younger (P=0.002) and had lower number of pregnancy (P=0.002), parity (P=0.004), and term pregnancy (P=0.005) than non-EAOC patients. A large proportion of EAOC cases had clear cell and endometrioid histopathology in comparison to non-EAOC individuals (P&lt;0.001) and most of the tumors in these cases were unilateral (P=0.01). Conclusions: We found that age, parity, gravidity, and term pregnancy as well as laterality and histopathologic type of epithelial ovarian cancers vary in EAOC and non-EAOC individuals. Further research is required to identify these differences.

Characteristics and Outcomes of Radiation Therapy-Related Myeloid Neoplasms

BACKGROUND: Therapy-related myeloid neoplasms (t-MN) develop after exposure to a variety of DNA-damaging agents including chemotherapy, radiation, and immunosuppressive therapies (IST). Recently, a cohort of radiation t-MN (Rt-MN) was described (Patel et al, Blood Adv, 2022). Most common cytogenetic and genetic abnormalities were that of chromosomes 5 and 7, and ASXL1 and TET2 mutations. However, only a smaller subset (n=16) underwent next-generation sequencing (NGS) analysis and comparison of clinicopathological features and outcomes with other forms of DNA-damaging therapies was not performed. We hypothesized that Rt-MN may have different clinicopathological features and outcomes compared to t-MN after other forms of therapy. METHODS: This retrospective, multicenter study was conducted at Mayo Clinic, Rochester (USA) and South Australian Local Health Network (South Australia, Australia). Following appropriate regulatory approvals at the respective institute, we identified 373 WHO-defined t-MN patients who had cytogenetics and NGS at t-MN diagnosis. The statistical analysis for continuous and categorical variables was performed using Mann-Whitney and chi-squared tests, respectively. Overall survival (OS) was calculated from the time of t-MN diagnosis to the last follow up or death, whichever came first using Kaplan-Meier method. Uni- and multivariate analyses were performed using Cox proportional hazard model. The statistical analysis was performed using BlueSky (Chicago, IL, USA). RESULTS: Sixty-four (17.2%) patients developed Rt-MN and 124 (33.2%) following chemoradiotherapy (chemoradiation t-MN or CRt-MN). The remaining 185 (49.6%) received chemotherapy and/or IST but did not receive radiation (non-radiation t-MN or NRt-MN). 1. Clinical characteristics: Rt-MN were significantly older at the time of primary diagnoses (Table 1) and presented with a higher median white blood cell count, absolute neutrophil count, and platelets. A significantly higher proportion of Rt-MN patients had solid primary malignancy compared to CRt-MN and NRt-MN (P<.001). 2. Biological characteristics: The proportion of patients with chromosome 5 and 7 abnormalities was significantly lower in Rt-MN patients and comparable to the previously described cohort. Similarly, a significantly lower proportion of Rt-MN patients had evidence of genomic instability in the form of complex karyotype (CK; P=.018) and monosomal karyotype (MK; P=.001) compared to CRt-MN and NRt-MN. Rt-MN was enriched in mutated SRSF2 (P=0.006), TET2 (P=.009) and NPM1 (P=.005) compared to CRt-MN and NRt-MN respectively. On the other hand, Rt-MN had a significantly lower proportion of TP53mut compared to CRt-MN and NRt-MN (P=.001). 3. Outcomes after t-MN diagnosis: Although a significantly higher proportion of Rt-MN patients received best supportive care only (P=0.004), median OS from the time of t-MN diagnosis was not different between for Rt-MN, CRt-MN, and NR-tMN (12 vs. 12.3 vs. 15 months, respectively; P=0.11). After a median follow up of 47 months, 288 (77.2%) patients died. Interestingly, among Rt-MN patients, receiving FL HMA was associated with an inferior survival compared to those receiving BSC or IC (HMA 11 mo., BSC 18 mo., and IC 73 mo., P=.01). 4. Factors predicting survival of Rt-MN patients: Univariate analysis identified hemoglobin, chromosome 5 and 7 abnormalities, CK, MK, RUNX1 and TP53 mutations, and the type of first line therapy as predictors of survival (Table 2). MVA that included the above factors, age, and type of primary disease identified RUNX1 mutation (median OS 6 mo. vs. 13 mo., P=.02) and chromosome 7 abnormalities (7.8 mo. vs. 19.4 mo., P<0.001) as independent variables for OS. CONCLUSIONS: While Rt-MN less frequently harbored the traditionally high-risk features including CK, MK, and TP53 mutation, and were less likely to receive disease-modifying therapies, survival was not different from the patients who received the other forms of DNA-damaging therapies. Possible explanations of the noted discrepancy include older age at t-MN diagnosis and under-utilization of disease-modifying therapies. IC treatment of Rt-MN appears to be associated with a favorable OS. The presence of mutated RUNX1 and chromosome 7 abnormalities are independent risk factors for survival in Rt-MN patients. In summary, Rt-MN is a distinct clinical and molecular entity within the heterogeneous t-MN category. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Clinicopathological Features and Outcomes Comparing Patients With Invasive Ductal and Lobular Breast Cancer.

There is increasing interest in better understanding the biology and clinical presentation of invasive lobular cancer (ILC), which is the most common special histological subtype of breast cancer. Limited large contemporary data sets are available allowing comparison of clinicopathologic features between ILC and invasive ductal cancer (IDC). The Great Lakes Breast Cancer Consortium was formed to compare clinical behavior of ILC (n = 3617) and IDC (n = 30 045) from 33 662 patients treated between 1990 and 2017 at 3 large clinical centers. We used Kaplan-Meier analysis, Cox proportional hazards modeling, and propensity score matching to evaluate treatment differences and outcomes. All statistical testing used 2-sided P values. Compared with IDC, patients with ILC were more frequently diagnosed at later stages and with more lymph node involvement (corrected P < .001). Estrogen receptor-positive ILCs were of lower grade (grade 1 and 2: 90% in ILC vs 72% in IDC) but larger in size (T3 and 4: 14.3% in ILC vs 3.4% in IDC) (corrected P < .001), and since 1990, the mean ILC size detected at diagnosis increased yearly. Patients with estrogen receptor (ER)-positive ILC underwent statistically significantly more mastectomies compared with ER-positive IDC (57% vs 46%). Using Kaplan-Meier analysis, patients with ER-positive ILC had statistically significantly worse disease-free survival and overall survival than ER-positive IDC although 6 times more IDCs were classified as high risk by OncotypeDx Breast Recurrence Score assay. This large, retrospective, collaborative analysis with 3 clinical centers identified meaningful differences in clinicopathological features between ILC and IDC, providing further evidence that these are 2 different entities requiring different clinical management.