Histopathological Type Of Tumor Research Articles

The Importance of Il8 Gene Expression and Il-8 A251t in Diagnosis and Prognosis of Ovarian Cancer in Iraqi Women

The present study aimed to shed light on the association between the gene expression of IL8 and its genetic polymorphism IL-8 A251T in the incidence and pathogenesis of ovarian cancer. A total of 43 Paraffin-embedded tissue blocks from patients with different stages of newly diagnosed ovarian cancer were provided by certain Iraqi hospitals as well as 14 samples of patients with benign ovarian tumors tissues as a control group were used in this study. In the present study, the level of IL8 gene expression was investigated by comparing it with that of benign tumors, the results detected that IL-8 mRNA was expressed in 47(81.02%) of samples, 36 samples with ovarian cancer and 11 benign ovarian. IL-8 mRNA levels in ovarian cancer tissues were statically significant higher than those in benign ovarian tissue (P=0.0328<0.05). The samples were divided into high and low mRNA-expression depending on the mean value of IL8 gene expression in benign tumors which used as a cutoff, the results showed that samples with high mRNA-expressing 25(69.4%) which showed high significant differences compare with samples that showed low expressing 11(30.55%) (P value=0.0028<0.01). In correlation with histopathological type of ovarian tumors, mucinous tumors showed statistically significant difference in compare with other histopathologic tumor type (P=0.0516,<0.05). According to the tumor stages, statistically significant difference was found between 31(86.11%) of samples with stage I which showed the highest level of expression and 5(13.88%) of samples with stage III (P value=0.0410<0.05). For A251T polymorphism, the result showed that 21(58.33%) patients were heterozygous A/T, 14(38.88%) were homozygous T/T, and 1(2.77%) was homozygous A/A. For patients with benign ovarian tumors 11(91.66%) were heterozygous A/T, 1(8.33%) was homozygous T/T, and no one of the patients were homozygous for the A/A genotype. High significant prevalence of the IL-8 251T allele was detected in both ovarian cancer patients (P value 0.0047 <0.01) and patients with benign ovarian tumors (P value 0.014 <0.02) as compared with IL-8 251A allele. In the present study the association of the A251T polymorphism with ovarian cancer were investigated by attending to levels of IL-8 mRNA in benign and malignant ovarian tissues related with the respective genotypes. In benign ovarian tumors statically analysis showed that there were no significant differences between genotypes, while for cancer samples, the average of IL-8 gene expression in ovarian cancer patients carrying +251TT genotype was highly significant than that in ovarian cancer patients with the +251AT and +251AA genotypes (p value= 0.0037<0.01). In conclusion, the results reflected the possibility of detecting the IL8 gene transcript in benign as well as the malignant ovarian tissues but with wide differences in the sample percentages and level of gene expression which in turn reflect the value of IL8 gene as a useful tool for discriminating malignant breast tumors from non-malignant ones. On the other hand the high level of gene expression associated with stage I of tumor may be reveals the diagnostic value of this gene for early diagnosis of ovarian cancer. The results showed that the genetic variation of IL-8 gene influences susceptibility to ovarian cancer, we also suggested that the TT genotype of IL-8 -251A/T may associate with increase the risk of ovarian cancer in Iraqi women because of altered IL-8 gene expression.

Clinicopathologic significance of human epidermal growth factor receptor 2 expression and gene amplification in gastric carcinoma.

This study is aimed at determining the human epidermal growth factor receptor-2 (HER-2) gene status in gastric cancers using immunohistochemistry (IHC) and silver DNA in situ hybridization (SISH) technique and investigating the relationship between HER-2 status and clinicopathological variables. We examined 104 gastric carcinoma cases with gastrectomy specimens. The age, sex, histopathological tumor type, tumor differentiation, tumor localization, tumor size, invasion depth, lymph node metastasis status, HER-2 IHC evaluation results, and SISH evaluation results of the cases were recorded. In the present study, the SISH-confirmed HER-2 positivity rate (SISH amplification) is 14.4%. A statistically significant relationship was found between HER-2 status and tumor invasion depth (P = 0.03). It was observed that as the depth of invasion increased, HER-2 positivity decreased. No statistically significant relationship was found between HER-2 status and sex, age, tumor size, differentiation, histopathological classification, lymph node metastasis, and tumor localization (P > 0.05). The rate of HER-2 2+ cases was found to be high. HER-2 status is negatively correlated with the depth of invasion in gastric cancers, and HER-2 positivity increases as the depth of invasion decreases. HER-2 may be early molecular evidence in oncogenesis. Immunohistochemically, HER-2 2+ cases should be confirmed by the in situ hybridization (ISH) technique.

E-Cadherin Expression in Relation to Clinicopathological Parameters and Survival of Patients with Epithelial Ovarian Cancer.

It is generally accepted that loss/reduction of E-cadherin expression on tumor cells promotes their migration, invasiveness, and metastasis. It is also an indicator of cancer cells' aggressiveness. The aim of this study was to assess how the expression of E-cadherin varies in primary ovarian cancer tissue in regard to overall survival of patients; FIGO stage; grade; histopathological type of tumor; and potential factors discriminating malignant and nonmalignant ovarian tumors. Our analysis was based on literature research (1 January 2000-8 November 2021) conducted according to the PRISMA guidelines. Most studies support the assumption that loss/reduced expression of E-cadherin results in shorter overall survival of EOC patients. Moreover, most research has shown that there is a correlation between the low level of E-cadherin and the advancement stage of disease, especially in high-grade serous ovarian carcinoma type. However, E-cadherin expression seems to not be helpful to distinguish malignant and nonmalignant tumors. In conclusion, reduced E-cadherin expression in primary ovarian cancer tissue may indicate a less favorable disease outcome and is associated with high advancement of the disease.

977P Phase II study of brigatinib in patients with tyrosine kinase inhibitor (TKI)-naïve ROS1-rearranged advanced non-small cell lung cancer (NSCLC): Barossa cohort 1

Barossa is a multicenter, phase II basket study of brigatinib in patients with ROS1-rearranged solid tumors. We report the results of the cohort 1, in which TKI-naïve ROS1-rearranged NSCLC patients were enrolled. Patients with advanced, TKI-naïve ROS1-rearranged advanced NSCLC received brigatinib at a dose of 180 mg once daily with a 7-day lead-in period at 90 mg. The primary end point was objective response rate (ORR; RECIST 1.1) by independent review. Key secondary endpoints were PFS, OS, and safety. The sample size was set at 28 patients, with a one-sided alpha of 0.05, beta of 0.2, and threshold and expected values for primary endpoint of 50% and 75%, respectively. Between September 2019 and May 2020, 28 patients were enrolled from 9 institutions. Baseline characteristics as follows: median age (range): 65 (38-81) years; women, n=18 (64%); ECOG PS of 0-1, n=28 (100%); never smoker, n= 16 (57%); tumor histopathological type: adenocarcinoma, n=27 (96%); brain metastasis, n=8 (29%). The median duration of follow-up for PFS was 9.3 months. Seventeen patients (61%) continued study treatment at the data cutoff date of 30 Nov 2021. The primary endpoint was met as 19 patients achieved PR with ORR at 67.9% (90%CI, 50.6-82.1%). Another 3 patients achieved SD and the disease control rate was 78.6% (95%CI, 59.0-91.7%). The PFS and OS were not yet mature: the median PFS was 12.0 months (95% CI, 5.8-not evaluable). Twenty-five out of the 28 patients remained alive at the data cutoff. Grade 3 pneumonitis, which was considered treatment-related, was observed in 3 patients (10.7%), and all 3 cases resulted in treatment discontinuation. Pneumonitis was improved with steroid therapy in all 3 patients. Other grade ≥3 TRAEs were CPK increased (28.6%), hypertension (21.4%), AST increased (10.7%), ALT increased (7.1%), nausea (3.6%), hyperglycemia (3.6%). No treatment-related deaths were observed. Brigatinib demonstrated encouraging antitumor activity in patients with TKI-naïve ROS1-rearranged advanced NSCLC. The safety profile of brigatinib was consistent with previous studies.

Omentoplasty and omentopexy post-pelvic lymph node dissection in surgical management of gynecological tumors

Background: Lymphadenectomy is staging procedure used in studied cases with pelvic gynaecological cancer, however, pelvic lymphadenectomy was associated with morbidities like lymphedema & lymphocysts, Omentoplasty-omentopexy has been utilized for prevention of lymphocysts that develop following pelvic lymphadenectomy. Patients and methods: This study is randomized controlled trial. 41 consecutive patients who were candidates for pelvic lymphadenectomy during radical hysterectomy for cancer cervix or endometrium were enrolled in this research & were allocated to 2 groups. Intervention group (Omentoplasty-Omentopexy (A) group) included twenty-one patients who underwent omentoplasty-omentopexy. Control group (B) group included twenty patients who did not underwent omentoplasty-omentopexy. The two groups were compared regarding development of lymphocyst. The study was done at National Cancer Institute, Cairo University from January 2020 to June 2021. Results: Forty-one consecutive studied cases were enrolled in this research from January 2020 to June 2021. With an average age 58.9±12.4 years,no statistically significant variation between the Omentoplasty-Omentopexy (A) & control group (B) regarding tumor site and histopathologic tumor types and tumor grade. No significant difference was found regarding primary tumor location either endometrial or cervical and its effect on post operative complications.

Ovarian tumors and genetic predisposition.

Summary of knowledge in the field of ovarian cancer and genetic predisposition. Ovarian tumors are usually diagnosed at advanced stages of the disease and the prognosis for these patients is generally poor. The 5-year overall survival rate, regardless of the histopathological type of tumor, is around 44%. Germline mutations causing hereditary tumor syndromes are predominantly involved in the development of epithelial ovarian tumors. The most common is hereditary breast and ovarian cancer syndrome, which is caused by germline mutations in the tumor suppressor genes BRCA1 and BRCA2. Several other tumor suppressor genes and oncogenes are known to be associated with ovarian tumors and cause other types of tumor syndromes. Inherited tumor syndromes include Lynch syndrome, Peutz-Jegers syndrome, Gorlin syndrome, Li-Fraumeni syndrome and others. The indication for genetic examination of germline mutations is given by a clinical geneticist on the basis of the recommendation of the attending physician. At present, every ovarian tumor, primary peritoneal tumor and tube tumor diagnosed at any age is indicated for genetic testing. Early identification of genes for hereditary cancer syndromes, thanks to rapidly developing molecular genetic methods, is an important step towards personalized treatment of ovarian cancer and preventive measures in families at risk. It is also important to note that a negative molecular genetic test result does not exclude genetic risk.

Odontogenic Keratocyst: The Dos and Don’ts in a Clinical Case Scenario

Patient: Male, 19-year-old Final Diagnosis: Odontogenic keratocyst Symptoms: Swelling Medication:— Clinical Procedure: Enucleation Specialty: Otolaryngology Objective: Challenging differential diagnosis Background:Odontogenic keratocysts are odontogenic cysts that increase in dimension based on growth factors and have a high recurrence rate. The radiological features of odontogenic keratocysts can be confusing owing to their similarity with other intraosseous cysts. The aim of treatment is to minimize patient morbidity and to reduce the risk of recurrence, along with complete surgical excision.Case Report:We report a case of a young man who presented to our hospital for a cystic lesion located in the posterior left mandible with clinical and radiological features of a dentigerous cyst. The lesion was treated accordingly for this diagnosis by enucleation. During surgery, a thick and firm cystic membrane was identified. Histopathological examination of the specimen established the final diagnosis of odontogenic keratocyst by identifying squamous epithelium with focal parakeratosis and ulceration and a diffuse inflammatory lymphoplasmacytic infiltrate. The patient’s evolution was favorable, with no sign of recurrence on cone beam computed tomography examination at the 6-month follow-up and with healing of the surgical defect.Conclusions:The diagnosis of odontogenic keratocyst is challenging, requiring preoperative 3-dimensional imaging and biopsy for extensive lesions. Adjuvant biochemical and immunological examination of cystic aspirate could sometimes be helpful for making a correct diagnosis. The treatment needs to be individualized according to the patient’s age and the tumor’s histopathological type and features. If the histopathological examination of surgical specimen indicates a more aggressive lesion than expected, a careful and individualized follow-up is imperative. No reintervention is needed if the patient does not present evidence of recurrence.

Clinico-pathologic characteristics and prognostic factors of ovarian carcinoma with different histologic subtypes - A benchmark analysis of 482 cases

PurposeOvarian carcinomas (OCX) have traditionally been thought to arise from the ovarian surface epithelium. However, recent (immuno-) histopathological and molecular analyses suggest that OCX consist of morphological subtypes with different epidemiologic features and a varying prognosis. MethodsThe data of 482 OCX from the Clinical Cancer Registry of Leipzig who were surgically treated between 2000 and 2019 and were evaluated regarding incidence, clinico-pathologic characteristics and prognostic factors. Cases were separated into high-grade and non-high-grade serous tumors. Both groups were analyzed regarding the tumor stage, lymph node involvement, site of origin and prognosis. ResultsThe overall incidence for OCX was 17.9. The most common histological subtype was high-grade serous OCX (57.9%; 279/482). Patients with high-grade were significantly older than those with a non-high-grade serous OCX (63.9 versus 58.5 years; p < 0.001), more frequently diagnosed at an advanced stage >pT3 (78.5% (219/279) versus 42.8% (87/203); p < 0.001) and showed a 2.4-fold higher frequency of lymph node metastases (53.4% vs. 21.2%; p < 0.02) with a 4.6-fold higher rate of > 1 cm metastatic deposits (pN1b) within the lymph nodes (14.8% vs. 4.6%; p < 0.02). Irrespective of tumor stage and morphological subtype, the 1- and 5-year overall survival (OAS) was 72.9% and 40.8%, respectively. Patients with high-grade serous OCX showed a shorter 5-year OAS compared to non-high-grade serous OCX (34.1% vs. 57.0%; p 0.001). This association was reproducible in patients with an advanced tumor stage irrespective of the histopathologic tumor type serous OCX (pT3: 32.4% vs. pT1: 75.1%; p 0.001) as well as within high-grade (pT3: 28.7% vs. pT1: 55.5%; p = 0.003) and non-high-grade serous OCX (pT3: 43.0% vs. 80.0%; p 0.001). There were no differences in OAS depending on the site of origin (fallopian tube, ovary, peritoneum) within the two histologic subgroups. ConclusionOCX cases from a single institution with uniform surgical treatment and a standardized histopathological workup were evaluated. The poor prognostic outcome of patients with high-grade serous compared non-high-grade serous OCX as well as an advanced stage of the disease was confirmed. This study demonstrates for the first time that the histopathological distinction into high-grade serous and non-high-grade serous tumors may be much more prognostically relevant than the site of origin.

Relation of Receptor Status and Tumor Grade with Menopausal Status in Patients of Carcinoma Breast

Background: Carcinoma of the breast is the most common female cancer and its incidence is rapidly increasing over the last few decades. In Bangladesh, breast cancer is an issue of gaining concern. Receptor status and histological grade are two important prognostic factors of carcinoma breast. Aim of the study: To assess the relation and distribution of receptor status and tumor grade among pre and postmenopausal patients of carcinoma breast. Methods: This cross-sectional observational study was carried out in the Department of General Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka over a period of one year, a total of 59 admitted female patients with histologically proven carcinoma of the breast were divided into two groups included in this study. The premenopausal age group was considered as a group I (n=31) and the postmenopausal age group was considered as group II (n=28). Data regarding the tumor histopathological type, grading, and receptor status along with other variables were included in a pre-designed data collection sheet. After compiling data, Statistical analyses of the data were done with Statistical Packages for Social Sciences (SPSS- 22). Results: Sociodemographic variables and personal histories leading to a risk of breast cancer have no significant difference between pre and postmenopausal groups. Invasive ductal carcinoma (grade-II) was predominant in both groups. Estrogen and progesterone receptor-negative tumors were more frequent in premenopausal patients and estrogen and progesterone receptor-positive tumors were more frequent in a postmenopausal patient, but no statistically significant difference between the two groups. More than eighty percent of tumors were human epidermal growth factor-2 negative in both groups. The frequency of estrogen and progesterone receptor positivity gradually reduce from grade I to III in both groups and the frequency of estrogen and progesterone receptor negativity gradually increase from grade

Adjuvan Radyoterapi Alan İnvaziv Meme Kanseri Hastalarında Prognostik Faktörlerin Değerlendirilmesi

Objective: The aim of this study is to investigate the effect of adjuvant radiotherapy applied on patients with invasive breast cancer on survival and to determine the relationship between prognostic factors and survival in patients. Introduction: Breast cancer is the most common cause of death in women between the ages of 35-55. Surgery, chemoradiotherapy, radiotherapy, hormone therapy and immunotherapy are treatment modalities applied in breast cancers. Materials and Methods: Our retrospective study included 120 patients ranging between 39 and 68 years who were admitted to Adana City Education and Research Hospital Radiation Oncology outpatient clinic between May 2016 and March 2019 and who received adjuvant radiotherapy due to invasive breast cancer. Results: Statistically significant findings were obtained between lymphovasculer invasion, human epidermal growth factor receptor 2 positivity, tumor and lymph node status and overall survival. But, no statistically significant findings could be attained between menapause status, surgical method applied, histopathological type of tumor, presence of extracapsular invasion, estrogen and progesterone hormone receptors and overall survival. Discussion: Statistically insignificant results are thought to arise from insufficient number of patients incorporated in the study, however, their effect on overall survival was exhibited. Although early diagnosis with modern imaging methods increases overall survival in breast cancer, the selection of appropriate treatments for suitable patients is crucial. Conclusion: Even though we could not specify enough statistically, we concluded that adjuvant radiotherapy positively affected survival in the light of previous studies in the literature and our observations during present study.

Surgical resection of intradural extramedullary tumors in the atlantoaxial spine via a posterior approach.

BACKGROUNDThe anatomical features of the atlantoaxial spine increase the difficulty of complete and safe removal of atlantoaxial intradural extramedullary (IDEM) tumors. Studies concerning surgical interventions via a posterior approach are limited.AIMTo investigate the safety and efficacy of atlantoaxial IDEM tumor resection using a one-stage posterior approach.METHODSWe retrospectively analyzed clinical databases for one-stage atlantoaxial IDEM tumor resection via a posterior approach between January 2008 and January 2018. The analyzed data included tumor position, histopathological type, pre- and post-operative Japanese Orthopedic Association (JOA) scores and Nurick grades, postoperative complication and recurrence status.RESULTSA total of 13 patients who underwent C1-C2 Laminectomy and/or unilateral facetectomy via the posterior approach were enrolled in the study. In all cases reviewed, total tumor resection and concomitant C1-C2 fusion were achieved. The average follow-up was 35.3 ± 6.9 mo (range, 26-49 mo). A statistically significant difference was noted between the preoperative JOA score (11.2 ± 1.1) and the score at the last final follow-up (15.6 ± 1.0) (P < 0.05). A statistically significant difference was noted between the preoperative Nurick grade (2.3 ± 0.9) and that at the last follow-up (1.2 ± 0.4) (P < 0.05). However, no statistically significant difference was noted between the preoperative and last follow-up C1-2 Cobb angle and C2-7 Cobb angle (P > 0.05). No mortalities, severe complications or tumor recurrence were observed during the follow-up period. CONCLUSIONTotal resection of atlantoaxial IDEM tumors is feasible and effective via a posterior approach. Surgical reconstruction should be considered to avoid iatrogenic kyphosis and improve spinal stability and overall clinical outcomes.

PATTERN OF KRAS GENE EXPRESSION IN IRAQI WOMEN OVARIAN CARCINOMA.

The aim: The goal of this study was to detect if KRAS gene and levels of had any clinical significance in the ovarian cancer by measuring levels of KRAS mRNA. Materials and methods: The investigation was conducted on 84 tissue samples from newly diagnosed patients with ovarian cancer. Twenty-eight tissue sections with benign ovarian tumors were used as a control group. The qRT- PCR technique was used for measuring and analyzing levels of KRAS mRNA. Results: Relative increasing of KRAS mRNA level in cancer samples was statistically significant (P<0.01) when compared to benign tumors. Statistically no significant differences were found between KRAS mRNA levels and menopausal status or family history. Gene expression has been substantially connected with age groups as the highest levels of KRAS mRNA was recorded in patients with age 50-74 years (P<0.01). Endometrium tumors exhibited significant correlations (P<0.01) across histopathological tumor types. In correlation with tumor stages, stage I was substantially linked compared to stage I (P<0.01). Conclusions: It was concluded that over expression of the KRAS gene is linked to early stages of ovarian cancer, which implying that mRNA levels could be used as a diagnostic and predictive factor for ovarian cancer. More research with larger groups of ovarian cancer specimens in both primary and advanced stages is needed.

Fever and Abdominal Pain in a 10-year-old with Autism.

Fever and Abdominal Pain in a 10-year-old with Autism.

Clinical Approach to Neuroendocrine Neoplasm Associated With Ovarian Teratoma.

BackgroundNeuroendocrine neoplasms are a heterogeneous group of cancers that develop from enterochromaffin cells of the diffuse endocrine system, with an increase in incidents over the last years. Ovarian neuroendocrine tumors (NET) are rare neoplasms, comprising 0.1% of all ovarian neoplasms and less than 5% of all neuroendocrine tumors. They may arise alone (as monodermal, specialized teratoma – ovarian carcinoid) or as a part of other ovarian lesion: cystic mature or immature teratomas. Due to the rarity and limited amount of such cases reported in the literature, there is no consensus on diagnostic and therapeutic procedures in this group of patients.Materials and MethodsThe group of 10 patients at the age of 19 to 77 years (mean 42.8 ± 17.9), diagnosed with unilateral NET within ovarian teratoma were analyzed. The histopathological type of tumor, progression free survival after surgical treatment and presence of hormonally active syndrome were assessed.Results70% (n=7) of patients was diagnosed with mature cystic teratomas containing NET component and 30% (n=3) with monodermal teratoma (strumal carcinoid). All cases of monodermal teratomas were found in women at premenopausal age. Determined Ki67 ranged from 2% to 9%. Ninety percent of lesions (n=9) stained positive for synaptophysin and chromogranin, while markers: CK20, CK7, TTF-1 and CDX2 were negative in all cases, which ruled out their metastatic nature. None of the patients presented with carcinoid syndrome. All followed-up patients remain progression-free, which confirms surgical intervention being a crucial and sufficient method of treatment.ConclusionsThe prognosis and clinical behavior of NETs associated with ovarian teratomas are good with long progression-free survival.

Vertical Axillary Incision for Treatment of Breast Outer Quadrants Tumors

Background: Breast cancer is the second most common cancer among women, with an estimated 3.5 million survivors as of 2015. There is continuous annual improvement of the overall survival of breast cancer patients, with 5-year overall survival estimates increasing from 84.6% to 90.9% over the previous two decades. Objective: The aim of the current work was to improve aesthetic satisfaction and oncological outcome of patients with breast outer quadrant tumors. Patients and Methods: This interventional study included a total of 18 cases with early breast cancer at upper and lower-outer quadrants of breast, attending at Onco-Surgery Unit, General Surgery Department, Faculty of Medicine, Zagazig University. This study was conducted between December 2020 to May 2021. All patients were subjected to demographic data taking, complete clinical examination, and investigations including imaging, biopsies, and histopathology. Results: The Histopathological type of tumor, all of them had Invasive ductal carcinoma. Most of the tumors were (ER) and (PR) Positive with HER2/neo Negative. The mean duration of operation was 86.94±10.45 (range 70–105) minute and the mean blood loss was 286±12.34 (range 250-315) milliliter and all patients had no intraoperative complication. Conclusions: It could be concluded that the vertical axillary incision is a safe and effective approach for the management of tumors of the outer quadrant of the breast; and cosmetically appropriate maneuver for these tumors.

Prediction of the histopathological tumor type of newly diagnosed liver lesions from standard abdominal computer tomography with a machine-learning classifier based on convolutional neural networks

Abstract Background and objectives: Liver lesions are a relatively common incidental finding in computer tomography (CT) of the abdomen. The current gold standard is liver biopsy, which has the downside of respecting only a small part of the total lesion volume. Furthermore, this invasive method carries interventional risks like bleeding or infection. Therefore, an image-based biomarker would be highly desirable. Conventional “radiomics” methods have often been utilized for similar problems, but the results are often not reproducible. This is mainly due to sampling errors and interobserver variability, but also the seemingly complex nature of the problem. We present a new approach that implements cutting-edge research in machine learning which is nevertheless cheap and easily applicable in a routine clinical setting. To achieve this, we use convolutional neural networks (CNN) to predict the histopathological findings from liver lesions from preoperative liver CT. Methods: After splitting the study population into a training and test set we trained a CNN to predict the histopathological tumor type from CT data. Results: The developed CNN workflow is able to predict liver tumor histology from routine CT images. We also evaluated in how far transfer learning and data augmentation can help in solving this problem and implemented the developed workflow in a clinical routine setting. Conclusion: We propose a robust semiautomatic end-to-end classification workflow for the prediction of the histopathological type of tumor lesions based on abdominal CT and a deep convolutional neural network model. In our cohort, the model shows reliable and accurate results even with limited computational resources.

Altona Prognostic Index: A New Prognostic Index for ER-Positive and Her2-Negative Breast Cancer of No Special Type.

Simple SummaryBreast cancer is the most common tumor-related cause of death in women in Europe and worldwide. The aim of our retrospective study, including 6654 women, was on the one hand to verify the validity of the worldwide known Nottingham prognostic index (NPI), and on the other hand to create a new model with even more prognostic validity. Our newly developed Altona prognostic index (API) shows significantly superior outcome in calculating progression free survival. In contrast to the NPI, the API considers characteristics such as subtypes of breast cancer, as this disease is heterogenous involving different entities, and patient’s age. Evaluating progression free survival in different subgroups, our study shows that both these prognostic indices should only be applied on a patient collective that is ≤70 years old with first primary, unifocal, unilateral breast cancer that is of no special type (NST), estrogen receptor-positive and Her2-negative to get valid prediction data. Breast cancer is a heterogeneous disease representing a number of different histopathologic and molecular types which should be taken into consideration if prognostic or predictive models are to be developed. The aim of the present study was to demonstrate the validity of the long-known Nottingham prognostic index (NPI) in a large retrospective study (n = 6654 women with a first primary unilateral and unifocal invasive breast cancer diagnosed and treated between April 1996 and October 2018; median follow-up time of breast cancer cases was 15.5 years [14.9–16.8]) from a single pathological institution. Furthermore, it was intended to develop an even superior risk stratification model considering an additional variable, namely the patient’s age at the time of diagnosis. Heterogeneity of these cases was addressed by focusing on estrogen receptor-positive as well as Her2-negative cases and taking the WHO-defined different tumor types into account. Calculating progression free survival Cox-regression and CART-analysis revealed significantly superior iAUC as well as concordance values in comparison to the NPI based stratification, leading to an alternative, namely the Altona prognostic index (API). The importance of the histopathological tumor type was corroborated by the fact that when calculated separately and in contrast to the most frequent so-called “No Special Type” (NST) carcinomas, neither NPI nor API could show valid prognostic stratification.

Some epidemiological data about Stomach Cancer in Kosovo.

Despite the continuing decline in incidence, stomach cancer remains one of the most common and deadly neoplasms in the world [1]. According to the literature, stomach cancer is the third leading cause of cancer deaths worldwide, ranking third after lung cancer and colorectal in global cancer mortality. About 1 in 12 neoplasm deaths can be attributed to stomach cancer, which has 5 times the highest incidence among all cancers, and over one million new cases of stomach cancer are diagnosed each year worldwide.[2]&#x0D; Our objectives were: Evidence and detailed statistical description of demographic, diagnostic, clinical, pathological data of stomach cancer patients are included in this study were hospitalized in two clinical surgery medical centers in the period from January 2009 to January 2019, in University Clinical Center in Prishtina-Department of Surgery, Regional Hospital in Ferizaj-Department of Surgery.&#x0D; Material and methods; The study included 115 patients who met the criteria, and the Study variables were obtained from clinical record data that include: Gender (Male, Female); Age; Clinic of the disease: (indigestion Weakness, Weight loss, anorexia, Melena, Abdominal pain, Epigastric pain, Vomiting…); Tumor stage, histopathologic and lesion type...&#x0D; Conclusion; Stomach cancer affects both sexes with a preference of men with a ratio of 1.4: 1 (M; F). The most affected age group is 51-70 years which includes about 61.3% of patients. Depending on the localization of gastric cancer, the most affected part of our study was the body of the stomach (46%), the antral part 38%, the cardia part with 15.7%. Typical symptoms in our patients included; Indigestion 46 (40%); Loss of appetite 41 (35.6%); Abdominal pain 70(60.8%); Nausea/ vomiting 35( 30.4%); Postprandial pain 39 (33.9%); Weight loss 56 (48.6%); Melena 19 (16.5%)...

Predictors of response in EGFR-mutant metastatic non-small cell lung cancer patients treated with tyrosine kinase inhibitors.

e21149 Background: EGFR mutations are detected in 15-62% of patients with non-small cell (NSCLC) lung cancer. We can use tyrosine kinase inhibitors (such as erlotinib, gefitinib, afatinib) to treat patients with EGFR-mutant lung cancer. Tyrosine kinase inhibitors improve the survival outcomes of the patients. This study aimed to assess predictors of overall response rate (complete or partial response) in EGFR-mutant non-small cell lung cancer patients treated with EGFR inhibitors. Methods: Data of the EGFR-mutant lung cancer patients were evaluated retrospectively. Clinical, pathological, radiological, and treatment features of the patients were recorded. SPSS 25 version was used for statistical analysis. Kaplan-Meier and Cox-regression methods were used for survival analysis. Also, predictors of overall response were evaluated with logistic regression analysis. Results: 105 patients were included in the study. The female/male patients ratio was 1.25, and the median age was 61 (range, 33-85) years. Adenocarcinoma (90.4%) was the most common histopathological type. The ratios of Exon 19, exon 21, and other (rare or multiple) mutations were 59%, 25%, and 16%, respectively. 89 (84.9%) patients were de-novo metastatic at diagnosis. Before EGFR inhibitor therapy, the patients had received chemotherapy (22.9%) and palliative radiotherapy (40%). The patients received erlotinib (83.8%) or other EGFR inhibitors (16.2%) for treatment. Median overall survival was 30.8 (range 20.2-41.4) months. Overall response rate (complete or partial response) was 61.9%, stable response 11.4%, and progressive disease 26.7%. In logistic regression analysis, we found that age (p = 0.008), number of metastasis sites (p = 0.037), pathological type (adenocarcinoma or other types) (p = 0.001) were statistically significant for the overall response rate. However, gender (p = 0.98), tumor localizations (left or right lung) (p = 0.39), de-novo metastasis (p = 0.81), EGFR mutations type (p = 0.13), and type of EGFR inhibitör (p = 0.30) were not statistically significant. Conclusions: In this study, we showed real-life outcomes of the patients with EGFR-mutant metastatic non-small cell lung cancer. The data of predictors of overall response for EGFR inhibitors is limited. We detected that age, the number of metastatic organs, and histopathological type of tumor were affected the response of treatment.

Phase II study of brigatinib in ROS1 positive non-small cell lung cancer (NSCLC) patients previously treated with crizotinib: Barossa cohort 2.

9040 Background: Brigatinib is a next-generation tyrosine kinase inhibitor targeting ALK and ROS1. Crizotinib is the first drug approved for the treatment of ROS1 fusion-positive NSCLC. Standard treatment for crizotinib-resistant ROS1 positive NSCLC is not established. Barossa is a multicenter, phase II basket, study of brigatinib in patients with ROS1 positive solid tumors. This study is composed of three cohorts. ROS1 inhibitor-naïve ROS1 positive NSCLC patients were enrolled in the cohort 1, and ROS1 positive NSCLC patients previously treated with crizotinib were enrolled in the cohort 2. Patients with ROS 1 positive solid tumors other than NSCLC were enrolled in the cohort 3. This time we report the cohort 2 results. Methods: Patients with advanced, previously treated with crizotinib, ROS1 positive NSCLC received brigatinib at a dose of 180 mg once daily with a 7-day lead-in period at 90 mg. The primary end point was objective response rate (ORR; RECIST 1.1) by independent review. Key secondary endpoint was PFS, OS, and safety. The sample size was set at 19 patients, with a one-sided alpha of 0.05, beta of 0.2, and threshold and expected values for primary endpoint of 20% and 50%, respectively. Results: From July 2019 and Jan 2020, 19 patients were enrolled from 9 institutions. Baseline characteristics as follows: median age (range): 60 (31-75) years; women, n = 10 (53%); ECOG PS of 0 to 1, n = 18 (95%); never smoker, n = 11 (58%); tumor histopathological type: adenocarcinoma, n = 18 (95%). Five and 6 patients achieved PR and SD, respectively at data cutoff date of 30 Oct 2020. The ORR was 26.3% (90%CI, 11.0-47.6), and the disease control rate was 57.9% (95%CI, 33.5-79.7). The median duration of follow-up for PFS was 12.0 months. The median PFS was 7.3 months (95% CI, 1.3-9.3), and the 1-year PFS rate was 26.9% (95%CI, 9.2-48.6). Grade ≥3 TRAEs were CPK increased (21.1%), infection (5.3%), AST and/or ALT increased (5.3%), hypercalcemia (5.3%), anorexia (5.3%), hypoxia (5.3%), erythema (5.3%), hypertension (5.3%). Pneumonitis was observed in one patient (5.3%, Grade 2). No treatment-related death was observed. Conclusions: Brigatinib has modest activity for ROS1 positive NSCLC patients previously treated with crizotinib. The safety profile of brigatinib was consistent with previous studies. Enrollment of the cohort 1 for ROS1 inhibitor-naïve NSCLC patients is ongoing, and the data will be presented at a future congress. Clinical trial information: JapicCTI-194851.