Histopathological Type Of Tumor Research Articles

The effect of 11th rib excision on perioperative outcomes in patients undergoing partial nephrectomy for upper pole renal tumors.

We aimed to evaluate the effect of eleven11th rib resection.on the perioperative period TRIFECTA criteria in patients who underwent retroperitoneal partial nephrectomy (PN) with the diagnosis of upper pole kidney tumors. We conducted a retrospective analysis of the data of the patients who underwent Open PN for upper pole renal masses between 2018 and 2023. The patients were divided into two groups: PN with rib resection and PN without rib resection. The demographic characteristics, tumor sizes, PADUA scores, warm-cold renal ischemia times, mass excision and tumor bed suturing times, histopathological tumor type and surgical margin positivity of the patients were examined. Both groups were evaluated comparatively based on this data. The renal nephrometry scores of the two groups were similar. The total renal ischemia time was significantly shorter in the patients who underwent a rib resection than in those who did not (p < 0.001). Both the tumor excision and tumor bed suturing times were significantly shorter in the group that underwent a rib resection than in the group that did not (p < 0.001). The Clavien-Dindo complication grades were statistically similar between the two groups. Complex in nature and high-risk renal masses located in the upper pole of the kidney, partial nephrectomy performed with an 11th rib resection can be considered a reliable surgical option with a shorter ischemia time, supporting the preservation of long-term renal function.

Diagnostic Challenges in Pancreatic Tumors

Background: Pancreatic tumors have a large diversity, with an increasing incidence and mortality. Although the diagnosis methods have improved in recent years, establishing a diagnosis and a histopathological type of pancreatic tumor can still pose a challenge. Aim: We propose to present a concise list of difficulties regarding the clinical, biological, and imagistic diagnosis of pancreatic tumors. Key information: The clinical manifestations of pancreatic tumors depend on their location and size, on the presence of metastatic lesions, but the difficulty of orientation towards this diagnosis is determined by the fact that most lesions are asymptomatic or present in the early stages of non-specific symptoms. The usual biological parameters are non-specific in pancreatic tumors in the early stages, but studies are underway regarding a series of biomarkers, genetic micro-sequences, or inorganic nanomaterials that could be used in the early diagnosis of pancreatic cancers. An essential stage in the diagnosis of pancreatic tumors is represented by imaging investigations, which are associated with endoscopic and tumor biopsy procedures and can outline a picture regarding the presence of the tumor at the level of the pancreas, the relationship with the neighboring organs, the nature of the tumor and the histopathological type. There are a series of indications and limitations regarding each of these investigations, trying to develop various algorithms for the diagnosis of pancreatic tumors. Conclusion: The medical research conducted to develop new diagnostic procedures has the objective of ensuring an early diagnosis of pancreatic tumors, in a stage that offers the best chances of recovery for the patient.

The Learning Curve for Pancreaticoduodenectomy: The Experience of a Single Surgeon.

Pancreaticoduodenectomy (PD) is a complex and high-skill demanding procedure often associated with significant morbidity and mortality. However, the results have improved over the past two decades. However, there is a paucity of research concerning the learning curve for PD. Our aim was to report the outcomes of 100 consecutive PDs representing a single surgeon's learning curve and to depict the factors that influenced the learning process. We reviewed the first 121 PDs performed at our academic center (2013-2019) by a single surgeon; 110 were PDs (5 laparoscopic and 105 open) and 11 were total PDs (1 laparoscopic and 10 open). Subsequent statistics was performed on the first 100 PDs, with attention paid to the learning curve and survival rate at 5 years. The data were analyzed comparing the first 50 cases (Group 1) to the last 50 cases (Group 2). The most frequent histopathological tumor type was pancreatic ductal adenocarcinoma (50%). A total of 39% of patients had preoperative biliary drainage and 45% presented with positive biliary cultures. The preferred reconstruction technique included pancreaticogastrostomy (99%), in situ hepaticojejunostomy (70%), and precolic gastro-jejunal anastomosis (88%). Postoperative complications included biliary fistula (1%), pancreatic fistula (8%), pancreatic stump bleeding (4%), and delayed gastric emptying (13%). The mean operative time decreased after the first 50 cases (p < 0.001) and blood loss after 60 cases (p = 0.046). R1 resections lowered after 25 cases (p = 0.025). Vascular resections (17%) did not influence the rate of complications (p = 0.8). The survival rate at 5 years for pancreatic adenocarcinoma was 32.93%. Outcomes improve as surgeon experience increases, with proper training being the most important factor for minimizing the impact of the learning curve over the postoperative complications. Analyzing the learning curve from the perspective of a single surgeon is mandatory for accurate statistical results and interpretation.

Successes and challenges in modeling heterogeneous BRAFV600E mutated central nervous system neoplasms.

Central nervous system (CNS) neoplasms are difficult to treat due to their sensitive location. Over the past two decades, the availability of patient tumor materials facilitated large scale genomic and epigenomic profiling studies, which have resulted in detailed insights into the molecular underpinnings of CNS tumorigenesis. Based on results from these studies, CNS tumors have high molecular and cellular intra-tumoral and inter-tumoral heterogeneity. CNS cancer models have yet to reflect the broad diversity of CNS tumors and patients and the lack of such faithful cancer models represents a major bottleneck to urgently needed innovations in CNS cancer treatment. Pediatric cancer model development is lagging behind adult tumor model development, which is why we focus this review on CNS tumors mutated for BRAFV600E which are more prevalent in the pediatric patient population. BRAFV600E-mutated CNS tumors exhibit high inter-tumoral heterogeneity, encompassing clinically and histopathological diverse tumor types. Moreover, BRAFV600E is the second most common alteration in pediatric low-grade CNS tumors, and low-grade tumors are notoriously difficult to recapitulate in vitro and in vivo. Although the mutation predominates in low-grade CNS tumors, when combined with other mutations, most commonly CDKN2A deletion, BRAFV600E-mutated CNS tumors are prone to develop high-grade features, and therefore BRAFV600E-mutated CNS are a paradigm for tumor progression. Here, we describe existing in vitro and in vivo models of BRAFV600E-mutated CNS tumors, including patient-derived cell lines, patient-derived xenografts, syngeneic models, and genetically engineered mouse models, along with their advantages and shortcomings. We discuss which research gaps each model might be best suited to answer, and identify those areas in model development that need to be strengthened further. We highlight areas of potential research focus that will lead to the heightened predictive capacity of preclinical studies, allow for appropriate validation, and ultimately improve the success of "bench to bedside" translational research.

Impact of SPARC expression on treatment response of pembrolizumab and brain metastasis in patients with metastatic non-small cell lung cancer

BackgroundNon-small cell lung cancer (NSCLC) often exhibits elevated Secreted Protein Acidic and Cysteine-Rich (SPARC) expression. In this study, we investigated the impact of SPARC expression on clinicopathologic features, pembrolizumab response, and prognosis in metastatic NSCLC patients. MethodsThirty-six patients diagnosed with metastatic NSCLC without actionable driver mutation and who received pembrolizumab with or without chemotherapy were included in this study. PD-L1 and SPARC expression were evaluated, with PD-L1 expression categorized based on tumor proportion score and SPARC staining intensity graded as 1+, 2+, and 3 +. Patients’ characteristics were compared across groups, and possible predictive markers were determined by binary logistic regression analysis. ResultsNo significant associations were found between SPARC expression and smoking status, histopathological tumor type, T and N status, and liver and bone metastasis. Higher SPARC expression was significantly linked to lower brain metastasis rates but higher CNS progression rates (p = 0.022 and p = 0.011, respectively. The objective response rate (ORR) showed a trend of being higher in the SPARC 1 + group (85.7% vs. 43.8% and 50.0% in 2 + and 3 + groups, respectively, p = 0.052. Univariate analysis did not find SPARC expression to be a significant prognostic factor for progression-free survival (PFS) (p = 0.7) and overall survival (OS) (p = 0.07).SPARC 1 + expression negatively affected the pembrolizumab response(p = 0.04,OR:0.11, 95%CI 0.01–0.92). ConclusionsOur study sheds light on a novel aspect of SPARC expression as a potential predictor of pembrolizumab response and a marker for CNS progression in metastatic NSCLC patients treated in the first-line setting.

Breast cancer molecular subtype and relationship with clinicopathological profiles among Vietnamese women: A retrospective study

BackgroundMolecular subtypes play an important role in predicting prognosis and guiding treatment for breast cancer. Having a better knowledge of ethnic molecular features is essential. ObjectivesDetermining the distribution of various breast cancer molecular subtypes and investigating the relationship between these subtypes and clinicopathological features. MethodsRetrospective data was collected from Hanoi National Cancer Hospital and Bach Mai Hospital that included 274 women diagnosed with invasive breast cancer between January 2017 and June 2019. Patients were categorized into five subtypes according to the 2015 St. Gallen molecular classification. The variables analyzed were molecular subtypes and tumor-related characteristics. To evaluate the relationship between these subtypes and clinicopathological features, a Chi-squared test and Fisher exact test were performed. ResultsThe most prominent subtype was Luminal A (33.2%), followed by Luminal B/Her2- (19.7%) and Luminal B/Her2 + (17.5%), then HER2 overexpression (16.4%), whereas triple negative was the least popular subtype (13.1%). Particularly, 33.9% of all patients, including the Luminal B/Her2 + and the HER2 overexpressing groups, were Her2 positive. There was a statistically significant difference between molecular subtypes and histological type (p = 0.01), tumor grade (p < 0.001), but it was independent of age, tumor size, lymph node metastasis, and lymphovascular invasion. ConclusionsIn contrast to the triple negative variant, the Luminal A variant is the most common among Vietnamese women. The rate of positive tests for HER2 was rather high. These subtypes were closely related to tumor grade and histopathological type. Understanding the molecular subtypes and their relation to clinicopathological features helps clinicians with patient treatment, and prognosis. The application of the 2015 St. Gallen molecular classification should be recommended for use in clinical practice.

Association between Histopathologic Type of Ovarian Cancer and Serum CA-125 Level

Objective: to find an association between the serum CA-125 level and the histopathological type of ovarian tumor. Study Design: Cross-sectional study. Place and Duration of Study: Medical Oncology, Jinnah postgraduate Medical Center, Karachi Pakistan from Jan 2018 to Dec 2019. Methodology: This study included 107 patients presenting with epithelial ovarian cancer. In each case, histological type, pathological stage, degree of differentiation and serum CA-125 was evaluated. The association between preoperative CA-125 and histopathological type of tumor were evaluated. Result: About 107 ovarian cancer patients were included. The mean age in our study was 50.80±10.16 years. Raised CA-125 level was found in most of the patients with serous histology 46(56.1%). Conclusion: Serum level CA-125 elevated in most patients with serous histology. A statistically non-significant association was found between raise CA-125 levels and histological types of ovarian cancer.

Central Nervous System tumor at “Prof. Dr. I.G.N.G. Ngoerah” General Hospital, Denpasar: An epidemiological study between 2020-2022

Background. Central Nervous System (CNS) tumor is neoplasm that located in central nervous system, which include brain and medulla spinalis. Despite its significant raise of incidence and morbidities, limited epidemiological data was available. Therefore, this study aimed to describe the epidemiological characteristic of CNS tumor over a 3-year period in a single tertiary hospital in Bali, Indonesia. Methods. This study was a descriptive study with cross sectional design. This study included all patients aged 18 year or over who were histopathologically diagnosed with central nervous tumor at “Prof. Dr. I.G.N.G. Ngoerah General Hospital”, Denpasar, between January 2020 and December 2022. Data about age, gender, tumor location, histopathological type, tumor grading, and source of metastases in secondary CNS tumor were obtained from medical record. Result. A total of 221 cases were recorded during this study period. The prevalence of primary CNS tumor was 81.9% while secondary CNS tumor was 18.1%. The majority of case, both in primary and secondary CNS tumor were female in age group of 50-59. Supratentorial constituted the most common lesion site in primary and secondary CNS tumor. The most frequent histopathological type of primary CNS tumor was meningioma, making up 48.1% of cases, followed by diffuse astrocytic and oligodendroglial tumors (26.5%), and tumor of the cranial and paraspinal nerve (9.9%). Carcinoma is the most common histological type in secondary CNS tumor with lung and breast tumor being the majority source of secondary CNS tumor, found in 40% and 27.5%, respectively. Conclusion. Adult female with age of 50-59 is the most affected group in CNS tumor. Primary CNS tumor were commonly found in supratentorial with meningioma and WHO grade I being the most frequent histopathological type and grade. Secondary CNS tumor were mostly found in supratentorial and originated from primary lung tumor.

Profil Klinikopatologi Meningioma di Instalasi Patologi Anatomi RSUD Dr. Saiful Anwar Malang Periode Tahun 2016-2020

Background. The most common intracranial neoplasms worldwide is meningioma. It has been classified into three grades by World Health Organization (WHO) in which each grade has several histological variants. The prognosis of meningioma is affected by many factors including histopathological type of tumor, age, and gender.&#x0D; Objective. The aim of this study is to determine the frequency of meningioma based on histopathological type, age, and gender from 2016 to 2020 in Saiful Anwar General Hospital Malang.&#x0D; Methods. This study was a quantitative descriptive study and data was collected from medical records from 2016 to 2020 in Department of Anatomic Pathology, Medical Faculty, Brawijaya University, Saiful Anwar General Hospital Malang. Histopathological type of meningioma, age, and gender were acquired.&#x0D; Results and Discussion. From 2016 to 2020, there were 96 eligible cases of meningioma. Ratio of men to women was 1:12.7. Meningioma was most commonly found in age group 41­50 years old (43.75%). The most common histopathological type of meningioma was meningotheliomatous meningioma (37.5%). The average of meningioma cases was 19 per year. In this study, there was an increase in incidence rate of meningioma in 2017, and decreased in 2020. It may happen because The government has a better referral system to provide health care, thus meningioma can be detected earlier.&#x0D; Conclusion. Frequency of meningioma is higher in women than men, and increases with age until 50 years, which then decreases. Meningotheliomatous meningioma is the most common histopathological type in this study.&#x0D; &#x0D;

Histopathological study of ovarian lesions at a tertiary health-care center

Background: Ovary is the most common site of non-neoplastic and neoplastic lesions, can appear at any age, and is the leading cause of hospitalization and surgery. The ovary is made up of totipotent sex cells and multipotent mesenchymal cells. As a result, when it becomes neoplastic, almost any type of tumor can develop. Aims and Objectives: The aim of the study was to find out the histopathological findings of ovarian lesions. Materials and Methods: The present study was carried out in the Department of Pathology, Pacific Institute of Medical Sciences, Udaipur, from April 2021 to September 2022 and includes 102 cases of ovarian lesions. Histopathology department received the specimens in formalin filled container and performed routine grossing and H and E staining procedure. Results: The incidence of neoplastic ovarian lesion was 40.2%. Majority of non-neoplastic lesion of ovary was follicular cyst (42.6%) followed by simple cyst (36.1%). Surface epithelial tumor was diagnosed in majority of ovarian tumors (73.2%) followed by germ cell tumor (22.0%). The majority histopathological benign tumor type was serous cystadenoma (43.9%) and malignant was high-grade serous carcinoma (14.63%). Conclusion: The incidence rate increased with age, with the greatest number of new cases being diagnosed beyond 4th and 5th decade. In our study, the youngest patient was of 2 year and oldest was of more than 60 years. However, histopathological study of ovarian tumors is still considered as a gold standard method, our observations and results proved to be valuable base line information regarding frequency and pattern of ovarian tumors.

Clinicopathological features of our renal cell carcinoma metastasis cases: A single-center experience

Renal cell carcinoma (RCC) is the most common renal tumor in adults, arising from renal tubular epithelial cells. Approximately 30% of patients with RCC have metastases at the time of diagnosis, while metastases can be seen in 40% of patients during follow-up after nephrectomy. Metastases most commonly occur in the lung, bone, and lymph nodes. In our study, we aimed to retrospectively examine the cases diagnosed with RCC metastasis and evaluate their clinicopathological features. Age, gender, metastasis site, number of metastatic foci, localization of primary kidney tumor, histopathological type of primary kidney tumor, diameter of primary kidney tumor, grade of primary kidney tumor, and survival status of 52 patients diagnosed with RCC metastasis were recorded. Eleven (21.2%) of the cases had primary RCC and simultaneous (synchronous) RCC metastasis in the kidney. In 27 (51.9%) cases, RCC metastasis was detected in the follow-up period (metachronous) after nephrectomy due to the diagnosis of primary. The number of patients who were initially diagnosed with RCC metastasis and then were found to have primary RCC in the kidney was 14 (26.9%). Thirty-nine (75%) cases had a single metastatic focus. Metastasis site distribution of the cases; bone 18 (34.6%), lung 16 (30.8%), lymph nodes 8 (15.4%), liver 6 (11.5%), adrenal gland 6 (11.5%), brain 4 (7.7%) was. RCC metastases can occur as metastatic disease before primary tumor diagnosis, at the time of primary tumor diagnosis, or years after nephrectomy.

Inflammatory Markers in Lung CancerA Comparative Cross-sectional Study

Introduction: Lung cancer is the most common cause of cancer mortality worldwide, principally because of its late diagnosis. Chronic inflammation plays a significant role in tumour growth and progression via increasing the levels of inflammatory markers in blood. Inflammatory markers are expected to be valuable prognostic biomarkers in cancer. Markers like Absolute Neutrophil Count (ANC), Absolute Lymphocyte Count (ALC), platelet count, Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) may aid in assessing prognosis of lung cancer. Aim: To study the inflammatory markers (ANC, ALC, Platelet count, NLR and PLR) in lung cancer and correlate these markers with cancer stage and histopathological type. Materials and Methods: A hospital-based cross-sectional study was conducted in lung cancer patients at Institute of Respiratory Diseases, SMS Medical College, Jaipur, Rajasthan, India. Sixty patients with lung cancer and sixty controls were included. The clinical characteristics, ANC, ALC, platelet count, NLR and PLR of cases and controls were assessed and compared. Also, the comparison of these inflammatory markers with Tumor, Nodes and Metastases (TNM) staging and histopathological type of lung cancer were documented and results were interpreted. The data analysis was done with the use of Statistical Package for Social Sciences (SPSS) software, IBM manufacturer, Chicago, USA, (Ver.) 26. Results: Mean age (years) of the case and control groups was 60.17 and 61.03, respectively. Distribution of gender in cases and controls was comparable. The major histology of lung cancer was Non-Small Cell Lung Cancer (NSCLC, 81.66%) out of which squamous cell carcinoma constituted 55.00% and adenocarcinoma 21.67%, followed by small cell carcinoma at 18.33%. Overall, 46.67% of the patients belonged to TNM staging IVA followed by IIIB (25.00%). The levels of ANC, platelet count, NLR and PLR were significantly elevated and ALC was decreased in cases as compared to control. There was no statistically significant association between the inflammatory markers ANC, ALC, platelet counts, NLR and PLR with the histopathological type of lung cancer. Mean ANC, platelet count, NLR and PLR were found to be significantly elevated in late stages of lung cancer, whereas, ALC had no such association with the stages of lung cancer. Conclusion: Inflammatory markers (ANC, platelet count, NLR, PLR, ALC) can serve as valuable prognostic biomarkers in lung cancer and can easily be used in resource-limited areas.

A hospital-based study on the distribution of ovarian tumors in the tribal and nontribal population of Ranchi, Jharkhand

Objectives: This study aimed to determine the types and management of ovarian tumors in tribal and nontribal population of Jharkhand. Methods: This prospective study was conducted in the Department of Pathology for duration of 24 months from December 2019 till November 2021. The study included the data (age and clinical symptoms) of patients of ovarian tumors who attended the Gynecology Outpatient Department and were managed with surgery or neoadjuvant therapy. The diagnosis was confirmed through radiology investigations, tumor markers, and histopathology. Histopathological reports of samples sent to the Department of Pathology were included. Results: A total of 150 patients with ovarian tumors were included, among which 63 (42%) were tribal. As compared to nontribals, tribals had comparable mean age (39.05 ± 12.18 vs. 36.55 ± 11.77, P = 0.469), comparable parity, and socioeconomic status. The most common complaints were pain in lower abdomen (80%), lump in lower abdomen (34%), and abdominal distension (18%). Epithelial tumors constituted the majority of tumors, and histopathological types included mucinous adenocarcinoma (26%), dermoid cyst (16%), serous cystadenoma (10%), and simple ovarian cyst (10%). Distribution of histopathological type of tumor was comparable between nontribal and tribal (P = 0.478). Seventy-four percent of the patients were managed operatively, which included unilateral ovarian mass/cyst removal, ovarian mass removal, total abdominal hysterectomy, and opposite side salpingo-oophorectomy, whereas 26% of the patients were managed conservatively with chemotherapy. There was no mortality, and the overall outcomes were comparable between nontribals and tribals (P > 0.05). Conclusion: The demographic characteristics, clinical presentations, histopathological type, management, and outcomes were similar among tribal and nontribal patients with ovarian tumors.

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&lt;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&lt;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,&lt;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&lt;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 &lt;0.01) and patients with benign ovarian tumors (P value 0.014 &lt;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&lt;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.

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 &amp; 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 &amp; 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) &amp; 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.