Organ-preserving Treatment Research Articles

Characteristics of multiple esophageal squamous cell carcinomas detected in the surveillance after endoscopic resection.

Endoscopic resection (ER) of esophageal squamous cell carcinoma (ESCC) is an organ-preserving treatment; however, heterochronic carcinomas are often encountered. Most patients are treated using ER; however, for some, this is inadequate and requires additional treatment. We sought to identify the characteristics and frequency of lesions at high risk of metastasis during surveillance based on Lugol-voiding lesion (LVL) grading and esophagogastroduodenoscopy (EGD) intervals. Of the 1301 patients who underwent ER, 956 underwent surveillance EGD at our hospital for at least 1year (median, 59months). We analyzed identified multiple ESCCs to reveal the characteristic of high-metastasis-risk lesions, which was defined ESCC with submucosal or lymphovascular invasion. In the 956 patients, 444 multiple ESCCs were identified in 216 patients and the cumulative incidence of multiple ESCCs was 15.4% and 22.9% at 3 and 5years, respectively, while for high-risk lesions, it was 1.0% and 1.8%. The risk factors for high-metastasis-risk lesions were being female (odds ratio (OR):5.58, 95% confidence interval (CI):1.96-15.9), lesions located in the cervical/upper thoracic esophagus (OR: 4.81, 95% CI:1.80-12.8), and the presence of submucosal tumor (SMT)-like marginal elevation (OR:65.4, 95% CI:11.0-390). No significant differences in the frequency of high-risk lesions were found based on LVL grade at any EGD intervals. During endoscopic surveillance, attention should be given to the cervical/upper thoracic esophagus and lesions with SMT-like marginal elevation. The frequency of high-metastasis-risk lesions was not different by LVL grade or EGD intervals.

The use of multipotent mesenchymal cells in the complex treatment of osteonecrosis of the femoral head.

Background. Avascular necrosis of the femoral head (ANFH) is a disabling disease that often leads to hip replacement. However, due to the increasing incidence among the young population, various methods of organ-preserving treatment have been proposed aimed at slowing the progression of ANFH and preserving the function of the hip joint. Today, the procedure for introducing mesenchymal cells into the focus of osteonecrosis causes a lot of controversy and disagreement, which is the subject of discussion in our review. Aim of the study: a non-systematic analysis of the accumulated literature data on the effectiveness, safety, advantages and disadvantages of treating patients with early stages of avascular necrosis of the femoral head using the tunneling method using multipotent mesenchymal cells, as well as their impact on reducing the risk of disease progression and long-term treatment results. Material and Methods. A 10-year literature search (2013-2023) was conducted in the PubMed, Scopus and eLIBRARY databases. According to our inclusion criteria, the review included 8 high-quality studies that used mesenchymal cells to treat ANFH. Results. We analyzed 548 hips from 8 studies based on our inclusion and non-inclusion criteria. The mean follow-up period was from 24 to 360 months. In most cases, functional indicators improved. Radiological progression to the next stage occurred in 31.25% of cases and the need for hip arthroplasty was 30.6% in the group where mesenchymal cells were used. Conclusion. The use of multipotent mesenchymal cells in the complex treatment of ANFH in the early (I, II according to ARCO) stages of ANFH can improve the function of the hip joint, slow down the progression of the disease and reduce the need for hip arthroplasty.

Endoscopic diagnosis of laryngeal precancerous lesions and early laryngeal cancer

ISince laryngeal cancer currently occupies a leading position in frequency of occurrence among all tumors of the upper respiratory tract of modern humans, the importance of its detection at an early stage of development cannot be overestimated. Existing diagnostic methods using rigid endoscopes, including direct and indirect laryngoscopy, have significant limitations in a number of patients. The use of modern video endoscopic technology allows diagnosing precancerous lesions and laryngeal cancer at an early stage of the tumor process, which significantly expands the possibilities of minimally invasive organ-preserving treatment.

Quality of life and functional outcome of rectal cancer patients: A prospective cohort study.

In the last decade, the Netherlands has implemented various diagnostic and treatment strategies to enhance rectal cancer outcomes. This study, using data from the Prospective Dutch ColoRectal Cancer (PLCRC) cohort, investigates whether these multidisciplinary advancements have translated into improved health-related quality of life (HRQoL) and functional outcomes for the general Dutch rectal cancer population. Patients with Stage I-III rectal cancer enrolled in the PLCRC cohort were included. HRQoL and functional outcomes were assessed 1 and 2 years after diagnosis using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30), EORTC QLQ Colorectal Cancer 29 and the Low Anterior Resection Syndrome score. HRQoL and functional outcomes were compared based on year of diagnosis (2014-2019). A total of 1294 patients were included. Two years after diagnosis, patients diagnosed in 2019 (n = 392) had a clinically relevant higher score on physical (8.2, 95% CI 4.1-12.3), role (13.5, 95% CI 7.3-19.7) and social functioning (5.8, 95% CI 0.3-11.2) compared to those diagnosed in 2014 (n = 65). Additionally, patients diagnosed in 2019 experienced less fatigue 2 years after diagnosis compared to those diagnosed in 2014 (-8.6, 95% CI -14.1 to -3.0). The Low Anterior Resection Syndrome score showed no differences. The findings of this study suggest that over the past decade rectal cancer patients in the Netherlands have witnessed improvements in HRQoL across various domains. Most probably, the improvement is due to a combination of implementation of population screening, a more restrictive neoadjuvant radiotherapy policy and advances in minimally invasive surgery and organ preserving treatment options.

Organ-preserving treatment for urothelial carcinoma of the upper urinary tract

Urothelial carcinoma of the upper urinary tract is rare but the incidence is currently increasing in western countries. Radical nephroureterectomy has long been the standard treatment; however, it can lead to chronic kidney failure and also the necessity for dialysis. Therefore, organ-preserving treatment is now recommended for selected patients with low-risk tumors. The choice of treatment depends on the tumor characteristics, comorbidities and individual risk factors. Surgical options for organ preservation include ureterorenoscopy (URS), percutaneous treatment and partial ureteral resection. The URS is the most frequently used method for organ preservation. Photodynamic diagnostics (PDD) and narrow band imaging (NBI) can potentially also be used for tumor detection in the upper urinary tract. Conservative options such as topical treatment with mitomycinC or Bacillus Calmette-Guérin (BCG) and systemic treatment options are also possible.

1340: Timing of Contact X-ray Brachytherapy in organ-preserving treatment of small rectal cancer

1340: Timing of Contact X-ray Brachytherapy in organ-preserving treatment of small rectal cancer

Brachytherapy for organ-preserving treatment of bladder cancer

Brachytherapy for organ-preserving treatment of bladder cancer

Factors associated with total laryngectomy following organ-preserving treatment of laryngeal SCC.

A subset of laryngeal squamous cell carcinoma (LSCC) patients undergoing larynx preserving treatment ultimately require total laryngectomy (TL) for oncologic or functional reasons. This study aims to identify TL risk factors in these patients. Retrospective cohort study using Veterans Affairs (VA) database. T1-T4 LSCC cases treated with primary radiotherapy (XRT) or chemoradiotherapy (CRT) were assessed for TL and recurrence. Binary logistic and Cox regression and Kaplan-Meier analyses were implemented. Of 5390 cases, 863 (16.0%) underwent TL. On multivariable analysis, age (adjusted odds ratio: 0.97 [0.96-0.98]; p < .001) and N3 disease (0.42 [0.18-1.00]; p = .050) were associated with reduced risk of TL, whereas current alcohol use (1.22 [1.04-1.43]; p = .015) and >T1 disease (T2, 1.76 [1.44-2.17]; p < .001; T3, 2.06 [1.58-2.68]; p < .001; T4, 1.79 [1.26-2.53]; p = .001) were associated with increased risk of TL. However, N2 (adjusted hazard ratio: 1.30 [1.10-1.55]; p = .003) and N3 (2.02 [1.25-3.26]; p = .004) disease were associated with an increased risk for local recurrence. Compared to XRT, treatment with CRT was associated with reduced risk for local recurrence after adjusting for other factors (0.84 [0.70-0.99]; p = .044). Those who do not receive TL following local recurrence have poorer disease-specific survival (log-rank, p < .001). In patients without local recurrence, N2 disease was associated with a fourfold increase in risk of TL (4.24 [1.83-9.82]; p < .001). Advanced nodal stage was associated with reduced rates of salvage TL in the setting of local recurrence, and subsequent worse prognosis after recurrence. Conversely, advanced nodal stage may increase the risk for functional salvage TL in patients without recurrence. Level 3.

Current state of the problem of assessing the quality of life in patients with cervical cancer after organ-preserving treatment

An indicator of the effectiveness of treatment of cancer patients, in addition to oncological results, is also the preservation of their quality of life. Quality of life assessment is a modern research method that allows identifying even minor changes in any spheres of human activity in order to comprehensively determine the effectiveness of treatment. The quality of life of cancer patients is a priority and promising area of modern medicine.The article presents information about the current state of the problem of quality of life of patients with cervical cancer after organ-preserving treatment. The results of a number of foreign studies published on this topic are presented. In addition, the results of a prospective study conducted in the Department of Gynecology of the Tomsk Oncology Research Institute are presented. In conclusion, the need for additional study of reproductive results and determining which factors need to be further evaluated, speaking of a comprehensive assessment, is shown.

Sequence of Contact X-ray Brachytherapy (CXB) and External Beam Radiation (EBRT) in organ-preserving treatment for small rectal cancer

Background and purposeExternal Beam Radiotherapy (EBRT) followed by Contact X-ray Brachytherapy (CXB) and vice versa are viable alternatives to surgery for selected rectal cancer patients who have small tumours (≤3 cm). However, the optimal sequence of treatment needs to be established. We compared two approaches using Propensity Score (PS) matching and inverse probability treatment weighting (IPTW) analyses to investigate whether the sequence of treatment affected patient outcomes. Materials and methodsThis retrospective analysis (2008–2019) included patients with rectal adenocarcinoma (cT1-3,N0-1,M0, grade 1–2, size ≤ 3 cm) who received both EBRT and CXB, irrespective of treatment sequence. PS matching and IPTW were conducted to balance covariate standardised mean differences between groups. Oncological outcomes and rate of post-treatment rectal bleeding were assessed. ResultsFollowing PS matching and IPTW analyses from 251 eligible patients; 103 starting with EBRT (median follow-up: 37 [IQR:18–56] months) and 148 with CXB (median follow-up: 32 [IQR:16–54] months, a significant improvement in 3-year overall survival (77% vs 85%, p = 0.02, [HR:0.58 (95% CI:0.37–0.91)]) and a higher risk of post-treatment rectal bleeding (grade 1 (26%) and grade 2 (6%)) were found in patients who started with CXB (p = 0.08). No significant differences were observed in local regrowth (18% vs 12%, p = 0.47), distant relapse (10% vs 6%, p = 0.53), 3-year organ preservation rates (70% vs 75%, p = 0.20, [HR:0.66 (95% CI: 0.35–1.26)]), or disease-free survival (78% vs 82%, p = 0.17, [HR: 0.47 (95% CI: 0.16–1.38)]) ConclusionIn patients with rectal cancer (≤3 cm), commencing with CXB rather than EBRT, was associated with improved overall survival, but had a higher risk of G1/2 rectal bleeding. No statistically significant differences were observed in other oncological outcomes.

Фотодинамическая терапия в комбинированном лечении меланомы хориоидеи

Abstract Photodynamic therapy in the combined treatment of choroidal melanoma E.V. Samkovich, I.E. Panova, E.V. Boyko, E.M. Svistunova, A.A. Bykhovskii S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, St. Petersburg North-Western State Medical University named after I.I. Mechnikov, St. Petersburg Purpose. To evaluate the effectiveness of the combined treatment ofchoroidal melanoma (CM) based on the use of PDT and Ru-106+Rh-106brachytherapy (BT). Material and methods. Retrospective analysiswas carried out in 48 patients (48 eyes) with CM. Distribution ofpatients according to TNM system: T1N0M0 – 2 patients, T2N0M0 – 14,T3N0M0 – 32. All patients were divided into 2 study groups: 1st group –25 patients (25 eyes) who underwent Ru/Ro-106 BT in isolation, SOD125.4±12.3 Gy; 2nd group – 23 patients (23 eyes) who underwentcombined treatment: Ru-106+Rh-106 BT (SOD 127.3±13.6 Gy) + PDT.Diagnostics was carried out on the basis of clinical and instrumentalexamination including complex ultrasound with estimation of thetumor vascularization degree. Results. Application of complex organpreservation treatment, including photodynamic therapy, followedby BT promotes acceleration of rates of tumor regression in 3, 6, 12 months (p&lt;0.05). It was reliably found that the signs of intratumoralvascularization of CM (p&lt;0.05) decrease after a combined treatment.A comparative analysis of the effectiveness of the two variants of organpreservation treatment of CM has shown a higher efficacy of PDT andBT, based on complete regression of the tumor and local control ina significantly larger number of patients (p&lt;0.05). Conclusion. Theresults of application of PDT in the combined treatment of CM show theprospects of the method application to achieve a faster rate of tumorregression and a preventive measure of haematogenous metastasis dueto necrosis and blocking of vessels feeding the tumor. Key words: choroidal melanoma, photodynamic therapy, brachytherapy,uveal melanoma, ophthalmo-oncology, choroidal melanoma treatment

Current Management of T1 Colon Cancer in Denmark: A Nationwide Cohort Study.

To describe the management of T1 colon cancer in a retrospective study of a national cancer registry. There is increasing interest in the potential of local excision (LE) as an organ-preserving treatment for early colon cancer. However, accurate identification of patients who may have lymph node metastases (LNM) and require further surgery is a major challenge. Patients diagnosed with T1 colon cancer in Denmark from 2016 to 2020 were included and divided according to treatment: polypectomy (referred to as LE), upfront colectomy and completion colectomy. Primary outcome was the proportion of patients diagnosed by LE. Secondary outcomes included the rate of LNM, the association of histopathological risk factors with LNM, and overall survival. 1,749 patients were included, and 1,022 patients (58.4%) underwent initial LE. The rate of R1 margins after initial LE was 31.0%. Colectomy was performed in 1,160 patients (upfront in 727, completion in 433), of whom 58.3% had pT1 cancer. The rate of LNM was 11.5%. Rates of LNM were similar in patients undergoing upfront or completion colectomy (10.2% vs 12.4%, P=0.392), and in patients with any single histopathological risk factor compared to those with none (8.9% vs 10.6%, P=0.565). Although overall survival was significantly shorter in patients undergoing LE alone, no association between survival and treatment strategy was found on multivariable analysis. LE is the most common mode of diagnosis in patients with T1 colon cancer and does not negatively impact survival and postoperative outcomes. Current strategies to stratify patients to completion surgery appear insufficient, and more robust predictors are needed.

#516 Cancer after kidney transplantation in the single transplant center

Abstract Background and Aims A retrospective analysis of peculiarities of development of malignant neoplasms in patients after kidney transplantation receiving long-term immunosuppression. Method In this study we evaluated incidence of malignancies observed among 718 renal transplant recipient with at least 6 months of follow-up. A total of 561 men and 257 women, mean age at transplantation 36.3 ± 8.3 years were included. Results Thirty-three out of 718 recipients (4.6%) developed malignant neoplasia: 45.5% of these were Kaposi's sarcomas, 12.1%—cancers of the uterine cervix, 12.1% cancer of the stomach, 12.1% - basal cell carcinomas, 6.06% - post transplant lymphoproliferative disorder. There was no significant effect of either cyclosporine A, tacrolimus doses or OKT3/ATG on the incidence of the tumors. The median time from onset of end-stage renal failure (dialysis start) and from the transplantation to the diagnosis of the tumor make up 32 (16-161) and 23 (5-158) mouths, respectively. One renal transplant recipient suffered from multiple myeloma with aggressive course. Three patients diagnosed with renal cell carcinoma of the transplant: clear cell carcinoma, papillary carcinoma, mucinous adenocarcinoma via 264, 24 and 4 months respectively. Conclusion The importance of strict adherence to intensive monitoring transplant patients, which can detect tumors at an early stage. Strict adherence to intensive follow-up of transplant patients is important, which makes it possible to identify neoplasms at an early stage, when organ-preserving treatment is feasible and effective. In addition, modification of immunosuppressive therapy in such patients involves reducing the dose or, if possible, completely eliminating calcineurin inhibitors and starting taking mTOR inhibitors (sirolimus or everolimus), taking into account the antitumor effect of this group of immunosuppressants.

Abstract PO1-02-09: Efficacy of breast conserving treatment of minimal residual tumors after neoadjuvant therapy for breast cancer

Abstract Background. Determining the most effective drug therapy regimens is one of the top priorities in the individualization of the treatment of patients with breast cancer (BC). Achievement of pathological complete response (pCR) is important prognostic factor, and used as the surrogate primary end point in many clinical trials. According to the literature, the achievement of pCR after neoadjuvant systemic treatment (NST) in breast cancer varies from 30 to 70%. Patients who do not achieve pCR require post-neoadjuvant treatment, even when reaching minimal size of residual tumors. Initially, primary minimal tumors are characterized by high survival rates, which are proved by international and domestic studies. It is required to clarify the survival rates in the presence of a minimal residual tumor (ypT &amp;lt; 10mm) after neoadjuvant systemic therapy and to compare with primary minimal forms of breast cancer (pT1a-b N0M0), characterized by the most favorable prognosis. Objective. Improvement of the effectiveness of treatment of residual minimal forms (ypT1a-b) of BC after NST. Determination of the correlation between the schemes of NST and the rates of tumor response based on the results of postoperative pathological reports including RCB scale. Methods. The study included 602 patients aged 18–65 years with early and locally advanced I–IIIC stage T1-3N1-3M0 breast cancer,who underwent complex or combined treatment. This study included patients treated at the N.N. Petrov National Medical Research Center of Oncology from 2015 to 2021 Conclusion. After reaching a complete pathomorphological response of the tumor to NST (RCB 0), the 5-year disease-free (DFS) and overall (OS) survival rates (DFS – 78.5%; OS 90.4%) were inferior to the survival rates of patients with primary minimal breast cancer (pT1ab N0M0) [DFS – 86.4%; OS – 98.6%]. Neoadjuvant chemotherapy regimens that allow achieving a pathological complete response in triple-negative and HER2- positive breast cancer have been defined. An assessment of adverse factors that affect the effectiveness of breast conserving treatment and correlate with a deterioration in overall survival was performed. Results. Our data analysis revealed that the survival rates (DFS and OS) of patients with minimal residual tumor after neojuvant systemic therapy were not comparable with those in the group of patients with primary minimal breast cancer. Data analysis revealed the most effective combinations of drugs expressed in the rates of pathomorphological response according to the RCB scale. An assessment of adverse factors that affect the effectiveness of organ-preserving treatment and correlate with a deterioration in overall survival was performed. Citation Format: Roman Pesotsky, Vladimir Semiglazov, Petr Krivorotko, Tengiz Tabagua, Konstantin Zernov, Alexander Emelyanov, Viktoria Mortada, Nikolay Amirov, Daria Ulrikh, Valerii Levchenko, Yana Bondarchuk, Diana Enaldieva, Nestan Bekkeldieva, Konsantin Zirov, Sergey Yerechshenko, Vladislav Evseev, Kirill Rychagov, Sergey Novikov, Maria Kazantseva, Larisa Gigolaeva, Elena Zhiltsova, Denis Nesterov, Olga Ivanova, Tatiana Semiglazova. Efficacy of breast conserving treatment of minimal residual tumors after neoadjuvant therapy for breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-02-09.

Organ-preserving treatment of a patient with a trophoblastic tumor of the placental bed (clinical observation and literature review)

Placental site trophoblastic tumor (PSTT) is а rare form of gestational trophoblastic neoplasia (GTN), accounting 0,2 % of total cases of GTN. PSTTs occur in women of childbearing age and most of them have strong desire to preserve fertility. PSSTs are tumors with unpredictable biological behavior, high chemo-resistance and possibly fatal outcome in case of metastatic disease.Hysterectomy is the primary treatment of choice in early disease. We report a rare clinical case of fertility sparing treatment for PSTT.

Transoral robotic surgery for supraglottic cancer. A review of oncological and functional outcomes compared to open surgery.

Supraglottic squamous cell carcinoma (SCC) represents a major surgical challenge in organ-preserving treatment. Type I open partial horizontal laryngectomy (OPHL I) is considered the most popular. To date, minimally-invasive approaches such as laser microsurgery and transoral robotic surgery (TORS) have gained increasing relevance. The aim of this narrative review is to obtain a descriptive comparison of functional and oncological outcomes from studies on patients with supraglottic SCC treated with OPHL I and TORS, respectively. A computerised search was performed using the Pubmed database for articles published from 2000 to 2023. A comparative analysis on functional and oncological outcomes of patients treated by TORS and OPHL I was performed. The present narrative review shows a superiority of TORS compared to open surgery for supraglottic SCC in terms of functional outcomes, while maintaining comparable oncological outcomes. Although recently introduced in the treatment of laryngeal pathology, TORS has been shown to be a reliable technique not only for functional but also for oncological outcomes, ensuring good overall survival, disease-free survival, and disease control rates comparable to OPHL I.

MODERN METHODS OF TREATMENT UTERINE FIBROIDS

Approaches to organ-preserving treatment of uterine fibroids began to develop in parallel with the creation of radical methods of treating this disease, but this direction has always lagged somewhat behind and had few supporters. Recently, organ-preserving treatment of uterine fibroids has become one of the priority areas. In general, this is a completely natural process, due to both the development of modern treatment technologies and the growing need of women to solve reproductive problems. What is the reason for this? On the one hand, there is a persistent tendency to get pregnant at a late reproductive age, on the other hand, uterine fibroids are increasingly diagnosed in young, nulliparous women. In addition, the development of the media and the Internet is of no small importance, which, in turn, began to pay more attention to health and medical issues, covering new medical technologies. Effective organ-preserving treatment of uterine fibroids is impossible without a full understanding of this disease. The concept of "uterine fibroids" includes a heterogeneous group of conditions that characterize pathological changes in the uterus. The doctor can call uterine fibroids a single node in the uterus 1 cm in size, which does not have any clinical manifestation, and multiple uterine fibroids, corresponding to 25 weeks of pregnancy, manifested by bleeding and compression of adjacent organs. Therefore, the approach to the treatment of this disease largely depends on the correct clinical classification. The currently existing classifications (histological and localization) are unacceptable in practical gynecology and in fact do not carry any tactical information. The currently widely used indications for hysterectomy in practice make it possible to observe patients up to the turn of 12 weeks, i.e., they allow passivity in relation to patients with smaller fibroids. Thus, a classification is needed that combines such characteristics as: size, number of nodes, localization, and reproductive plans of the patient, that is, a classification is needed that allows the doctor to predict treatment tactics immediately.

Analysis of CDO1, PITX2, and CDH13 Gene Methylation in Early Endometrial Cancer for Prediction of Medical Treatment Outcomes.

To determine CDO1, PITX2, and CDH13 gene methylation levels in early endometrial cancer and atypical hyperplasia specimens obtained before organ-preserving treatment in the patients with adequate response and with insufficient response to hormonal treatment. A total of 41 endometrial specimens obtained during diagnostic uterine curettage in women with EC (n = 28) and AEH (n = 13), willing to preserve reproductive function, were studied; 18 specimens of uterine cancer IA stage G1 from peri- and early postmenopausal women (comparison group) were included in the study. The control group included 18 endometrial specimens from healthy women obtained by diagnostic curettage for missed abortion and/or intrauterine adhesions. Methylation levels were analyzed using the modified MS-HRM method. All 13 women with AEH had a complete response (CR) to medical treatment. In the group undergoing organ-preserving treatment for uterine cancer IA stage G1 (n = 28), 14 patients had a complete response (EC CR group) and 14 did not (EC non-CR group). It was found that all groups had statistically significant differences in CDO1 gene methylation levels compared to the control group (p < 0.001) except for the EC CR group (p = 0.21). The p-value for the difference between EC CR and EC non-CR groups was <0.001. The differences in PITX2 gene methylation levels between the control and study groups were also significantly different (p < 0.001), except for the AEH group (p = 0.21). For the difference between EC CR and EC non-CR groups, the p-value was 0.43. For CDH13 gene methylation levels, statistically significant differences were found between the control and EC non-CR groups (p < 0.001), and the control and EC comparison groups (p = 0.005). When comparing the EC CR group with EC non-CR group, the p-value for this gene was <0.001. The simultaneous assessment of CDO1 and CDH13 genes methylation allowed for an accurate distinction between EC CR and EC non-CR groups (AUC = 0.96). The assessment of CDO1 and CDH13 gene methylation in endometrial specimens from patients with endometrial cancer (IA stage G1), scheduled for medical treatment, can predict the treatment outcome.

Organ preservation and watch-and-wait strategy in esophageal cancer: a promising future

The traditional treatment modalities for esophageal cancer include surgery, chemotherapy, and radiotherapy, each presenting its own limitations. With advancements in endoscopic techniques and the integration of immunotherapy, the feasibility and safety of organ preservation have significantly improved, offering patients improved survival and quality of life. The selection of patients suitable for organ preservation treatment demands ongoing exploration. Those selected for this approach require rigorous monitoring, with surgical intervention as a salvation for tumor progression or metastasis, though the timing of surgery remains a topic of debate. Organ preservation and watch-and-wait strategy may provide a more conservative treatment option, aiming to maximize quality of life.

Clinical and morphological features and the assessment of survival in patients with iris melanoma

Purpose. To analyze how the clinical and morphological features are associated with vital prognosis of iris melanoma patients.Material and methods. A retrospective analysis included 84 patients (54 women and 30 men) with iris melanoma treated between 2005 and 2019.The mean age at the time of treatment was 52.3 ± 14.5 years. All patients underwent standard and special ophthalmological examination, including ultrasound biomicroscopy, and followed up for 32 to 196 months (103.1 ± 44 months) after hospital discharge.Results. Pigmented tumors predominated (72.6% of patients), while others showed a slightly pigmented (15.4%) and nonpigmented forms (12.0%). Most of the patients (67.9%) received an organ preserving treatment, while others (32.1%) had to have a liquidating treatment (enucleation) due to anular tumor growth and secondary complications. Uveal melanoma was morphologically verified in all cases: spindle cell type A (14.3%), spindle cell type B (31.0%), mixed cell (42.8%), epithelioid cell (11.9%). The epithelioid cell type of tumor was more common when the tumor spread to the ciliary body rather than in iris melanoma (p = 0,046), but the spindle cell and mixed cell types were more common than the epithelioid cell type in both groups. An anular growth was typical for the epithelioid cell type of tumor (p = 0.006). The presence of vessels in tumor stroma was found to be more frequent in pigmented (p = 0.005) and non-pigmented forms (p = 0.0009). For pigmented tumors, spreading into the ciliary body was characteristic (p = 0.024).Conclusion. A retrospective analysis of clinical and morphological factors of iris melanoma patients with an iridociliary localization should that the specific survival was 98.8%, and overall survival was 87%. The data obtained indicated the importance of timely diagnosis of iris tumors for an organ preservation treatment.