Tumor Characteristics Research Articles

1367P Sex disparities in patient and tumour characteristics, and overall survival in advanced non-small cell lung cancer (NSCLC) within the precision oncology era: A Danish nationwide observational study

1367P Sex disparities in patient and tumour characteristics, and overall survival in advanced non-small cell lung cancer (NSCLC) within the precision oncology era: A Danish nationwide observational study

Clinical characteristics and therapeutic outcomes after endoscopic endonasal surgery for craniopharyngioma in the elderly

OBJECTIVE Craniopharyngiomas (CPs) in adults are rare benign epithelial tumors, and few contemporary studies have explored outcomes after surgical treatment in elderly patients, especially with regard to endoscopic endonasal surgery (EES). METHODS A retrospective cohort study was conducted on patients aged ≥ 18 years with CP who were treated with EES from 2013 to 2022. The cohort was divided into nonelderly (18–64 years) and elderly (≥ 65 years) groups based on age. Various parameters, including patient and tumor characteristics, surgical outcomes, complications, and follow-up, were compared between the two age groups. RESULTS A total of 193 patients met the inclusion criteria, with 161 (83.4%) patients in the nonelderly group and 32 (16.6%) patients in the elderly group. Preoperatively, older patients were more likely to have memory impairment (4.3% vs 18.8%, p = 0.010), fatigue or decreased energy (9.3% vs 34.4%, p = 0.001), hypopituitarism (68.7% vs 90.6%, p = 0.012), or hydrocephalus (18% vs 40.6%, p = 0.005), and they were more likely asymptomatic (1.2% vs 9.4%, p = 0.033) and less likely to experience headache (57.8% vs 31.3%, p = 0.006). Patients in the elderly group had a longer symptom duration (median [IQR] 5 [10] months vs 9.5 [13] months, p = 0.001) and higher comorbidity scores (p < 0.001). Postoperatively, gross-total resection was achieved in 145 (90.1%) and 28 (87.5%) patients in the nonelderly and elderly groups, respectively. Older patients were more likely to develop pneumonia (5% vs 21.9%, p = 0.004). There were no significant differences in the extent of resection (p = 0.541), pathological subtypes (88.2% vs 75.0% adamantinomatous, p = 0.089), operation time (mean ± SD 307.8 ± 68.3 minutes vs 323.5 ± 86.0 minutes, p = 0.257), estimated blood loss (median [IQR] 300 [200] ml vs 300 [238] ml, p = 0.594), length of stay (median [IQR] 15 [8] days vs 15 [22] days, p = 0.964), perioperative mortality (2.5% vs 3.1%, p > 0.99), or postoperative severe hypothalamic dysfunction (37.9% vs 50.0%, p = 0.237) between the groups. Multivariate Cox regression analysis demonstrated that tumor calcification (HR 3.406, 95% CI 1.859–27.233, p = 0.038) and preoperative hydrocephalus (HR 3.688, 95% CI 1.310–10.386, p = 0.013) were independently associated with decreased survival. The median follow-up period in the elderly group was shorter (71 months vs 44 months, p = 0.001), and no recurrence was observed (7.1% vs 0%, p = 0.132). CONCLUSIONS This study demonstrates that EES is a viable treatment option for older CP patients. With appropriate perioperative management, EES does not significantly increase mortality and, in selected populations, is well tolerated by patients.

External Beam Radiation therapy After Transarterial Chemoembolization Versus Transarterial Chemoembolization Alone for Treatment of Inoperable Hepatocellular Carcinoma: A Randomized Phase 3 Trial

PurposeTo compare the outcomes of transarterial chemoembolization (TACE) alone with those of TACE combined with external-beam radiotherapy (EBRT) in patients with hepatocellular carcinoma (HCC) in a multicenter randomized study. Methods and MaterialsFrom 2017 to 2022, 74 HCC patients with tumors confined to the liver without vascular invasion were treated with either TACE only (TACE group, 39 patients) or TACE combined with EBRT (TACE+EBRT group, 35 patients). The primary outcome measured was overall survival (OS). Secondary outcomes included progression-free survival (PFS), local tumor control (LC), and the assessment of treatment-related toxicity. ResultsDue to slow accrual, the trial was closed prematurely after enrolling 74 patients. All patients received two cycles of TACE before randomization. The TACE and TACE+EBRT groups showed comparable patient and tumor characteristics. The TACE group underwent an median of 3 TACE cycles, and the TACE+EBRT group received two cycles of TACE and a median of 5,500 cGy in 15 fractions. For the TACE group, the median LC duration was 13.1 months, while for the TACE+EBRT group, the median LC was not achieved (P<0.001). The PFS was recorded at 11.6 months in the TACE group compared to 15.4 months in the TACE+EBRT group (P=0.072). The median OS reached 36.8 months for the TACE group and extended to 47.1 months for the TACE+EBRT group (P=0.654). The incidence of toxicity was comparable between both groups. ConclusionsAlthough the number of patients enrolled in this clinical trial did not meet expectations. TACE combined with EBRT was shown to be more effective than TACE alone in improving local control (LC) without increasing toxicity, while PFS and OS was slightly improved. TACE+EBRT can be used as a standard treatment option for patients with inoperable but confined intrahepatic HCC.

Demographics, Histopathology, and Treatment Outcomes of Squamous Cell Carcinoma of the Prostate.

Squamous cell carcinoma of the prostate (SCCP) is a neoplasm that comprises fewer than 1% of all primary prostate cancer diagnoses. Given its rarity, there is a paucity of data regarding the treatment of this disease. The limited literature points to the potential of local therapy in conjunction with chemotherapy to improve patient mortality. Using the National Cancer Initiative's Surveillance, Epidemiology, and End Results (SEER) database, a retrospective review of patients diagnosed with primary SCCP between 2000 and 2018 was performed. Patient demographics, tumor characteristics, and patient outcomes based on treatment modality were analyzed. Univariate and survival analyses were conducted with p < 0.05 indicating statistical significance. A total of 66 patients were identified. Five-year overall survival (5y OS) was 24%; mean and median survival were 2.2 years (1.8, 2.7) and 1.2 years (0.3, 2.1), respectively. Patients with Grade I or Grade II disease had an increased 5y OS of 55% (27%, 83%). In comparison, 5y OS was 13% (-2%, 29%) for patients with Grade III and Grade IV disease (p = 0.017). Analysis of 5y OS based on disease histology revealed patients with papillary SCC had a 5y OS of 50% [9.2%, 91%], compared to 21% [9%, 34%] for patients with SCC, not otherwise specified and 0% for those with lymphoepithelial carcinoma (p = 0.048). Analysis of 5y OS stratified by treatment modality revealed no statistically significant change with any treatment (surgery, radiotherapy, and chemotherapy). No difference in 5y OS was seen between those treated with radical prostatectomy versus external beam radiation therapy. The literature on SCCP remains sparse; the rarity of this disease limits analysis. While the investigation undertaken in this paper does not find any change in 5y OS regardless of treatment modality, the variation in 5y OS based on histologic classification of SCCP points to a potential route for the future treatment of this disease.

PJY17 Impact of clinical risk factors, tumor characteristics, PADUA and RENAL scores on warm ischemia time during robot-assisted laparoscopic partial nephrectomy

PJY17 Impact of clinical risk factors, tumor characteristics, PADUA and RENAL scores on warm ischemia time during robot-assisted laparoscopic partial nephrectomy

Optimizing Management of Cavernous Sinus Meningiomas: A Novel Strategy Integrating Endoscopic Endonasal and Transorbital Surgery with Adjuvant Stereotactic Radiotherapy

Cavernous sinus meningiomas (CSMs) are challenging skull base tumors due to their proximity to vital neurovascular structures. Traditional aggressive transcranial resection often leads to significant morbidities with limited improvement of cranial nerve (CN) deficits. Recent advancements in endoscopic skull base surgery and stereotactic radiation therapy (SRT) offer a more conservative approach, facilitating tumor decompression while preserving critical structures. This retrospective study reviewed medical records of patients with symptomatic CSMs who underwent endoscopic endonasal and/or transorbital surgery, followed by adjuvant SRT, at our institution between January 2017 and April 2022. Patient demographics, tumor characteristics, surgical approaches, radiation, treatment outcomes, complications, and follow-up time were analyzed. Thirty-nine patients with CSMs were included. Endoscopic endonasal approach was performed in 24 patients (61.5%), endoscopic transorbital approach in 10 patients (25.6%), and combined approaches in 5 patients (12.8%). Adjuvant SRT was administered to 79.5% of patients. Postoperative outcomes showed recovery of CN 3-6 deficits and vision in 60.9% and 65% of cases, respectively. Complications included postoperative CN 3-6 deficits in 5 cases and postradiation visual deterioration in 1 case. During a mean follow-up period of 44months, tumor progression occurred in 4 patients (10.3%), with 3 diagnosed as World Health Organization grade II meningiomas and 1 as World Health Organization grade I. This study supports the use of endoscopic skull base surgery combined with adjuvant SRT for symptomatic CSMs, demonstrating both safety and efficacy. This approach yielded favorable outcomes in symptom improvement, tumor control, and positive safety profile.

272. HOSPITAL VARIATION IN PALLIATIVE TREATMENT FOR ESOPHAGEAL AND GASTROESOPHAGEAL JUNCTION CANCER: A NATIONWIDE POPULATION-BASED STUDY IN THE NETHERLANDS

Abstract Background Palliative care for patients with esophageal (EC) includes a large variety of treatments and data on variation of palliative care across centers are unknown. This study aims to evaluate treatment variation at the hospital level for EC and GC patients in the Netherlands. Methods A nationwide retrospective cohort study was conducted using population-based data from the Netherlands Cancer Registry. Patients diagnosed with inoperable advanced (cT4B) or synchronous metastatic (cM1) EC between 2015-2022 were included. Probability of receiving potentially life-prolonging treatment (palliative resection, chemoradiotherapy or systemic treatment) according to hospital of diagnosis was analyzed using multilevel logistic regression analysis. Hospitals were categorized in tertiles according to this probability (high, medium, low) and overall survival (OS) was assessed using cox regression analysis. Results 8,580 EC patients were included. Potentially life-prolonging treatment ranged from 23.5%-74.0% across hospitals of diagnosis (p&amp;lt;0.0001). After adjustment for patient and tumor characteristics, the probability of receiving these treatments was associated with hospital of diagnosis (p&amp;lt;0.0001). 13 of 79 hospitals demonstrated a significantly lower probability of giving potentially life-prolonging treatment. Patients diagnosed in hospitals with low probability of potentially life-prolonging treatment with had significantly worse OS than medium- (HR 0.85 (0.80-0.90) p&amp;lt;0.0001) or high-probability hospitals (HR 0.77 (0.73-0.82) p&amp;lt;0.0001). Conclusion This study shows substantial variation in palliative treatment for EC and GC care across Dutch hospitals, emphasizing the challenge of defining optimal treatment plans. Hospital of diagnosis was significantly associated with the probability of receiving potentially life-prolonging treatment and also with overall survival. These results suggest that appropriate selection of patients for treatment with potentially life-prolonging treatment leads to improved OS.

364. IMPROVING PERIOPERATIVE OESOPHAGECTOMY OUTCOMES WITH THE USE OF ROBOTIC SURGERY AT A HIGH VOLUME UK CENTRE

Abstract Background There is a rapid movement towards adoption of robotically assisted minimally invasive oesophagectomy (RAMIO) in the United Kingdom. Transition from an open or laparoscopic oesophagectomy to a RAMIO programme, which carries considerable financial and training cost, must ensure parity of oncological and perioperative outcomes. We sought to compare our centre’s results as we performed the three standard approaches to two-phase oesophagectomy undertaken in the UK: Open/Open (Open); laparoscopic/robotic abdomen with open chest (Hybrid); and RAMIO. Methods This prospective cohort study investigated the experience of five surgeons in a single high-volume UK institution. We analysed all consecutive patients undergoing two-phase transthoracic oesophagectomy for oncological reasons between 2018 and 2023. The study period was divided into three cohorts: Open (2018-2020, n=61), Hybrid (2020-2023, n=82) and RAMIO (2023, n=61). Patient demographics, tumour characteristics, perioperative outcomes, and oncological data were compared. Data were analysed using Kruskal-Wallis and Chi-squared statistical tests. Results No significant differences were observed in patient demographics or tumour stage between the groups. Comparison of Open vs. Hybrid vs. RAMIO demonstrated a significant reduction of major complications (Clavien-Dindo ≥III), 34.4% vs. 23.2% vs. 19.7%, respectively (p=0.033); pulmonary complications, 36.1% vs. 25.4% vs. 16.4% (p=0.007); and median length of hospital stay, 14 vs. 12 vs. 9 days (p=0.001), all favouring the RAMIO group in sub-group analysis. Comparison of Open vs. Hybrid vs. RAMIO demonstrated a non-significant reduction in anastomotic leak rate, 11.5% vs. 2.4% vs. 6.6%, respectively (p=0.112); and mortality, 4.9% vs. 1.2% vs. 0% (p=0.19), favouring the RAMIO group. Median lymph node yields were comparable across the groups, 49 vs. 43 vs. 44 (p=0.165). Conclusions This single-institution study demonstrates potential benefits of transitioning from open or hybrid to RAMIO for oesophagectomy. RAMIO was associated with significantly reduced pulmonary complications, major complications and a shorter length of hospital stay. Oncological outcomes remained on par across techniques. These findings have important patient, financial, and resource implications, and support the continued adoption of RAMIO in the UK.

Immunophenotypic and molecular changes during progression of papillary urothelial carcinoma.

Urothelial carcinoma has various molecular subtypes, each with different tumor characteristics. Although it is known that molecular changes occur during tumor progression, little is known about the specifics of these changes. In this study, we performed transcriptional analysis to understand the molecular changes during tumor progression. Formalin-fixed, paraffin-embedded tumor tissues were obtained from 12 patients with muscle-invasive bladder cancer (MIBC). The invasive and non-invasive papillary areas were identified in papillary urothelial carcinoma specimens. Immunohistochemistry (IHC) and mRNA sequencing were performed for each tumor area. Patients with CK5/6-negative and CK20-positive non-invasive papillary areas were selected and classified into the IHC switch subgroup (CK5/6-positive and CK20-negative in the invasive area) and the IHC unchanged subgroup (CK5/6-negative and CK20-positive in the invasive area) according to the IHC results of the invasive area. We identified differences in the mRNA expression between the non-invasive papillary and invasive areas of the papillary MIBC tissue samples. In both the non-invasive papillary and invasive areas, the IHC switch subgroup showed basal subtype gene expression, while the IHC unchanged subgroup demonstrated luminal subtype gene expression. The non-invasive papillary area showed a gene expression pattern similar to that of the invasive area. Therefore, even if the non-invasive papillary area exhibits a luminal phenotype on IHC, it can have a basal subtype gene expression depending on the invasive area.

Risk of Biochemical Recurrence and Metastasis in Prostate Cancer Patients Treated with Radical Prostatectomy After a 10-year Disease-free Interval

Background and objectiveProstate-specific antigen (PSA) testing is used to follow up prostate cancer (PCa) patients treated with radical prostatectomy (RP). Research on PSA thresholds for identifying PCa patients with biochemical recurrence (BCR) who are at a higher risk of progression yielded inconclusive results. This study aims to investigate the risk of late BCR in PCa patients treated with RP and long postoperative (120 mo) undetectable PSA follow-up, and to identify prognostic factors for late BCR within this patient cohort. MethodsPCa patients treated with curative RP (1992–2012) and free of BCR during the first 120 mo following RP were retrospectively identified within five European tertiary centers; BCR was defined as two consecutive PSA values of ≥0.2 ng/ml. Kaplan-Meier and Cox regression models tested for an association between BCR and patient or tumor characteristics. Key findings and limitationsThe study cohort consisted of 4639 patients, of whom 243 (5.2%) developed BCR at a medium follow-up of 147 mo. Of those with BCR, 23 (9.5%) subsequently developed metastatic progression. In Kaplan-Meier models, BCR-free survival differed according to advanced tumor status. In multivariable Cox regression models, pT stage (pT3a: hazard ratio [HR]: 1.46; pT3b: HR: 2.42), pathological Gleason score (pGS 3 + 4: HR: 1.71; pGS ≥4 + 3: HR: 2.47), surgical margin (R1/Rx: HR: 1.72), and pNx stage (pNx: HR: 0.72) represented independent predictors for BCR (all p < 0.05). Conversely, age, PSA at diagnosis, and year of surgery failed to achieve independent predictor status for BCR. Conclusions and clinical implicationsAmong PCa patients with an uneventful follow-up of at least 10 yr after RP, still one in 20 patients subsequently develop late BCR. Nevertheless, late BCR and subsequent progression to metastasis (0.3%) rates in patients with pT2 stage and pGS ≤3 + 4 were strikingly low, implicating that abandoning follow-up beyond an uneventful period of 10 yr is justifiable within this cohort of patients. Patient summaryIn this study, prostate cancer patients treated with a radical prostatectomy and at least 10 yr of uneventful prostate-specific antigen testing were identified within five European centers. Relying on these patients, the rate of subsequent late biochemical recurrence was calculated and risk factors were identified for biochemical recurrence following 10 yr of uneventful prostate-specific antigen testing.

Organ preservation after neoadjuvant long-course chemoradiotherapy versus short-course radiotherapy

Potential differences in organ preservation between total neoadjuvant therapy (TNT) regimens integrating long-course chemoradiotherapy (LCCRT) and short-course radiotherapy (SCRT) in rectal cancer remain undefined. This natural experiment arose from a policy change in response to the COVID-19 pandemic during which our institution switched from uniformly treating patients with LCCRT to mandating that all patients be treated with SCRT. Our study includes 323 locally advanced rectal adenocarcinoma patients treated with LCCRT-based or SCRT-based TNT from January 2018 to January 2021. Patients who achieved clinical complete response were offered organ preservation with watch-and-wait (WW) management. The primary outcome was 2-year organ preservation. Additional outcomes included local regrowth, distant recurrence, disease-free survival (DFS), and overall survival (OS). Patient and tumor characteristics were similar between LCCRT (n= 247) and SCRT (n= 76) cohorts. Median follow-up was 31 months. Similar clinical complete response rates were observed following LCCRT and SCRT (44.5% versus 43.4%). Two-year organ preservation was 40% [95% confidence interval (CI) 34% to 46%] and 31% (95% CI 22% to 44%) among all patients treated with LCCRT and SCRT, respectively. In patients managed with WW, LCCRT resulted in higher 2-year organ preservation (89% LCCRT, 95% CI 83% to 95% versus 70% SCRT, 95% CI 55% to 90%; P= 0.005) and lower 2-year local regrowth (19% LCCRT, 95% CI 11% to 26% versus 36% SCRT, 95% CI 16% to 52%; P= 0.072) compared with SCRT. The 2-year distant recurrence (10% versus 6%), DFS (90% versus 90%), and OS (99% versus 100%) were similar between WW patients treated with LCCRT and SCRT, respectively. While WW eligibility was similar between cohorts, WW patients treated with LCCRT had higher 2-year organ preservation and lower local regrowth than those treated with SCRT, yet similar DFS and OS. These data support induction LCCRT followed by consolidation chemotherapy as the preferred TNT regimen for patients with locally advanced rectal cancer pursuing organ preservation.

OBSERVE: guidelines for the refinement of rodent cancer models.

Existing guidelines on the preparation (Planning Research and Experimental Procedures on Animals: Recommendations for Excellence (PREPARE)) and reporting (Animal Research: Reporting of In Vivo Experiments (ARRIVE)) of animal experiments do not provide a clear and standardized approach for refinement during in vivo cancer studies, resulting in the publication of generic methodological sections that poorly reflect the attempts made at accurately monitoring different pathologies. Compliance with the 3Rs guidelines has mainly focused on reduction and replacement; however, refinement has been harder to implement. The Oncology Best-practices: Signs, Endpoints and Refinements for in Vivo Experiments (OBSERVE) guidelines are the result of a European initiative supported by EurOPDX and INFRAFRONTIER, and aim to facilitate the refinement of studies using in vivo cancer models by offering robust and practical recommendations on approaches to research scientists and animal care staff. We listed cancer-specific clinical signs as a reference point and from there developed sets of guidelines for a wide variety of rodent models, including genetically engineered models and patient derived xenografts. In this Consensus Statement, we systematically and comprehensively address refinement and monitoring approaches during the design and execution of murine cancer studies. We elaborate on the appropriate preparation of tumor-initiating biologicals and the refinement of tumor-implantation methods. We describe the clinical signs to monitor associated with tumor growth, the appropriate follow-up of animals tailored to varying clinical signs and humane endpoints, and an overview of severity assessment in relation to clinical signs, implantation method and tumor characteristics. The guidelines provide oncology researchers clear and robust guidance for the refinement of in vivo cancer models.

Effective utilization of polypectomy in endoscopic salvage treatment of rectal neuroendocrine tumors: a retrospective cohort study.

Current guidelines recommend endoscopic resection for rectal neuroendocrine tumors (RNETs) under 10 mm. Incomplete resections necessitate salvage procedures, highlighting the need for complete R0 resection. This study evaluates the efficacy and safety of wide hot snare polypectomy (WHSP) compared to endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR) for the salvage treatment of small RNETs. This retrospective study was conducted at Korea University Guro Hospital from January 2018 to December 2022. It compared the outcomes of salvage resections for RNETs ≤10 mm using 2 approaches: ESD and EMR vs. WHSP. Demographics, tumor characteristics, and clinical outcomes were compared. Efficacy was evaluated by the histological complete resection rate and procedure time, while safety was assessed by the incidence of complications. Out of 135 patients undergoing salvage resection for RNET, 14 who underwent transanal excision were excluded. Of the remaining 121, 99 underwent EMR or ESD, and 22 underwent WHSP. Baseline characteristics were similar between the 2 groups. The WHSP group demonstrated a significantly higher R0 resection rate (72.7% vs. 49.5%, P = 0.010) and a shorter median procedure time (3.5 minutes vs. 8.3 minutes). No complications were reported in the WHSP group. WHSP is a rapid, straightforward, safe, and effective approach for the salvage treatment of RNETs less than 10 mm in diameter, particularly in patients without additional risk factors.

Extracapsular Dissection Versus Traditional Parotid Surgery: A Comprehensive Review of Techniques and Outcomes.

Parotid tumours, encompassing both benign and malignant forms, present significant challenges in surgical management. Traditional parotid surgery, including various forms of parotidectomy, has long been the standard approach, aiming for complete tumour removal while addressing potential complications such as facial nerve injury. However, extracapsular dissection (ECD) has emerged as an alternative technique, focusing on excising the tumour along with a thin layer of surrounding tissue, which may offer benefits in preserving healthy glandular tissue and reducing postoperative complications. This review comprehensively compares ECD and traditional parotid surgery techniques, evaluating their efficacy, outcomes, and associated complications. We analyse clinical studies and evidence to assess differences in tumour recurrence rates, facial nerve function preservation, and overall patient recovery. Additionally, the review explores the indications for each surgical approach, considering tumour characteristics and patient-specific factors. The findings suggest that while ECD may offer advantages in terms of reduced postoperative complications and improved preservation of glandular tissue, traditional parotidectomy remains a robust method for managing complex cases. This review aims to inform clinical decision-making by presenting a detailed comparison of both techniques, ultimately guiding surgeons in selecting the most appropriate approach for individual patients.

380. GROWTH CHARACTERISTICS OF ESOPHAGEAL PATIENT DERIVED ORGANOIDS REFLECT CLINICOPATHOLOGIC VARIABLES

Abstract Background Esophageal patient derived organoids (PDOs) are three-dimensional cell culture models derived from esophageal cancer tissue. We have previously shown that PDOs recapitulate the genetic and morphologic characteristics of the primary tumour, and that PDOs may predict patient responses to neoadjuvant regimens and potentially allow personalisation perioperative therapies. Nevertheless, up to 30% of tissue samples fail to establish organoids in vivo, although the reasons for this are unclear. This study interrogates the clinical characteristics of biopsies that establish or fail to establish PDOs. Methods Esophageal adenocarcinomas from locally advanced (LA) or metastatic (M) disease were biopsied at initial endoscopy, following surgical resection, or image-guided biopsy of metastatic disease (n=75 total). Following a standardised protocol, cells were dissociated and seeded for organoid culture. Organoids are considered ‘established’ after passage 4. Samples were discarded if there was obvious contamination (n=9) or if there were no obvious tumour cells (n=6). Clinicopathologic variables for successfully established or unsuccessfully established were compared for both LA and M disease. Statistical analysis was performed to interrogate characteristics associated with successfully establishing organoids. Results There were significant differences between successful and unsuccessful organoids. Organoids were more likely to be established from endoscopic biopsies (p=0.002). Samples pre-treated with neoadjuvant chemoradiation or chemotherapy were less likely to grow (p=0.02). Samples from poorly differentiated tumours were less likely to grow compared with well and moderately differentiated tumours (p=0.05). Tumour stage, lymphovascular invasion, perineural invasion, MSI status and HER-2 status were not associated with growth characteristics. Conclusion Growth characteristics of esophageal adenocarcinoma PDOs correlate with clinicopathologic characteristics. Samples from patients who have undergone chemotherapy or chemoradiation, and poorly differentiated tumours are less likely to establish in vitro models. Understanding the altered in vitro growth patterns is key to translating use of organoids into clinical practice.

Inter-Ethnic Variations in the Clinical, Pathological, and Molecular Characteristics of Wilms Tumor.

Wilms tumor is the commonest primary renal malignancy in children and demonstrates substantial inter-ethnic variation in clinical, pathological, and molecular characteristics. Wilms tumor occurs at a lower incidence and at a younger age in Asians compared to Caucasians and Africans. Asians also present at an earlier stage of disease, with a higher incidence of favorable histology tumors and a lower incidence of perilobar nephrogenic rests compared to Caucasians, while African children present with more advanced disease. Studies have implicated population differences in the incidence of WT1 mutations, loss of imprinting of the IGF2 locus, and loss of heterozygosity of 1p/16q, or 1q gain as possible bases for epidemiological differences in the disease profile of Wilms tumors in various ethnic groups. Yet, evidence to support these associations is confounded by differences in treatment protocols and inequalities in the availability of treatment resources and remains limited by the quality of population-based data, especially in resource-limited settings.

Patient-derived organoids and mini-PDX for predicting METN375S-mutated lung cancer patient clinical therapeutic response

Lung cancer as a molecularly and histologically high heterogonous disease, there is an urgent need to predict lung cancer patients' responses to anti-cancer treatment, and patient-derived organoids (PDOs) have been recognized as a valuable platform for preclinical drug screening. In this study, we successfully established 26 PDO lines from various subtypes of lung cancers including benign tumor, adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, large-cell carcinoma, and small-cell carcinoma. These PDOs were shown to retain the major genomic and histological characteristics of primary tumors and remain stable during long-term culture. With the help of targeted genomic sequencing, we found that lung cancer that harbors METN375S mutation is selectively sensitive to afatinib, and a combination of afatinib and gemcitabine induced synthetic lethality in PDO and mini-PDX models. In summary, our findings demonstrate the potential of PDO in predicting lung cancer drug response, and reveal a promising strategy for METN375S mutant lung cancer treatment.

Uterine tumor with characteristics of ovarian sex-cord tumor: case report

Uterine tumor with characteristics of ovarian sex-cord tumor: case report

Imaging characteristics of uterine smooth muscle tumors of uncertain malignant potential: a case report and literature review.

Uterine smooth muscle tumors of uncertain malignant potential (STUMPs) are rare tumors of the uterine myometrium that are often misdiagnosed, owing to limited knowledge of their characteristics on ultrasonography (US) and magnetic resonance imaging (MRI). We report a woman in her mid-30s who was hospitalized because of a pelvic tumor. A 6-cm mass was found in her lower left abdomen. US and MRI revealed a well-demarcated mass in the left adnexal area, with both cystic and solid elements, visible blood flow within the septa, a strong signal across >50% of the volume on T2-weighted imaging (T2WI), and a strong signal on diffusion-weighted imaging (DWI). After hysterectomy and bilateral salpingectomy, immunohistochemical examination confirmed STUMP. A review of the literature revealed characteristic imaging features of STUMP. Ultrasonography reveals STUMP as a solitary, well-circumscribed lesion with isoechoic or mixed echogenicity, the absence of posterior shadowing, and variations in blood flow. STUMP is characterized by strong signal intensity on T2WI, small areas of strong signal on T1WI, and non-enhancing cystic areas on contrast-enhanced MRI scans. Early diagnosis is crucial for the management and treatment of STUMP, and here we have summarized the imaging features of the lesion, thereby providing a valuable diagnostic reference.

Analysis of Histologic, Immunohistochemical and Genomic Features of Large B Cell Lymphoma Tumors May Predict Response to Polatuzumab Vedotin Based Therapy in Patients With Relapsed/Refractory Disease

BackgroundLarge B cell lymphoma (LBCL) is the most common form of lymphoma. Polatuzumab vedotin (polatuzumab) is an effective therapy for patients diagnosed with LBCL; however, only limited information regarding pathologic features detected by clinical laboratory assays is available to determine which patients are most likely to benefit from polatuzumab based therapies. Patients and MethodsWe collected data from real world patients with relapsed or refractory LBCL whose tumors underwent next generation sequencing and were treated with polatuzumab based therapy at a single large academic cancer center. Tumor and patient characteristics were analyzed to look for factors that predict response to polatuzumab based therapies. ResultsWe identified high grade B cell lymphoma (HGBL) -NOS or MYC/BCL2 histology and presence of MYC rearrangement as factors that predict inferior response to polatuzumab based therapy. Patients with germinal center B cell of origin (GCB COO) LBCL without these factors had a high response rate (73%) to polatuzumab based therapy. ConclusionIn a single center real world retrospective analysis of R/R LBCL patients with available genomic data, polatuzumab based therapy may be less effective in patients with HGBL-NOS or MYC/BCL2 histology and MYC rearrangements, but not in patients with GCB COO LBCL without these features. Routine performance of more comprehensive pathologic analysis of tumors may inform the use of polatuzumab based therapy in patients with LBCL.