News Update on Adenocarcinoma Research: April – 2019

The Impact of Positive Resection Margins on Survival and Recurrence Following Resection and Adjuvant Chemotherapy for Pancreatic Ductal Adenocarcinoma

Objective and Background: native and distant malady return are ofttimes discovered following carcinoma surgery, however AN improved understanding of surgery margin assessment is needed to help tailored therapies.

Methods: Analyses were administered to assess the association between clinical characteristics and margin involvement also because the effects of individual margin involvement on website of return and overall and recurrence-free survival victimization individual patient knowledge from the eu Study cluster for carcinoma (ESPAC)-3 irregular controlled trial.

Results: there have been 1151 patients, of whom 505 (43.9%) had AN R1 surgery. The median and ninety five confidence interval (CI) overall survival was twenty four.9 (22.9–27.2) months for 646 (56.1%) patients with surgery margin negative (R0 >1 mm) tumors, 25.4 (21.6–30.4) months for 146 (12.7%) patients with R1 [1]

Proposed Modification of the 8th Edition of the AJCC Staging System for Pancreatic Ductal Adenocarcinoma

Objective: The aim of this study was to enhance the eighth edition (8th) of the yankee Joint Committee on Cancer (AJCC) staging system for exocrine gland ductal glandular cancer (PDAC).

Background: The new eighth AJCC staging system for PDAC was discharged in Oct, 2016, and can be applied in clinical follow in 2018.

Methods: 2 massive cohorts were enclosed during this analysis. One consisted of forty five,856 PDAC patients within the police investigation, medical specialty, and finish Results (SEER) info (2004–2014), and therefore the different consisted of 3166 PDAC patients within the Fudan University Shanghai Cancer Center (FUSCC) info (2005–2015).

Results: victimisation the eighth AJCC staging system, the median overall survival of the patients within the same stage varied wide among the various substages. we tend to projected a changed staging system supported median OS within which we maintained the T, N, and M definitions, however regrouped the substages. within the SEER cohort, the concordance index was higher for native unwellness with the changed staging system [0.637; ninety five confidence interval (CI) zero.631–0.642] than with the eighth AJCC staging system (0.620, 95% CI 0.615–0.626). Similar findings were conjointly discovered within the FUSCC cohort. additionally, we tend to verified the dependability of the changed staging system in AN analysis of patients with completely different examined node counts (≥15 or 1–14).

Conclusions: The changed eighth AJCC staging system for PDAC projected during this study provides enhancements and will be evaluated for potential adoption within the next edition. [2]

Clinicopathologic and Molecular Characteristics of Mesonephric Adenocarcinoma Arising From the Uterine Body

Mesonephric carcinoma (MNAC) could be a rare tumour of the feminine reproductive organ tract primarily occurring within the cervix. To date, solely some cases of MNAC arising from of the female internal reproductive organ body (UB-MNAC) are rumored. The clinicopathologic and molecular characteristics of UB-MNAC stay unknown. during this study, we tend to investigated the clinical, histopathologic, immunohistochemical, and genetic options of UB-MNAC. In total, eleven cases were enclosed. Six patients developed pathological process illness, most ordinarily in lungs (5/6). Histopathologically, UB-MNAC was characterised by associate degree admixture of hollow, glandular, papillary, retiform, glomeruloid, sex cord-like, and comedonecrosis-like discipline patterns. 3 adverse pathologic characteristics, as well as advanced International Federation of medical specialty and OB stage, high mitotic activity, and presence of lymphovascular the invasion, were freelance factors predicting the event of metastasis. All cases were positive for GATA-binding supermolecule three and paired box two expression and showed wild-type p53, patchy p16, and preserved PTEN expression, as indicated by assay. Next-generation sequencing mistreatment twelve samples (11 primary tumors and one pathological process tumor) unconcealed forty two single ester variations in sixteen genes, largely in KRAS (10/12) and ARID1A (9/12). Copy variety variation was found in sixteen genomic regions, and consisted of fifty seven gains and ten losses, with 1q gain (11/12) being the foremost rife. last, UB-MNAC displays associate degree aggressive biological behavior, with a bent to spread to the lungs. Adverse pathologic characteristics mirror the aggressive nature of UB-MNAC. Distinct molecular options of UB-MNAC embrace frequent corporeal mutations of KRAS and ARID1A and gain of 1q. [3]

Quasimesenchymal phenotype predicts systemic metastasis in pancreatic ductal adenocarcinoma

Metastasis following surgical surgical process could be a leading explanation for mortality in duct gland ductal carcinoma. Epithelial-mesenchymal transition is believed to play a very important role in metastasis, though its clinical connectedness in metastasis remains unsure. we tend to evaluated a panel of RNA unmoved cross probes for epithelial-mesenchymal transition-related genes expressed in current growth cells. we tend to assessed the prognosticative price of this panel for metastasis in duct gland ductal carcinoma and, to work out if the makeup is generalizable between cancers, in colonic carcinoma. 100 58 duct gland ductal adenocarcinomas and 205 colonic adenocarcinomas were classified as animal tissue or quasimesenchymal makeup exploitation twin quantitative analysis RNA-in-situ cross. SMAD4 expression on duct gland ductal adenocarcinomas was assessed by assay. duct gland ductal adenocarcinomas with quasimesenchymal makeup had a considerably shorter disease-specific survival (P = 0.031) and metastasis-free survival (P = 0.0001) than those with associate animal tissue makeup. duct gland ductal adenocarcinomas with SMAD4 loss additionally had lower disease-specific survival (P = 0.041) and metastasis-free survival (P = 0.001) than those with intact SMAD4. However, the quasimesenchymal makeup tried a a lot of sturdy predictor of metastases—area beneath the curve for quasimesenchymal = 0.8; SMAD4 = 0.6. The quasimesenchymal makeup additionally foreseen metastasis-free survival (P = 0.004) in colonic carcinoma. Epithelial-mesenchymal transition outlined 2 makeups with distinct pathologic process capabilities—epithelial phenotype tumors with preponderantly organ-confined unwellness and quasimesenchymal phenotype with high risk of metastatic disease in two animal tissue malignancies. put together, this work validates the connectedness of epithelial-mesenchymal transition in human gi tumors. [4]

Gallbladder Carcinoma in Ghana: Histopathological Examination of Cholecystectomy Specimen

Objective: The aim of the study was to search out out the incidence of bladder malignant neoplastic disease in extirpation specimen and also the histologic sorts from Korle-Bu Teaching Hospital, Ghana.

Methods: The study was a retrospective study victimization findings from 507 extirpation specimen that were received at the Department of Pathology, Korle-Bu Teaching Hospital from 2006 – 2013.

Findings: Sixteen out of the 507 extirpation specimen were malignant representing three.15%. the most common histologic kind of malignancy according was carcinoma, the mean age at presentation was sixty five.3 years (SD ±11.9 years) with the most common clinical presentation being right region pain.

Conclusion: The histopathological classification of gall bladder malignant neoplastic disease in Ghanaian doesn’t disagree abundant from according cases. [5]

Reference

[1] Ghaneh, P., Kleeff, J., Halloran, C.M., Raraty, M., Jackson, R., Melling, J., Jones, O., Palmer, D.H., Cox, T.F., Smith, C.J. and O’reilly, D.A., 2019. The impact of positive resection margins on survival and recurrence following resection and adjuvant chemotherapy for pancreatic ductal adenocarcinoma. Annals of surgery, 269(3), pp.520-529. (Web Link)

 [2] Shi, S., Hua, J., Liang, C., Meng, Q., Liang, D., Xu, J., Ni, Q. and Yu, X., 2019. Proposed modification of the 8th edition of the AJCC staging system for pancreatic ductal adenocarcinoma. Annals of surgery, 269(5), pp.944-950. (Web Link)

[3] Na, K. and Kim, H.S., 2019. Clinicopathologic and molecular characteristics of mesonephric adenocarcinoma arising from the uterine body. The American journal of surgical pathology, 43(1), p.12. (Web Link)

[4] Quasimesenchymal phenotype predicts systemic metastasis in pancreatic ductal adenocarcinoma

Krishnan K. Mahadevan, Kshitij S. Arora, Arnaud Amzallag, Erik Williams, Anupriya S. Kulkarni, Carlos Fernandez-del Castillo, Keith D. Lillemoe, Nabeel Bardeesy, Theodore S. Hong, Cristina R. Ferrone, David T. Ting & Vikram Deshpande

Modern Pathology (2019) (Web Link)

[5] Derkyi-Kwarteng, L., Ampomah Brown, A., P. Akakpo, K., Addae, E., Amoah, D., Diabor, E. and E. Quayson, S. (2016) “Gallbladder Carcinoma in Ghana: Histopathological Examination of Cholecystectomy Specimen”, Journal of Cancer and Tumor International, 3(4), pp. 1-4. doi: 10.9734/JCTI/2016/24468. (Web Link)

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