Cancer Research and Treatment

Original Articles

Gastrointestinal cancer

Survival Benefit of Adjuvant Chemotherapy in Patients with Pancreatic Ductal Adenocarcinoma Who Underwent Surgery Following Neoadjuvant FOLFIRINOX: So Heun Lee, Dae Wook Hwang, Changhoon Yoo, Kyu-pyo Kim, Sora Kang, Jae Ho Jeong, Dongwook Oh, Tae Jun Song, Sang Soo Lee, Do Hyun Park, Dong Wan Seo, Jin-hong Park, Ki Byung Song, Jae Hoon Lee, Woohyung Lee, Yejong Park, Bong Jun Kwak, Heung-Moon Chang, Baek-Yeol Ryoo, Song Cheol Kim; Cancer Res Treat. 2023;55(3):956-968. Published online February 27, 2023; DOI: https://doi.org/10.4143/crt.2022.409

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Purpose
The benefit of adjuvant chemotherapy following curative-intent surgery in pancreatic ductal adenocarcinoma (PDAC) patients who had received neoadjuvant FOLFIRINOX is unclear. This study aimed to assess the survival benefit of adjuvant chemotherapy in this patient population.
Materials and Methods
This retrospective study included 218 patients with localized non-metastatic PDAC who received neoadjuvant FOLFIRINOX and underwent curative-intent surgery (R0 or R1) between January 2017 and December 2020. The association of adjuvant chemotherapy with disease-free survival (DFS) and overall survival (OS) was evaluated in overall patients and in the propensity score matched (PSM) cohort. Subgroup analysis was conducted according to the pathology-proven lymph node status.
Results
Adjuvant chemotherapy was administered to 149 patients (68.3%). In the overall cohort, the adjuvant chemotherapy group had significantly improved DFS and OS compared to the observation group (DFS: median, 13.8 months [95% confidence interval (CI), 11.0 to 19.1] vs. 8.2 months [95% CI, 6.5 to 12.0]; p < 0.001; and OS: median, 38.0 months [95% CI, 32.2 to not assessable] vs. 25.7 months [95% CI, 18.3 to not assessable]; p=0.005). In the PSM cohort of 57 matched pairs of patients, DFS and OS were better in the adjuvant chemotherapy group than in the observation group (p < 0.001 and p=0.038, respectively). In the multivariate analysis, adjuvant chemotherapy was a significant favorable prognostic factor (vs. observation; DFS: hazard ratio [HR], 0.51 [95% CI, 0.36 to 0.71; p < 0.001]; OS: HR, 0.45 [95% CI, 0.29 to 0.71; p < 0.001]).
Conclusion
Among PDAC patients who underwent surgery following neoadjuvant FOLFIRINOX, adjuvant chemotherapy may be associated with improved survival. Randomized studies should be conducted to validate this finding.

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The survival effect of neoadjuvant therapy and neoadjuvant plus adjuvant therapy on pancreatic ductal adenocarcinoma patients with different TNM stages: a propensity score matching analysis based on the SEER database
Hao Hu, Yang Xu, Qiang Zhang, Yuan Gao, Zhenyu Wu
Expert Review of Anticancer Therapy.2024; 24(6): 467. CrossRef
Neoadjuvant treatment of pancreatic ductal adenocarcinoma: Whom, when and how
Nebojsa Manojlovic, Goran Savic, Stevan Manojlovic
World Journal of Gastrointestinal Surgery.2024; 16(5): 1223. CrossRef
Case Study on Analysing the Early Disease Detection of Pancreatic Ductal Adenocarcinoma in Korean Association for Clinical Oncology
Sijithra Ponnarassery Chandran, N. Santhi
American Journal of Clinical Oncology.2024; 47(10): 475. CrossRef
Evaluating the benefits of adjuvant chemotherapy in patients with pancreatic cancer undergoing radical pancreatectomy after neoadjuvant therapy—a systematic review and meta-analysis
Jiahao Wu, Yike Zhang, Haodong Wang, Wenyi Guo, Chengqing Li, Yichen Yu, Han Liu, Feng Li, Lei Wang, Jianwei Xu
Frontiers in Oncology.2024;[Epub] CrossRef

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Lung and Thoracic cancer

Occupational Exposure to Pesticides and Lung Cancer Risk: A Propensity Score Analyses: Byungmi Kim, Eun Young Park, Jinsun Kim, Eunjung Park, Jin-Kyoung Oh, Min Kyung Lim; Cancer Res Treat. 2022;54(1):130-139. Published online March 31, 2021; DOI: https://doi.org/10.4143/crt.2020.1106

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Purpose
Occupational exposure to pesticides is thought to be associated with lung cancer, but studies have yielded conflicting results. We performed a propensity score (PS) based analyses to evaluate the relationship between occupational exposure to pesticides and lung cancer risk in the Korea National Cancer Center community-based cohort study (KNCCCS).
Materials and Methods
During the follow-up period, 123 incidental lung cancer cases were identified, of the 7,471 subjects in the final statistical analysis. Information about occupational exposure to pesticides and other factors was collected at enrollment (2003-2010). Cox proportional hazards regression analyses were conducted. Four PS-based approaches (i.e., matching, stratification, inverse probability-of-treatment weighting, and the use of the PS as a covariate) were adopted, and the results were compared. PS was obtained from the logistic regression model. Absolute standardized differences according to occupational exposure to pesticides were provided to evaluate the balance in baseline characteristics.
Results
In the Cox proportional hazards regression model, the hazard ratio (HR) for lung cancer according to occupational exposure to pesticides was 1.82 (95% confidence interval [CI], 1.11 to 2.98). With all the propensity score matching (PSM) methods, the HRs for lung cancer based on exposure to pesticides ranged from 1.65 (95% CI, 1.04 to 2.64) (continuous term with PSM) to 2.84 (95% CI, 1.81 to 4.46) (stratification by 5 strata of the PS). The results varied slightly based on the method used, but the direction and statistical significance remained the same.
Conclusion
Our results strengthen the evidence for an association between occupational exposure to pesticides and the risk of lung cancer.

Citations

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Flavonoids as Insecticides in Crop Protection—A Review of Current Research and Future Prospects
Verónica Pereira, Onofre Figueira, Paula C. Castilho
Plants.2024; 13(6): 776. CrossRef
Comprehensive assessment of pesticide use patterns and increased cancer risk
Jacob Gerken, Gear Thomas Vincent, Demi Zapata, Ileana G. Barron, Isain Zapata
Frontiers in Cancer Control and Society.2024;[Epub] CrossRef
Dietary Exposure to Pesticide and Veterinary Drug Residues and Their Effects on Human Fertility and Embryo Development: A Global Overview
Ambra Colopi, Eugenia Guida, Silvia Cacciotti, Serena Fuda, Matteo Lampitto, Angelo Onorato, Alice Zucchi, Carmela Rita Balistreri, Paola Grimaldi, Marco Barchi
International Journal of Molecular Sciences.2024; 25(16): 9116. CrossRef
Longitudinal study and predictive modelling of urinary pesticide metabolite concentrations in residents of Guangzhou, China
Xiangyu Jia, Xiaotong Li, Fenfang Deng, Jia He, Qin Li, Chongshan Guo, Jun Yuan, Lei Tan
Chemosphere.2024; 365: 143353. CrossRef
Trend Analysis of Lung Cancer Incidence and Mortality in Xiamen (2011-2020)
Jianni Cong, Jiahuang Chi, Junli Zeng, Yilan Lin
Risk Management and Healthcare Policy.2024; Volume 17: 2375. CrossRef
How Does Environmental and Occupational Exposure Contribute to Carcinogenesis in Genitourinary and Lung Cancers?
Massimiliano Cani, Fabio Turco, Simona Butticè, Ursula Maria Vogl, Consuelo Buttigliero, Silvia Novello, Enrica Capelletto
Cancers.2023; 15(10): 2836. CrossRef
How to promote agricultural enterprises to reduce the use of pesticides and fertilizers? An evolutionary game approach
Qizheng He, Yong Sun, Maoan Yi, Huimin Huang
Frontiers in Sustainable Food Systems.2023;[Epub] CrossRef
Vaping, Environmental Toxicants Exposure, and Lung Cancer Risk
Shaimaa A. Shehata, Eman A. Toraih, Ezzat A. Ismail, Abeer M. Hagras, Ekramy Elmorsy, Manal S. Fawzy
Cancers.2023; 15(18): 4525. CrossRef
Respiratory Tract Cancer Incidences across Industry Groups: A Nationwide Cohort Study with More Than 70 Million Person-Years of Follow-Up
Seong-Uk Baek, Woo-Ri Lee, Ki-Bong Yoo, Jun-Hyeok Choi, Kyung-Eun Lee, Wanhyung Lee, Jin-Ha Yoon
Cancers.2022; 14(21): 5219. CrossRef

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The Prognostic Value of Albumin-to-Alkaline Phosphatase Ratio before Radical Radiotherapy in Patients with Non-metastatic Nasopharyngeal Carcinoma: A Propensity Score Matching Analysis: Jae Sik Kim, Bhumsuk Keam, Dae Seog Heo, Doo Hee Han, Chae-Seo Rhee, Ji-hoon Kim, Kyeong Cheon Jung, Hong-Gyun Wu; Cancer Res Treat. 2019;51(4):1313-1323. Published online January 29, 2019; DOI: https://doi.org/10.4143/crt.2018.503

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Purpose
We first analyzed the prognostic power of albumin-to-alkaline phosphatase ratio (AAPR) before radical radiotherapy (RT) in non-metastatic nasopharyngeal carcinoma (NPC) patients.
Materials and Methods
The records of 170 patients with biopsy-proven, non-metastatic NPC treated by radical RT between 1998 and 2016 at our institution were retrospectively reviewed. Median follow-up duration was 50.6 months. All patients received intensity-modulated RT and cisplatin based chemotherapy before, during, or after RT. The major treatment of patients was based on concurrent chemoradiotherapy (92.4%). The AAPR was calculated by the last value of both albumin and alkaline phosphatase within 1 month immediately preceding RT. The optimal cut-off level of AAPR was determined by using Cutoff Finder, a web-based system. Propensity score matching (PSM) analysis was performed.
Results
The optimal cut-off level of AAPR was 0.4876. After PSM analysis of whole cohort, an AAPR was not related to survival outcomes. In PSM analysis for patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC), an AAPR ≥ 0.4876 was related to better overall survival (OS), progression-free survival (PFS), and locoregional relapse–free survival (LRRFS) (OS: hazard ratio [HR], 0.341; 95% confidence interval [CI], 0.144 to 0.805; p=0.014; PFS: HR, 0.416; 95% CI, 0.189 to 0.914; p=0.029; and LRRFS: HR, 0.243; 95% CI, 0.077 to 0.769; p=0.016, respectively).
Conclusion
The AAPR, inexpensive and readily derived from a routine blood test, could be an independent prognostic factor for patients with LA-NPC. And it might help physicians determine treatment plans by identifying the patient's current status. Future prospective clinical trials to validate its prognostic value are needed.

Citations

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Construction and validation of a prognostic nutritional index-based nomogram for predicting pathological complete response in breast cancer: a two-center study of 1,170 patients
Fanli Qu, Yaxi Luo, Yang Peng, Haochen Yu, Lu Sun, Shengchun Liu, Xiaohua Zeng
Frontiers in Immunology.2024;[Epub] CrossRef
The effect of albumin to alkaline phosphatase ratio on survival in patients with metastatic bone sarcomas
Emel MUTLU, Oktay BOZKURT, Mevlüde İNANÇ, Metin OZKAN, Sedat Tarık FIRAT, Ramazan COŞAR, İrfan BUĞDAY, Muhammet CENGİZ, Ahmet Kürşad DİŞLİ, Murat ESER
Hitit Medical Journal.2024; 6(1): 71. CrossRef
Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study
Yong Ou, Yang Zheng, Dong Wang, Shangqing Ren, Yisha Liu
BMC Surgery.2024;[Epub] CrossRef
Predicting pathological complete response after neoadjuvant chemotherapy in breast cancer by clinicopathological indicators and ultrasound parameters using a nomogram
Tingjian Zhang, Yuyao Liu, Tian Tian
Scientific Reports.2024;[Epub] CrossRef
Prognosis of hepatocellular carcinoma using the albumin to alkaline phosphatase ratio, literature review, and meta-analysis
Abdulrahman Ibn Awadh, Khulud Alanazi, Abdullah Alkhenizan
Annals of Medicine & Surgery.2024; 86(10): 6062. CrossRef
The Influence of the Preoperative Albumin to Alkaline Phosphatase Ratio on Overall Survival in Post-Radical Surgery for Colorectal Cancer and the Construction of a Nomogram Prediction Model
Wenliang Jiang, Feng Xun, Zhenchi Li, Yong Xia, Haoran Hu, Yujun Liu, Zhibin Zhao, Honggang Wang
The American Surgeon™.2023;[Epub] CrossRef
Low albumin-to-alkaline phosphatase ratio is associated with inferior prognosis in patients with head and neck cancer underwent concurrent chemoradiation: A propensity score-matched analysis
Donghyun Kim, Yongkan Ki, Wontaek Kim, Dahl Park, Jihyeon Joo, Hosang Jeon, Jiho Nam
Journal of Cancer Research and Therapeutics.2023; 19(5): 1340. CrossRef
Albumin-to-Alkaline Phosphatase Ratio as a Novel Prognostic Factor in Patients Undergoing Nephrectomy for Non-Metastatic Renal Cell Carcinoma: Propensity Score Matching Analysis
Il Won, Sung Ryul Shim, Sun Il Kim, Se Joong Kim, Dae Sung Cho
Clinical Genitourinary Cancer.2022; 20(3): e253. CrossRef
Pretreatment serum albumin-to-alkaline phosphatase ratio is an independent prognosticator of survival in patients with metastatic gastric cancer
Yu-Ting Li, Xiao-Shu Zhou, Xiao-Ming Han, Jing Tian, You Qin, Tao Zhang, Jun-Li Liu
World Journal of Gastrointestinal Oncology.2022; 14(5): 1002. CrossRef
The Prognostic Value of Preoperative Albumin-to-Alkaline Phosphatase Ratio on Survival Outcome for Patients With Locally Advanced Oral Squamous Cell Carcinoma
Ming-Hsien Tsai, Hui-Ching Chuang, Yu-Tsai Lin, Kun-Lin Yang, Hui Lu, Tai-Lin Huang, Wen-Ling Tsai, Yan-Ye Su, Fu-Min Fang
Technology in Cancer Research & Treatment.2022;[Epub] CrossRef
Feasibility and safety of neck level IB-sparing radiotherapy in nasopharyngeal cancer: a long-term single institution analysis
Dowook Kim, Bhumsuk Keam, Soon-Hyun Ahn, Chang Heon Choi, Hong-Gyun Wu
Radiation Oncology Journal.2022; 40(4): 260. CrossRef
Albumin-to-alkaline phosphatase ratio as a promising indicator of prognosis in human cancers: is it possible?
Lin An, Wei-tian Yin, Da-wei Sun
BMC Cancer.2021;[Epub] CrossRef
Prognostic Utility of Prechemoradiotherapy Albumin-to-Alkaline Phosphatase Ratio in Unresectable Locally Advanced Pancreatic Carcinoma Patients
Veysel Haksoyler, Erkan Topkan, Roberto Caronna
Gastroenterology Research and Practice.2021; 2021: 1. CrossRef
Association Between the Pretreatment Albumin-to-Alkaline Phosphatase Ratio and Clinical Outcomes in Patients With Bladder Cancer Treated With Radical Cystectomy: A Retrospective Cohort Study
Shijie Li, Shiyang Lu, Xuefeng Liu, Xiaonan Chen
Frontiers in Oncology.2021;[Epub] CrossRef
Construction and Validation of a Serum Albumin-to-Alkaline Phosphatase Ratio-Based Nomogram for Predicting Pathological Complete Response in Breast Cancer
Fanli Qu, Zongyan Li, Shengqing Lai, XiaoFang Zhong, Xiaoyan Fu, Xiaojia Huang, Qian Li, Shengchun Liu, Haiyan Li
Frontiers in Oncology.2021;[Epub] CrossRef
Albumin-To-Alkaline Phosphatase Ratio as a Novel and Promising Prognostic Biomarker in Patients Undergoing Esophagectomy for Carcinoma: A Propensity Score Matching Study
Xianying Zhu, Dongni Chen, Shuangjiang Li, Wenbiao Zhang, Yongjiang Li, Xiaoyu Wang, Jian Zhou, Zhesheng Wen
Frontiers in Oncology.2021;[Epub] CrossRef
Prognostic markers compared to CD3+TIL in locally advanced nasopharyngeal carcinoma
Nasser Al-Rajhi, Shamayel F. Mohammed, Hatim A. Khoja, Mohammad Al-Dehaim, Hazem Ghebeh
Medicine.2021; 100(46): e27956. CrossRef
Pretreatment Albumin-to-Alkaline Phosphatase Ratio Is a Prognostic Marker in Lung Cancer Patients: A Registry-Based Study of 7077 Lung Cancer Patients
Birgitte Sandfeld-Paulsen, Ninna Aggerholm-Pedersen, Anne Winther-Larsen
Cancers.2021; 13(23): 6133. CrossRef
Prognostic Value of Clinical Biochemistry-Based Indexes in Nasopharyngeal Carcinoma
Xiaojiao Zeng, Guohong Liu, Yunbao Pan, Yirong Li
Frontiers in Oncology.2020;[Epub] CrossRef
Prognostic Value of Pretreatment Albumin-to-Alkaline Phosphatase Ratio in Extensive-Disease Small-Cell Lung Cancer: A Retrospective Cohort Study

Shaozhang Zhou, Huiling Wang, Wei Jiang, Qitao Yu, Aiping Zeng
Cancer Management and Research.2020; Volume 12: 2015. CrossRef
Predictive value of pretreatment albumin‐to‐alkaline phosphatase ratio for overall survival for patients with advanced non‐small cell lung cancer
Shaozhang Zhou, Wei Jiang, Huilin Wang, Ni Wei, Qitao Yu
Cancer Medicine.2020; 9(17): 6268. CrossRef
Prognostic effect of pretreatment albumin-to-alkaline phosphatase ratio in human cancers: A meta-analysis
Xiaoli Guo, Qijiu Zou, Jiaxin Yan, Xingxing Zhen, Hongmei Gu, Jason Chia-Hsun Hsieh
PLOS ONE.2020; 15(8): e0237793. CrossRef
Prognostic Value of Pretreatment Albumin-to-Alkaline Phosphatase Ratio in Cancer: A Meta-Analysis
Hailun Xie, Lishuang Wei, Shuangyi Tang, Jialiang Gan, Musthafa M. Essa
BioMed Research International.2020; 2020: 1. CrossRef
Prognostic Value of Preoperative Albumin-to-Alkaline Phosphatase Ratio in Patients with Muscle-Invasive Bladder Cancer After Radical Cystectomy
Ming Zhao, Mingxin Zhang, Yonghua Wang, Xuecheng Yang, Xue Teng, Guangdi Chu, Xinsheng Wang, Haitao Niu
OncoTargets and Therapy.2020; Volume 13: 13265. CrossRef
Albumin-to-alkaline phosphatase ratio as a novel prognostic indicator for patients undergoing minimally invasive lung cancer surgery: Propensity score matching analysis using a prospective database
Shuang-Jiang Li, Wen-Yu Lv, Heng Du, Yong-Jiang Li, Wen-Biao Zhang, Guo-Wei Che, Lun-Xu Liu
International Journal of Surgery.2019; 69: 32. CrossRef
New prognostic indicators in surgery
Burcin Ekser, Massimiliano Veroux
International Journal of Surgery.2019; 68: 176. CrossRef

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Chemotherapy versus Best Supportive Care in Advanced Biliary Tract Carcinoma: A Multi-institutional Propensity Score Matching Analysis: Jun Ho Ji, Young Saing Kim, Inkeun Park, Soon Il Lee, Rock Bum Kim, Joon Oh Park, Sung Yong Oh, In Gyu Hwang, Joung-Soon Jang, Haa-Na Song, Jung-Hun Kang; Cancer Res Treat. 2018;50(3):791-800. Published online August 23, 2017; DOI: https://doi.org/10.4143/crt.2017.044

Abstract PDF PubReader ePub

Purpose
Although chemotherapy is recommended by various guidelines for advanced biliary tract cancer (BTC), the evidence supporting its use over best supportive care (BSC) is limited. The aim of this study was to investigate the survival benefit of chemotherapy over that of BSC in advanced BTC patients.
Materials and Methods
Advanced BTC patientswith a good performance status (Eastern CooperativeOncologyGroup [ECOG] 0-2) were eligible for the study. Data were retrospectively collected from four tertiary cancer centers and analyzed using propensity score matching (PSM). Of the 604 patients enrolled, 206 received BSC and 398 received chemotherapy. PSM analysis was performed using the following variables: age, ECOG status, carcinoembryonic antigen (CEA) level, white blood cell level, albumin level, total bilirubin level, and aspartate aminotransferase level. The sample size of each group was 164 patients after PSM. Median survival was compared between the two groups by using the Kaplan-Meier method, and prognostic factors were investigated using Cox proportional regression analysis.
Results
In post-PSM analysis, the respective median survival for the chemotherapy and BSC groups was dependent on the following prognostic factors: total population, 12.0 months vs. 7.5 months (p=0.001); locally advanced disease, 16.7 months vs. 13.4 months (p=0.490); cancer antigen 19-9 ≤ 100 IU/mL, 12.7 months vs. 10.6 months (p=0.330); and CEA ≤ 3.4 ng/mL, 17.1 months vs. 10.6 months (p=0.052).
Conclusion
Chemotherapy improved overall survival of patients with advanced BTC who had a good performance status. However, this survival benefit was not observed in BTC patients with locally advanced disease or with lower tumor marker. Individualized approach is needed for initiation of palliative chemotherapy in advanced BTC.

Citations

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National guidelines for the diagnosis and treatment of hilar cholangiocarcinoma
Faisal Saud Dar, Zaigham Abbas, Irfan Ahmed, Muhammad Atique, Usman Iqbal Aujla, Muhammad Azeemuddin, Zeba Aziz, Abu Bakar Hafeez Bhatti, Tariq Ali Bangash, Amna Subhan Butt, Osama Tariq Butt, Abdul Wahab Dogar, Javed Iqbal Farooqi, Faisal Hanif, Jahanzai
World Journal of Gastroenterology.2024; 30(9): 1018. CrossRef
Treatment patterns and survival in older adults with unresected nonmetastatic biliary tract cancers
Ali Belkouz, Elise de Savornin Lohman, Jyothi R. Thumma, Bas Groot Koerkamp, Philip R. de Reuver, Martijn G.H. van Oijen, Cornelis J.A. Punt, Hari Nathan, Heinz-Josef Klümpen
Journal of Geriatric Oncology.2023; 14(3): 101447. CrossRef
Main causes of death in advanced biliary tract cancer
Kana Kimura‐Seto, Yasushi Kojima, Shiori Komori, Yuya Hisada, Yuki Otake, Yuka Yanai, Akiko Saito, Naoki Akazawa, Yasuo Tanaka, Chizu Yokoi, Mikio Yanase, Junichi Akiyama, Natsuyo Yamamoto, Kazuhiko Yamada
Cancer Medicine.2023; 12(9): 10889. CrossRef
A Systematised Literature Review of Real-World Treatment Patterns and Outcomes in Unresectable Advanced or Metastatic Biliary Tract Cancer
Vivian Peirce, Michael Paskow, Lei Qin, Ruby Dadzie, Maria Rapoport, Samantha Prince, Sukhvinder Johal
Targeted Oncology.2023; 18(6): 837. CrossRef
Short- and Long-Term Survival of Metastatic Biliary Tract Cancer in the United States From 2000 to 2018
Van Nghiem, Sarah Wood, Rekha Ramachandran, Grant Williams, Darryl Outlaw, Ravikumar Paluri, Young-il Kim, Olumide Gbolahan
Cancer Control.2023;[Epub] CrossRef
Anticancer Drugs Compared to No Anticancer Drugs in Patients with Advanced Hepatobiliary Cancer: A Mapping Review and Evidence Gap Map
Carolina Requeijo, Javier Bracchiglione, Nicolás Meza, Roberto Acosta-Dighero, Josefina Salazar, Marilina Santero, Adriana-G Meade, María Jesús Quintana, Gerardo Rodríguez-Grijalva, Anna Selva, Ivan Solà, Gerard Urrútia, Xavier Bonfill Cosp
Clinical Epidemiology.2023; Volume 15: 1069. CrossRef

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The Clinical Significance of Occult Gastrointestinal Primary Tumours in Metastatic Cancer: A Population Retrospective Cohort Study: Malek B. Hannouf, Eric Winquist, Salaheddin M. Mahmud, Muriel Brackstone, Sisira Sarma, George Rodrigues, Peter K. Rogan, Jeffrey S. Hoch, Gregory S. Zaric; Cancer Res Treat. 2018;50(1):183-194. Published online March 21, 2017; DOI: https://doi.org/10.4143/crt.2016.532

Abstract PDF PubReader ePub

Purpose
The purpose of this study was to estimate the incidence of occult gastrointestinal (GI) primary tumours in patients with metastatic cancer of uncertain primary origin and evaluate their influence on treatments and overall survival (OS).
Materials and Methods
We used population heath data from Manitoba, Canada to identify all patients initially diagnosed with metastatic cancer between 2002 and 2011. We defined patients to have “occult” primary tumour if the primary was found at least 6 months after initial diagnosis. Otherwise, we considered primary tumours as “obvious.” We used propensity-score methods to match each patient with occult GI tumour to four patients with obvious GI tumour on all known clinicopathologic features. We compared treatments and 2-year survival data between the two patient groups and assessed treatment effect on OS using Cox regression adjustment.
Results
Eighty-three patients had occult GI primary tumours, accounting for 17.6% of men and 14% of women with metastatic cancer of uncertain primary. A 1:4 matching created a matched group of 332 patients with obvious GI primary tumour. Occult cases compared to the matched group were less likely to receive surgical interventions and targeted biological therapy, and more likely to receive cytotoxic empiric chemotherapeutic agents. Having an occult GI tumour was associated with reduced OS and appeared to be a nonsignificant independent predictor of OS when adjusting for treatment differences.
Conclusion
GI tumours are the most common occult primary tumours in men and the second most common in women. Patients with occult GI primary tumours are potentially being undertreated with available GI site-specific and targeted therapies.

Citations

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Relationship between metastasis and second primary cancers in women with breast cancer
Chaofan Li, Mengjie Liu, Jia Li, Xixi Zhao, Yusheng Wang, Xi Chen, Weiwei Wang, Shiyu Sun, Cong Feng, Yifan Cai, Fei Wu, Chong Du, Yinbin Zhang, Shuqun Zhang, Jingkun Qu
Frontiers in Oncology.2022;[Epub] CrossRef
The Potential Clinical and Economic Value of Primary Tumour Identification in Metastatic Cancer of Unknown Primary Tumour: A Population-Based Retrospective Matched Cohort Study
Malek B. Hannouf, Eric Winquist, Salaheddin M. Mahmud, Muriel Brackstone, Sisira Sarma, George Rodrigues, Peter K. Rogan, Jeffrey S. Hoch, Gregory S. Zaric
PharmacoEconomics - Open.2018; 2(3): 255. CrossRef

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Is There a Role for Adjuvant Therapy in R0 Resected Gallbladder Cancer?: A Propensity Score-Matched Analysis: Se-Il Go, Young Saing Kim, In Gyu Hwang, Eun Young Kim, Sung Yong Oh, Jun Ho Ji, Haa-Na Song, Se Hoon Park, Joon Oh Park, Jung Hun Kang; Cancer Res Treat. 2016;48(4):1274-1285. Published online February 12, 2016; DOI: https://doi.org/10.4143/crt.2015.502

Abstract PDF PubReader ePub

Purpose
The purpose of this study is to assess the role of adjuvant therapy in stage I-III gallbladder cancer (GBC) patients who have undergone R0 resection.
Materials and Methods
Clinical data were collected on 441 consecutive patients who underwent R0 resection for stage I-III GBC. Eligible patients were classified into adjuvant therapy and surveillance only groups. Propensity score matching (PSM) between the two groups was performed, adjusting clinical factors.
Results
In total, 84 and 279 patients treated with adjuvant therapy and followed up with surveillance only, respectively, were included in the analysis. Before PSM, the 5-year relapse-free survival (RFS) rate was lower in the adjuvant therapy group than in the surveillance only group (50.8% vs. 74.8%, p < 0.001), although there was no statistically significant difference in the 5-year overall survival (OS) rate (66.2% vs. 79.5%, p=0.089). After the PSM, baseline characteristics became comparable and there were no differences in the 5-year RFS (50.8% vs. 64.8%, p=0.319) and OS (66.2% vs. 70.4%, p=0.703) rates between the two groups.
Conclusion
The results suggest that fluoropyrimidine-based adjuvant therapy is not indicated in stage I-III GBC patients who have undergone R0 resection.

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Prospective Randomized Controlled Trial Comparing Adjuvant Chemotherapy vs. No Chemotherapy for Patients with Carcinoma of Gallbladder Undergoing Curative Resection
Sundeep Singh Saluja, Phani Kumar Nekarakanti, Pramod Kumar Mishra, Anurita Srivastava, Kishore Singh
Journal of Gastrointestinal Surgery.2022; 26(2): 398. CrossRef
Adjuvant Therapy for Resectable Biliary Tract Cancer: A Bayesian Network Analysis
Xiuqiong Chen, Fanqiao Meng, Hua Xiong, Yanmei Zou
Frontiers in Oncology.2021;[Epub] CrossRef
Current standards and future perspectives in adjuvant treatment for biliary tract cancers
Angela Lamarca, Julien Edeline, Mairéad G McNamara, Richard A Hubner, Masato Nagino, John Bridgewater, John Primrose, Juan W Valle
Cancer Treatment Reviews.2020; 84: 101936. CrossRef
Prognostic factors and patterns of loco-regional failure in patients with R0 resected gallbladder cancer
Jung Ho Im, Woo Jung Lee, Chang Moo Kang, Ho Kyoung Hwang, Jinsil Seong
HPB.2020; 22(8): 1168. CrossRef
Prognostic Factors for Operated Gallbladder Cancer
Bala Basak Oven Ustaalioglu, Ahmet Bilici, Mesut Seker, Umut Kefeli, Dincer Aydin, Serkan Celik, Tarik Demir, Burcak Erkol
Journal of Gastrointestinal Cancer.2019; 50(3): 451. CrossRef
Role of Adjuvant Chemotherapy in Resected T2N0 Gall Bladder Cancer
Abhay K. Kattepur, Shraddha Patkar, Mahesh Goel, Anant Ramaswamy, Vikas Ostwal
Journal of Gastrointestinal Surgery.2019; 23(11): 2232. CrossRef
A systematic review of the effectiveness of adjuvant therapy for patients with gallbladder cancer
Carlos Manterola, Galo Duque, Luis Grande, Xabier de Aretxabala, Roque Conejeros, Tamara Otzen, Nayely García
HPB.2019; 21(11): 1427. CrossRef
Adjuvant Chemoradiotherapy is Associated with Improved Survival for Patients with Resected Gallbladder Carcinoma: A Systematic Review and Meta-analysis
Byoung Hyuck Kim, Jeanny Kwon, Eui Kyu Chie, Kyubo Kim, Young Hoon Kim, Dong Wan Seo, Amol K. Narang, Joseph M. Herman
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Clinical Benefit of Hepatic Arterial Infusion Concurrent Chemoradiotherapy in Locally Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis: Hong In Yoon, Ki Jun Song, Ik Jae Lee, Do Young Kim, Kwang-Hyub Han, Jinsil Seong; Cancer Res Treat. 2016;48(1):190-197. Published online March 5, 2015; DOI: https://doi.org/10.4143/crt.2014.276

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Purpose
The aim of this study was to evaluate whether hepatic arterial infusion concurrent chemoradiotherapy (CCRT) could improve overall survival (OS) in patients with locally advanced hepatocellular carcinoma (LAHCC). Materials and Methods Two databases were reviewed from Yonsei Cancer Center (YCC) and Korean Liver Cancer Study Group (KLCSG) nationwide multi-center hepatocellular carcinoma (HCC) cohort. The CCRT group included 106 patients, with stage III-IV, Child-Pugh classification A, Eastern Cooperative Oncology Group performance status 0 or 1, who underwent definitive CCRT as the initial treatment at YCC. We used propensity score matching to adjust for seven clinical factors, including age, tumor size, TNM stage by the Liver Cancer Study Group of Japan, T stage, Barcelona Clinic Liver Cancer (BCLC) staging system, etiology of HCC, and portal vein invasion, which all differed significantly in the two databases. From the KLCSG cohort enrolled at 32 institutions, 106 patients for the non-CCRT group were defined. Results After propensity score matching, all patient characteristics were balanced between the two groups. The CCRT group had better OS (median, 11.4) than the non-CCRT group (6.6 months; p=0.02). In multivariate analyses for all patients, CCRT (hazard ratio [HR], 1.48; 95% confidence interval [CI], 1.11 to 1.97; p=0.007), tumor size (HR, 1.08; 95% CI, 1.04 to 1.12; p < 0.001), and BCLC stage (HR, 0.54; 95% CI, 0.36 to 0.8; p=0.003) were independent prognostic factors for OS. Conclusion CCRT showed better OS for LAHCC patients. In LAHCC patients with a good performance and normal liver function, CCRT could be a feasible treatment option. All of these findings need to be validated in prospective clinical trials.

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