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[PMID]:29374706
[Au] Autor:Ceausu AR; Ciolofan A; Cimpean AM; Magheti A; Mederle O; Raica M
[Ad] Endereço:Department of Microscopic Morphology/Histology, Angiogenesis Research Center Timisoara, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
[Ti] Título:The Mesenchymal-Epithelial and Epithelial-Mesenchymal Cellular Plasticity of Liver Metastases with Digestive Origin.
[So] Source:Anticancer Res;38(2):811-816, 2018 02.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Few data are available regarding the epithelial to mesenchymal transition (EMT) /mesenchymal to epitheilal transition (MET) in the liver metastasis of digestive cancers. The aim of this study was to establish EMT/MET metastatic tumor cell plasticity according to the histological growth pattern of liver metastases. MATERIALS AND METHODS: Biopsies from 25 patients with liver metastasis (desmoplastic, replacement and pushing type) were evaluated. Double immunostaining of E-cadherin/vimentin, keratin 8,18/vimentin and E-cadherin/ keratin 8,18 were performed. RESULTS: The following cell types were noted: epithelial, mesenchymal, non-differentiated and differentiated hybrid mesenchymal/ epithelial and non-hybrid phenotype. All cases had mesenchymal/ epithelial phenotype cells. A significant correlation was found between the non-differentiated hybrid mesenchymal/ epithelial phenotype metastatic cells and histological growth pattern for gastric and colorectal cancer. CONCLUSION: A MET-targeting strategy, in conjunction with conventional chemotherapy, may be useful for the treatment of liver metastases.
[Mh] Termos MeSH primário: Neoplasias do Sistema Digestório/patologia
Neoplasias Hepáticas/secundário
[Mh] Termos MeSH secundário: Caderinas/metabolismo
Plasticidade Celular/fisiologia
Neoplasias Colorretais/metabolismo
Neoplasias Colorretais/patologia
Neoplasias do Sistema Digestório/metabolismo
Transição Epitelial-Mesenquimal/fisiologia
Seres Humanos
Imuno-Histoquímica
Queratinas/metabolismo
Neoplasias Hepáticas/metabolismo
Neoplasias Hepáticas/patologia
Neoplasias Pancreáticas/metabolismo
Neoplasias Pancreáticas/patologia
Neoplasias Gástricas/metabolismo
Neoplasias Gástricas/patologia
Vimentina/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (CDH1 protein, human); 0 (Cadherins); 0 (Vimentin); 68238-35-7 (Keratins)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180129
[St] Status:MEDLINE


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[PMID]:29300750
[Au] Autor:Guo HW; Yuan TZ; Chen JX; Zheng Y
[Ad] Endereço:Department of General Surgery, The Fourth Affiliated Hospital of Nan Chang University, Nanchang, Jiangxi, China.
[Ti] Título:Prognostic value of pretreatment albumin/globulin ratio in digestive system cancers: A meta-analysis.
[So] Source:PLoS One;13(1):e0189839, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The albumin/globulin ratio (AGR) has been widely reported to be a potential predictor of prognosis in digestive system cancers (DSCs), but convincing conclusions have not been made. Therefore, herein, we performed a meta-analysis of relevant studies regarding this topic to evaluate the prognostic value of AGR in patients with DSCs. Three databases, including PubMed, EMBase, and Web of science, were searched comprehensively for eligible studies through September 8, 2017. The outcomes of interest included overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS). In our meta-analysis, pooled analysis of 13 studies with 9269 patients showed that a low AGR was significantly correlated with poor OS (HR = 1.94; 95% CI: 1.57-2.38; P <0.001). Five studies with 6538 participants involved DFS, and our pooled analysis of these studies also demonstrated that there was a significant association of a low AGR with worse DFS (HR = 1.49; 95% CI: 1.10 to 2.00; P < 0.001). In addition, only 2 studies referred to CSS, and we also detected a significant relationship between a low AGR and worse CSS from the results of our meta-analysis. In summary, a low pretreatment AGR was related to unfavorable survival in human digestive system cancers. A low pretreatment AGR may be a useful predictive prognostic biomarker in human digestive system cancers.
[Mh] Termos MeSH primário: Albuminas/metabolismo
Biomarcadores Tumorais/sangue
Neoplasias do Sistema Digestório/patologia
Globulinas/metabolismo
[Mh] Termos MeSH secundário: Neoplasias do Sistema Digestório/sangue
Seres Humanos
Prognóstico
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Albumins); 0 (Biomarkers, Tumor); 0 (Globulins)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180210
[Lr] Data última revisão:
180210
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180105
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189839


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[PMID]:29020592
[Au] Autor:Lemery S; Keegan P; Pazdur R
[Ad] Endereço:From the Office of Hematology and Oncology Products (S.L., P.K.) and the Oncology Center of Excellence (R.P.), Center for Drug Evaluation and Research, Food and Drug Administration, Silver Spring, MD.
[Ti] Título:First FDA Approval Agnostic of Cancer Site - When a Biomarker Defines the Indication.
[So] Source:N Engl J Med;377(15):1409-1412, 2017 Oct 12.
[Is] ISSN:1533-4406
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Anticorpos Monoclonais Humanizados/uso terapêutico
Antineoplásicos/uso terapêutico
Biomarcadores Tumorais
Neoplasias Encefálicas/tratamento farmacológico
Neoplasias Colorretais/tratamento farmacológico
Neoplasias do Sistema Digestório/tratamento farmacológico
Aprovação de Drogas
Instabilidade de Microssatélites
Síndromes Neoplásicas Hereditárias/tratamento farmacológico
Receptor de Morte Celular Programada 1/antagonistas & inibidores
[Mh] Termos MeSH secundário: Adulto
Antígeno B7-H1/metabolismo
Neoplasias da Mama/tratamento farmacológico
Criança
Neoplasias Colorretais/patologia
Feminino
Seres Humanos
Masculino
Metástase Neoplásica/tratamento farmacológico
Receptor de Morte Celular Programada 1/metabolismo
Estados Unidos
United States Food and Drug Administration
Neoplasias Urogenitais/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal, Humanized); 0 (Antineoplastic Agents); 0 (B7-H1 Antigen); 0 (Biomarkers, Tumor); 0 (CD274 protein, human); 0 (PDCD1 protein, human); 0 (Programmed Cell Death 1 Receptor); DPT0O3T46P (pembrolizumab)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMp1709968


  4 / 2972 MEDLINE  
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[PMID]:28927476
[Au] Autor:Egnell M; Fassier P; Lécuyer L; Gonzalez R; Zelek L; Vasson MP; Hercberg S; Latino-Martel P; Galan P; Druesne-Pecollo N; Deschasaux M; Touvier M
[Ad] Endereço:1Nutritional Epidemiology Research Team (EREN),Sorbonne Paris Cité Epidemiology and Statistics Research Center (CRESS),Institute for Health and Medical Research (Inserm, U1153),Institut National de la Recherche Agronomique (INRA, U1125),Conservatoire National des Arts et Métiers (CNAM),University Pa
[Ti] Título:Antioxidant intake from diet and supplements and risk of digestive cancers in middle-aged adults: results from the prospective NutriNet-Santé cohort.
[So] Source:Br J Nutr;118(7):541-549, 2017 Oct.
[Is] ISSN:1475-2662
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Experimental studies suggest beneficial effects of antioxidants in digestive cancer prevention. However, epidemiological results are contrasting and few studies quantitatively assessed supplemental intake. This study aimed at investigating the associations between antioxidant intakes (dietary, supplemental and total) and digestive cancer risk. This prospective study included 38 812 middle-aged subjects (≥45 years) from the NutriNet-Santé cohort (2009-2016). Dietary data were collected using repeated 24 h records. A specific questionnaire assessed dietary supplement use over a 12-month period. A composition database of about 8000 dietary supplements was developed. Associations between continuous and sex-specific quartiles of vitamins C and E, ß-carotene and Se intakes and digestive cancer risk were characterised using multivariable Cox proportional hazard models. A total of 167 incident digestive cancers (120 colorectal, twenty-six pancreatic, nine oesophagus, seven stomach and five liver) were diagnosed during follow-up investigation. Dietary (hazard ratios (HR)Q4 v. Q1=0·56; 95 % CI 0·34, 0·91, P trend=0·01) and total (HRQ4 v. Q1=0·51; 95 % CI 0·30, 0·84, P trend=0·008) vitamin C intakes, dietary (HRQ4 v. Q1=0·56; 95 % CI 0·34, 0·92, P trend=0·005) and total (HRQ4 v. Q1=0·58; 95 % CI 0·36, 0·94, P trend=0·003) vitamin E intakes, and dietary (HRfor an increment of 10 µg/d=0·92; 95 % CI 0·85, 1·00, P=0·04) and total (HRfor an increment of 10 µg/d=0·92; 95 % CI 0·86, 0·99, P=0·03) Se intakes were associated with a decreased digestive cancer risk. Statistically significant interactions were observed between dietary and total Se intakes and alcohol consumption as well as between total vitamin E intake and smoking status. This prospective cohort study with quantitative assessment of supplemental intakes suggests a potential protective effect of several antioxidants (vitamins C and E and Se) on digestive cancer risk, and a modulation of some of these relationships by alcohol consumption and smoking status.
[Mh] Termos MeSH primário: Antioxidantes/administração & dosagem
Dieta
Suplementos Nutricionais
Neoplasias do Sistema Digestório/epidemiologia
[Mh] Termos MeSH secundário: Ácido Ascórbico/administração & dosagem
Feminino
Seres Humanos
Masculino
Meia-Idade
Análise Multivariada
Avaliação Nutricional
Modelos de Riscos Proporcionais
Estudos Prospectivos
Fatores de Risco
Selênio/administração & dosagem
Inquéritos e Questionários
Vitamina E/administração & dosagem
beta Caroteno/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antioxidants); 01YAE03M7J (beta Carotene); 1406-18-4 (Vitamin E); H6241UJ22B (Selenium); PQ6CK8PD0R (Ascorbic Acid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171017
[Lr] Data última revisão:
171017
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170921
[St] Status:MEDLINE
[do] DOI:10.1017/S0007114517002392


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[PMID]:28854347
[Au] Autor:Wang HL; Kim CJ; Koo J; Zhou W; Choi EK; Arcega R; Chen ZE; Wang H; Zhang L; Lin F
[Ti] Título:Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas.
[So] Source:Arch Pathol Lab Med;141(9):1155-1180, 2017 Sep.
[Is] ISSN:1543-2165
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CONTEXT: - Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. OBJECTIVES: - To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. DATA SOURCES: - Data sources include literature review, authors' research data, and personal practice experience. CONCLUSIONS: - Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.
[Mh] Termos MeSH primário: Biomarcadores Tumorais/análise
Neoplasias do Sistema Digestório/diagnóstico
Imuno-Histoquímica/métodos
Patologia Cirúrgica/métodos
Oncologia Cirúrgica/métodos
[Mh] Termos MeSH secundário: Neoplasias do Sistema Biliar/diagnóstico
Neoplasias Gastrointestinais/diagnóstico
Seres Humanos
Neoplasias Hepáticas/diagnóstico
Neoplasias Pancreáticas/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biomarkers, Tumor)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171002
[Lr] Data última revisão:
171002
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170831
[St] Status:MEDLINE
[do] DOI:10.5858/arpa.2016-0489-RA


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[PMID]:28807841
[Au] Autor:Ashktorab H; Kupfer SS; Brim H; Carethers JM
[Ad] Endereço:Department of Medicine, Howard University, Washington, District of Columbia; Cancer Center, Howard University, Washington, District of Columbia.
[Ti] Título:Racial Disparity in Gastrointestinal Cancer Risk.
[So] Source:Gastroenterology;153(4):910-923, 2017 Oct.
[Is] ISSN:1528-0012
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Cancer from the gastrointestinal tract and its associated excretory organs will occur in more than 300,000 Americans in 2017, with colorectal cancer responsible for >40% of that burden; there will be more than 150,000 deaths from this group of cancers in the same time period. Disparities among subgroups related to the incidence and mortality of these cancers exist. The epidemiology and risk factors associated with each cancer bear out differences for racial groups in the United States. Esophageal adenocarcinoma is more frequent in non-Hispanic whites, whereas esophageal squamous cell carcinoma with risk factors of tobacco and alcohol is more frequent among blacks. Liver cancer has been most frequent among Asian/Pacific Islanders, chiefly due to hepatitis B vertical transmission, but other racial groups show increasing rates due to hepatitis C and emergence of cirrhosis from non-alcoholic fatty liver disease. Gastric cancer incidence remains highest among Asian/Pacific Islanders likely due to gene-environment interaction. In addition to esophageal squamous cell carcinoma, cancers of the small bowel, pancreas, and colorectum show the highest rates among blacks, where the explanations for the disparity are not as obvious and are likely multifactorial, including socioeconomic and health care access, treatment, and prevention (vaccination and screening) differences, dietary and composition of the gut microbiome, as well as biologic and genetic influences. Cognizance of these disparities in gastrointestinal cancer risk, as well as approaches that apply precision medicine methods to populations with the increased risk, may reduce the observed disparities for digestive cancers.
[Mh] Termos MeSH primário: Grupos de Populações Continentais
Neoplasias do Sistema Digestório/etnologia
Disparidades nos Níveis de Saúde
Estilo de Vida/etnologia
[Mh] Termos MeSH secundário: Neoplasias do Sistema Digestório/diagnóstico
Neoplasias do Sistema Digestório/mortalidade
Neoplasias do Sistema Digestório/terapia
Feminino
Seres Humanos
Incidência
Masculino
Prognóstico
Medição de Risco
Fatores de Risco
Distribuição por Sexo
Fatores de Tempo
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170816
[St] Status:MEDLINE


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[PMID]:28783542
[Au] Autor:Simin J; Tamimi R; Lagergren J; Adami HO; Brusselaers N
[Ad] Endereço:Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research (CTMR), Karolinska Institutet, Nobels Väg 16, SE-171 77 Stockholm, Sweden; Science for Life Laboratory (SciLifeLab), SE-171 21 Stockholm, Sweden.
[Ti] Título:Menopausal hormone therapy and cancer risk: An overestimated risk?
[So] Source:Eur J Cancer;84:60-68, 2017 Oct.
[Is] ISSN:1879-0852
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: We aimed to assess the overall cancer risk among contemporary menopausal hormone therapy (MHT) users in Sweden and the risk for different cancer types. METHODS: A nationwide Swedish population-based cohort study including all 290,186 women aged ≥ 40 years having used systemic MHT during the study period (July 2005 and December 2012), compared with the Swedish female background population. MHT ever-use (all MHT, oestrogen-only MHT [E-MHT] and oestrogen plus progestin MHT [EP-MHT]) was based on the nationwide Prescribed Drug Registry. Cancer diagnoses were grouped into 16 different anatomical locations, for which standardised incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated. RESULTS: The SIR of any cancer was 1.09 (95% CI: 1.07-1.11) following ever MHT, 1.04 (95% CI: 1.01-1.06) for E-MHT and 1.14 (95% CI: 1.12-1.17) for EP-MHT. The highest SIR was found for EP-MHT among users aged ≥70 years (SIR = 1.33, 95% CI: 1.26-1.40). The risk for invasive breast, endometrial or ovarian cancer combined was increased for any MHT (SIR = 1.31, 95% CI: 1.28-1.34). The risk of invasive breast cancer was increased following MHT and increased with age for EP-MHT users. The risk of gastrointestinal cancers combined was decreased (SIR = 0.90, 95% CI: 0.86-0.94), particularly the oesophagus (SIR = 0.81, 95% CI: 0.64-1.00), liver (SIR = 0.81, 95% CI: 0.65-0.99) and colon (SIR = 0.90, 95% CI: 0.84-0.95). CONCLUSIONS: MHT, notably EP-MHT, was associated with a limited increase in overall cancer risk. The increased risk of female reproductive organ cancers was almost balanced by a decreased risk of gastrointestinal cancers.
[Mh] Termos MeSH primário: Terapia de Reposição de Estrogênios/efeitos adversos
Estrogênios/efeitos adversos
Menopausa
Neoplasias/induzido quimicamente
Neoplasias/epidemiologia
Progestinas/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Idoso
Neoplasias da Mama/induzido quimicamente
Neoplasias da Mama/epidemiologia
Neoplasias do Sistema Digestório/epidemiologia
Neoplasias do Sistema Digestório/prevenção & controle
Esquema de Medicação
Composição de Medicamentos
Neoplasias do Endométrio/induzido quimicamente
Neoplasias do Endométrio/epidemiologia
Estrogênios/administração & dosagem
Feminino
Seres Humanos
Incidência
Meia-Idade
Neoplasias/diagnóstico
Neoplasias/prevenção & controle
Neoplasias Ovarianas/induzido quimicamente
Neoplasias Ovarianas/epidemiologia
Progestinas/administração & dosagem
Fatores de Proteção
Sistema de Registros
Medição de Risco
Fatores de Risco
Suécia/epidemiologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Estrogens); 0 (Progestins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170808
[St] Status:MEDLINE


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[PMID]:28570095
[Au] Autor:Çekiç B; Toslak IE; Sahintürk Y; Cekin AH; Koksel YK; Koroglu M; Demos TC
[Ad] Endereço:1 Department of Radiology, Antalya Training and Research Hospital, Antalya, Turkey.
[Ti] Título:Differentiating Transudative From Exudative Ascites Using Quantitative B-Mode Gray-Scale Ultrasound Histogram.
[So] Source:AJR Am J Roentgenol;209(2):313-319, 2017 Aug.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The purpose of this article is to differentiate exudative from transudative ascites using B-mode gray-scale ultrasound histogram analysis. SUBJECTS AND METHODS: Sixty-two consecutive patients with ascites were prospectively studied from June 2014 through June 2015. All underwent ultrasound (US) and paracentesis in the radiology department. Five patients were excluded (three with hemorrhage and two with peritoneal carcinomatosis). The remaining 57 patients were divided into those with exudative and transudative ascites according to results of paracentesis. Electronically recorded US images were transferred to a workstation, and gray-scale histograms were generated. The ascites-to-rectus abdominis muscle echogenicity ratio (ARAER) was obtained from ascites adjacent to the rectus abdominis muscle. ROC curves were used to evaluate the sensitivity and specificity of this method in differentiating exudative from transudative ascites. RESULTS: ARAERs for exudative ascites were significantly higher than those for transudative ascites (p < 0.001). ROC was done to evaluate ARAERs for exudative ascites. The best cutoff value for ARAER histogram was 0.002. The sensitivity and specificity of ARAER were 87.5% and 79.2% (AUC = 0.843), respectively. CONCLUSION: ARAER is an easily applicable noninvasive quantitative sonographic method with high sensitivity and specificity in differentiating exudative from transudative ascites.
[Mh] Termos MeSH primário: Neoplasias Abdominais/complicações
Ascite/diagnóstico por imagem
Ascite/etiologia
Neoplasias do Sistema Digestório/complicações
Exsudatos e Transudatos
Hipertensão Portal/complicações
Ultrassonografia/métodos
[Mh] Termos MeSH secundário: Idoso
Diagnóstico Diferencial
Feminino
Seres Humanos
Masculino
Meia-Idade
Paracentese
Estudos Prospectivos
Ultrassonografia de Intervenção
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170803
[Lr] Data última revisão:
170803
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170602
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.16.16509


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[PMID]:28384791
[Au] Autor:Deutsch GB; Flaherty DC; Kirchoff DD; Bailey M; Vitug S; Foshag LJ; Faries MB; Bilchik AJ
[Ad] Endereço:Division of Surgical Oncology, Department of Surgery, Hofstra Northwell School of Medicine, Uniondale, New York.
[Ti] Título:Association of Surgical Treatment, Systemic Therapy, and Survival in Patients With Abdominal Visceral Melanoma Metastases, 1965-2014: Relevance of Surgical Cure in the Era of Modern Systemic Therapy.
[So] Source:JAMA Surg;152(7):672-678, 2017 Jul 01.
[Is] ISSN:2168-6262
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Systemic therapy for metastatic melanoma has evolved rapidly during the last decade, and patient treatment has become more complex. Objective: To evaluate the survival benefit achieved through surgical resection of melanoma metastatic to the abdominal viscera in patients treated in the modern treatment environment. Design, Setting, and Participants: This retrospective review of the institutional melanoma database from the John Wayne Cancer Institute at Providence St Johns Health Center, a tertiary-level melanoma referral center, included 1623 patients with melanoma diagnosed as having potentially resectable abdominal metastases before (1969-2003) and after (2004-2014) advances in systemic therapy. Main Outcomes and Measures: Overall survival (OS). Results: Of the 1623 patients identified in the database with abdominal melanoma metastases, 1097 were men (67.6%), and the mean (SD) age was 54.6 (14.6) years. Of the patients with metastatic melanoma, 1623 (320 [19.7%] in the 2004-2014 period) had abdominal metastases, including 336 (20.7%) with metastases in the gastrointestinal tract, 697 (42.9%) in the liver, 138 (8.5%) in the adrenal glands, 38 (2.3%) in the pancreas, 109 (6.7%) in the spleen, and 305 (18.8%) with multiple sites. Median OS was superior in surgical (n = 392; 18.0 months) vs nonsurgical (n = 1231; 7.0 months) patients (P < .001). The most favorable 1-year and 2-year OS was seen after surgery for gastrointestinal tract (52% and 41%) and liver (51% and 38%) metastases, respectively. Multivariable analysis found increasing age (hazard ratio [HR], 1.01; 95% CI, 1.00-1.01; P = .02) and the presence of ulceration (HR, 1.21; 95% CI, 1.01-1.45; P = .04) were associated with a worse OS. Alternatively, treatment with metastasectomy (HR, 0.59; 95% CI, 0.46-0.74; P < .001) and metastases involving the gastrointestinal tract (HR, 0.65; 95% CI, 0.48-0.87; P = .004) were associated with a better OS. The systemic treatment era did not significantly affect outcomes (HR, 0.82; 95% CI, 0.67-1.02; P = .15). Overall, patients with gastrointestinal tract metastases undergoing complete, curative resection derived the greatest benefit, with a median OS of 64 months. Conclusions and Relevance: To our knowledge, this series is the largest single-institution experience with abdominal melanoma metastases, demonstrating that surgical resection remains an important treatment consideration even in the systemic treatment era.
[Mh] Termos MeSH primário: Neoplasias das Glândulas Suprarrenais/cirurgia
Neoplasias do Sistema Digestório/cirurgia
Neoplasias Gastrointestinais/cirurgia
Neoplasias Hepáticas/cirurgia
Melanoma/cirurgia
Neoplasias Pancreáticas/cirurgia
Neoplasias Esplênicas/cirurgia
[Mh] Termos MeSH secundário: Neoplasias das Glândulas Suprarrenais/tratamento farmacológico
Neoplasias das Glândulas Suprarrenais/secundário
Adulto
Fatores Etários
Idoso
Anticorpos Monoclonais/uso terapêutico
Anticorpos Monoclonais Humanizados/uso terapêutico
Antineoplásicos/uso terapêutico
Neoplasias do Sistema Digestório/tratamento farmacológico
Neoplasias do Sistema Digestório/secundário
Feminino
Neoplasias Gastrointestinais/tratamento farmacológico
Neoplasias Gastrointestinais/secundário
Seres Humanos
Ipilimumab
Neoplasias Hepáticas/tratamento farmacológico
Neoplasias Hepáticas/secundário
Masculino
Melanoma/tratamento farmacológico
Melanoma/secundário
Metastasectomia
Meia-Idade
Neoplasias Pancreáticas/tratamento farmacológico
Neoplasias Pancreáticas/secundário
Estudos Retrospectivos
Neoplasias Esplênicas/tratamento farmacológico
Neoplasias Esplênicas/secundário
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antibodies, Monoclonal, Humanized); 0 (Antineoplastic Agents); 0 (Ipilimumab); 31YO63LBSN (nivolumab); DPT0O3T46P (pembrolizumab)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170407
[St] Status:MEDLINE
[do] DOI:10.1001/jamasurg.2017.0459


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[PMID]:28351315
[Au] Autor:Zheng J; Zhao M; Li J; Lou G; Yuan Y; Bu S; Xi Y
[Ad] Endereço:Diabetes Center, Zhejiang Provincial Key Laboratory of Pathophysiology, Institute of Biochemistry and Molecular Biology, School of Medicine, Ningbo University, Ningbo, China.
[Ti] Título:Obesity-associated digestive cancers: A review of mechanisms and interventions.
[So] Source:Tumour Biol;39(3):1010428317695020, 2017 Mar.
[Is] ISSN:1423-0380
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The prevalence of obesity has steadily increased over the past few decades. Previous studies suggest that obesity is an oncogenic factor and that over 20% of all cancers are obesity-related. Among such cancers, digestive system malignancies (including esophageal adenocarcinomas, colorectal cancers, and cancers of the gastric cardia, liver, and pancreas) are reported most frequently. While the 5-year survival rates of cancers of the breast and prostate are 90%, that rate is only 45% for digestive cancers. In this review, the mechanisms of obesity-associated digestive cancers are discussed, with an emphasis on obesity-related gene mutations, insulin and insulin-like growth factor signaling pathways, chronic inflammation, and altered adipokine levels. Evidence that these factors often function interdependently rather than independently in carcinogenesis is presented. Recommended interventions that may reduce the burden of obesity-associated digestive cancers, such as participation in physical activity, diet modulation, and calorie restriction, are also described.
[Mh] Termos MeSH primário: Neoplasias Colorretais/patologia
Neoplasias do Sistema Digestório/patologia
Neoplasias Esofágicas/patologia
Neoplasias Gastrointestinais/patologia
Obesidade/patologia
[Mh] Termos MeSH secundário: Neoplasias Colorretais/etiologia
Neoplasias Colorretais/genética
Neoplasias do Sistema Digestório/etiologia
Neoplasias do Sistema Digestório/genética
Metabolismo Energético/genética
Neoplasias Esofágicas/etiologia
Neoplasias Esofágicas/genética
Neoplasias Gastrointestinais/etiologia
Neoplasias Gastrointestinais/genética
Seres Humanos
Obesidade/complicações
Obesidade/genética
Fatores de Risco
Transdução de Sinais/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170407
[Lr] Data última revisão:
170407
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170330
[St] Status:MEDLINE
[do] DOI:10.1177/1010428317695020



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