فهرست مطالب
Middle East Journal of Cancer
Volume:4 Issue: 3, Jul 2013
- تاریخ انتشار: 1392/06/10
- تعداد عناوین: 8
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Pages 95-99The vast entity of the aging process must be well thought out while considering optimal management for elderly patients with cancer. Co-morbidity and functional status are the key factors which determine the overall survival of patients. Multidisciplinary approaches to patient management must be emphasized and stressed to deal with end- of-life issues. Researchers need to identify elderly people who are most susceptible to treatment toxicities and must deal with palliation and hospice care for these patients. One approach to the issue of aging as a variable in treatment outcome would be to utilize programs and facilities supported by cancer institutes to address age-related questions in clinical trials. Academic oncologists, geriatricians and pathologists can create realistic and imminent goals to achieve victory against cancer and provide optimal treatment that includes adequate supportive care and reduces the burden of post- treatment morbidities that compromise quality of life in these patients. This review focuses on the basis of cancers that affect the elderly and how momentous advances can be obtained to expound the pathways most critically involved in tumor development and progression. Through this review, an attempt has been made to explain the impact of peculiar mutations and altered cell behavior underlying geriatric oncogenesis.
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Pages 101-108BackgroundThe aim of this study was to measure the concentrations (levels) of serum total proteins and advanced oxidation protein products as markers of oxidant mediated protein damage in the sera of patients with oral cancers.MethodsThe study consisted of the sera analyses of serum total protein and advanced oxidation protein products’ levels in 30 age and sex matched controls, 60 patients with reported pre-cancerous lesions and/or conditions and 60 patients with histologically proven oral squamous cell carcinoma. One way analyses of variance were used to test the difference between groups. To determine which of the two groups’ means were significantly different, the post-hoc test of Bonferroni was used. The results were averaged as mean ± standard deviation. In the above test, P values less than 0.05 were taken to be statistically significant. The normality of data was checked before the statistical analysis was performed.ResultsThe study revealed statistically significant variations in serum levels of advanced oxidation protein products (P<0.001). Serum levels of total protein showed extensive variations; therefore the results were largely inconclusive and statistically insignificant.ConclusionThe results emphasize the need for more studies with larger sample sizes to be conducted before a conclusive role can be determined for sera levels of total protein and advanced oxidation protein products as markers both for diagnostic significance and the transition from the various oral pre-cancerous lesions and conditions into frank oral cancers.
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Pages 109-112BackgroundRenal cell carcinoma is the third most common urological cancer. Surgical resection is still the mainstay of treatment for this tumor. Here we present a new surgical approach for the management of locally advanced renal cell carcinoma.MethodsWe chose ten patients with extensive renal masses. The patient, under general anesthesia after preparation and draping, was placed in the supine position. We made either a right or left classic subcostal incision which was then extended as a midline incision through the linea alba to the lower abdomen. After mobilization of the right ascending or left descending colon, the renal artery and vein were detected, ligated and divided. Next, the involved kidney was released from the adjacent structures and removed, including Gerota’s fascia.ResultsThe study included 6 men (60%) and 4 women (40%) with a mean age of 57 years. Mean blood loss was 1500 mL and mean operative time was 180 minutes. The patients'' surgical wounds were checked for two weeks after the operation; none of the patients developed wound infections or dehiscence. At the time of writing this manuscript, in January 2011, 7 patients (70%) were alive with no evidence of abdominal herniation at the surgical site.ConclusionA subcosto-midline incision or anterior triangular flap incision is a modified abdominal incision. In our experience, this incision is useful for the resection of locally advanced large renal masses.
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Pages 113-118BackgroundMalignant neoplastic lesions of the breast are one of the main causes of cancer death among women. Several factors can be influential in the treatment process of breast cancer patients. The expression status of estrogen and progesterone receptors in tumor cells is among the most important determinants affecting the treatment approach and prognosis of these patients. In this paper, we will evaluate changes in the expression of these biomarkers between primary and loco-regional recurrent tumors in breast cancer patients.MethodsThis cross-sectional study included 50 female patients aged 30 to 85 years old who underwent surgical intervention between 1994 and 2011. All experienced loco-regional recurrence of the primary tumor between 6 months and 12 years after the first therapeutic intervention. Detection of estrogen and progesterone receptors was based on the immunohistochemistry staining of tissue samples of malignant neoplastic lesions prepared from tissue biopsies of patients with primary or recurrent breast cancer.ResultsNo statistically significant change in the expression of estrogen and progesterone receptors between primary tumors and their matching loco- regional were seen (P>0.05).ConclusionThis research shows no significant changes in estrogen and progesterone receptor expression after loco-regional recurrence of tumors in breast cancer patients. It can be concluded that the assessment of the expression of these biomarkers in primary tumors provides reliable information for the treatment approach of loco-regional tumors.
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Pages 119-124BackgroundLymphomas are a complex group of malignancies that require advanced technology for proper classification. Unfortunately Uganda, as with numerous other Sub-Saharan African countries, lacks these resources. As a result, lymphoma diagnoses do not follow WHO guidelines.MethodsHistopathology records at Makerere University College of Health Sciences, Department of Pathology and the population estimates available through the Population Division of the United Nations Department of Economic and Social Affairs (2011) were used to calculate the prevalence of lymphomas in Uganda.ResultsThe most common pediatric (age: less than 15 years) lymphoma was Burkitt’s lymphoma, followed by lymphoblastic lymphoma. For adolescents and young adults (age: 15 to 24 years), Hodgkin’s lymphoma was the leading subtype, followed by lymphoblastic lymphoma. For adults, small lymphocytic lymphoma was the most common subtype, followed by Hodgkin’s lymphoma. In this study there was a dip in the prevalence of lymphomas during the period 1979 to 1988, followed by a steady increase. This coincided with the time when Uganda lost many of its experts because of political turmoil and therefore might be due to a lack of clinicians and histopathologists that lead to this decline.ConclusionThis study highlights the deficiencies in diagnosis of lymphomas, making it difficult to compare with other centers. There is a need to invest in immuno- histochemistry techniques to aid better classification of lymphomas in Uganda.
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Pages 125-129BackgroundGastric cancer is the leading cause of cancer deaths in Iran. Treatment for gastric adenocarcinoma varies worldwide. The aim of this study is to evaluate char- acteristics and survival rate of gastric and gastroesophageal junction adenocarcinoma in Yazd, Iran.MethodsThis study was conducted on 53 patients with gastric or gastroesophageal junction adenocarcioma who referred to Shahid Ramezanzadeh Radiation Oncology Center between 2004 and 2010. All patients underwent surgery, chemotherapy and radiotherapy. Data from patients’ records were extracted and follow up was conducted through telephone contacts. To analyze data, Kaplan Meier curves and SPSS software were employed.ResultsThere were 17 (32.1%) female and 36 (67.9%) male patients. The mean age was 58.32 years. CT scans were performed preoperatively for 18 (34%) patients. In 14 (26.9%) patients no lymph node was resected or reported by the pathologist; in 29 (54.7%) patients one to six lymph nodes were found; and in 10 (18.9%) patients seven lymph nodes or more were detected. In 2 (3.77%) patients there were more than fifteen lymph nodes resected. Surgical staging was impossible for 16 (30.2%) patients. Mean survival was 50.9 months and median survival was 51 months. The survival rates were 73% for three years, 36% for five years and 18% for seven years. Among the variables only histologic grade had a significant relation to survival.ConclusionPreoperative staging procedures and surgical resections are inadequate in our province. Survival rates are acceptable and similar to Western countries. This finding may have been the result of the effectiveness of combination chemotherapy regimens and radiotherapy used in our patients.
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Pages 131-133Pure apocrine carcinoma of the breast is one of the rare variants of invasive breast carcinoma. Significant research has been conducted on cases of apocrine carcinoma, and the results may help in development of new therapies and assessing prognosis. We hereby present a case of pure invasive apocrine carcinoma in a 50-year old female, with a short review of recent developments with regard to this lesion.
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Pages 135-136