International Journal of Cancer Management
Volume:11 Issue: 5, May 2018

Ovarian cancer (OC) has been reported as one of the three most prevalent malignant tumors in women. It has an onset of a difficult early diagnosis. The early detection of diseases has a vital role in survival rate of patients; the ovarian malignant tumor is no exception. The currently used tumor markers for differentiating low and high-risk levels of this disease are cancer (carbohydrate) antigen 125 (CA 125) as well as the risk of ovarian malignancy algorithm (ROMA). Carcinoembryonic antigen (CEA) is fetal glycoprotein synthesized in fetal tissues and in some carcinomas.
In this study, we investigated ROMA, CA-125, and CEA to evaluate the efficacy of these markers as predictors of peritoneal dissemination in early diagnosis of low-grade serous ovarian cancer.
In this experimental study, CA-125, CEA, ROMA were determined in 10 patients with early-stage serous ovarian cancer and in 10 patients with benign tumors. Values and a cut-off level of CA-125, CEA, and ROMA were defined as positive when the values were as expected for ovarian cancer (CA-125 > 35 U/mL, CEA In our patients, the serum level of CA-125, CEA, and ROMA was higher in patients who were at their early stage of serous ovarian cancer than those with benign tumors.
In this study, the difference between CA-125, ROMA, CEA levels in healthy and malignant cancerous patients was statistically significant, which is encouraging. The finding indicates that combined results of serum CA125, ROMA, and CEA can be considered as a promising biomarker for early stage detection of serous ovarian cancer.

Systemic and intrathecal adenosine reduce chronic neuropathic and nociceptive pain; however, the effect of adenosine epidural injection in the treatment of neuropathic cancer-related pains remains unclear.
The objective of this study was to evaluate the efficacy of a single epidural administration of adenosine in alleviating chronic neuropathic pain in patients with primitive neuroectodermal tumors.
In this single-blind randomized clinical trial with the unique ID of IRCT2017031428878N1, 88 patients with chronic neuropathic pain were divided into two equivalent groups. Two groups were treated with a single dose epidural administration of ropivacaine, 0.75 mL/kg from 0.2% solution (both groups), plus adenosine, 50 mcgr/kg (adenosine group), or normal saline (control group). Patients were evaluated on the days 1, 2, 3, 5, 7, 10, and 14 after injection.
Both groups showed a reduction in pain severity according to verbal rating scale (VRS) (3 ± 0.09-1 ± 0.05 in adenosine, 4 ± 0.08-1 ± 0.00 in the control group) and visual analogue scale (VAS) (7 ± 0.25-1 ± 0.12 in adenosine, 8 ± 0.22-1 ± 0.06 in the control group); however, this reduction was significantly higher in the control group (P Administration of bolus epidural adenosine is not effective in reducing neuropathic pain in patients with primitive neuroectodermal tumors.

Bladder cancer is the ninth most commonly diagnosed malignancy worldwide. The trend of bladder cancer incidence and mortality is rising in Iran. This study was aimed to evaluate the survival rate of patients with bladder cancer in Yazd province, Iran.
In this retrospective cohort study, data were collected from 340 patients suffering from bladder cancer referred to Shahid Rahnemon and Shohada-Kargar Hospitals in Yazd province, Iran between April, 2001 and March, 2012. Variables included age, gender, stage of cancer, place of residence and type of treatment. The Kaplan-Meier and Cox regression analyses were used to evaluate the relationship between each variable and survival time. A P value less than 0.05 was considered significant.
The mean age of total patients was 65.8 ± 13.6 years, and their mean survival time was 68.55 ± 6.05 months. Cumulative survival rates at the end of 1, 3, and 5 years in bladder cancer patients were 91%, 58%, and 51.4%, respectively. A statistically significant association was found between age (P = 0.005), stage of disease (P = 0.0003), type of treatment (P = 0.0003) and survival time of patients. Data showed no significant correlation between age, gender, place of residence and patients’ survival.
The survival of patients suffering from bladder cancer in this study was less than other reports. Patients’age and cancer stage were the effective factors in survival time. Continuous screening of older people for cancer diagnosis in early stages is seemed to improve survival in patients.

In oncology studies, categorizing a quantitative prognostic variable or determining cut point is aimed at categorizing individuals into homogenous groups. Such categorizations are useful for treatment recommendations and clinical trial design.
This article aims at determining the cut point for breast cancer diagnosis age by factors affecting the patients’ survival, using cure model.
In this longitudinal study, a total 559 patients with breast cancer referring to breast cancer research center, Tehran, Iran, from 1986 to 2006 entered the study. Patients were followed until 2013. The last status of patients was recorded, using telephone conversation. Then, the cut point of breast cancer diagnosis age was determined, using change point cure model with survival-related covariates and R v.2.15.0 software.
In the present study, the mean age of diagnosis was reported 46.31 ± 11.17. Median time of follow-up was 68.36 months with the range of 0.89 to 324. The results showed that age cut point was 49.45 (± 0.64). In young group, one unit increase in tumor size led to 57% reduction in the chance of cure. In old group, the chance of recovery declined by 51%. In old group, the chance of cure among those with lymph node declined by %61 compared to those without lymph node. In the young group, this variable was not significant. Level of education, type of surgery, and estrogen receptor had no significant relationship with cure in none of the age groups at 5% error level.
The results showed that the effect of age in breast cancer prognosis is adjusted at 50-year cut point, leading to two relatively homogeneous groups. This cut point is effective in assessing predictive and prognostic factors in breast cancer. The difference between effect of tumor size and effect of lymph node involvement in different age groups can be helpful in determining more appropriate therapeutic strategies.

Esophageal cancer (EC) is among the ten most common cancers and causes-related mortality worldwide.
To determine the global inequality in the incidence and mortality rates of EC and decomposing of determinants in inequality.
The rates of incidence and mortality about EC were obtained for 172 countries from the global cancer project. The World Bank database was also used to obtain the HDI and its gradient for 169 countries. Inequality in the age-specific incidence and mortality rates of EC was calculated according to the HDI by using the concentration index (CI). We were decomposing CI to determine contributors in inequality.
The concentration index was negative for incidence (-0.23) and mortality (-0.25) rates of EC, indicating the higher concentration of the rates among deprived countries. The important contributors in incidence and mortality inequality rates of EC were HDI and Urbanization with about 0.25 absolute contributions.
Global inequalities exist in the EC incidence and mortality rates, which have contributed to the cancer-related health disparities worldwide. The important positive contributors in inequalities were HDI and urbanization. These findings suggest that prevention, early detection, and public health education programs and policies should be targeted to reduce global cancer disparities, particularly in low and middle-income developing countries.

Neoadjuvant chemotherapy is the standard treatment for patients with locally advanced breast cancer which was recently introduced for operable breast cancer especially to achieve negative margins in breast conservation. Several studies have shown that Pathologic complete response (pCR) after neoadjuvant chemotherapy increases survival rate. The aim of this study therefore, was to evaluate the rate of pathologic complete response and its effective factors in breast cancer research center (BCRC).
During a cross-sectional study, 179 patients with stage I to III breast cancer, who received neoadjuvant chemotherapy in breast cancer research center from 1997 to 2014, were included. Cases with pathologic complete response were defined as no tumor residue in the breast tissue and axillary region. This group of patients was compared with patients who had residual tumor at pathology. Data were analyzed by descriptive and inferential statistics using SPSS 19.
The mean age of patients was 45.4 years. Thirty-four patients (19%) were identified in the pathological complete response group (pCR). There was no significant difference between the pCR and non-pCR groups with respect to Age, Menopausal status, Family history of breast cancer, Tumor size, Histological type, Hormone receptors, Her-2neu and Phenotypic subtypes. However, ki67 index was significantly different between the two groups of patients, indicating that in patients with Ki67 of more than 40, pCR was the most observed (P = 0.01).
This study showed that among the demographic, clinical, pathological and therapeutic factors, Ki67 can be a predicting factor for pathologic complete response after neoadjuvant chemotherapy.

Breast cancer is the most frequent diagnosed solid cancer with the incidence rate of 32 patients in 100,000 among Iranian women. Neo-adjuvant chemotherapy (NAC) is the standard treatment for patients with locally advanced breast cancer, which was recently introduced for early stage disease to achieve breast preservation.
The aim of this study was to evaluate the rate of local recurrence, distant recurrence, breast cancer mortality, five years disease free survival (DFS) and five years overall survival (OS) in patients with breast cancer after NAC and to compare these factors with patients, who received adjuvant chemotherapy.
In this cross sectional study, 188 patients with stage I to III breast cancer, who received NAC (group A), and 376 patients with breast cancer, who received adjuvant chemotherapy (group B), were selected and matched based on a time- stratified 2:1 approach between October 2002 and December 2014. Their clinical-pathological profile and survival study were compared.
The mean age of patients was 48.23 years in group A and 48.76 years in group B. The median follow-up time was 52 months. In group A and group B, 13.1% and 7.7% of the patients had local recurrence during the five years of follow up, respectively (P This study showed that higher frequency of local recurrence in NAC group than adjuvant chemotherapy group was not associated with any significant increase in distant recurrence or breast cancer mortality. Longer follow-up time of the patients to compare survival between two groups is recommended.

Rapid progression in medical and health sciences have caused survival studies, where some patients have long-term survival, especially for chronic diseases such as breast cancer. Cure models can be applicable to analyze such data.
The aim of this study was to determine the risk factors associated with breast cancer, using mixture cure fraction model.
We studied data for 438 patients, who were referred to cancer research center in Shahid Beheshti University of Medical Sciences. The patients were visited and treated during 1992 to 2012 and followed-up until October 2014. The data were analyzed by mixture cure fraction model based on GMW (generalized modified Weibull) distribution and inferences were obtained with Bayesian approach, using standard MCMC (Markov Chain Monte Carlo) methods. All analyses were performed, using SPSS v20 and OpenBUGS software. The significant level was considered at 0.05.
During the follow-up period, 75 (17.12%) deaths occurred by breast cancer and the one-year overall survival rate was 98%. Covariates such as numbers of metastatic lymph nodes and histologic grade were statistically significant. Also, the cure fraction estimation was obtained 58%.
When some patients have a long-term survival, cure models can be an interesting model to study survival and these models estimate parameters better than the traditional models such as cox model. In this paper, the mixture cure fraction model based on GMW was fitted for analysing survival times in patients with breast cancer.

Gliosarcoma (GS) is a rare primary neoplasm of the central nervous system. It is a subtype of glioblastoma and has a biphasic pattern consisting of glial and malignant mesenchymal elements. Its onset is between the fourth and sixth decade of life.
Since protein - protein interaction (PPI) network analysis can provide useful information about molecular aspects of diseases, the aim of this study is GS protein analysis via PPI network and gene ontology assessment.
The related genes to GS were gathered from STRING DB and organized in the interacted network by Cytoscape software version 3.6.0. The network was analyzed based on topological parameters and the central nodes were introduced. The significant clusters were identified by ClusterONE and the cluster included more key genes enriched via gene ontology by ClueGO.
Nine crucial genes including TP53, EGFR, PTEN, EGR1, VEGFA, HSP90AA1, IL2, KNG1, and HSP90AB1 were introduced as related key genes to GS. Two significant clusters contain most of central genes. Twenty - one elements of cluster - 1, which included 7 key genes, were enriched via gen ontology and 115 related terms were determined and discussed.
The nine introduced central genes may play main roles in pathology of GS. However, experimental investigation is proposed to validate the findings.

Background parenchymal enhancement (BPE) in breast magnetic resonance imaging (MRI) potentially correlates with breast cancer (BC). Thus, BPE may be used for BC risk stratification and for monitoring chemo-prevention.
We aimed to investigate the BPE patterns in benign and malignant breast lesions and in pre-menopausal and post-menopausal women.
In 2017, 128 consecutive pre-menopausal or post-menopausal patients underwent breast MRI with different indications were examined. Subjects with the history of breast surgery, radiotherapy, or chemotherapy were excluded. A 1.5 Tesla device was used with the same protocol, and a blinded radiologist visually assessed and categorized breast BPE as minimal, mild, moderate, and marked. We used frequency distribution, mean, and standard deviation to report the findings. Comparing age or BPE in categorical variables, we appropriately used ANOVA, or Chi-square and Fisher’s exact tests.
The mean (± standard deviation) age was 42.43 (± 10.82) years, and 89 (69.5%) patients were hormonally active. Eighteen (14.1%), 55 (43.0%), 41 (32.0%), and 14 (10.9%) patients were classified as having minimal, mild, moderate, and marked BPE, respectively. Age did not change among BPE levels (P = 0.197). Prevalence of moderate and marked BPE was higher in pre-menopausal women. BPE was not associated with breast lesion histopathology (P value = 0.857) in pre-menopausal or post-menopausal women (P = 0.790, and 0.840, respectively).
BPE is a measure of breast tissue hormonal activity, and it is not correlated with histopathological diagnosis of breast lesion in both pre-menopausal and post-menopausal women. The data of this study do not support the use of BPE for BC risk estimation.