International Journal of Cancer Management
Volume:2 Issue: 2, Spring 2009

Esophageal anastomosis leaks continue to be a significant cause of morbidity and mortality after esophagectomy. The purpose of the present study was to identify the predisposing factors of esophageal anastomotic leakage. 95 patients who underwent surgical resection for esophageal or cardia cancer were included for the study. The mean age of the patients was 59.5 years and male to female ratio was 1.56 to 1. The preferred management strategy for anastomotic leakage was the conservative approach when possible. The operative approach was reserved for those patients with fulminant sepsis or those who did not respond to the conservative management. Data were analyzed using SPSS 13.0 software and P-values less than 0.05 were considered significant. Sixty six patients had cervical esophageal anastomosis and 29 had intrathoracic anastomosis; 18.9% anastomotic leakage was diagnosed. Patients with symptoms longer than 6 months prior to operation, and diabetic patients had a significantly higher risk of anastomotic leakage. Our data showed that the presences of diabetes mellitus as well as prolonged symptoms (more than six months) are associated with higher anastomotic leakage after esophagectomy. Controlling blood glucose, early diagnosis of esophageal cancer, early resection of tumor before a long-term period of symptoms, and effective screening program for esophageal cancer may reduce the risk of esophageal leakage.

Anti-phospholipid syndrome (APS) is an autoimmune systemic disease characterized by the persistent presence of anti-phospholipid antibodies (APA) and the occurrence of thrombotic events. Nowadays, the association between specific antibodies for anionic phospholipids with thrombotic events and other main clinical manifestations is well-recognized as "antiphospholipid syndrome". The present study was done to evaluate the frequency of antiphospholipid antibodies in neoplastic patients. One hundred and eighty patients were included in this cross sectional study. Their suspected neoplasm disorders were confirmed by pathology or flowcytometry. History taking and clinical examination were done for patients to detect all symptomatic clinical thrombotic events. Antiphospholipid antibodies were tested for all patients. The study was concluded with 156 study samples. Thirty three patients (21.2%) had antiphospholipid antibodies. There was no significant difference on antiphospholipid antibodies frequency between two genders. APA frequency showed no significant difference between solid or non-solid tumors. The rate of thrombosis was significantly higher in neoplastic patients with antiphospholipid antibodies. Frequency of antiphospholipid antibodies was significantly higher in neoplastic patients. Antiphospholipid antibodies were one of the multifactorial accelerating factors for thrombotic events in neoplastic patients.

To analysis the epidemiological and clinopathological aspects of gastric cancer. We retrospectively studied the characteristics of 752 gastric carcinoma patients registered in cancer registry center of Taleghani hospital from 2001 to 2006. All the patients confirmed gastric cancer histopathologically. Univariate methods (Mann-Whitney U-test, and chi-square) were used for analysis. Among 752 cases, 535 (71.1%) were male. Sex ratio (male: female) was 2.49:1. The mean age of the patients was 59.7 years (SD = 12.9) at the time of the diagnosis. Weight loss, as a frequent symptom at the time of diagnosis, was observed in 57.7% of the cases. Most of the patients were diagnosed with advanced pathologic stage. In addition, tumor grading was poorly differentiated in most cases (28.7%); and in 49.9% of the patients, the tumors were located in the stomach, NOS; and distant metastasis was observed in 24.6% of the cases. Based on the results, earlier detection in younger ages and in primary stages of tumor, and subsequent higher quality care to cure GC and increase patients'' life expectancy are recommended.

Chest wall irradiation for early breast cancer affects forced vital capacity (FVC), forced expiratory volume in the first second of expiration (FEV1) and may change peripheral oxygen saturation (SpO2). In our institute chest wall is irradiated with a four field technique: two tangential and two oppositional anterior and posterior supraclavicular fields. Regional recurrence in this technique is less than 5 percent. We conducted this study to compare changes in FEV1, FVC and SpO2 between standard three field and four fields technique. We randomized 51 stage I and II breast cancer cases after modified radical mastectomy and completion of chemotherapy in two groups. In group I patients were treated with four field and in group II with three field technique using cobalt 60 teletherapy. Patients with a history of smoking, pulmonary disease, heart disease and any deformities in chest wall were excluded. Patients were stratified due to central lung distance (CLD), fields separation in tangential fields and filed borders defined in standard manner. Radiotherapy dose was 50.4 Gy in 28 fractions. Spirometry and pulse oxymetry was done before, one month after and three months after the completion of radiotherapy. FEV1, FVC and FEV1/FVC showed no significant difference between two groups one month and three months after radiotherapy. Also there was no significant difference in FEV1, FVC, FEV1/FVC one month after radiotherapy comparing with pre-radiotherapy values. There were significant differences in FEV1 and FVC reduction three months after radiotherapy in comparison with pre-radiotherapy values (P<0.001, P<0.006 respectively). SpO2 showed no significant difference between two groups and also in each group after one and three months. Locoregional radiotherapy of chest wall and supraclavicular lymph nodes causes reduction in FEV1 and FVC three months after radiotherapy but there is no significant difference between three field and four fields techniques. We suggest this study be completed by using pulmonary function tests including spirometry and diffusion capacities.

Bachground and Mutation analysis of mitochondrial genome and BRCA genes are helpful in the early diagnosis of familial breast cancers. In this study, we investigated mitochondrial common deletion and BRCA mutations through multiplex PCR and clinical parameters for the detection of familial breast cancers in archival breast cancer samples. The multiplex PCR was conducted on DNA from 34 archive breast tissue samples and 13 blood samples. Five mtDNA4977 deletions and three 5382insC mutations were detected from familial breast cancers. The mtDNA4977 deletion was highly prevalent in peripheral blood but it was absent in the breast tissue of the cancer cases. On the other hand, familial breast cancer tumors exhibited different clinical parameters such as higher mitotic activity, higher polymorphism, lower necrosis, lower tubules, higher ER- and PR-negatives and lower TP53-positives compared to the non-familial cancers. Our results demonstrated that the testing of mtDNA4977 deletion and 5382insC mutation in combination with clinical parameters can serve as major risk factors in the identification of familial breast cancers.

Acute Meyloid Leukemia (AML) in adults is known to be a heterogeneous disease with diverse chromosome abnormalities. Some of these chromosome abnormalities are found with a high incidence in populations from specific geographical areas and ethnic societies. Therefore, we studied the cytogenetic features of AML cases in contrasting societies of Iran and India. Cytogenetic investigation was performed in various subtypes of AML with unstimulated short-term culture and High Resolution Cell Synchronization with some modification. Cytogenetically, Iranian M3 displayed a higher frequency of t(15;17) than Indian M3 (33.8% vs 19.3%) followed by M2 [t(8;21) (27.7% vs 16.2%)] and M1 [t(9;22) (16.0% vs 11.3%)]; whereas, inv(16)11q23 and numerical chromosomal aberrations in chromosome 5,7,8 occurred more frequently in Indian than Iranian. These findings represented different cytogenetic characteristics of t(15;17) between the two populations. This is the first systematic cytogenetic study of an ethnic Iranian population. Extensive biological studies of AML in Iran and India and various countries to be needed to clarify the role of genetic as well as geographic heterogeneity in the pathogenesis of AML.

Artificial hyperthermia in association with radiotherapy or chemotherapy has become a promising method for cancer treatment. Thus, this study was designed to assess the impact of repetitive hyperthermia (41° ± 0.5°C) on some normal histological, histochemical, and biochemical variables in newborn rats. After parturition, the neonates were randomly chosen and assigned to two groups (each being comprised of ten animals): one group was exposed to hyperthermia (41° ± 0.5°C) and the other one was exposed to normothermia (25° ± 0.5°C). Both groups were treated daily for 2 hours from the day of labor until the age of 21 days. Histological and histochemical examination of the tissue sections of hypothermic rat neonates exhibited numerous cirrhotic changes in liver with deposition of collagen fibers extending from the central veins or portal tracts forming thick or thin fibrotic septa and even pseudolobule formations. The kidneys showed areas of necrosis, edema, glomerular hyperplasia or infiltration of inflammatory cells, marked amounts of collagen surrounding some Malpigian corpuscles and in between the renal tubules in a focal or diffuse fashion. The lungs revealed alveolar haemorrhage, focal fibrosis, emphysema of the alveoli with rupture of some alveolar walls and hyperplasia of the cells lining alveoli with collagen distribution in the peribronchiolar area as well as in the tunica adventitia of the peribronchiolar dilated blood vessels, and in the interalveolar and perialveolar areas. The spleen suffered from severe hyperemia in the red pulps and sinusoids with distorted lymphoid nodules and atrophy of others. The quantitative measurement of the degree of fibrosis proved a significant (p < 0. 01) accumulation of collagen fibers in all the examined tissues except for spleen. Additionally, hyperthermia caused a significant increase in most measured serum biochemical variables (ALT, AST, GGT, LDH, total bilirubin, total protein, albumin, creatinine & urea) except for the globulin content whose concentration showed a significant decrease. As high preferential absorption ability of tumour tissue components to heat over normal tissues rely, in part, upon their higher collagen and protein content, attention should be paid to the repetitive effect of high temperature on the architecture of normal tissues, total collagen and protein contents in addition to its upshots on certain biochemical indices to appraise the impact of the method on patients particularly newborns and those with multi-recurrences carcinoma.

Introduction & Schwannoma, a benign tumor of nerve sheath origin, is commonly found in the head and neck, as well as flexor surfaces of the extremities. It can rarely occur in the breast and stomach with only a few cases being reported.Case Reports: The cases are: 1) a 57-year- old man with breast mass, 2) a 58 -year -old man with gastrointestinal complaints who were finally diagnosed as peripheral nerve schwannomas. Clinical suspicion and histopathological confirmation are the keys to schwannomas diagnosis. Surgical excision is the treatment of choice for such patients.