Open Access Original Research Article

Occurrence of Factors Influencing Recurrence and/or Metastasis in Dermatofibrosarcoma Protuberans

A. Y. Benneh, P. S. Kay, M. J. Hale, J. B. L. Kiluba, T. E. Luvhengo

Journal of Cancer and Tumor International, Page 1-9
DOI: 10.9734/JCTI/2017/35247

Introduction: Dermatofibrosarcoma protuberans (DFSP) is a slow growing tumour with limited metastatic potential. However it acquires aggressive attributes as it enlarges or if it recurs following excision. The fibrosarcomatous (FS) variant of DFSP has a higher propensity for local recurrence and distant metastasis.

Aim: To determine the frequency of findings of markers of aggressive disease including FS-DFSP in patients presenting with DFSP.

Methods: A review of histopathology records of patients diagnosed with DFSPs was undertaken.  Data retrieved included patients’ demography, tumour site, size, biopsy type, excision margin, CD34 stain result, mitotic count, presence of necrosis and evidence of fibrosarcomatous change. The Pearson’s chi-square was used to determine if there was an association between DFSP subtype and; gender, age and tumour site. Significance was set at below 5%.

Results: 75 histopathological records were found of which 25.3% were recurrent. Majority 57.3% (43/75) were from female patients. All were black Africans. Their average age was 39.7 years and 66.7% were from the trunk with an average size of 8.1 cm (range: 1.5 cm-19.5 cm). Excision was performed for 57.3% (43/75) and resection margin was adequate in 5.7%.

FS-DFSP was reported in 16.0% (12/75) overall and in 27.9% (12/43) of DFSPs which were excised. 75.0% (9/12) of patients who had FS-DFSPs were females. Only 9.7% of classical DFSPs involved limbs whereas 25.0% (3/12) of FS-DFSPs were in extremities. The median age of patients who had FS-DFSPs was 40.5 years (IQR: 34-46) and their average size was 10.4 cm. Mitotic count of 5 and above per 10 high-power fields was reported in 74.9% (9/12) of FS-DFSPs. Gender, age, tumour site and tumour size did not significantly influence occurrence of classical DFSP and FS-DFSP. The difference in mitotic count for DFSP and FS-DFSP was however statistically significant.  

Conclusion: Majority of DFSPs are larger than 5 cm at presentation. FS-DFSP variant is common and affects older patients compared to the classical DFSP. Mitotic count above 5 is likely in FS-DFSP as compared to classical DFSP. Adequate tumour resection margin of 2 cm and above is rarely achieved in our setting, especially for FS-DFSP.


Open Access Original Research Article

Impact of ADAM17 Expression as a Potential Prognostic Biomarker and Target for Therapy in Node-negative Breast Carcinoma

Regina Sam, Carlos Lopes, Oriana Marques, Claudia Carvalho, Samuel Victor Nuvor

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/JCTI/2017/35955

Aims: To evaluate the expression and the possible prognostic impact of the tissue-based protein ADAM17 in node-negative breast cancer and investigate its association with clinical and pathological features to aid in differentiating indolent node-negative breast cancer from aggressive node-negative breast cancer.

Study Design:  Cross sectional.

Place and Duration of Study: Department of Pathology and Molecular Immunology, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, from December 2012 to June 2013.

Methodology: 50 cases of breast cancer patients (40 node-negative and 10 node-positive) with ages ranging from 24 - 89 and with tumor size ranging from 0.6 cm to 4.7 cm were used. The ADAM17 protein expression was confirmed by immunohistochemistry analysis, which was performed on formalin-fixed, paraffin-embedded, 3 micro meters thick tissue sections using the avidin-biotin-peroxidase complex method. In addition, the presence of HER2, Ki67, Progesterone and Estrogen receptors were also determined.

Results: Both node-negative and node-positive breast cancer showed ADAM17 expression with more expression in node-negative cases. The anti-ADAM17 antibodies showed immunostaining with 19 strong expression (38% - 19/50) and 31 weak expression (62% - 31/50) .In addition to ADAM17, other markers such as ER, PR, HER2 and Ki67 were also expressed. In analyzing the relationship between ADAM17 expression and clinicopathological parameters, the expression level did not present any statistical relationship with all the conventional prognostic factors with P value >0.05 except histological type with P value of .009 and .01.

Conclusion: Our study shows ADAM17 protein expression may be involved in human breast cancer initiation, progression and distant metastasis and its prognostic impact could be independent of conventional prognostic factors. In grouping high expression against low, we had 19 high risks and 31 low risks. Upon further confirmation, ADAM17 could be used to determine individuals who may need adjuvant chemotherapy and those who could be spared from the toxic effect of chemotherapy.


Open Access Original Research Article

No Evidence for Association of -2518 A/G Promoter Polymorphism of MCP-1 with Risk of Esophageal Cancer in Punjab, North-West India

Vasudha Sambyal, Kamlesh Guleria, Mridu Manjari, Meena Sudan, Manjit Singh Uppal, Neeti Rajan Singh

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/JCTI/2017/36431

Aim: To investigate the role of MCP-1 -2518 A/G polymorphism in the susceptibility to esophageal cancer in patients from Punjab, North-West India.

Methods: In this case-control study, 159 sporadic esophageal cancer patients and 159 age and gender matched controls were included. MCP-1 -2518 A/G promoter polymorphism was analyzed using PCR-RFLP method.

Results: The frequencies of GG, GA, and AA genotypes were 43.40%, 47.80% and 8.80% in patients, and 47.17%, 44.65%, 8.18% among the controls respectively. There were no significant differences in genotype and allele frequencies between the patients and controls. 

Conclusion: In this study, we found no association between MCP-1 -2518 A/G polymorphism and the esophageal cancer risk in North-West Indians.


Open Access Original Research Article

Pediatric and Adolescent Malignant Ovarian Tumors: Mansoura 5 - Year Experience

Mohamed Sarhan, Amal Halim, Ibrahim Elzayat, Tamer Saber, Amira El-Hawary, Adel El-Badrawy, Hanan Wahba, Hend El-Hadaad, Omar Farouk, Wagdi El Kashif

Journal of Cancer and Tumor International, Page 1-10
DOI: 10.9734/JCTI/2017/36261

Background: Pediatric ovarian tumors are rare. The aim of this work is to study the epidemiological characteristics and treatment outcome of these tumors in our locality.

Methods: This retrospective study was performed in accordance with the ethical policies. Between January 2011 to December 2015, Thirteen cases of pediatric ovarian cancers were recorded in the Pediatric Oncology Unit of Oncology Center of Mansoura University and the Clinical Oncology & Nuclear Medicine Department of Mansoura University Hospital. The clinico-epidemiologic data and the treatment protocols were analyzed. 

Results: The median age was 10 years (range: 2-17). Presenting symptoms were mainly lower abdominal pain (6; 46.2%) and palpable abdominal mass (4; 30.7). Through laparotomy all patients underwent unilateral salpingo-oophorectomy except one case for whom bilateral salpingio-oophorectomy was done. Six patients were stage I (46.2%), 2 patients were stage II (15.4%) and 5 patients were stage III tumors (38.4%). The majority had germ cell tumors (11; 85%). Adjuvant chemotherapy was given to all cases. Further chemotherapy was needed in 6 cases due to progression or recurrence. The median follow up was 35 months while the median overall survival was 40 months. Mortality rates were 90% in stages II and III together. The advanced stages and yolk sac pathology had the highest mortality. One of the survived cases got married and delivered a baby.

Conclusion: Germ cell tumors are the commonest pediatric malignant ovarian tumors. Multimodality treatment is essential. Fertility preservation should be respected. Our mortality rates are relatively high.


Open Access Original Research Article

Analysis of Orthopedic Surgery for Long Bone Metastases and Pathologic Fractures

A. I. Radchenko, A. G. Zhukovets, Y. M. Bogdayev

Journal of Cancer and Tumor International, Page 1-6
DOI: 10.9734/JCTI/2017/36830

The study made a retrospective analysis of treatment outcomes in 105 patients subjected to 128 surgical interventions for metastatic involvement of long tubular bones. Endoprosthetic replacement of large joints (40.2%) and intramedullary osteosynthesis (29.7%) were the main types of surgical interventions. The postoperative morbidity rate was 24.2%.The treatment administered made it possible to preserve extremity functioning in 85.7% of the patients and to significantly improve their quality of life, with one-year survival rate being 62.0%, 3-year – 28.5%, 5-year – 11.4%. Lung cancer, the presence of visceral metastases and the time of distant metastasis development were proved to be the unfavourable prognostic factors.