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Objective To summarize the clinicopathological characteristics and prognostic factors of salivary duct carcinoma (SDC) patients. Methods This study was reviewed and approved by the Ethics Committee, and informed consent was obtained from the patients. The clinical data of 30 SDC patients who were admitted to the Fourth Hospital of Hebei Medical University from 2014 to 2022, including case records, pathological diagnoses, immunohistochemical indicators, treatment methods, follow-up data, and other data, were retrospectively analyzed. SPSS 26.0 software was used to process the data and construct relevant curves. The chi-square test was used to analyze the correlation between different immunohistochemical indices and the recurrence and metastasis of SDC, and a single factor was used to analyze clinical prognostic factors. Results Among the 30 SDC patients, the male-to-female ratio was 5∶1, with a median age of 61.5 years. Approximately 60% of cases occurred in the parotid gland, whereas the remainder occurred in the submaxillary gland, sublingual gland, or minor salivary gland. Among them, 19 patients were androgen receptor-positive, 23 patients were human epidermal growth factor receptor-2 positive, and 26 patients were Ki-67 positive. Postoperative follow-up was 18-94 months, with a median follow-up of 37 months. There were 13 cases of recurrence and 14 cases of distant metastasis. The 5-year overall survival rate was only 31.2%. The long-term survival of patients who underwent postoperative radiotherapy and chemoradiotherapy was better than that of patients who underwent surgery alone (P= 0.027). T stage and lymph node invasion were associated with prognosis and survival (PP = 0.025). Conclusion Radical surgery combined with postoperative radiotherapy and chemoradiotherapy is helpful for improving long-term overall survival, and tumor T stage and lymph node metastasis may be the main factors affecting the prognosis of patients with SDC. Patients with Ki-67-positive cell counts ≥ 40% are prone to postoperative recurrence or metastasis.

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Background: The eighth edition of the American Joint Committee on Cancer tumour, node, and metastasis staging system did not take T stage into consideration when evaluating Stage IV C medullary thyroid carcinoma (MTC) patients. The aim of this study is to investigate the clinical outcomes and implications of T stage in this population. Methods: Eligible patients from the Surveillance, Epidemiology, and End Results database and the Department of Thyroid Surgery in West China Hospital of Sichuan University and who were diagnosed with Stage IV C MTC were included in this study. The overall survival (OS), the cancer‐specific survival (CSS), and the precise cause of MTC‐induced death were analysed. The potential risk factors, including the T stage, in the OS and CSS were evaluated by univariate and multivariate Cox regression models. Results: This retrospective study enroled 204 Stage IV C MTC patients. The 5‐ and 10‐year OS rates were 31.8% and 17.1%, respectively, and the 5‐ and 10‐year CSS rates were 40.4% and 22.5%, respectively. More importantly, the rates of MTC‐induced death between primary or distant metastatic lesions in Stage IV C MTC patients were comparable in our institution. Additionally, the univariate and multivariate analyses demonstrated that the presence of an advanced T stage was an independent prognostic factor for both the OS (T4 vs. T1–T3, hazard ratio [HR]: 1.714, 95% confidence interval [CI]: 1.175–2.500, p =.005) and the CSS (T4 vs. T1–T3, HR: 1.848, 95% CI: 1.229–2.780, p =.003). Conclusion: To achieve a better risk stratification, further classification of Stage IV C MTC patients by the T stage may be preferable. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to explore the prognostic value of thyroid invasion of parathyroid carcinoma without lymph node or distant metastasis. Methods: Two hundred and nine cases of parathyroid carcinoma from the SEER (1989–2014) were eligible for this study. A Chi-squared test, t test, X-tile, Kaplan–Meier curves, and multivariate Cox proportional hazard regression were used for analysis. Results: Thyroid invasion, sex, race, age, radiation, and surgery were not significantly associated with cancer-specific survival by multivariate analysis. However, tumor size ≥ 4 cm was significantly associated with worse cancer-specific survival (P < 0.001). Conclusion: Thyroid invasion, which was the criterion for T1 and T2 staging criteria of parathyroid carcinoma according to the AJCC, did not affect the prognosis of patients with parathyroid carcinoma without local lymph node or distant metastasis. Our study indicates that a tumor size ≥ 4 cm may be an appropriate indicator of T1 and T2 cancer staging. [ABSTRACT FROM AUTHOR]

Objective: Stage I and II cervical cancer with pelvic and/or para-aortic lymph node (LN) metastases are upstaged to stage IIIC under the new FIGO 2018 staging system, and radical chemoradiotherapy was recommended. But heterogeneity in outcome existed in this group of patients. We conducted this retrospective analysis to evaluate the heterogeneity of these patients and tried to provide a more detailed classification to reflect the prognosis and guide the treatment. We also evaluated the efficacy and toxicity of surgery followed by sequential chemoradiotherapy in this cohort. Methods: Early-stage cervical cancer with LN involvement that had radical hysterectomy followed by sequential chemoradiotherapy were retrospectively analyzed. Survival analyses were conducted to identify the prognostic factors. Results: A total of 242 patients were included in the study; 64 (26.4%) patients had treatment failure, and 51 (21.1%) died. Pathology, T stage, the number of pathologic LN (pLN), and neoadjuvant chemotherapy or not were independent prognostic factors for disease-free survival and overall survival (OS). Patients with T1N < 3 pLN had significantly better survival than T2N < 3 pLN/T1-2 N≥ 3 pLN, with failure rates of 11.6% and 35.8% in each group; and 5 year OS was 92% and 62%, respectively (P = 0.000). About 1.5% of the patients discontinued radiotherapy, and 14.1% had G3-4 hematological toxic effects during radiotherapy; 1.7% developed G2-3 lower limb edema, and 2.9% developed severe urinary toxicity. Conclusion: Nodal involvement alone is inadequate as the sole pathologic factor to predict survival in early-stage cervical cancer. The combination of tumor and node subcategory provides better prognostic discrimination. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to identify the cutoff value for depth of infiltration that predicts the risk of lymph node metastasis in the neck in surgically treated patients affected by pT1/pT2 cN0 oral squamous cell carcinoma (OSCC). Materials and Methods: Meta-analysis of six articles, including 938 patients, was performed from a PubMed search of the last 15 years. Results: The mean depth of infiltration in N0 neck was 4.42 mm, standard deviation (SD) 0.66 (95% confidence interval [CI], 3.89–4.95), while the mean depth of infiltration in N+ neck was 6.95 mm, SD 1.36 (95% CI, 5.86–8.04). One sample t-test done to analyze the level of significance between the cutoff depth of infiltration for N0 and N+ was found to be significant,P= 0.002. Receiver operating characteristic analysis was done to find the cutoff depth of infiltration in all N0 necks which was 4.5 mm with odds ratio 9.32, sensitivity of 84.7% in N+ necks which makes elective neck dissection an important surgical option for good prognosis of OSCC. Conclusion: Tumor infiltration depth is an important prognosticator in pT1/pT2 cN0 necks. Tumors with depth of infiltration >4.5 mm radiologically or clinically should undergo an elective neck dissection to improve the prognosis of OSCC.

Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Out of 14,391 patients,8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%,p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most. [ABSTRACT FROM AUTHOR]

Background: Differences in relative survival (RS) of melanoma between histologic subtypes were discussed to be mainly caused by tumor thickness.Objective: To investigate RS of melanoma, stratified by tumor thickness for each histologic subtype, and identify survival trends.Methods: With use of cancer registry data on melanoma cases (International Classification of Diseases, 10th Revision, codes C43.0-C43.9) diagnosed in Germany in 1997-2013, 5- and 10-year age-standardized RS stratified by histologic subtype and stratified or standardized by T stage was estimated by standard and modeled period analyses. We restricted 10-year RS analyses to patients younger than 75 years.Results: We analyzed 82,901 cases. Overall, the 5- and 10-year RS rates were 91.7% and 90.8%, respectively. Prognosis worsened with increasing T stage for all histologic subtypes, but T-stage distribution varied substantially. Survival differences by histologic subtype were strongly alleviated after adjustment for T stage but remained significant. Overall, 5-year RS increased significantly (by 3.8 percentage points) between the periods 2002-2005 and 2010-2013. This increase was no longer seen after adjustment for T stage.Limitations: Exclusion of cases on account of missing information on T stages, changes in the definition of T stages, and lack of information on screening and treatment limit our analyses.Conclusion: Differences in RS between histologic subtypes were strongly mediated by tumor thickness. Over time, RS of melanoma increased as a result of changes in T-stage distribution. [ABSTRACT FROM AUTHOR]

Background: Head and neck cancer (HNC) represents more than 550,000 cases annually. It accounts for 380,000 deaths every year. Despite aggressive treatment, only 35% to 55% of patients who present with locally advanced HNC remain alive and free of disease 3 years after standard curative treatment. Thirty percent to 40% of patients develop locoregional recurrences, and distant metastases occur in 20% to 30%. Most recurrences appear quickly within 2 years of initial treatment and an additional 10% of patients will have evidence of distant metastases at the time of first presentation. Purpose: To retrospectively determine the prognostic effect of T stage in locally advanced head and neck cancer. Patients and Methods: This study retrospectively analyzed 40 patients diagnosed with locally advanced head and neck cancer. Patients were diagnosed by a tissue biopsy and they were staged by endoscope and CT neck or MRI neck with contrast. They received their treatment and were followed up every 3 months by CTs. Results: We found a statistically significant correlation between T stage and both PFS and OS in HNC (95%, CI 1.00 - 3.10, p=0.04 and 95% CI 1.01 - 2.65, p=0.05 respectively). We did not find any other statistically significant correlation between other patients' sub-groups such as age, gender, smoking, affected site, stage, lymph node infiltration, receiving induction chemotherapy, receiving radiotherapy with or without chemotherapy, and response to treatment and between PFS and OS. Conclusion: This study confirmed that the T stage of the tumor is an important prognostic factor in locally advanced head and neck cancer. [ABSTRACT FROM AUTHOR]

Purpose: The prognostic value of primary tumor surgery (PTS) in minor salivary-gland carcinoma (MiSGC) with distant metastasis (DM) at diagnosis has never been investigated. In this study, we aimed to provide the first evidence.Patients and methods: The Surveillance, Epidemiology, and End Results (SEER) database was employed to identify MiSGC patients with DM at diagnosis. The prognostic value of PTS was evaluated by Kaplan–Meier methods, log-rank analyses, and multivariate Cox proportional-hazard regression models.Results: Of the 152 eligible patients included in our study, 50 (32.9%) had undergone PTS. Kaplan–Meier analyses showed that the PTS group had >20% increase in 1- and 2-year overall survival (OS) and cancer-specific survival (CSS) compared with their counterparts without PTS (PTS group vs no-PTS group, 1-year OS 66.1% vs 43.9%, 1-year CSS 69.9% vs 44.9%, 2-year OS 56.6% vs 24.2%, 2-year CSS 59.9% vs 25.7%). Compared with the no-PTS group, multivariate analyses also demonstrated a significantly decreased risk of overall mortality (HR 0.601, 95% CI 0.379–0.952; P=0.031) and cancer-specific mortality (HR 0.547, 95% CI 0.336–0.891; P=0.015) in the PTS group. Subgroup multivariate analyses revealed patients with T1–T3 oropharynx, nasal cavity, or paranasal sinus primary MiSGC, especially adenoid cystic carcinoma, might benefit from PTS (all P<0.05).Conclusion: PTS is associated with improved survival in highly selected MiSGC patients and may be considered in future clinical practice. However, prospective studies with larger sample size are still necessary to validate our findings. [ABSTRACT FROM AUTHOR]

Purpose To assess the ability of diffusion-weighted imaging (DWI) for evaluating T stage and correlation with histological T stage of rectal cancer. Method The diagnostic accuracy, sensitivity, and specificity of T 2 WI and DWI combined with T 2 WI for T stage were evaluated. Mean tumor apparent diffusion coefficient (ADC) was compared with histological T stage. Result There were no significant differences in the diagnostic accuracy, sensitivity, and specificity no matter what kind of T stage was concerned. The difference between ADC values and histological T stage were significantly different. Conclusion DWI was useful for evaluating T stage of rectal cancer. The ADC may predict the histological grade. [ABSTRACT FROM AUTHOR]

Background: Invasive lobular cancer (L) differs clinically and morphologically from invasive ductal cancer (D); differences notwithstanding, Nottingham grades are provided in both. This study compared 22,719 lobular carcinomas with 201,517 ductal carcinomas, dividing them into the grades: well differentiated (W), moderately differentiated (M), poorly differentiated (P), and ungraded to see if differences between comparable grades of lobular and ductal cancer were uniform, consistent with the notion the grading system provides similar information for both cancer subtypes. Methods: The Surveillance, Epidemiology and End Results (SEER) database was used to limn relationships among grades, as respects proportions of patients with T3 tumors and nodal metastases, as well as cancer-specific survival. Taken into account were age, estrogen and progesterone receptor status, and the administration of radiotherapy. Results: More lobular than ductal carcinomas were T3; grades were not homogenous, with the incidence rate ratio (IRR) comparing lobular and ductal carcinomas being 8.2 for well differentiated, 4.1 for moderately differentiated, and 2.48 for poorly differentiated. With respect to nodal metastases, the 1.16 W L:W D IRR (P < 0.05) was not explicable by chance, but both the 0.97 M L:M D IRR (P > 0.05) and the 0.96 P L:P D IRR (P > 0.05) could have been due to chance. As respects survival, neither the 1.4 P L:P D time ratio (TR) (P < 0.05) nor the 1.23 M L:M D TR (P < 0.05) could have been explained by chance; the 1.05 W L: W D (P > 0.05) might have been due to chance. Conclusion: Grades of lobular carcinoma imply different meanings than do grades of ductal carcinoma. Studies of breast cancer should not assume commonality with respect to grade. [ABSTRACT FROM AUTHOR]