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Background and Objectives: Ovarian cancer, including tubal and peritoneal cancer, is the third most common gynecological cancer and the leading cause of death from gynecological malignancies in developed countries. This study explores the prognostic value of the neutrophil-to-lymphocyte ratio (NLR) in determining the optimal duration of neoadjuvant chemotherapy (NACT) for advanced ovarian cancer. It also investigates the correlation between NLR dynamics and the KELIM score, a chemosensitivity marker, to enhance individualized therapeutic strategies. Materials and Methods: A total of 79 patients underwent NACT followed by interval debulking surgery (IDS) or palliative care. The data collected included demographic information, tumor characteristics, treatment modalities, and laboratory parameters. The baseline NLR (NLR-T0) and post-therapeutic NLR (NLR-T1) were calculated, and their variation (NLR∆) was analyzed. The KELIM score was determined using CA-125 values. Results: Patients with a high baseline NLR (≥2.5) had significantly worse progression-free survival (PFS) and overall survival (OS) compared to those with a low NLR (<2.5). A negative NLR∆ was associated with poorer PFS and OS. The KELIM score indicated a more effective treatment response, with higher scores correlating with better outcomes. The majority of patients achieved R0 resection, and those with favorable KELIM scores showed improved survival rates. Conclusions: The NLR is a valuable prognostic marker for assessing treatment response and guiding NACT duration in advanced ovarian cancer. [ABSTRACT FROM AUTHOR]

Introduction. The latest histological classification of lung adenocarcinoma includes lepidic, acinar, papillary, micropapillary, and solid as subtypes. Testing these subtypes for their prognostic and predictive value is an ongoing scientific challenge. The present research article aims to describe the influence this classification has on patient survival. Materials and Methods. Thirty-three patients were included in the trial. The most important enrollment criterion was the clear specification of the adenocarcinoma subtype in the pathology report. Patients were stratified into three groups which included the adenocarcinoma pathological subtypes as follows: lepidic (LEP), acinar and papillary (ACN/PAP), and micropapillary/solid (MIP/SOL). The primary endpoint was progression-free survival. Other endpoints included overall survival. Results. The lepidic subtype of ADC had superior PFS and OS, regardless of stage. Papillary and acinar subtype showed an intermediate prognosis, whereas micropapillary and solid subtypes were the most aggressive. Conclusions. The experience of this single center confirmed data in the literature. Further studies are needed to demonstrate all the possible implications of this pathology classification.

Copyright of Paliatia: Journal of Palliative Care is the property of HOSPICE Casa Sperantei Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Paliatia: Journal of Palliative Care is the property of HOSPICE Casa Sperantei Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The treatment in locally advanced rectal cancers continues to evolve. Therefore, in the past years, patients have benefited from either neoadjuvant radiochemotherapy or total neoadjuvant therapy (TNT), the latter demonstrating improved control of systemic disease and becoming, according to guidelines, the standard treatment in carefully selected cases. Studies have shown a higher therapeutic response rate in patients receiving TNT; however, the overall surviving rate is contradictory. The choice of treatment is made on the basis of these results, but the toxicities that may occur with each therapeutic strategy are weighed against each other, and the possibility of overtreatment of certain patients is also discussed. We performed a retrospective study in which there were included patients with rectal cancer, eligible for neoadjuvant treatment, in the last three years, in the Oncology Clinic of the “Elias” University Emergency Hospital, Bucharest. The aim was to compare the therapeutic outcomes between the two treatment strategies, the overall survival, the progression-free survival and the time until progression. We also monitored the tolerance of patients in terms of toxicities for the two therapeutic approaches. We conclude that there is better therapeutic response in terms of total neoadjuvant therapy, but without large differences regarding the global survival and with variable toxicities. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common malignancy in women, whereas metastases to the breast from extra mammary malignancies are very rare, accounting for only 0.43% of all malignant breast tumors, with an often poor prognosis: about 80% of patients dying within 1 year of diagnosis. Case report: We present two cases of female patients treated for extra mammary malignancies which developed breast metastases. The first patient, 59 years old, was diagnosed in April 2014 with small cell lung carcinoma, sub diaphragmatic lymph nodes and bone metastases, developed under chemotherapy breast metastasis. This was revealed on a clinical examination in December 2014 and certified in March 2015 by immunohistochemistry as a mammary metastasis of small cell lung carcinoma. The second patient, 45 years old, was diagnosed in February 2012 with sigmoid adenocarcinoma and bilateral ovarian metastases. In January 2015 she performed a digital mammography and a breast tumour was discovered. This was certified in March 2015 by immunohistochemistry as a mammary adenocarcinoma metastasis, intestinal type (colonic). Conclusions: The breast is an uncommon site for metastatic disease. The most frequent source of the metastatic breast lesions are the contralateral breast, lymphomas, melanomas, prostate cancers, lung carcinomas, ovarian carcinomas, renal cell carcinomas, and intestinal tumours. It is important to be acutely aware of both common and uncommon metastases to the breast and to include these appropriately in the differential diagnosis for the optimal patient management. [ABSTRACT FROM AUTHOR]

Background Breast cancer is the most common female cancer worldwide with an incidence increasing by 1% yearly. About 20% of breast cancer patients present metastases and around 50% of those with an operable breast cancer experience relapse. Despite the new era of cancer treatment, the average survival for patients with metastatic breast cancer is still between 2 and 4 years. The quality of life of these patients should be one of the primary end points of the treatment. Case series We present an analysis of a 5 cases of patients with metastatic breast cancer showing that chemotherapy, immunotherapy and osteoclast inhibitors modified the levels of quality of life by significantly improving it. The patients filled in a questionnaire (Edmonton Symptom Assessment System) to assess their quality of life before treatment initiation in our clinic, after the first 3 cycles of chemotherapy, and after the last cycle. We found that quality of life was improved especially in terms of pain control, relief of tiredness, appetite and well-being. Despite disease progression and development of new metastasis, the patients did not experience important changes in their clinical status. They maintained a good performance status that allowed us to alternate multiple lines of therapy and to control the disease with minimal toxicity. Conclusion Metastatic breast cancer is a disease with a long natural evolution, but a well conducted treatment with a multidisciplinary approach may achieve a quality of life comparable with that of women of a similar age with no personal history of breast carcinoma. [ABSTRACT FROM AUTHOR]

Background. The Spitz nevus and the spitzoid malignant melanoma represent the two ends of the spitzoid lesion spectrum. The atypical spitzoid neoplasias represent an ambiguous clinical category which includes lesions presenting both benign and malignant histologic characteristics. Therefore, these tumors remain a challenge for the pathologists, given the fact that a clear prediction of the future behavior of the tumor is difficult, if not impossible. Some tumors will metastasize and will have a poor prognosis, some will present no metastatic behavior and will have an indolent evolution, and some will metastasize modestly and exclusively to the locoregional lymph nodes. Case description. This paper presents a case of an atypical spitzoid tumor in a 21­year­old patient with no significant personal or familial family history which expressed borderline characteristics between benign and malignant lesions. The patient underwent SLNB, with a positive result for an isolated micrometastasis and the biopsy material was further tested for molecular and genetic abnormalities. Complete lymph node dissec tion was performed and consequent adjuvant treatment with immune checkpoint inhibitors was initiated. The case aims at emphasizing the challenges that these tumors imply in terms of diagnosis and further treatment. Conclusions. Borderline melanocytic tumors represent a challenge for the oncological field, due to their unpredictive behavior. Between the two concepts of primum non nocere and precaution is better than curing, it is important to take a collective decision, including patients, their families and the specialists with a high expertise level in this field. How far should reach the treatment choice is yet unknown and should be carefully decided upon. Seeking a second opinion is therefore indicated in these difficult to define cases. Further research is needed to better define predictive factors and to separate between histologic categories. [ABSTRACT FROM AUTHOR]

Copyright of ORL.ro is the property of MEDICHUB MEDIA, S.R.L. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Paraneoplastic syndromes of the nervous system are rare disorders, strongly linked with lung cancer. This report aims to explore the challenges in the diagnosis and treatment of a patient with early-stage small cell lung cancer and neurological manifestations as initial clinical symptoms. [ABSTRACT FROM AUTHOR]

Multigene assays were developed to guide treatment in early-stage breast cancer and to evaluate the benefit of adjuvant chemotherapy. Patients with invasive breast carcinoma, either T1 or T2, N0 or N1 (one to three positive lymph nodes), with no invaded surgical margins (R0), positive for hormone receptors and negative for Her2 receptor derive benefit from these tests. The Food and Drug Administration (FDA) validated the use of the following tests: OncotypeDX (a 21 gene test), Mammaprint (70 ARN messenger genes), Predictor Analysis of Microarray 50- PAM50 (50 genes) also known as Prosigna and Endopredict (12 genes). These gene expression signatures have been increasingly used to evaluate the prognosis (such as Endopredict- that can predict outcomes more accurately than ki67 values in early-stage breast cancer) or the benefit of adjuvant chemotherapy (such as Oncotype DX). For the moment only two assays, the 70-gene signature (MammaPrint) and the 21-gene Recurrence Score (RS) assay (Oncotype DX), are supported by prospective randomized phase 3 trials. However, all multigene assays are important tools in the identification of low-risk, breast cancer patients, for whom chemotherapy could be avoided. [ABSTRACT FROM AUTHOR]

Introduction: When discussing cytotoxic chemotherapy, the way the drugs are administered is as important as choosing the regimen. Several aspects like hyperhydration, emesis, the period of administration, diet and allergic reactions have to be taken into consideration. Method: Recent literature on these five main topics was revised. Most relevant data was collected and summarized in an attempt to familiarize any reader with this matter. Conclusion:These aspects are of utmost importance in reducing toxicity, thus enabling more extended treatment compliance, administration of effective doses and better oncological outcomes. [ABSTRACT FROM AUTHOR]

Introduction: When discussing cytotoxic chemotherapy, the way the drugs are administered is as important as choosing the regimen. Several aspects like hyperhydration, emesis, the period of administration, diet and allergic reactions have to be taken into consideration. Method: Recent literature on these fi ve main topics was revised. Most relevant data was collected and summarized in an attempt to familiarize any reader with this matter. Conclusion:These aspects are of utmost importance in reducing toxicity, thus enabling more extended treatment compliance, administration of effective doses and better oncological outcomes. [ABSTRACT FROM AUTHOR]

Background This study aims to evaluate the prognostic significance of the modified Glasgow Prognostic Score (mGPS) in patients with metastatic colorectal cancer (mCRC). Methodology A retrospective analysis was conducted among 65 patients diagnosed with stage IV colorectal cancer who received treatment and follow-up at the Oncology Department of Elias Emergency University Hospital in Bucharest, Romania, from January 2016 to January 2024. Patient data were collected, including demographic information, tumor characteristics, and laboratory parameters. The mGPS was calculated based on serum albumin and C-reactive protein (CRP) levels. Patients were stratified into the following three mGPS categories: 0 (normal CRP and albumin), 1 (elevated CRP or hypoalbuminemia), and 2 (elevated CRP and hypoalbuminemia). Results Of the 65 patients included, 33 (50.8%) were male and 32 (49.2%) were female, with a mean age of 63.7 years. According to mGPS, 25 (38.5%) patients scored 0, 30 (46.2%) scored 1, and 10 (15.4%) scored 2. The median overall survival (OS) was 53 months (95% confidence interval (CI) = 23.512-82.488), and the median progression-free survival (PFS) was 23 months (95% CI = 19.244-26.756). Although numerical differences in the median PFS and OS were observed between treatment groups, these differences were not statistically significant (PFS: p = 0.292; OS: p = 0.5). Conclusions The mGPS is a useful prognostic tool in mCRC, providing insights into patient survival outcomes. However, further studies with larger sample sizes are needed to validate these findings and clarify the role of mGPS in guiding clinical decision-making for mCRC patients., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institutional Review Board (Ethics Committee) of Elias Emergency University Hospital, Bucharest, Romania issued approval 750/May 2024. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Cotan et al.)

Background In the field of precision oncology, comprehensive genomic profiling tests play a very important role by providing a complex understanding of the molecular characteristics of malignant tumors. Therefore, next-generation sequencing (NGS) has become a valuable tool in various aspects of cancer care from diagnosis and monitoring to treatment selection and personalized cancer treatment. Our aim was to evaluate the role of tumor molecular profiling in tailored treatment selection. Methods In our study, we conducted a retrospective analysis to assess the practicality of utilizing NGS testing in patients with metastatic solid tumors. The genomic testing was performed on blood or tissue samples from a fresh biopsy, less than six months old, and the expression of programmed death-ligand 1 was evaluated by immunohistochemistry. Results A total of 75 tests were performed on 66 patients between 2019 and 2022, with a success rate of 80%. The most common pathologies were gastro-intestinal tract cancer (26%), breast cancer (14%), non-small cell lung cancer (11%), and pancreatic cancer (11%). There were 9% liquid biopsies and 91% tissue biopsies. From all 66 patients tested, 55 had at least one genetic alteration. The most frequent genetic alteration found was TP53 (n=32) followed by KRAS (n=15) and BRCA1/2 (n=12) mutations. There were nine patients tested (14%) that presented a high tumor mutational burden, and only one patient presented high microsatellite instability. There were 37 patients (56%) with actionable alterations found from which 14 received matched therapy and four patients were enrolled in clinical trials. The NGS testing played a significant role in determining the next therapeutic strategy in 20 out of 66 patients (30.3%). Conclusion From all the patients included in our analysis, 83% had at least one mutation that is known to be of pathogenic significance but only 23% received treatment selected by the analysis of the tumor's genome, and only 6% were included in a clinical trial. This moderate success of personalized medicine using NGS testing highlights the importance of evaluating the factors that could lead to further improvement., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Popa et al.)

Background and Aim: Prior research linked a high preoperative neutrophil-to-lymphocyte ratio (NLR) to a worse prognosis in individuals with a variety of malignancies. This study aimed to establish the prognostic and predictive usefulness of preoperative NLR in colorectal cancer (CRC) patients and to identify an appropriate cut-off value for the NLR. We enrolled a total of 195 patients that underwent surgery for stage II and III colorectal cancer that required adjuvant chemotherapy as well as stage IV colorectal cancer patients treated with palliative intent. The mean NLR value was 3.42 +- 2.27. We used a receiver operating characteristic curve to estimate the optimum NLR cut-off value at 3. Patients with a NLR value above 3 were classified as high-NLR, while patients with a NLR below 3 were classified as low-NLR; Results Overall survival (OS) and progression-free survival (PFS) were significantly reduced in high-NLR patients. The overall response rate (ORR) was also lower in high-NLR patients. Conclusions Preoperative NLR is an accessible measurement that seems to have prognostic and predictive value in patients with colorectal cancer., (Celsius.)