Journal of Oncology Translational Research

Importance: It is well established that adjuvant chemotherapy yielded better prognosis in breast cancer. Yet, there is a wide discrepancy in the allowed time frame between surgery and chemotherapy.

Purpose: To identify the optimal initiation time to chemotherapy (TTC) after definitive surgery for breast cancer patients in terms of overall survival (OS) and disease-free survival (DFS), also to identify the main causes of chemotherapy delay at department of Clinical Oncology and Nuclear Medicine at Ain Shams University Hospitals.

Patients and methods: A retrospective study including a population of 300 patients with non-metastatic breast cancer received adjuvant chemotherapy at time interval Between January 2007 till December 2011 using database from the department of Clinical Oncology and Nuclear Medicine, Ain Shams University Hospital. Chi-Square test and Kaplan-Meier method were used.

Results: Among the studied population, the mean age at diagnosis was 50 years and the median TTC was 5 weeks. Compared with patients receiving chemotherapy earlier than 4 weeks from definitive surgery, there was no adverse outcome as regards the OS and DFS among those with TTC of 4 to 8 weeks, 8 to 12 weeks or more than 12 weeks with non-significant P values (0.67 and 0.9, respectively). Factors associated with chemotherapy delay included sociodemographic problems among rural patients, long residential distance to institution, system related causes as late referral, governmental insurance support and long waiting lists for diagnostic imaging.

Conclusion: Adjuvant chemotherapy is equally effective up to 12 weeks after definitive surgery with similar survival benefit among breast cancer patients even those with high risk factors.

Mini Abstract

Adjuvant chemotherapy is equally effective up to 12 weeks with similar survival benefit in breast cancer patients in a retrospective study included 300 patients.

Significant advances have been made to understand the association between ALK genetic aberrations and disease prognosis in neuroblastoma. ALK targeted therapies are evolving quickly and several randomized controlled trials of ALK inhibitors are underway or nearing completion in adult cancers. Ongoing research will bring new challenges and newer technologies to fully define the pathogenic and prognostic alterations, to stratify the risk of recurrence or progression, and to develop optimal monitoring and treatment strategies in this malignancy.

Background: Breast cancer remains a leading cause of cancer-related death in women. Numerous studies have demonstrated that mammaglobin is one of the most promising markers for diagnosis of breast cancer. However, little is known about the relationship between mammaglobin and overall survival. The small number of published studies has yielded controversial results.

Objective: This study was performed to clarify the association between expression of mammaglobin in peripheral blood and prognosis in breast cancer patients.

Methods: We systematically reviewed and meta-analyzed the data showing the association between expression of mammaglobin in peripheral blood and prognosis in breast cancer patients. The data were obtained from analysis of disease free survival (DFS)/event free survival (EFS) and overall survival (OS).

Results: Our analysis showed that patients expressing mammaglobin in peripheral blood before the removal of the primary tumors or chemotherapy showed shorter DFS/EFS, but no change in OS. The detection of mammaglobin mRNA in peripheral blood was not associated with worse outcome for OS, but the effect size was not small.

Conclusion: These data indicate that a meaningful association of mammaglobin might be found if large scale studies are performed. Large prospective studies are necessary to determine the prognostic value of the detection of mammaglobin mRNA in peripheral blood of breast cancer patients.

Purpose: The surgical treatment of most vulvar cancers includes a lymph node evaluation. Historically, inguinofemoral lymphadenectomy was performed with significant associated morbidity. Sentinel lymph node biopsy has been studied as an alternative in order to decrease postoperative morbidity. This review summarizes the evidence supporting the use of sentinel lymph node biopsy as standard of care in vulvar cancer.

Findings: Sentinel lymph node biopsy has a sensitivity of 92% with a negative predictive value of 97-98%. Combining both radiotracer and dye methods improves the sentinel lymph node detection rate and sensitivity. The rate of groin recurrence and 5-year overall survival are comparable to inguinofemoral lymphadenectomy. Postoperative complications including lymphedema, wound infection and wound separation are significantly lower after sentinel lymph node biopsy.

Summary: Sentinel lymph node biopsy for the surgical evaluation of vulvar cancer is feasible, cost-effective, associated with less short- and long-term morbidity when compared to inguinofemoral lymphadenectomy and has comparable rates of survival and groin recurrence. Sentinel lymph node biopsy should be performed as the standard of care for appropriate patients in high-volume centers.