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Clinicopathologic features and outcomes following surgery for pancreatic adenosquamous carcinoma
Jun-Te Hsu, Han-Ming Chen, Ren-Chin Wu, Chun-Nan Yeh, Ta-Sen Yeh, Tsann-Long Hwang, Yi-Yin Jan, Miin-Fu Chen
World Journal of Surgical Oncology , 2008, DOI: 10.1186/1477-7819-6-95
Abstract: The medical records of 12 patients with pancreatic ASC undergoing surgical treatment (1993 to 2006) were retrospectively reviewed. Survival data of patients with stage IIB pancreatic adenocarcinoma and ASC undergoing surgical resection were compared.Symptoms included abdominal pain (91.7%), body weight loss (83.3%), anorexia (41.7%) and jaundice (25.0%). Tumors were located at pancreatic head in 5 (41.7%) patients, tail in 5 (41.7%), and body in 4 (33.3%). Median tumor size was 6.3 cm. Surgical resection was performed on 7 patients, bypass surgery on 3, and exploratory laparotomy with biopsy on 2. No surgical mortality was identified. Seven (58.3%) and 11 (91.7%) patients died within 6 and 12 months of operation, respectively. Median survival of 12 patients was 4.41 months. Seven patients receiving surgical resection had median survival of 6.51 months. Patients with stage IIB pancreatic ASC had shorter median survival compared to those with adenocarcinoma.Aggressive surgical management does not appear effective in treating pancreatic ASC patients. Strategies involving non-surgical treatment such as chemotherapy, radiotherapy or target agents should be tested.Adenocarcinoma accounts for the majority of pancreatic malignancies. Adenosquamous carcinoma (ASC) of the pancreas is an unusual variant of pancreatic neoplasm [1-4], and is characteristic by histological patterns of both ductal adenocarcinoma and squamous carcinoma within the same tumor. The prognosis of this rare tumor appears to be even less favorable than the common invasive ductal tumor with few patients surviving more than 1 year after surgical resection [4]. Most of studies on this disease have been small series or single case reports, and few studies have investigated the clinicopathologic features and outcome of patients with pancreatic ASC following surgical treatment [1,2,5,6]. Therefore, medical records of 12 patients with pancreatic ASC treated surgically at Chang Gung Memorial Hospital (CGMH), Taoy
Surgical outcome of adenosquamous carcinoma of the pancreas  [cached]
Takehiro Okabayashi, Kazuhiro Hanazaki
World Journal of Gastroenterology , 2008,
Abstract: Adenosquamous carcinoma is rare, accounting for 3%-4% of all pancreatic carcinoma cases. These tumors are characterized by the presence of variable proportions of mucin-producing glandular elements and squamous components, the latter of which should account for at least 30% of the tumor tissue. Recently, several reports have described cases of adenosquamous carcinoma of the pancreas. However, as the number of patients who undergo resection at a single institute is limited, large studies describing the clinicopathological features, therapeutic management, and surgical outcome for adenosquamous carcinoma of the pancreas are lacking. We performed a literature review of English articles retrieved from Medline using the keywords ‘pancreas’ and ‘adenosquamous carcinoma’. Additional articles were obtained from references within the papers identified by the Medline search. Our subsequent review of the literature revealed that optimal adjuvant chemotherapy and/or radiotherapy regimens for adenosquamous carcinoma of the pancreas have not been established, and that curative surgical resection offers the only chance for long-term survival. Unfortunately, the prognosis of the 39 patients who underwent pancreatic resection for adenosquamous carcinoma was very poor, with a 3-year overall survival rate of 14.0% and a median survival time of 6.8 mo. Since the postoperative prognosis of adenosquamous carcinoma of the pancreas is currently worse than that of pancreatic adenocarcinoma, new adjuvant chemotherapies and/or radiation techniques should be investigated as they may prove indispensible to the improvement of surgical outcomes.
Clinical Characteristics and Prognostic Factors of Lung Adenosquamous Carcinoma ?in SEER Database between 2010 and 2015  [PDF]
Cheng ZHAN, Tian JIANG, Xiaodong YANG, Weigang GUO, Lijie TAN
- , 2018, DOI: : 10.3779/j.issn.1009-3419.2018.08.14
Abstract: Background and objective The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients’ prognosis. Methods We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma. Results 1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively. Conclusion Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.?
Identification of Prognostic Molecular Features in the Reactive Stroma of Human Breast and Prostate Cancer  [PDF]
Anne Planche,Marina Bacac,Paolo Provero,Carlo Fusco,Mauro Delorenzi,Jean-Christophe Stehle,Ivan Stamenkovic
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0018640
Abstract: Primary tumor growth induces host tissue responses that are believed to support and promote tumor progression. Identification of the molecular characteristics of the tumor microenvironment and elucidation of its crosstalk with tumor cells may therefore be crucial for improving our understanding of the processes implicated in cancer progression, identifying potential therapeutic targets, and uncovering stromal gene expression signatures that may predict clinical outcome. A key issue to resolve, therefore, is whether the stromal response to tumor growth is largely a generic phenomenon, irrespective of the tumor type or whether the response reflects tumor-specific properties. To address similarity or distinction of stromal gene expression changes during cancer progression, oligonucleotide-based Affymetrix microarray technology was used to compare the transcriptomes of laser-microdissected stromal cells derived from invasive human breast and prostate carcinoma. Invasive breast and prostate cancer-associated stroma was observed to display distinct transcriptomes, with a limited number of shared genes. Interestingly, both breast and prostate tumor-specific dysregulated stromal genes were observed to cluster breast and prostate cancer patients, respectively, into two distinct groups with statistically different clinical outcomes. By contrast, a gene signature that was common to the reactive stroma of both tumor types did not have survival predictive value. Univariate Cox analysis identified genes whose expression level was most strongly associated with patient survival. Taken together, these observations suggest that the tumor microenvironment displays distinct features according to the tumor type that provides survival-predictive value.
Clinicopathologic Features and Prognostic Implications in 72 Cases ?with Lung Adenosquamous Carcinoma  [PDF]
Xi WU, Junling LI, Shulan CHEN, Lei YU, Boyan YANG
- , 2016, DOI: : 10.3779/j.issn.1009-3419.2016.10.03
Abstract: Background and objective Adenosquamous carcinoma (ASC) is a rare subtype of lung cancer, it is mixed glandular and squamous cell carcinoma with a more aggressive behavior and poor prognosis than the other histologic subtypes. The aim of the study was to explore the clinicopathological characteristics and prognostic factors of ASC. Methods A total of 72 patients were enrolled. We investigated clinicalpathological features and prognostic factors retrospectively. Results The overall 72 ASC patients’ median age was 34.7 months, 5-year survival rate was 14.9%. The influence of tumor size, M stage, and N stage, gene mutation and surgery on the prognosis of patients show statistical significance. Conclusion ASC is characterized by both histologic aggressiveness and adverse prognosis. We suggest the comprehensive therapy based on surgery, and given small molecule tyrosine kinase inhibitors (TKIs) treatment may prolong patients’ overall survival.
Primary gastric adenosquamous carcinoma in a Caucasian woman: a case report
Gil R Faria, Catarina Eloy, John R Preto, Eduardo L Costa, Teresa Almeida, José Barbosa, Maria Paiva, Joaquim Sousa-Rodrigues, Amadeu Pimenta
Journal of Medical Case Reports , 2010, DOI: 10.1186/1752-1947-4-351
Abstract: We report the case of an 84-year-old Caucasian woman with an adenosquamous carcinoma extending to her serosa with lymphatic and venous invasion (T3N1M1). Nodal and hepatic metastasis presented with both cellular types, with dominance of the squamous component.Adenosquamous gastric cancer is a rare diagnosis in western populations. We present the case of a woman with a very aggressive adenosquamous carcinoma with a preponderance of squamous cell component in the metastasis. Several origins have been proposed for this kind of carcinoma; either evolution from adenocarcinoma de-differentiation or stem cell origin might be possible. The hypothesis that a particular histological type of gastric cancer may arise from stem cells might be a field of research in oncological disease of the stomach.Primary gastric adenosquamous carcinoma is a rare malignant neoplasia [1-3]. Most cases reported in the literature refer to Asian people [4-6]. It amounts to less than one percent of all gastric carcinomas and its clinical and endoscopic findings are similar to the intestinal-type adenocarcinoma. Its male-to-female ratio is 4:1 and it peaks in the sixth decade of life, occurring, on average, earlier than sporadic adenocarcinoma [1,7].Adenosquamous carcinoma is a mixed neoplasia (gland-like and squamous). Intestinal-type adenocarcinomas may present with variable areas of squamous differentiation. For a diagnosis, it has been established that the squamous component should be present in more than 25 percent of the tumoral sample [8].It appears more frequently in the esophagogastric junction but, due to its proximity with esophageal mucosa, a collision tumor (squamous cell esophageal carcinoma with gastric adenocarcinoma) cannot be ruled out and the diagnosis of adenosquamous carcinoma should not be made. Adenosquamous carcinomas usually invade deep into the muscular layer, present with venous and lymphatic invasion and tend to be diagnosed later, in more advanced stages. Its biological
Patients with Localised Prostate Cancer (T1 - T2) Show Improved Overall Long-Term Survival Compared to the Normal Population  [cached]
Michael J. Mathers, Stephan Roth, Monika Klinkhammer-Schalke, Michael Gerken, Ferdinand Hofstaedter, Stefan Wilm, Theodor Klotz
Journal of Cancer , 2011,
Abstract: Background: Little information is available on the long-term outcomes of patients with localised prostate cancer. Objective: To examine the long-term survival of patients with localised prostate gland carcinoma T1 - T2, N0, M0 (UICC stage I and II) compared to the normal population. Design: Retrospective cohort. Setting: Regensburg, Germany. Participants: Data on 2121 patients with histologically-confirmed, localised prostate cancer diagnosed between 1998 and 2007 were extracted from the cancer registry of the tumour centre in Regensburg, Germany. Measurements: Overall survival rate in the patient cohort was estimated and compared to the expected survival rate of a comparable group in the general population derived from the official life-tables of Germany stratified by age, sex and calendar year. Results: Ten years after diagnosis, patients with stage I and II localised prostate gland carcinoma had an approximately 10% increase in survival compared to the normal male population (Relative Survival = 110.7%, 95%-CI 106.6 - 114.8%). Limitations: We did not examine the effect of cancer treatment or cancer aggressiveness on the overall survival of patients. We did not assess the incidence of subsequent non-primary cancers in our patient population or how this incidence affects the patients' follow-up care and survival. Conclusions: Patients with stage I+II localised prostate gland carcinoma have improved survival compared with the normal male population. This finding cannot be explained solely by the administration of prostate carcinoma treatments, suggesting that men who participate in PSA screening may have better overall health behaviors and care than men who do not participate in screening. Future research should examine how treatment choice, especially an “active surveillance” approach to care, affects survival in these patients more than ten years after diagnosis.
Primary renal adenosquamous carcinoma
Zainuddin Mohammad,Hong Tan
Urology Annals , 2010,
Abstract: A case of renal adenosquamous carcinoma is presented. The fact that the urothelium has no glandular or squamous structures makes the pathogenesis of this tumor unique. The process is assumed to begin with urothelial metaplasia resulting from chronic irritation leading to dysplasia and subsequently squamous and glandular differentiation.
Outcomes and Prognostic Factors for Adenocarcinoma/Adenosquamous Carcinomas Treated with Radical Hysterectomy and Adjuvant Therapy  [PDF]
Masayuki Yamaguchi, Yoko Yamagishi, Nobumichi Nishikawa, Masayuki Sekine, Takehiro Serikawa, Katsunori Kashima, Takayuki Enomoto
Open Journal of Obstetrics and Gynecology (OJOG) , 2014, DOI: 10.4236/ojog.2014.414128
Abstract: Objective: To determine outcomes and prognostic factors for early-stage cervical adenocarcinoma/ adenosquamous carcinomas (AC/ASC) patients who are treated with radical hysterectomy and adjuvant therapy to optimize their treatment. Methods: We retrospectively reviewed the medical records of 26 patients with International Federation of Gynecologists and Obstetricians stage IB-IIB cervical AC/ASC who were treated with radical hysterectomy and adjuvant therapy. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier method and compared using the log-rank test. The prognostic significance of various clinical features was determined by using multivariate analysis with the Cox proportional hazards regression model. Results: Univariate analysis revealed that OS was significantly shorter in patients with lymph node metastasis and lymphovascular space invasion. Similarly, PFS was significantly shorter for patients with lymph node metastasis and parametrial invasion. Furthermore, multivariate analysis showed that lymph node metastasis was the only independent predictor for PFS (hazard ratio: 6.47, 95% confidence interval: 1.33 - 31.44, p = 0.021). However, the use of adjuvant chemoradiotherapy did not have any significant effect on either OS or PFS, regardless of lymph node metastasis. Conclusions: Lymph node metastasis is an independent prognostic factor for poor survival in cervical AC/ASC patients treated with radical hysterectomy and adjuvant therapy. In addition, adjuvant chemoradiotherapy does not improve their survival, regardless of lymph node metastasis, which suggests that novel or personalized adjuvant therapeutic strategies with fewer adverse effects than existing strategies are needed.
The Effect of Prostate Weight on the Radical Prostatectomy Outcomes  [PDF]
Taylan Oksay,Osman Ergün,Mustafa Ho?can,Alim Ko?ar
Journal of Clinical and Analytical Medicine , 2012, DOI: 10.4328
Abstract: Aim: The aim of study was to evaluate the impact of prostate weight on radical prostatectomy outcomes (cancer control, urinary continence, and erectile dysfunction) in prostate cancer patients. Material and Method: The files of 92 patients who underwent retropubic radical prostatectomy were retrospectively reviewed. Patients%u2019 data on demography, tumor characteristics, oncological, urinary and erectile function outcomes were estimated. Results were compared according to the prostate weights (Group 1: %u2264 60 g, Group 2: > 60 g). Result: Patients that have prostate weight of >60 g were %35,9. Preoperative Prostate Spesific Antigen (PSA) volumes (9.9 %u2013 14.1 ng/ ml, p
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