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  Citation statistics : Table of Contents
   2013| November  | Volume 9 | Issue 7  
    Online since November 30, 2013

 
 
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CASE REPORT
Surgical resection of multiple liver metastasis of functional malignant pheochromocytoma: A case report and literature review
Shaozhong Wei, Dongde Wu, Junqiu Yue
November 2013, 9(7):183-185
DOI:10.4103/0973-1482.122522  PMID:24516058
Functional malignant pheochromocytoma is a rare tumor. Also, liver metastatic pheochromocytoma is deemed to be incurable because of its poor prognosis. Surgical debulking and removal of primary and metastases tumors, as well as radiosurgical or surgical treatment are recommended for patients. We treated a patient with multiple liver metastasis of functional malignant pheochromocytoma 4 years after the adrenal primary lesion was resected. The liver metastases were successfully removed by surgical resection. During the operation, the blood pressure increased quickly when the tumor was held between the fingers, reached the highest (201/110 mmHg), and then quickly declined to normal when the pressure was relieved. The patient is alive for more than 5 years after the operation. Thus, we believe that functional liver metastases of malignant pheochromocytoma may be curable by surgical resection with careful monitoring of anesthesia and blood pressure. Every effort should be taken to avoid direct stimulation of the tumor in the operation.
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ORIGINAL ARTICLES
A retrospective study of different local treatments in breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis
Xin-Zhong Chang, Jian Yin, Jinyan Sun, Xue-Hui Zhang, Xu-Chen Cao
November 2013, 9(7):158-161
DOI:10.4103/0973-1482.122514  PMID:24516053
Aim: To evaluate the local treatment outcome and efficacy of supraclavicular lymph node dissection and radical radiotherapy for breast cancer patients with synchronous ipsilateral supraclavicular lymph node metastasis (ISLM). Materials and Methods: A total of 29 patients with ISLM in the absence of distant metastases were retrospectively analyzed. All patients received radical or modified radical mastectomy and systemic therapy. Thirteen patients received supraclavicular lymph node dissection surgery and the other patients were treated with radical radiotherapy. Results: At the median follow-up of 47 months, 23 patients had developed distant metastases. The 3-year distant metastasis-free survival (DMFS) rates were 46.2% for the supraclavicular lymph node dissection group and 31.3% for the radical radiotherapy group. The 5-year overall survival rates were 46.2% for the supraclavicular lymph node dissection group and 37.5% for the radical radiotherapy group. Conclusion: Breast cancer with ISLM should be considered as a locoregional disease. Besides systemic therapy, local therapy may be helpful in enhancing local control and correspondingly reducing distant metastasis. In some individual patients, supraclavicular lymph node dissection might get a good prognosis
  1 2,449 166
REVIEW ARTICLES
Role of Toll-like receptors in microbiota-associated gastrointestinal cancer metastasis
Qi Lu, Hao Ding, Weiping Li
November 2013, 9(7):142-149
DOI:10.4103/0973-1482.122509  PMID:24516050
Toll-like receptors (TLRs) serve as specific pattern recognition molecules that bind to microbial components to activate innate immunity and instruct and modulate adaptive immunity in the face of immunological danger. Accumulating evidence supports that TLR signaling pathway responses to luminal microbes participate in the development of gastrointestinal malignancies. This review summarizes current knowledge on the roles of TLR in microbiota-associated gastrointestinal cancer metastasis, focusing on TLR recognition of microbiota ligands, initiating inflammation, and promoting tumorigenesis, as well as the therapeutic strategies to target TLR. Studying the link between TLR signaling and gastrointestinal malignancies offers the possibility to identify novel ways to both prevent and treat gastrointestinal cancer.
  1 3,357 234
EDITORIAL
Tumor metastasis: What happened to the invading cancer cells?
Qian Liu, Qinghua Zhou
November 2013, 9(7):121-122
DOI:10.4103/0973-1482.122502  PMID:24516046
  - 1,698 312
ORIGINAL ARTICLES
Immune responsiveness in a mouse model of combined adoptive immunotherapy with NK and dendritic cells
Feng Cui, Jingjing Ji, Huifang Lv, Di Qu, Changhua Yu, Yu Yang, Yuqing Xu
November 2013, 9(7):162-168
DOI:10.4103/0973-1482.122516  PMID:24516054
Objective: To determine the tumoricidal ability of combined immunotherapy of natural killer (NK) cells and dendritic cells (DCs) in a melanoma mouse model and the functions of tumor-associated effector cells. Materials and Methods: A C57BL/6 mouse model of subcutaneous melanoma and lung metastasis was established. NK cells and DCs were cultured and labeled in vitro. Varying frequencies of both NK cells and DCs were adoptively transferred into tumor-bearing mice. Tumor, liver, spleen, and lung were studied for the number and distribution of effector cells. Additionally, CD8+T cell numbers in the lung and numbers of metastatic lung nodules were determined. Results: Co-culture of NK cells and DCs might maintain and promote NK cell activity without exogenous cytokines. Both NK cells and DCs were distributed in the tumor microcirculation and parenchyma. We found significant time-dependent differences in the numbers of infiltrating NK cells and DCs (P < 0.01), which stimulated the highest frequencies of effector cells 4 h after transfer and the lowest at 12 h. Low NK cell numbers were found in the spleen, and fewer numbers were found in liver and lung. Infiltration of tumors with effector cells was greatest following mixed cell transfers as compared to single transfers, and markedly increased CD8+T cells were associated with significant decreases in lung metastases. Conclusion: NK cells and DCs adoptive immunotherapy targeted the tumor and exhibited improved therapeutic efficacy as compared to that of the cells given alone. This strategy could induce tumorigenic immunological memory and suggests that mixed NK cells and DCs adoptive immunotherapy offers therapeutic options against cancer.
  - 2,181 179
Efficiency and prognosis of whole brain irradiation combined with precise radiotherapy on triple-negative breast cancer
Xinhong Wu, Bo Luo, Shaozhong Wei, Yan Luo, Yaojun Feng, Juan Xu, Wei Wei
November 2013, 9(7):169-172
DOI:10.4103/0973-1482.122518  PMID:24516055
Aim: To investigate the treatment efficiency of whole brain irradiation combined with precise radiotherapy on triple-negative (TN) phenotype breast cancer patients with brain metastases and their survival times. Materials and Methods : A total of 112 metastatic breast cancer patients treated with whole brain irradiation and intensity modulated radiotherapy (IMRT) or 3D conformal radiotherapy (3DCRT) were analyzed. Thirty-seven patients were of TN phenotype. Objective response rates were compared. Survival times were estimated by using the Kaplan-Meier method. Log-rank test was used to compare the survival time difference between the TN and non-TN groups. Potential prognostic factors were determined by using a Cox proportional hazard regression model. Results : The efficiency of radiotherapy treatment on TN and non-TN phenotypes was 96.2% and 97%, respectively. TN phenotype was associated with worse survival times than non-TN phenotype after radiotherapy (6.9 months vs. 17 months) (P < 0.01). On multivariate analysis, good prognosis was associated with non-TN status, lower graded prognosis assessment class, and nonexistence of active extracranial metastases. Conclusion: After whole brain irradiation followed by IMRT or 3DCRT treatment, TN phenotype breast cancer patients with intracranial metastasis had high objective response rates but shorter survival time. With respect to survival in breast cancer patients with intracranial metastasis, the TN phenotype represents a significant adverse prognostic factor.
  - 1,813 138
RASSF7 and RASSF8 proteins are predictive factors for development and metastasis in malignant thyroid neoplasms
Xi Li, Ge Zhao, Yinghou Wang, Jian Zhang, Zhiquan Duan, Shijie Xin
November 2013, 9(7):173-177
DOI:10.4103/0973-1482.122519  PMID:24516056
Objectives: To study the expression status of Ras-association domain family 7 (RASSF7) and Ras-association domain family 8 (RASSF8) in nodular thyroid goiter (NTG), medullary thyroid carcinoma (MTC), and papillary thyroid carcinoma (PTC) and establish whether a correlation exists between the presence of RASSF7 and RASSF8 proteins and clinicopathological parameters of the disease. Materials and Methods: RASSF7 and RASSF8 protein expression was examined immunohistochemically on paraffin-embedded thyroid tissues from 112 cases with PTC, 20 cases with MTC, and 38 cases with NTG. Results: The immunohistochemical expression of RASSF7 and RASSF8 was higher in PTC and MTC than in NTG (P < 0.001). In thyroid carcinomas, RASSF7 and RASSF8 expression was significantly correlated with a more advanced TNM stage (P = 0.035, P = 0.037), age, sex, lymph node metastasis (P = 0.006, P = 0.002), and tumor size (P = 0.012, P = 0.015). Conclusions: RASSF7 and RASSF8 expression was increased in PTC and MTC compared to NTG, and this may be linked to the development and progression of thyroid carcinoma. In addition, these proteins were correlated with more advanced tumor stages, tumor size, and metastasis.
  - 1,803 134
Retrospective analysis of clinical and pathologic risk factors in liver resection for hepatic colorectal metastases
Lei Zhou, Guochao Zhag, Tao Tang, Rui Lian, Wenyue Wang
November 2013, 9(7):178-182
DOI:10.4103/0973-1482.122521  PMID:24516057
Objective: To analyze the clinical and pathologic risk factors of surgical treatment for liver metastases from colorectal cancer. Materials and Methods: The data on 98 patients who underwent liver resection for hepatic colorectal metastases were collected and analyzed retrospectively. Results: Overall 1-, 3-, and 5-year survival rates after hepatectomy for metastases were 94.6%, 45.0%, and 22.3%, respectively. Gender, pathologic primary tumor stage, histologic differentiation, size of metastatic tumor, and type of metastases were not statistically significant prognostic factors (P > 0.05). The 5-year survival rate was significantly lower in patients with lymph node metastases from the primary site than that in patients without lymph node metastases (14.1% vs. 39.5%, P = 0.013); survival rate in patients with vascular invasion from the primary tumor was also significantly lower than in those without invasion (10.2% vs. 49.0%, P = 0.032). The survival rate in patients who had unilobar metastases was higher than that in patients who had bilobar metastases (25.3% vs. 0%, P = 0.012). The 5-year survival rates in solitary metastasis, two to three metastases, and with the transfer number ≥4 were 29.1%, 14.4%, and 0%, respectively (P = 0.019). Multivariate analysis revealed resection margin, distribution of metastases, and the number of metastases as the independent risk factors associated with the overall survival rates (P = 0.044, 0.037, and 0.005, respectively). Conclusions: Surgical resection may be the only treatment modality for the cure of colorectal liver metastases. Negative resection margin, metastases confined to unilobar type, and number of metastases ≤3 are associated with better prognosis
  - 1,539 152
A phase II study of triweekly paclitaxel and capecitabine combination therapy in patients with fluoropyrimidine-platinum-resistant metastatic gastric adenocarcinoma
Xiao-tian Zhang, Jian Li, Yu Bai, Yu-ping Chu, Jie Li, Yan Li, Ji-fang Gong, Lin Shen
November 2013, 9(7):153-157
DOI:10.4103/0973-1482.122512  PMID:24516052
Background: Although randomized trials have shown a survival benefit of second-line chemotherapy (SLC) in metastatic gastric adenocarcinoma (MGA), no standard regimen has yet been established. Paclitaxel acts synergistically with capecitabine. In this phase II study, we evaluated the efficacy and safety of paclitaxel/capecitabine (PX) as an SLC regimen for patients with fluoropyrimidine-resistant MGA. Materials and Methods: Patients were eligible if the tumor progressed to fluoropyrimidine-based regimens or relapsed within 6 months after completion of therapy with adjuvant fluoropyrimidines. Treatment consisted of paclitaxel (80 mg/m 2 , days 1 and 8) and capecitabine (1000 mg/m 2 , bid, days 1-14), called PX, every 3 weeks. The primary endpoint was the objective response rate (ORR). Thirty-five patients were required according to the statistical design, and PX combination would be rejected if fewer than five patients responded. Results: From November 2004 to May 2007, 36 eligible patients were enrolled. Among them, 35 (97.2%) had previously received platinum/fluoropyrimidine as first-line therapy. Response was assessed in 35 patients; 10 partial responses were obtained, resulting in an ORR of 28.5%. The median progression-free survival was 5.0 months, and the median overall survival was 11.1 months. The most frequent grade 3/4 toxicity was neutropenia, observed in 11.1% of the patients. Conclusions: PX regimen was clearly demonstrated to be active and safe for fluoropyrimidine-platinum-resistant MGA, and further evaluation in future phase III trials is warranted.
  - 1,783 144
REVIEW ARTICLES
Cancer stem cells and tumor metastasis
Shaoqiang Sun, Xue Shan Qiu
November 2013, 9(7):150-152
DOI:10.4103/0973-1482.122510  PMID:24516051
Cancer stem cells (CSCs) are endowed with an inherent resistance to cytotoxic drugs, and are closely related to the migration, invasiveness, and anti-apoptotic ability of the cancer cells. Epithelial-mesenchymal transition (EMT) is a process where epithelial cells acquire the highly invasive and metastatic characteristics of mesenchymal cells, and has a close connection with CSCs. In this paper, the authors address the recent progress made in the relationship between the EMT status of CSCs and tumor metastasis and between the localization and chemotaxis of CSCs and the formation of the metastatic colonies, as well as the relation of CSCs with the therapeutic strategy for cancer treatment
  - 2,118 286
The role of neural-related factors in the metastasis of the gastrointestinal cancer
Xiao-tao Xu, Bin Xu, Qi-bin Song, Heng Zeng
November 2013, 9(7):123-128
DOI:10.4103/0973-1482.122505  PMID:24516047
Neurotransmitters are identified to be endogenous chemicals and act on neurons to transmit signals to each other or to a target cell across synapse. They are involved in many brain functions including analgesia, reward, food intake, metabolism, reproduction, social behaviors, learning, and memory. Recently, sympathetic nerve fibers were detected in many solid tumors including gastrointestinal cancer, supporting the idea that neural system has effects on tumor progression. Neurotransmitters were secreted from the sympathetic nerve fibers and subsequently infiltrated into tumor tissues. Further studies disclosed the different mechanisms of various kinds of neurotransmitters in the progression of carcinogenesis, including tumor cell proliferation, angiogenesis, and tumor invasion and metastasis. Neurotransmitters are mainly subdivided into four types, amino acids, monoamines, peptides, and others, each of which contains multiple chemicals. For this reason, we cannot describe each in detail. In this review, we will focus on several important neurotransmitters including tachykinis, neuropeptide Y, and b-adrenergic receptors. How they function and their crosstalks with the immune system in the progression, especially the metastasis of gastrointestinal cancer, will be described. Finally, we will summarize the clinical implications in the treatment of gastrointestinal cancer.
  - 2,551 250
The function of the RNA-binding protein hnRNP in cancer metastasis
Na Han, Wentao Li, Mengxian Zhang
November 2013, 9(7):129-134
DOI:10.4103/0973-1482.122506  PMID:24516048
Heterogeneous ribonucleoproteins (hnRNPs) are involved in a variety of key cellular functions and are most likely involved in different steps of pre-mRNA processing. Over the past decades, the central roles of hnRNPs have been detected, which show that they are involved in RNA splicing, telomere biogenesis, DNA repair, cell signaling, and in transcription and translation. Mounting evidence suggests that they are involved in the regulation of mRNA stability and translation in many cancer types. The hnRNPs have a variety of potential roles in inhibition of apoptosis, angiogenesis, cell invasion, and epithelial-mesenchymal transition (EMT). It is thus suggested that hnRNP might be a novel and promising therapeutic target and a marker for treatment response and prognostic evaluation. The aims of this review are to survey the existing evidence and discuss the diverse functions of hnRNPs in cancer metastasis.
  - 7,044 384
The potential therapeutic targets to bone pain induced by cancer metastasis
Jianguo Wu, Yibing Wei, Jingsheng Shi, Feiyan Chen, Guangyong Huang, Jie Chen, Jun Xia
November 2013, 9(7):135-141
DOI:10.4103/0973-1482.122508  PMID:24516049
About 75-90% of patients with advanced metastatic cancer experience significant cancer pain. Bone cancer pain is one of the most common pains experienced by patients with advanced breast, prostate, or lung cancer. It is characterized by significant skeletal remodeling, fractures, pain, and anemia, all of which reduce the functional status, quality of life, and survival of the patient. Recent years have seen great progress toward alleviating bone pain with the identification of a range of chemicals as well as receptors modulating cancer pain progression. However, the complicated interactions among these factors and, sometimes, the contradicting effects of the same factor in different pathways make it difficult to spot individual effective targets. The sheer quantity of the chemicals involved and the limited understanding from animal models are the constraints in the development of effective therapies for cancer bone pain. In this review, key targets will be discussed along the pain transduction pathway, including peripheral pain sensation, spinal cord transduction pathway, and the central nervous system, to offer a logical and systematic study for the development of combined anti-bone pain treatments.
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