e18104 Background: Papillary serous uterine cancer (PSUC) is a rare, clinically aggressive histotype accounting for 40% of uterine cancer deaths. Clinicopathologic characteristics and outcomes between older and younger PSUC patients may differ. Methods: With IRB approval, we conducted a retrospective analysis of 554 consecutive patients with uterine cancer treated at our institution from 2009-19. Consistent with findings from the SEER database, 28 patients (5%) had PSUC. Most PSUC patients were Caucasian; Latinas comprised 14.2%. Thirteen patients were seventy years of age or younger (≤70) and fifteen were older than seventy ( > 70). Clinicopathologic features, therapy and survival were compared between two cohorts. Statistical analysis: Significance of associations was assessed with Fishers' exact test. Survival analysis was performed with Cox proportional model with censoring to calculate hazard ratios (HR). Results: The two cohorts were well-balanced for stage (TNM stages I+II vs. TNM stages III+IV). More than 90% of patients in each group had surgical excision/debulking, and nearly half of patients in each group received systemic chemotherapy. The most frequently used chemotherapy regimen was carboplatin-paclitaxel. Compared to patients ≤70, patients > 70 were less likely to undergo postoperative radiation therapy (6% vs 61.5%; p = 0.001). Cancer-specific survival (CSS) was worse in patients > 70 as opposed to patients ≤70 (21.8 vs. 27.4 months; HR 0.61, p = 0.03). Four PSUC patients > 70 had a personal history of metachronous breast cancer; none ≤70 had a history of breast cancer. We identified five cases of breast cancer, two cases of colon cancer, and one case each of ovarian and uterine cancer in first-degree relatives of PSUC patients > 70. Conclusions: Older PSUC patients displayed significantly shorter CSS than their younger counterparts. They were also less likely to receive radiation therapy. As personal and family history of older PCUS patients identified an excess of other cancers, comprehensive germline mutation testing may be warranted. Final statistical analysis, comparison to SEER data and significance will be presented.
Introduction Conventional first-line therapy for squamous cell carcinoma of anal canal is definitive chemoradiotherapy with a curative intent. Due to the efficacy of treatment for locoregional disease and rarity of metastatic anal carcinoma, clinical trial data for treatment of metastatic disease is lacking. Case report Herein, we describe a patient with relapsed, metastatic squamous cell carcinoma of the anal canal treated with cetuximab as the third-line therapy. Management and outcome: The patient responded to this pharmacological agent, meeting the definition of a partial response per response evaluation criteria in solid tumors (RECIST). Discussion EGFR inhibitors are potential avenues for the subsequent lines of therapy in metastatic or relapsed/refractory anal cancer. Prospective clinical trials of cetuximab alone or in combination with other agents are warranted in this setting in the future.
Introduction Polycythemia vera is a myeloproliferative neoplasm (MPN) characterized by increased red blood cell mass. The natural evolution of this MPN is to progress to an anemic/cytopenic phase also known as “spent” phase prior to transformation into an accelerated and/or an overt leukemic phase. Case Report Herein, we describe a case of a patient with polycythemia vera transitioning though a “spent” phase to an MPN in accelerated phase (MPN-AP). The patient had anemia, thrombocytopenia, neutrophilia and increased blasts in the bone marrow. Management and outcome: Upon treatment with four cycles of 5-azacitidine, the patient’s polycythemia vera reversed back to the proliferative phase. Serial phlebotomies were again required. Discussion Reversal of a “spent” phase by 5-azacitidine back to a proliferative polycythemia vera phase requiring phlebotomies has not been previously reported in the scientific literature. We might witness similar cases in the literature in the future years, which could lead to yet another therapeutic indication of this important pharmacologic agent.
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