Background:The literature is inconsistent for the role of neutrophil-to-lymphocyte ratio (NLR) obtained before neoadjuvant therapy (pre-NLR) in predicting pathological response to neoadjuvant chemoradiation (neoCRT) in patients with locally advanced rectal cancer (LARC). In the present cohort study, we explored the predictive role of pre-NLR in this setting. Methods: We prospectively included patients with LARC who were candidates for neoCRT at the Shohada-e-Hafte Tir Hospital (Tehran, Iran) between Mar 2018 and Feb 2020. The pre-NLR was obtained through a peripheral blood smear before CRT. We used the AJCC system for evaluating tumor regression grade (TRG). The TRGs were categorized into: response-group 1 (TRG 0-1 vs. 2-3), response-group 2 (TRG 0 vs. 1-3), and responsegroup 3 (TRG 0-2 vs. 3). We applied receiver operating characteristic (ROC) analysis to assess the predictive value of pre-NLR. Results: Of the 86 screened patients with rectal cancer, 30 patients who fulfilled the inclusion criteria were included in the study. In total, 63.3% were responsive, and 23.3% had complete pathologic response. Pre-NLR could not predict the pathologic response in response-group 1 (area under the ROC curve [AUC]: 0.45, 95%CI 0.23-0.66) and response-group 2 (AUC: 0.36, 95%CI 0.13-0.59). Nevertheless, it had a poor predictive value in response-group 3 (AUC: 0.55, CI%95 0.33-0.75) with an optimal NLR cutoff value of 2.94. Conclusions: Pre-NLR could not predict the pathological response to neoCRT in our cohort of patients with LARC.
Primary thyroid sarcomas (PTS) are an incredibly uncommon type of thyroid cancer. Undifferentiated pleomorphic sarcomas of the thyroid (UPS-T) are extremely rare subtypes of thyroid sarcoma with no defined cell differentiation. Here, we report the case of a 60-year-old female with a two-year history of hypothyroidism who presented to our hospital with productive cough, dyspnea, and diffuse facial edema for two weeks. Her chest computed tomography (CT) scan revealed a large anterior mediastinal mass and multiple bilateral pulmonary nodules. Her thyroid ultrasound showed two hypoechoic nodules, while a CTvenogram of the right upper extremity showed superior vena cava and the right brachiocephalic vein obstruction, which was relieved with angioplasty. A biopsy of the anterior mediastinal mass showed poorly differentiated pleomorphic thyroid sarcoma. The patient was not a candidate for inpatient chemo-or radiotherapy because of her overall medical condition. One week later, she developed worsening respiratory failure, was intubated and transferred to the intensive care unit (ICU), where she passed away two days later.
Histiocytic sarcoma (HS) is a rare, aggressive non-Langerhans histiocytic cell neoplasm of hematopoietic origin. Histiocytic sarcoma is prone to early systemic metastasis, rendering early diagnosis and treatment critical determinants for patient outcome. Primary HS originating from the central nervous system (CNS) is exceptionally rare and portends a poor prognosis. This grim clinical course is further complicated by the challenging diagnosis and the lack of standard treatment guidelines for the disease. This is due to the exceptionally rare nature of primary CNS histiocytic sarcoma and the limited data available on the successful management of the disease, prompting the therapeutic approach to be guided by retrospective data from case reports or single-institutional studies with a limited number of patients. Here, we report a case of a young Middle Eastern male who was diagnosed with primary CNS histiocytic sarcoma, successfully treated with frontotemporal craniotomy and adjuvant radiation therapy. We also elucidate the role of the CD163 biomarker in diagnosing HS and using surgery and adjuvant radiotherapy (RT) as a successful treatment approach for primary CNS histiocytic sarcoma.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.