Background:In Egypt, there has been a remarkable increase in the proportion of hepatocellular carcinoma (HCC) among chronic liver diseases patients. This rising proportion may be explained by the increasing risk factors as hepatitis C virus (HCV) infection, hepatitis B virus (HBV) infection, improvement of the diagnostic tools of HCC as well as the extended survival among patients with cirrhosis to allow time for some of them to develop HCC. The aim of this study was to study the epidemiology of HCC in Nile delta over the last decade.Methods:The study was carried out on patients diagnosed as HCC in liver cancer clinic in Tanta University Hospital, Egypt, from January 2005 to January 2015. This retrospective study reviewed the files of HCC patients with special stress on age, sex, residence, occupation, smoking, and viral markers.Results:Over the last decade, 1440 HCC patients were diagnosed or referred to liver cancer clinic in Tropical Medicine Department in Tanta University Hospital from January 2005 to January 2015. The mean age of HCC patients was 56.13 ± 9.53 years. Nearly, half of the patients with HCC were smokers and quarter of HCC patients were diabetics. HBV surface antigen-positive patients were only 3.26%, and the majority of patients were HCV-Ab positive (94.86% of patients).Conclusions:In Nile delta, hepatitis C rather than hepatitis B was linked to the development of HCC in our region which may be related to the high prevalence of HCV in this area.

It is clear that triple-negative breast cancer (TNBC) tumors are heterogeneous group, but clinically important subsets have begun to emerge. We investigate the immunohistochemical expression of androgen receptor (AR) among those hormonal insensitive groups which have only the option of chemotherapy. Exploiting this knowledge for therapy has been challenging. Patients & methods: Seventy seven patients with TNBC subtype, treated from January 2009 until February 2011 were evaluated for AR expression where AR-positive expression group (P10% nuclear stained cells) was conducted to receive anti-androgen therapy post adjuvant chemotherapy (Bicalutamide ''CasodexÒ'') 50 mg, once daily with or without meals at the same time each day, to date. AR expression was correlated with other prognostic factors and survival (disease free survival (DFS) and overall survival (OS)). Cox proportional hazard model was used to assess variables in the multivariate analysis. Results: The median age in the present study was 35.6 year (19-63 years). The median follow-up period was 24 months (3-60 months). AR-positive expression in the present study was (21n77) 27.27% correlated with clinical outcomes, for recurrent event (n = 4, 19.05%), (P = 0.000, HR 12.750, Cl 95% 3.668-44.318) and for death event, no body died in AR positive expression group (P = 0.000, HR 0.644, Cl 95% 0.533-0.779). Improved survival with AR-positive expression group for 2-year and 3-year DFS was 85% and 78% respectively with (P = <0.001, Cl 95% 39.17-51.39) and for OS at 2-year and 3-year was 100% (P = 0.0005). In univariate and multivariate analysis, AR positive expression with anti-androgen therapy in TNBC patients in our present study had retained their independent prognostic value for DFS (P = 0.0006, HR 4.659, Cl 95% 1.553-13.977). Bicalutamide was well-tolerated therapy with no grade 3/4 treatment-related adverse events. Conclusions: Bicalumide is well tolerated in AR positive TNBC subtype patients and could offer an alternative to cytotoxic chemotherapy in those patients with better OS and DFS.

Among Egyptian patients, the left breast is at greater risk of cancer than the right one. Despite right-sided tumors seemed more aggressive, Left-sided ones tend to confer worse survival than right-sided tumors.

Background: Early diagnosis of hepatocellular carcinoma (HCC) is the most important step in successful treatment. However, it is usually rare due to the lack of a highly sensitive specific biomarker so that the HCC is usually fatal within few months after diagnosis. The aim of this work was to study the role of plasma nuclear factor kappa B (NF-ĸB) and serum peroxiredoxin 3 (PRDX3) as diagnostic biomarkers for early detection of HCC in a high-risk population. Materials and Methods: Plasma nuclear factor kappa B level (NF-ĸB) and serum peroxiredoxin 3 (PRDX3) levels were measured using enzyme linked immunosorbent assay (ELISA), in addition to alpha-fetoprotein (AFP) in 72 cirrhotic patients, 64 patients with HCC and 29 healthy controls. Results: NF-ĸB and PRDX3 were significantly elevated in the HCC group in relation to the others. Higher area under curve (AUC) of 0.854 (for PRDX3) and 0.825 (for NF-ĸB) with sensitivity of 86.3% and 84.4% and specificity of 75.8% and 75.4% respectively, were found compared to AUC of alpha-fetoprotein (AFP) (0.65) with sensitivity of 72.4% and specificity of 64.3%. Conclusions: NF-ĸB and PRDX3 may serve as early and sensitive biomarkers for early detection of HCC facilitating improved management. The role of nuclear factor kappa B (NF-ĸB) as a target for treatment of liver fibrosis and HCC must be widely evaluated.

Background: Hepatocellular carcinoma (HCC) is the commonest primary malignant cancer of the liver in the world. Insulin-like growth factor-1 (IGF-1) levels reflect hepatic function and are inversely correlated with the severity of background chronic liver disease. Objective: This study evaluated whether basal serum IGF-1 levels can predict prognosis of HCC patients according to different risks of disease progression. Materials and Methods: A total of 89 patients with hepatocellular carcinoma (HCC) were recruited in 3 groups: Group I, 30 HCC patients receiving sorafinib; Group II, 30 HCC patients with best supportive care; and Group III include 29 patients undergoing transcatheter arterial chemoembolization (TACE). All patients were investigated for serum levels of AST, ALP, Bb, Cr, BUN, AFP and IGF-I. Results: Patients with disease control had significantly higher baseline IGF-1 levels 210 (185-232.5) ng/mL (p value<0.01) than did patients without disease control. Low basal IGF-1 levels were associated with advanced HCC, such as multiple tumors and advanced stage, and low IGF-1 levels predicted shorter TTP and overall survival in patients treated with TACE. Conclusions: The levels of serum IGF-1, expressed as continuous values, may be helpful for accurately assessing hepatic function and the prognostic stratification of patients with HCC.

The V30 may predict risk of developing HT after RT for HNSCC patients. V30 of 42.1%, defined as dose-volumetric threshold of radiation-induced HT, can be useful in treatment planning of HNSCC patients.

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Pre-emptive methylprednisolone infusion is an effective prophylactic agent in the prevention of radiation-induced pain flare and improves functional motor status after short-term radiotherapy in patients with vertebral metastases.