Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer and the third leading cause of cancer related death overall. The role of insulin resistance in the development of HCC associated with chronic HCV infection has not been established. Resistin is a polypeptide hormone belonging to the adipokine family which could contribute to tumorigenesis and angiogenesis. Our aim was to study serum resistin and insulin resistance as risk factors for HCC in HCV cirrhotic patients. Materials and Methods: This prospective case controlled study included 100 patients with HCV related liver cirrhosis and HCC, 100 patients with HCV related liver cirrhosis without HCC and 50 apparently healthy participants as controls. For all subjects, liver profile, serologic markers for viral hepatitis, lipid profile, alpha-fetoprotein level (AFP), homeostasis model assessment (HOMA) were examined along with resistin. Results: HCC patients had higher mean values of HOMA-IR and resistin than cirrhotic patients and the control subjects (p<0.01). HOMA and resistin were considered independent risk factors in development of HCC, those patients with resistin › 12 ng/ml and HOMA ›4 being 1.6 times more likely to have HCC. Conclusions: HOMA and serum resistin allow for early identification of patients with cirrhosiswho are at substantially increased risk of HCC. Recommendation: HOMA and serum resistin could represent novel markers to identify HCV cirrhotic patients at greater risk of development of HCC.

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Background: The most common non-cutaneous malignancy for men is Prostate cancer (PCa). PCa diagnosed by biopsy and PSA detection. Bone metastasis (BM) causes a lot of complications, such as bone pain and pathological fracture that cause overall compromised quality of life. Bone scintigraphy (BS) is commonly used for monitoring and detection of (BM). Objective: To correlate between serum PSA level and BM in PCa patients on series of 250 patients through detecting PSA levels and BSs. Patients and Methods: In the present study Patients were stratified (group A) & (group B) according to BM. Out of the 250 patients, 180 patients (Group A localized PCa) were with age range from 57 -92 years, the remaining 70 patients (Group B metastasis PCa) the age range was 53-88 years. Prostate specific antigen (PSA) level for both groups were detected. Results: By comparing group A and group B there was a highly significant difference in PSA value in favor of positive BS group (p-value < 0.001). The present study recommends BS in asymptomatic patients with PSA above 60 Ng/ml. Conclusion: PCa is the most common malignant non-cutaneous tumor for men. The most common spread for PCa is bone spread. Age doesn’t correlate with BM in PCa patients. PSA total show highly significance with BM in PCa patients. PSA cut-off value for BM in PCa patients was 60 Ng/ml so it was recommended to perform BS for asymptomatic patients with PSA total above 60 Ng/ml.

Background Lung cancer is the most commonly diagnosed cancer worldwide for both sexes. There are 1.8 million new cases in 2012 (12.9% of the total), 58% of which occurred in the less developed regions. The disease remains the most common cancer in men worldwide (1.2 million, 16.7% of the total) and the most common causes of cancer deaths worldwide for both sexes, estimated to be responsible for nearly one in five (1.59 million deaths, 19.4% of the total) Aim of the Work are to evaluate the effect of platinum-based chemotherapy combinations as a first line treatment on health related quality of life (HRQOL) in advanced NSCLC Egyptian patients and to assess tumor’s response to treatment and treatment toxicity. Patients and Methods A prospective, single arm clinical study, to evaluate the effect of palliative chemotherapy on advanced NSCLC patient’s health related quality of life before starting chemotherapy and after 3 cycles of treatment, patient’s response to treatment and toxicity related to treatment. Results 61 patients completed the EORTC QLQ-C30 and the QLQ-LC13 for the evaluation of HRQoL before the 1st cycle of chemotherapy. Started with 70 patients, 9 were excluded during the study (because of a change in the chemotherapy protocol or because of treatment discontinuation during the following cycles of chemotherapy. Conclusion The present study explored self-reported quality of life in advanced NSCLC patients receiving chemotherapy, Aiming for a better understanding of how chemotherapy influences HRQoL. The importance of patient perception of their own health regarding the complexity of cancer, which is a disease that affects every dimension of life and the way in which individuals perceive the environment, the diagnosis, and the therapy. Therefore, the combination of periodic quality of life assessments and clinical practice should be more extensively.

Background Gastrointestinal Stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GIT) i.e. sarcoma. GIST is classified into mutation in KIT (cluster of differentiation 117, CD117) oncogene (85%), Platelet — derived growth factor receptor alpha gene (PDGFRA) (10%) or rarely B-Raf gene. C.Kit - which is mutated & activated in 80% of GIST- is an oncogene which encodes cell surface receptor Tyrosine Kinase TK (CD 117) which is responsible for activation of multiple signaling cascades leading to cellular proliferation. Aim of the Work to explore the best management options of care for patients at Ain Shams University Hospitals (ASUH) by retrospectively analyzing epidemiological factors in Gastrointestinal stromal tumor patients and correlate them to clinical outcome; these factors are either patient or disease ones, while outcome include clinical benefits, survival and encountered toxicities. Patients and Methods this is a retrospective study. This study included 34 patients with GIST treated at the department of Clinical Oncology and Nuclear medicine, Ain Shams University between 2011 -2017 and followed up till 1-2017. Results many prognostic factors were selected for analysis to evaluate their impact on overall survival. Age, gender, site and size of tumor, mitotic index, histopathology, presence of metastasis at time of presentation and anemia all had no statistically significant impact on overall survival. Conclusion the prognosis of GIST is undoubtedly better than other sarcomas. No clear risk factor of GIST. Patient selection is paramount as to minimize the high cost of treatment. Tumor density must be known by Hounsfield unit before treatment to detect pseudo progression. Molecular analysis by PCR is very important to know sensitivity to treatment as a predictive biomarker. Patients should be kept on follow up for early detection of recurrence.

Background: Procedure tract metastasis (PTM) may complicate pleural procedures in malignant pleural mesothelioma (MPM) patients and cause significant morbidity. Aim: To evaluate the effectiveness of prophylactic radiotherapy (RTH) in preventing PTM and reducing pain. Methods: Forty patients with MPM, who had a pleural invasive procedure within the preceding 15 days, were randomized in a 1:1 ratio to receive prophylactic RTH to the procedure site (21 Gy in three consecutive daily fractions using 9MeV) vs. no RTH. During a 12-month follow up period, patients were examined monthly for PTM, toxicities and pain at the procedure site. Results: Patients receiving RTH had lower incidence of PTM than the control group (2/20, 10% vs. 5/20, 25%); however, this difference was not statistically significant. The proportion of patients who experienced pain at the pleural procedure site was significantly less in the RTH group compared with the control group (2/20, 10% vs. 12/20, 60%; p=0.001). Pain scores were significantly less in the RTH group compared with the control group (mean pain score 1.6 vs. 2.8, respectively; p=0.014). Conclusion: Prophylactic RTH to the pleural procedure site in MPM was not significantly effective in preventing or delaying PTM. However, prophylactic RTH reduced significantly the rate and severity of pain at the procedure site. Future studies may be needed to assess the effect of prophylactic RTH timing and its technique on preventing PTM.