A total of 473 patients (mean age: 63 years; 73% male) underwent resection, 51% 2-stage, 18% 3-stage, 12% transhiatal, and 19% extended total gastrectomy. Ninety-six (20%) patients developed new-onset AF, in 18%, 27%, 29%, and 14% of 2-, 3-, transhiatal, and extended total gastrectomy cohorts, respectively (P=0.05). Age, diabetes, neoadjuvant therapy, and cardiac history predisposed (P<0.05) to AF, and AF was significantly (P<0.0001) associated with pneumonia, pleural effusions requiring drainage, and maximum postoperative C-reactive protein (CRP) (P<0.05) but not with anastomotic leak/conduit necrosis or mortality. Amiodarone was the primary treatment in 63% of cases, 1% underwent cardioversion, and 92% were in sinus rhythm on discharge. At a median follow-up of 40 months (7-109 months), the median survival was 40 months versus 53 months in the AF and non-AF cohorts, respectively (P=0.353) CONCLUSIONS: New-onset AF is common, linked to age, diabetes, cardiac disease, and neoadjuvant therapy. It is strongly associated with complications, principally respiratory sepsis, and systemic inflammation. For most, it resolves, with no impact on oncologic outcomes.

Growth arrest-specific gene 6 (Gas6), identified in 1995, acts as the ligand to the Axl/Tyro3 family of tyrosine kinase receptors and exerts mitogenic activity when bound to these receptors. Overexpression of the Axl/Tyro3 receptor family has been found in breast, ovarian and lung tumours. Gas6 is upregulated 23-fold by progesterone acting through the progesterone receptor B (PRB). Recently, Gas6 has been shown to be a target for overexpression and amplification in breast cancer. Quantitative real-time PCR analysis was used to determine the levels of Gas6 mRNA expression in 49 primary breast carcinomas. Expression of PRB protein was evaluated immunohistochemically with a commercially available PRB antibody. The results showed a positive association between PRB protein and Gas6 mRNA levels (P ¼ 0.04). Gas6 correlated positively with a number of favourable prognostic variables including lymph node negativity (P ¼ 0.0002), younger age at diagnosis (P ¼ 0.04), smaller size of tumours (P ¼ 0.02), low Nottingham prognostic index scores (P ¼ 0.03) and low nuclear morphology (P ¼ 0.03). This study verifies for the first time the association between PRB and Gas6 in breast cancer tissue.

The impact of body mass index (BMI) on postoperative outcomes after curative resection for esophageal cancer has been assessed in many studies worldwide with conflicting conclusions. The aim of this meta-analysis is to evaluate the influence of preoperative BMI on surgical and oncologic outcomes after radical surgery for esophageal cancer, in Western studies. A comprehensive electronic search was performed to identify Western publications reporting BMI and outcomes following surgery for esophageal cancer. Articles that did not report preoperative BMI, postoperative morbidity, and early mortality were excluded. Statistical analysis was performed using the OpenMetaAnalyst software (Version 10.10). One hundred and ninety records were examined and 8 studies were included with a total of 2838 patients. The study population was stratified into two groups: a nonobese group (BMI < 30 kg/m2), containing 2199 patients, and an obese group (BMI ≥ 30 kg/m2), with 639 patients. In the obese group, there was an increased risk (up to 35%) of anastomotic leak (P = 0.003; RR: 0.857, 95% CI: 0.497, 0.867). The obese group showed a significantly more favorable five-year overall survival (P = 0.011). Although there was a significant association between anastomotic leak and obesity, patients with obesity also have a better overall 5-year survival. This meta-analysis demonstrates that patients with obesity should be counseled regarding the specific risks of surgery but they can be reassured that despite these risks overall outcome is satisfactory.

The 11p15.5 region harbors three imprinted sense/antisense transcript pairs, SLC22A18/SLC22A18AS, IGF2/IGF2AS (PEG8), and KCNQ1/KCNQ1OT1 (LIT1). SLC22A18 (solute carrier family 22 (organic cation transporter) member 18) and its antisense transcript SLC22A18AS are paternally suppressed in fetal samples. In adult tissue, SLC22A18 displays polymorphic imprinting, but the imprinting status of SLC22A18AS remains elusive. SLC22AI8 DNA-PCR-RFLP analysis using NlaIII restriction digestion identified SLC22A18 heterozygotes within this breast tissue cohort (n = 89). Commercial sequencing identified informative SLC22A18AS samples. Random hexamer-primed cDNA synthesis, SLC22A18/SLC22A18AS-specific PCR, and imprinting evaluation by commercial sequencing demonstrated that SLC22A18AS displays a nonimprinted profile in reduction mastectomies (n = 6). However, SLC22A18 showed a gain of imprinting (GOI) in 1/4 of these normal cases. In the malignant cohort, GOI was also demonstrated in 18% for SLC22A18 and 14% for SLC22A18AS, occurring concomitantly in one case. This study reports the imprinting status of SLC22A18AS in adult tissue, and shows that GOI affects both the sense, and antisense transcripts at this locus in human breast tissue.

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The rate of non-attendance is 17%. A reminder would eradicate more than half of non-attendance, allowing significantly more new patients to be seen, translating to more efficient use of clinic time.

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The majority of tumours were methylated for PRB. This did not directly compromise PRB expression suggesting that other factors may down regulate the PR gene. When PRB was expressed, it correlated with good prognostic markers and better overall survival.