MicroRNA-21 expression efficiently predicts preoperative chemoradiotherapy pathological response in locally advanced rectal cancer.

Incidence, predictors and prognostic significance of thromboembolic disease in patients with advanced ALKrearranged non-small cell lung cancer To the Editor: Thromboembolic disease is fairly common in patients with lung cancer [1-3]. This incidence seems to be higher in patients with lung adenocarcinomas [4], with approximately 15% of those with advanced stage disease developing venous thromboembolisms (VTE) during the whole course of their disease [5-7]. Pulmonary adenocarcinomas are a heterogeneous group of diseases that can be stratified according to the presence of major oncogenic driver alterations. Anaplastic lymphoma kinase (ALK) rearrangements are detected in approximately 4% of these cases [8]. Isolated reports have suggested that patients bearing ALK-rearranged tumours might have a higher than expected incidence of thromboembolisms [9, 10]. In the present study, we have analysed the incidence, predictors and prognostic significance of thromboembolic events in a large, multi-institutional and homogeneous cohort of advanced stage patients with ALK-rearranged lung cancers from Spain and Portugal. Our primary objective was to estimate the incidence of thromboembolic events and their association with overall survival in these patients. A centralised institutional ethics committee approval at the 12 de Octubre University Hospital valid for all Spanish centres, and an institutional ethics committee approval at the Portuguese Institute of Oncology of Porto, were obtained before the study was initiated. We retrospectively selected all consecutive patients diagnosed with advanced stage (stages III and IV) ALK fusion positive non-small cell lung cancers (NSCLCs) between January 2012 and December 2016. Data were contributed by 29 Medical Centres from Spain and one from Portugal. ALK positivity was determined according to local standard protocols in each institution. We excluded patients with neuroendocrine tumours and patients on therapeutic doses of anticoagulants prior to advanced stage cancer diagnosis. We defined a thromboembolic event as any venous or arterial thromboembolism, documented by imaging studies, that occurred at the time or after advanced stage cancer diagnosis. In addition to thromboembolic events, collected during the whole patients' follow-up period, we collected baseline information (within 1 month of advanced stage cancer diagnosis) of several clinical and analytical variables of interest. We included 241 ALK-rearranged NSCLCs in this study. The median age was 56 years (range 17-84 years). Half of the patients were never smokers (52%), and most had stage IV pulmonary adenocarcinomas (n=204, 85%). Baseline brain and liver metastasis were detected in 22% and 25% of the patients, respectively. 17 patients (7%) and 185 patients (77%) had high and intermediate Khorana risk scores (KRS) [11] respectively. The median follow-up of our study population was 19 months (range 0-59 months), and 127 (53%) of the patients died. The median follow-up of alive patients was 30 months (range 4-49 months). The est...

Prognostic value of Ki-67 in TNBC, using a cut-off point of 60%, may vary depending on age.

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Results: We analyzed 114 patients, 50% female and male, median age 67 years (55-79), 43% greater than 70. Primary tumor site was lung (34.2%), breast (22.8%), hematological cancers (9.6%), prostate (7.9%) and thyroid (2.6%). Metastasis locations were 62.3% in femur and 33.3% in humerus. 71% had PS 0-1, 20.2% were oligometastatic and 56% had visceral metastasis. 31.6% were prophylactic surgery, 69.4% due to fracture (83.3% pathological, 9% traumatic, 7.7% mix component). 36% received perioperative radiotherapy and 34.2% bone-targeted agents. Intervention was mainly endomedullary nailing (69.3%) and oncological surgery (26.3%), with 20% of early complications and 7.8% of late ones. 47 patients (41.2%) had a skeletal-related event: pain (38.3%), fractures (34%), hypercalcemia (17%), and spinal compression (10.7%). Median overall survival (OS) and progression free survival (PFS) according to type of tumor is: Lung 9.3 and 8.2 months, respectively. Prostate 28 and 26.3 months. Hematological cancers 22.3 and 17.9 months. Breast 50.8 and 27.4 months. Thyroid 98.3 and 71.2 months. Comparing prophylactic vs emergency surgery, median OS is 25.6 vs 18.5 months (p-value 0.166), and median PFS 21.8 vs 19.5 months (p-value 0.677). Complication were lower in the first group (13.9% early and 5.6% late complications). The subanalysis by type of tumor shows a significant difference in OS in lung cancer (17.7 vs 4.7, p-value 0.002).Conclusions: Surgical treatment of bone metastases is an emerging treatment modality, being an effective and safe alternative. Prophylactic surgery, if possible, should be performed since it is related to lower complication rates, more radical attitude and better prognosis.Legal entity responsible for the study: The authors.