BackgroundLess than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients.MethodsWe retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients’ OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis.ResultsIn the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS.ConclusionsLymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease.
The influence of rituximab therapy on prognosis and hepatic toxicity (HT) in patients with hepatitis C virus (HCV)-positive diffuse large B-cell lymphoma (DLBCL) is unclear. Thus, we assessed HT and clinical outcome in patients with DLBCL and HCV infection who received rituximab-containing immunochemotherapy. We carried out a prospective analysis on a total of 280 HCV-positive patients with DLBCL, 200 of whom received chemotherapy plus rituximab (R-CHT), 80 received chemotherapy (CHT)-only. Survival outcomes and HT were compared according to rituximab administration. The median follow-up was 41 months. Addition of rituximab did not significantly affect prognosis (median progression-free survival, 40 vs 35 months, P = 0.26; median overall survival, 51 vs 43 months P = 0.09). Of 200 patients who received rituximab, 53 (26.5 %) had severe HT (grade 3-4), compared with 11 of 80 (13.75 %) patients who received rituximab-free regimens (P = 0.033). Among patients treated with rituximab, 50 patients (25 %) did not complete planned course of therapy, 14 patients because of hepatic toxicity and 36 patients because of progressive disease. Pretreatment liver function impairment was predictive of severe HT. These results raise concerns regarding the routine use of rituximab with chemotherapy in individuals with HCV-positive DLBCL. However, more studies are warranted before a definitive conclusion can be made.
Background: The treatment of breast cancer in large breast patients represents a great challenge to both surgical oncologist and radiation oncologist. The aim of this study is to evaluate the outcome of inferior pedicle therapeutic mammoplasty in large-breasted patients with upper quadrants early breast cancer. Methods: Thirty five large-breasted patients with early breast cancer were included in this study. Simultaneous bilateral inferior pedicle therapeutic mammoplasty was performed. Results: The age of the patients is ranged from 36 to 61 (median 46) years and tumour size is ranged from one to three and half cm. The weight of tissue removed is ranged from 350 gm to 780 gm and the tumour safety margins are ranged from three to eight cm. Wound dehiscence was the commonest post operative complications and six patients were affected (17.6%). The cosmetic outcome was excellent in 22 patients (64.5%), nine patients (26.5%) showed good results, two patients (6%) were satisfactory and one patient (3%) showed poor result. The follow up period is ranged from 6 to 42 months with one case (3%) of systemic metastasis. Conclusion: Inferior pedicle therapeutic reduction mammoplasty for upper quadrants early breast cancer in large breasted women is a surgically and oncologically safe procedure, and it carries a satisfactory aesthetic outcome.
e12004 Background: Vinorelbine (V) and capecitabine (C) are likely to have a synergisitic interaction. Vinorelbine upregulates thymidine phosphorylase; a key enzyme in the conversion of capecitabine to active 5-FU in tumor tissue. Available phase II clinical data reports response rates ranging from 48-70% in first line metastatic breast cancer (MBC) for this combination. We evaluated the efficacy and safety of vinorelbine plus capecitabine in patients with MBC relapsing after adjuvant anthracycline based treatment. Methods: Sixty patients were enrolled between Oct 2008 through Dec 2010. All patients had measurable MBC relapse after adjuvant anthracycline and/or taxanes, WHO PS < 2, adequate bone marrow, renal and hepatic functions. Patients received intravenous vinorelbine 25 mg/m2 on day 1 and 8 and oral capecitabine 1000 mg/m2 bid on days 1 to 14, cycles to be repeated every 3 weeks. Patients with PD went off the study while those with CR, PR or SD continued treatment for a maximum of 8 cycles. Results: Median age 54 years (range 35-67 years), Median WHO PS 0 (range 0-1). Previous adjuvant therapy anthracycline (100%) and hormone therapy (60%). Median disease free interval was 6 months. Main metastatic sites were lung (40%), liver (25%), bone (40%) skin (35%), and lymph nodes (35%). Twenty five percent of patients had one metastatic site, 60% had two sites, 10% had three sites and 5% had more than three sites. The total number of cycles delivered was 441 with a median number of cycles/patients of 7 (range 3-8). An objective tumor response was achieved in 36 pts (60%), complete response (CR) in 6 pts (10%), 12 pts (20%) had stable disease (SD). After a follow up period of 6-36 months, the median time to progression and median survival were 14 and 23 months, respectively. No WHO G4 toxicities were noted, 3 pts (5%) developed G3 neutropenia and one patient (1.7%) developed G3 hand and foot syndrome. G2 anemia, neutropenia and diarrhea were reported in 2 pts (3.3%), 3 pts (5%) and 6 pts (10%), respectively. Conclusions: The combination of vinorelbine and capecitabine showed significant efficacy and mild toxicity as a first-line treatment for patients with metastatic breast cancer after failure of adjuvant anthracycline based therapy.
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