Purpose This study focuses on the oncologic influence of BRAF V600E mutations in a cohort of Middle Eastern papillary thyroid carcinoma (PTC) patients treated at a single centre. We tested the association of BRAF V600E mutation with papillary thyroid carcinoma at King Hussein Cancer Center. Methods Patients with histologically confirmed PTC who underwent surgical treatment between 2006 and 2015 were included in this study. Oncological outcomes, both short- and long-termed, were collected. Results A total of 128 patients (68% females) were included in this study with a mean age of 38 years (±13.8). The median follow-up period was 50 months. The BRAF V600E mutation was found in 71% of patients. The tumour size for patients with a negative BRAF V600E mutation was significantly larger in comparison to patients who tested positive for the mutation (3.47 cm vs 2.31 cm, respectively, P = 0.009). The two groups showed similar disease-free survival (DFS) rates; positive = 75% (median 43 months (0–168)) compared to 78% for the negative BRAF V600E mutation (median 38 months (3–142)) (P = 0.162, HR = 0.731) Furthermore, both groups showed similar overall survival rates, positive = 94.5% (median 56 months (0–228)) compared to 94.6% for the negative BRAF V600E mutation (median 43 months (3–157)) (P = 0.941, HR = 0.940). Conclusion BRAF V600E mutation had no effect on loco-regional recurrence, distant metastasis, overall survival, or DFS. These findings may be attributed to geographic variations or reflect that BRAF V600E may only serve as an indicator of poor prognosis in high-risk group as such.
Background: Infrared thermal imaging is a non-invasive technique capable of detecting changes in temperature that could ultimately signify changes in blood supply. Flir One is a smartphone-based thermal camera, working by a downloadable application, capable of detecting the limb temperature through a non-contact method using infrared thermography technology. Using the Flir One camera, we will assess the lower limb reperfusion profile following the tourniquet release post total knee arthroplasty (TKA). Methods: A prospective study included 46 patients who underwent primary TKA. We used the (Flir One Gen 3) thermographic camera to capture images at ankle joint preoperatively, and at 1, 10, and 20 minutes post tourniquet release on operation side. The contralateral ankle stands as control. Results: The mean preoperative temperature (in Celsius) of ankle control side and operated side were 33.03 (SD=1.65) and 33.26 (SD=1.42), respectively. The mean ankle temperature on operation side was 19.73 (SD=2.85), 30.49 (SD=2), and 32.43 (SD=1.31) at 1, 10, and 20 minutes post tourniquet release, respectively, while the control side showed a mean temperature of 32.85 (SD=1.42), 32.84 (SD=0.91), and 33.15 (SD=0.95) at the same time intervals. There was a significant statistical difference between both ankle temperatures at 1 and 10 minutes (P=0.00 for each time). At 20 minutes, 37 ankles (80.4%) at operation side reached a temperature level similar but below the level of control side; however, the difference was not significant (P=0.692). Conclusion: Infrared thermography using the smartphone-connected camera is a simple, non-invasive, feasible, and reliable technology. It provides an objective measure to assess the perfusion status of the limbs. In TKA, the distal limb will reach full reperfusion status after approximately 20 minutes of tourniquet release.
Background: Thymomas, although rare, remain the most frequently encountered primary tumor of the anterior mediastinum comprising about 50% of all masses in the region. Surgical resection, via thymectomy, remains the mainstay treatment modality conventionally. In locally advanced and borderline resectable tumors, neoadjuvant chemotherapy may be utilized to increase the chance of R0 resection. Therefore, questions of efficacy and safety of the NACT arise.Methods: Data from 25 patients (10 NACT vs 15 primary surgery) who had undergone tumor resection (January 2015-October 2021) was collected from electronic medical records at the King Hussein Cancer Center. Both radiological and pathological tools used to assess the effect of neoadjuvant chemotherapy on tumor. CT scan was used to delineate clinical staging, tumor size and to detect post-therapeutic variations in tumor burden. The response evaluation criteria in solid tumors (RECIST) was used to classify the effect of neoadjuvant chemotherapy (NACT) on tumor burden as complete response (CR), partial response (PR), stable disease (SD), or progressive disease (PD). The pathological response was determined by measuring the percentage of necrotic tissue.Results: The majority of patients were male. Mean age 46.28 +-15.31 at diagnosis. Distribution among stages was as followed; stage I (4; 16%), stage II (7; 28%), stage III (7; 28%), stage IV (7; 28%). Patients who received NACT were evenly distributed among stages III and IV accounting for 71.4% each. Eleven patients underwent VATS tumor resection; one of them is in the NACT group (10%). Negative resection margins in 96%; 24 patients. Patients received 3–6 cycles of platinum-based NACT. A single patient who received definitive radiation and 12 cycles of chemotherapy outside our center developed chemotherapy induced heart failure and died immediately postoperatively. No other patients reported severe toxicity. The mean change in tumor volume and maximum diameter was 165 cm3 (p = 0.079) and 1.53 +- 1.49 cm (p < 0.01) respectively. Tumor diameter stratified according to stage showed a variation of 2.0+- 1.6 cm in stage IVa (p = 0.02) and 1+-1.35 cm in stage III (p = 0.08), respectively. The effect of NACT on tumor burden based on RECIST criteria was minimal as 80% (n = 8) of patients had SD and the remaining 2 patients had PR and PD. Based on pathological findings, the average necrotic portion of the tumor was 39.5%.; 23% in stage III and 56% in stage IVa (p = 0.152). The overall survival rate is 91.2%, mean survival was 115 months (4-125). Recurrence occurred in 28% (n = 7). The NACT group had a higher risk for recurrence (5; 50%) with a mean survival of 43.8 months compared to 59.6 months in those who did not receive induction therapy.Conclusions: The exact role of induction chemotherapy in locally advanced thymoma patients theoretically to increase the chance of R0 resection remains controversial. Though our study group number is small but we combined both radiological and pathological tools for better assessment of neoadjuvant chemotherapy effect on tumor burden, we found that the radiographic and histopathological effect of NACT on thymic tumors is minimal especially on stage III with the greatest variation in tumor burden is in Stage IVa. However, NACT was not found to significantly improve oncological outcomes compared to upfront surgery in locally advanced disease. To further demonstrate the impact of induction chemotherapy, we recommend multicentric collaborative studies.
Objectives: The incidence of bladder cancer in the Middle East is increasing. Nevertheless, data on the young population with urothelial carcinoma (UC) of the urinary bladder in this region is scarce. Therefore, we evaluated clinical and tumor characteristics, in addition to treatment details in patients younger than 45 years old. Methodology: We reviewed all patients presenting with UC of the urinary bladder from July 2006 to December 2019. Clinical characteristics including demographics, stage at presentation, and treatment outcomes were extracted. Results: Out of 1272 new cases of bladder cancer, a total of 112 (8.8%) patients were ≤45 years old. Seven patients (6%) had nonurothelial histology and were excluded from the study. The remaining 105 eligible patients with UC had a median age at presentation of 41 years (35–43). Ninety-three patients (88.6%) were males. Tumor stage at presentation: nonmuscle invasive disease (Ta-T1), locally advanced muscle-invasive bladder cancer (MIBC) (T2-3), and metastatic disease were 84.7%, 2.8%, and 12.5%, respectively. All patients with MIBC received neoadjuvant cisplatin-based chemotherapy. Radical cystectomy was performed in 8 (7.6%) cases; three patients with MIBC and five with high-volume non-MIBC. Neobladder reconstruction was done in six patients. A total of 13 patients with metastatic disease (93%) received palliative chemotherapy (gemcitabine/cisplatin), and one (7%) was a candidate for best supportive care only. Conclusion: Bladder cancer is relatively rare in the young population, although the incidence at our region is higher than other reports in the literature. Most patients present with early disease. Early diagnosis and multidisciplinary approach are paramount for the management of these patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.