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Esophagogastric Anastomosis with Invagination of Esophageal Stump into Stomach versus Direct End To End Anastomosis after Subtotal Esophagectomy for Esophageal Cancer: Tertiary Centre Experience.

Mahmoud Hussein Elshoieby, and Khalid Rezk and Hussein Fakhry

Surgical Oncology Department, South Egypt Cancer Institute, Assiut University. elshoieby@live.co.uk

Abstract: Background: We aim to compare the outcome of two techniques of recontinuity after subtotal esophagectomy for esophageal cancer: cervical esophagogastricanastomosis with invagination of the cervical esophageal stump and direct end to end anastomosis with gastric tube, mainly for incidence of post-operative fistula and stenosis. Patients & Methods: A prospective included all operable patients admitted to South Egypt Cancer Institute in period of beginning of 2013 to end of 2015 with cancer middle and lower third cancer esophagus underwent subtotal esophagectomy with cervical esophagogastric anastomosis. Patients were grouped according to the method of recontinuity into 2 groups: - Group 1: cervical esophagogastricanastomosis with invagination of the cervical esophageal stump (21 patients). - Group 2: direct end to end cervical esophagogastricanastomosis with gastric tube (21 patients). Results: Postoperative fistula at esophagogastric anastomosis was diagnosed in 9 (21.4%) patients, 7 patients had minimal leakage of air or saliva through cervical incision while 2 patients had mild to moderate leakage which required fistula repair. Postoperative stenosis was noticed 13 (31%) patients whom were managed well by regular endoscopic dilatation. Incidence of postoperative fistula was significantly lower in group I compared to group II (3 (33.3%) versus 6 (66.7%), p= 0.040). Similarly, incidence of postoperative stenosis was significantly lower in group I compared to group II (4 (30.8%) versus 9 (69.2%), P = 0.036). Conclusions: cervical esophagogastric anastomosis with invagination of the proximal esophageal stump into the stomach after subtotal esophagogastrectomy in patients with esophageal cancer is better and advantageous over conventional direct end to end esophagogastricanastomosis regarding postoperative fistula and stenosis.

[Mahmoud Hussein Elshoieby, and Khalid Rezk and Hussein Fakhry. Esophagogastric Anastomosis with Invagination of Esophageal Stump into Stomach versus Direct End To End Anastomosis after Subtotal Esophagectomy for Esophageal Cancer: Tertiary Centre Experience. Cancer Biology 2018;8(3):1-8]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 1. doi:10.7537/marscbj080318.01.

Key Words: Esophageal cancer, Esophagogastric anastomosis, Invagination of esophageal stump, Telescopic surgery, Esophageal fistula

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Signet ring carcinoma of the stomach: impact on prognosis and outcome

Khalid Rezk¹, Hanan Ahmed Mohammed², Mayada Fawzy Sedik² and Ahmed Refaat Abd Elzaher²

¹Surgical oncology department, South Egypt Cancer Institute, Assuit University, Egypt

²Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Egypt

rezk.khalid@gmail.com

Abstract: Background: Signet ring cell carcinoma (SRC) of the stomach is a histological type based on microscopic characteristics. SRC's clinicopathological characteristics and prognosis are still controversial. This study compared the clinicopathological features and prognosis of patients with SRC carcinoma with those with non-signet ring cell carcinoma of the stomach (NSRC). Patients and methods: We retrospectively analyzed data from 109 patients who had gastric carcinoma, including 30 SRC and 79 NSRC. Results: No significant differences existed with respect to age, tumour size, depth of invasion and lymph node metastasis between the patients with SRC histology and NSRC. The overall survival not affected by different histopathological types of gastric carcinoma (P= 0.699). Conclusion: Patients with SRC histology do not have a worse prognosis than those with NSRC.

[Khalid Rezk, Hanan Ahmed Mohammed, Mayada Fawzy Sedik  and Ahmed Refaat Abd Elzaher. Signet ring carcinoma of the stomach: impact on prognosis and outcome. Cancer Biology 2018;8(3):9-13]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 2. doi:10.7537/marscbj080318.02.

Keyword: gastric cancer, prognosis, signet ring cell carcinoma

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Analysis of Volumetric Changes in Rectal Cancer Patients during Preoperative Chemo-Radiation Therapy Using Weekly Cone-Beam Computed Tomography

Hanan Darwish, M.D, Moustafa Al Daly, M.D, Felix Sinzabakira, M.Sc, Wedad Hashem, M.D

Department of Clinical Oncology, Kasr Al-Ainy School of Medicine, Cairo University, Egypt

moustafadaly@yahoo.com, weedo_82@hotmail.com

Abstract: Objectives: The purpose of this study was to quantify the rectum & bladder volume changes, as well as assessing the motion of rectum during pre-operative Concurrent Chemo-Radiation Therapy (CRT) in rectal cancer patients, using Simulator Cone Beam Computed Tomography [CBCT] scans. Patients and Methods: Between the period of June 2017 and January 2018, 10 consecutive patients with histologically proven, locally advanced rectal adenocarcinoma were enrolled in this study. They received preoperative CRT in Al Kasr Al Ainy Center of Clinical Oncology and Nuclear Medicine (NEMROCK), Cairo University. Weekly CBCTs were acquired by Varian Acuity simulator function (Varian medical systems, Inc. Palo Alto, CA, USA) by re-simulating patients with the same treatment position and isocenter. Variation of rectal and bladder volumes (cm³) for each CBCT image were calculated and compared to the baseline planning CT. Assessment of the inter-fraction movement of the rectum was also studied. Results: All patients exhibited a significant linear decrease in the mean rectal volume compared with planning over the treatment course (28.66 vs 61.07 cc; P= 0.0001). An average volume reduction of 53% was found between the start and the end of treatment; almost all reduction was observed in the second half of the treatment course. The mean bladder volume was decreased on CBCTs compared to planning CT (149.85 vs 167.00 cc) but without statistical significant difference (P=0.36). A significant rectal movement was noted more in AP and lateral directions among all patients. The majority of rectal wall displacements were observed in the upper and middle region (P= 0.05) while it was minimal in the lower part (P=0.77). Conclusion: Despite the limited number of patients, the availability of weekly simulator CBCT images permitted the careful monitoring of each weekly rectal shape variation during CRT. Individualized asymmetric margins are recommended to adequately overcome the rectal movements.

[Hanan Darwish, Moustafa Al Daly, Felix Sinzabakira, Wedad Hashem. Analysis of Volumetric Changes in Rectal Cancer Patients during Preoperative Chemo-Radiation Therapy Using Weekly Cone-Beam Computed Tomography. Cancer Biology 2018;8(3):14-19]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 3. doi:10.7537/marscbj080318.03.

Key words: Cone Beam CT, Rectal volume, Bladder volume, Rectal movements

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HCMV among Pediatrics Acute Lymphoblastic Leukemia patients in South Egypt Cancer Institute

Mohamed H. Maher¹, Abdel-Rahman N Zekri², Mahmoud N. El-Rouby², Lobna Shalaby², Rania M. Bakry¹ and Khaled F Riad¹

¹South Egypt Cancer Institute, Assiut University, Egypt

²National Cancer Institute, Cairo University, Egypt

mhelmy@aun.edu.eg

Abstract: Background: Objective: Human Cytomegalovirus (HCMV) is one of the causes of morbidity and mortality in pediatric cancer patients. Patients and methods: Out of 48 newly diagnosed ALL pediatric cancer patients (age range 2 to 13 years); treated with Total XIII Chemotherapy protocol in SECI were studied for HCMV Seropositivity (IgM/IgG) and viremia in blood plasma via PCR at diagnosis (day 0) and on the end of Chemotherapy Induction phase (day 36). Results: Shown that at diagnosis (Day 0) IgG was positive in 21/48 (43.8%), equivocal in 10/48 (20.8%) and Negative in 17/48 (35.4%) of patients while IgM and plasma PCR were negative in 48/48 (100%) of cases and upon repeating the same panel at the end of Induction phase (day 36) we observed complete Seroconversion with 48/48 (100%) of patients with negative IgG, IgM and PCR were also Negative and when reviewing the BMA results at the end of induction we have found that only 2/21 (9.5%) of patients failed to reach Bone Marrow Remission; both were HCMV IgG positive. Conclusion: No observation of Acute CMV Infection either recent before cancer diagnosis, Hospital Acquired or even reactivation through chemotherapy induction phase treatment; further studies are to be made to assure HCMV impact on cancer treatment outcome in SECI

[Mohamed H. Maher, Abdel-Rahman N Zekri, Mahmoud N. El-Rouby, Lobna Shalaby, Rania M. Bakry and Khaled F Riad. HCMV among Pediatrics Acute Lymphoblastic Leukemia patients in South Egypt Cancer Institute. Cancer Biology 2018;8(3):20-23]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 4. doi:10.7537/marscbj080318.04.

Keywords: HCMV - Pediatrics ALL - Virology

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Adjuvant chemotherapy for elderly (>65 years) breast cancer patients: a retrospective study

Soha Mohammed Talima MD

Department of Clinical Oncology & Nuclear Medicine, Kaser Alainy Faculty of Medicine, Cairo University, Egypt

soha_talima@hotmail.com

Abstract: Background: The substitution of docetaxel for doxorubicinthus creating a non-anthracycline combination for adjuvant therapy has proven its activity. However, scares data about the efficacy and toxicity of these different regimens are present in older patients with breast cancer. Therefore, we performed a retrospective analysis comparing Anthracycline based chemotherapy versus regimens with no Anthracyclines in the adjuvant chemotherapy regimens. Patients and methods: Charts of all consecutive elderly patients aged 65 years or more with operable BC referred to our institution between 2008 and 2015 were reviewed. Patients had stage I, II, or III breast cancer; and received adjuvant chemotherapy consisting of CMF, an Anthracycline-based regimen (FAC or FEC and TC. Data DFS, overall survival and toxicities of these regimens were calculated. Results: One hundred twenty patients were included, with a mean age of 69 (range 65–91); with stages: I (5%), II (27.5%), III (57.5%), unknown stage (10%). Forty-eight percent of the patients received anthracycline-based regimen, 30.8% received CMF and 20.8% received TC. The DFS was as follow 73 months for TC group,43.5 months for Anthracyclines (FAC) and 36.5 months for CMF group (p < 0.08). Five-year OS was 88% for TC, 85% for Anthracyclines, and 77% for CMF (p < 0.6). Moreneutropenia experienced more during Anthracycline based chemotherapy (22.4%) as compared TC (16%) or CMF (13.5%). Treatment delays due to myelosuppression occurred more frequently in patients receiving Anthracycline based regimens. Conclusion: TC was associated with a superior DFS, OS as compared with Anthracycline based chemotherapy and CMF.

[Soha Mohammed Talima. Adjuvant chemotherapy for elderly (>65 years) breast cancer patients: a retrospective study. Cancer Biology 2018;8(3):24-30]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 5. doi:10.7537/marscbj080318.05.

Keywords: Chemotherapy-elderly-Anthracycline-Taxanes

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Association of SNPs in miR-196a2 with the risk of Ovarian Cancer and its relation with Clinicopathological data

Abeer Ismail¹, Ghada Mohamed², Marwa Fathy Amer³, Fatama AL-Zahraa Mohamed⁴

¹Department of Clinical & Chemical Pathology, NCI, Cairo University, Egypt

²Department of Pathology, NCI, Cairo University, Egypt

³Department of Medical Biochemistry, Cairo University, Egypt

⁴Department of biochemistry, Faculty of Pharmacy (Gils), AL-Azhar University, Egypt

abeersalah1@hotmail.com

Abstract: Objective: The rs11614913 polymorphism of miR-196a2 is associated with carcinogenesis in several types of cancer. This study aims to investigate the association between miR-196a-2 (rs11614913) SNP and ovarian cancer risk in a group of Egyptian patients. Methods: This retrospective study included 50 newly-diagnosed patients with different stages of ovarian cancer, 15 patients with benign ovarian tumors, and 35 healthy female volunteers as a control group. Venous blood samples were collected to detect serum CA-125 and serum HE4 in addition to DNA extraction and detection of miR-196a2 (rs11614913) SNP. Results: Ovarian cancers were mostly epithelial with advanced stage. Ovarian cancer group had significantly higher frequencies of CT and TT genotypes compared to controls, and benign ovarian groups separated (p = 0.037) or combined (p = 0.008). The presence of CT genotype is associated with a risk of developing ovarian cancer with an OR of 3.9 (95%CI: 1.5-10.2). The TT genotype was associated with a risk of developing ovarian cancer with an OR of 3.8 (95%CI: 1.3-10.9). The T allele was associated with a risk of developing ovarian cancer with an OR of 2.4 (95%CI: 1.3-4.2). CT/TT genotypes were significantly associated with advanced stage (p = 0.004) and presence of metastasis (p < 0.001), but not associated with grade (p = 0.629), or levels of tumor markers. Conclusion: ThemiR-196a-2 rs11614913 polymorphism may serve as a diagnostic and prognostic biomarker in ovarian cancer.

[Abeer Ismail, Ghada Mohamed, Marwa Fathy Amer, Fatama AL-Zahraa Mohamed. Association of SNPs in miR-196a2 with the risk of Ovarian Cancer and its relation with Clinicopathological data. Cancer Biology 2018;8(3):31-37]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 6. doi:10.7537/marscbj080318.06

Keywords: Association; SNPs; miR-196a2; risk; Ovarian; Cancer; relation; Clinicopathological data

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Comparison of Zoledronic Acid Every 12 Weeks versus Slandered 4 Weeks Regimen in Breast Cancer Patients with Bone Involvement

Emad Sadaka¹ and Rasha Khedr²

¹Clinical Oncology Department, Faculty of Medicine, Kafer Elsheikh University, Egypt

²Clinical Oncology Department, Faculty of Medicine, Tanta University, Egypt

e_sadaka@hotmail.com

Abstract: Purpose: The present study is to evaluate the 12 weeks interval of zoledronic acid compared to the 4 weeks regimen. Methods: Patients were distributed in 2 groups, for receive 4.0 mg of intrvenous zoledrnic acid every four weeks (group 1) or 12 weeks (group 2) / year. One hundred and forty patients (140) were enroled in this study on 69 patients randomlly to receive zoledrnic acid every four weeks and 71patients randomly receive zoledronic acid every 12 weeks. The primary endpoint was the proportion of patients having at least 1 SRE within 1 year after that. Secondary end points included pain, the incidences of adverse events of zoledrnic acid (osteoncrosis and renal dysfunction) and the skeletal morbidity rate. Results: After 1 years of follow-up, SREs occurred in 15 (21.7%) patients in the zoledrnic acid every 4 weeks group and 16 (22.5%) patients in zoledrnic acid every 12 weeks group; (noninferiority with P= 0.910). The time to first SRE between treatment groups was not statistically significantly different (hazard ratio [HR], 1.04; 95% CI, 0.52-2.1; P = 0.903). According to pain score the 2 treatment groups was not statistic significant different (p=0.595). The mean skeletal morbidity rate (SMR) 0.46 (1.06) vs 0.50 (1.50) events per year in the every four weeks versus every 12 weeks groups (P = .85). Conclusion: Zoledrnic acid every 12 weeks compared with every 4 weeks did not result in an increased risk of skeletal events, seems to be noniferior and may be an acceptable treatment option.

[Emad Sadaka and Rasha Khedr. Comparison of Zoledronic Acid Every 12 Weeks versus Slandered 4 Weeks Regimen in Breast Cancer Patients with Bone Involvement. Cancer Biology 2018;8(3):38-41]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 7. doi:10.7537/marscbj080318.07.

Keywords: Zoledronic acid, skeletal events, adverse events

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Impact of Breast Cancer Molecular Subtypes on the Incidence of Axilllarylymhp Nodes Metastases

Emad Sadaka¹ and Walid Almorsy²

¹Clinical Oncology Department, Faculty of Medicine, Kafer Elsheikh University, Egypt

²Clinical Oncology Department, Faculty of Medicine, Tanta University, Egypt

e_sadaka@hotmail.com

Abstract: Purpose: Breast cancer has at least four molecular subtypes with significant differences in prognosis and ALN involvement. This study aimed to investigate the impact of breast cancer molecular subtypes on the incidence of axillarylymph nodes metastases Methods: Three hundred and twenty-nine female patients with invasive breast cancer were included in this study. Age at diagnosis, menopausal status, tumor size, type and grade, lymph node status and molecular subtypes were recorded. Four major molecular subtypes were classified, Luminal A; Luminal B, HER2+ and triple negative. Results: The mean age was 51.34 years old. Most of patients (86.9%) have Invasive ductal carcinoma. One hundred sixty four (49.5%) patients had node negative disease while 166 (50.5%) had node positive disease. Luminal A molecular subtype was recorded in 87 patients (26.4%), luminal B 163 patients (49.5%), HER-2+ 35 patients (10.6%) and TNBC 44 patients (13.5%). There are differences in ALN positivity by molecular subtypes, node positive disease was (11.5%) among luminal A patients, luminal B patients (66.9%), HER2+ (91.4%) and TNBC (34.1%). There were significant correlation between molecular subtypes and nodal status (p=0.03 for luminal B and <0.001 for luminal A, HER 2 positive and triple negative). Conclusion: luminal B and HER2+ve breast cancer subtypes were more likely to be associated with ALNM. Also, tumor size and a grade, LVI and ki67 were correlated with lymph node status. Further confirmatory studies are necessary to define factors that predict ALN metastases.

[Emad Sadaka and Walid Almorsy. Impact of Breast Cancer Molecular Subtypes on the Incidence of Axilllarylymhp Nodes Metastases. Cancer Biology 2018;8(3):42-46]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 8. doi:10.7537/marscbj080318.08.

Keywords: Breast cancer, molecularsubtypes, axillary lymph nodes metastases

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Lymph node ratio as prognostic factor in patients with stage III rectal carcinoma

Nehal El-Mashad M.D.¹, Mohamed A Alm El-Din M.D. ¹,Wael Wahid Mayah M.D. ²^,5, Boshra El-Sayed Hussein M.D. ², Ali M Turki M.D.³, Sherif El-Saadany M.D.²^,4 Wael M. Elmashad M.D ⁶

¹ Department of Clinical Oncology, Faculty of Medicine, Tanta University, Egypt

² Department of Tropical Medicine and Infectious Diseases, Faculty of Medicine, Tanta University, Egypt

³ Department of General Surgery, Faculty of Medicine, Tanta University, Egypt.

⁴ Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia

⁵Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia

⁶ Physiology Department, Faculty of Medicine, Tanta University Hospital, Egypt

almeldin@gmail.com

Abstract: Introduction: Although the predictive and prognostic importance of total number of infiltrated lymph nodes in rectal cancer is well established, the role of lymph node ratio (LNR) is yet to be defined.

Objective: To test the prognostic value of LNR in patients with rectal cancer. Patients and Methods: Data of 232 patients with stage III rectal adenocarcinoma who were treated at the department of Clinical Oncology, Tanta University Hospital from January 2008 to December 2012 was retrospectively analyzed. Only data of 107 were eligible for our study. The cut-off values of LNRs were statistically calculated as 0.21, 0.32, and 0.61 dividing the patients into four groups (LNR 1-4). Results: A higher LNR value is significantly correlated with higher tumor grade (P= 0.004), margin involvement, local recurrence and distant metastasis (P = <0.001). Overall Survival (OS) for all patients is 93.2%. Patients with < 12 resected lymph nodes (LNs) have significantly shorter OS (86.1%) than those with ≥12 resected LNs (100%) P value = 0.024. According to LNR, OS for patients with LNR1, LNR2, LNR3 is 100% as compared to 83.3% in those with LNR4 (P value = 0.073). Patients with < 12 resected LN have significantly shorter DFS (16.8 %) than those with ≥12 resected LN (90.7%) P value < 0.001. Similarly, patients with LNR4 have significantly shorter DFS as compared to the three other groups (LNR1-3). Conclusions: Higher LNRs (more than or equal to 0.61) have strong independent prognostic impact in stage III rectal cancer, and should be considered for treatment decision making.

[Nehal El-Mashad, Mohamed A Alm El-Din, Wael Wahid Mayah, Boshra El-Sayed Hussein, Ali M Turki, Sherif El-Saadany, Wael M. Elmashad. Lymph node ratio as prognostic factor in patients with stage III rectal carcinoma. Cancer Biology 2018;8(3):47-55]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 9. doi:10.7537/marscbj080318.09.

Keywords: Rectal cancer, Lymph node ratios.

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Comparison between Vaginal Delivery and Caesarean Section in Preeclampsia at Tertiary Care Hospital in Egypt

Laila Ezzat

Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt

lailaezzat972000@gmail.com

Abstract: Introduction: Preeclampsia is a Pregnancy Induced Hypertension (PIH) of unknown etiology. PIH causes intra uterine growth retardation (IUGR), pre-mature delivery, intra uterine fetal death, (IUFD), abruption placentae. It also causes increase morbidity and mortality among pregnant women. The cause for (PET) is unknown, there appear to be certain risk factors associated with the condition. The factors that have been postulated to influence the risk of (PET) among the mothers include diabetes, obesity, multiple gestation, primiparity, age, personal or family history of (PET), and chronic hypertension Methods: Retrospective study at Aswan University Hospital from January 1/2013 to December 31/2013. Pateint diagnosed by (systolic blood pressure 160 or more and/or diastolic blood pressure 110 or more in two occasion four hours apart in semi setting position plus 24hrs protein collection in urine 5 gram or more). Results: 152 were delivered by caesarean section (CS) with incidence (64.95%) and 82 patients terminated by vaginal delivery (VD) with incidence 35.04% PET was more common in the age group 21-30 years 99 cases with incidence (42.3%) and less common in the age group >37 years 23 cases with incidence (9.82%) prematurity 35 cases in CS delivery with incidence (23.02%) versus 16 cases in VD with incidence (19.51%) accidental haemorrhage cases 2 in CS with incidence (1.31%) versus 2cases in VD with incidence (2.43 %), acute renal failure 2 cases in VD with incidence (2.43 %). Conclusion: PET increases the incidence of CS rate to prevent maternal complications of PET and ET. CS if done promptly leads to more favourable outcome than conservative obstetric management with vaginal delivery in sever PET especially in PG after 28 weeks. Termination of pregnancy by CS reduces maternal morbidity improves maternal outcome by reducing complications.

[Laila Ezzat. Comparison between Vaginal Delivery and Caesarean Section in Preeclampsia at Tertiary Care Hospital in Egypt. Cancer Biology 2018;8(3):56-59]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 10. doi:10.7537/marscbj080318.10.

Key Words: Preeclampsia, caesarean section, vaginal delivery, Outcome and complications.

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The Outcome of Radiotherapy (Rapid Arc) Versus Supportive Care in Management of Inoperable Hepatocellular Carcinoma Not Amenable to Local Ablative Therapies

A. Mounir M. D. and S. Nassar MSc.

Clinical Oncology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

drsarahnassar@gmail.com

Abstract: Background: To assess the role of volumetric modulated arc therapy (VMAT) in management of advanced Hepatocellular carcinoma (HCC) patients and compare survival outcome with Best Supportive Care (BSC) as well as the response rate and toxicity of VMAT. Method: Fifty patients were enrolled in the study and divided into two groups, arm (A) which is radiotherapy included 25 patients received radiation therapy 50.4Gy in 28 fractions and arm (B) which is Best Supportive Care where patients received palliative care in the form of pain management, nutritional and liver support. Median age of the whole group is 56.5 years, the majority are males who are HCV positive carriers > 90%. More than 50% are child Pugh (B), the rest are (A). according to BCLC staging 48% of the patients are stage C. Patients in both arms are closely similar regarding baseline clinical and pathological parameters. Results: Median progression free survival (PFS) in arm A was 6.9 months versus 5.9 months for arm B and this was statistically significant with P-value =0.01, but median Overall Survival (OS) was equal in both arms (10 months in both) with P = 0.5. The overall response rate (ORR) is 44% (1 patient had Complete Response (CR) and 10 patients had Partial Response (PR). Tumor response and performance status (PS) are the 2 most important prognostic factors that shows statistical significant difference with overall survival in arm (A), where patients with CR or PR had longer OS survival (12 months) compared to those with Stationary Disease (SD) (10 months) or Progressive Disease (PD) (4 months) with P-value 0.001. Also patients with PS 1 had longer survival (10 months) compared to those with PS 2 (6 months) with P-value 0.01. The most common toxicity with radiation was radiation induced liver disease (RILD) (28%) and the most important factor associated With the occurrence of RILD was the planning target volume (PTV) (P=0.02). Conclusion: Radiotherapy with VMAT provides PFS advantage over BSC and achieved a good response rate in patients with advanced Hepatocellular carcinoma and patients who had a good response lived longer than patients who had poor response.

[A. Mounir and S. Nassar. The Outcome of Radiotherapy (Rapid Arc) Versus Supportive Care in Management of Inoperable Hepatocellular Carcinoma Not Amenable to Local Ablative Therapies. Cancer Biology 2018;8(3):60-69]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 11. doi:10.7537/marscbj080318.11.

Key words: Hepatocellular carcinoma, radiotherapy, RapidArc, VMAT, Best Supportive Care

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 Immunohistochemical expression of 5-Hydroxymethylcytosine (5hmC) and mutational analysis of IDH1 gene in patients with diffuse astrocytoma WHO grade II: clinical value and impact on survival

Fatma Gharib¹, Omnia Abd –El-Fattah¹, Yomna zamzam², Ayman Elsaka² and Mona Mohamed Watany³

¹Departments of Clinical Oncology, ² Pathology and

³ Clinical Pathology, Tanta University Hospitals, Egypt.

omniaabdelfattah@yahoo.com

Abstract: Background: Diffuse astrocytoma (WHO grade II) is a primary low-grade, slow growing tumor, but has high recurrence rate. The 2016 edition of WHO classification, classified gliomas according to histopathologic appearance and molecular parameters. 5-Hydroxymethylcytosine (5hmC) is considerable epigenetic marker. Regulation of 5hmC in malignant glioma may represent an important determinant of tumor differentiation and aggressive behavior. Aim: our study measured the level of 5hmC in diffuse astrocytoma WHO grade II and analyze its relationship with other molecular markers to investigate their potential roles as prognostic indicator for astrocytoma patients. Patients & Methods: This prospective study included 55 adult patients with histologically confirmed grade II astrocytoma on the basis of WHO grading system. Those patients treated at Tanta University Hospitals through the period from January 2015 to June 2018. Results: low level of 5hmC was significantly associated with tumor size ≥5cm (P < 0.001), but there was nonsignificant correlation between 5hmc level and age, gender, location and extent of resection. Also, there is significant correlation between high level of 5hmC and presence of isocitrate dehydrogenase1(IDH1) mutation, low level Ki-67 and low level of P53 (P <0.001, P=0.007 and P=0.001 respectively). Univariate analysis revealed significant correlation between overall survival and 5hmC, IDH1 status and Ki-67.

Conclusion Molecular classification may frame diffuse infiltrating astrocytomas into variable pathogenic and prognostic groups, to allow better treatment strategies.

[Fatma Gharib, Omnia Abd –El-Fattah, Yomna zamzam, Ayman Elsaka and Mona Mohamed Watany. Immunohistochemical expression of 5-Hydroxymethylcytosine (5hmC) and mutational analysis of IDH1gene in patients with diffuse astrocytoma WHO grade II: clinical value and impact on survival. Cancer Biology 2018;8(3):70-76]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 12. doi:10.7537/marscbj080318.12.

Key words: Diffuse astrocytoma WHO grade II. 5-Hydroxymethylcytosine. isocitrate dehydrogenase1 mutation.

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Programmed Cell Death and Cancer Biology Research Literatures

Mark Herbert, PhD

39-06 Main Street, Flushing, Queens, New York 11354, USA, ma8080@gmail.com

Abstract: Cancer is the general name for a group of more than 100 diseases. Although there are many kinds of cancer, all cancers start because abnormal cells grow out of control. Untreated cancers can cause serious illness and death. The body is made up of trillions of living cells. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person’s life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. This article introduces recent research reports as references in the related studies.

[Mark H. Programmed Cell Death and Cancer Biology Research Literatures. Cancer Biology 2018;8(3):77-135]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 13. doi:10.7537/marscbj080318.13.

Key words: cancer; life; research; literature; cell

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Idiopathic Granulomatous Mastitis: A Three-Year Experience at the National Cancer Institute, Egypt

Dr. Ihab Saad Hussein Ahmed¹, Prof. Dr. Mona Ali Sakr², Dr. Anthony Nozhy Ghalioum Abd El Messeh¹ Dr. Ibrahim Abdelaziz Ibrahim Malash³

¹Surgical Oncology Department, National Cancer Institute, Cairo University, Egypt

²Surgical Pathology Department, National Cancer Institute, Cairo University, Egypt

³Medical Oncology Department, National Cancer Institute, Cairo University, Egypt

Ihab.saad@nci.cu.edu.eg; drihab2013@gmail.com

Abstract: Purpose: Idiopathic granulomatous mastitis (IGM) is a rare, benign, chronic, inflammatory lesion of the breast. This study is a retrospective analysis of diagnostic and therapeutic approaches of IGM at the National Cancer Institute (NCI), Cairo University. Patients and Methods: This retrospective study included 86 patients with IGM who attended the NCI during the period between January 2012 and January 2015. The medical records of these patients were revised to retrieve data concerning different diagnostic and therapeutic approaches. Results: The median age of the patients was 35 years (range 20-50 years). The lesion was unilateral in all patients, mostly presenting with an irregular breast mass (79.1%). Radiological findings (by ultrasonography or sono-mammography) were misleading; the main finding was an irregular, ill-defined suspicious breast mass (48.8%). Diagnosis was established only by biopsy and histopathological examination via core biopsy (n=48), FNAC (n=13), FNAC and core biopsy (n=5), or excisional biopsy (n=20). Two treatment approaches were offered; wide surgical excision (n=59, 68.6%) or medical treatment (n=26, 30.2%). One patient was treated by simple mastectomy. Following surgery, 37 cases (62.7%) did not suffer any recurrence clinically or radiologically. Eighteen patients (20.9%) received oral prednisolone tablets and 8 (9.3%) received antibiotics for two weeks (mostly amoxicillin) followed by steroid therapy. Recurrence rate was 30.7% after steroid therapy. Conclusion: Idiopathic granulomatous can be misdiagnosed as breast cancer due to ambiguous clinical and imaging profile. Biopsy is the only way to reach a definitive diagnosis. Wide local excision and steroid therapy had comparable results.

[Ihab Saad Hussein Ahmed, Mona Ali Sakr, Anthony Nozhy Ghalioum Abd El Messeh and Ibrahim Abdelaziz Ibrahim Malash. Idiopathic Granulomatous Mastitis: A Three-Year Experience at the National Cancer Institute, Egypt. Cancer Biology 2018;8(3):136-141]. ISSN: 2150-1041 (print); ISSN: 2150-105X (online). http://www.cancerbio.net. 14. doi:10.7537/marscbj080318.14.

Keywords: Idiopathic; Granulomatous; Mastitis; Cancer; Egypt

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