scholarly journals Survival Outcomes of Breast Cancer in Sudanese Women: A Hospital-Based Study

2021 ◽  
pp. 324-332
Author(s):  
Hiba F. Muddather ◽  
Moawia M. A. Elhassan ◽  
Areeg Faggad
Keyword(s):  
Breast Cancer ◽  
Clinical Stage ◽  
Advanced Stage ◽  
Survival Times ◽  
African Countries ◽  
Curative Intent ◽  
Central Sudan ◽  
Raising Awareness ◽  
Stage Disease ◽  
Clinicopathologic Factors

PURPOSE Breast cancer (BC) is the leading malignancy among Sudanese women. Yet, data on survival are limited. This study aimed to determine 5-year overall survival (OS) of BC in Sudanese women, and identify prognostic demographic and clinicopathologic factors. PATIENTS AND METHODS A hospital-based retrospective study was conducted by reviewing data of women with BC diagnosed and treated at the National Cancer Institute—University of Gezira during 2012, and followed up to end of August 2018. Data were retrieved from medical records and analyzed, OS was determined, and the prognostic factors were explored. RESULTS A total of 225 cases were recruited. The median age at presentation was 45 years (range, 22-85 years). Clinical stage I, II, III, and IV represented 3.1%, 31.6%, 48%, and 17.3%, respectively. Most women (81.3%) were treated with curative intent. Of those, 25.1% received neoadjuvant chemotherapy. Mastectomy was the commonest (61.7%) type of surgery. The median follow-up period was 59.8 months with mean OS time of 55.7 months. The 5-year cumulative survival rate was 58%. The 5-year OS rates for stages I, II, III, and IV were 71.5%, 82.4%, 56.5%, and 8.4%, respectively. For lymph node (LN)-positive cases, 5-year OS rate was 63% and for LN-negative was 83.5%. Presenting with advanced-stage disease and positive LN status associated with short OS times ( P < .005). CONCLUSION OS of women with BC in Central Sudan is worse than in the developed world, but similar to African countries. Our findings indicate that advanced stage at diagnosis and lymph nodal involvement are strong predictors of short survival times. Raising awareness and introducing early detection programs are critical for better survival of these patients.

Limited-Stage Mantle Cell Lymphoma

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5330-5330 ◽  
Author(s):  
Ritsuro Suzuki ◽  
Dai Chihara ◽  
Naoko Asano ◽  
Ken Ohmachi ◽  
Tomohiro Kinoshita ◽  
...  
Keyword(s):  
Research Funding ◽  
Cell Lymphoma ◽  
Clinical Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Advanced Stage ◽  
Limited Stage ◽  
Stage Disease

Abstract [Background] Mantle cell lymphoma (MCL) is an aggressive B-cell lymphoma, characterized by the overexpression of cyclin D1 derived from t(11;14)(q13;q32) and poor prognosis. Most MCLs show nodal presentation, but also accompany extranodal involvement, such as bone marrow, peripheral blood or gastrointestinal tract. As a result, many MCLs present with advanced stage disease. Since only a small portion of patients show limited-stage disease, minimal data exist on treatment of patients diagnosed with limited stage disease. Nevertheless, the treatment strategy of MCL is recommended according to the clinical stage of limited- (stage I or non-bulky II) vs. advanced-stage, as well as other types of lymphoma. [Patients and methods] We recently collected 633 patient data of MCL (Chihara, et al. Ann Oncol 2015). Information of clinical stage was available in 626 patients. The patient data were retrospectively analyzed the by the clinical stage at initial presentation. [Results] The clinical stage was I in 24 patients (4%), II in 33 (5%), III in 70 (11%), and IV in 499 (80%). Only one patient presented with bulky stage II. Detailed demographic information by the clinical stage are listed in Table. Age and sex were not significantly different by clinical stage. Limited stage patients were associated with better performance status (PS), less B symptoms, no extranodal involvement, and lower lactate dehydrogenase (LDH) level and white blood cell (WBC) count. Most patients in any stage were treated with cytotoxic chemotherapy, but more patients in limited stage received radiotherapy. The proportion of high-dose cytarabine (HDCA)-containing regimen over CHOP/CHOP-like was higher in advanced stage patients. Complete and overall response rates were 92% and 96% in stage I, 58% and 94% in stage II, 66% and 86% in stage III, and 52% and 82% in stage IV, respectively (P = 0.02). However, the higher response rate in limited stage patients did not translate into better prognosis. The median survival was 11.0 years in stage I, 13.4 years in stage II, 11.5 years in stage III, and 5.6 years in stage IV (Figure). The prognosis was not significantly different among patients with stage I, II, and III (P = 0.33). [Conclusion] Prognosis of limited-stage MCL was almost similar to that of stage III MCL. Although the present study includes several limitations including a retrospective nature and limited number of patients, prognosis of patients with limited-stage MCL was not satisfactory. The significance of radiotherapy, as well as the optimal choice of chemotherapy, for limited-stage MCL needs re-evaluation. Table Table. Figure Figure. Disclosures Suzuki: Chugai: Honoraria; Kyowa Hakko kirin: Honoraria; Bristol-Myers Squibb: Honoraria. Asano:Jannsen: Honoraria; Chugai: Honoraria. Kinoshita:Ono: Research Funding; Gilead: Research Funding; Zenyaku: Honoraria, Research Funding; Takeda: Research Funding; Chugai: Honoraria, Research Funding; Eisai: Honoraria, Research Funding; Solasia: Research Funding; Janssen: Honoraria; Kyowa Kirin: Honoraria. Suzumiya:Chugai: Honoraria, Research Funding; Astellas: Research Funding; Eisai: Honoraria, Research Funding; Takeda: Honoraria; Toyama Chemical: Research Funding; Kyowa Hakko kirin: Research Funding. Ogura:SymBio Pharmaceuticals: Consultancy, Honoraria; Celltrion, Inc.: Consultancy, Honoraria.

scholarly journals Downregulation of CCL22 and mutated NOTCH1 in tongue and mouth floor squamous cell carcinoma results in decreased Th2 cell recruitment and expression, predicting poor clinical outcome

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuejie Li ◽  
Zheqi Liu ◽  
Wenkai Zhou ◽  
Xiaofang Liu ◽  
Wei Cao
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Early Stage ◽  
Clinical Stage ◽  
Th2 Cells ◽  
Advanced Stage ◽  
Cell Recruitment ◽  
Th2 Cell ◽  
Stage Disease

Abstract Objective Tongue and mouth floor squamous cell carcinoma (T/MF SCC) exhibits a high rate of local recurrence and cervical lymph node metastasis. The effect of the tumor microenvironment on T/MF SCC remains unclear. Materials and methods Transcriptome and somatic mutation data of patients with T/MF SCC were obtained from HNSC projects of the Cancer Genome Atlas. Immune infiltration quantification in early- (clinical stage I–II) and advanced-stage (clinical stage III–IV) T/MF SCC was performed using single sample Gene Set Enrichment Analysis and MCPcounter. Differentially expressed gene data were filtered, and their function was assessed through Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses. Kaplan–Meier survival curve analysis and Cox regression model were conducted to evaluate the survival of patients with the CCL22 signature. Maftools was used to present the overview of somatic mutations. Results In T/MF SCC, T helper (Th)2 cell counts were significantly increased in patients with early-stage disease compared to those with advanced-stage disease. Expression of the Th2 cell-related chemokine, CCL22, was downregulated in patients with advanced-stage T/MF SCC. Univariate and multivariate Cox analyses revealed that CCL22 was a good prognostic factor in T/MF SCC. A nomogram based on the expression of CCL22 was constructed to serve as a prognostic indicator for T/MF SCC. NOTCH1 mutations were found at a higher rate in patients with advanced-stage T/MF SCC than in those with early-stage T/MF SCC, resulting in the inhibition of the activation of the NOTCH1-Th2 cell differentiation pathway. The expression levels of CCL22, GATA-3, and IL4 were higher in patients with early-stage T/MF SCC than in those with advanced-stage T/MF SCC. Conclusion In T/MF SCC, high expression of CCL22 may promote the recruitment of Th2 cells and help predict a better survival. Mutations in NOTCH1 inhibit the differentiation of Th2 cells, facilitating tumor progression through a decrease in Th2 cell recruitment and differentiation.

Demographics of uterine serous cancer (USC) patients: A single institutional experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15581-e15581
Author(s):  
Maria de Leon ◽  
Lingeng Lu ◽  
Pei Hui ◽  
Alessandro Santin ◽  
Thomas J. Rutherford ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Uterine Cancer ◽  
Figo Stage ◽  
Disease Stage ◽  
Prior History ◽  
Advanced Stage ◽  
Stage Disease ◽  
Seer Data ◽  
Institutional Experience ◽  
History Of

e15581 Background: The common uterine cancer (UC) occurs in obese, diabetic (DM), hypertensive (HTN), postmenopausal women and are estrogen dependent. Small institutional series suggest USC occurs in older, thin women and is not associated with estrogen dependency. The objective of this study is to report demographic features of USC patients (pts) in a large single-institution experience and compared them with SEER data for UC (National Cancer Institute, SEER 2004-2008, uterine cancer. http://seer.cancer.gov/statistics/ ). Methods: Institutional records were reviewed from 1987 to 2009. Pts age, menopause status, race, disease stage, histology, past medical history (PMH) and additional demographics were collected. Results: 334 USC (pts) were identified. Their average age at diagnosis was 69.1 years (range 37-92). 282 (88.1%) were Caucasian and 32 (10%) were African Americans. The FIGO stage was IA 121 (36.2%), IB 36 (10.8%), II 27 (8.1%), IIIA 39 (11.7%), IIIB 2 (0.6%), IIIC1 32 (9.6%), IIIC2 9 (2.7%), IVA 28 (8.4%) and IVB 40 (12%). PMH revealed 177 of 221 (80%) had HTN and 69 of 221 (32%) had DM. 132 of 292 (45.3%) were obese; 95 (32.5%) had BMI between 30-39,31 (10.6%) had BMI between 40-49 and 6 (2.1%) had BMI >50. 89 of 315 (28.2%) smoked cigarettes, 48 of 250 (19.2%) used oral contraceptives for an average of 4 years (range 1-15) and 42/299 (14%) used HRT for an average of 4 years (range 1-20). 35 (17.3%) had a prior history of breast cancer, 5 (2.5%) colon cancer and 13 (6.4%) had other forms of cancer. Compared to published SEER data1 for all UC, more USC pts were diagnosed with advanced stage disease (II-IVB) 53% vs. 28%. USC patients were older at diagnosis (mean age of 69 vs. 61 years). Conclusions: Like UC, USC often presents in obese (45.3%), hypertensive (80%) diabetic (33%) women who have a prior history of breast cancer (17%). However, USC typically is found in older pts and at a more advanced stage.

scholarly journals A Single Institution Experience of Incorporation of Cisplatin into Adjuvant Chemotherapy for Patients With Triple-Negative Breast Cancer of Unknown BRCA Mutation Status

2018 ◽  
Vol 12 ◽  
pp. 117955491879467 ◽  
Author(s):  
Ying-Wen Su ◽  
Chia-Yen Hung ◽  
Hung-Bun Lam ◽  
Yuan-Ching Chang ◽  
Po-Sheng Yang
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Triple Negative ◽  
Brca Mutation ◽  
Clinical Stage ◽  
Univariate Analysis ◽  
Mutation Status ◽  
Clinicopathologic Factors ◽  
The Mean

The clinical benefit of adding platinum to adjuvant chemotherapy for patients with triple-negative breast cancer (TNBC) has not been well investigated, although it was associated an improved response rate in neoadjuvant setting. We retrospectively analyzed the time to tumor progression (TTP) and overall survival (OS) of patients with resected stage I-III TNBC who were treated with or without cisplatin-containing chemotherapy (CisCT or noCisCT) during 2004 and 2010. Of 129 patients, 25 received CisCT. In univariate analysis, the mean TTP for CisCT and noCisCT was 4.42 and 5.88 years, respectively ( P = .004). The mean OS for CisCT and noCisCT was 6.76 and 9.63 years, respectively ( P = .24). After adjusting for other clinicopathologic factors, only clinical stage II/III disease was independently associated with worse OS. The adjusted hazard ratio for CisCT was 1.48 ( P = .46) and was not statistically significant. In this small retrospective study, adding cisplatin to adjuvant chemotherapy for early TNBC with unknown BRCA mutation status did not benefit OS.

scholarly journals Study characteristics affecting the responses to neoadjuvant chemotherapy and the prognosis of patients with bilateral breast cancer: A retrospective analysis

2019 ◽  
Author(s):  
Zhenrong Tang ◽  
Yihua Wang ◽  
Luo Yang ◽  
Ling Chen ◽  
Yingzi Zhang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Survival Time ◽  
Tumor Size ◽  
Breast Tumor ◽  
Molecular Subtype ◽  
Clinical Stage ◽  
Axillary Lymph ◽  
Tumor Type ◽  
Survival Times ◽  
The Right

Abstract BackgroundBilateral breast cancer (BBC) is defined as breast cancer diagnosed in both breasts in the same patient. Neoadjuvant chemotherapy (NAC) is a well-established approach to evaluate the tumor response to chemotherapeutic agents. The consensus is that different responses in characteristics after NAC can affect prognosis in unilateral breast cancer (UBC), but little is known about the responses of the BBC to NAC. This analysis explored the characteristics that can affect the prognosis of patients with BBC.MethodsThe characteristics of patients diagnosed with BBC (n = 126) was collected and the immunohistochemistry staining was used to detect expression levels of estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2. A statistical analysis of the differences was performed to identify the factors that affect survival times in all patients with BBC.ResultsA logistic regression indicated that the status of sentinel and axillary lymph node, expression of PR of the right breast tumor, and molecular subtype of the right breast tumor might relate to survival times. Tumor size, status of axillary lymph node, clinical stage, tumor type, histological grade, and molecular subtype of the left breast tumor might have a more profound effect on the survival time than the right breast tumor in the synchronous breast cancer (SBBC) patients. A multivariate analysis of overall survival times in patients with metachronous breast cancer (MBBC) showed that age was the only factor affecting survival time. After NAC treatment in SBBC patients, the Kaplan-Meier survival estimate showed that a decrease in tumor size, clinical stage, Ki67 and P53 levels were positive for a prolonged life span. However, a decrease in ER, PR, and HER2 were negative for prolonged life span. Changes in tumor type and molecular subtype also influenced the survival time.ConclusionCharacteristic changes in the left breast tumor were significant factors affecting survival times in patients with SBBC. After NAC treatment, changes in tumor size, Ki67, P53, ER, PR, and HER2 might affect the prognosis of patients with SBBC. For MBBC, only age was a factor affecting survival time. These findings provide clinical insight for the treatment of patients with BBC.

scholarly journals Characteristics of Breast Cancer at First Presentation in Sudanese Patients Attending the National Cancer Institute–University of Gezira (NCI–UG)

2020 ◽  
pp. 104-110
Author(s):  
Muna Ahmed Eltayeb ◽  
Areeg Faggad ◽  
Osama Sharafeldin Abbadi ◽  
Moawia Mohammed Ali Elhassan
Keyword(s):  
Breast Cancer ◽  
National Cancer Institute ◽  
Clinical Stage ◽  
Limited Resource ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Advanced Stage ◽  
Stage At Diagnosis ◽  
Cross Sectional ◽  
Resource Setting

Background: Little information is available about breast cancer (BC) in Sudan. Therefore, the present study aimed to provide baseline information about the demographic features and tumor characteristics, and also to investigate the associations between demographic variables and presentation stage in BC patients attending the National Cancer Institute-University of Gezira (NCI-UG), Sudan.Methods: In this cross-sectional study, we included all BC patients treated at the NCI-UG from January to December 2013. Patients' demographic, clinical and pathological data were retrieved from the hospital records and analyzed using SPSS version 20, and associations between these factors were tested as well.Results: A total of 232 cases were included in this research. The majority (97.8%) of subjects were females and 2.2% were males. The median age at diagnosis was 50 years (range, 22-90). The mean time between identification of symptoms and diagnosis was 13 months (SD=16.1). Clinical stages I, II, III, and IV represented 6.9%, 37.0%, 40.9% and 15.2%, respectively. Advanced stage at diagnosis was associated with longer duration between identifying the symptoms to diagnosis (P=0.006). Also the level of education of BC patients was significantly associated with clinical stage at presentation (P = 0.01).Conclusions: Sudanese patients with BC present at a younger age and with more advanced stage at diagnosis than those in developed countries. Patients' education level and duration from identification of BC symptoms to diagnosis significantly impact the stage at the time of presentation. In limited resource setting, early diagnosis of symptomatic BC is crucial in reducing the disease burden.

scholarly journals Patient delay impact on breast cancer survival at Khartoum Referral Hospital: a retrospective study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 862
Author(s):  
Amanda Elgoraish ◽  
Ahmed Alnory
Keyword(s):  
Breast Cancer ◽  
Demographic Data ◽  
Patient Delay ◽  
Diagnosis And Treatment ◽  
P Value ◽  
Fisher Exact Test ◽  
Advanced Stage ◽  
Breast Cancer Patients ◽  
Survival Times ◽  
Cross Sectional

Background: Breast cancer can be invasive and advanced at diagnosis causing enormous suffering and premature death. Delay to stage diagnosis and treatment is related to survival evaluation and several factors determine delay. The aim of the study was to examine predictor covariates associated with breast cancer delay and its impact on patient prognosis and survival. Methods: This retrospective cross-sectional hospital-based study was carried out at Khartoum Oncology Hospital. Participants were 411 breast cancer patients diagnosed and treated during the period 2016. Patients’ pathological and socio-demographic data were extracted from their medical files and delay data from telephone questionnaire survey and survival times calculated from follow-up. Fisher exact test, Cox and Logistic regression models were used to examine relationships between demographic, clinical and delay variables and survival outcome. Results: The mean age of the study subjects was 50.07 years old and the majority were ≥45 years. Cancer delay analysis showed that there were different reasons for different types of delay but the majority of participants (86.2%) claimed fear of the disease and treatment and lack of information were real drivers of delay. The study confirmed the majority of participants expressed  long delay estimated at 28.3 weeks and patient delay had a significant association with the advanced stage (P-value<0.05). The hazard ratio was four times for risk of dying from cancer for long delay compared to the short one. Conclusion: The results of the study suggest delays at diagnosis and treatment are more common steps leading to advanced stage at diagnosis and poor survival. Early detection of the disease provides tremendous opportunities for early diagnosis, effective treatment and high chances of survival.

Breast cancer burden in Africa: evidence from GLOBOCAN 2018

2020 ◽  
Author(s):  
Rajesh Sharma
Keyword(s):  
Breast Cancer ◽  
Central African Republic ◽  
The Gambia ◽  
Limited Resources ◽  
African Countries ◽  
Cancer Burden ◽  
Stage Disease ◽  
Incidence And Mortality ◽  
Standardized Mortality Rate ◽  
Mortality Estimates

Abstract Background Breast cancer is the leading malignancy in African females. This study aims to examine the breast cancer burden in Africa using recently released GLOBOCAN 2018 estimates. Methods The incidence and mortality estimates of age- and country-wise burden of breast cancer in 54 African countries were obtained from GLOBOCAN 2018. Results In Africa, breast cancer caused 74 072 deaths, and 168 690 cases were estimated to have occurred in 2018. The age-standardized incidence rate stood at 37.9/100 000 in Africa, varying from 6.9/100 000 in the Gambia to 69.6/100 000 in Mauritius. The age-standardized mortality rate stood at 17.2/100 000 in 2018, ranging from 4/100 000 in the Gambia to 29.1/100 000 in Somalia in 2018. Nigeria was the leading country in terms of absolute burden with 26 310 cases and 11 564 deaths, followed by Egypt with 23 081 new cases and 9254 deaths. The mortality-to-incidence ratio for Africa stood at 0.44, varying from 0.24 in Libya to 0.68 in the Central African Republic. Conclusion To tackle breast cancer burden in Africa, the main challenges are late-stage disease presentation, lack of screening and therapeutic infrastructure, lack of awareness and limited resources.

Circulating regulatory T cells in advanced breast cancer patients

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10567-10567
Author(s):  
M. V. Karamouzis ◽  
S. A. Perez ◽  
A. D. Gritzapis ◽  
A. Ardavanis ◽  
D. V. Skarlos ◽  
...  
Keyword(s):  
Breast Cancer ◽  
T Cells ◽  
T Cell ◽  
Clinical Stage ◽  
Cd4 T Cell ◽  
Stage Iii ◽  
Advanced Stage ◽  
Breast Cancer Patients ◽  
Dismal Prognosis ◽  
Healthy Donors

10567 Background: It has been recently shown that regulatory CD4+CD25bright T cells (Tregs) are increased in patients with several malignancies and this increase correlates with advanced stage and dismal prognosis. Breast cancer (BC) patients represent a heterogeneous population with unpredictable natural history, even at advanced stages. We sought to monitor advanced stage (III and IV) BC patients, overexpressing HER-2/neu (HER) or not, for circulating Tregs before, during and after the administration of chemotherapy, either alone or in combination with Trastuzumab. Methods: Determination of circulating Tregs was performed in 50 μl whole peripheral blood by a Lyse NoWash FACS procedure and staining for CD45, CD4 and CD25. Tregs were determined as the lymphocytes expressing lower CD4 within the CD4+ T cell compartment and higher CD25 expression compared to the CD4 negative lymphocytes. Clinical evaluation of the patients was done according to RECIST criteria. Results: 24 HER+ and 19 HER- stage III / IV BC patients have been compared to 14 healthy donors, before therapy. The percentage of Tregs among the CD4+ T cell population of HER+ patients was significantly increased compared to both HER- patients and healthy donors (8,74 ± 2,68 vs 6,07 ± 1,85 and 6,55 ± 1,49, respectively). Trastuzumab combined with chemotherapy resulted in a progressive decrease in the percentage of circulating Tregs, reaching normal levels after the fourth cycle of treatment (6,95 ± 1,17). On a per patient basis, decrease in Tregs correlated either with documented partial response or stable disease, while increased Tregs during treatment coincided with progressive disease. No statistically significant change in the percentage of Tregs after chemotherapy was observed in HER- patients. Conclusions: 1) Increased Tregs do not directly correlate with clinical stage in BC, as stage III and IV HER (+) and (−) patients exhibit significantly different Tregs profiles. 2) HER+ advanced BC patients exhibit increased percentages of circulating Tregs and respond to the combination of Trastuzumab and chemotherapy by decreased Tregs. This decrease is either due to a reduction of the tumor burden or neutralization of circulating HER antigen by Trastuzumab, or a combination of both. No significant financial relationships to disclose.

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