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Neoadjuvant therapy in ACC

Caitlin Takahashi, Ravi Shridhar, Jamie Huston, Kenneth Meredith
The long-term survival for patients with locally advanced esophageal cancer (EC) remains poor despite improvements in multi-modality care. Neoadjuvant chemoradiation (NCR) followed by surgical resection remains pivotal in the management of patients with EC. However, the outcome of patients whose primary tumor exhibits a complete response with residual regional nodal disease (T0N1) remains unclear as well as the role for adjuvant therapy.Utilizing the National Cancer Database we identified patients with EC who underwent NCR followed by esophagectomy who had subsequent pathology of T0N1...
October 2018: Journal of Gastrointestinal Oncology
Paxton V Dickson, Lawrence Kim, Tina W F Yen, Anthony Yang, Elizabeth G Grubbs, Dhavel Patel, Carmen C Solórzano
This is the second of a two-part review on adrenocortical carcinoma (ACC) management. While margin-negative resection provides the only potential cure for ACC, recurrence rates remain high. Furthermore, many patients present with locally advanced, unresectable tumors and/or diffuse metastases. As a result, selecting patients for adjuvant therapy and understanding systemic therapy options for advanced ACC is important. Herein, we detail the current literature supporting the use of adjuvant mitotane therapy, consideration of adjuvant radiation therapy, and utility of cytotoxic chemotherapy in patients with advanced disease...
September 14, 2018: Annals of Surgical Oncology
I Gockel, C Wittekind
The microscopic identification of residual tumor tissue in the oral or aboral resection margins (R1 resection) of esophageal specimens following oncologic esophageal resection, increases the risk of tumor recurrence and disease-related morbidity. Esophageal resection with its associated risks is only meaningful, if an R0 situation can be safely achieved. The relevance of microscopic involvement of the circumferential resection margin (CRM) in esophageal carcinoma in its different definitions by the British and the American Societies of Pathology has up to now never been investigated in a prospective study...
September 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Felipe Nör, Kristy A Warner, Zhaocheng Zhang, Gerson A Acasigua, Alexander T Pearson, Samuel A Kerk, Joseph I Helman, Manoel Sant'Ana Filho, Shaomeng Wang, Jacques E Nör
Purpose: Conventional chemotherapy has modest efficacy in advanced adenoid cystic carcinomas (ACC). Tumor recurrence is a major challenge in the management of ACC patients. Here, we evaluated the antitumor effect of a novel small-molecule inhibitor of the MDM2-p53 interaction (MI-773) combined with cisplatin in patient-derived xenograft (PDX) ACC tumors. Experimental Design: Therapeutic strategies with MI-773 and/or cisplatin were evaluated in SCID mice harboring PDX ACC tumors (UM-PDX-HACC-5) and in low passage primary human ACC cells (UM-HACC-2A, -2B, -5, -6) in vitro The effect of therapy on the fraction of cancer stem cells (CSC) was determined by flow cytometry for ALDH activity and CD44 expression...
February 15, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Yu Wang, Sinan Wang, Xuan Zhou, Hongyuan Zhou, Yunlong Cui, Qiang Li, Lun Zhang
BACKGROUND: Acinar cell carcinoma (ACC) is a relatively rare pancreatic neoplasm with poorly defined prognosis. This study aimed to investigate this rare pancreatic neoplasm through comparing patients with ACC to pancreatic ductal cell adenocarcinoma (DCA). METHODS: Tianjin Medical University Cancer Institute and Hospital pathology database was reviewed from 1995 to 2015, and 19 patients with pathologically confirmed ACC were enrolled while 19 conventional DCA patients assigned randomly as control...
June 28, 2016: World Journal of Surgical Oncology
Mohammadtaghi Rajabi Mashhadi, Reza Bagheri, Abbas Abdollahi, Mohammad Javad Ghamari, Soudabeh Shahidsales, Maryam Salehi, Reza Shahkaram, Mohamad Reza Majidi, Shima Sheibani
INTRODUCTION: Early diagnosis and appropriate treatment is required in esophageal cancer due to its invasive nature. The aim of this study was to evaluate early post-esophagectomy complications in patients with esophageal cancer who received neoadjuvant chemoradiotherapy (NACR). MATERIALS AND METHODS: This randomized clinical trial was carried out between 2009 and 2011. Patients with lower-third esophageal cancer were randomly assigned to one of two groups. The first group consisted of 50 patients receiving standard chemoradiotherapy (Group A) and then undergoing surgery, and the second group consisted of 50 patients undergoing surgery only (Group B)...
July 2015: Iranian Journal of Otorhinolaryngology
Barbra S Miller
Significant progress has been made in the understanding of how surgical technique impacts outcome in patients with adrenal cancer. Current and future areas of investigation center on expanding the role of surgery in patients with locally recurrent or metastatic disease, use of neoadjuvant therapy as a bridge to surgery, the impact of formal lymphadenectomy on survival, and improved diagnosis, prognosis, and selection of patients for surgery and other treatments using morphomic analysis.
February 2016: Hormones & Cancer
Shogo Tajima, Kenji Koda
Complete dissection of tracheobronchial adenoid cystic carcinoma (TACC) by surgery alone is sometimes difficult and has a greater propensity than tracheobronchial mucoepidermoid carcinoma (TMEC) for its surgical margin to become positive. In addition, TACC is more likely to present distant metastases than TMEC. Considering these facts, TACC and TMEC should be differentiated based on histopathological examination of biopsy specimens. Herein, we present a case of 54-year-old woman with a tumor in the right main bronchus, whose biopsy specimen was difficult to diagnose as TACC or TMEC...
2015: International Journal of Clinical and Experimental Pathology
Eric Baudin
Recent developments in the treatment of adrenocortical carcinoma (ACC) include diagnostic and prognostic risk stratification algorithms, increasing evidence of the impact of historical therapies on overall survival, and emerging targets from integrated epigenomic and genomic analyses. Advances include proper clinical and molecular characterization of all patients with ACC, standardization of proliferative index analyses, referral of these patients to large cancer referral centers at the time of first surgery, and development of new trials in patients with well-characterized ACC...
June 2015: Endocrinology and Metabolism Clinics of North America
Amaka Eneh, Kami Parsa, Kenneth W Wright, Yi Ning J Strube
Adenoid cystic carcinoma (ACC) of the lacrimal gland is the most common primary malignant tumor of the lacrimal gland. It typically affects patients in the fifth decade of life and presents with rapid progression of pain, ptosis, motility disturbances, and sensory deficits of less than 1 year's duration. ACC is rare in children. Due to early, aggressive perineural and bony spread, there is a high risk of intracranial extension. Additionally, due to frequent hematogenous and lymphatic spread, there is a high rate of distant metastases even after treatment, which can occur late up to a decade or more...
June 2015: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Sun Young Jang, Dong Joon Kim, Chang Yeom Kim, Cheng Zhe Wu, Jin Sook Yoon, Sang Yeul Lee
BACKGROUND: We describe four cases of primary lacrimal adenoid cystic carcinoma (ACC) treated with neoadjuvant intra-arterial chemotherapy (NAIC). METHODS: The outcomes and complications of NAIC were reviewed. Several treatment-related local and/or systemic complications were noted. RESULTS: One patient experienced ipsilateral eyelid and eyeball necrosis and permanent facial palsy; the second patient developed ipsilateral facial swelling and jaw claudication; and the third patient had febrile neutropenia, cellulitis, and phlebitis...
2014: Cancer Imaging: the Official Publication of the International Cancer Imaging Society
Benzon M Dy, Veljko Strajina, Ashley K Cayo, Melanie L Richards, David R Farley, Clive S Grant, William S Harmsen, Doug B Evans, Elizabeth G Grubbs, Keith C Bible, William F Young, Nancy D Perrier, Florencia G Que, David M Nagorney, Jeffrey E Lee, Geoffrey B Thompson
INTRODUCTION: Metastatic adrenocortical carcinoma (ACC) is rapidly fatal, with few options for treatment. Patients with metachronous recurrence may benefit from surgical resection. The survival benefit in patients with hematogenous metastasis at initial presentation is unknown. METHODS: A review of all patients undergoing surgery (European Network for the Study of Adrenal Tumors) stage IV ACC between January 2000 and December 2012 from two referral centers was performed...
January 2015: Annals of Surgical Oncology
Lina He, Lanfang Wu, Guidong Su, Wenfei Wei, Li Liang, Lingfei Han, Mehdi Kebria, Ping Liu, Chunlin Chen, Yanhong Yu, Mei Zhong, Wei Wang
OBJECTIVE: To determine whether the efficacy of neoadjuvant chemotherapy (NACT) is different among cervical cancer types, squamous cell carcinoma (SCC) and non-SCC, including adenocarcinoma of the cervix (ACC) and adenosquamous carcinoma (ASC). METHODS: We searched PubMed, MEDLINE, ScienceDirect, Springerlink and CNKI for studies published between Jan 1987 and Sep 2012 and evaluated the studies published in English and Chinese on NACT and cervical carcinoma based on specific inclusion and exclusion criteria...
August 2014: Gynecologic Oncology
A M Joshua, V E Zannella, M R Downes, B Bowes, K Hersey, M Koritzinsky, M Schwab, U Hofmann, A Evans, T van der Kwast, J Trachtenberg, A Finelli, N Fleshner, J Sweet, M Pollak
BACKGROUND: Metformin is an inhibitor of complex 1 in the respiratory chain, and is widely used to reduce insulin resistance. It has also been described to have pleotropic effects including via AMPK on inhibiting the mTOR kinase. Pre-clinical and epidemiological studies suggest an ability to modulate disease evolution in prostate cancer. In this study, we aimed to (i) demonstrate safety and tolerability of neoadjuvant metformin administration and (ii) document changes in proliferative (Ki67) and AMPK-related signalling indices between matching biopsies and prostatectomies METHODS: Men were treated in a single-arm 'window of opportunity' study between their decision to undergo radical prostatectomy and the operation itself...
September 2014: Prostate Cancer and Prostatic Diseases
Ying-Wen Su, Yun-Ho Lin, Man-Hui Pai, An-Chi Lo, Yu-Chieh Lee, I-Chih Fang, Johnson Lin, Ruey-Kuen Hsieh, Yi-Fang Chang, Chi-Long Chen
BACKGROUND: Epidemiological studies have indicated that impaired glucose metabolism may increase the risk of squamous cell carcinoma of the head and neck (SCCHN). AMP-activated protein kinase (AMPK) regulates glucose and lipid metabolism via the phosphorylation and subsequent inactivation of its downstream target acetyl-CoA carboxylase (ACC).Thus, we analyzed the expression of pAMPK and its downstream target phosphorylated acetyl-CoA carboxylase (pACC), as well as their impact on the survival of patients with resected SCCHN...
2014: PloS One
Brian K Bednarski, Mouhammed Amir Habra, Alexandria Phan, Denai R Milton, Christopher Wood, Nicholas Vauthey, Douglas B Evans, Matthew H Katz, Chaan S Ng, Nancy D Perrier, Jeffrey E Lee, Elizabeth G Grubbs
BACKGROUND: Adrenal cortical carcinoma (ACC) may have tumor or patient characteristics at presentation that argue against immediate surgery because of an unacceptable risk of morbidity/mortality, incomplete resection, or recurrence. This clinical stage can be characterized as borderline resectable ACC (BRACC). At present, systemic therapies in ACC can reduce tumor burden in some patients, creating an opportunity in BRACC for a strategy of preoperative chemotherapy (ctx) followed by surgery...
June 2014: World Journal of Surgery
Rong-xin Deng, Xin Xu, Chen-ping Zhang, Zhi-yuan Zhang, Yue He
PURPOSE: Adenoid cystic carcinoma (ACC), formerly known as cylindroma, is a malignant epithelial neoplasm typically derived from the salivary glands. Of all salivary gland tumors, the incidence of malignant salivary gland tumor has been 15 to 32% in the parotid glands, 70 to 90% in the sublingual glands, and about 50% in the minor salivary glands. Intraosseous ACC of the jaw has rarely been reported and is poorly understood. The aim of the present study was to analyze this tumor clinically and histopathologically to improve the diagnosis, management, and treatment...
April 2014: Journal of Oral and Maxillofacial Surgery
David T Tse, Andrea L Kossler, William J Feuer, Pasquale W Benedetto
PURPOSE: To compare the long-term outcomes after intra-arterial cytoreductive chemotherapy (IACC) with conventional treatment for lacrimal gland adenoid cystic carcinoma (ACC). DESIGN: Retrospective case series. PARTICIPANTS: Nineteen consecutive patients treated with IACC, followed by orbital exenteration, chemoradiotherapy, and intravenous chemotherapy. INTERVENTIONS: Analyses of the histologic characteristics of biopsy specimens, extent of disease at the time of diagnosis, diagnostic surgical procedures, incidence of locoregional recurrences or distant metastases, disease-free survival time, response to IACC, tumor margins at definitive surgery, and toxicity and complications...
July 2013: Ophthalmology
A Redlich, N Boxberger, D Strugala, M C Frühwald, I Leuschner, S Kropf, P Bucsky, P Vorwerk
BACKGROUND: Adrenocortical cancer (ACC) in childhood is a rare disease with poor prognosis. Complete surgical resection, systemic chemotherapy, and mitotane therapy are important curative treatment options for patients with advanced-stage tumors. Since 1997, pediatric ACC patients in Germany have been treated according to the non-randomized, single arm study GPOH-MET-97. PATIENTS AND METHODS: Data regarding disease course, treatment, and survival rates of 60 patients (age 0...
October 2012: Klinische Pädiatrie
R Min, L Siyi, Y Wenjun, A Ow, W Lizheng, D Minjun, Z Chenping
Adenoid cystic carcinoma (ACC) is an infrequent malignant neoplasm that originates most commonly in the major and minor salivary glands of the head and neck region. This study provides new information on head and neck ACC with cervical lymph node metastasis. Of 616 patients who underwent primary tumour resection from 1995 to 2008 in the authors' hospital, 62 cases with cervical lymph node metastasis were analyzed. The general incidence of cervical lymph node metastasis in ACC was approximately 10%. The base of tongue, mobile tongue and mouth floor were the most frequent sites of lymph nodes metastasis, with incidences of 19...
August 2012: International Journal of Oral and Maxillofacial Surgery
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