International Journal of Cancer Management
Volume:10 Issue: 6, Jun 2017

To investigate the prognosis factors of survival in patients with colorectal cancer in presence of competing risks, using generalized Weibull distribution, and to compare the results of Weibull model as well as semi parametric models.
A total of 1462 patients with colorectal cancer, registered in cancer registry center of research institute of gastroenterology and liver disease (from 2004 to 2015), Taleghani hospital, Tehran, Iran entered this study. Death and the causes of death were confirmed via telephone contact to patients’ families. The demographic and clinical features included age at diagnosis, sex, family history of CRC, body mass index (BMI), tumor size and tumor site extracted from hospital documents. Generalized Weibull distribution, Cox regression analysis and Fine-Gary model were used to assess the prognosis of CRC survival. The analysis was carried out using R software version 3.0.2. P value less than 0.05 were considered significant.
Overall, 1060 CRC patients with completed data were included in the analysis. 58% were men and the mean ± SD of age at diagnosis was 53.67 ± 0.46 years. The mean ± SD of survival time was 56.96 ± 1.46 with median = 45.5 months. 380 patients (35.5%) died from CRC and 49 patients (4.6%) died from other causes of death, such as myocardial infarction, stomach cancer, liver cancer etc. Generalized Weibull model with competing risk analysis and other models indicated age and BMI as the prognosis.
This study indicated age and BMI as the prognosis, using a generalized Weibull model with competing risk analysis. Also according to the survival curve estimation, generalized Weibull model with competing risk has a better fit to the data, compared to Weibull model.

Pituitary adenomas are categorized into two groups: the secretory and non-secretory adenomas. The first group overproduce normal pituitary hormones, which cause Cushing’s disease (high ACTH- adernocorotitrophic hormone), Acromegaly (high growth hormon) and prolactinomas (high prolactin). They may diffuse into the sphenoid sinus, cavernous sinus and diaphragma sellae. Tumor invasion into the adjacent structures and incomplete tumor resection are the most common causes of hypercortisolism after the first surgery. The first explored radiation modality for persistent Cushing’s disease was fractionated radiation, with increased rates of hypopituitarism. Over time, several studies have demonstrated the power of the GKS (gamma knife surgery) for persistent Cushing’s disease.
A 32-year-old female who was diagnosed with Cushing’s disease secondary to an ACTH secreting pituitary adenoma, underwent trans-sphenoidal resection of the adenoma. Surprisingly, no postoperative hormonal and clinical improvements were observed. The patient was treated with oral ketoconazole. Twenty months after surgery, she had complaints of sudden onset of headache with diplopia, ptosis and paralysis of extraocular muscles of the left eye. A repeated MRI revealed residual tumor with local invasion to the left cavernous sinus. Following the consultation with a neurosurgeon, the patient underwent GKS. Within two months, there was a significant improvement in peribulbar muscle paresis and laboratory results were satisfying.
The case presented here indicates that the most common indicators for radiosurgery are residual tumors, especially in the cavernous sinus, which are recurrent and/or resistant to medical treatment. The purpose is to call attention to the GKS as a successful adjunctive therapy in Cushing’s disease.

Due to the high prevalence and mortality rates of esophageal cancer in some parts of the world and considering that in most patients, symptoms occur when cancer is advanced, this study aimed to compare early and late complications in three esophagectomy techniques for treatment of esophageal cancer.
The present study was a descriptive research on 316 patients with esophageal cancer referring to Shohada Tajrish hospital, Tehran. The results were recorded in the research forms consisting of individual characteristics, symptoms and reasons for referring to the hospital. Findings were extracted after classification and evaluated using descriptive statistics.
Among 316 patients studied, 190 patients (60%) were male and 126 (40%) were female. The highest prevalence was between 40 and 60 years old. The most significant reason for referring to the hospital was dysphagia and weight loss. Among 260 patients, 72 patients (27.7%) underwent surgery by transthoracic (Ivor Lewis type) approach, 76 patients (29.2%) underwent surgery by three-incision approach (Mc Keown procedure), and 112 patients (43%) underwent surgery by Trans-Hiatal (Oringer). A total of 36 deaths occurred. 22 deaths occurred using Ivor-Lewis (61%), 10 deaths occurred using Mc Keown (27.7%) and 4 deaths occurred after Oringer (11.1%). In terms of prevalence of complications, the most common early complication was pleural effusion (11%) and the most common late complication was anastomotic stricture (17.8%).
Complications occurred in all three surgeries. The most complications occurred using transthoracic (Ivor Lewis type) approach and the least complications occurred using Trans-Hiatal (Oringer).

Lower rate of mammography in Iranian women was reported compared to the rates reported from developed countries. Therefore, we aimed to evaluate the rate of mammography in female academics of Tehran University of medical sciences (TUMS) and its influential factors according to Champion health belief model questionnaire.
In this descriptive survey conducted in 2015, the standardized short version of Champion health belief model questionnaire was used to gather information from 99 female academics of TUMS. Further collected data included demographic characteristics of the subjects, past medical history, previous diseases affecting breast and personal knowledge about breast cancer screening.
Among the participants, who were 40 years and older, only 3.7% underwent annual mammography and only 22% of those aged over 45 underwent mammography every three years. Comparison between the two groups according to Champion health belief model revealed significant difference in the mammography benefits and barriers while the scores from susceptibility, severity, breast self-examination (BSE) Barriers, BSE Benefits and BSE Self-Efficacy did not differ significantly between the two groups.
Surprisingly, the rate of mammography among attending physicians of TUMS was found to be similar to the rest of Iranian female population and considerably lower than the figures reported in developed countries.

In recent decades, various studies have shown a relationship between exercise and decreased mortality in patients with breast cancer. However, potentially involved molecular mechanisms are yet to be detected.
The goal of this study was to investigate the effect of endurance training on gene expression of miR-126, miR-296, HGS and protein expression of VEGF-A, in the tumor tissues of breast cancer bearing mice.
Twelve laboratory female BALB/c mice, weighing 19 ± 1.05 g, were randomly divided into two groups of 6 each; that is, endurance training and control, after inducing cancer by subcutaneous injection with MC4-L2 into their right sides. Each session of endurance training involves 60-min of running on a treadmill at an intensity of 60% - 65% VO2max, five days a week for 10 weeks. Twenty-four hours after the last exercise session, the mice are sacrificed and the genes expression is measured.
Endurance training caused a significant decrease in miR-296 (P Data from this study demonstrate that endurance training can significantly decreases tumor growth in BALB/c mice. Endurance training mediates its effects through reduction of level of the vascular endothelial growth factors (VEGF) and VEGF receptors (VEGFR) in tumor tissue.

Designing a vaccine against a defined tumor is a promising but complicated process that can be used as tumor immunotherapy. The presence of human telomerase reverse transcriptase (hTERT) has been proved in about 85% of tumors; therefore, this enzyme is a promising vaccine target. Most studies in tumor immunotherapy have focused on induction and reinforcement of CD8 T cell responses against tumor antigens, but some evidence indicates that CD4 T cell responses are important for induction of CD8 T cell response and memory. Therefore, in this in vitro study, we combined an hTERT peptide with HIV peptides restricted to HLA-DRB1*11:03/04, the most common MHC class II molecule in Iran, to induce CD4 T cell responses in healthy individuals and lung cancer patients.
Peripheral blood mononuclear cells (PBMCs) were isolated by Ficoll gradient centrifugation from nine healthy individuals and six lung cancer patients who were HLA-DRB1*11:03/04 positive. PBMCs were incubated with the tumoral and viral peptides for five days and then exposed to A549 cells to evaluate specific proliferative responses. The proliferation of PBMCs was examined by the MTT assay. Then, levels of secreted interferon-γ in culture media were analyzed by enzyme-linked immunosorbent assay (ELISA).
Proliferation of PBMCs was significantly greater in the presence of the tumoral peptide than in controls (P = 0.001). In addition, PBMC proliferation was greater when the viral peptides were added than with the tumoral peptide alone (P = 0.000). The IFN-γ secretion assay results supported the MTT assay (P = 0.000).
In this study, we demonstrated that the hTERT-derived peptide induced CD4 T cell proliferation in healthy individuals and patients with lung cancer. Both PBMC proliferation and IFN-γ secretion were further induced by the addition of tumor and viral peptides in combination.

Colorectal cancers, including colon, rectum and anus, are relatively prevalent in Iran. Use of opium and its derivatives is also considerably prevalent in some areas in Iran.
The aim of this study was to assess the association between use of opium and its derivatives, and incidence of lower gastrointestinal (LGI) cancers.
This study was a matched case-control study in Shiraz (south of Iran). Cases were the new colorectal cancers from cancer registry center of Shiraz University of Medical Sciences and controls were selected from healthy volunteers of cases’ neighbors matched for age and gender (2 controls per 1 case). Data related to consumption of opium and its derivatives, smoking, alcohol use and diet status were collected through a structured questionnaire. The conditional logistic regression models were used to assess all associations.
160 cases and 320 controls participated in the present study with non-response rate less than 9 %. Opium use was associated with increased risk of colorectal cancer (adjusted OR = 4.4; 95% CI: 2.2 - 8.8). Also, a dose-response association was observed between cumulative consumption of opium and the colorectal cancer incidence (OR = 3.8; 95% CI: 1.5 - 9.1), and (OR = 4.6; 95% CI: 1.7 - 12.0) for low and high use, respectively. Also, the significant dose-response association was observed for low (OR = 3.4; 95% CI: 1.2 - 9.2) and high (OR = 7.7; 95% CI: 1.5 - 38.6) opium use with presence of colon cancer.
The results of this study showed that opium use can be an important risk factor for colorectal cancer in Iran.

The hepatocellular carcinoma is believed to be the third cause of death due to cancer, worldwide. A new derivative of the (2R,4S)-N-(2,5-difluorophenyl)-4-hydroxy-1-(2,2,2-trifluoroacetyl) pyrrolidine-2-carboxamide compound were synthesized, employing a facile one-pot reaction of trans-4-hydroxy proline and N-(2,5-difluorophenyl)-2,2,2-trifluoroacetimidoyl chloride in the presence of TiO2 as catalysts and sodium hydrogen carbonate.
Therefore, in the present study we aimed to explore whether if the above new derivative pyrrolidine-2-carboxamide can affect cellular viability and apoptosis in cancerous HepG2 cell line.
HepG2 cells were cultured in RPMI 1640 medium containing fetal bovine serum. Cultured cells were then treated with 7.8 µM to 125 µM of pyrrolidine-2-carboxamide. The toxicity of the compound was assayed by MTT method and detection of annexin V signal, using a flowcytometry system.
We found the pyrrolidine-2-carboxamide derived inhibition of HepG2 cells following a dose and time dependent fashion. The highest numbers of dead cells were observed in 125 µM dose, after 48 hours of treatment. Flow cytometric analysis also revealed that massive numbers of apoptotic cells were detectable in response to treatment with this pyrrolidine derivative.
Overall, according to the data presented here, the pyrrolidine-2-carboxamide could possibly control cellular viability/apoptosis. Thus it can potentially be concerned as a useful therapeutic tool for hepatocellular carcinoma treatment.

Radio therapy plays an important role in controlling tumor growth in esophageal cancer patients.
Our study provided comprehensive information about radio-sensitivity of Hdm2 gene in esophageal cancer cells in cancer cells.
The expression of Hdm2 gene in radiosensitive and radio-resistant esophageal squamous cell carcinoma TE1, TE8 and TE11 cell lines is studied. RNA extracted from each esophageal cancer cell, then Quantitative reverse transcription PCR (RT-qPCR) assay were used for measuring HDM2 gene expression. Finally, radiosensitivity was determined for every three esophageal cancer cell lines.
It was found that Hdm2 gene significantly expressed in TE1, TE8 and TE11 cell lines by qRT-PCR analysis. Clonogenic assay showed that TE-11 was very sensitive to radiation relative to other cell lines.
Hdm2 protein binding to the P53 protein is a key regulator of cell cycle control and ýgenome protection Cell cycle control, programmed cell death and response cells to ýradition play important roles.ý

Basaloid squamous cell carcinoma (BSCC) of the cervix is an uncommon tumor in female genital tract. The aggressive clinical behavior makes this entity distinguished from other SCC subtypes.
We described a case of basaloid squamous cell carcinoma in uterine cervix in a 62-year old woman with previous subtotal hysterectomy. Clinical and radiologic examination suggested a 3 cm mass in cervical stump involving left parametrium. She underwent trachelectomy and lymph node dissection followed by adjuvant radiochemotherapy. The light microscopy and immunohistochemistry warranted the basaloid SCC diagnosis that was suspected in pre-operational biopsy. The small, round to oval-shaped cells with scant cytoplasm and hyperchromatic nuclei were positive for cytokeratin AE1/AE3 (CK AE1/AE3) and negative for p63, C-KIT, chromogranin and synaptophysin.
Although this tumor has an aggressive behavior, this is not enough to substantiate that BSCC has a poorer medical outcome as compared to conventional SCC of the cervix.

With regard to the major role of insulin resistance in colorectal cancer (CRC), this study investigated whether insulin (INS) gene -23HphI variant was associated with susceptibility to CRC risk.
Our study was conducted as a case-control study and 312 cases with CRC and 438 controls were enrolled. All 750 subjects were genotyped for INS gene -23HphI variant using PCR-RFLP method.
There was no significant difference for the -23HphI variant of INS gene in either genotype or allele frequencies between the cases and the controls and this lack of difference remained non-significant even after adjustment for age, BMI, sex, smoking status, regular NSAID use, and family history of CRC. No evidence for the effect modification of the association -23HphI variant and CRC by BMI, sex, or tumor site was also observed. Moreover, the risk of obesity in relation to the -23HphI variant in the controls and the cases was separately analyzed and we observed no significant difference between normal weight (BMI These findings do not support the plausible effect of the INS gene -23HphI variant on CRC risk; nonetheless, our finding requires confirmation and the role of the gene variant in carcinogenesis needs to be further evaluated.