International Journal of Cancer Management
Volume:12 Issue: 6, Jun 2019

Architectural distortion is an important mammographic finding for non-palpable breast cancer, which is a difficult part of mammographic reporting. In this study, we assessed the relationship between architectural distortion without mass or history of previous breast intervention with pathological findings, as well as the risk of malignancy associated with architectural distortion. The factors that might increase the chance of malignancy in architectural distortion were also evaluated. In this descriptive, comparative cross sectional survey, 30 consecutive patients with mammographic primary architectural distortion were enrolled. The pathological findings were determined through core needle biopsy and compared across the other variables. The pathological results were fibrocystic changes, carcinoma in situ, invasive ductal carcinoma, other benign pathology, and high-risk lesion of adenosis sclerosing with 5 (16.7%), 5 (16.7%), 13 (43.3%), 6 (20%), and 1 (3.3%) patients, respectively. Higher BI-RADS category (P = 0.064), accompanying mammographic lesion (P = 0.004), positive clinical symptoms (P = 0.040), and positive ultrasonography finding (P = 0.013) were related to greater chance of malignant pathology result. Based on our findings, it can be concluded that architectural distortion in imaging is accompanied by malignancy in 60% of the cases and there are some important factors that can increase the risk of malignancy for architectural distortion (AD).

pancreaticoduodenectomy is associated with higher morbidity and mortality rates. The leak of activated pancreatic enzymes can cause several complications which could be life threatening. One of the suggested methods, which can prevent complications, is double Roux anastomosis technique. The aim of this study was to evaluate the outcomes and complications of double Roux anastomosis method. In this prospective study, patients who underwent pancreaticoduodenectomy with double Roux anastomosis were evaluated from 2013 to 2017. The outcomes and complications such as mortality rate, pancreatic leak or fistula, bile leakage, and abscess formation were evaluated. A total of 12 patients were evaluated. The mean age was 53.08 ± 13.43 (19 - 70). Seven of them were male and five were female. Indications of surgery in the patients were periampullary cancer (6 patients), pancreatic head cancer (4 patients), distal cholangiocarcinoma (1 patient) and duodenal trauma (1 patient). There was no mortality, no pancreatic leak or fistula, no hemorrhage, and no abscess in any of the patient. There was one case of the biliary leakage, which was managed expectantly. The results of this study showed that use of separate double Roux, one for the pancreas and the other one for the stomach and bile duct reduces complications and mortality. Although this method requires more anastomosis and the operating time is prolonged, but ultimate outcome of the patient has great effects.

Tuberculosis (TB) is a life-threatening disease, which still remains a major public health concern in Iran, as the country is an endemic region for TB. On the other hand, carcinoma of the lung is the most common and lethal cancer. As the lung cancer involves respiratory system, it has many common connections with TB, too, and it is likely that immunosuppressant drugs, like the ones used in cancer treatments, increase the risk of TB development. To assess the possible association of TB and lung cancer, the current study evaluates the incidence of TB among patients with lung cancer. In the present cross-sectional study, patients with diagnosis of lung cancer were selected from the referral centers between 2011 and 2016. The TB among the patients was diagnosed, using radiographic pulmonary infiltration, M. tuberculosis culturing, and sputum smear. The diagnostic tests were done twice to certitude the results. From 845 cases entering the study, 9 patients (1.1%) were diagnosed with TB and the smear test was positive in 5 patients. The cases aged between 40 and 67 years old, with the mean age of 53.92 ± 8.02. Women had a significantly more average age than men and adenocarcinoma was the most common type of lung cancer with a rate of 57.63%. According to results of current study, there was a relationship between lung cancer and TB, while the incidence of TB in patients with lung cancer was more than the normal average rate of TB incidence in the region.

Esophageal cancer is an invasive lethal disease with a 10-year survival rate since diagnosis. About 45% of the tumor is completely removed by surgery, which has 5% mortality and 20% survival rate. In the locoregional stage, the use of neoadjuvant chemoradiotherapy and then surgery reduces recurrence and increases survival. This study was performed to investigate the effect of neoadjuvant chemoradiotherapy and the subsequent chemotherapy with platinum-based regimen on survival, recurrence, and response to treatment. Planning a descriptive retrospective follow-up study, during 2010 to 2016, 44 patients with esophageal cancer, who received chemotherapy with 5-Fluorouracil + Oxaliplatin + Docetaxel before and after radiotherapy (45 - 50 Gray) accompanying by oral Capecitabin, were followed up. Five operable patients underwent surgery. Response to treatment and recurrence were evaluated by periodic endoscopic biopsy and imaging. To calculate the response rate to treatment, survival, and recurrence, the data were extracted and analyzed, using SPSS version 18. The categorized variables were compared, using Pearson’s test. The survival curves were drawn, using the Kaplan Meier method and compared with the log-rank test. Among 44 patients with an average age of 61.5 ± 11.5 years, 88.6% had squamous cell carcinoma (SCC) and 11.4% had adenocarcinoma; surgery was performed for 5 patients, one of whom had severe complication leading to death and 54.5% had complete response as well as more survival rate. The patients suffering from SCC and middle segment tumors had more response rate. Also, recurrence was seen in 16 patients (36.4%), of whom 9.1% had local recurrence and 27.3% had metastatic recurrence. The mean survival rate was 38.87 months and 1-, 3-, and 5-year survival rate was %81.6, %47.6, and 39.6%, respectively. It was significantly more in middle esophageal segment and also tumors with complete response to treatment. Regarding the results, this treatment approach increases overall and disease-free survival, and response to treatment and reduces locoregional recurrence even if no surgery is performed. This treatment is recommended as a definitive treatment for esophageal cancer without metastasis.

The negative side effects of chemotherapeutic drugs have led to the need to identify safer therapeutics. A wide array of epidemiological and experimental data encourages the use of dietary agents to impede or delay different stages of cancer. Well tolerated lower doses of individual agents can be effectively employed if there is therapeutic synergy; thereby minimizing the side effects and enhancing successful outcome. However, a variety of interactions are possible when different agents are used in combination, therefore, dietary agents alone or in combination with chemotherapeutic agents must be thoroughly studied before considering them for clinical settings. This study was designed to determine the interaction of two phytochemicals (quercetin, sulforaphane) with each other as well as with established chemotherapeutic drugs, like cisplatin and 5-fluorouracil. Cell viability assay, cell cycle analysis, and scratch wound assay were performed to understand their combined impact on proliferation and metastasis of HeLa cells. Further, combination index (CI) was calculated to identify the type of interaction between the tested compounds concurrently. Concurrent administration of sublethal doses of the phytochemicals with chemotherapeutic drugs resulted in augmented anti-proliferative potential evidenced in elevated cytotoxicity, apoptosis induction, and inhibition of migration. Combination index was < 1 and indicated synergy between the tested compounds. Combination of these compounds can help to develop cancer treatment better.

Cancer is the first cause of death followed by ischemic heart disease (IHD) and stroke, worldwide, with increasing 19.5% years of life lost (YLL) due to cancer from 2007 to 2017. The cancer burden is steadily increased with decreasing 4.4% death rate from 2007 - 2017. The incidence rate of cancer is twice to 3 times higher in developed countries with low mortality due to care regarding developing countries. Here, we report the 10 years’ incidence and mortality of malignancies in Iran with different patterns compared to the other parts of the world. Data of national cancer registry system from 2005 to 2014 were analyzed in order to find out the trend of age standardized incidence rate (ASIR)/age standardized mortality rate (ASMR)/ mortality to incidence ratio (MIR) in both sexes in Iranian population. Growing trend in ASIR for both sexes in all of the cancers were seen. ASMR decreased from 2005 to 2014 in both sexes with higher rate in males. MIR decreased by half in 2014 compared to 2005 regarding the increase of cancer in Iran. In Iran, the incidence of cancer is increasing due to aging people and death is decreasing due to the good care of patient. So, it is a good sample of developing country, which is comparable with the developed ones.