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Coexistence of multiple liver metastases from sigmoid colon cancer and a gastrointestinal stromal tumor in the small intestine. Clin J Gastroenterol 2022; 15:117-122. [PMID: 34988880 DOI: 10.1007/s12328-021-01556-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 11/09/2021] [Indexed: 02/07/2023]
Abstract
A 60-year-old man was referred to our hospital for the evaluation and treatment of general malaise. Contrast-enhanced computed tomography detected sigmoid colon cancer that had invaded the bladder, multiple liver metastases, and a small intestinal tumor. Hartmann's procedure was performed, with partial bladder and small bowel resection. A pathological examination revealed that the patient had sigmoid colon cancer and a gastrointestinal stromal tumor. The biopsy findings of a tumor in segment 8 of the liver indicated the presence of adenocarcinoma, thereby indicating the origin of multiple liver metastases from sigmoid colon cancer. On chemotherapy, the tumors in liver segments 2/3 and 8 shrank. However, the tumor in segment 6 enlarged. Since radical resection of all metastatic liver tumors was possible, hepatectomy was performed 10 months after the initial surgery. A pathological examination revealed that the tumors in segments 2/3, 4, and 8 were adenocarcinomas and the tumors in segments 4, 6, and 7 had originated from the gastrointestinal stromal tumor. This suggested the coexistence of liver metastases from sigmoid colon cancer and the gastrointestinal stromal tumor. In cases involving multiple primary tumors, it is necessary to consider the possible coexistence of multiple metastases from different primary tumors.
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Waidhauser J, Bornemann A, Trepel M, Märkl B. Frequency, localization, and types of gastrointestinal stromal tumor-associated neoplasia. World J Gastroenterol 2019; 25:4261-4277. [PMID: 31435178 PMCID: PMC6700699 DOI: 10.3748/wjg.v25.i30.4261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/22/2019] [Accepted: 07/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, increasing evidence of second neoplasms associated with gastrointestinal stromal tumors (GIST) has been found. Numerous case reports, mostly retrospective studies and a few reviews, have been published. To our knowledge, however, no systematic review or meta-analysis of the existing data has been performed so far. AIM To prepare a compilation, as complete as possible, of all reported second tumor entities that have been described in association with GIST and to systematically analyze the published studies with regard to frequency, localization, and types of GIST-associated neoplasms. METHODS The MEDLINE and EBSCO databases were searched for a combination of the keywords GIST/secondary, synchronous, coincident/tumor, neoplasm, and relevant publications were selected by two independent authors. RESULTS Initially, 3042 publications were found. After deletion of duplicates, 1631 remained, and 130 papers were selected; 22 of these were original studies with a minimum of 20 patients, and 108 were case reports. In the 22 selected studies, comprising a total number of 12050 patients, an overall rate of GIST-associated neoplasias of 20% could be calculated. Most second neoplasias were found in the gastrointestinal tract (32%) and in the male and female urogenital tract (30%). The specific risk scores of GISTs associated with other tumors were significantly lower than those without associated neoplasias. CONCLUSION In this first systematic review, we could confirm previously reported findings of a more than coincidental association between GIST and other neoplasias. The question whether there is an underlying causal association will need further investigation. Our data suggest that even GIST with a very low risk of disease progression should prompt screening for second neoplasia and subsequent frequent controls or extended staging.
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Affiliation(s)
- Johanna Waidhauser
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Anne Bornemann
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Martin Trepel
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
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Wang WJ, Li HT, Yu JP, Li YM, Han XP, Chen P, Yu WW, Chen WK, Jiao ZY, Liu HB. Identification of key genes and associated pathways in KIT/PDGFRA wild‑type gastrointestinal stromal tumors through bioinformatics analysis. Mol Med Rep 2018; 18:4499-4515. [PMID: 30221743 PMCID: PMC6172374 DOI: 10.3892/mmr.2018.9457] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 08/23/2018] [Indexed: 12/20/2022] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal tumor in the gastrointestinal tract. The present study aimed to identify the potential candidate biomarkers that may be involved in the pathogenesis and progression of v-kit Hardy-Zuckerman 4 feline sarcoma viral oncogene homolog (KIT)/platelet-derived growth factor receptor α (PDGFRA) wild-type GISTs. A joint bioinformatics analysis was performed to identify the differentially expressed genes (DEGs) in wild-type GIST samples compared with KIT/PDGFRA mutant GIST samples. Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of DEGs was conducted using Database for Annotation, Visualization and Integrated Discovery and KEGG Orthology-Based Annotation System (KOBAS) online tools, respectively. Protein-protein interaction (PPI) networks of the DEGs were constructed using Search Tool for the Retrieval of Interacting Genes online tool and Cytoscape, and divided into sub-networks using the Molecular Complex Detection (MCODE) plug-in. Furthermore, enrichment analysis of DEGs in the modules was analyzed with KOBAS. In total, 546 DEGs were identified, including 238 upregulated genes primarily enriched in ‘cell adhesion’, ‘biological adhesion’, ‘cell-cell signaling’, ‘PI3K-Akt signaling pathway’ and ‘ECM-receptor interaction’, while the 308 downregulated genes were predominantly involved in ‘inflammatory response’, ‘sterol metabolic process’ and ‘fatty acid metabolic process’, ‘small GTPase mediated signal transduction’, ‘cAMP signaling pathway’ and ‘proteoglycans in cancer’. A total of 25 hub genes were obtained and four modules were mined from the PPI network, and sub-networks also revealed these genes were primarily involved in significant pathways, including ‘PI3K-Akt signaling pathway’, ‘proteoglycans in cancer’, ‘pathways in cancer’, ‘Rap1 signaling pathway’, ‘ECM-receptor interaction’, ‘phospholipase D signaling pathway’, ‘ras signaling pathway’ and ‘cGMP-PKG signaling pathway’. These results suggested that several key hub DEGs may serve as potential candidate biomarkers for wild-type GISTs, including phosphatidylinositol-4,5-bisphosphate 3-kinase, catalytic subunit γ, insulin like growth factor 1 receptor, hepatocyte growth factor, thrombospondin 1, Erb-B2 receptor tyrosine kinase 2 and matrix metallopeptidase 2. However, further experiments are required to confirm these results.
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Affiliation(s)
- Wen-Jie Wang
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Hong-Tao Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Jian-Ping Yu
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Yu-Min Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Xiao-Peng Han
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Peng Chen
- Department of General Surgery, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Wen-Wen Yu
- Department of General Surgery, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Wei-Kai Chen
- Department of General Surgery, Lanzhou General Hospital of Chinese People's Liberation Army, Lanzhou, Gansu 730050, P.R. China
| | - Zuo-Yi Jiao
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
| | - Hong-Bin Liu
- Second Clinical Medical College, Lanzhou University, Lanzhou, Gansu 730030, P.R. China
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Joensuu H, Blay JY, Comandone A, Martin-Broto J, Fumagalli E, Grignani G, Del Muro XG, Adenis A, Valverde C, Pousa AL, Bouché O, Italiano A, Bauer S, Barone C, Weiss C, Crippa S, Camozzi M, Castellana R, Le Cesne A. Dovitinib in patients with gastrointestinal stromal tumour refractory and/or intolerant to imatinib. Br J Cancer 2017; 117:1278-1285. [PMID: 28850565 PMCID: PMC5672922 DOI: 10.1038/bjc.2017.290] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/04/2017] [Accepted: 07/31/2017] [Indexed: 12/20/2022] Open
Abstract
Background: This multicentre phase II trial (DOVIGIST) evaluated the antitumour activity of dovitinib as second-line treatment of patients with gastrointestinal stromal tumour (GIST) refractory to imatinib or who do not tolerate imatinib. Methods: Patients received oral dovitinib 500 mg day−1, 5 days on/2 days off, until GIST progression or unacceptable toxicity, with an objective to evaluate efficacy, assessed as the disease control rate (DCR) at 12 weeks. Tumour assessment and response to dovitinib therapy were evaluated by Response Evaluation Criteria In Solid Tumours (RECIST v1.1) and the Choi criteria. Secondary objectives included assessment of progression-free survival (PFS), safety and tolerability, and DCR at the end of treatment. Results: Thirty-eight of the 39 patients enrolled had histologically confirmed GIST. The DCR at 12 weeks was 52.6% (90% confidence interval (CI), 38.2–66.7%) meeting the preset efficacy criterion for the primary end point. The objective response rate (complete response+partial response) was 2.6% (1 of 38; 90% CI, 0.1–11.9%), and 5.3% (n=2; 90% CI, 0.9–15.7%) at the end of the study. The median PFS was 4.6 months (90% CI, 2.8–7.4 months). Dose interruption was required in 26 patients (66.7%), of which 18 (69.2%) were due to adverse events. The most frequently observed grade 3 adverse events included hypertension (n=7), fatigue (n=5), vomiting (n=4), hypertriglyceridaemia (n=4), and γ-glutamyltransferase increase (n=4). Conclusions: Dovitinib is an active treatment for patients with GIST who are intolerant to imatinib or whose GIST progresses on imatinib.
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Affiliation(s)
- Heikki Joensuu
- Department of Oncology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 4, Helsinki, Finland
| | - Jean-Yves Blay
- University Claude Bernard Lyon I, Centre Leon Berard, Lyon, France
| | | | | | - Elena Fumagalli
- Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | | | | | | | | | | | - Antoine Italiano
- Institut Bergonie, Comprehensive Cancer Centre, Bordeaux, France
| | - Sebastian Bauer
- Sarcoma Center, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Carlo Barone
- University Hospital A. Gemelli, Universitá Cattolica, Rome, Italy
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Thewes B, Husson O, Poort H, Custers JAE, Butow PN, McLachlan SA, Prins JB. Fear of Cancer Recurrence in an Era of Personalized Medicine. J Clin Oncol 2017; 35:3275-3278. [PMID: 28723231 DOI: 10.1200/jco.2017.72.8212] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Belinda Thewes
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Olga Husson
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Hanneke Poort
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jose A E Custers
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Phyllis N Butow
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Sue-Anne McLachlan
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Judith B Prins
- Belinda Thewes, Olga Husson, Hanneke Poort, Jose A.E. Custers, Radboud University Medical Center, Nijmegen, the Netherlands; Phyllis N. Butow, The University of Sydney, Sydney, New South Wales, Australia; Sue-Anne McLachlan, St Vincent's Hospital, Melbourne, and The University of Melbourne, Parkville, Victoria, Australia; and Judith B. Prins, Radboud University Medical Center, Nijmegen, the Netherlands
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Popa E, Schnoll‐Sussman F, Jesudian A, Nandakumar G, Shah MA. Uncommon Cancers of the Stomach. TEXTBOOK OF UNCOMMON CANCER 2017:395-415. [DOI: 10.1002/9781119196235.ch27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2025]
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Abstract
PURPOSE Gastrointestinal stromal tumor (GIST) is the most common mesenchymal malignancy of the gastrointestinal tract. GISTs may coexist with different types of cancer, either synchronous or metachronous. The frequency of this association and the spectrum of neoplasms involved have not been sufficiently analyzed; most of publications describe a single case report and rare case series. In the absence of definitive data, it could be interesting to compare the frequency of the occurrence of GIST and second malignancies in literature. METHODS A review of all case series that reported the frequency of the occurrence of GIST and synchronous second malignancies were considered. RESULTS Six retrospective case series were considered, including 440 GIST patients; of these, there were 64 (14.5 %) patients with other synchronous second malignancies. Median age was 67 years, median GIST size was 3.91 cm (range 3.0-4.79 cm), and all cases (100.0 %) were CD117 and CD34 positive. According to the risk categories, 35.2 % of patients had a very low risk, 24.0 % a low risk, 27.6 % an intermediate risk, and 13.2 % a high risk. CONCLUSIONS Regarding the occurrence of GISTs and synchronous second malignancies, we can consider it as more common than it has been considered. Differently, concerning the topic of the incidence of second primary malignancies (SPMs) and metachronous second malignancies in pre-imatinib and after-imatinib era, we can consider it as a clinically relevant topic; according to the present knowledge, the main cause for the increased incidence of SPMs in the imatinib era is explained by the increased survival of patients with metastatic GISTs and therefore more time available to develop SPMs.
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Theodoropoulos DG. Gastrointestinal stromal tumors of the colon and rectum. SEMINARS IN COLON AND RECTAL SURGERY 2015. [DOI: 10.1053/j.scrs.2015.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Shen S, Krzyzanowska MK. A Decade of Research on the Quality of Systemic Cancer Therapy in Routine Care: What Aspects of Quality Are We Measuring? J Oncol Pract 2015; 11:55-61. [DOI: 10.1200/jop.2014.001564] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Most studies evaluating quality of systemic cancer therapy have focused on access to cytotoxic chemotherapy in early-stage disease. Studies on other aspects of quality and in different clinical settings are needed.
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Affiliation(s)
- Shixin Shen
- University of Toronto; Institute for Clinical Evaluative Sciences; and Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Monika K. Krzyzanowska
- University of Toronto; Institute for Clinical Evaluative Sciences; and Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Özer-Stillman I, Strand L, Chang J, Mohamed AF, Tranbarger-Freier KE. Meta-analysis for the association between overall survival and progression-free survival in gastrointestinal stromal tumor. Clin Cancer Res 2014; 21:295-302. [PMID: 25477532 DOI: 10.1158/1078-0432.ccr-14-1779] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Gastrointestinal stromal tumor (GIST) is a relatively rare tumor that is treated with targeted therapies in advanced stages. Randomized clinical trials (RCT) often require long follow-up and large sample sizes to evaluate overall survival (OS), the gold-standard measure of treatment efficacy. However, changes in therapy following disease progression may complicate survival assessments. Establishing surrogate endpoints may facilitate the drug approval and availability of new efficacious treatments; however, no published studies have investigated this topic in unresectable and/or metastatic GIST. EXPERIMENTAL DESIGN A systematic literature review identified 14 RCTs and five observational studies of sufficient methodologic quality published between January 1995 and December 2013 (29 treatment arms; 2,189 patients). Weighted linear regression was used to evaluate the relation between median OS and median progression-free survival (PFS) for all arms combined and stratified by treatment line, treatment type, and quality score. RESULTS Median OS and PFS were positively related with a correlation of 0.91. The association was still moderate (correlation 0.72) after eliminating four influential data points. In stratified analyses, correlation of OS and PFS was greater in later lines of therapy (first line = 0.52; second line = 0.80; third- and later-line = 0.70) and imatinib showed a stronger association (0.91) than other evaluated treatments (-0.26 to 0.69). CONCLUSION This analysis identified a strong relationship between median OS and PFS, especially in later lines of therapy. Findings suggest that PFS could serve as a surrogate marker for OS; however, analyses of patient-level data are needed to establish its validity in GIST.
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Affiliation(s)
| | | | - Jane Chang
- Bayer HealthCare Pharmaceuticals Inc., Whippany, New Jersey
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Giuliani J, Bonetti A. Gastrointestinal stromal tumors and second primary malignancies before and after the introduction of imatinib mesylate. Chin J Cancer Res 2013; 25:486-7. [PMID: 24255568 PMCID: PMC3828449 DOI: 10.3978/j.issn.1000-9604.2013.10.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/10/2013] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jacopo Giuliani
- Department of Oncology, Mater Salutis Hospital-ASL 21 della Regione Veneto, Legnago (VR), Italy
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Abstract
Gastrointestinal stromal tumors (GISTs) of the colon and rectum are the most common mesenchymal tumors of the gastrointestinal tract. GISTs of the colon and rectum constitute ~5% of all cases. Although colorectal GISTs can be small and found incidentally, the majority appear to be high risk and carry a significant likelihood of recurrent and metastatic disease. Surgery remains the mainstay of treatment for primary disease. There is now considerable interest in GISTs because they can be treated effectively with targeted molecular therapies, specifically tyrosine kinase inhibitors (TKIs), such as imatinib mesylate and sunitinib malate. GISTs are best treated by a multidisciplinary team comprised of the surgeon, medical oncologist, pathologist, and radiologist in the initial evaluation, management, and in continued follow-up. Increasing the number of resectable cases through pharmacologic debulking, optimizing the timing of surgery and organ preservation, reducing recurrence and surgical morbidity, prolonging survival, and possibly enhancing response to imatinib through surgical cytoreduction are all potential benefits of multidisciplinary management.
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Global breast cancer: the lessons to bring home. Int J Breast Cancer 2011; 2012:249501. [PMID: 22295243 PMCID: PMC3262607 DOI: 10.1155/2012/249501] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2011] [Accepted: 10/26/2011] [Indexed: 11/18/2022] Open
Abstract
Breast cancer is the most common cancer affecting women globally. This paper discusses the current progress in breast cancer in Western countries and focuses on important differences of this disease in low- and middle-income countries (LMCs). It introduces several arguments for applying caution before globalizing some of the US-adopted practices in the screening and management of the disease. Finally, it suggests that studies of breast cancer in LMCs might offer important insights for a more effective management of the problem both in developing as well as developed countries.
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Rare anorectal neoplasms: gastrointestinal stromal tumor, carcinoid, and lymphoma. Clin Colon Rectal Surg 2010; 22:107-14. [PMID: 20436835 DOI: 10.1055/s-0029-1223842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Several uncommon tumors occur in the anal canal such as gastrointestinal stromal tumors, carcinoids, and lymphoma. Increased clinical experience and advancements in molecular biology have improved the accuracy of pathologic diagnosis and guided treatment recommendations, which the author addresses in this article.
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Cheung MC, Zhuge Y, Yang R, Koniaris LG. Disappearance of Racial Disparities in Gastrointestinal Stromal Tumor Outcomes. J Am Coll Surg 2009; 209:7-16. [DOI: 10.1016/j.jamcollsurg.2009.03.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 03/13/2009] [Accepted: 03/18/2009] [Indexed: 10/20/2022]
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Blay JY. New paradigms in gastrointestinal stromal tumour management. Ann Oncol 2009; 20 Suppl 1:i18-24. [DOI: 10.1093/annonc/mdp075] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Diagnosing Gastrointestinal Stromal Tumors before the Year 2000. Cancer Epidemiol Biomarkers Prev 2009; 18:1013-4; author reply 1014-5. [DOI: 10.1158/1055-9965.epi-08-0865] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Artinyan A, Ellenhorn J. The Appropriate Selection of a Representative Sample Population: The Case of Surveillance, Epidemiology, and End Results and Gastrointestinal Stromal Tumor. Cancer Epidemiol Biomarkers Prev 2009. [DOI: 10.1158/1055-9965.epi-09-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Avo Artinyan
- Department of General and Oncologic Surgery, City of Hope, Duarte, California
| | - Joshua Ellenhorn
- Department of General and Oncologic Surgery, City of Hope, Duarte, California
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