Interaction between microtubule inhibitors and ionizing radiation.
Prof Dr.G. Strome is a scientific consultant and board member of the Oncologic Center UZ Brussels Former President and Executive Secretary of the Organization of European Cancer Institutes, still the representative of Belgium with the OECI
Diffuse large B-cell lymphoma: It is the most common type of non-Hodgkin lymphoma among adults. Diffuse large B-cell lymphoma occurs primarily in older individuals, with a median age of diagnosis at approximately 65-70 years of age, though it can also occur in children and young adults in rare cases. Diffuse large B-cell lymphoma is an aggressive tumor, sometimes associated with fever, weight loss, and night sweats. The cause of diffuse large B-cell lymphoma is not well understood. Typically, diffuse large B-cell lymphoma arises from normal B cells, but it can also represent a malignant transformation of other types of lymphoma or leukemia. However, the usual treatment of these is chemotherapy, often in combination with an antibody targeted at the tumor cells. However, survival rate of patients varies. The details of the clinical data will be presented
Dr. Ashok Srivastava is Chief Executive Officer and Chief Medical Officer of Cure Pharmaceuticals, and ClinFomatrix Oncology, He was founder, Chief Executive Officer and Chief Medical Officer of CareBeyond - A Radiation Therapy Cancer Center, New Jersey, USA. He has more than 15 years of experience in drug development , medical affairs and commercialization of cancer drugs including radiopharmaceutical and supportive care; Phase I – 4, and marketing commercialization of Hematology, Oncology and radio-immuno-oncology drugs in USA , EU and Japan. He is leader in Cancer Drug Development Worldwide large and complex Phase 3 Clinical Trials.
Since clinical trials have been advocated as evidence based guidelines for radiotherapy many RCTs were carried out. Can they be considered compared with empirical studies, as a milestone progress in radiation oncology. Large heterogenous tumor sites and stages were enrolled into the trials on hyperoxygen therapy, radiosensitizers and altered fractionations raise some uncertainties and criticism regarding therapeutic gain usually reported as median end-points. Local tumor control rates have been and still are related to the tumor TNM status, but almost never to initial tumor volume (number of initial cancer stem cells) whereas the effect of irradiation is cell killing, not tumor stage killing. Many RCTs became disappointing or at least therapeutic gain has been lower than expected. Well known trials are reviewed and discussed. In contrary, some retrospective studies have provided important practical informations, i.g. tumor volume is more predictive to design dose fractionation than T stage, overall treatment time has been show as a strong determinant of treatment outcome. This findings initiated series of altered fractionation trials. Alpha/beta values for H&N tumors and cell survival curves derived from skin cancer data were one of the first estimations based on empirical clinical studies. Identifying very low alpha/beta for prostate cancer has attracted stereotactic hypofractionated radiosurgery as an effective therapeutic modality. In this review we discuss the pros and cons of the trials and empirical studies and it looks they are complementary to one another.
Bogusław Maciejewski has completed his PhD and got scientific title of a Full Professor in Radiotherapy. He released research projects in the UCLA Los Angeles, Gray Lab London, MGH Harvard University, Boston, MDACC Houston and other cancer centers in Europe. He was the Director of Cancer Center Institute Gliwice, Poland with over 45 years of research experience. He is Author of over 200 papers published in reputed journals (IF=1650, citation index=3500). He was awarded G F Fletcher Gold Medal, Gold Medal of Life Achievements in Oncology given by all European Oncologic Societies as he is a honorary Member of American College of Radiology, Radiotherapy Expert of the IAEA in Vienna, and for 10 years he was a Member of European Board of Radiotherapy, participating in the development European curriculum for radiotherapy. His major scientific interest is importance of treatment time and tumor repopulation and altered dose fractionation in clinical radiotherapy for human tumors.
Clinical trials design, lung cancer, genitourinary tumors, immune response criteria
Dr. Sonia Maciá was born in Spain in 1978. She pursued her graduation in Medicine from Universidad Miguel Hernández, Alicante, Spain, in 2002 and later completed her MD in Medical Oncology in Hospital General Universitario de Elche, in Elche, Alicante, Spain, in 2006; thereafter was working as Medical Oncologist in Hospital General de Elda, in Alicante for five years until 2012, when she decided to devote her career to clinical research and joined Pivotal Contract Research Organization (Madrid, Spain), firstly as Medical Manager and later on as Oncology Medical Director. She finished her PhD in lung cancer in 2016. She has ten years of experience in the field of Medical Oncology, mainly in lung and genitourinary tumors, and five year experience as medical advisor and medical monitor in phase I-III clinical trials across several European countries. She is a reviewer and member of the editorial board in several scientific journals in the field of Medical Oncology and has 23 publications in scientific journals to her credit.
Finding and development of new treatments for malignant tumors in experiments in vitro and in vivo; photodynamic therapy and fluorescent diagnostics of malignant tumors (clinical); Intraoperative sono-intraoperative photodynamic therapy of malignant brain tumors (clinical).
Medical faculty in Vitebsk State Medical University and Junior researcher, Department of complex therapy with experimental therapy with chemotherapy group, N.N. Alexandrov National Cancer Centre of Belarus. Photodynamic therapy and fluorescence diagnostics for malignant tumors.
Computer-aided diagnosis of lesions in the abdomen, thorax, and heart, and machine learning in medical imaging including ones inspired by the human visual system for image processing and pattern recognition. The long-term goal of Dr. Suzuki's research is to develop a computer system that diagnoses diseases in medical images as an expert radiologist does to assist non-expert doctors in making diagnoses. To approach his goal, he believes that the development of sophisticated machine-learning and image-analysis techniques, their theoretical backups, and an understanding of radiologists’ decision-making process and of the human visual system are essential.
Kenji Suzuki, Ph.D. (by Published Work; Nagoya University) worked at Hitachi Medical Corporation, Japan, Aichi Prefectural University, Japan, as a faculty member. He joined Department of Radiology, University of Chicago, in 2001, and he was Assistant Professor in the department and Graduate Program in Medical Physics. Since 2014, he has joined Department of Electric and Computer Engineering and Medical Imaging Research Center, Illinois Institute of Technology, as Associate Professor. Since 2017, he has been jointly appointed in World Research Hub Initiative at Tokyo Institute of Technology, Japan, as Full Professor (Specially Appointed). He published more than 320 papers (including 110 peer-reviewed papers in leading journals) in the fields of machine and deep learning, computer-aided diagnosis, and medical image processing and analysis. He invented and has been actively studying a machine-learning framework that learns images directly in the past 20 years.
Precision cancer medicine
Dr. D. Roukos has graduated from Athens University School of Medicine, Greece. He underwent specialist training in surgery at the J.W.Goethe-University Hospital in Frankfurt a.M., Germany where received his Doctorate (Dr.med). He moved back to Greece and since 1990 works at the Ioannina University School of Medicine.
To evaluate the multidisciplinary management modalities for chest wall ES/PNET and its outcome. This was the results of a retrospective study that conducted on all patients of both sexes and definite age groups attending at the outpatient clinic at the National Cancer Institute and with thoracic ES / PNET and candidate for surgical intervention. from January 2000 to December 2014. A combination of neoadjuvant chemotherapy followed by surgery and radiotherapy resulted in optimal outcome in patients with this tumor. With extended follow-up, our series demonstrates that upfront interval- compressed systemic multi-agent chemotherapy followed by delayed local control in the form of adequate surgery, alone or combined with radiotherapy, along with concurrent consolidation chemotherapy are the backbone in the treatment of patients with localized chest wall Ewing tumors, decreasing the incidence of both local and systemic relapses and leads to a longer OS and DFS.
Dr. Ahmed S. Salama done his Master of Surgical Oncology, National Cancer Institute (NCI), Cairo University and Master Thesis, Recent Multidisciplinary Approach in Thoraco pulmonary Ewing Sarcoma, NCI Experience, Cairo.
Purpose:The primary goal was to measure toxicities of using SBRT to deliver a single fraction of 10-15 Gy to the prostate (in a phase 1 dose escalation strategy) as a boost in patients with intermediate risk prostate cancer. It was hypothesized that HDR brachytherapy-level doses of 10-15 Gy can be safely delivered using SBRT. Materials/Methods:From 2011-2013, 30patients withintermediate risk prostate cancer were enrolled,with10 patients in each of 3 sequentialSBRT boost dose cohorts (10 Gy, 12.5 Gy, and 15 Gy). SBRT single fraction was delivered with a rectal balloon and foley catheter. Magnetic resonance imaging was used to aid in contouring and determination of patient specific planning target volumes. All patients received intensity modulated radiotherapy (37.5 Gy in 15 fractions) afterwards. Acute/late toxicities (Common Terminology Criteria for Adverse Events, version 3.0) andhealth-related quality of life (Expanded Prostate Cancer Index Composite [EPIC]) were collected prospectively.The minimally clinically important change (MCIC) was defined as EPIC score decrease (baseline score – average follow-up score) > 0.5 SD, where SD is the standard deviation of baseline scores for each domain. Results:Median age was 71 years. Prostate volumesranged from 24-48cc. Mean baseline PSA was 10.2 ng/mL. Median follow-up was 51 months.There was no significant difference among the 3 cohorts except for baseline PSA (15 Gy cohort had higher PSA values), and duration of follow-up (follow-up was longest in the 10 Gy cohort given sequential nature of study).Acute toxicity was mild, with only 30% of all patients experiencing grade 2 GU toxicity and 0% grade 2 GI toxicity. Any late grade ≥2 GU toxicity occurred in 40% of patients, while any late grade ≥ 2 GI toxicity occurred in 30% of patients. One patient developed a rectal-urethral fistula after multiple biopsies of a rectal ulcer. There was no significant difference in the proportion of any late grade ≥2 GU or GI toxicity among the 3 cohorts. The mean EPIC scores did not significantly change during the follow-up period in all domains amongall patients. MCIC occurred in 27.6%, 37.9%, and 42.3%, respectively, in the urinary, bowel, and sexual domains. There were no significant differencesin the proportion of MCIC among the 3 cohorts, except for the sexual domain. Patients in the 15 Gycohort had a higher proportion of sexual MCIC.(p=0.0386).There was only 1 patient who failed biochemically according to Phoenix definition.Patients in the 10 Gycohort had significantly higher post treatment PSA levels over time compared to the other2 cohorts (p <0.002). Conclusion:Single fraction SBRT boost was well tolerated. 15 Gy arm patients had worse sexual function afterwards but lower post treatment PSA values compared to the 10Gy arm.
Motasem Mohammad Al-Hanaqta is Radiation Oncology specialist (Jordanian Board) at Queen Alia oncology center, King Hussein Medical City(KHCC) / Royal Medical servicesAmman Jordan.
Objectives Study of the PSA changes after radiotherapy for local prostate cancer, using 3DCRT technique and evaluating these changes in relation to disease progression. Patients and Methods Between 1.6.2006 and 1.6.2008, a total of 135 patients were treated with Three Dimensional Conformal Radiation Therapy (3DCRT) for clinical stages T1-T3 Adenocarcinoma of the prostate. The median age was 67 years (50-83), 10% had family history. 81% were smokers. The median PSA level was17.5 ng/ml (3.1-95). 32% were T2a and 50% T2b. The median Gleason score was 6 (3-7). 34% received the treatment after radical surgery for biochemical relapse and 64% as primary treatment. 60% received 66-70 Gy and 40% received 72-76 Gy. Patients were followed with PSA 3 monthly for 24 months. The median follow up was 12 months. 39 patients didn’t follow and therefore cancelled from the study. Only 96 patients ended the treatment and the follow up Results The PSA decreased 6-9 months post External Beam Radiation Therapy (EBRT) .However PSA value increased in 27 cases, but 69 patients remained under 0.5-1 ng/ml after 24 months post treatment with EBRT. The Bone scan was positive (bone metastases )in the 27 cases that PSA level had increased.24 cases from these patients received 66-70 GY XRT (low dose) and their median age was more than 70 years and18 cases/27cases were directly treated with EBRT. Conclusion Recurrence after RPR was good controlled by RT, but primary RT was not sufficient in the majority of our patients. Those patients received only 66-70 Gy, therefore Patients should receive a maximum dose of RT, and however more complications are expected. Measurement of Prostatic Specific Antigen (PSA) after Radiation Therapy is a good marker for specificity and sensitivity of the treatment. PSA was a powerful predictor of local relapse and distant metastases (DM) and Patients who develop biochemical relapse should be considered for systemic therapy as distant metastases are expected.
Local Tumor Control in Patients with Brain Glioblastoma
Alexei Leonidovich KRIVOSHAPKIN, PhD., Moscow,. MD, Leningrad, FRCS(NS), London. Born: 15 May 1953, Novosibirsk, Siberia, Russia. Postgraduate qualifications: Neurosurgery consultant qualification [including basic general surgical training]: MD, Leningrad, 26 Jan 1983 [Awarded by the Leningrad Board of Neurological Surgery sitting at the Polenov Neurosurgical Institute, Leningrad] Neurosurgical higher qualification [required to hold a chair or senior academic position], PhD, Moscow, 7 Oct 1994 [Awarded by the Russian Federation Supreme Higher Degree Commission]. Fellowship of the Royal College of Surgeons of England, 11 Feb 1999, London. UK GMC Registration: Certificate of Limited Registration as a Medical Practitioner, Registration No.: 180999, Date of Cert.: 21/08/96, Period of Limited Registration From: 20/08/96 To: 26/08/97. Date of Cert.: 26/08/97, Period of Limited Registration From: 26/08/96 To: 30/09/97. Russian Speciality Certificate A № 2044049
Dr. Jing Wang
Institute of Neurosciences of Montpellier, France
In recent years, with the improvement of cancer survival through more effective treatment, the emphasis has been in trying to minimize the side effects caused by chemo- and radiotherapy, to ensure that patients have the best quality of life throughout their cancer journey. The tumor suppressor p53 is widely implicated in a broad range of cancers. Indeed, p53 is either mutated or inactivated in the majority of cancers. Abundant evidence indicates that toxicity caused by DNA-damaging anticancer therapies in normal tissues is also mainly mediated by p53. p53 accumulates in the cells shortly after anticancer challenges and acts as a nuclear transcription factor that modulates the expression of numerous p53-responsive genes (e.g. p21Waf1, 14-3-3-σ, Mdm2, cyclin G, Bax). This initiates a cascade of events leading to massive programmed cell death in specific normal tissues during the systemic genotoxic stress associated with chemo- and radio-therapies. This makes p53 a target for therapeutic suppression: an approach to reduce side effects associated with treatment of p53-deficient cancers. Here I summarise the role of p53 and the possibilities of its manipulation to improve side effects during active treatment through survivor-ship.
After her MD from Medical school of University Kunming, China and her PhD thesis on inner ear cell degeneration and therapies from University of Montpellier, France. Jing Wang is the team leader of Sensory loss and rescue group at the Institute of Neurosciences of Montpellier, Montpellier, France. During her career, Jing Wang has more than 42 research publications and supervised 7 PhD students and 3 Postdoctoral researchers, 9 book chapters and more than 150 communications or posters. She is member of the Editorial Boards of international journals. In addition to basic research, she took out 3 patents for tinnitus and deafness treatments and promoted translational research.
The Pathogenesis of primary central nervous system (CNS)lymphoma poses a unique set of diagnostic, prognostic, therapeutic challenges. The Pathogenesis of CNS Lymphoma affects multiple compartments within the neuraxis, and proper treatment of the CNS Lymphoma patient requires a multidisciplinary team with expertise not only in Hematology/Oncology but also Neurology, Neuroradiology and radiation Oncology.
Transmembrane-4-L-Six-Family-1 (TM4SF1) is a member of L6 family, which functions as signal transducer to regulate cell development, growth and motility. Our results suggested that TM4SF1 was strongly upregulated in human muscle invasive bladder cancer (MIBC) tissues, corroborated with our transcriptome analysis. Moreover, tissue microarray showed significant correlations between TM4SF1 and T stage, TNM stage, lymph node metastasis status and survival rate of MIBC, indicating a positive association of TM4SF1 and poorer prognosis. Furthermore, in vitro and in vivo studies suggested that proliferation of human bladder cancer (BCa) cells was significantly suppressed by downregulated TM4SF1. Functionally, reduction of TM4SF1 could induce cell cycle arrest and apoptosis possibly via upregulation of reactive oxygen species (ROS) in the BCa cells. Interestingly, these observations were scavenged by treatment of GW9662 (antagonist of PPAR) and resveratrol (activator of SIRT1), respectively. Taken together, our results suggested that TM4SF1 may be a novel biomarker for MIBC.
Rui CAO has completed his Ph. D. degree from Wuhan University, China. Now he works as a resident in Zhongnan Hospital of Wuhan University. His research interest was to investigate the specific biomarkers for urinary malignancy, such as prostate cancer and bladder cancer. And he has published more than 10 papers and has been serving as a reviewer for some peer review journals.
Breast conserving surgery (BCS) or lumpectomy has been established as a standard treatment option for women with early-stage invasive breast cancers. Goals of BCS are to remove the cancer with negative margins and preserve maximum cosmetic appearance of the breast. Surgical margin status has a significant impact on local recurrence. Achieving a negative lumpectomy margin is a complex process which requires team efforts from surgeon, pathologist and radiologist. Each member of a multidisciplinary team needs to be cognizant of the how to help each other in obtaining the negative specimen margin. There are multiple risks and predictors of positive surgical margins that the team also needs to be familiar with. These risks and factors will be reviewed with multiple cases of positive margins with a correlation of specimen, radiological and pathologic images. Despite the common use of mammography to help avoid positive surgical margins, it is important to remember the limitations of standard intraoperative specimen radiographs. After attendance of this lecture the audience will be able to understand the complexity of achieving a negative lumpectomy margin; describe the risks and predictors of positive surgical margins; understand the limitations of specimen radiographs; and appreciate the importance of working as a member of the multidisciplinary team.
Xiaoqin Jennifer Wang, M.D., is an Assistant Professor and Radiologist at the Department of Radiology, University of Kentucky College of Medicine. She completed her medical school and residency training at the University of Kentucky in 2015. After finished her Breast Imaging fellowship training at the University of Chicago, she returned to University of Kentucky as a faculty in 2016. As a specialized Breast Imager, she reports breast images (mammography, ultrasound, and MRI) and performs imaging guided procedures. Other than her clinical duty, she teaches trainees (medical students, residents, and fellows) and conducts multiple research projects with a focus on application of artificial intelligence in medical imaging. She has presented at multiple national and international conferences and authored and co-authored 16 peer-reviewed papers and book chapters.
Ovarian cancer remains as the leading cause of death from gynecological cancer with more than 150,000 female deceases around the world each year. The main problem of this disease is that it is usually detected at later stages, for which the survival rates are relatively low. Therefore, it is important to design efficient methods for an early diagnosis. The screening and initial procedures for the detection of ovarian cancer are often carried out by testing serum biomarkers that are known to correlate with the appearance of tumours. In particular, the serum biomarker Cancer Antigen 125 (CA125) is the most commonly used oncomarker in the screening of this type of cancer. However, we will show how combining longitudinal time series of different onco-markers can improve the classification of pre-diagnosis samples. The proposed method for the detection of tumours relies on a hierarchical Bayesian model that detects the presence of change-points in patients with ovarian cancer. The study is carried out for a subset of the data collected in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS, number ISRCTN22488978; NCT00058032). The selected dataset included 179 controls (healthy women) and 44 cases (diagnosed women): 35 cases of invasive epithelial ovarian cancer, 3 cases of Fallopian tube cancer and 6 cases of peritoneal cancer.
Ines P. Marino (MSc 1995, PhD 1999) is an Associate Professor at the Department of Biology and Geology, Physics and Inorganic Chemistry, Universidad Rey Juan Carlos (Spain) and a Honorary Senior Research Associate in the Institute for Women’s Health, University College London (UK). Her interests are in the fields of dynamical systems, computational statistics and their applications in biology and medicine. She has published over 50 publications in international journals and proceedings of international conferences.
Coefficient of Pancreatic Adenocarcinoma
Mahmoud Mohamed Mounir Aly Higazi is specialized in Diagnostic Radiology, Egypt
Purpose: To observe the effect of Rapid Cooling procedure on thepreparation of thermoplastic used for immobilization in Head and Neck cancer patients in our center. Background: In our normal practice we use CIVCO Standard perforated head, neck and shoulderthermoplastic masks for immobilization. Our normal preparation and procedure for thermoplastics requires20 to 25 min amount of time with cooling at room temperature. Due to significant number of our patients being referred to our center from remote areas that are unable to stay locally or visit in the days following their outpatient appointments. To meet these concerns and to avoid any delays in start of treatment, we tend to scan them on the day of their visit. This in turn puts a significant pressure on the single CT simulator available. Due to patient related concerns and related pressures we decided to improvise by shortening of the preparation time of Orfit through rapid cooling with a wet sheet of cloth placed in the freezer. Method: Standard Thermoplastic for head and neck immobilisation were used following based on Civco recommendation; from water bath temperature 74 degree and leaving the Orfit for 6 min in the water bath. Orfit was then placed on the patient after choosing the appropriate head rest with 3 mm shim in a comfortable position. While the Orfit was being prepared a wet sheet of cloth was put in the freezer at 0 degree temp for the duration of 4-5 minutes. As the final step the thermoplastic maskwaswrappedin the cold sheet for 5-7 min and then refitted again on the patient. We used the rapid cooling procedure on 5 patients and noted the effects and compared it with equal number of patients done as routine practice. This was anticipated to reduce the CT sim time by 15 minutes per patient requiring orfit use. Result: It was interesting to observe that even within a short period of time i.e. up to 5 minutes in the cold sheet, there was significant shrinkage detected. In all our patients the 3 mm shim had to be removed due to significant shrinkage of the Orfit. We observed the up to 6mm shrinkage in the Orfitincluding sup/inf direction. It was also observed that from preparation till treatment time, the Orfit showed further shrinkage. This did put us in a challenging situation with the daily patient set up but did not require any interruptions or re preparation of the Orfit. Conclusion: Although rapid cooling of the orfit as described in our short study is a novel concept. However, its application in clinical practice led to set up uncertainty due to significant shrinkage even when the rapid cooling was applied for a short duration. We have found the cooling of the orfit at room temperature to be safest practice. At this point we can speculate that perhaps allowing even less period of time in the cold sheet may offer a solution to the excessive shrinkage.
Lung cancer is the leading cause of dead in the U.S and one of the top 5 oncologic entities worldwide. Non-invasive therapeutic options for non-small cell lung cancer (NSCLC) have progressively advanced and local radiation is the main therapeutic option, alone in stage 1 NSCLC and adjuvant to surgery in more advanced stages. Imaging with Multidetector CT (MDCT) of the chest is one of the most important tools for treatment planning and post-treatment follow-up. Radiologists in general need to be familiar with the imaging appearance of lung cancer after local radiation treatment in order to accurately recognize the post treatment appearance of the radiation bed as it evolves over time, as well as appropriately diagnose complications such as infection, recurrence and bronchopleural fistula, among others. This lecture will provide a general review of the current options of local radiation in the setting of NSCLC such as conventional radiotherapy, conformal radiotherapy and single beam radiotherapy (SBRT); a timeline of the imaging appearance after treatment, according to the type of treatment received, and the imaging appearance of the most frequent complications after treatment, with an emphasis in the recognition of local recurrence.
• Management of complete clinical response: gateway to non-surgical treatment? • Strategies against re-excision and local recurrence in breast-conserving therapy • Gene expression risk scores and the surgeon • Trends in oncoplastic breast-conserving surgery • Breast reconstruction: choosing the right technique
the majority of patients present advanced disease at diagnosis, the management of epithelial ovarian cancer needs specialist multidisciplinary teamwork. Expertise in surgery, chemotherapy, imaging and histopathology is essential to achieve optimum outcomes. Computed tomography scans are routinely used to determine the extent of disease and to aid in surgical planning. The histologic classification is crucial to plan the best therapeutic strategy and to define the prognosis of disease. Pathological prognostic factors, such as degree of differentiation, FIGO-stage, and histological type have to be described. This report is fundamental to assessing prognosis and selection of appropriate treatment strategy. An adequate staging procedure is an extensive staging by an experienced gynecological oncologist, exploring the entire upper abdomen, and the pelvic and para-aortic lymph node regions to define the Peritoneal Cancer Index (PCI). The final assessment is the completeness of cytoreduction (CC) score, which is an assessment of residual disease after a maximal surgical effort. Initial management of advanced ovarian cancer is best provided by a specialist multidisciplinary team, including a radiologist, a pathologist, a gynecologic oncologist and a medical oncologist. Different management options for patients with advanced ovarian cancer either surgery, chemotherapy and targeted therapy.
A newly emerging technology, digital breast tomosynthesis (DBT) or 3D mammography can reduce the masking effect of the breast tissue on mammography by creating multiple 2D imaging slices of the breast. Hence, it has been proven to have higher breast cancer detection rate compared with 2D mammography.DBT improves the detection of low contrast lesions such as uncalcified masses or architectural distortions. Moreover, DBT can decrease the summation artifact and has been shown to have less call back rates which help to avoid unnecessary additional evaluation. Both retrospective and prospective studies have clearly shown that DBT can detect more breast cancer with lower call back rate compared to digital mammography.Since some of the suspicious breast lesions can only be visualized on the DBT, a new DBT guided vacuum-assisted biopsy (TVAB) is necessary to sample the breast lesions that are occult on both ultrasound and 2D mammography. TVAB has a better clinical performance compared to conventional SVAB because it can target not only the lesions detected on 2D mammography like SVAB but also the lesions only visualized on DBT. TVAB can replace stereotactic vacuum assisted biopsy (SVAB) in routine clinic practice with equivalent successful biopsy rate and less procedure time and less exposures.
Dr. Margaret Szabunio is a Professor of Radiology, Surgery and Biomedical Engineering at the University of Kentucky in Lexington, Kentucky. Dr. Szabunio also holds appointments as Chief of Women’s Radiology and Associate Medical Director of the Comprehensive Breast Care Center at the Markey Cancer Center. In addition, Dr. Szabunio is Program Director of the Women’s Radiology Fellowship. She obtained her degree from Drexel University College of Medicine in Philadelphia, Pennsylvania, followed by radiology residency and fellowship at Long Island Jewish Medical Center in New York. She is a Fellow of the American College of Radiology and has served on numerous committees and boards. Dr. Szabunio has more than two decade track record of documented success in the scientific, administrative and clinical aspects of breast imaging and oncology. Dr. Szabunio has received 10 Teaching Awards, and has been an invited speaker at more than 70 professional, scientific, and public organizations and society meetings nationally and internationally.
Tumor budding is correlated with expression of EMT regulators and has an impact on the prognosis of OSCC. During the past few decades, tumor budding has been established as an additional prognostic factor for patients with colorectal cancer. However, its value as a prognostic marker and molecular background in OSCC is still incompletely understood. This study aimed to identify whether tumor budding has an impact on the progression and prognosis of OSCC and investigated the relationship between tumor budding and regulated protein involved in EMT. This study protocol was approved by the Institutional Review Board (IRB) of Seoul National University Dental Hospital (IRB number: CRI14001).Fifty-six cases of OSCC were selected and their tumor budding status was reviewed using archived hematoxylin and eosin-stained slides.Among the 56 OSCC cases examined,the positive tumor budding was observed in 19 cases (33.9%). Statistical analysis revealed that the positive tumor budding was strongly associated with lymph node metastasis (P = 0.001) and shorter overall survival (P=0.002)with Kaplan–Meier method.The expression of Snail and Twist was correlated with lymph node metastasis (P<0.001 and 0.002, respectively) and poorer overall survival (P= 0.024 and 0.024, respectively). Tumor budding was significantly associated with the expression of Snail (P= 0.003) and showed a tendency toward higher expression of Twist (P= 0.08). Therefore, our results suggest thattumor budding is significantly associated with poor prognosis in patients with OSCC and histologically represents an EMT process in OSCC.
Epithelial ovarian cancer (EOC) accounts for 4% of all cancers in women and is the leading cause of death from gynecologic malignancies. The molecular basis of EOC initiation and progression is still poorly understood. Previously, we have applied an epigenomics approach to investigate the possible implication of aberrant DNA methylation in EOC etiology. We used methylated DNA immunoprecipitation in combination with CpG island tiling arrays to characterize at high resolution the DNA methylation changes that occur in the genome of serous EOC tumors during disease progression. We found widespread DNA hypermethylation that occurs even in less invasive/early stages of ovarian tumorigenesis. In contrast, significant DNA hypomethylation was observed only in high-grade (G3) serous tumors. This approach led to the identification of novel EOC oncogenes, potentially modulated by epigenetic mechanisms (hypomethylation) in advanced EOC, and displaying implication in different mechanisms of EOC dissemination, including alterations in gene expression control (RUNX1, RUNX2), abnormal metabolism (BCAT1), aberrant O-glycosylation (GALNT3) and importantly, epithelial to mesenchymal transition (EMT) regulation (Ly75, GRHL2, HIC-5). These genes could represent new therapeutic targets and/or novel biomarkers indicative for EOC progression. Moreover, our data are indicative for the implication of aberrant DNA methylation in EMT-mediated EOC progression.
Dimcho Bachvarov, Professor at Université Laval, Québec PQ Canada, grew up in Bulgaria and received his B.Sc. and M.Sc. degrees from the University of Sofia in 1975-1978. He obtained his Ph.D. degree in 1986 in the Institute of Molecular Biology at the Bulgarian Academy of Science. In 1990, he joined Professor Tom Moss's Laboratory at Université Laval as a Postdoctoral Associate, and in 1994 he was appointed as Adjunct Professor at the Dept. Pharmacology, Université Laval. Consecutively, Dr. Bachvarov was promoted to Assistant Professor (1997), Associate Professor (2002) and since 2005 he is a Full Professor at the Dept. Mol. Medicine, Université Laval. He has been a recipient of different Scholarship Awards, with the most representative being the Ernest J.B. Tomlinson Scholarship Award from the Kidney Foundation of Canada and two consecutive Scholarship Awards (Junior and Senior) from Fonds de recherche du Québec - Santé (FRQS). Dr. Bachvarov is strongly involved in the research activities of the provincial Cancer Research Network (CRN), supported by FRQS, as he is the head of the CRN ovarian tumor bio-bank and the CRN genomic platform in Québec City. Currently Dr. Bachvarov’ research interests are focused on the characterization of novel epigenetically regulated epithelial ovarian cancer (EOC) oncogenes and their role in EOC dissemination, as well as the role of EMT and aberrant glycosylation in EOC progression.
Introduction: Treatment of recurrent and residual RCC after previous treatment is challenging. The accepted treatments are mainly surgical including partial or radical nephrectomy. Purpose: To report on thermal ablation as a method of treatment for recurrent and residual RCC. Material and methods: From April 2012 to august 2018 radiofrequency ablation (RF) was performed in 14 patients (11 males, 3 females, average age 59)with recurrence RCC or tumor remnant after previous treatment . Result: Percutaneous RF were performed in 5 patients with recurrence RCC after partial nephrectomy (PN), 1 patient with residual RCC after PN, 2 patients after PN and new RCC in the contralateral kidney, 2 patients after radical nephrectomy (RN) and de novo RCC in the single kidney and 2 patients with residual and recurrence RCC after previous ablation. In two patients with recurrence after PN ,thermal ablation was not possible due to adhesion of colon and proximity of the ureter which could not be distance by hydro-dissection. All patients underwent the procedures without complications and were discharged from the hospital after 24 hours. During a follow-up period of 31-87 months (average 59) no recurrences were observed. Conclusion: Thermal ablation is an effective method for treatment for recurrent or residual RCC and should be included in the treatment armamentarium.
Dr. Wandel Ayelet Department of Medical Imaging Edith Wolfson Medical Center Holon, Israel