bims-netuvo 2023-04-09 papers

World J Surg. 2023 Apr 04.

Perineural Invasion of Pancreatic Ductal Adenocarcinoma is Associated with Early Recurrence after Neoadjuvant Therapy Followed by Resection.

Da Eun Cha, Allen T Yu, Nazanin Khajoueinejad, Elizabeth Gleeson, Tali Shaltiel, Yael Berger, Rebekah Macfie, Benjamin J Golas, Umut Sarpel, Daniel M Labow, Spiros Hiotis, Noah A Cohen.

BACKGROUND: Neoadjuvant therapy (NAT) is increasingly utilized in the treatment of pancreatic ductal adenocarcinoma (PDAC). However, there are limited data on risk factors and patterns of recurrence after surgical resection. This study aimed to analyze timing and recurrence patterns of PDAC after NAT followed by curative resection.
METHODS: The medical charts of patients with PDAC treated with NAT followed by curative-intent surgical resection at a single health system from January 1, 2012 to January 1, 2020 were retrospectively reviewed. Early recurrence was defined as recurrence within 12 months of surgical resection.
RESULTS: 91 patients were included and median follow up was 20.1 months. Recurrence occurred in 50 (55%) patients, with median recurrence free survival (RFS) of 11.9 months. Overall, 18 (36%) patients had local and 32 (64%) had distant recurrences. Median RFS and overall survival (OS) between local and distant recurrence were similar. Perineural invasion (PNI) and the presence of a T2 + tumor was significantly higher in recurrence group than in no recurrence group. PNI was a significant risk factor for early recurrence.
CONCLUSION: After NAT and surgical resection of PDAC, disease recurrence was common, with distant metastasis being the most common. PNI was significantly higher in the recurrence group.

DOI: https://doi.org/10.1007/s00268-023-06983-w

Clin Transl Oncol. 2023 Apr 07.

Impact of perineural invasion on the outcome of patients with synchronous colorectal liver metastases treated with neoadjuvant chemotherapy and surgery.

Gabriel Zozaya, Javier Álvarez Cienfuegos, Pablo Martí-Cruchaga, José Luis Hernández-Lizoain, Jorge Baixauli, Fernando Pardo, Ramón Robledano, Javier Rodríguez, Leire Arbea, Fernando Rotellar.

PURPOSE: To analyze the prognostic value of variables of the primary tumor in patients with synchronous liver metastases in colorectal cancer (CLRMs) treated with neoadjuvant chemotherapy and surgery.
METHODS/PATIENTS: From a prospective database, we retrospectively identified all patients with synchronous CLRMs who were treated with neoadjuvant chemotherapy and liver resection. Using univariate and multivariate analyses, we identified the variables associated with tumor recurrence. Overall survival and disease-free survival were calculated using the Kaplan-Meier method with differences determined by the Cox multiple hazards model. Results were compared using the log-rank test.
RESULTS: Ninety-eight patients with synchronous CLRMs were identified. With a median follow-up of 39.8 months, overall survival and disease-free survival at 5 and 10 years were 53%, 41.7%, 29% and 29%, respectively. Univariate analysis identified three variables associated with tumor recurrence: location in the colon (p = 0.025), lymphovascular invasion (p = 0.011) and perineural invasion (p = 0.005). Multivariate analysis identified two variables associated with worse overall survival: perineural invasion (HR 2.36, 95% CI 1.162-4.818, p = 0.018) and performing frontline colectomy (HR 3.286, 95% CI 1.256-8.597, p = 0.015). Perineural invasion remained as the only variable associated with lower disease-free survival (HR 1.867, 95% CI 1.013-3.441, p = 0.045). Overall survival at 5 and 10 years in patients with and without perineural invasion was 68.2%, 54.4% and 29.9% and 21.3%, respectively (HR 5.920, 95% CI 2.241-15.630, p < 0.001).
CONCLUSIONS: Perineural invasion in the primary tumor is the variable with most impact on survival in patients with synchronous CLRMs treated with neoadjuvant chemotherapy and surgery.

Keywords: Colorectal cancer; Liver metastases; Neoadjuvant chemotherapy; Perineural invasion; Stage IV

DOI: https://doi.org/10.1007/s12094-023-03138-0

Front Oncol. 2023 ;13 1162728

Editorial: Improving our understanding of the management and pathogenesis of rare and neglected tumors of the central and peripheral nervous system.

Ignazio G Vetrano, Pierpaolo Alongi, Laura Gatti.

Keywords: DIPG (diffuse infiltrative pontine gliomas); MPNST (malignant peripheral nerve sheath tumors); astroblastoma; intracranial lymphomas; peripheral nerve sheath tumors; pleomorphic xanthoastrocytomas; sodium fluorescein (SF); solitary fibrous tumor (SFT)

DOI: https://doi.org/10.3389/fonc.2023.1162728

Radiol Case Rep. 2023 May;18(5): 2043-2046

CT of pancreatic schwannoma.

Elias Lugo-Fagundo, Carolina Lugo-Fagundo, Edmund M Weisberg, Elliot K Fishman.

Schwannomas are a type of nerve sheath tumor formed by Schwann cells. They typically occur in the head and neck area, the trunk, and flexor surfaces of the upper and lower extremities. Schwannomas are often benign, and pancreatic schwannomas are extremely uncommon. Given the rarity of these tumors and their clinical similarity to other pancreatic lesions, however, pancreatic schwannomas are challenging to diagnose preoperatively. In this article, we report the case of a 69-year-old female who was diagnosed with a pancreatic schwannoma. We focus on optimizing diagnosis and management through the application of radiological imaging modalities, specifically computed tomography scans with cinematic rendering.

Keywords: Cinematic rendering; Computed tomography; Pancreas; Pancreatic schwannoma; Schwannoma

DOI: https://doi.org/10.1016/j.radcr.2023.02.054

J Int Med Res. 2023 Apr;51(4): 3000605231163049

Gastric schwannoma coexisting with tubular adenoma of the gallbladder: a rare combination.

Meng Cai, Xiaodi Chen, Yang Peng, Yufei Liu, Chang Zhou.

We report a case of a man in his early 50 s who was admitted to our hospital for anorexia. An imaging examination led to a preoperative diagnosis of a gastrointestinal stromal tumor and gallbladder stones. He underwent treatment by laparoscopic cholecystectomy and distal partial gastrectomy with lymph node dissection. The final histopathological diagnosis was gastric schwannoma and tubular adenoma of the gallbladder. Gastric schwannoma accounts for only 0.2% of all gastric tumors, and tubular adenoma constitutes only 2.2% of gallbladder tumors. This report describes the diagnosis and treatment process for this combination of tumors, thus providing a reference for similar cases.

Keywords: Synchronous benign tumor; case report; computed tomography; gallbladder; gastric schwannoma; tubular adenoma

DOI: https://doi.org/10.1177/03000605231163049

Mol Carcinog. 2023 Apr 04.

Dual role of sprouty2 as an inhibitor of RAS/ERK-driven proliferation and a promoter of cancer invasion in KRAS wild-type colorectal cancer.

Chung-Ta Lee, Chien-An Chu, Yu-Ming Wang, Yi-Wen Wang, Yi-Lin Chen, Chung-Liang Ho, Yu-Min Yeh, Peng-Chan Lin, Bo-Wen Lin, Po-Chuan Chen, Shang-Hung Chen, Ren-Hao Chan, Chen Chang, Nan-Haw Chow.

Sprouty2 (SPRY2) is known to inhibit the RAS/MAPK/ERK pathway, and is a potential study target for cancer. The effect of SPRY2 in colorectal cancer (CRC) and whether it is influenced by KRAS mutation are not known. We manipulated SPRY2 gene expression and used an activating KRAS-mutant plasmid to determine its effect on CRC cell function in vitro and/or in vivo. We performed SPRY2 immunohistochemical staining in 143 CRC specimens and analyzed the staining results with various clinicopathological characteristics in relation to KRAS mutation status. SPRY2 knockdown in Caco-2 cells carrying the wild-type (WT) KRAS gene upregulated phosphorylated ERK (p-ERK) levels and increased cell proliferation in vitro, but inhibited cell invasion. However, SPRY2 knockdown in SW480 cells (activating KRAS mutant) or Caco-2 cells transfected with KRAS-mutant plasmid did not significantly alter p-ERK levels, cell proliferation, or invasion. The xenografts of SPRY2-knockdown Caco-2 cells were larger with less deep muscle invasion than those of control cells. The clinical cohort study revealed a positive association of SPRY2 protein expression with pT status, lymphovascular invasion, and perineural invasion in KRAS-WT CRCs. However, the associations were not observed in KRAS-mutant CRCs. Interestingly, high SPRY2 expression was related to shorter cancer-specific survival in both KRAS-WT and KRAS-mutant CRC patients. Our study demonstrated the dual role of SPRY2 as an inhibitor of RAS/ERK-driven proliferation and as a promoter of cancer invasion in KRAS-WT CRC. SPRY2 may promote the invasion and progression of KRAS-WT CRC, and might also enhance KRAS-mutant CRC progression through pathways other than invasion.

Keywords: KRAS; cetuximab; colorectal cancer; invasion; sprouty2

DOI: https://doi.org/10.1002/mc.23537