bims-netuvo 2023-11-12 papers

bims-netuvo

Biomed News

on Nerves in tumours of visceral organs

Issue of 2023–11–12
eight papers selected by
Maksym V. Kopanitsa, The Francis Crick Institute

Preoperative Prediction of Perineural Invasion in Oesophageal Squamous Cell Carcinoma Based on CT Radiomics Nomogram: A Multicenter Study.
Non-invasive prediction of perineural invasion in intrahepatic cholangiocarcinoma by clinicoradiological features and computed tomography radiomics based on interpretable machine learning: a multicenter cohort study.
Peripheral nerve sheath tumour mimicking deep calf thrombus: An incidental finding during lower limb venous Doppler ultrasound.
Endoscopic En-Bloc Resection of Neurilemmoma of the Foot Dorsum.
The role of radiotherapy in the management of malignant peripheral nerve sheath tumors: a single-center retrospective cohort study.
Risk-factors for locally advanced rectal cancer relapse after neoadjuvant chemoradiotherapy: A single center experience.
Establishment and characterization of a recurrent malignant peripheral nerve sheath tumor cell line: RsNF.
Central Nervous System-related Conditions and Associated Healthcare Resource Use Among Japanese nmCRPC Patients Based on Retrospective Claims Data.

Acad Radiol. 2023 Nov 08. pii: S1076-6332(23)00506-8. [Epub ahead of print]

Preoperative Prediction of Perineural Invasion in Oesophageal Squamous Cell Carcinoma Based on CT Radiomics Nomogram: A Multicenter Study.

Hui Zhou, Jianwen Zhou, Cai Qin, Qi Tian, Siyu Zhou, Yihan Qin, Yutao Wu, Jian Shi, Feng Feng.

   RATIONALE AND OBJECTIVES: To investigate the value of computed tomography (CT) radiomics nomogram in the preoperative prediction of perineural invasion (PNI) in oesophageal squamous cell carcinoma (ESCC) through a multicenter study.
MATERIALS AND METHODS: We retrospectively collected postoperative pathological data of 360 ESCC patients with definite PNI status (131 PNI-positive and 229 PNI-negative) from two centres. Radiomic features were extracted from the arterial-phase CT images, and the least absolute shrinkage and selection operator and logistic regression algorithm were used to screen valuable features for identifying the PNI status and calculating the radiomics score (Rad-score). A radiomics nomogram was established by integrating the Rad-score and clinical risk factors. A receiver operating characteristic curve was used to evaluate model performance, and decision curve analysis was used to evaluate the predictive performance of the radiomics nomogram in the training, internal validation, and external validation sets.
RESULTS: Twenty radiomics features were extracted from a full-volume tumour region of interest to construct the model, and the radiomics nomogram combined with radiomics features and clinical risk factors was superior to the clinical and radiomics models in predicting the PNI status of ESCC patients. The area under the curve values of the radiomics nomogram in the training, internal validation, and external validation sets were 0.856 (0.794-0.918), 0.832 (0.742-0.922), and 0.803 (0.709-0.898), respectively.
CONCLUSION: The radiomics nomogram based on CT has excellent predictive ability; it can non-invasively predict the preoperative PNI status of ESCC patients and provide a basis for preoperative decision-making.

Keywords:  Nomogram; Oesophageal squamous cell carcinoma; Perineural invasion; Radiomics

DOI:  https://doi.org/10.1016/j.acra.2023.09.026
Int J Surg. 2023 Nov 03.

Non-invasive prediction of perineural invasion in intrahepatic cholangiocarcinoma by clinicoradiological features and computed tomography radiomics based on interpretable machine learning: a multicenter cohort study.

Ziwei Liu, Chun Luo, Xinjie Chen, Yanqiu Feng, Jieying Feng, Rong Zhang, Fusheng Ouyang, Xiaohong Li, Zhilin Tan, Lingda Deng, Yifan Chen, Zhiping Cai, Ximing Zhang, Jiehong Liu, Wei Liu, Baoliang Guo, Qiugen Hu.

BACKGROUND: Perineural invasion (PNI) of intrahepatic cholangiocarcinoma (ICC) is a strong independent risk factor for tumor recurrence and long-term patient survival. However, there is a lack of non-invasive tools for accurately predicting the PNI status. We develop and validate a combined model incorporating radiomics signature and clinicoradiological features based on machine learning for predicting PNI in ICC, and used the Shapley Additive explanation (SHAP) to visualize the prediction process for clinical application.
METHODS: This retrospective and prospective study included 243 patients with pathologically diagnosed ICC (training, n=136; external validation, n=81; prospective, n=26, respectively) who underwent preoperative contrast-enhanced CT between January 2012 and May 2023 at three institutions (three tertiary referral centers in Guangdong Province, China). The ElasticNet was applied to select radiomics features and construct signature derived from CT images, and univariate and multivariate analyses by logistic regression were used to identify the significant clinical and radiological variables with PNI. A robust combined model incorporating radiomics signature and clinicoradiological features based on machine learning was developed and the SHAP was used to visualize the prediction process. A Kaplan-Meier survival analysis was performed to compare prognostic differences between PNI positive and negative groups and was conducted to explore the prognostic information of the combined model.
RESULTS: Among 243 patients (mean age, 61.2 y ± 11.0 (SD); 152 men and 91 women), 108 (44.4%) were diagnosed as PNI-positive. The radiomics signature was constructed by seven radiomics features, with areas under the curves (AUCs) of 0.792, 0.748, and 0.729 in the training, external validation, and prospective cohorts, respectively. Three significant clinicoradiological features were selected and combined with radiomics signature to construct a combined model using machine learning. The eXtreme Gradient Boosting (XGBoost) exhibited improved accuracy and robustness (AUCs of 0.884, 0.831, and 0.831, respectively). Survival analysis showed the construction combined model could be used to stratify relapse-free survival (hazard ratio, 1.933; 95% confidence interval (CI): 1.093-3.418; P=0.021).
CONCLUSIONS: We developed and validated a robust combined model incorporating radiomics signature and clinicoradiological features based on machine learning to accurately identify the PNI statuses of ICC, and visualize the prediction process through SHAP for clinical application.

DOI: https://doi.org/10.1097/JS9.0000000000000881
Ultrasound. 2023 Nov;31(4): 317-322

Peripheral nerve sheath tumour mimicking deep calf thrombus: An incidental finding during lower limb venous Doppler ultrasound.

Christopher Ekene Ilounoh, Rajuno Ernest Eteng, Samuel Lincoln Bukenya.

   Introduction: Peripheral nerve sheath tumours are neurogenic neoplasms that arise from the nerve sheath which are not within the central nervous system. While most of these lesions may be benign, some of them may undergo malignant transformation, establishing why it is imperative for ultrasound practitioners to familiarise themselves with ultrasound presentations of this lesion to facilitate early and effective diagnosis, which would in turn positively impact patient management.
Case report: We present an incidental finding of a thrombus-mimicking peripheral nerve sheath tumour in a female patient who came to the ultrasound department for a left leg deep vein thrombosis scan.
Discussion: This case study demonstrates a peripheral nerve sheath tumour which by virtue of its location (very closely adjacent the deep calf veins) and appearance (incompressible, heterogeneous, minimal colour flow), mimicked a deep calf vein thrombus on ultrasound. Careful surveillance of the area on ultrasound revealed the lesion was distinct from the calf vasculature, and further imaging was advised. A magnetic resonance imaging was conducted confirming the diagnosis of a peripheral nerve sheath tumour.
Conclusion: In addition to assessing the lower limb venous system during deep venous thrombosis scans, sonographers should be mindful that other soft tissue lesions such as peripheral nerve sheath tumour may be present with symptoms that mimic those of a thrombotic leg, and therefore check to exclude or confirm the presence of any adjacent soft tissue lesions, especially at the symptomatic site indicated by the patient.

Keywords:  Peripheral nerve sheath tumour mimicking deep calf vein thrombus; peripheral nerve sheath tumour mimicking deep venous thrombosis; soft tissue lesion mimicking deep venous thrombosis; thrombotic calf pain as a result of peripheral nerve sheath tumour; thrombotic calf pain as a result of soft tissue lesion

DOI:  https://doi.org/10.1177/1742271X231155407
Arthrosc Tech. 2023 Oct;12(10): e1773-e1777

Endoscopic En-Bloc Resection of Neurilemmoma of the Foot Dorsum.

Yu Hei Choi, Tun Hing Lui.

Neurilemmoma (schwannoma) is a benign, slow-growing, encapsulated tumor originating from the Schwann cells of the peripheral nerve sheath. The purpose of this technical note is to describe the technique of endoscopic en-bloc resection of neurilemmoma of the foot dorsum. This has the advantage of better cosmetic result and less postoperative perineural fibrosis.

DOI: https://doi.org/10.1016/j.eats.2023.06.005
J Cancer Res Clin Oncol. 2023 Nov 04.

The role of radiotherapy in the management of malignant peripheral nerve sheath tumors: a single-center retrospective cohort study.

Siyer Roohani, Noa Marie Claßen, Felix Ehret, Armin Jarosch, Tomasz Dziodzio, Anne Flörcken, Sven Märdian, Daniel Zips, David Kaul.

   PURPOSE: This study sought to investigate the role of radiotherapy (RT) in addition to surgery for oncological outcomes in patients with malignant peripheral nerve sheath tumors (MPNST).
METHODS: In this single-center, retrospective cohort study, histopathologically confirmed MPNST were analyzed. Local control (LC), overall survival (OS), and distant metastasis-free survival (DMFS) were assessed using the Kaplan-Meier estimator. Multivariable Cox regression analysis was performed to identify factors associated with LC, OS, and DMFS.
RESULTS: We included 57 patients with a median follow-up of 20.0 months. Most MPNSTs were located deeply (87.5%), were larger than 5 cm (55.8%), and had high-grade histology (78.7%). Seventeen patients received surgery only, and 25 patients received surgery and pre- or postoperative RT. Median LC, OS, and DMFS after surgery only were 8.7, 25.5, and 22.0 months; after surgery with RT, the median LC was not reached, while the median OS and DMFS were 111.5 and 69.9 months. Multivariable Cox regression of LC revealed a negative influence of patients presenting with local disease recurrence compared to patients presenting with an initial primary diagnosis of localized MPNST (hazard ratio: 8.86, p = 0.003).
CONCLUSIONS: The addition of RT to wide surgical excision appears to have a beneficial effect on LC. Local disease recurrence at presentation is an adverse prognostic factor for developing subsequent local recurrences. Future clinical and translational studies are warranted to identify molecular targets and find effective perioperative combination therapies with RT to improve patient outcomes.

Keywords:  Local control; MPNST; Malignant peripheral nerve sheath tumor; Prognostic factor; Radiotherapy; Survival

DOI:  https://doi.org/10.1007/s00432-023-05449-9
Medicine (Baltimore). 2023 Nov 03. 102(44): e35519

Risk-factors for locally advanced rectal cancer relapse after neoadjuvant chemoradiotherapy: A single center experience.

Dragana Stupar, Saša Jungić, Zdenka Gojković, Jelena Berendika, Živojin Janičić.

The overall prognosis of locally advanced rectal cancer (LARC) remains unsatisfactory due to a high incidence of disease relapse. The present understanding of the factors that determine the likelihood of recurrence is limited or ineffective. We aimed to identify the main risk factors influencing tumor relapse in LARC patients after neoadjuvant chemoradiotherapy (nCRT) and surgical treatment in a single center in Republika Srpska. Patients with stage II or stage III who received nCRT before surgery for primary rectal cancer at the Oncology Clinic, University Clinical Center of Republika Srpska from January 2017 and December 2022 were included in the study. We collected patient demographics, clinical stage and characteristics, neoadjuvant therapy, and surgical methods, along with the pathological response after treatment completion, and analyzed them to identify the risk factors for tumor relapse. Out of 109 patients diagnosed with LARC, 34 (31,2%) had tumor relapse. The median time to relapse was 54 months. Participants with clinical T4 stage had a significantly shorter relapse time compared to the patients with clinical T2/3 stage. Subjects with positive lymph nodes removed, perivascular and perineural invasion, intraoperative perforation and patients without ypN stage improvement had significantly shorter time to relapse. Subjects with T4 stage had more than 4 times higher risk of relapse than patients with clinical T2/3 stage. Higher clinical T stage was an essential risk factor for tumor relapse in LARC patients after nCRT and surgical treatment. Comprehensive understanding and identification of the risk factors for tumor relapse in LARC patients are crucial for improving their long-term outcomes.

DOI: https://doi.org/10.1097/MD.0000000000035519
Hum Cell. 2023 Nov 08.

Establishment and characterization of a recurrent malignant peripheral nerve sheath tumor cell line: RsNF.

Xingnan Zhang, Chenhao Hu, Dezhi Li, Song Liu.

  Malignant peripheral nerve sheath tumor (MPNST) is a highly aggressive and recurrent soft tissue sarcoma. It most commonly occurs secondary to neurofibromatosis type I, and it has a 5-year survival rate of only 8-13%. To better study the tumor heterogeneity of MPNST and to develop diverse treatment options, more tumor-derived cell lines are needed to obtain richer biological information. Here, we established a primary cell line of relapsed MPNST RsNF cells derived from a patient diagnosed with NF1 and detected the presence of NF1 mutations and SUZ12 somatic mutations through whole-exome sequencing(WES). Through tumor molecular marker targeted sequencing and single-cell transcriptome sequencing, it was found that chromosome 7 copy number variation (CNV) was gained in this cell line, and ZNF804B, EGFR, etc., were overexpressed on chromosome 7. Therefore, RsNF cells can be used as a useful tool in NF1-associated MPNST genomic amplification studies and to develop new therapeutic strategies.

Keywords:  Copy number variation (CNV); Insertions and Deletions (INDELs); MPNST; NF1; Primary cell; Single Nucleotide Polymorphisms (SNPs); Single-cell RNA sequencing; Whole-exome sequencing(WES)

DOI:  https://doi.org/10.1007/s13577-023-01000-7
J Health Econ Outcomes Res. 2023 ;10(2): 91-99

Central Nervous System-related Conditions and Associated Healthcare Resource Use Among Japanese nmCRPC Patients Based on Retrospective Claims Data.

Dianne A Ledesma, Jonathan L Chua, Susan S H Tang, Xiu W Lim.

  Background: Japanese patients with prostate cancer are typically treated with primary androgen deprivation therapy (ADT), most commonly administered as a combination of a luteinizing hormone-releasing hormone (LHRH) agonist and an antiandrogen (AA). Since LHRH agonists and AA therapy can be maintained for several years, the long-term effects of these treatments on patients must be carefully considered, including the risk of concomitant central nervous system (CNS) conditions which could affect treatment choices. Objective: To describe CNS-related concomitant conditions during ADT and/or AA treatment and the subsequent healthcare resource utilization in Japanese nonmetastatic castration-resistant prostate cancer (nmCRPC) patients. Methods: Patients diagnosed with nmCRPC and CNS-related conditions while on ADT and/or AA therapy between April 2009 and August 2017 were retrospectively followed up for a maximum of 2 years using a claims database. Results: A total of 455 patients (average age, 78.5 years), were included. The 3 most common concomitant CNS-related conditions were pain (~60% of events), insomnia (~30%), and headache (2%-3%). The frequency of CNS-related conditions in these patients increased approximately threefold after starting AA therapy (before, 969 events; after, 2802). On average, a patient had 10 episodes of concomitant CNS-related conditions in a year. Medical costs did not significantly increase due to CNS-related conditions. Discussion: The most frequently reported CNS-related conditions were pain, insomnia, and headaches. Furthermore, more concomitant CNS-related conditions 1 year after CRPC diagnosis and 1 year after starting AA treatment were recorded. Conclusion: Patients with nmCRPC experience an increase in the frequency of concomitant CNS-related conditions, including pain, insomnia, and headaches, after CRPC diagnosis or starting AA treatment. Future research should explore the causes of this increased frequency.

Keywords:  androgen deprivation therapy; antiandrogen; castration-resistant prostate cancer; central nervous system-related; gonadotropin-releasing hormone analogs

DOI:  https://doi.org/10.36469/001c.87550