bims-netuvo 2024-11-24 papers

Cancer Imaging. 2024 Nov 18. 24(1): 158

Seeing through "brain fog": neuroimaging assessment and imaging biomarkers for cancer-related cognitive impairments.

Quanquan Gu, Liya Wang, Tricia Z King, Hongbo Chen, Longjiang Zhang, Jianming Ni, Hui Mao.

Advances in cancer diagnosis and treatment have substantially improved patient outcomes and survival in recent years. However, up to 75% of cancer patients and survivors, including those with non-central nervous system (non-CNS) cancers, suffer from "brain fog" or impairments in cognitive functions such as attention, memory, learning, and decision-making. While we recognize the impact of cancer-related cognitive impairment (CRCI), we have not fully investigated and understood the causes, mechanisms and interplays of various involving factors. Consequently, there are unmet needs in clinical oncology in assessing the risk of CRCI and managing patients and survivors with this condition in order to make informed treatment decisions and ensure the quality of life for cancer survivors. The state-of-the-art neuroimaging technologies, particularly clinical imaging modalities like magnetic resonance imaging (MRI) and positron emission tomography (PET), have been widely used to study neuroscience questions, including CRCI. However, in-depth applications of these functional and molecular imaging methods in CRCI and their clinical implementation for CRCI management are largely limited. This scoping review provides the current understanding of contributing neurological factors to CRCI and applications of the state-of-the-art multi-modal neuroimaging methods in investigating the functional and structural alterations related to CRCI. Findings from these studies and potential imaging-biomarkers of CRCI that can be used to improve the assessment and characterization of CRCI as well as to predict the risk of CRCI are also highlighted. Emerging issues and perspectives on future development and applications of neuroimaging tools to better understand CRCI and incorporate neuroimaging-based approaches to treatment decisions and patient management are discussed.

Keywords: Brain functions; Cancer survivors; Chemotherapy; Cognitive impairment; Magnetic resonance imaging; Neuroimaging; Positron-Emission Tomography; Radiation

DOI: https://doi.org/10.1186/s40644-024-00797-2

BMC Psychiatry. 2024 Nov 15. 24(1): 809

Development and validation of a risk prediction model for cognitive impairment in breast cancer patients.

Xinmiao Zhang, Junyue Lu, Zhangyi Ding, Yan Qiao, XiChen Li, Gaoxiang Zhong, Huixia Cui.

BACKGROUND: Breast cancer patients often experience cognitive impairment as a complication during treatment, which seriously affects their quality of life. This study aimed to assess the risk factors associated with cognitive impairment in breast cancer patients and to construct and validate a nomogram model to predict cognitive impairment in this population.
METHODS: In this study, we used a convenience sampling method to select 423 breast cancer patients who attended the Department of Breast Surgery at the First Hospital of Jinzhou Medical University from September 2023 to March 2024. We analyzed these patients' cognitive impairment risk factors through LASSO regression and logistic regression analysis to develop a predictive model. The model was evaluated using the area under the curve (AUC) from the receiver operating characteristic (ROC) curve and the calibration curve and decision curve analysis.
RESULTS: This study found a prevalence of cognitive impairment of 19.62% among breast cancer patients. A nomogram model was developed based on six influencing factors: age, educational level, pathological type, treatment program, emotional state, and fatigue. The area under the curve (AUC) for the model's training and validation groups was 0.944 and 0.931, respectively. The model calibration curves showed a high degree of consistency, and the decision curve analysis (DCA) indicated good clinical applicability of the model.
CONCLUSIONS: This nomogram demonstrates good discrimination, calibration, and clinical applicability, making it a more intuitive predictor of the risk of cognitive impairment in breast cancer patients.

Keywords: Breast cancer; Cognitive impairment; Nomogram; Risk factors; Risk prediction

DOI: https://doi.org/10.1186/s12888-024-06278-x

World J Gastrointest Surg. 2024 Oct 27. 16(10): 3239-3252

Risk factors and survival prediction model establishment for prognosis in patients with radical resection of gallbladder cancer.

Xing-Fei Li, Tan-Tu Ma, Tao Li.

BACKGROUND: Gallbladder cancer (GBC) is the most common malignant tumor of the biliary system, and is often undetected until advanced stages, making curative surgery unfeasible for many patients. Curative surgery remains the only option for long-term survival. Accurate postsurgical prognosis is crucial for effective treatment planning. tumor-node-metastasis staging, which focuses on tumor infiltration, lymph node metastasis, and distant metastasis, limits the accuracy of prognosis. Nomograms offer a more comprehensive and personalized approach by visually analyzing a broader range of prognostic factors, enhancing the precision of treatment planning for patients with GBC.
AIM: To identify risk factors and develop a predictive model for GBC prognosis.
METHODS: A retrospective study analyzed the clinical and pathological data of 93 patients who underwent radical surgery for GBC at Peking University People's Hospital from January 2015 to December 2020. Kaplan-Meier analysis was used to calculate the 1-, 2- and 3-year survival rates. The log-rank test was used to evaluate factors impacting prognosis, with survival curves plotted for significant variables. Single-factor analysis revealed statistically significant differences, and multivariate Cox regression identified independent prognostic factors. A nomogram was developed and validated with receiver operating characteristic curves and calibration curves.
RESULTS: Among 93 patients who underwent radical surgery for GBC, 30 patients survived, accounting for 32.26% of the sample, with a median survival time of 38 months. The 1-year, 2-year, and 3-year survival rates were 83.87%, 68.82%, and 53.57%, respectively. Univariate analysis revealed that carbohydrate antigen 19-9 expression, T stage, lymph node metastasis, histological differentiation, surgical margins, and invasion of the liver, extrahepatic bile duct, nerves, and vessels (P ≤ 0.001) significantly impacted patient prognosis after curative surgery. Multivariate Cox regression identified lymph node metastasis (P = 0.03), histological differentiation (P < 0.05), nerve invasion (P = 0.036), and extrahepatic bile duct invasion (P = 0.014) as independent risk factors. A nomogram model with a concordance index of 0.838 was developed. Internal validation confirmed the model's consistency in predicting the 1-year, 2-year, and 3-year survival rates.
CONCLUSION: Lymph node metastasis, tumor differentiation, extrahepatic bile duct invasion, and perineural invasion are independent risk factors. A nomogram based on these factors can be used to personalize and improve treatment strategies.

Keywords: Gallbladder cancer radical surgery; Independent risk factors; Multifactor analysis; Nomogram; Prognosis of gallbladder cancer; Survival prediction model

DOI: https://doi.org/10.4240/wjgs.v16.i10.3239

Respirol Case Rep. 2024 Nov;12(11): e70066

An incidental finding of a pleural based schwannoma.

William Griffin, Nina Mac Auley Srinivasan, Aurelie Fabre, David Healy.

A man in his 40s was incidentally found to have a large right sided apical pleural based mass on imaging. This was further investigated with a CT-guided biopsy. Histological and immunohistochemical analysis of the tissue revealed a diagnosis of a Schwannoma: a rare, slow-growing benign nerve sheath tumour. Only a handful of pleural based Schwannomas have been documented in the literature. They account for about 0.2% of lung tumours. The patient was referred to cardiothoracic surgery who advised surgical resection of the mass, which he is awaiting. Here, we report a rare case of a pleural based Schwannoma which was diagnosed incidentally on chest x-ray.

Keywords: S100; SOX10; pleural based tumour; schwannoma

DOI: https://doi.org/10.1002/rcr2.70066

J Clin Ultrasound. 2024 Nov 19.

Ultrasound Imaging for Preoperative Assessment of Schwannomas in the Palm: A Case Report.

Chia-Sung Chang, Shih-Chiang Huang, Yung-Lun Li, Lin-Fen Hsieh.

Peripheral nerve sheath tumors of the hand are rare occurrences. Among them, schwannomas are benign tumors originating from peripheral nerves. In this case report, we presented a patient with schwannomas in the palm, examined using ultrasound for preoperative assessment and was confirmed by pathological specimen. By highlighting the utility of ultrasound in detecting this condition, we aimed to enrich existing literature and ultimately enhance patient outcomes.

Keywords: Schwannomas; high‐resolution probes; palm; peripheral nerve sheath tumors; ultrasound

DOI: https://doi.org/10.1002/jcu.23894

Pak J Med Sci. 2024 Nov;40(10): 2447-2450

Minimally invasive resection of a giant esophageal schwannoma.

Sajida Qureshi, Sumayah Khan, Waqas Ahmad Abbasi, Muneeba Sohail.

Benign tumors of the esophagus are uncommon, and primary esophageal schwannoma of the esophagus is even rarer, accounting for 2% of cases. Less than 30 cases have been reported in the literature. Here we report a case of a young man with a symptomatic giant esophageal schwannoma, which was completely removed by laparoscopic three-staged esophagectomy. This is the first case of such a large lesion being removed by a minimally invasive approach. Our patient was a 22-year-old male, presented with dysphagia and dyspnea for five years. An endoscopy and CT scan suggested a giant leiomyoma. Postoperative biopsy revealed a primary esophageal schwannoma. We present our case of benign esophageal tumor measuring about 10.5 cm in greatest dimension. This is the first schwannoma resection performed with the Mckeown technique among the limited case reports in the literature. Esophageal schwannoma must be kept as a possible diagnosis in patients presenting with benign esophageal tumors. Esophagectomy is the mainstay of treatment for giant esophageal schwannomas. Minimally invasive esophagectomy can be safely performed for giant benign esophageal tumors.

Keywords: Esophageal benign tumor; Esophageal schwannoma; Giant schwannoma; McKeown esophagectomy; Minimally invasive esophagectomy

DOI: https://doi.org/10.12669/pjms.40.10.8824

Int J Surg Pathol. 2024 Nov 20. 10668969241295689

The "Pigmented Side" of Nerve Sheaths: Malignant Melanotic Nerve Sheath Tumor.

Raduan Ahmed Franca, Rosa Maria Di Crescenzo, Lorenzo Ugga, Rosa Della Monica, Elena D'Avella.

Malignant melanotic nerve sheath tumor (MMNST) represents a highly aggressive neoplasm arising both in peripheral and cranial nerves. It accounts for < 1% of all nerve sheath tumors, but the real incidence may not be well defined yet because of the evolution of its nomenclature. To date, it is considered a distinct tumor type, no longer as the pigmented variant of schwannoma, with a different clinical course and biological behavior. MMNSTs exhibit a specific genetic hallmark related to the PRKAR1A gene, which explains the major incidence in Carney Complex-affected patients. One of the more frequent localizations is the paravertebral region, where it poses diagnostic concerns with both primary tumors arising from soft tissues and the meningeal covering, as well as metastatic ones (ie, melanoma). Herein we present a patient with an MMNST accompanied by the main clinical, radiological, histopathological, and molecular findings, stressing the need for a multidisciplinary diagnostic approach. To the best of our knowledge, this is the first report of proton beam therapy for MMNST. We also performed a literature review to collect and compare the more recent data in English literature and to highlight the "keep-in-mind" concepts to apply in a multidisciplinary diagnostic algorithm, with a focus on histopathology and related pitfalls.

Keywords: malignant melanotic nerve sheath tumor; malignant nerve sheath tumor; melanotic nerve sheath tumor; pigmented lesions

DOI: https://doi.org/10.1177/10668969241295689