Focused ultrasound: tumor ablation and its potential to enhance immunological therapy to cancer.
Br J Radiol. 2017 Nov 23;:20170641
Authors: Mauri G, Nicosia L, Xu Z, Di Pietro S, Monfardini L, Bonomo G, Varano GM, Prada F, Della Vigna P, Orsi F
Various kind of image-guided techniques have been successfully applied in the last years for the treatment of tumours, as alternative to surgical resection. High Intensity focused ultrasound (HIFU) is a novel, totally non-invasive, image-guided technique that allow for achieving tissue destruction with the application of focused ultrasound at high intensity. This technique has been successfully applied for the treatment of a large variety of diseases, including oncological and non-oncological diseases. One of the most fascinating aspects of image-guided ablations, and particularly of HIFU, is the reported possibility of determining a sort of stimulation of the immune system, with an unexpected "systemic" response to treatments designed to be "local". In the present article the mechanisms of action of HIFU are described, and the main clinical applications of this technique are reported, with a particular focused on the immune-stimulation process that might originate from tumour ablations.
PMID: 29168922 [PubMed - as supplied by publisher]
Gastrointestinal Stromal Tumor of the Prostate: Staging and Evaluation of Response to Therapy With 18F-FDG PET/CT.
Clin Nucl Med. 2017 Nov 22;:
Authors: Alabed YZ
A 49-year-old man presented for routine general physical examination was found with an enlarged prostate gland without associated symptoms. Ultrasound followed by computed tomography (CT) of abdomen and pelvis confirmed a markedly enlarged heterogeneous prostate gland. Subsequently, a staging flourine-18 fluorodeoxyglucose (F-FDG) positron emission tomography (PET/CT) scan revealed intensely FDG-avid mass involving the prostate, which was biopsied as gastrointestinal stromal tumor (GIST). The patient was treated with imatinib and a follow-up PET/CT scan showed complete metabolic response. F-FDG PET/CT scan is useful in staging and follow-up of this very rare extragastrointestinal stromal tumor (EGIST).
PMID: 29166334 [PubMed - as supplied by publisher]
Effect of subclinical hypothyroidism on the skeletal system and improvement with short-term thyroxine therapy.
Oncotarget. 2017 Oct 27;8(52):90444-90451
Authors: Gao C, Wang Y, Li T, Huang J, Tian L
The purpose of the study was to observe changes in the skeletal system of rats with subclinical hypothyroidism (SCH) and to determine whether L-thyroxine (L-T4) administration suppresses those changes. Sixty male Wistar rats were randomly divided into control, SCH, and SCH+T4 groups. SCH was induced in rats by administration of methimazole (MMI), and rats in the SCH+T4 group were treated with L-T4 after 45 days of MMI administration. The SCH group had higher thyroid-stimulating hormone (TSH) level than the control and SCH+T4 groups. There were no differences in serum thyroid hormone (FT4 and FT3) levels among the three groups. Bone mineral density; serum levels of BALP and TRACP-5b, two bone metabolic markers; and the biomechanical properties of the femurs were lower in the SCH group than in the control group. After L-T4 treatment, serum BALP and TRACP-5b levels and the femur biomechanical properties were higher in the SCH+T4 than the SCH group. Histopathological examination revealed damage to the structure of the femur trabecular bone network in rats with SCH, and L-T4 treatment improved this condition to some extent. These findings demonstrate that L-T4 treatment ameliorates the destructive effects of SCH on the skeletal system in rats.
PMID: 29163843 [PubMed]
A systematic review and meta-analysis of effectiveness and safety of therapy for overactive bladder using botulinum toxin A at different dosages.
Oncotarget. 2017 Oct 27;8(52):90338-90350
Authors: Gu HY, Song JK, Zhang WJ, Xie J, Yao QS, Zeng WJ, Zhang C, Niu YM
Purpose: To assess the effectiveness and safety of botulinum toxin A (BTX-A) at different dosages for overactive bladder (OAB).
Materials and Methods: The MEDLINE, EMBASE, and Cochrane Controlled Trials Register databases were searched through November 3, 2016 to identify relevant randomized controlled trials (RCTs).
Results: Eleven studies were identified in this meta-analysis. Compared with placebo, the urinary incontinence (UI) episodes per week as the primary outcomes, urodynamic parameters including maximum cystometric capacity (MCC), and maximum detrusor pressure (MDP) for neurogenic detrusor overactivity (NDO) at 6 weeks, and for idiopathic detrusor overactivity (IDO) at 36 weeks were evaluated. These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo. However, there were no significant differences between some dosages. Compared with placebo, the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications.
Conclusions: In consideration that the treatments of BTX-A were with minimal, local, and manageable adverse effects, this meta-analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U. The short-term efficacies of BTX-A for IDO remain to be investigated.
PMID: 29163833 [PubMed]
Recurrent Early Coronary Stent Thrombosis under Chronic Disseminated Intravascular Coagulation.
Int Heart J. 2017 Nov 22;:
Authors: Oba Y, Hoshide S, Mitama T, Shinohara H, Komori T, Kabutoya T, Imai Y, Ogata N, Kario K
A 62-year-old Japanese man presented with chest pain indicating that acute myocardial infarction had occurred. Eleven years earlier, he underwent a splenectomy due to idiopathic portal hypertension. Coronary angiography revealed diffuse stenosis, with calcification in the left anterior descending coronary artery (LAD). We performed a primary percutaneous coronary intervention (PCI). We deployed two drug-eluting stents with sufficient minimal cross-sectional stent area by intravascular ultrasound and thrombolysis in myocardial infarction (TIMI) 3 flow. The initial laboratory examination revealed chronic disseminated intravascular coagulation (DIC). On the 8th hospital day, he developed chest pain indicating early coronary stent thrombosis, although he had been prescribed dual antiplatelet therapy. We performed an emergent second PCI, and the TIMI flow grade improved from 0 to 3. Clopidogrel was replaced with prasugrel. On the 18th hospital day, we detected a repeated coronary stent thrombosis again. We performed a third PCI and the TIMI flow grade improved from 0 to 3. After anticoagulation therapy with warfarin, the DIC was improved and his condition ran a benign course without the recurrence of stent thrombosis for 1 month. Contrast-enhanced CT showed portal vein thrombosis. This patient's case reveals the possibility that the condition of chronic DIC can lead to recurrent stent thrombosis. Stent thrombosis is infrequent, but remains a serious complication in terms of morbidity and mortality. Although stent thrombosis is multifactorial, the present case suggests that DIC is a factor in stent thrombosis. To prevent stent thrombosis after PCI under DIC, anticoagulation might be a treatment option in addition to antiplatelet therapy.
PMID: 29162782 [PubMed - as supplied by publisher]
Management of Biochemical Recurrence after Primary Curative Treatment for Prostate Cancer: A Review.
Urol Int. 2017 Nov 21;:
Authors: Artibani W, Porcaro AB, De Marco V, Cerruto MA, Siracusano S
How to manage patients with prostate cancer (PCa) with biochemical recurrence (BCR) following primary curative treatment is a controversial issue. Importantly, this prostate-specific antigen (PSA)-only recurrence is a surrogate neither of PCa-specific survival nor of overall survival. Physicians are therefore challenged with preventing or delaying the onset of clinical progression in those deemed at risk, while avoiding over-treating patients whose disease may never progress beyond PSA-only recurrence. Adjuvant therapy for radical prostatectomy (RP) or local radiotherapy (RT) has a role in certain at-risk patients, although it is not recommended in low-risk PCa owing to the significant side-effects associated with RT and androgen deprivation therapy (ADT). The recommendations for salvage therapy differ depending on whether BCR occurs after RP or primary RT, and in either case, definitive evidence regarding the best strategy is lacking. Options for treatment of BCR after RP are RT at least to the prostatic bed, complete or intermittent ADT, or observation; for BCR after RT, salvage RP, cryotherapy, complete or intermittent ADT, brachytherapy, high-intensity focused ultrasound (HIFU), or observation can be considered. Many patient- and cancer-specific factors need to be taken into account when deciding on the best strategy, and optimal management depends on the involvement of a multidisciplinary team, consultation with the patient themselves, and the adoption of an individualised approach. Improvements in imaging techniques may enable earlier detection of metastases, which will hopefully refine future management decisions.
PMID: 29161715 [PubMed - as supplied by publisher]
Proton range verification in homogeneous materials through acoustic measurements.
Phys Med Biol. 2017 Nov 21;:
Authors: Nie W, Jones KC, Petro S, Kassaee A, Sehgal CM, Avery S
Clinical proton beam quality assurance (QA) requires a simple and accurate method to measure the proton beam Bragg peak (BP) depth. Protoacoustics, the measurement of the pressure waves emitted by thermal expansion resulting from proton dose deposition, may be used to obtain the depth of the BP in a phantom by measuring the time-of-flight (TOF) of the pressure wave. Rectangular and cylindrical phantoms of different materials (aluminum, lead, and polyethylene) were used for protoacoustic studies. Four different methods for analyzing the protoacoustic signals are compared. Data analysis shows that, for methods 1 & 2, plastic phantoms have better accuracy than metallic ones because of the lower speed of sound. Method 3 does not require characterizing the speed of sound in the material, but it results in the largest error. Method 4 exhibits minimal error, less than 3 mm (with an uncertainty ≤1.5 mm) for all the materials and geometries. Psuedospectral wave-equation simulations (k-Wave MATLAB toolbox) are used to understand the origin of acoustic reflections within the phantom. The presented simulations and experiments show that protoacoustic measurements may provide a low cost and simple QA procedure for proton beam range verification as long as the proper phantoms and calculation methods are used.
PMID: 29160776 [PubMed - as supplied by publisher]
Effects of Pilates and yoga in patients with chronic neck pain: A sonographic study.
J Rehabil Med. 2017 Nov 16;:
Authors: Uluğ N, Yılmaz ÖT, Kara M, Özçakar L
BACKGROUND: Various studies have shown the efficacy of conventional isometric, Pilates and yoga exercises. However, data on the effects and comparison of these specific exercises on the cervical muscle morphology are insufficient or lacking.
OBJECTIVE: To investigate the effects of different exercise treatments on neck muscles in patients with chronic neck pain.
DESIGN: A randomized study.
METHODS: Fifty-six patients with chronic neck pain were randomized into 3 groups as follows: Pilates group (n = 20), yoga group (n = 18) and isometric group (n = 18). Demographics and background information were recorded. The thickness and cross-sectional area of neck muscles were evaluated by ultrasound imaging. Cervical motions were measured with a goniometer. Pain severity was evaluated with the McGill Pain Scale, disability with the Neck Disability Index, quality of life with the Nottingham Health Profile, and emotional status with the Beck Depression Inventory. In addition to a conventional physio-therapy programme, 15 sessions of physical therapy, including hot pack, ultrasound, and transcutaneous electrical nerve stimulation (TENS), were provided to all patients. All groups performed the exercises for 6 weeks. The aforementioned assessments were performed before and 6 weeks after the treatment.
RESULTS: Although pain, disability, depression and quality of life improved similarly within all groups (all p < 0.05), muscle thickness values as regards the semispinalis capitis were increased only in the Pilates group (p = 0.022).
STUDY LIMITATIONS: The lack of complex (progressive resistive) exercise treatment protocols, short treatment duration and partial supervision.
CONCLUSION: All 3 types of exercise had favourable effects on pain and functional scores, but no differences were found among the groups, except for the Pilates group, in which the semispinalis capitis muscle increased in thickness.
PMID: 29160551 [PubMed - as supplied by publisher]
Ultrasound biomicroscopy in acetazolamide-induced myopic shift with appositional angle closure.
Arq Bras Oftalmol. 2017 Sep-Oct;80(5):327-329
Authors: Grigera JD, Grigera ED
We report a case of a 49-year-old female who presented to the emergency department with blurred vision and vomiting, hours after taking two tablets of 250 mg of acetazolamide. The anterior chamber was bilaterally flat, with normal intraocular pressure in both eyes. An ultrasound biomicroscopic (UBM) examination showed bilateral ciliary effusion and complete appositional angle closure in all quadrants. Acetazolamide-induced bilateral angle closure was diagnosed. Steroid and cycloplegic therapy were initiated, and acetazolamide was discontinued. The following day, the anterior chamber had regained its volume without substantial change in the effusion size. Three weeks later, complete resolution of the ciliary effusion was verified by means of a third UBM scan.
PMID: 29160547 [PubMed - in process]
Discordant fetal phenotype of hypophosphatasia in two siblings.
Am J Med Genet A. 2017 Nov 21;:
Authors: Ikenoue S, Miyakoshi K, Ishii T, Sato Y, Otani T, Akiba Y, Kasuga Y, Ochiai D, Matsumoto T, Ichihashi Y, Matsuzaki Y, Tachikawa K, Michigami T, Nishimura G, Ikeda K, Hasegawa T, Tanaka M
Hypophosphatasia (HPP) is an autosomal recessive metabolic disorder with impaired bone mineralization due to mutations in the ALPL gene. The genotype-phenotype correlation of this disorder has been widely described. Here, we present two affected siblings, whose fetal phenotypes were discordant. A 31-year-old Japanese woman, G0P0, was referred to our institution because of fetal micromelia. After obstetric counseling, the pregnancy was terminated at 21 weeks' gestation. Post-mortem radiographs demonstrated severely defective mineralization of the skeleton. The calvarial, spinal, and tubular bones were mostly missing. Only the occipital bones, mandible, clavicles, ribs, one thoracic vertebra, ilia, and tibia were relatively well ossified. The radiological findings suggested lethal HPP. Genetic testing for genomic DNA extracted from the umbilical cord identified compound heterozygous mutations in the ALPL gene (c.532T>C, p.Y178H; c.1559delT, p.Leu520Argfs*86). c.532T>C was a novel variant showing no residual activity of the protein by the functional analysis. The parents were heterozygous carriers. In the next pregnancy, biometric values on fetal ultrasonography at 20 and 26 weeks' gestation were normal. At 34 weeks, however, a small chest and shortening of distal long bones came to attention. The neonate delivered at 41 weeks showed serum ALP of <5U/L. Radiological examination showed only mild thoracic hypoplasia and metaphyseal mineralization defects of the long bones. ALP replacement therapy was introduced shortly after birth, and the neonate was discharged at day 22 without respiratory distress. Awareness of discordant fetal phenotypes in siblings with HPP precludes a diagnostic error, and enables early medical intervention to mildly affected neonates.
PMID: 29160033 [PubMed - as supplied by publisher]
Two-Stage Ionoacoustic Range Verification Leveraging Monte Carlo and Acoustic Simulations to Stably Account for Tissue Inhomogeneity and Accelerator-Specific Time Structure - a simulation study.
Med Phys. 2017 Nov 20;:
Authors: Patch SK, Hoff DEM, Webb TB, Sobotka LG, Zhao T
PURPOSE: Range errors constrain treatment planning by limiting choice of ion beam angles and requiring large margins. Ionoacoustic range verification requires recovering the location of an acoustic source from low frequency signals. A priori information is applied to stably overcome resolution limits of inverse acoustic source imaging in this simulation study. In particular, the accuracy and robustness of ionoacoustic range verification for lateral and oblique delivery of high-energy protons to the prostate is examined.
METHODS: Dose maps were computed using GEANT4 Monte Carlo simulations via the TOPAS user interface. Thermoacoustic pulses were propagated using k-Wave software, with initial pressures corresponding to instantaneous dose deposition and piecewise constant maps of tissue properties derived from the planning CT. A database of dose maps with corresponding thermoacoustic emissions and Bragg peak locatiosns, referred to as "control points." Corresponding emissions were also pre-computed. Pulses were recorded at four co-planar locations corresponding to the outer surface of a virtual transrectal array. To model experimental beam delivery, k-Wave results were convolved in time with a Gaussian envelope to account for non-instantaneous proton delivery by a synchrocyclotron. Thermoacoustic pulses were bandlimited below 150 kHz, and amplitudes were directly proportional to charge delivered. To test robustness of our method, white noise was added. Range was estimated in a two-step process. The first step obtained a preliminary range estimate by one-way beamforming. The second step was taken using data corresponding to the "control point" nearest to the preliminary range estimate. For each receiver, the time of flight difference, ∆t, between the measured and control thermoacoustic signals was accurately estimated by applying the Fourier shift theorem. Receiver-Bragg peak distance was then estimated by adding Vs∆t to the known distance of the control point, where Vs is soundspeed. A linear system of equations based upon all receiver locations and distances was solved to recover the Bragg peak location. All simulations were performed relative to the planning CT. Because ultrasound (US) images were not available, results were overlaid onto the planning CT.
RESULTS: Beamformed estimates from noise-free data tracked all beam locations within 1 cm. Final estimates for oblique and lateral beams were accurate to within 1.0 and 1.6 mm, respectively. Average errors of final range estimates for oblique beams from data with SNR = 0 dB were no greater than 2.0 mm.
CONCLUSIONS: Ionoacoustic range verification may improve current practice. Ionoacoustic range estimates can be inherently co-registered to ultrasound images of underlying anatomy. To ensure estimates are robust in clinical practice, dose maps based upon the planning CT should be overlaid onto ultrasound volumes acquired at time of treatment and acoustic simulations re-computed to provide a database of control points and corresponding thermoacoustic emissions. Computation times for beamformed estimates are already fast enough for online range verification, but are not accurate enough for a measurement aperture limited to the surface of a transrectal ultrasound probe. Accelerated acoustic simulations will be required to enable online two-stage correction, but offline calculation is already suitable for adaptive planning. This article is protected by copyright. All rights reserved.
PMID: 29159885 [PubMed - as supplied by publisher]
Toxic Adenoma in a Patient with Thyroid Hemiagenesis.
Cureus. 2017 Sep 17;9(9):e1695
Authors: Gurleyik E, Dogan S, Cetin F, Gursoy F, Ipor AM
Thyroid hemiagenesis (TH) is a rare congenital anomaly that is usually asymptomatic. Functional disorders of the thyroid make the patient symptomatic. TH is usually and incidentally established during evaluation of patients with symptomatic thyroid pathology. We report the case of a patient of TH who became symptomatic with hyperactivity of the gland. The patient presented with signs and symptoms of thyrotoxicosis. Physical examination revealed asymmetric nodular goiter at the right lobe. Biochemical analysis established the diagnosis of hyperthyroidism. Ultrasound of the thyroid gland revealed the absence of the left lobe and a large, solitary hypoechoic solid nodule in the right lobe. Nuclear scan showed the absence of the left lobe and revealed a large, autonomous solitary nodule in the right lobe. The diagnosis was a toxic adenoma. After medical control of hyperthyroidism, the patient was surgically treated with hemithyroidectomy. We prescribed postoperative replacement medication with L-thyroxin. Hyperthyroidism makes TH cases symptomatic. Thyroid ultrasound and scintigraphy incidentally discover agenesis of one lobe during evaluation of thyrotoxicosis. Hemithyroidectomy, including the autonomous nodule, is the procedure of choice for patients with toxic adenoma. Hemithyroidectomy in TH cases technically becomes a total thyroidectomy with a need for postoperative thyroid replacement therapy.
PMID: 29159003 [PubMed]
A Laser-Activated Biocompatible Theranostic Nanoagent for Targeted Multimodal Imaging and Photothermal Therapy.
Authors: Deng L, Cai X, Sheng D, Yang Y, Strohm EM, Wang Z, Ran H, Wang D, Zheng Y, Li P, Shang T, Ling Y, Wang F, Sun Y
Multifunctional nanoparticles have been reported for cancer detection and treatment currently. However, the accurate diagnosis and efficient treatment for tumors are still not satisfied. Here we report on the development of targeted phase change multimodal polymeric nanoparticles for the imaging and treatment of HER2-positive breast cancer.
METHODS: We evaluated the multimodal imaging capabilities of the prepared nanoparticles in vitro using agar-based phantoms. The targeting performance and cytotoxicity of the nanoparticles were examined in cell culture using SKBR3 (over-expressing HER2) and MDA-MB-231 (HER2 negative) cells. We then tested the magnetic resonance (MR)/ photoacoustic (PA)/ ultrasound (US)/ near-infrared fluorescence (NIRF) multimodal imaging properties and photothermal effect of the nanoparticles in vivo using a SKBR3 breast xenograft model in nude mice. Tissue histopathology and immunofluorescence were also conducted.
RESULTS: Both in vitro and in vivo systematical studies validated that the hybrid nanoparticles can be used as a superb MR/US/PA/NIRF contrast agent to simultaneously diagnose and guide tumor photothermal therapy (PTT). When irradiated by a near infrared laser, the liquid PFP vaporizes to a gas, rapidly expelling the contents and damaging surrounding tissues. The resulting micro-sized bubbles provide treatment validation through ultrasound imaging. Localization of DIR and SPIO in the tumor region facilitate photothermal therapy for targeted tumor destruction. The mice treated with HER2 targeted nanoparticles had a nearly complete response to treatment, while the controls showed continued tumor growth.
CONCLUSION: This novel theranostic agent may provide better diagnostic imaging and therapeutic potential than current methods for treating HER2-positive breast cancer.
PMID: 29158836 [PubMed - in process]
Prostatic Calculi: Do They Matter?
Sex Med Rev. 2017 Nov 17;:
Authors: Cao JJ, Huang W, Wu HS, Cao M, Zhang Y, Jin XD
INTRODUCTION: Prostatic calculi (PC) are frequently detected at computed tomography or ultrasound in men attending the health center or the urology outpatient department. PC have attracted more attention from urologists, but the clinical significance of PC is unknown.
AIM: To review the available literature on the effects of PC on prostatic diseases and sexual function in men.
METHODS: Relevant clinical trials were identified by searching the PubMed, Embase, and Cochrane Library databases. Results were classified, summarized, and analyzed.
MAIN OUTCOME MEASURES: Transabdominal and rectal ultrasonography; urodynamics analysis; International Prostate Symptom Score; pathologic examination of prostatic tissue; prostate-specific antigen; and expressed prostatic secretion.
RESULTS: PC can not only prolong the duration of bothersome symptoms but also decrease the cure rate of antibacterial therapy in patients with chronic prostatitis. Patients with PC usually have more severe lower urinary tract symptoms (LUTS), and some studies reported that moderate to marked PC are a predisposing factor for moderate to severe LUTS. Studies also reported that the serum level prostate-specific antigen is not influenced by PC. In addition, the presence of PC is not associated with an increased risk of prostate cancer. However, the correlation between PC in the peripheral zone and prostate cancer is statistically significant. In addition, the association between PC and Gleason scores is controversial. Some novel studies suggested that PC might play an important role in sexual impairment in middle-age men or men with chronic pelvic pain syndrome or chronic prostatitis. Recently, PC were found to increase the incidence of severe LUTS, urinary retention, and hematospermia after transrectal ultrasound-guided prostate biopsy.
CONCLUSION: PC can aggravate LUTS, chronic prostatitis, and sexual dysfunction in men, but the association between PC and prostate cancer is still controversial. Cao J-J, Huang W, Wu H-S, et al. Prostatic Calculi: Do They Matter? Sex Med Rev 2017;X:XXX-XXX.
PMID: 29157875 [PubMed - as supplied by publisher]
Worse disease-free, tumor-specific, and overall survival in surgically-resected lung adenocarcinoma patients with ALK rearrangement.
Oncotarget. 2017 Oct 17;8(49):86066-86081
Authors: Gao Q, Li P, Jiang X, Zhan Z, Yan Q, Zhang B, Huang C
Introduction: This study determined the prevalence of anaplastic lymphoma kinase (ALK) rearrangement, and identified the associations of ALK rearrangement with clinicopathologic characteristics and treatment outcomes in patients with surgically-resected stage I-III lung adenocarcinoma.
Methods: A total of 534 surgically-resected lung adenocarcinoma patients were studied. The prevalence of ALK protein over-expression was determined by a fully-automated immunochemistry assay (with mouse monoclonal Ventana D5F3 antibody), and the associations of ALK rearrangement with clinicopathologic characteristics and treatment outcomes were analyzed.
Results: Forty-two (7.9%) of the 534 lung adenocarcinoma patients were ALK IHC-positive. ALK rearrangement was significantly associated with younger age (P = 0.011), high T-stage (P = 0.025), high pathologic stage (P = 0.002), solid predominant adenocarcinoma with mucin production (P = 0.006), invasive mucinous adenocarcinoma (P = 0.009), and receipt of adjuvant therapy after surgery (P = 0.036), but no significant associations were found between the ALK rearrangement and sex or smoking status. ALK IHC-positivity was significantly associated with a shorter disease-free survival, tumor-specific survival, and overall survival (P = 0.001, 0.026, and 0.007, respectively). Multivariate analysis showed that ALK IHC-positivity was an adverse prognostic factor for disease-free survival (HR, 1.80; 95% CI 1.18-2.77; P = 0.007), tumor-specific survival (HR, 2.59; 95% CI 1.35-4.97; P = 0.004), and overall survival (HR, 1.92; 95% CI 1.07-3.44; P = 0.030).
Conclusion: The clinical characteristics of patients with ALK-positive lung adenocarcinoma were similar to those of EGFR-mutated patients. ALK rearrangement was an adverse prognostic factor in surgically-resected lung adenocarcinoma patients.
PMID: 29156778 [PubMed]