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Povzetek: Oncocytic thyroid carcinoma (OTC) is a rare disease. There is little information about risk factors for recurrence. The aim of our retrospective, single-institution study was to investigate the recurrence rate in OTC patients with and without an excellent response after initial treatment according to the 2025 American Thyroid Association guidelines response criteria based on type of initial intervention. Material/Methods: Altogether, 260 patients with OTC (57 men, 203 women; mean age 60.35 years; range 16-90 years) treated from 1972 to 2024 were included. Initially, regional and distal metastases were diagnosed in 15 (6%) and 25 (10%) patients, respectively. Cox’s multivariate regression model was used to identify the risk factors for recurrence. Results: The follow-up period ranged from 0.1 to 45.2 (median 7.9) years. Recurrence was diagnosed in 39 (17%) of the 235 patients without disease after initial treatment. Locoregional, distant, and combined locoregional and distant recurrence was diagnosed in 18, 14, and 7 patients, respectively. Among 154 patients with an excellent response, recurrence occurred in 6.5%, and among the 81 patients without an excellent response, it occurred in 36% (P<0.001). Independent risk factors for recurrence were: sex (males, hazard ratio (HR)=2.5, 95% CI 1.3-4.8; P=0.009), age (³55 years, HR=2.7, 95% CI 1.2-5.8; P=0.012), pT stage (pT3 or pT4, HR=1.4, 95% CI 1.0-1.9; P=0.023), and residual tumor after surgery (R1 or R2 residual tumor, HR=1.2, 95% CI 1.07-1.3; P=0.001). The 5-year disease-free survival rate for the entire cohort was 88%, while the 10-year and 20-year disease-free survival rates were 79%, and 74%, respectively. Conclusions: Recurrence rate in patients with and without an excellent response was 6.5% and 35%, respectively. Recurrence was more common in men, older patients, those with regional metastases, and those with residual tumor after surgery
Ključne besede: prognosis, risk factors, survival rate, thyroid neoplasms
Objavljeno v DiRROS: 03.06.2026; Ogledov: 120; Prenosov: 98
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Povzetek: Tumor-infiltrating lymphocytes (TILs) are an established predictor of pathological complete response (pCR) after neoadjuvant chemotherapy (NACT) in breast cancer. However, TILs primarily reflect the extent of immune infiltration and provide limited insight into immune functional state. We investigated whether integrating measures of immune infiltration (TILs), effector T-cell presence (CD8), and functional context (immune checkpoint components) may improve prediction of pCR beyond TILs alone. Pretreatment tumor biopsies from 166 patients with early breast cancer treated with standard NACT were assessed for stromal TILs and mRNA expression of CD8, PD-1, LAG-3, and TIM-3. Associations with pCR were evaluated using univariate and multivariable logistic regression, and composite immune phenotypes were constructed to capture functional immune states. In univariate analyses, higher TILs, CD8, PD-1, and LAG-3 were associated with pCR (all p < 0.05), whereas TIM-3 was not (p = 0.801). In multivariable models, TILs remained independently associated with pCR when adjusted for checkpoint markers, but this association was attenuated when CD8 was included, consistent with the strong biological correlation between TILs and CD8, and neither CD8 nor checkpoint markers retained independent significance. PD-1 and LAG-3 expression strongly correlated with CD8 and moderately correlated with TILs, indicating that checkpoint expression predominantly reflects an immune effector-engaged tumor microenvironment. Composite immune phenotypes based on CD8/PD-1 co-expression identified distinct immune functional states, with CD8-high/PD-1-high tumors demonstrating the highest pCR rates. Hierarchical modeling showed modest improvements in discrimination with sequential addition of immune variables to clinical predictors, with the integrative CD8/PD-1 model achieving the highest discrimination within the cohort (AUC = 0.849), although the magnitude of improvement beyond TIL assessment alone was limited. In conclusion, immune infiltration, effector T-cell presence, and functional immune context represent complementary dimensions for pCR prediction following NACT in breast cancer. However, TILs remain the most robust and clinically feasible immune biomarker.
Ključne besede: PD-1 immune checkpoint, breast cancer, immune microenvironment, neoadjuvant chemotherapy
Objavljeno v DiRROS: 20.04.2026; Ogledov: 298; Prenosov: 210
Celotno besedilo (23,29 MB)
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Ključne besede: rak (medicina), ginekološki raki, ginekologija, onkologija, epidemiologija, histopatologija, preživetje, diagnostika, zdravljenje, kirurgija
Objavljeno v DiRROS: 22.01.2026; Ogledov: 453; Prenosov: 338
Celotno besedilo (9,77 MB)
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Povzetek: We assessed the prevalence, localization, type and outcome of occult cancer at risk-reducing salpingo-oophorectomy or salpingectomy (RRSO) in asymptomatic carriers of pathogenic or likely pathogenic BRCA1/2 variants and high-risk BRCA1/2 negative women. Patients and methods. A retrospective analysis of all consecutive gynaecologic preventive surgeries from January 2009 to December 2015 was performed. Participants underwent genetic counselling and BRCA1/2 testing before the procedure. Data on clinical parameters, adjuvant treatment and follow-up were collected and analysed. Results. One hundred and fifty-five RRSO were performed in 110 BRCA1, 35 BRCA2 carriers of pathogenic or likely pathogenic variants and 10 high-risk BRCA1/2 negative women, at the mean age of 48.3 years. Nine occult cancers (9/155, 5.8%) were identified; eight in BRCA1 positive women and one in high-risk BRCA1/2 negative woman. We identified four non-invasive serous intraepithelial tubal carcinomas (3 in BRCA1 carriers and 1 in a high-risk BRCA1/2 negative woman) and five invasive tubo-ovarian high grade serous cancers (all detected in BRCA1 carriers). Only one out of nine patients (11.1%) with occult cancer had a slightly elevated CA-125 value preoperatively. Conclusions. A 5.8% prevalence of occult invasive and noninvasive tubo-ovarian serous cancer after RRSO was found in high risk asymptomatic and screen negative women. We conclude that RRSO should be performed in BRCA1/2 carriers and in high-risk BRCA1/2 negative women. Age of preventive gynaecologic surgery should be carefully planned, taking into account the completion of childbearing age and type of mutation. The results favour the tubal hypothesis of tubal origin of high grade serous ovarian and peritoneal cancer. Cytology result of peritoneal cavity washing was important for the decision making process in determining treatment. Cytology examination should be performed in all cases of RRSO. CA-125 assay did not prove to be an effective screening tool for early cancer detection in our patients.
Ključne besede: risk-reducing salpingo-oophorectomy, occult serous cancer, serous tubal intraepithelial cancer, BRCA1/2 pathogenic or likely pathogenic variant
Objavljeno v DiRROS: 12.07.2024; Ogledov: 1215; Prenosov: 478
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Povzetek: The goal of our study was to find out whether the immunohistochemical expression of nuclear factor-kappa beta (NF-%B) p65 in biopsy samples with Gleason score 3 + 3 = 6 (GS 6) can be a negative predictive factor for Prostate cancer (PCa) indolence. Patients and methods Study was conducted on a retrospective cohort of 123 PCa patients with initial total PSA % 10 ng/ml, number of needle biopsy specimens % 8, GS 6 on biopsy and T1/T2 estimated clinical stage who underwent laparoscopic radical prostatectomy and whose archived formalin-fixed and paraffin-embedded (FFPE) prostate needle biopsy specimens were used for additional immunohistochemistry staining for detection of NF-%B p65. Both cytoplasmic and nuclear NF-%B p65 expression in biopsy cores with PCa were correlated with postoperative pathological stage, positive surgical margins, GS and biochemical progression of disease. Results After follow-up of 66 months, biochemical progression (PSA % 0.2 ng/ml) occurred in 6 (5.1%) patients, 3 (50%) with GS 6 and 3 (50%) with GS 7 after radical prostatectomy. Both cytoplasmic and nuclear NF-%B p65 expressions were not significantly associated with pathological stage, positive surgical margin and postoperative GS. Patients with positive cytoplasmic NF-kB reaction had significantly more frequent biochemical progression than those with negative cytoplasmic NF-kB reaction with PSA 0.2 ng/ml as cutoff point (p = 0.015) and a trend towards more biochemical progression with PSA % 0.05 ng/ml as cutoff point (p = 0.068). Conclusions Cytoplasmic expression of NF-%B is associated with more biochemical progression and might be an independent prognostic factor for recurrence-free survival (RFS), but further studies including larger patient cohorts are needed to confirm these initial results.
Ključne besede: prostate cancer, needle biopsy, nuclear factor-kappa beta, Gleason
Objavljeno v DiRROS: 12.07.2024; Ogledov: 1415; Prenosov: 959
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