DSpace Collection:https://hdl.handle.net/2440/100162024-03-29T00:04:42Z2024-03-29T00:04:42ZIdentification of consensus head and neck cancer-associated microbiota signatures: a systematic review and meta-analysis of 16S rRNA and The Cancer Microbiome Atlas datasetsYeo, K.Li, R.Wu, F.Bouras, G.Mai, L.T.H.Smith, E.Wormald, P.-J.Valentine, R.Psaltis, A.J.Vreugde, S.Fenix, K.https://hdl.handle.net/2440/1404232024-02-18T23:49:53Z2024-01-01T00:00:00ZTitle: Identification of consensus head and neck cancer-associated microbiota signatures: a systematic review and meta-analysis of 16S rRNA and The Cancer Microbiome Atlas datasets
Author: Yeo, K.; Li, R.; Wu, F.; Bouras, G.; Mai, L.T.H.; Smith, E.; Wormald, P.-J.; Valentine, R.; Psaltis, A.J.; Vreugde, S.; Fenix, K.
Abstract: Introduction. Multiple reports have attempted to describe the tumour microbiota in head and neck cancer (HNSC).Gap statement. However, these have failed to produce a consistent microbiota signature, which may undermine understanding the importance of bacterial-mediated effects in HNSC.Aim. The aim of this study is to consolidate these datasets and identify a consensus microbiota signature in HNSC.Methodology. We analysed 12 published HNSC 16S rRNA microbial datasets collected from cancer, cancer-adjacent and non-cancer tissues to generate a consensus microbiota signature. These signatures were then validated using The Cancer Microbiome Atlas (TCMA) database and correlated with the tumour microenvironment phenotypes and patient's clinical outcome.Results. We identified a consensus microbial signature at the genus level to differentiate between HNSC sample types, with cancer and cancer-adjacent tissues sharing more similarity than non-cancer tissues. Univariate analysis on 16S rRNA datasets identified significant differences in the abundance of 34 bacterial genera among the tissue types. Paired cancer and cancer-adjacent tissue analyses in 16S rRNA and TCMA datasets identified increased abundance in Fusobacterium in cancer tissues and decreased abundance of Atopobium, Rothia and Actinomyces in cancer-adjacent tissues. Furthermore, these bacteria were associated with different tumour microenvironment phenotypes. Notably, high Fusobacterium signature was associated with high neutrophil (r=0.37, P<0.0001), angiogenesis (r=0.38, P<0.0001) and granulocyte signatures (r=0.38, P<0.0001) and better overall patient survival [continuous: HR 0.8482, 95 % confidence interval (CI) 0.7758-0.9273, P=0.0003].Conclusion. Our meta-analysis demonstrates a consensus microbiota signature for HNSC, highlighting its potential importance in this disease.
Description: Published 01 February 20242024-01-01T00:00:00ZInternational Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian PatientsTeras, J.Kroon, H.M.Miura, J.T.Kenyon-Smith, T.Beasley, G.M.Mullen, D.Farrow, N.E.Mosca, P.J.Lowe, M.C.Farley, C.R.Potdar, A.Daou, H.Sun, J.Carr, M.Farma, J.M.Henderson, M.A.Speakman, D.Serpell, J.Delman, K.A.Smithers, B.M.et al.https://hdl.handle.net/2440/1404182024-02-22T06:07:58Z2020-01-01T00:00:00ZTitle: International Multicenter Experience of Isolated Limb Infusion for In-Transit Melanoma Metastases in Octogenarian and Nonagenarian Patients
Author: Teras, J.; Kroon, H.M.; Miura, J.T.; Kenyon-Smith, T.; Beasley, G.M.; Mullen, D.; Farrow, N.E.; Mosca, P.J.; Lowe, M.C.; Farley, C.R.; Potdar, A.; Daou, H.; Sun, J.; Carr, M.; Farma, J.M.; Henderson, M.A.; Speakman, D.; Serpell, J.; Delman, K.A.; Smithers, B.M.; et al.
Abstract: BACKGROUND:Isolated limb infusion (ILI) is used to treat in-transit melanoma metastases confined to an extremity. However, little is known about its safety and efficacy in octogenarians and nonagenarians (ON). PATIENTS AND METHODS:ON patients (≥ 80 years) who underwent a first ILI for American Joint Committee on Cancer seventh edition stage IIIB/IIIC melanoma between 1992 and 2018 at nine international centers were included and compared with younger patients (< 80 years). A cytotoxic drug combination of melphalan and actinomycin-D was used. RESULTS:Of the 687 patients undergoing a first ILI, 160 were ON patients (median age 84 years; range 80-100 years). Compared with the younger cohort (n = 527; median age 67 years; range 29-79 years), ON patients were more frequently female (70.0% vs. 56.9%; p = 0.003), had more stage IIIB disease (63.8 vs. 53.3%; p = 0.02), and underwent more upper limb ILIs (16.9% vs. 9.5%; p = 0.009). ON patients experienced similar Wieberdink limb toxicity grades III/IV (25.0% vs. 29.2%; p = 0.45). No toxicity-related limb amputations were performed. Overall response for ON patients was 67.3%, versus 64.6% for younger patients (p = 0.53). Median in-field progression-free survival was 9 months for both groups (p = 0.88). Median distant progression-free survival was 36 versus 23 months (p = 0.16), overall survival was 29 versus 40 months (p < 0.0001), and melanoma-specific survival was 46 versus 78 months (p = 0.0007) for ON patients compared with younger patients, respectively. CONCLUSIONS:ILI in ON patients is safe and effective with similar response and regional control rates compared with younger patients. However, overall and melanoma-specific survival are shorter.2020-01-01T00:00:00ZStoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patientsGreijdanus, N.G.Wienholts, K.Ubels, S.Talboom, K.Hannink, G.Wolthuis, A.de Lacy, F.B.Lefevre, J.H.Solomon, M.Frasson, M.Rotholtz, N.Denost, Q.Perez, R.O.Konishi, T.Panis, Y.Rutegård, M.Hompes, R.Rosman, C.van Workum, F.Tanis, P.J.et al.https://hdl.handle.net/2440/1403962024-02-09T04:02:18Z2023-01-01T00:00:00ZTitle: Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients
Author: Greijdanus, N.G.; Wienholts, K.; Ubels, S.; Talboom, K.; Hannink, G.; Wolthuis, A.; de Lacy, F.B.; Lefevre, J.H.; Solomon, M.; Frasson, M.; Rotholtz, N.; Denost, Q.; Perez, R.O.; Konishi, T.; Panis, Y.; Rutegård, M.; Hompes, R.; Rosman, C.; van Workum, F.; Tanis, P.J.; et al.
Abstract: Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/ secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2 : 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of −1.1 (95 per cent c.i. −9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (−28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding.2023-01-01T00:00:00ZMalignant features present in pre-treatment lateral pelvic lymph nodes in low rectal cancer predict distant metastases and survival, but not local recurrencesKroon, H.Dudi-Venkata, N.Bedrikovetski, S.Liu, J.Haanappel, A.Ogura, A.Van de Velde, C.Rutten, H.Beets, G.Thomas, M.Kusters, M.Sammour, T.https://hdl.handle.net/2440/1403522024-01-22T06:39:46Z2021-01-01T00:00:00ZTitle: Malignant features present in pre-treatment lateral pelvic lymph nodes in low rectal cancer predict distant metastases and survival, but not local recurrences
Author: Kroon, H.; Dudi-Venkata, N.; Bedrikovetski, S.; Liu, J.; Haanappel, A.; Ogura, A.; Van de Velde, C.; Rutten, H.; Beets, G.; Thomas, M.; Kusters, M.; Sammour, T.
Abstract: Background: Pre-treatment enlarged lateral lymph nodes (LLNs) in patients with low rectal cancer predict local recurrences after neoadjuvant (chemo)radiotherapy (n(C)RT) followed by total mesorectal excision (TME). Not much is known what the impact on oncological outcomes is when malignant features are present in LLNs. Materials and Methods: An international multi-center cohort study at five tertiary referral centers in the Netherlands and Australia was conducted. All patients were diagnosed with low rectal cancer with or without LLNs on pre-treatment MRI and underwent n(C)RT followed by TME. LLNs were considered enlarged in case of a short-axis of ≥5mm on pre-treatment MRI. Malignant features in LLNs were defined as nodes with internal heterogeneity or border irregularity. Survival was estimated using the Kaplan-Meier method with the Mantel-Haenszel test. Three-year recurrences were evaluated with the Chi-square/Fisher's exact test. Results: A total of 213 patients were included. The majority was male (67.7%) with a median age of 64 years (range 20-89). Median pre-treatment LLN short-axis was 7mm (range 5-28), 52.2% of the LLNS had malignant features. After a median follow-up of 47 months, patients with enlarged LLNs (7-9mm and 10mm+) had a worse local recurrence-free survival (LRFS; p<0.0001), but similar distant metastatic-free (DMFS; p=0.30) and overall survival (OS; p=0.27) compared to patients with smaller LLNs (0-4 and 5-6mm). On the other hand, patients with malignant features in LLNs had a similar LRFS (p=0.20), but worse DMFS (p=0.004) and OS (p=0.006) compared to patients without malignant features in the LLNs. Similar patterns were seen upon three-year recurrence analysis (table). Conclusions: Malignant features present in LLNs on pre-treatment MRI are predictive for worse DMFS and OS, but not for local recurrences.2021-01-01T00:00:00Z