Journal of Integrative Oncology

We experienced a case of renal cell carcinoma in congenital solitary kidney of an 80-year old male with a status post bypass grafts of coronary arteries and advanced heart failure. Incidentally we identified a left renal cell carcinoma 60mm in diameter, and an aneurysm of left renal artery. According to the R.E.N.A.L. Nephrometry Score, the tumor had 2-2-3-2 and total 9 points. Preoprerative e-GFR was 62.1 ml/min. He underwent open nephron sparing surgery by using intestinal forceps for kidney clamp instead of vascular clamp. Following an uneventful postoperative course, e-GFR became 45.6 ml/min. No recurrence was observed at 25 months after surgery. Even though laparoscopic partial nephrectomy is the gold standard for small renal mass, open procedure is still a mainstay for imperative cases.

The human epoxide hydrolase 1 (EPHX1) is a metabolism gene, which is responsible for the first phase of the xenobiotic metabolism. The product, microsomal epoxide hydrolase (mHE), plays an important role in the detoxification of carcinogenic polycyclic aromatic hydrocarbons. Many reports also have studied the correlation between EPHX1 gene polymorphisms and development and generation of cancers. However, few of studies on EPHX1 participating in chemotherapeutics metabolism were reported. The purpose of the present study was to evaluate the prognostic significance of the EPHX1 gene expression in acute myeloid leukemia (AML). Using real time-quantitative polymerase chain reaction (RT-qPCR), mRNA expression levels of EPHX1 gene was measured in bone marrow samples of newly diagnosed AML patients (n=46) and control group (n=12) without tumors. The levels expression of EPHX1 had a significant association with the treatment response and prognosis of AML patients. Additionally, the EPHX1 expression levels can aid for an improved understanding of the multidrug resistant mechanism in AML.

Background: The carcinoembryonic antigen (CEA) is widely used as a tumor marker because of its overexpression in adenocarcinomas, particularly colorectal cancer. The aim of this study was to investigate the metabolic factors including visceral obesity that are associated with serum CEA levels in non-smokers. Methods: This was a cross-sectional study of 1958 Koreans (1181 males, mean age 54.6 ± 8.7 years) who underwent serum CEA level and computed tomography-based visceral fat area assessments on the same day as a screening examination. The subjects were divided into 2 groups according to their median CEA level (1.20 ng/mL). Results: The multivariable analysis revealed that CEA was associated with age (OR=1.029, 95% CI=1.017 – 1.040, P<0.001), being male (OR=1.650, 95% CI=1.210 – 2.250, P=0.002) and glycosylated hemoglobin (HbA1c) values (OR=1.386, 95% CI=1.103 – 1.742, P=0.005) but not with visceral fat area after adjusting for age, gender and other variables. Among the diabetic patients, the mean CEA level was significantly higher in the group with HbA1c values ≥ 7.0% than in those with HbA1c values<7.0% (P=0.023). After adjusting for confounding factors, the association between CEA levels and poorly controlled diabetes (HbA1c ≥ 7.0%) persisted (OR=2.331, 95% CI=1.323 – 4.108, P=0.003). Conclusion: A serum CEA level within the normal range was related to the HbA1c level but not to visceral fat in Korean non-smokers, particularly among those with poorly controlled diabetes.

Most common cancer diagnosed in Indian men which is also the leading cause of cancer death is the oral cancer. Concept of oral cancer has been widely described as multietiogenic. Though, tobacco, alcohol, areca nut are the common causes of oral cancer, increased incidence of head and neck cancers have been reported in individuals even without any habit. The most common among them are infections and chronic irritations, which lead to inflammatory response alteration leading to increased mutagenesis. Hence, a different approach considering the appropriate facts is necessary. The paper highlights the current researches on etiological role on uncommon facts of viral, bacterial, fungal and chronic irritational causes of oral cancer.

Objective: Colorectal cancer is the third most common cancer in the world. Quality of life is important to achieve successful treatment outcomes. The aim of this study was to assess the functional quality of life of patients with newly diagnosed colorectal cancer in order to improve our understanding as physicians of how cancer therapy influences the patients’ lives, and how we can help patients improve the quality of life on a daily basis. Method: This was a cross-sectional study conducted between January-September 2013, of a sample of 647 patients newly diagnosed with colon cancer at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Participants completed the EROTIC QLQ-CR29 questionnaire, translated into Arabic and modified for a KSA population by three oncologists. Results: In total, 40 patients were included (males, 25; females, 15). Similar findings were reported between both genders in terms of body image, postoperative complications and stomas, and these were significant issues in a substantial number of respondents. Conclusion: The quality of life of patients with colorectal cancer in KSA is poor in general, as a result of both physician- and patient-specific factors. Further studies to assess this issue are recommended. Am understanding of the difficulties that patients face should encourage physicians to consider this vital aspect of their care, positively influencing the treatment course with the aim of creating the conditions for a peaceful and optimal psychological, as well as disease, outcome.

Objective: Colorectal cancer is the third most common cancer in the world. Quality of life is important to achieve successful treatment outcomes. The aim of this study was to assess the functional quality of life of patients with newly diagnosed colorectal cancer in order to improve our understanding as physicians of how cancer therapy influences the patients’ lives, and how we can help patients improve the quality of life on a daily basis. Method: This was a cross-sectional study conducted between January-September 2013, of a sample of 647 patients newly diagnosed with colon cancer at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Participants completed the EROTIC QLQ-CR29 questionnaire, translated into Arabic and modified for a KSA population by three oncologists. Results: In total, 40 patients were included (males, 25; females, 15). Similar findings were reported between both genders in terms of body image, postoperative complications and stomas, and these were significant issues in a substantial number of respondents. Conclusion: The quality of life of patients with colorectal cancer in KSA is poor in general, as a result of both physician- and patient-specific factors. Further studies to assess this issue are recommended. Am understanding of the difficulties that patients face should encourage physicians to consider this vital aspect of their care, positively influencing the treatment course with the aim of creating the conditions for a peaceful and optimal psychological, as well as disease, outcome.

Background: Concurrent chemo-radiation is now the standard treatment of nasopharyngeal carcinoma. However, distant metastases remain the major cause of death. The purpose of this study was to evaluate the impact of neoadjuvant chemotherapy of 3 cycles or more on survival of patients with N2-3 nasopharyngeal carcinoma.
Methods: In this study, a total of 553 consecutive patients with non-metastatic N2-3 nasopharyngeal carcinoma were recruited. 102 patients with neoadjuvant chemotherapy of 3 cycles or more (NACT≥3 group) were matched 1:2:1 to 204 patients with neoadjuvant chemotherapy of 2 cycles (NACT=2 group) and 102 patients without neoadjuvant chemotherapy (NACT=0 group), according to age, N stage, histological subtype, neoadjuvant chemotherapy regimen. Five candidate variables (sex, T stage, concurrent chemotherapy, intensity-modulated radiation therapy and cycle number of neoadjuvant chemotherapy) were analyzed for association with survival.
Results: After matching, 5-year overall survival, 5-year disease-free survival, 5-year local-recurrence-free survival and 5-year distant-metastasis-free survival of NACT≥3 group were better than those of NACT=2 group and those of NACT=0 group. In multivariate analysis, sex, T stage and cycle number of neoadjuvant chemotherapy maintained statistical significance on 5-year overall survival (P values were 0.029, <0.001), 5-year disease-free survival (P values were 0.020, ><0.001). 5-year disease-free survival (P values were 0.020, and 0.002), 5-year local-recurrence-free survival (P values were 0.048, 0.001 and 0.002) and 5-year distant-metastasis-free survival (P values were 0.017, <0.001and <0.001).
Conclusion: For N2-3 nasopharyngeal carcinoma, neoadjuvant chemotherapy of 3 cycles or more appeared to be an independent factor associated with improvement of survival.

Lung cancer presents a heterogeneous nature, which became more and more evident. Generally this type of cancer in an advanced state has a poor prognosis. The discovery of multiple molecular mechanisms, associated to the development, proliferation and prognosis of lung cancer has created new opportunities for a targeted therapy, improving clinical results. Non-small cells lung cancer is characterized by mutations on Epidermal Growth Factor Receptor and/or in the signaling pathways related to this receptor, which promoted the development of selective monoclonal antibodies and Epidermal Growth Factor Receptor-Tirosine Kinase Inhibitors, blocking the proliferation, differentiation, angiogenesis and tumor survival. Thus, our review highlighted the importance of a continuous research of new molecular targets in lung cancer to achieve better therapeutic outcomes and overall survival rates.