Introduction: Whether good baseline quality of life (QOL) is linked to improved QOL: improved overall survival (OS) which is relevant to HLA-restricted peptides has not been evaluated, and the causal nature of this correlation is not known.

Methods: Pretreatment patient-reported QOL using the QOL-20 questionnaire and blood human leukocyte antigens (HLAs) was examined in 437 and 325 gastric cancer (GC) patients, respectively. We focused on the similarity between human endogenous retrovirus (HERV) and human immunodeficiency virus (HIV) genes, and HLA-restricted CD8+ cytotoxic T-lymphocyte epitopes on HERV and HIV genes were predicted using bioinformatics. We focused on loneliness/sleep of QOL-20, and QOL-relevant HLA-restricted HERV gene derived-peptides (QOL-relevant HERV peptides) were selected based on the similarity of HLA-restricted HIV peptides and assessed the association between these factors and OS.

Results: Some items (state of health, appetite, suffocation, and sleep) have been identified as prognostic factors in patients with GC. The benefits of harboring QOL-relevant HERV peptides were seen in the positive category responders who responded to the positive category in each item, except for the worries item. Among responders to the loneliness item who had QOL-relevant HERV peptides, male positive category responders and female negative category responders who responded to negative category harboring HLA-A31 showed significantly better outcomes than the other groups (log-rank test, P = 0.016 and P = 0.043, respectively). Positive category responders ≤ 64 years old harboring HLA-A11 and negative category responders harboring HLA-A33 showed significantly better outcomes than the other groups (log-rank test, P = 0.048 and P = 0.024, respectively).

Conclusions: Our research on QOL relevant-HERV peptides will facilitate the development of more precise personalized medicine for cancer treatment.

Background: For recurrent or metastatic radioactive iodine-refractory (RAI-R) papillary thyroid carcinoma (PTC), repetitive surgery is one form of local therapy that is evolving but hampered by technical challenges and complications. The goals of this study were to evaluate the efficacy of reoperations for local relapses of RAI-R PTC and to determine the effect of surgical treatment on disease progression.

Methods: We retrospectively reviewed data from patients with recurrent/metastatic RAI-R PTC who underwent revision operations at Hospital 108 between December 2018 and March 2021. We analyzed clinicopathological factors, perioperative features, biochemical and structural outcomes, disease progression, and related risk factors.

Results: Of the 71 patients with PTC (64 female, 7 male) enrolled in this study, 91.5% were in initial stages I and II, according to the American Joint Committee on Cancer Classification. All patients had undergone total thyroidectomy, and 61 (85.9%) had also undergone lymph node dissection (LND). The median radioactive iodine course and cumulative radioactive iodine dose were 2 times and 300 mCi, respectively. Surgery was performed in 9 (12.7%) patients for thyroid bed recurrence, 38 (53.5%) for central lymph node recurrence, and 53 (74.6%) for lateral lymph node recurrence. Major complications occurred in 9 (12.7%) patients. 15 (21.1%) patients had excellent responses, 16 (22.5%) had indeterminate responses, 33 (46.5%) had biochemically incomplete responses, and 7 (9.9%) had structurally incomplete responses. During follow-up (median time, 25 months), 21 (29.6%) patients suffered clinical and biochemical progression of disease. The median length of progression-free survival (PFS) was 27 months. Cox multifactor regression analyses revealed that the lymph node ratio and the incomplete (biochemical and structural) response were independent unfavorable prognostic factors for PFS.

Conclusions: Repetitive surgery is effective for locoregional RAI-R PTC recurrences/metastases and helps mitigate disease progression.

Introduction: Many studies have found a high prevalence of depression and anxiety in cancer patients. Bio-psychosocial and economic factors are suspected to trigger depression and anxiety in cancer patients. Therefore, the objective of this study is to examine the association between bio-socio-economic characteristics and depression/anxiety in Moroccan cancer patients.

Methods: This is a cross-sectional study in which a convenience sample of 862 participants was recruited to complete questionnaires. Socioeconomic and medical characteristics were assessed. The HADS scale (Arabic version) was used to assess depression and anxiety. Univariate analysis, bivariate chi-square, and multivariate logistic regression were used to examine the data.

Results: 40.8% of patients suffer from mild depression and 7.5% from severe depression. 34.7% suffer from mild anxiety and 10.1% from severe anxiety. Being younger, being female, having breast cancer or lung cancer, having metastatic cancer, pain, and smoking increase the risk of anxiety and depression. When taking economic characteristics into account, having a job, being on social security, and supporting family members decreased the risk of anxiety and depression.

Conclusion: Among Moroccan cancer patients, being a woman, being younger, and having metastatic cancer are all factors that contributed to depression and anxiety. However, having employment, having social security, and having a good marital relationship may significantly contribute to lowering the chance of having anxiety and depression.

Introduction: RAS status is a predictive biomarker for anti-EGFR response in metastatic colorectal cancer (mCRC). The Idylla technology (IT) is a fully automated molecular testing system based on real-time PCR and provides rapid results in a very short preparation time. In this study, we aimed to evaluate the full RAS mutation status in Moroccan patients with mCRC.

Methods: formalin-fixed, paraffin-embedded (FFPE) specimens obtained between January 22 and December 15, 2020, were analyzed using the IT. The minimum percentage of tumor cells was 10.0%, after morphological control. One to five-micron sections were collected via a dedicated microtome and inserted directly into the Idylla cartridge.

Results: 195 mCRC samples were tested for RAS mutation, 9 (4.6%) could not be treated due to insufficient tumor material. A total of 186 mCRC patients were included in this study, 50.0% were women and 50.0% were men, the mean age was 60.9 years with extremes ranging from 19 to 90 years. The primary site was the most common (83.9%) and the most common histological type was adenocarcinoma (89.8%). 56.5% of tumors were KRAS mutants and the majority of mutations resulted in an amino acid substitution of glycine for aspartic acid. The most frequent mutations were the G>T transversions (41.0%) and the G>A transitions (40.9%). In contrast, NRAS mutations were detected in 8 patients (4.0%). No statistically significant relationship between mCRC patient characteristics and KRAS/NRAS mutations was found.

Conclusions: Several studies have shown that the Idylla? KRAS mutation assay can be applied as a routine tool without requiring infrastructure or molecular expertise, to guide the personalized treatment of CRC patients. Our results suggest that KRAS mutations are more common in Moroccan mCRC patients, which is in agreement with previous studies. Further studies with a larger number of mCRC patients are recommended to confirm our results.

Introduction: Reducing “patient delay” in upper aerodigestive tract cancer (UADTC) is critical to improving patient prognosis and quality of life. The objective of this study was to assess “patient delay” and identify the association between this delay and other factors such as socio-economic, clinical, and traditional medicine use.

Methods: A cross-sectional study was conducted at Sidi Mohammed Ben Abdellah National Institute of Oncology in Rabat, Morocco. A consecutive series of patients with UADTC were selected. “patient delay” was calculated using the date of the patients’ awareness of the symptoms and the date of the first medical consultation. A multivariate binary logistic regression analysis was performed to measure the association between other different factors and “patient delay”.

Results: 201 patients were selected for this study. 65.7% of the patients were male, 79.4% were diagnosed with stage III or IV, the median of the patient’s delay was 120 days, 57.7% of them had a long “patient delay”. In addition, 60.2% of patients used traditional medicine, of which 57.0% had already used it before the first consultation. Multivariate analysis revealed that the use of traditional medicine for more than 15 days (p = 0.017) was a risk factor for “patient delay”, whereas medium or high socio-economic status (p = 0.045) and malignant interpretation of the patient’s symptoms (p = 0.008) were protective factors.

Conclusion: Our results will help to understand the individual and collective factors that may explain the issue of “patient delay”, which is a critical parameter in the early diagnosis and prevention of mortality from UADTC.

The skeletal muscle has a significant role on physical functions, and the assessment of the skeletal muscle is important in critically ill patients. Computed tomography (CT), ultrasound examination, bioelectrical impedance analysis (BIA) device, and biomarkers can all be used to assess skeletal muscle mass. CT is useful for accurately measuring skeletal muscle mass, and the measurement is conducted at the third lumbar vertebra level as the gold standard. However, the assessment using CT is done retrospectively because CT involves radiation exposure and requires patients to be transported to the examination room. On the other hand, ultrasound and BIA are noninvasive and can be used at the bedside to assess longitudinal skeletal muscle mass. However, accurate assessment requires knowledge and skills. Assessments using BIA should be carefully interpreted because critically ill patients are under dynamic fluid change and edema. Furthermore, various biomarkers for the assessment of skeletal muscle mass have been recently reported. Appropriate skeletal muscle assessment will contribute to the nutrition and rehabilitation intervention of critically ill patients so that they can return to society.

Introduction: The possible contribution of psychological stress to the development of breast cancer (BC) has been largely investigated. One of the most extensively used psychological scales is the Perceived Stress Scale (PSS), which demonstrates sufficient reliability and validity. Thus, the purposes of this study were first to translate the PSS-10 into the Moroccan Arabic dialect language and second to evaluate its validity in women with BC.

Methods: A method of translation and counter-translation into the Moroccan dialect was performed for the 10-item of PSS. Then the translated questionnaire was administered to a representative sample of 100 women with BC. Validation of metrological qualities was established by examining: internal reliability, test-retest reliability, convergent validity, and factorial structure.

Results: The Moroccan version of the PSS showed a good internal reliability (α = 0.87) and test-retest reliability (0.95 with IC_95% = [0.88, 0.98]). The confirmatory factor analysis showed a bi-dimensional structure with two related latent factors. Moreover, the principal component analysis of the PSS allowed us to extract two factors that explained 67% of the total variance.

Conclusions: We showed that the Moroccan version of the PSS-10 has good internal consistency and reliability. The factor structure is similar to that of the PSS translated into other languages. We consider this version of the PSS-10 to be an adequate instrument for assessing perceived stress in the Moroccan population. Moreover, it will be interesting to conduct further studies as comparative investigations between patients with BC and healthy women by using this validated Scale PSS.

Introduction: The effect of total mesorectal excision with lateral lymph node dissection for advanced lower rectal cancer is controversial. This study aimed to assess the efficacy of total mesorectal excision with lateral lymph node dissection for advanced lower rectal cancer.

Methods: Randomized controlled trials were searched in electronic databases and trial registries until July 2021. Meta-analyses were performed using random-effects models. The Grading of Recommendations, Assessment, Development, and Evaluation approach was used to assess the certainty of evidence.

Results: Four studies (984 patients) were included in the meta-analysis. Total mesorectal excision with lateral lymph node dissection may result in little to no difference in overall survival (hazard ratio: 1.24, 95% confidence interval: 0.89–1.73, p = 0.21), disease free survival (hazard ratio: 1.11, 95% confidence interval: 0.86–1.43, p = 0.42), and postoperative complication (risk ratio: 1.23, 95% confidence interval: 0.94–1.60, p = 0.13). However, Total mesorectal excision with lateral lymph node dissection probably results in a large reduction in local recurrence (risk ratio: 0.63, 95% confidence interval: 0.41–0.99, p = 0.04).

Conclusions: There is little robust evidence to recommend the relative superiority of total mesorectal excision with lateral lymph node dissection for advanced rectal cancer so further research is necessary to identify the specific populations in which the procedure is recommended.

Introduction: This study aimed to evaluate survival in patients aged ≥80 years with oral squamous cell carcinoma (OSCC) treated with intra-arterial chemotherapy using docetaxel, cisplatin, and peplomycin combined with intravenous chemotherapy using 5-fluorouracil (IADCPIVF).

Methods: The present study was a retrospective analysis of 32 OSCC patients who were determined to require reconstructive surgery. We performed IADCPIVF as neoadjuvant chemotherapy and then minimally invasive surgeries (MIS) on patients with complete responses or good partial responses.

Results: The study population included 16 patients with stage II OSCC, seven with stage III, and nine with stage IV. The primary tumor response rate was 100% (complete response rate, 37.5%; good partial response rate, 28.1%; and fair partial response rate, 34.4%). After IADCPIVF, 32 patients underwent surgery; MIS was performed on 21 patients. The 3-year overall survival rate was 76.5% (stage II, 77.9%; stage III, 85.7%; and stage IV, 55.6%). In the multivariate analysis of survival, clinical tumor response was a significant prognostic factor. The rate of grade 3 adverse events was 46.9%, and most of the events were due to mucositis in the area of the intra-arterial injection.

Conclusion: IADCPIVF is highly safe and has an excellent antitumor effect by itself, so it may be a possible new treatment method with high curability, even for patients aged ≥80 years who want to avoid reconstructive surgery and preserve oral function.

Pembrolizumab, a treatment for advanced cancers, can cause immune-related adverse events (irAEs), and among these, esophagitis is rare. We report on an 80-year-old man with squamous cell lung carcinoma who started treatment with pembrolizumab at 200 mg every three weeks. After the first administration, the patient developed odynophagia. Esomeprazole did not improve symptoms, and upper gastrointestinal endoscopy and biopsy revealed esophagitis dissecans superficialis, which was considered as an irAE. Oral prednisolone was started, and odynophagia rapidly improved and the mucosal lesions healed. However, steroid withdrawal was unsuccessful because of repeated relapses. When patients on immune checkpoint inhibitors develop dysphagia, esophagitis should be suspected as an irAE.

The spouse is affected by lung cancer throughout the disease's progression, from diagnosis through survival following treatment. This review explores lung cancer's economic, social, sexual, and religious impact on patients' spouses. The reviewed studies show that younger spouses have a more significant economic impact. 74% of spouses had experienced one or more adverse economic or social changes since the patient's illness, and 56% have disengaged from most social and leisure activities. In addition, lung cancer-affected couples believed that intimacy and sexuality issues were salient, but few reported discussing them. Instead, they turn to effective religious coping strategies as a remedy. Therefore, the significant financial burden of treating a spouse's lung cancer should be known to healthcare practitioners.

Background: Expression of major histocompatibility complex class I-related chain A/B (MICA/B) has been intended to play a significant role in tumor immunosurveillance. Downregulation of MICA/B expression in tissues and augmented sera levels are assumed to impair the antitumor immune response.

Method and results: In this study, the potential of sMICA as a marker for oral cancer (OC) was investigated. The sMICA levels in sera, saliva, and urine of OC patients were significantly different from those of the control group. The sMICA was correlated with tumor stage to evaluate the diagnostic power of MICA as a marker. However, the findings indicate that the expression of MICA/B in positive control and Stage I and IV showed significant difference as per one-way analysis of variance (P value <0.0001). Serum levels of sMICA showed a significant difference in the positive control and stages I and IV (P value <0.0001). MICA/B expression in patients with Stages II and III also showed a significant difference compared to positive control (P value of 0.0028 and 0.0003). Analysis of sMICA in serum, saliva and urine from OC patients showed significantly (P value <0.0001) higher levels (median 34.25 ± 3.57 pg/ml in pre-treatment sera, 193.93 ± 1.95 pg/ml in saliva and 109.89 ± 1.59 pg/ml in urine) than in control (median <1.2 pg/ml). Patients with poorly differentiated tumors exhibited a smaller amount of sMICA levels and well-differentiated tumors revealed higher levels of sMICA in biofluids.

Conclusion: The release of sMICA and its expressions in biofluids reflect an impairment of tumor immunity. The sMICA levels may provide useful additional information for the diagnosis, staging and prognosis of cancer.

A 65-year-old female nonsmoker showed an abnormal shadow in the left lung field on X-ray. She underwent a left upper lobectomy and was diagnosed with pulmonary adenocarcinoma at pathological stage IIIA. After 9 months, she received whole-brain radiation therapy because of a brain metastasis in the right parietal lobe. First-line induction therapy with gefitinib was performed for 32 months but the patient failed to respond to the chemotherapy. However, second-line induction therapy with docetaxel led to the shrinkage of lymph nodes. Because of the re-enlargement of lymph nodes, erlotinib, a tyrosine kinase inhibitor (TKI), was started orally and the disease was controlled for 9 years. Due to the recurrence of brain metastasis, induction therapy using bevacizumab (15 mg/kg), a humanized anti-vascular endothelial growth factor (VEGF) monoclonal antibody, was added. After 1 month, contrast-enhanced magnetic resonance imaging revealed that the lesions had shrunk. The patient has now survived for more than 17 years. The addition of monoclonal antibody targeting VEGF would have the advantage of improving outcomes to control brain metastases that may appear in patients with non-small cell lung cancer receiving first-generation TKIs.