Background: Human telomerase reverse transcriptase (hTERT) promoter mutations are common genetic events in bladder cancer (BC) and have been recognized as potential biomarkers for BC diagnosis and prognosis. Detection of TERT promoter mutations as urine-based tests has previously been reported to detect primary and recurrent BC. This study was planned to evaluate hTERT promoter mutations in both biopsies and urines from BC patients to assess the interest and the usefulness of introducing these biomarkers for better management of BC in Morocco.

Methods: In a cohort study involving a series of BC 70 patients with different stages and grades, hTERT promoter mutations were identified in both fresh biopsies and urine sediments by PCR amplification and DNA sequencing.

Results: Overall, hTERT promoter mutations were reported in 60% of cancer biopsies (42/70), the hotspot mutations C228T and C250T were respectively identified in 80.95% (34/42) and 16.67% (7/42) of positive cases. Other mutations: A161C and G149T were also reported and were obtained in 2.38% (1/42) and 2.38% (1/42), respectively. hTERT promoter mutations were identified in 30% of matched urine sediments (21/70) and showed an overall sensitivity of 50% and specificity of 100%. In patients with non-muscle invasive bladder cancer, no statistically significant association was detected between TERT promoter mutations and recurrence-free survival (HR: 1.224, 95% CI: 0.373–4.011, p = 0.739), and overall survival (HR: 0.363, 95% CI: 0.041–3.244, p = 0.364).

Conclusion: hTERT promoter mutations are early events occurring with high frequencies and can be identified in the exfoliated cells, making them an interesting non-invasive biomarker for diagnosis and follow-up of bladder cancer.

Background: The main side effects of Tamoxifen are menopausal symptoms. We report a case of leucopenia induced by Tamoxifen in a 28-year-old woman treated in the adjuvant setting.

Case Presentation: A 28-year-old woman was diagnosed with invasive ductal carcinoma of the left breast. The final tumor stage was T2, N3, M0, Stage IIIc. She received adjuvant chemotherapy with four cycles of Adriamycin and Cyclophosphamide every three weeks, followed by four cycles of Taxol every three weeks. After chemotherapy, she received the standard dose of adjuvant radiotherapy (50 Gy/15 fractions) for three weeks. Then she received tamoxifen and goserelin treatment for two years. Zoladex was discontinued, and she received tamoxifen only for five months. Blood examination during tamoxifen treatment demonstrated the patient had anemia (hemoglobin: 9.5 g/dL), leucopenia (white blood cells (WBC): 2.2×10⁹/L), neutropenia (granulocytes: 0.9×10⁹/L) and no thrombocytopenia (platelets: 222×10⁹/L). Antinuclear antibodies (ANA) test, anti-double stranded DNA antibody test, erythrocyte sedimentation rate, or C - Reactive Protein (CRP) didn’t suggest connective tissue disorder. Moreover, bone marrow aspirate and biopsy of bilateral iliac crest didn’t reveal abnormal findings. Tamoxifen was discontinued for one month, and we found improvement of leucopenia (WBC: 3.24×10⁹/L). However, leucopenia recurred to the severer degree after resume of tamoxifen treatment (WBC: 2.6×10⁹/L). These findings suggested that tamoxifen was responsible for leucopenia in this patient.

Conclusion: Leucopenia is a rare and important adverse event of tamoxifen, which can cause treatment interruption.

Background: The aim of this study is to document the time intervals of breast cancer and especially the delays of patient, diagnosis and treatment and to evaluate how clinical, socio-demographic and treatment factors influence the delays along the clinical course of a patient.

Methods: A retrospective study was conducted at the FEZ Oncology Hospital of the Hassan II University Hospital Center in MOROCCO.

Results: 410 medical records of breast cancer patients were collected. The 31.2% of the patients were 45–54 years old. Median patient delay was 6 days, median diagnostic delay was 97 days, and median treatment delay was 44 days. Multivariate analysis revealed that the patient age was associated with the delay in diagnosis and treatment. The diagnosis year (the year in which the patient was diagnosed (either from 2012 to 2014 or 2015 to 2017), was associated with the patient delay and the diagnosis delay. The age, the type of medical consultation (general physician, private physician, specialist physician or Health Care Worker), the Union for International Cancer Control (UICC) tumour stage and the biopsy exam were associated with the diagnosis delay. Thus, the delay of the treatment was significantly associated with the nodal status.

Conclusion: The concept of measuring time intervals in the cancer patient pathway is a crucial indicator for improving the quality of care.

We report on a 67-year-old man with primary malignant pericardial mesothelioma, a rare neoplasm with a poor prognosis that has various causes, including asbestos, radiation, erionite, and simian virus 40. The patient had a history of asbestos exposure and radiation for a mediastinal tumor. The role of asbestos exposure in the development of primary malignant pericardial mesothelioma is not as clear as its role in the development of pleural mesothelioma. We speculate that both asbestos exposure and radiation were associated with the primary malignant pericardial mesothelioma in this patient.

Aim: Recently, using natural products has become a rapidly evolving option to treat human malignancies, such as leukemia. Herein, we examined the anti-leukemic effects of flavonoid genistein in human T-cell acute lymphoblastic leukemia (T-ALL) MOLT-4 cell lines.

Methods: Firstly, MOLT-4 cells were treated with various concentrations of genistein (2.5–40 µg/ml) to evaluate the potent effect of genistein on MOLT-4 cell proliferation using tetrazolium-based MTT assay with 12–72 hours of exposure. Also, apoptosis percentages were estimated by fluorescence-activated cell sorting (FACS) analysis in MOLT-4 cells upon exposure with genistein 2.5 and 10 µg/ml at 24 hours of treatment. The expression levels of anti-apoptotic protein c-FLIP, Mcl-1, survivin, and XIAP were evaluated at mRNA levels by Real-Time PCR within 12–48 hours of treatment.

Results: Based on the analysis, genistein at various concentrations and time points inhibited MOLT-4 cell proliferation compared with control cells. Moreover, it significantly induced apoptosis in the treated cell compared to control cells. Moreover, down-regulation of the expression of candidate genes, more evidently, c-FLIP, Mcl-1, and survivin were evidenced upon exposure with genistein.

Conclusion: In sum, consequences exhibited that genistein could stimulate anti-leukemic effects in T-ALL cells mainly by down-regulation of anti-apoptotic protein, culminating in apoptosis.

Primary hepatic neuroendocrine carcinoma is a sporadic tumor. It is challenging to differentiate from other hepatic tumors such as cholangiocarcinoma, hepatocellular carcinoma, and other focal hepatic lesions based on diagnostic imaging results. A 66-year-old woman was referred for evaluation of a hepatic mass discovered on an incidentally abdominal ultrasound. The findings from computed tomography led to a diagnosis of hepatocellular carcinoma, while magnetic resonance imaging results suggested fibrolamellar hepatocellular carcinoma or focal nodular hyperplasia. A partial hepatectomy was performed, and the tumor was removed entirely. Pathology diagnosed a malignant neoplasm of unknown type, and immunohistochemistry confirmed a grade 2 neuroendocrine tumor. Adjuvant chemotherapy was not required after surgery. This case highlights that the diagnosis of primary hepatic neuroendocrine carcinoma remains a challenge that needs to distinguish from other focal liver lesions and differentiate from a secondary metastatic neuroendocrine tumor.

Background: We developed a new smartphone application to record images of daily meals and physical symptoms for postoperative gastrointestinal patients.

Methods: Patients took pictures of their daily meals and uploaded them on the researcher’s server. They also entered the appetite, physical condition, and digestive symptoms. Two dietitians quantitatively assessed the images of diets and performed nutritional guidance for patients The primary endpoint was the percentage of evaluable meals during the study period (10 days).

Results: Ten patients participated in the study as planned. The median age was 64 (32–72) years old, and there were six males and four females. Six patients underwent distal gastrectomy, three underwent total gastrectomy and one underwent esophagectomy. The mean postoperative time was 4.6 months. The percentage of evaluable dietary images was 94.6%.

Conclusion: We confirmed the feasibility of the delivering nutritional guidance using a smartphone application for patients who have undergone gastrointestinal cancer surgery.

Introduction: Oral combination chemotherapy using capecitabine and cyclophosphamide (XC) has demonstrated synergistic antitumor activity in preclinical studies. We investigated the efficacy and safety of early-linen XC therapy use in patients with metastatic breast cancer (MBC).

Methods: In this prospective cohort study conducted at 10 site in Kyushu, Japan, patients with human epidermal growth factor receptor 2 (HER2)-negative MBC, regardless of the history of previous treatment, were enrolled. XC therapy was administered at the recommended dose on a three-week schedule for at least six courses unless disease progression and unacceptable toxicities occurred. The primary endpoint was response rate (RR), and the secondary endpoints were progression-free survival (PFS), overall survival (OS), and adverse events.

Results: Of the 83 patients enrolled, 71 (median age, 60 years [range, 34–86 years]) fulfilled the inclusion criteria and were analyzed. A total of 45 (63%) patients did not previously receive chemotherapy for metastatic disease, 10 (14%) received one chemotherapy regimen. The median number of cycles of XC was eight (range, 1–45), and the RR was 28%. Median PFS was 7.6 months (95% confidence interval [CI]: 5.7–9.5 months), and median OS was 26.4 months (95% CI: 13.9–38.9 months). The most frequent grade 3–4 adverse events were leukopenia (n = 20) and neutropenia (n = 15).

Conclusions: In clinical practice, XC therapy exhibited efficacy and manageable tolerability in Japanese women with MBC in early-line use. (ID: UMIN000044444)

Purpose: Omentectomy is a standard procedure to prevent advanced gastric cancer recurrence; however, there is no supporting evidence. We aimed to evaluate the benefit of omentectomy for patients with pT3 gastric cancer.

Methods: We reviewed 140 patients who underwent radical gastrectomy for pT3 gastric cancer between 2002 and 2016, and classified them into the omentum-preserved group (OPG) and the omentum-resected group (ORG). After propensity score matching, 23 patients in each group were included in the final analysis. Postoperative outcomes, overall survival, and relapse-free survival were compared between the two groups.

Results: The median follow-up was 5.14 years in OPG and 5.15 years in ORG. The incidence of postoperative complications of Clavien–Dindo grade III or more and postoperative hospital stay were not significantly different between the groups. The OPG and ORG had 5-year overall survival (OS) rates of 77.6% and 81.8% (P = 0.64) and relapse-free survival (RFS) rates of 95.0% and 72.7% (P = 0.04), respectively.

Conclusion: In pT3 gastric cancer, the OS and RFS rates were comparable between the two groups, which warrant further investigation in randomized clinical trials.

Introduction: Acute promyelocytic leukemia (APL) is a phenotypic and pathological distinct variant of acute myeloid leukemia represents as a medical emergency attributed to a high rate of mortality following induction treatment. The aim of this study is to assess clinical and paraclinical parameters associated with early death in patients with APL.

Methods: This retrospective study enrolled newly diagnosed APL patients admitted in the hematology and oncology wards of Namazi Hospital (Shiraz, Iran) from April 2014 to March 2018. The hospital archives of all patients who met the inclusion criterion were examined, and the following data were extracted: age, gender, ethnicity, comorbidities, white blood cell (WBC), hemoglobin and platelet count at the admission, the blood transfusion protocol (restrictive vs. liberal) and the patient’s outcome in the first 30 days of hospitalization (survival or death).

Results: This study consisted of 41 patients with APL including 23 men and 18 women with mean ages and standard deviations of 37.8 ± 12.1 and 35 ± 11.3 for men and women, respectively. In this study, 33 patients (80.4%) survived the induction therapy. Multivariate analysis showed WBC count more than 20 (×10⁹/L) (adjusted odds ratio: 1.34 with 95% confidence interval of 1.15–1.57), receive of liberal transfusion (1.25, 1.11–1.42), platelet count lower than 40 (×10⁹/L) (1.25, 1.10–1.41) and being older (1.008, 1.002–1.014) increased the odds of early death in patients with APL.

Conclusion: Our study showed that being older, having higher WBC count and lower platelet count at the admission and receive of liberal blood transfusion were associated with higher early death and there is a need for strategies to reduce early death in these high-risk patients.