Browsing by Author "Dunstan, J"

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A biomarker study in Peruvian males with breast cancer
(Baishideng Publishing Group, 2021) Castaneda, Carlos; Castillo, Miluska; Bernabe, LA; Sanchez, J; Torres, E; Suarez, N; Tello, K; Fuentes, H; Dunstan, J; De La Cruz, M; Cotrina, JM; Abugattas, J; Guerra, H; Gomez, HL
AIM:To investigate clinicopathological features and biomarkers of BC tumors in males and their prognostic value in Peruvian population. METHODS: This study looked at a single-institution series of 54 Peruvian males with invasive BC who were diagnosed from Jan 2004 to June 2018. Standard pathological features, TIL levels, MMR proteins, AR immunohistochemistry staining, and PIK3CA gene mutations were prospectively evaluated in cases with available paraffin material. Percentage of AR and estrogen receptor (ER) positive cells was additionally calculated by software after slide scanning. Statistical analyses included association tests, intraclass correlation test and Kaplan Meier overall survival curves. RESULTS: The median age was 63 years and most cases were ER-positive (85.7%), HER2 negative (87.2%), Luminal-A phenotype (60%) and clinical stage II (41.5%) among our male breast tumors. Median TIL was 10% and higher levels tended to be associated with Luminal-B phenotype and higher grade. AR-positive was found in 85.3% and was correlated with ER (intraclass index of 0.835, P < 0.001). Loss of MMR proteins was found in 15.4% and PIK3CA mutation (H1047R) in 14.3% (belonged to the Luminal-A phenotype). Loss of MMR proteins was associated with AR-negative (P = 0.018) but not with ER (P = 0.43) or TIL (P = 0.84). Early stages (P < 0.001) and lower grade (P = 0.006) were associated with longer overall survival. ER status, phenotype, AR status, TIL level, MMR protein loss nor PIK3CA mutation was not associated with survival (P > 0.05). CONCLUSION: Male BC is usually ER and AR positive, and Luminal-A. MMR loss and PIK3CA mutations are infrequent. Stage and grade predicted overall survival in our South American country population.
ASO Author Reflections: Distilling Wisdom From Two Decades of Cutaneous Malignant Melanoma at a Peruvian Cancer Institute: A Stirring Call for Action
(Springer Science and Business Media Deutschland GmbH, 2024) Ziegler-Rodriguez, G; Ziegler-Rodriguez, O; De, La, Cruz-Ku, G; Cotrina-Concha, JM; Dunstan, J; Pinillos-Portella, M; Vilchez-Santillan, S; Möller, MG
Resumen disponible en la revista donde esta publicada
Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy
(Baishideng Publishing Group, 2018) Galvez, M; Castaneda, CA; Sanchez, J; Castillo, M; Rebaza, LP; Calderon, G; Cruz, M; Cotrina, JM; Abugattas, J; Dunstan, J; Guerra, H; Mejia, O; Gomez, HL
Aim: To investigate the survival impact of clinicopathological factors, including pathological complete response (pCR) and tumor-infiltrating lymphocytes (sTIL) levels according to subtypes, in breast cancer (BC) patients who received neo-adjuvant chemotherapy (NAC). Methods: We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. sTIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preNAC core biopsy. pCR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, sTIL, pCR and survival were carried out using SPSSvs19. Results: Median age was 49 years (range 24-84 years) and the most frequent clinical stage was IIIB (58.3%). Luminal A, Luminal B, HER2-enriched and (triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. pCR was observed in 11% and median percentage of sTIL was 40% (2%-95%) in the whole population. pCR was associated to Ct1-2 (P = 0.045) and to high sTIL (P = 0.029) in the whole population. There was a slight trend towards significance for sTIL (P = 0.054) in Luminal A. sTIL was associated with grade III (P < 0.001), no-Luminal A subtype (P < 0.001), RE-negative (P < 0.001), PgR-negative (P < 0.001), HER2-positive (P = 0.002) and pCR (P = 0.029) in the whole population. Longer disease-free survival was associated with grade I-II (P = 0.006), cN0 (P < 0.001), clinical stage II (P = 0.004), ER-positive (P < 0.001), PgR-positive (P < 0.001), luminal A (P < 0.001) and pCR (P = 0.002). Longer disease-free survival was associated with grade I-II in Luminal A (P < 0.001), N0-1 in Luminal A (P = 0.045) and TNBC (P = 0.01), clinical stage II in Luminal A (P = 0.003) and TNBC (P = 0.038), and pCR in TNBC (P < 0.001). Longer overall survival was associated with grade I-II (P < 0.001), ER-positive (P < 0.001), PgR-positive (P < 0.001), Luminal A (P < 0.001), cN0 (P = 0.002) and pCR (P = 0.002) in the whole population. Overall survival was associated with clinical stage II (P = 0.017) in Luminal A, older age (P = 0.042) in Luminal B, and pCR in TNBC (P = 0.005). Conclusion: Predictive and prognostic values of clinicopathological features, like pCR and sTIL, differ depending on the evaluated molecular subtype.
Correction to: Unveiling Melanoma: A Deep Dive into Disparities at a Latin-American Cancer Institute (Annals of Surgical Oncology, (2024), 31, 9, (6097-6117), 10.1245/s10434-024-15573-6)
(Springer Science and Business Media Deutschland GmbH, 2024) Ziegler-Rodriguez, G; De, La, Cruz-Ku, G; Piedra-Delgado, L; Torres-Maldonado, J; Dunstan, J; Cotrina-Concha, JM; Galarreta-Zegarra, JA; Calderon-Valencia, G; Vilchez-Santillan, S; Pinillos-Portella, M; Möller, MG
In the original online version of this article Luis Piedra‑Delgado's affiliation was incorrect. It is correct as reflected here. The original article was corrected.
Critical review of axillary recurrence in early breast cancer
(Elsevier Ireland Ltd, 2018) Castaneda, Carlos; Rebaza, P; Castillo, Miluska; Gomez, HL; De La Cruz, M; Calderon, G; Dunstan, J; Cotrina, JM; Abugattas, J; Vidaurre, T
Around 2% of early breast cancer cases treated with axillary lymph node dissection (ALND) underwent axillary recurrence (AR) and it has a deleterious effect in prognosis. Different scenarios have incorporated Sentinel Lymph Node (SLN) Biopsy (SLNB) instead of ALND as part of the standard treatment and more effective systemic treatment has also been incorporated in routine management after first curative surgery and after regional recurrence. However, there is concern about the effect of SLNB alone over AR risk and how to predict and treat AR. SLN biopsy (SLNB) has been largely accepted as a valid option for SLN-negative cases, and recent prospective studies have demonstrated that it is also safe for some SLN-positive cases and both scenarios carry low AR rates. Different studies have identified clinicopathological factors related to aggressiveness as well as high-risk molecular signatures can predict the development of locoregional recurrence. Other publications have evaluated factors affecting prognosis after AR and find that time between initial treatment and AR as well as tumor aggressive behavior influence patient survival. Retrospective and prospective studies indicate that treatment of AR should include local and systemic treatment for a limited time.
Relationship between tumor-associated immune infiltrate and p16 staining over clinicopathological features in acral lentiginous melanoma
(Springer-Verlag Italia Srl, 2013) Castaneda, Carlos; Castillo, Miluska; Torres-Cabala, C; Bernabe, LA; Casavilca, S; Villegas, V; Sanchez, J; de la Cruz, M; Dunstan, J; Cotrina, JM; Gomez, HL; Chavez, C; Landa-Baella, MP; Tello, K; Felix, BF; Abugattas, J
Purpose: This study aims to evaluate the association between composition of tumor-infiltrating lymphocytes (TIL) and expression of p16 in acral lentiginous melanoma (ALM), and their impact on prognosis.
Unveiling Melanoma: A Deep Dive into Disparities at a Latin-American Cancer Institute
(Springer Science and Business Media Deutschland GmbH, 2024) Ziegler-Rodriguez, G; De, La, Cruz-Ku, G; Piedra-Delgado, L; Torres-Maldonado, J; Dunstan, J; Cotrina-Concha, JM; Galarreta-Zegarra, JA; Calderon-Valencia, G; Vilchez-Santillan, S; Pinillos-Portella, M; Möller, MG
Introduction: The worldwide incidence of melanoma has increased in the last 40 years. Our aim was to describe the clinic-pathological characteristics and outcomes of three cohorts of patients diagnosed with melanoma in a Latin-American cancer institute during the last 20 years. Methods: We evaluated three retrospective patient cohorts diagnosed with melanoma at Instituto Nacional de Enfermedades Neoplasicas (INEN), a public hospital in Lima, Peru, for the years 2005–2006, 2010–2011, and 2017–2018. Survival rate differences were assessed using the Log-rank test. Results: Overall, 584 patients were included (only trunk and extremities); 51% were male, the mean age was 61 (3–97) years, and 48% of patients resided in rural areas. The mean time to diagnosis was 22.6 months, and the mean Breslow thickness was 7.4 mm (T4). Lower extremity was the most common location (72%). A majority of the patients (55%) had metastases at the time of presentation, with 36% in stage III and 19% in stage IV. Cohorts were distributed as 2005–2006 (n = 171), 2010–2011 (n = 223), and 2017–2018 (n = 190). No immunotherapy was used. Cohort C exhibited the most significant increase in stage IV diagnoses (12.3%, 15.7%, 28.4%, respectively; p < 0.01). The median overall survival rates at the three-year follow-up demonstrated a decline over the years for stages II (97%, 98%, 57%, respectively; p < 0.05) and III (66%, 77%, 37%; p < 0.01). Conclusions: There has been a worsening in the incidence of late-stage metastatic melanoma in Peru throughout the years, coupled with a significant decline in overall survival rates. This is underscored by the fact that half of the population lives in regions devoid of oncological access.