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Abstract Background Data: Hepatic resection of a large HCC represents a surgical challenge. In patients with large HCC in the right liver, the conventional technique for hepatectomy, i.e., mobilization of the right liver from the retro peritoneum and anterior surface of the inferior vena cava may be difficult because of the tumor volume and local adhesions. Likewise, even if the mobilization can be accomplished, the forceful manipulation of the liver can result in tumor rupture and dissemination of malignant disease. Objective: To report the efficacy of using the anterior approach versus the conventional approach, in surgical resection for large hepatocellular carcinoma (HCC) in terms of surgical and long-term outcomes. Methods: Between 2000 and 2006, 126 consecutive patients who underwent hepatic resection with curative intent for large right HCC ≥7 cm were identified from a prospective database. The 36 patients who had anterior approach were compared with the remaining 90 patients who had conventional approach .Clinicopathological features and surgical results were analyzed and prognostic factors were evaluated by multivariate analysis. Results: There was no significant difference between the 2 groups as regard clinical, laboratory and pathological parameters. The operative results had shown a comparable proportion of patients experienced massive operative blood loss and postoperative complications in the 2 groups. The AA group had a lower recurrence rate (P = 0•015), better disease-free survival (DFS) (P = 0•001) and overall survival than the CA group. Our study identified that AA is prognostic factor of both overall survival and disease-free survival for large HCC ≥7cm. Conclusion: The anterior approach is a safe and effective technique for right hepatic resection for large HCC and achieves more advantageous long survival outcome over the conventional approach.

Abstract Background Data: Hepatic resection of a large HCC represents a surgical challenge. In patients with large HCC in the right liver, the conventional technique for hepatectomy, i.e., mobilization of the right liver from the retro peritoneum and anterior surface of the inferior vena cava may be difficult because of the tumor volume and local adhesions. Likewise, even if the mobilization can be accomplished, the forceful manipulation of the liver can result in tumor rupture and dissemination of malignant disease. Objective: To report the efficacy of using the anterior approach versus the conventional approach, in surgical resection for large hepatocellular carcinoma (HCC) in terms of surgical and long-term outcomes. Methods: Between 2000 and 2006, 126 consecutive patients who underwent hepatic resection with curative intent for large right HCC ≥7 cm were identified from a prospective database. The 36 patients who had anterior approach were compared with the remaining 90 patients who had conventional approach .Clinicopathological features and surgical results were analyzed and prognostic factors were evaluated by multivariate analysis. Results: There was no significant difference between the 2 groups as regard clinical, laboratory and pathological parameters. The operative results had shown a comparable proportion of patients experienced massive operative blood loss and postoperative complications in the 2 groups. The AA group had a lower recurrence rate (P = 0•015), better disease-free survival (DFS) (P = 0•001) and overall survival than the CA group. Our study identified that AA is prognostic factor of both overall survival and disease-free survival for large HCC ≥7cm. Conclusion: The anterior approach is a safe and effective technique for right hepatic resection for large HCC and achieves more advantageous long survival outcome over the conventional approach.

Abstract Background: Hodgkin's lymphoma (HL) is a highly curable malignant disease. Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life. Objectives: To assess the outcome of the HL patients treated with risk-adapted therapy approach at pediatric oncology department in South Egypt Cancer Institute and to assess the prognostic factors of survival in pediatric HL patients. Methods: This prospective study was carried out from January 2009 to January 2014, with median follow up of 36.5 months (range 8-58 months). Thirty four patients were eligible for this study stratified into three risk groups: low risk (LR), intermediate risk (IMR) and high risk (HR). Patients treated with two, four and six cycles respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved partial response. Results: Six patients were LR, 18 patients were IMR and 10 patients were HR. Six patients had events, progressive disease in 3 patients, relapse in 2 patients, death in one patient due to fever neutropenia. The 3-years overall survival (OS) and event free survival (EFS) rates (± SE) were 91.2% ± 5.3% and 82.3% ± 7.3% respectively. Multivariate analysis revealed "B" symptoms and anemia were the significant independent factors for inferior EFS, however, hypoalbuminemia and anemia were the significant independent factor for lower OS. Conclusion: Risk-adapted combined-modality therapy with ABVD/COEP and involved-field radiation therapy has high efficacy and minimal toxicity in the treatment of pediatric HL.

Abstract Background: Hodgkin's lymphoma (HL) is a highly curable malignant disease. Risk-adapted therapy for children with HL is directed toward high survival, minimal toxicity and optimal quality of life. Objectives: To assess the outcome of the HL patients treated with risk-adapted therapy approach at pediatric oncology department in South Egypt Cancer Institute and to assess the prognostic factors of survival in pediatric HL patients. Methods: This prospective study was carried out from January 2009 to January 2014, with median follow up of 36.5 months (range 8-58 months). Thirty four patients were eligible for this study stratified into three risk groups: low risk (LR), intermediate risk (IMR) and high risk (HR). Patients treated with two, four and six cycles respectively of alternating ABVD/COEP chemotherapy followed by involved-field radiation therapy (IFRT): 15 Gy for patients achieved complete response, and 25.5 Gy for those achieved partial response. Results: Six patients were LR, 18 patients were IMR and 10 patients were HR. Six patients had events, progressive disease in 3 patients, relapse in 2 patients, death in one patient due to fever neutropenia. The 3-years overall survival (OS) and event free survival (EFS) rates (± SE) were 91.2% ± 5.3% and 82.3% ± 7.3% respectively. Multivariate analysis revealed "B" symptoms and anemia were the significant independent factors for inferior EFS, however, hypoalbuminemia and anemia were the significant independent factor for lower OS. Conclusion: Risk-adapted combined-modality therapy with ABVD/COEP and involved-field radiation therapy has high efficacy and minimal toxicity in the treatment of pediatric HL.

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Abstract BACKGROUND: Gene expression profile studies classify breast carcinomas according to the molecular profile into 4 groups; Normal-like group, Luminal group, Basal group and HER-2 group. The basal group has aggressive behavior and do not respond to either radiotherapy or chemotherapy. They express genes characteristic of basal/myoepithelial (basal/ME) cells as high molecular-weight cytokeratins including CK5/6, CK14, and CK17. They have high histologic grade, pushing (non-infiltrative) borders, large zones of geographic or comedo-type necrosis, stromal lymphocytic infiltrates and scant stromal content. AIM OF THE STUDY: The aim of this study was identification of breast carcinomas with basal phenotype referred to South Egypt Cancer Institute, relation between the clinicopathologic characteristics of both basal and non-basal phenotypes and relation of basal phenotypes with the available clinical follow up data of patients aiming to find out how basal phenotype affect patients’ outcomes. MATERIALS AND METHODS: Formalin-fixed paraffin-embedded blocks of 168 female patients diagnosed as primary invasive breast carcinoma were obtained from the archives of the Surgical Pathology Laboratory, South Egypt Cancer Institute, Assiut University between years 2008 and 2012. Using tissue microarray technique, tissue cores from all specimens were immunostained with CK5/6 and CK14 to detect the basal group and other non-basal groups. RESULTS: 77 cases (45.6%) were positive for CK5/6 and 81 cases (47.9%) were positive for CK14. Accordingly, 81 cases (47.9%) were of basal phenotype (which was positive for CK5/6 or CK14 or both) corresponding to 66 cases (39%) of the other types and 21 cases (13.1%) were missed. There was significant association between the basal phenotype and presence of lymphovascular invasion (p-value 0.001), presence of necrosis (p-value 0.001), infiltrative margin (p-value 0.001), inflammatory stromal infiltrate (p-value= 0.006) and cytoplasmic expression of CK5/6 (p-value= 0.014). . No statistical significance was observed between the basal phenotype and overall survival (OS), disease-free interval (DFI) or distant metastasis-free interval (DMFI). CONCLUSION: Basal-like breast carcinomas (BLBCs) have some distinctive features as presence of lymphovascular invasion (LVI), necrosis, infiltrative tumor margin and inflammatory stromal infiltrate. They showed tendency to occur in older age group, to be of large tumor size and of moderate grade.