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Background: Human papilloma virus (HPV) infection is implicated in a proportion of invasive squamous cell carcinoma of the penis (PC). A subset of PC involves dysregulation of the p53 pathway. HPV in situ hybridization (ISH) and p16 ink4a positivity are surrogate markers for HPV infection, and p53 immunohistochemistry (IHC) denotes abnormality in the p53 pathway. Clinicopathologic characteristics of a cohort of Indian PC patients with respect to p16 and p53 expression were analyzed.Methods: 123 PC patients were studied for p16 and p53 IHC and HPV ISH and the results were correlated with various clinicopathologic parameters.Results: p16 and HPV ISH were positive in 47% and 53% of the tumors, respectively. The proportion of warty, basaloid, or mixed warty-basaloid tumor subtypes showed significant p16 positivity (p < 0.0001) compared to other subtypes. In patients where p16 was negative, a p53-positive phenotype had a higher propensity for lymph node metastases (OR, 5.4; 95% CI, 1.7 to16.8; p¼0.003). Similarly, p53 positivity dictates nodal involvement in the p16-positive subset of tumors (OR, 5; 95% CI, 1.2 to 20.1; p¼0.024). On multivariate analyses, pathologic subtypes (warty, warty-basaloid, and basaloid) (p<0.0001), p16 expression (p<0.0001), and absence of nodal metastasis (p<0.0001) were significant predictors of improved overall (OS) and cancer specific survival (CSS). The OS was significantly longer in patients with p16+ tumors (p<0.0001), as was the CSS (p<0.0001). Patients with dual positive tumors had a significantly higher OS (p<0.001) and CSS (p¼0.01), in the entire cohort. In the node positive patients, dual positivity was associated with significantly higher OS (p<0.0001); however, the median CSS for p53+/p16+tumors was not significantly different compared to p53-/p16-tumors (p¼0.064), although there was a trend towards improved CSS.Conclusions: There is a strong concordance between p16 IHC and HPV ISH results. p16 status is an independent predictor of survival (OS and CSS) in our cohort of PCs. p53 is a predictor of nodal metastasis irrespective of p16 status. Dual positive tumors have a significantly better outcome in comparison to dual negative tumors.

Background: Extended pancreatectomy (EP) is the only potential cure for patients with borderline resectable and locally advanced pancreatic cancer.Methods: In the period 2011-2018, 618 resections were performed in patients with pancreatic adenocarcinoma. Standard resections were performed in 476 (77%) patients. EP was performed in 142 (23%) patients. Extended pancreaticoduodenectomy was performed in 79 (55.6%), extended distal resections in 52 (36.6%), extended total pancreatectomy in 11 (7.8%). EP with arterial resections was performed in 14 (2.3%) patients, with venous resections in 91 (14.7%) patients.Results: One or more postoperative complications occurred in 182 patients (38.2%) in the standard resection group and in 63 (44.3%) in the EP group. Mortality was 13.2% (15 patients): 6 (4.2%) patients died after EP and 9 (1.9%) after standard pancreatectomy. Median survival and 5-year overall survival rates were reduced in patients having EP compared with those undergoing a standard resection (15 months, 18% and 25 months, 33%, respectively; c 2 ¼ 2.83, P¼ 0.09, c 2 ¼ 0.16, P¼0.69).Conclusions: These results suggest that morbidity and mortality after EP are comparable with standard pancreatectomy. However, long term results of EP are worse compared with standard pancreatectomy. Extended resections are possible and can increase the number of radically operated patients.

Conclusions: Interrogative BiologyÒ platform analytics was employed to infer causal relationships between existing pancreatic cancer therapies and longitudinal alterations in the proteomic, metabolomic, and lipidomic responses to 253 treatment interventions and 211 progression events. We believe this cohort to be the largest high-fidelity pan-omic characterization of pancreatic cancer and its risk factors..

proteinuria (27.3%), stomatitis (11.4%). Nine (20.5%) pts required treatment discontinuation and reasons were due to death, PD and AE in 5 (11.4%), 2 (4.5%) and 2 (4.5%) pts, respectively. Five deaths occurred. Dose reductions to 20, 18, 14 and 10 mg were in 10 (22.7%), 3 (6.7%), 7 (15.9%) and 7 (15.9%) pts, respectively; 16 (36.4%) pts did not require dose reduction.Conclusions: 61,4 % ORR shows good efficacy of lenvatinib in population of pts with poor performance status (ECOG 1-2).Legal entity responsible for the study: The authors.