Testicular Metastasis as an Initial Manifestation of Gastrointestinal Cancer

Metastatic small bowel tumors in the testes are uncommon often indicating an advanced stage of sickness with poor prognosis. The route of spread to the scrotal level has not yet been defined. The most of these tumors are diagnosed at autopsy or orchiectomy for metastatic carcinoma. The diagnosis is mainly based on histological and immunohistochemical data. In this paper, we report the case of a 36-year-old patient with a spermatic torsion secondary to a testis metastasis from an adenocarcinoma of the small intestine confirmed histologically, occurring as first clinical manifestation that was taken care in the medical oncology department of CHU Hassan II in Fès. The aim of the subject is to highlight this rare metastatic localization of gastrointestinal cancer;how to approach the diagnosis and distinguish between primary testicular cancer and testicular metastasis;by describing the different clinical, radiological and anatomopathological aspects of metastatic gastrointestinal cancer to the testis.

Prognostic Factors Influencing the Survival of Patients with Metastatic Non-Small Cell Lung Cancer in the Moroccan Population: Retrospective Study of 405 Cases

Introduction: Non-small cell lung cancer is the most common lung cancer. Despite the therapeutic advances, its prognosis is very reserved. Aim: Determine the different prognostic factors of patients with metastatic non-small cell lung cancer and their correlation with patient survival. Methods: A retrospective study was conducted at the medical oncology department of Hassan II University Hospital in Fez, collecting 405 patients during a period of 10 years, from January 2008 to January 2018. The statistical analysis of the results was done by the software SPSS version 23, the survival was calculated by the Kaplan-Meier method. The Cox method was used to study prognostic factors. Results: The average age of our patients was 59 years, with a sex ratio M/F of 6.1. In multivariate analysis, we found a significant correlation between the deterioration of survival and an age greater than 75 years (p = 0.023), a general degraded state (p < 0.001), presence of a biological inflammatory syndrome (p < 0.001), anemia (p < 0.001) and hypoalbuminemia (p < 0.001). In addition, no significant association was found in patients with toxic habits or multiple metastatic sites. Conclusion: The prognostic factors of metastatic NSCLC in our patients were PS, age, anemia, hypoalbuminemia and inflammatory syndrome. We propose to validate all the factors identified by retrospective studies by prospective studies in order to guarantee the best chances of survival for patients.

Non-Clear Cell Renal Carcinomas: About 23 Cases Experience of the Medical Oncology Department of the Hassan II Hospital in Fez, Morocco

Background: Non-clear cell renal cell carcinomas represent a very rare and heterogeneous variety of kidney cancer. The aim of this study is to describe the main epidemiological, clinical, paraclinical, histological and therapeutic characteristics of these cancers. Methods: A descriptive retrospective study was conducted in the Medical Oncology Department of the Hassan II Hospital in Fez, collecting 23 patients with these tumors during the period from January 2008 to January 2020. The statistical analysis is made by the SPSS software version 23. Survival was calculated by the Kaplan-Meier method. Results: The average age of the patients was 57.4 years. The sex ratio M/F was 1.3. The main risk factor was smoking (n = 10). The most common symptom was low back pain (n = 23). 17 patients were metastatic, while 6 patients had localized disease. The most common histological type was papillary carcinoma (n = 12). Patients with localized disease have undergone an extended total nephrectomy. After a median follow-up of 145 months, the median of recurrence-free survival was 48 months and that of overall survival was 150 months. In a metastatic situation, 16 patients had received systemic treatment, of which 13 patients had received sunitinib, 2 patients pazaopanib and only one patient received everolimus. After a median follow-up of 20 months, the median of progression-free survival was 5 months and that of overall survival was 9 months. Conclusion: At the present time, there is no therapeutic standard for the management of patients with these tumors. Surgery for people with localized or locally advanced disease remains the initial and most important approach. For patients with advanced disease, a clinical trial should be considered.

Tyrosine Kinase Inhibitors against Cancer: Their Safety in 216 Moroccan Patients

Tyrosine kinase inhibitors (TKIs) have become a prominent option in the therapeutic arsenal of several cancers. The safety of these drugs has shown various toxicities with varying frequency and severity between different agents. The aim of this study is to describe the safety profile of different classes of TKI used in various solid tumors. It is a retrospectively descriptive study conducted in the Department of Medical Oncology at Hassan II University Hospital of Fez, Morocco, over a period of 6 years from April 2013 until April 2019. It included 216 patients who received one or more TKI for different indications in solid tumors. The average age in our series was 61.4 years with a sex ratio F/M of 1.07. Among the most used TKIs in our department according to their availability: Imatinib (32%) and sunitinib (32%). All patients received one or more tyrosine kinase inhibitors according to the indication. Kidney cancer was the most common malignancy (36%), followed by gastrointestinal stromal tumors (33%). The median duration of treatment was 15 months with extremes of 1 month and 102 months. The main side effects were: Cutaneous in 43% of patients. Digestive toxicity occurred in 36% of cases. Hematotoxicity was reported in 33% of cases. The safety profile of TKIs used in our study was comparable to their global tolerance reported in literature. More studies are needed to investigate the relationship between their toxicity and their efficacy in Moroccan population.