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High expression of Rsf-1 correlates with poor prognosis in breast cancer
ABSTRACTS with sarcomatoid differentiation had metastatic disease. 18 (30%) of 62 patients with clear cell RCC and only 1 (6%) of 17 patients with chromophobe RCC had metastatic disease. Most of the patients with metastatic disease were poor risk (n ¼ 23, 72%) at presentation followed by intermediate risk (n ¼ 8, 25%) and favourable risk (n ¼ 1) on MSKCC (memorial sloan-kettering cancer center) prognostic score. Conclusion: As compared to the figures mentioned in the medical literature, median age of the patients with RCC at our center is 10 years less and Chromophobe rather than papillary subtype of RCC is the second most common type. Clear cell RCC remains the most common type. Chromophobe RCC tends to have a better prognosis and fewer tendencies for metastatic disease. http://dx.doi.org/10.1016/j.ejso.2016.07.126
447. High expression of Rsf-1 correlates with poor prognosis in breast cancer Shaima’a Hamarsheh1, Chitra Joseph1, Madeleine Craze1, Elena Provenzano2, Christopher Nolan1, Carlos Caldas3, Andrew R. Green1, Emad Rakha4, Ian O. Ellis4, Abhik Mukherjee4 1 University of Nottingham, UK 2 Addenbrooke’s Hospital, Cambridge University Hospital NHS Foundation Trust, UK 3 CRUK Cambridge Research Institute, UK 4 Department of Histopathology, Nottingham University Hospitals NHS Trust Nottingham, UK
S251 prognosis of critically ill cancer pts varies within population studied but is determined by the nature and number of organ failure. We sought to determine the outcome of ST pts admitted to ICU in a large cancer centre and investigate factors associated with outcome Method: Medical records and ICU charts of ST pts admitted to ICU over a 2-year period, with at least six months follow-up were reviewed. Information on cancer treatment, reason for admission, co-morbidities and outcome was collected. Elective ICU admissions post-surgery were excluded Results: 98 pts, median age 56 years (range 16e88) were identified. Common tumour types included sarcoma (19%), lung (18%), head and neck (15%) and breast (12%). Most patients had AJCC stage 3 (18%) or 4 (62%) disease. At the time of ICU admission 74% of pts were undergoing active treatment (9% radical, 18% adjuvant and 46% palliative), 11% treatment na€ıve and 15% on surveillance or receiving palliative care. Respiratory failure (20%), seizure/low GCS (19%), sepsis (18%) and renal failure (14%) were the most common reasons for ICU admission. The majority of pts had one (54%) or two organ failures (33%). Median duration of ICU admission was 3 days (range 0 to 64 days, average 5.6 days) and total hospital admission 17 days (range 0 to 374 days). 29% of pts died on ICU. Overall, 52% of pts survived to hospital discharge. Median survival from ICU admission was 32 days (range 0 to 631 days) with 47%, 37% and 29% of pts alive at 30 days, 60 days and 6 months respectively. Conclusion: The outcome of patients with ST requiring ICU admission is poor. Work is on-going to identify factors associated with adverse outcome. http://dx.doi.org/10.1016/j.ejso.2016.07.128
Background: Remodelling and Spacing Factor (Rsf-1), also known as HBXAP, is a nuclear protein member of the chromatin-remodelling complex and functions as a histone chaperone. Genomic/transcriptomic profiling on the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort showed RSF1 to be one of the putative drivers within IntClust2, a subgroup comprised of ER-positive Luminal A/B breast cancers (BCs) of poor prognosis [METABRIC: Curtis et al, Nature. 2012]. This study aimed to investigate the role of Rsf-1 in BC at the protein level. Method: BC tissue microarrays (n ¼ 998) were immuno-stained for Rsf-1 and expression patterns correlated with clinicopathological and molecular variables as well as patient outcome. Results were validated in other BC cohorts [Breast Cancer Gene miner]. Results: Nuclear Rsf-1 expression was positively associated with grade, lymph node status but negatively associated with ER/PR status, Ki67 & NPI (p < 0.05). Positive associations were also observed with the DNA damage response marker gH2AX and histone modifier H4R3Me2 (p < 0.005). Rsf-1 expression was associated with poor breast cancer specific survival (p < 0.05) at 5, 10 and 20 years in the whole cohort and ER+ sub cohort. Molecular subtype specific prognostic analysis for Rsf-1 via the BC gene miner (n ¼ 1248) indicates that low expression correlates with better survival in Luminal A & B patients (p < 0.005). Conclusion: Results indicate that nuclear Rsf-1expression significantly correlates with high tumour grade and poor prognosis in BC. The aggressiveness is probably explained by its relationship to DNA damage and genomic instability. *Project supported by NIHR, Academy of Medical Sciences and CDF from the PathSOC http://dx.doi.org/10.1016/j.ejso.2016.07.127
455. Outcome of patients with solid tumours admitted to intensive care Sarah Stewart, Miriam Hopwood, Rowan Miller, Pericao Ana, Kai-Keen Shiu, David Walker, Laura Sellers University College Hospital, UK Background: Indications for ICU admission in pts with ST may be cancer-related, treatment-related or due to co-morbid illness. The
457. Challenges encountered in end of life care research with young adults with cancer Nothando Ngwenya1, Charlotte Kenten1, Susie Pearce1, Caroline Stirling2, Faith Gibson3, Geoff Wong4, Louise Jones5, Jeremy Whelan1 1 University College Hospital, UK 2 Central and North West London NHS Trust, Islington ELiPSe and UCLH & HCA Palliative Care Service, UK 3 Great Ormond Street Hospital for Children NHS Foundation Trust and London South Bank University, UK 4 Nuffield Department of Primary Care Health Sciences, University of Oxford, UK 5 Marie Curie Palliative Care Research Department, UCL, UK Background: Recent years have seen a valuable increase in end of life (EoL) research. However, there still remains limited evidence describing the end of life care needs of young adults aged 16e40 with cancer. Despite the awareness by a professional that a young person may be facing the possibility of death from a life-threatening illness, there are often delays in talking about prognosis and dying. This hesitancy may extend to the research domain affecting recruitment of young adults to EoL research. Method: A national multi-centre qualitative study was conducted in three cancer care networks across England. Sixty nine in-depth interviews with patients, families and professionals and six workshops with bereaved family members and professionals were conducted, and findings considered by an expert panel. Interview data were initially analysed thematically and then re-analysed using realist logic of analysis. Results: We found that care and support for young adults with cancer and their families does not fully meet expressed needs and expectations. Recommendations for practice have been defined. None of the participants experienced distress, but instead valued the opportunity to contribute. However, the voice of important informants was absent, namely patients with haematological cancers and younger patients aged 16-24 who proved challenging to recruit in large part due to gatekeeping by healthcare professionals. Social perceptions and personal attitudes to talking about dying with young people made it difficult for them to approach these patient groups for the study.
447. High expression of Rsf-1 correlates with poor prognosis in breast cancer Shaima’a Hamarsheh1, Chitra Joseph1, Madeleine Craze1, Elena Provenzano2, Christopher Nolan1, Carlos Caldas3, Andrew R. Green1, Emad Rakha4, Ian O. Ellis4, Abhik Mukherjee4 1 University of Nottingham, UK 2 Addenbrooke’s Hospital, Cambridge University Hospital NHS Foundation Trust, UK 3 CRUK Cambridge Research Institute, UK 4 Department of Histopathology, Nottingham University Hospitals NHS Trust Nottingham, UK
S251 prognosis of critically ill cancer pts varies within population studied but is determined by the nature and number of organ failure. We sought to determine the outcome of ST pts admitted to ICU in a large cancer centre and investigate factors associated with outcome Method: Medical records and ICU charts of ST pts admitted to ICU over a 2-year period, with at least six months follow-up were reviewed. Information on cancer treatment, reason for admission, co-morbidities and outcome was collected. Elective ICU admissions post-surgery were excluded Results: 98 pts, median age 56 years (range 16e88) were identified. Common tumour types included sarcoma (19%), lung (18%), head and neck (15%) and breast (12%). Most patients had AJCC stage 3 (18%) or 4 (62%) disease. At the time of ICU admission 74% of pts were undergoing active treatment (9% radical, 18% adjuvant and 46% palliative), 11% treatment na€ıve and 15% on surveillance or receiving palliative care. Respiratory failure (20%), seizure/low GCS (19%), sepsis (18%) and renal failure (14%) were the most common reasons for ICU admission. The majority of pts had one (54%) or two organ failures (33%). Median duration of ICU admission was 3 days (range 0 to 64 days, average 5.6 days) and total hospital admission 17 days (range 0 to 374 days). 29% of pts died on ICU. Overall, 52% of pts survived to hospital discharge. Median survival from ICU admission was 32 days (range 0 to 631 days) with 47%, 37% and 29% of pts alive at 30 days, 60 days and 6 months respectively. Conclusion: The outcome of patients with ST requiring ICU admission is poor. Work is on-going to identify factors associated with adverse outcome. http://dx.doi.org/10.1016/j.ejso.2016.07.128
Background: Remodelling and Spacing Factor (Rsf-1), also known as HBXAP, is a nuclear protein member of the chromatin-remodelling complex and functions as a histone chaperone. Genomic/transcriptomic profiling on the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) cohort showed RSF1 to be one of the putative drivers within IntClust2, a subgroup comprised of ER-positive Luminal A/B breast cancers (BCs) of poor prognosis [METABRIC: Curtis et al, Nature. 2012]. This study aimed to investigate the role of Rsf-1 in BC at the protein level. Method: BC tissue microarrays (n ¼ 998) were immuno-stained for Rsf-1 and expression patterns correlated with clinicopathological and molecular variables as well as patient outcome. Results were validated in other BC cohorts [Breast Cancer Gene miner]. Results: Nuclear Rsf-1 expression was positively associated with grade, lymph node status but negatively associated with ER/PR status, Ki67 & NPI (p < 0.05). Positive associations were also observed with the DNA damage response marker gH2AX and histone modifier H4R3Me2 (p < 0.005). Rsf-1 expression was associated with poor breast cancer specific survival (p < 0.05) at 5, 10 and 20 years in the whole cohort and ER+ sub cohort. Molecular subtype specific prognostic analysis for Rsf-1 via the BC gene miner (n ¼ 1248) indicates that low expression correlates with better survival in Luminal A & B patients (p < 0.005). Conclusion: Results indicate that nuclear Rsf-1expression significantly correlates with high tumour grade and poor prognosis in BC. The aggressiveness is probably explained by its relationship to DNA damage and genomic instability. *Project supported by NIHR, Academy of Medical Sciences and CDF from the PathSOC http://dx.doi.org/10.1016/j.ejso.2016.07.127
455. Outcome of patients with solid tumours admitted to intensive care Sarah Stewart, Miriam Hopwood, Rowan Miller, Pericao Ana, Kai-Keen Shiu, David Walker, Laura Sellers University College Hospital, UK Background: Indications for ICU admission in pts with ST may be cancer-related, treatment-related or due to co-morbid illness. The
457. Challenges encountered in end of life care research with young adults with cancer Nothando Ngwenya1, Charlotte Kenten1, Susie Pearce1, Caroline Stirling2, Faith Gibson3, Geoff Wong4, Louise Jones5, Jeremy Whelan1 1 University College Hospital, UK 2 Central and North West London NHS Trust, Islington ELiPSe and UCLH & HCA Palliative Care Service, UK 3 Great Ormond Street Hospital for Children NHS Foundation Trust and London South Bank University, UK 4 Nuffield Department of Primary Care Health Sciences, University of Oxford, UK 5 Marie Curie Palliative Care Research Department, UCL, UK Background: Recent years have seen a valuable increase in end of life (EoL) research. However, there still remains limited evidence describing the end of life care needs of young adults aged 16e40 with cancer. Despite the awareness by a professional that a young person may be facing the possibility of death from a life-threatening illness, there are often delays in talking about prognosis and dying. This hesitancy may extend to the research domain affecting recruitment of young adults to EoL research. Method: A national multi-centre qualitative study was conducted in three cancer care networks across England. Sixty nine in-depth interviews with patients, families and professionals and six workshops with bereaved family members and professionals were conducted, and findings considered by an expert panel. Interview data were initially analysed thematically and then re-analysed using realist logic of analysis. Results: We found that care and support for young adults with cancer and their families does not fully meet expressed needs and expectations. Recommendations for practice have been defined. None of the participants experienced distress, but instead valued the opportunity to contribute. However, the voice of important informants was absent, namely patients with haematological cancers and younger patients aged 16-24 who proved challenging to recruit in large part due to gatekeeping by healthcare professionals. Social perceptions and personal attitudes to talking about dying with young people made it difficult for them to approach these patient groups for the study.