In contrast, one of the two cases with metachronous peritoneal metastases developed an additional KRAS mutation compared to the paired primary, shifted from moderately to poorly differentiated morphology, and exhibited mismatch-repair deficiency by immunohistochemistry, while remaining microsatellite stable by NGS. These findings suggest interlesional molecular heterogeneity in SBA and emphasize the need for re-biopsies in precision oncology for metachronous metastases.
Our work presents the largest UK cohort of DA with long-term follow-up making it an excellent resource for future biomarker studies. Validation studies in prospective clinical studies are required for clinical application.
Taxane-based therapy demonstrated activity in metastatic SBA, with 24% response and 3.1-month mTTP. TP53 mutation may be a negative predictive marker for taxane efficacy. These findings support prospective investigation in metastatic SBA.
13 days ago
Retrospective data • Journal
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KRAS (KRAS proto-oncogene GTPase) • TP53 (Tumor protein P53) • SMAD4 (SMAD family member 4)
These findings suggest that nonampullary duodenal neoplasms of gastric phenotype can be reclassified as "gastric-type adenomas" based on excellent prognosis and common genetic alterations, albeit a wide spectrum of morphology and gastric phenotypic expression. MDM2 amplification may contribute to histologic progression.
The postoperative course was uneventful and the patient remained disease-free at 8-month follow-up after completing R-CHOP chemotherapy...Although rare, DLBCL should be considered as a differential diagnosis in unexplained SBO. Early recognition and a multidisciplinary management strategy improve prognosis.