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These studies suggest four types of cancer: gastric cancer, non-small cell lung cancer, ovarian/fallopian tube/primary peritoneal cancer, and pancreatic cancer.
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Gastric cancer is a leading cause of cancer-related deaths and is known for its heterogeneity. Researchers have identified four molecular subtypes of gastric cancer, each associated with distinct clinical outcomes. The mesenchymal-like subtype, which includes diffuse-subtype tumors, has the worst prognosis and the highest recurrence rate (63%) among the four subtypes. This type tends to occur at an earlier age. Microsatellite-unstable tumors, which are hyper-mutated intestinal-subtype tumors, have the best overall prognosis and the lowest recurrence rate (22%). The TP53-active and TP53-inactive subtypes have intermediate prognosis and recurrence rates, with the TP53-active group showing a better prognosis compared to the TP53-inactive group. These subtypes are characterized by specific molecular alterations, which have been validated in independent cohorts to provide a consistent framework for clinical and preclinical research.
Lung cancer is the most prevalent malignant neoplasm in the United States, with a high mortality rate. The World Health Organization (WHO) classifies lung cancer into four major types: squamous cell carcinoma, adenocarcinoma, large cell carcinoma, and small cell carcinoma. These are broadly divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC is the focus of extensive research due to its high prevalence. Treatment strategies for NSCLC emphasize the importance of smoking cessation, early diagnosis through screening, and the pivotal role of surgery for local disease management. Newer radiation therapy techniques and chemotherapy, including combination chemotherapy and surgical adjuvant treatments, are also critical components of NSCLC management. Personalized treatment approaches are recommended based on individual patient factors such as age, health status, and personal values.
Ovarian cancer is not a single disease but a group of diseases with different morphologies and biological behaviors. Approximately 90% of ovarian cancers are carcinomas, with five main histological types: high-grade serous carcinoma (HGSC), endometrioid carcinoma (EC), clear-cell carcinoma (CCC), mucinous carcinoma (MC), and low-grade serous carcinoma (LGSC). These types differ in epidemiologic and genetic risk factors, precursor lesions, patterns of spread, molecular events during oncogenesis, response to chemotherapy, and prognosis. The International Federation of Gynecology and Obstetrics (FIGO) has updated the staging system for ovarian, fallopian tube, and peritoneal cancer to reflect these differences. Accurate histopathologic diagnosis is essential for successful treatment, as different tumor histotypes respond differently to chemotherapy.
Pancreatic cancer (PC) is the 10th most common cancer type and the fourth leading cause of cancer-related deaths. The majority of pancreatic cancers are pancreatic adenocarcinomas. Early detection of small tumors or premalignant lesions that can be surgically resected offers the best chance for survival, potentially increasing 5-year survival rates from approximately 5% to 20-30% or higher at specialized treatment centers. However, early stages of pancreatic cancer are usually asymptomatic, and the disease's aggressive nature, combined with limited early detection capabilities, results in a low percentage of patients being diagnosed with resectable disease. Many early diagnoses are incidental findings during abdominal imaging procedures.
Understanding the distinct characteristics and treatment approaches for different types of cancer is crucial for improving patient outcomes. Gastric cancer's molecular subtypes, NSCLC's classification and treatment strategies, ovarian cancer's histological types and staging, and the challenges in early detection and treatment of pancreatic cancer highlight the complexity and diversity of cancer as a disease. Continued research and personalized treatment approaches are essential for advancing cancer care and improving survival rates.
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