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Margaux Foulfoin Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Emmanuelle Graillot Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France
University of Lyon, Université Lyon 1, Lyon, France

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Mustapha Adham University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de chirurgie, Lyon, France

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Pascal Rousset University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de radiologie, Lyon, France

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Julien Forestier Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Valérie Hervieu University of Lyon, Université Lyon 1, Lyon, France
Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Central d’Anatomie et Cytologie Pathologiques, Lyon, France

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Philip Robinson Hospices Civils de Lyon, DRCI, Lyon, France

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Jean-Yves Scoazec Hospices Civils de Lyon, Hôpital Edouard Herriot, Service Central d’Anatomie et Cytologie Pathologiques, Lyon, France

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Catherine Lombard-Bohas Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France

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Thomas Walter Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Gastroentérologie et d’Oncologie Médicale, Lyon, France
University of Lyon, Université Lyon 1, Lyon, France

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was 64 (95% CI: 35–93) months in Group 3, P  < 0.001 ( Fig. 1B ). High liver tumor involvement, high-grade tumor and the TGR were significantly associated with a worse OS in univariate and multivariate analyses ( Fig. 2A, B, C and Table 3 ). A cut

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Matthew Saldana Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

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Kacey VanderVorst Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

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Anastasia L Berg Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

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Hyun Lee Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

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Kermit L Carraway III Department of Biochemistry and Molecular Medicine, UC Davis School of Medicine, UC Davis Comprehensive Cancer Center, Sacramento, California, USA

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axis as a promising therapeutic target. OTUB1 promotes invasion in glioma, colon, gastric and esophageal cancer via EMT Glioblastoma, a high-grade glioma, is the most deadly form of brain cancer, with a 5-year survival rate of 5% ( Goodenberger

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Raquel Santana da Cruz Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Johan Clarke Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Ana Cristina P Curi Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Aseel Al-Yawar Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Lu Jin Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Ali Baird Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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M Idalia Cruz Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Bhaskar Kallakury Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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Sonia de Assis Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA

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accelerated development of high-grade PanIN and invasive PDAC in offspring carrying the Kras G12D/+ mutation. This phenotype was associated with increased rates of acinar-to-ductal reprogramming as well as increased desmoplasia and other alterations in the

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Georgios P Skliris Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine
Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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Zoann J Nugent Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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Brian G Rowan Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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Carla R Penner Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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Peter H Watson Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine
Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine
Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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Leigh C Murphy Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine
Department of Biochemistry and Medical Genetics, Manitoba Institute of Cell Biology, Department of Structural and Cellular Biology, Manitoba Breast Tumour Bank, Tumour Tissue Repository and Deeley Research Centre, Faculty of Medicine

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/421); PR-negative, 38% (160/421); low-grade, 28% (118/420); intermediate-grade, 62% (260/420); high-grade, 10% (42/420); tumour size <2.5 cm, 56% (237/422); tumour size >2.5 cm, 44% (185/422); age <50 years, 7% (31/420); age >50 years, 93% (389/420); node

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R Engers
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S Ziegler
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M Mueller
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A Walter
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R Willers
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H E Gabbert
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potential prognostic relevance of Rac expression in human tumors has not been investigated yet. In the present study, we have analyzed Rac protein expression in benign secretory epithelium, high-grade prostatic intraepithelium neoplasia (HG-PIN), and

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G Rindi Department of Pathology and Laboratory Medicine, University of Parma,Via Gramsci 14, I-43100 Parma, Italy. guido.rindi@unipr.it

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C Bordi Department of Pathology and Laboratory Medicine, University of Parma,Via Gramsci 14, I-43100 Parma, Italy. guido.rindi@unipr.it

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Originating from cells of the diffuse endocrine system the endocrine tumours of the gut and the pancreatic tract are rare entities characterized by a common phenotypic aspect and producing several bioactive substances including growth factors. Two major categories are identified: well-differentiated and poorly differentiated tumours. The clinical behaviour varies ranging from benign to low grade malignant for well-differentiated tumours/carcinomas to high grade malignant for poorly differentiated carcinomas. The two major categories of well-differentiated and poorly differentiated tumours display distinct phenotypes and genetic backgrounds possibly supporting distinct histogenesis. Genetic abnormalities associated with either induction or progression of tumours may vary depending on the site of origin.

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Brandi B Knight Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Gabriela M Oprea-Ilies Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Arumugam Nagalingam Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Lily Yang Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA
Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Cynthia Cohen Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Neeraj K Saxena Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Dipali Sharma Department of Hematology and Medical Oncology, Department of Pathology and Laboratory Medicine, Emory Winship Cancer Institute, Department of Surgery, Department of Medicine, Department of Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA

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Obese breast cancer patients exhibit a higher risk for larger tumor burden and an increased likelyhood of metastasis. The molecular effects of obesity on carcinogenesis are mediated by the autocrine and paracrine effects of the adipocytokine leptin. Leptin participates in the tumor progression and metastasis of human breast. We show that leptin induces clonogenicity and increases the migration potential of breast cancer cells. We found that survivin expression is induced in response to leptin. In this study, we examine the role and leptin-mediated regulation of survivin. Leptin treatment leads to survivin upregulation, due in part to the activation of Notch1 and the release of a transcriptionally active Notch1 intracellular domain (NICD). Chromatin immunoprecipitation analysis shows that NICD gets recruited to the survivin promoter at the CSL (CBF1/RBP-Jk, Su(H), Lag-1) binding site in response to leptin treatment. Inhibition of Notch1 activity inhibits leptin-induced survivin upregulation. Leptin-induced transactivation of epidermal growth factor receptor (EGFR) is involved in leptin-mediated Notch1 and survivin upregulation, demonstrating a novel upstream role of leptin–EGFR–Notch1 axis. We further show that leptin-induced migration of breast cancer cells requires survivin, as overexpression of survivin further increases, whereas silencing survivin abrogates leptin-induced migration. Using a pharmacological approach to inhibit survivin, we show that 3-hydroxy-3-methylglutaryl-coenzyme-A-reductase inhibitors, such as lovastatin, can effectively inhibit leptin-induced survivin expression and migration. Importantly, leptin increased breast tumor growth in nude mice. These data show a novel role for survivin in leptin-induced migration and put forth pharmacological survivin inhibition as a potential novel therapeutic strategy. This conclusion is supported by in vivo data showing the overexpression of leptin and survivin in epithelial cells of high-grade ductal carcinomas in situ and in high-grade invasive carcinomas.

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Derek Raghavan Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Antoinette R Tan Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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E Shannon Story Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Earle F Burgess Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Laura Musselwhite Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Edward S Kim Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Peter E Clark Departments of Solid Tumor Oncology, Endocrinology, and Urologic Oncology, Levine, Cancer Institute, Charlotte, North Carolina, USA

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Substantial management changes in endocrine-related malignancies have been required as a response to the COVID-19 pandemic, including a draconian reduction in the screening of asymptomatic subjects, delay in planned surgery and radiotherapy for primary tumors deemed to be indolent, and dose reductions and/or delays in initiation of some systemic therapies. An added key factor has been a patient-initiated delay in the presentation because of the fear of viral infection. Patterns of clinical consultation have changed, including a greater level of virtual visits, physical spacing, masking, staffing changes to ensure a COVID-free population and significant changes in patterns of family involvement. While this has occurred to improve safety from COVID-19 infection, the implications for cancer outcomes have not yet been defined. Based on prior epidemics and financial recessions, it is likely that delayed presentation and treatment of high-grade malignancy will be associated with worse cancer outcomes. Cancer patients are also at increased risk from COVID-19 infection compared to the general population. Pandemic management strategies for patients with tumors of breast, prostate, thyroid, parathyroid and adrenal gland are reviewed.

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Marijn A Vermeulen Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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Shusma C Doebar Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

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Carolien H M van Deurzen Department of Pathology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands

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John W M Martens BOOG Study Center/Dutch Breast Cancer Research Group, Amsterdam, The Netherlands
Department of Medical Oncology and Cancer Genomics Netherlands, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands

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Paul J van Diest Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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Cathy B Moelans Department of Pathology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

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which low-grade DCIS progresses to low-grade IDC and high-grade DCIS to high-grade IDC. These parallel pathways have been postulated to have distinct genomic aberrations ( Hwang et al . 2004 , Moelans et al . 2010 a , Burger et al . 2013

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Pushpa Patel
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Rowan Hardy
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Vaiyapuri Sumathi School of Clinical and Experimental Medicine, Department of Musculoskeletal Pathology, Oncology Department, Institute of Biomedical Research, The University of Birmingham, Birmingham B15 2TT, UK

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Gillian Bartle School of Clinical and Experimental Medicine, Department of Musculoskeletal Pathology, Oncology Department, Institute of Biomedical Research, The University of Birmingham, Birmingham B15 2TT, UK

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Lars-Gunnar Kindblom School of Clinical and Experimental Medicine, Department of Musculoskeletal Pathology, Oncology Department, Institute of Biomedical Research, The University of Birmingham, Birmingham B15 2TT, UK

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Robert Grimer School of Clinical and Experimental Medicine, Department of Musculoskeletal Pathology, Oncology Department, Institute of Biomedical Research, The University of Birmingham, Birmingham B15 2TT, UK

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Iwona Bujalska
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Paul M Stewart
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Elizabeth Rabbitt
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Neil J L Gittoes
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Mark S Cooper
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). Most OSs are high grade and there are few morphological markers relating to long-term survival. Patients with metastases at presentation have a very poor outlook. For patients without clinically evident metastasis, the most important prognostic factor

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