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Rawla P, Sunkara T, Gaduputi V. Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol 2019; 10:10-27. [PMID: 30834048 PMCID: PMC6396775 DOI: 10.14740/wjon1166] [Citation(s) in RCA: 1273] [Impact Index Per Article: 254.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/14/2018] [Indexed: 12/24/2022] Open
Abstract
Pancreatic cancer is the seventh leading cause of cancer-related deaths worldwide. However, its toll is higher in more developed countries. Reasons for vast differences in mortality rates of pancreatic cancer are not completely clear yet, but it may be due to lack of appropriate diagnosis, treatment and cataloging of cancer cases. Because patients seldom exhibit symptoms until an advanced stage of the disease, pancreatic cancer remains one of the most lethal malignant neoplasms that caused 432,242 new deaths in 2018 (GLOBOCAN 2018 estimates). Globally, 458,918 new cases of pancreatic cancer have been reported in 2018, and 355,317 new cases are estimated to occur until 2040. Despite advancements in the detection and management of pancreatic cancer, the 5-year survival rate still stands at 9% only. To date, the causes of pancreatic carcinoma are still insufficiently known, although certain risk factors have been identified, such as tobacco smoking, diabetes mellitus, obesity, dietary factors, alcohol abuse, age, ethnicity, family history and genetic factors, Helicobacter pylori infection, non-O blood group and chronic pancreatitis. In general population, screening of large groups is not considered useful to detect the disease at its early stage, although newer techniques and the screening of tightly targeted groups (especially of those with family history), are being evaluated. Primary prevention is considered of utmost importance. Up-to-date statistics on pancreatic cancer occurrence and outcome along with a better understanding of the etiology and identifying the causative risk factors are essential for the primary prevention of this disease.
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Affiliation(s)
- Prashanth Rawla
- Department of Internal Medicine, SOVAH Health, Martinsville, VA 24112, USA
| | - Tagore Sunkara
- Department of Gastroenterology and Hepatology, Mercy Medical Center, Des Moines, IA 50314, USA
| | - Vinaya Gaduputi
- Division of Gastroenterology, SBH Health System, Bronx, NY, USA
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Clinical and radiological response of BRAF inhibition and MEK inhibition in patients with brain metastases from BRAF-mutated melanoma. Melanoma Res 2019; 28:126-133. [PMID: 29356790 DOI: 10.1097/cmr.0000000000000429] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patients with brain metastases (BM) from melanoma have an overall survival (OS) of 2-6 months after whole-brain radiotherapy. Targeted therapy (TT) is an effective treatment for BRAF-mutated metastatic melanoma. Moreover, recent studies indicate intracranial responses of TT in patients with BM. We analyzed 146 patients with BM from BRAF-mutated melanoma treated with vemurafenib, dabrafenib, or dabrafenib+trametinib between 2010 and 2016. We determined clinical and radiological response, progression-free survival (PFS), and OS. Median OS of patients treated with dabrafenib+trametinib was 11.2 months [n=30; 95% confidence interval (CI): 6.8-15.7], 8.8 months for dabrafenib alone (n=31; 95% CI: 3.9-13.7), and 5.7 months for vemurafenib (n=85; 95% CI: 4.6-6.8). A significantly longer OS was observed in the dabrafenib+trametinib group than in the vemurafenib group (hazard ratio for death, 0.52; 95% CI: 0.30-0.89; P=0.02). Median intracranial PFS of all patients was 4.1 months. Median intracranial PFS for patients treated with dabrafenib+trametinib was 5.8 months (95% CI: 3.2-8.5), 5.7 months (95% CI: 3.0-8.4) for dabrafenib, and 3.6 months (95% CI: 3.5-3.8) for vemurafenib (P=0.54). A total of 63 (43%) patients had symptomatic BM. Intracranial disease control rate at 8 weeks in these patients was 65 versus 70% extracranially. Neurological symptoms improved in 46% of patients with symptomatic BM, whereas in 21%, they remained stable. Median OS in patients with BM from BRAF-mutated melanoma treated with dabrafenib+trametinib was significantly longer than for vemurafenib. Improvement of neurological symptoms was seen in almost half of the patients with symptomatic BM treated with TT.
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Al-Husseini MJ, Kunbaz A, Saad AM, Santos JV, Salahia S, Iqbal M, Alahdab F. Trends in the incidence and mortality of transitional cell carcinoma of the bladder for the last four decades in the USA: a SEER-based analysis. BMC Cancer 2019; 19:46. [PMID: 30630456 PMCID: PMC6327491 DOI: 10.1186/s12885-019-5267-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/02/2019] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Transitional cell carcinoma (TCC) accounts for around 95% of bladder cancers and is the 4th most common cancer among men and the tenth most common in women, in the US. There is a constant need to clarify current TCC incidence and mortality rates among different population groups for better clinical practice guidelines. We aimed to describe the TCC incidence and incidence-based mortality by demographic and tumor-related characteristics over the last 40 years in the US. METHODS We obtained data from the SEER 18 registries to study TCC cases that were diagnosed between the years 1973 and 2014. We calculated incidence rates and incidence-based mortality rates in different demographic and tumor-related characteristics and expressed rates by 100,000 person-years. We then calculated the annual changes in incidence and incidence-based mortality rates and displayed them as annual percent changes (APCs). RESULTS There were 182,114 patients with TCC between 1973 and 2014 in the United States. Overall incidence rates of TCC increased 0.16% (95% CI, 0.02-0.30, p = .02) per year over the study period. However, the incidence declined significantly since 2007; (95%CI,-1.89- -0.77, p < .001), except among the elderly and African Americans, which increased significantly over the study period. Overall TCC mortality rates did not change over the study period. However, since 2000 it started to decrease significantly. CONCLUSION TCC incidence and incidence-based mortality rates had been showing significant increases over the previous decades. However, significant declines in both incidence and incidence-based mortality rates have been observed over the recent years, except in some patients with certain racial groups. Improved understanding of the etiological and ecological factors of TCC could lead to further declines in incidence and incidence-based mortality rates.
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Affiliation(s)
| | - Ahmad Kunbaz
- Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Anas M. Saad
- Clinical Oncology Department, Faculty of Medicine, Damascus University, Damascus, Syria
| | - João Vasco Santos
- MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS – Centre for Health Technology and Services Research, Porto, Portugal
- Public Health Unit, AceS Grande Porto VIII – Espinho/Gaia, Porto, Portugal
| | - Sami Salahia
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Fares Alahdab
- Mayo Evidence-based Practice Center, Mayo Clinic, Rochester, MN USA
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Altobelli E, Rapacchietta L, Marziliano C, Campagna G, Profeta VF, Fagnano R. Differences in colorectal cancer surveillance epidemiology and screening in the WHO European Region. Oncol Lett 2018; 17:2531-2542. [PMID: 30675315 DOI: 10.3892/ol.2018.9851] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/15/2018] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was to describe the Colorectal Cancer (CRC) burden and prevention actions in 53 countries of the World Health Organization (WHO) European Region (ER). Multiple correspondence analysis was applied to examine the association among the following variables: Measures of occurrence; type of screening programme; existence of cancer registries; data quality and; and gross national income (GNI) level. The study demonstrated clear differences according to GNI: low-middle income (LMI) countries show low mortality rates and unorganized screening programme; upper-middle income (UMI) countries show no test offered, incomplete or absent data mortality, and low quality of the method used to estimate incidence and mortality rates; high income (HI) countries show high mortality rates, test offered (FOBT and colonoscopy), the existence of a national registry, screening population-based, insurance of payment policy, and high quality of the method used to estimate incidence and mortality rates. HI countries reflect a strong interest in epidemiological monitoring and produce accurate indicators of disease occurrence. On the other hand, surveillance strategies need to be improved in UMI and LMI countries: As national vital statistics are unavailable, partial or inaccurate, the coverage and completeness of the mortality data are frequently poor, there is a less efficient general organization. In conclusion, it is important to underline that the resources available (as measured by GNI) appear to be major factors in the Colorectal Cancer Surveillance Epidemiology and Screening in the WHO European Region.
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Affiliation(s)
- Emma Altobelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila I-67100, Italy.,Epidemiology and Biostatistics Unit, Teramo I-64100, Italy
| | | | - Ciro Marziliano
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila I-67100, Italy.,Epidemiology and Biostatistics Unit, Teramo I-64100, Italy
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Wang Y, Xie D, Wang Z, Zhang X, Zhang Q, Wang Y, Newton AD, Singhal S, Cai H, Wang Y, Lu Q, Hu Q, Wang Z. Kinetics of indocyanine green: Optimizing tumor to normal tissue fluorescence in image-guided oral cancer surgery applications. Head Neck 2018; 41:1032-1038. [PMID: 30549410 DOI: 10.1002/hed.25541] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 08/08/2018] [Accepted: 10/05/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The study aimed to define indocyanine green (ICG) kinetics to determine the optimal ICG dose and surgical time for near-infrared fluorescence-guided oral cancer surgery. METHODS Spectrometer and grayscale digital imaging were used to quantify the ICG kinetics in 12 patients with oral cancer. The fluorescence intensity and signal-to-background ratio (SBR) of tumor and normal tissue were tested at 1, 6, and 24 hours after ICG injection. RESULTS The greatest contrast in the fluorescence intensity between tumor and normal tissue was observed at 6 hours (P < .01), and of three dose groups (0.5, 0.75, and 1.0 mg/kg), 0.75 mg/kg showed the highest SBR (2.06 ± 0.23) after ICG injection. CONCLUSIONS Fluorescence quantification based on spectrometry and grayscale imaging could be effective in determining the optimal ICG dose and surgical time after ICG injection in this cohort of patients with oral cancer.
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Affiliation(s)
- Yuxin Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Diya Xie
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Ziyang Wang
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Xudong Zhang
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Qian Zhang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yang Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Andrew D Newton
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Sunil Singhal
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Huiming Cai
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Yiqing Wang
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Qian Lu
- Department of Biomedical Engineering, College of Engineering and Applied Sciences, Nanjing University, Nanjing, China
| | - Qingang Hu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zhiyong Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Abstract
The aim of this study was to interpret long-term trends in cancer mortality. We analyzed age, period of death, and cohort of birth effects for 18 major cancer sites and all neoplasms combined in the European Union and 16 European countries over the period 1970-2009 using data from the WHO mortality database. We used a log-linear Poisson model with a likelihood penalizing function to solve the identifiability problem. The present comprehensive analysis confirms the appreciable declines of cancer mortality since the late 1980s in most European countries. For several major sites, the declines were appreciably greater for cohort effects than for period ones. This reflects - besides the inherent characteristics of the model used - a major impact of tobacco smoking on total cancer mortality, particularly in men, as the role of tobacco in mortality of subsequent generations is largely - although not totally - a cohort effect. For neoplasms largely affected by improvements in management and therapy (e.g. testis, Hodgkin lymphoma, leukemia, but also breast and colorectal cancer), a favorable period effect is evident. However, there is also a cohort effect as the advancements have been generally greater in younger generations. For several cancer sites, there were considerable differences in cohort and period effects across Europe, and particularly high age-specific estimates were observed in eastern countries.
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Ge L, Arul K, Mesfin A. Spinal Cord Injury From Spinal Tumors: Prevalence, Management, and Outcomes. World Neurosurg 2018; 122:e1551-e1556. [PMID: 30471447 DOI: 10.1016/j.wneu.2018.11.099] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 11/09/2018] [Accepted: 11/12/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND With the aging population in the United States, it can be anticipated that the prevalence of spinal cord injuries (SCIs) and cancer will increase. Primary or metastatic spine tumors sit at a unique intersection of these 2 realms. Our objective was to evaluate the prevalence, outcomes, and complications after the management of SCI arising from spinal tumors. METHODS In the present retrospective evaluation, all patients with SCI and a diagnosis of primary or metastatic spinal cancer who had been admitted to the inpatient rehabilitation unit at a level 1 trauma center from January 2003 to January 2014 were evaluated. The demographic data (age, sex, race/ethnicity), tumor characteristics, American Spinal Injury Association score, and complications were evaluated. RESULTS A total of 757 SCI entries were identified, and 685 unique patients met our inclusion criteria. Of those, 81 had SCIs due to spinal tumors (11.8% of all SCIs and 19.2% of nontraumatic SCIs). Most tumors were located in the thoracic region (65.4%) and were primary central nervous system in origin (21.0%), including meningioma (7.4%), schwannoma (3.7%), and ependymoma (2.5%). The next most common origins of the spinal tumors were metastases from the lung (17.3%), prostate (9.9%), kidney (8.6%), lymphoma (7.4%), and multiple myeloma (7.4%). Of these patients, 76.5% underwent surgical management, with a complications rate of 61.3%. The overall mortality rate at the latest follow-up examination was 63.0%. CONCLUSIONS SCI associated with spinal tumor is often managed surgically and associated with high rates of complications. The present study has demonstrated longer survival rates compared with the existing data.
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Affiliation(s)
- Laurence Ge
- Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Karan Arul
- Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Addisu Mesfin
- Department of Orthopaedic Surgery, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.
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To accelerate cancer prevention in Europe: Challenges for cancer registries. Eur J Cancer 2018; 104:151-159. [DOI: 10.1016/j.ejca.2018.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/29/2018] [Accepted: 09/04/2018] [Indexed: 01/05/2023]
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Ferlay J, Colombet M, Soerjomataram I, Dyba T, Randi G, Bettio M, Gavin A, Visser O, Bray F. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries and 25 major cancers in 2018. Eur J Cancer 2018; 103:356-387. [PMID: 30100160 DOI: 10.1016/j.ejca.2018.07.005] [Citation(s) in RCA: 1508] [Impact Index Per Article: 251.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 06/29/2018] [Accepted: 07/03/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Europe contains 9% of the world population but has a 25% share of the global cancer burden. Up-to-date cancer statistics in Europe are key to cancer planning. Cancer incidence and mortality estimates for 25 major cancers are presented for the 40 countries in the four United Nations-defined areas of Europe and for Europe and the European Union (EU-28) for 2018. METHODS Estimates of national incidence and mortality rates for 2018 were based on statistical models applied to the most recently published data, with predictions obtained from recent trends, where possible. The estimated rates in 2018 were applied to the 2018 population estimates to obtain the estimated numbers of new cancer cases and deaths in Europe in 2018. RESULTS There were an estimated 3.91 million new cases of cancer (excluding non-melanoma skin cancer) and 1.93 million deaths from cancer in Europe in 2018. The most common cancer sites were cancers of the female breast (523,000 cases), followed by colorectal (500,000), lung (470,000) and prostate cancer (450,000). These four cancers represent half of the overall burden of cancer in Europe. The most common causes of death from cancer were cancers of the lung (388,000 deaths), colorectal (243,000), breast (138,000) and pancreatic cancer (128,000). In the EU-28, the estimated number of new cases of cancer was approximately 1.6 million in males and 1.4 million in females, with 790,000 men and 620,000 women dying from the disease in the same year. CONCLUSION The present estimates of the cancer burden in Europe alongside a description of the profiles of common cancers at the national and regional level provide a basis for establishing priorities for cancer control actions across Europe. The estimates presented here are based on the recorded data from 145 population-based cancer registries in Europe. Their long established role in planning and evaluating national cancer plans on the continent should not be undervalued.
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Affiliation(s)
- J Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France.
| | - M Colombet
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - I Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - T Dyba
- European Commission, Joint Research Centre, Institute for Health and Consumer Protection, Ispra, Italy
| | - G Randi
- European Commission, Joint Research Centre, Institute for Health and Consumer Protection, Ispra, Italy
| | - M Bettio
- European Commission, Joint Research Centre, Institute for Health and Consumer Protection, Ispra, Italy
| | - A Gavin
- Northern Ireland Cancer Registry, Belfast, Northern Ireland, UK
| | - O Visser
- Netherlands Comprehensive Cancer Organisation, Utrecht, Netherlands
| | - F Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Groen JV, Sibinga Mulder BG, van Eycken E, Valerianova Z, Borras JM, van der Geest LGM, Capretti G, Schlesinger-Raab A, Primic-Zakelj M, Ryzhov A, van de Velde CJH, Bonsing BA, Bastiaannet E, Mieog JSD. Differences in Treatment and Outcome of Pancreatic Adenocarcinoma Stage I and II in the EURECCA Pancreas Consortium. Ann Surg Oncol 2018; 25:3492-3501. [PMID: 30151560 DOI: 10.1245/s10434-018-6705-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The EUropean REgistration of Cancer CAre (EURECCA) consortium aims to investigate differences in treatment and to improve cancer care through Europe. The purpose of this study was to compare neo- and adjuvant chemotherapy (ACT) and outcome after tumor resection for pancreatic adenocarcinoma stage I and II in the EURECCA Pancreas consortium. METHODS The eight, collaborating national, regional, and single-center partners shared their anonymized dataset. Patients diagnosed in 2012-2013 who underwent tumor resection for pancreatic adenocarcinoma stage I and II were investigated with respect to treatment and survival and compared using uni- and multivariable logistic and Cox regression analyses. All comparisons were performed separately per registry type: national, regional, and single-center registries. RESULTS In total, 2052 patients were included. Stage II was present in the majority of patients. The use of neo-ACT was limited in most registries (range 2.8-15.5%) and was only different between Belgium and The Netherlands after adjustment for potential confounders. The use of ACT was different between the registries (range 40.5-70.0%), even after adjustment for potential confounders. Ninety-day mortality was also different between the registries (range 0.9-13.6%). In multivariable analyses for overall survival, differences were observed between the national and regional registries. Furthermore, patients in ascending age groups and patients with stage II showed a significant worse overall survival. CONCLUSIONS This study provides a clear insight in clinical practice in the EURECCA Pancreas consortium. The differences observed in (neo-)ACT and outcome give us the chance to further investigate the best practices and improve outcome of pancreatic adenocarcinoma.
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Affiliation(s)
- J V Groen
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - B G Sibinga Mulder
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Z Valerianova
- Bulgarian National Cancer Registry/National Oncological Hospital, Sofia, Bulgaria
| | - J M Borras
- Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - L G M van der Geest
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - G Capretti
- Pancreatic Surgery Unit, Department of Surgery, Humanitas University, Milan, Italy
| | - A Schlesinger-Raab
- Munich Cancer Registry, Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany
| | - M Primic-Zakelj
- Epidemiology and Cancer Registry/Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Ryzhov
- Taras Shevchenko National University of Kyiv and Ukrainian National Cancer Institute, Kiev, Ukraine
| | - C J H van de Velde
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - B A Bonsing
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - E Bastiaannet
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - J S D Mieog
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
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Berger DMS, Wassenberg RM, Jóźwiak K, van de Wiel BA, Balm AJM, van den Berg JG, Klop WMC. Inter-observer variation in the histopathology reports of head and neck melanoma; a comparison between the seventh and eighth edition of the AJCC staging system. Eur J Surg Oncol 2018; 45:235-241. [PMID: 30385156 DOI: 10.1016/j.ejso.2018.10.529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/01/2018] [Accepted: 10/22/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND TNM staging of melanoma has recently been altered by the introduction of the 8th edition of the AJCC Cancer Staging manual. The purpose of this study is to analyze the inter-observer variation of histopathology reports and its effect on recommended treatment policy. METHODS We retrospectively analyzed 296 cases, diagnosed as primary cutaneous head and neck melanoma (2005-2016), referred to the Netherlands Cancer Institute (NCI) for treatment after prior diagnosis in another hospital (non-NCI). All reports were analyzed for patients demographics, tumor characteristics and histopathologic features. RESULTS In 53% and 40% of the cases, the histopathologic parameters were discordant, according to AJCC 7th and 8th edition, respectively. This indicated a perfect inter-observer agreement for the measurement of Breslow thickness (Intraclass correlation coefficient (ICC) = 0.981) and a substantial agreement for subtype (kappa statistic (κ) = 0.648) and ulceration (κ = 0.802), while only moderate for dermal mitotic activity (κ = 0.472). After NCI review, recommended treatment policies were changed in 13% and 11% of the patients when applying TNM 7 and TNM 8, respectively. Scheduling sentinel lymph node biopsy (SLNB) changed in 14 (5%) and 10 (3%) cases when using TNM 7 and TNM 8, respectively. CONCLUSION Review by a NCI pathologist of histopathologic parameters of primary cutaneous head and neck melanoma led to significant changes in treatment decision. Introduction of the AJCC 8th edition led to slightly less discordances between NCI and non-NCI reports and consequently smaller impact on treatment planning. Expert review remains indicated when a SLNB is considered for additional staging in selected cases.
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Affiliation(s)
- Danique M S Berger
- Department of Head and Neck Surgery and Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands.
| | - Roos M Wassenberg
- Department of Head and Neck Surgery and Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands
| | - Katarzyna Jóźwiak
- Department of Epidemiology and Biostatistics at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands
| | - Bart A van de Wiel
- Department of Pathology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands
| | - Alfons J M Balm
- Department of Head and Neck Surgery and Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands
| | - José G van den Berg
- Department of Pathology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands
| | - W Martin C Klop
- Department of Head and Neck Surgery and Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands.
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Ghavifekr Fakhr M, Rezaie Kahkhaie K, Shanehbandi D, Farshdousti Hagh M, Zarredar H, Safarzadeh E, Abdolrahimi Vind M, Baradaran B. Scrophularia Atropatana Extract Reverses TP53 Gene Promoter Hypermethylation and Decreases Survivin Antiapoptotic Gene Expression in Breast Cancer Cells. Asian Pac J Cancer Prev 2018; 19:2599-2605. [PMID: 30256066 PMCID: PMC6249477 DOI: 10.22034/apjcp.2018.19.9.2599] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: In many cases of breast cancer, the aberrant methylation of TP53 gene leads to uncontrolled cell
proliferation and apoptosis inhibition. Moreover, expression of oncogenes which are under the control of P53 protein
could be altered. Survivin as a conspicuous example of this category plays important roles in tumorigenesis, drug
resistance and apoptosis inhibition. The present study was done to reveal the effects of Scrophularia atropatana extract
on epigenetic situation of TP53 gene promoter and the expression levels of anti-apoptotic gene, survivin and its potential
for production of cancer epi-drugs. Methods: Cytotoxic effect of dichloromethane extracts of Scrophularia plant on
MCF-7 cell line was assessed in our previous study. Cell death ELISA (enzyme-linked immunosorbent assay) and
TUNEL (Terminal deoxynucleotidyl transferase dUTP nick end labeling) tests were used to investigate the occurrence of
apoptosis in the treated cells. Methylation Specific PCR (MSP) was employed to assess the changes in methylation
status of the TP53 gene promoter. Furthermore, quantitative real time PCR was utilized to evaluate the resulting changes
in TP53 and survivin genes expression. Results: Cell death ELISA and TUNEL assays confirmed the occurrence of
apoptosis. MSP test revealed a significant change in the methylation status of TP53 promoter. QRT-PCR showed
an increased TP53 gene expression in the treated cells while a significant decrease in survivin mRNA was evident.
Conclusions: According to the outcomes, dichloromethane extract of S. atropatana returned the TP53 gene promoter
hypermethylation to normal state. This plant could be a promising source for production of epi-drugs due to its apoptotic
effects and reversal of TP53 epigenetic alterations.
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Affiliation(s)
- Mehrdad Ghavifekr Fakhr
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee,Zabol University of Medical Science, Zabol, Iran.
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63
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Johnson-Obaseki S, Caulley L, Corsten M, Liu G, Dimitroulakos J, Goldstein D, Irish J, Rider J. C-reactive Protein in HPV-Positive and HPV-Negative Oropharyngeal Cancer. Otolaryngol Head Neck Surg 2018; 160:494-501. [PMID: 30226795 DOI: 10.1177/0194599818800297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Evaluate serum C-reactive protein (CRP) in human papillomavirus (HPV)-positive oropharynx cancer as compared with HPV-negative oropharynx cancer and determine if CRP levels were associated with overall survival and/or recurrence-free survival. STUDY DESIGN Prospective cohort study. SETTING Tertiary care academic cancer center between 2007 and 2010. SUBJECTS AND METHODS Among patients with oropharynx cancer and confirmed HPV status, plasma CRP levels were measured with a high-sensitivity ELISA kit. Multivariable logistic regression analysis compared 4 categories of CRP (low, moderate, high, very high) between the HPV-positive and HPV-negative groups. Kaplan-Meier methods and Cox regression models were used to determine overall survival and recurrence-free survival by CRP level in both populations. RESULTS Between 113 HPV-positive and 110 HPV-negative patients, CRP levels were significantly higher in the HPV-positive group, but these levels did not demonstrate a statistically significant dose-response trend. Higher CRP levels were also associated with reduced overall survival ( P = .016) and recurrence-free survival ( P < .001) within the HPV-negative group in univariable analysis; in multivariate analysis, the comparisons were not significantly different. Within HPV-positive oropharynx cancer, CRP levels were not significantly associated with overall survival or recurrence-free survival in univariable or multivariable analyses. CONCLUSION Circulating CRP was higher in HPV-positive versus HPV-negative oropharynx cancer. Among HPV-negative patients, higher CRP levels were associated with reduced survival.
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Affiliation(s)
| | | | | | - Geoffrey Liu
- 3 University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Jennifer Rider
- 4 Harvard University, Cambridge, Massachusetts, USA.,5 Boston University, Boston, Massachusetts, USA
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64
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Alves AM, Correa MB, Silva KDD, Araújo LMAD, Vasconcelos ACU, Gomes APN, Etges A, Tarquinio SBC. Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population. Braz Dent J 2018; 28:301-306. [PMID: 29297550 DOI: 10.1590/0103-6440201601257] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher's exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.
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Affiliation(s)
- Alessandro Menna Alves
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Dental School, UNIVATES - Unidade Integrada Vale do Taquari de Ensino Superior, Lajeado, RS, Brazil
| | - Marcos Britto Correa
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Karine Duarte da Silva
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Ana Carolina Uchoa Vasconcelos
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Ana Paula Neutzling Gomes
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Adriana Etges
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Sandra Beatriz Chaves Tarquinio
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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65
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Duarte AF, Sousa-Pinto B, Freitas A, Delgado L, Costa-Pereira A, Correia O. Skin cancer healthcare impact: A nation-wide assessment of an administrative database. Cancer Epidemiol 2018; 56:154-160. [PMID: 30179829 DOI: 10.1016/j.canep.2018.08.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/04/2018] [Accepted: 08/13/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Skin cancer is an important health concern, with an increasing incidence worldwide. OBJECTIVE To assess the clinical and economic burden of melanoma (MM) and non-melanoma skin cancer (NMSC) at public hospitals in mainland Portugal. METHODS We used an administrative database containing a registration of all hospitalizations and ambulatory episodes occurred in Portuguese public hospitals between 2011 and 2015. We assessed all episodes with associated diagnoses of MM or NMSC regarding neoplasm location, metastases occurrence, length of stay, in-hospital mortality and hospital costs. RESULTS We assessed 15,913 MM and 72,602 NMSC episodes. 14.3% of MM episodes presented with metastases, compared to 1.9% of NMSC episodes. Patients' median age was lower for MM (66 years) than NMSC (76 years). The trunk was the most common location for MM (32.5%), followed by the lower limbs (26.5%). NMSC presented with higher length of stay than MM (median 5 versus 4 days; p < 0.001), but with lower in-hospital mortality (7.3% versus 11.9%; p < 0.001). MM episodes had higher average hospital costs than NMSC episodes (1197.7 versus 1113.5 €; p < 0.001). Overall, NMSC episodes amounted a total of 80.8 million € in hospital costs versus 19.1 million € for MM episodes. CONCLUSION Skin neoplasms have substantial impact on healthcare services. NMSC is an important contributor to this burden. NMSC underreporting should be tackled and it should not be downplayed in skin cancer preventative strategies.
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Affiliation(s)
- A F Duarte
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal; MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal.
| | - B Sousa-Pinto
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - A Freitas
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - L Delgado
- CINTESIS - Center for Health Technology and Services Research, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
| | - A Costa-Pereira
- MEDCIDS - Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal
| | - O Correia
- Centro de Dermatologia Epidermis, Instituto CUF, Porto, Portugal; CINTESIS - Center for Health Technology and Services Research, Porto, Portugal; Basic and Clinical Immunology Unit, Department of Pathology, Faculty of Medicine, University of Porto, Portugal
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66
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Albini A, Gallo M. What the oncologist can learn from diabetes studies: Epidemiology, prevention, management, cure. Diabetes Res Clin Pract 2018; 143:364-368. [PMID: 29410239 DOI: 10.1016/j.diabres.2018.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 01/24/2018] [Indexed: 11/15/2022]
Abstract
Notwithstanding massive efforts and investment in improving cancer therapy, the limited progress made in reducing overall mortality has mostly been achieved through early diagnosis. Mortality rates for cardiovascular disease are in decline, a success attributable in large part to an active prevention approach coupled with identification of risk factors and biomarkers. Promising natural and synthetic molecules including numerous flavonoids have the potential to be used in diabetes care and in prevention of cardiovascular pathologies. These concepts should also be applied to cancer, the incidence of which continues to increase. In cancer chemoprevention low toxicity drugs or dietary constituents are used to prevent or delay onset of malignancy. Evidence is accumulating that cancer chemoprevention is a valuable weapon against human cancer. For example, doubling of fruit and fiber intake is associated with reduction of colorectal cancer whereas fat food consumption appears to increase malignant progression of certain tumors. Breast, colorectal and prostate cancer are the most suitable cancers for dietary prevention and scientists have strong data in these cancers at basic, translational, clinical and epidemiological levels, due to experimental evidence and the large EPIC study. Physical activity is also crucial. Yet, cancer chemoprevention research in oncology is largely underrepresented and lags far behind the efforts dedicated to therapy; it is important to close this gap. Few European phase III clinical trials are ongoing and systematic development of novel agents for cancer prevention is rare in Europe.
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Affiliation(s)
- Adriana Albini
- Scientific and Technology Pole, IRCCS MultiMedica, Milano, Italy.
| | - Marco Gallo
- Oncological Endocrinology Unit, Department of Medical Sciences, University of Turin, AOU Città della Salute e della Scienza di Torino, Turin, Italy
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67
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Breugom AJ, Bastiaannet E, Dekker JWT, Wouters MWJM, van de Velde CJH, Liefers GJ. Decrease in 30-day and one-year mortality over time in patients aged ≥75 years with stage I-III colon cancer: A population-based study. Eur J Surg Oncol 2018; 44:1889-1893. [PMID: 30262327 DOI: 10.1016/j.ejso.2018.08.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/03/2018] [Accepted: 08/17/2018] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Monitoring time trends of cancer mortality is essential. Thirty-day mortality is an important surgical outcome measure, though postoperative mortality exceeds to one year after surgery in patients with colorectal cancer. The aim of this nationwide observational study was to assess changes over time in 30-day and one-year mortality in patients with stage I-III colorectal cancer. METHODS All surgically treated patients with stage I-III colorectal cancer, diagnosed between 2009 and 2013 were selected from the Netherlands Cancer Registry. Changes in 30-day and one-year mortality were assessed using logistic regression by tumour localisation (colon, rectum) and age group (<75 years, ≥75 years). RESULTS Overall, 41,186 patients were included. Among patients with colon cancer ≥75 years, 30-day mortality decreased from 8.3% in 2009 to 6.2% in 2013 (p-value for trend = 0.011), and one-year mortality from 18.5% in 2009 to 15.0% in 2013 (p-value for trend = 0.007). No significant differences in mortality over time were observed for patients <75 years with colon cancer and for patients with rectal cancer. CONCLUSION Thirty-day and one-year mortality decreased over time in patients ≥75 years with stage I-III colon cancer, though the absolute decrease is small. However, 30-day mortality and in particular the one-year mortality are both still high in older patients with colorectal cancer and will need to be focused on to further improve outcomes for these patient subgroups.
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Affiliation(s)
- A J Breugom
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - E Bastiaannet
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands; Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - J W T Dekker
- Department of Surgery, Reinier de Graaf Gasthuis, Delft, The Netherlands
| | - M W J M Wouters
- Department of Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C J H van de Velde
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - G J Liefers
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
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68
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de la Rosa-Díaz I, Torres-Lacomba M, Acosta-Ramírez P, Orive IGD, Nee RJ, de la Villa-Polo P, Andrés-Esteban EM, Sánchez-Sánchez B. Protective myoelectric activity at performing upper limb neurodynamic test 1 in breast cancer survivors. A cross-sectional observational study. Musculoskelet Sci Pract 2018; 36:68-80. [PMID: 29860136 DOI: 10.1016/j.msksp.2018.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 05/11/2018] [Accepted: 05/21/2018] [Indexed: 11/25/2022]
Abstract
Myoelectric activity and range of motion during ULNT1 were recorded in 62 breast cancer (BC) survivors who had axillary lymph node dissection (n = 30) or sentinel lymph node biopsy (n = 32) within the previous 18 months, and 63 age-matched healthy women. BC survivors' symptoms were reproduced by ULNT1 and exhibited greater myoelectric activity in the biceps brachii than healthy women (MD (95% CI): 21,26 (10,83-31,70)). No differences between the axillary lymph node dissection and sentinel lymph node biopsy groups (MD (95% CI): 8,47 (-7,84-24,79)) were found. Myoelectric activity in the triceps brachii was greater in the sentinel lymph node biopsy group (MD (95% CI): 2,70 (-2,06-7,60)). BC survivors exhibited less shoulder and elbow range of motion during ULNT1 than healthy women. Increased upper limb nerve mechanosensitivity in BC survivors was associated with a greater protective muscle response during ULNT1.
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Affiliation(s)
- Irene de la Rosa-Díaz
- Physical Therapist in Women´s Health Research Group, Department of Physical Therapy, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - María Torres-Lacomba
- Physical Therapist in Women´s Health Research Group, Department of Physical Therapy, University of Alcalá, Alcalá de Henares, Madrid, Spain.
| | - Paz Acosta-Ramírez
- Physical Therapist in Torrejón Hospital, Rehabilitation Department, Torrejón de Ardoz, Madrid, Spain
| | - Itxaso García-de Orive
- Physical Therapist in Torrejón Hospital, Rehabilitation Department, Torrejón de Ardoz, Madrid, Spain
| | - Robert J Nee
- Physical Therapist in School of Physical Therapy, Pacific University, Hillsboro, OR, USA
| | - Pedro de la Villa-Polo
- Medical Doctor in the Neurophysiology Research Group, Department of Systems Biology, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Eva M Andrés-Esteban
- Biostatistician, Department of Preventive Medicine, Universtiy of Jaume I, Castellón, Spain
| | - Beatriz Sánchez-Sánchez
- Physical Therapist in Women´s Health Research Group, Department of Physical Therapy, University of Alcalá, Alcalá de Henares, Madrid, Spain
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Relation between mortality trends of cardiovascular diseases and selected cancers in the European Union, in 1970-2017. Focus on cohort and period effects. Eur J Cancer 2018; 103:341-355. [PMID: 30029971 DOI: 10.1016/j.ejca.2018.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/29/2018] [Accepted: 06/05/2018] [Indexed: 01/01/2023]
Abstract
AIM To characterise mortality trends from major non-communicable diseases in the European Union (EU) analysing data from the World Health Organization (WHO) Mortality Database. METHODS We obtained EU population and death certification data for major non-communicable diseases, i.e. seven cancer sites (stomach, intestine, pancreas, lung, breast, prostate and haematopoietic), total cancers, coronary heart diseases (CHDs) and cerebrovascular diseases (CVDs) from the WHO Mortality Database over the 1970 and 2012 period. We computed age-standardised rates (world standard population) and applied joinpoint regression models to identify temporal trends and age period cohort (APC) models to disentangle the effects of age, period of death and cohort of birth on mortality. RESULTS In 2012, 2.4 million deaths were recorded in the EU (1.3 million from cancers and 1.1 million from CHD and CVD combined). Over the last decade, mortality from cancer fell by 14% in men and 8% in women, resulting in age-standardised rates of 144 and 88/100,000 persons, respectively, in 2012. The only exceptions to the general downward trends were pancreatic cancer and female lung cancer. Both cardiovascular diseases mortality fell over 35% in both sexes with rates of 60 and 28/100,000 for CHD, and of 30 and 23/100,000 for CVD, in men and women, respectively, in 2012. CONCLUSIONS Overall trends in mortality rates from non-communicable diseases in the EU were favourable, and the joinpoint and APC models indicated these trends are likely to continue in the near future. Lack of progress in tobacco-related mortality in women underlines the importance of female-specific anti-tobacco policies.
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Incidence of bladder cancer in Benghazi, Libya over the past three decades. Sci Rep 2018; 8:10822. [PMID: 30018344 PMCID: PMC6050245 DOI: 10.1038/s41598-018-29187-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/06/2018] [Indexed: 11/26/2022] Open
Abstract
There are limited data on the disease of bladder cancer in Libya. The objective of this study was to assess the pattern of incidence and clinical presentation of bladder cancer in Benghazi, Libya. This study was a retrospective cohort analysis conducted among consecutive individuals who were diagnosed and/or were treated for bladder cancer from January 1st 1983 to December 31st 2009. A total of 835 cases of bladder tumour were recorded. The world age-standardized incidence rate was 13.1 and 1.9 per 100,000 for males and females, respectively. The mean (standard deviation) age of all patients was 63.7 (14.7). The majority of patients (n = 750, 89.8%) were male, two-thirds of which (n = 594, 79.2%) were smokers while all female patients were non-smokers. Hematuria was the most frequent presenting symptom. Most tumours were well differentiated, and transitional cell carcinoma was the most frequent histological type. The incidence of bladder cancer in Libya is lower than most developed countries, increases by aging, and is more prevalent among males. The incidence of this disease is expected to grow in developing countries such as Libya because of increase in smoking popularity, the shift to sedentary life, diabetes mellitus, and obesity.
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Tajirika T, Tokumaru Y, Taniguchi K, Sugito N, Matsuhashi N, Futamura M, Yanagihara K, Akao Y, Yoshida K. DEAD-Box Protein RNA-Helicase DDX6 Regulates the Expression of HER2 and FGFR2 at the Post-Transcriptional Step in Gastric Cancer Cells. Int J Mol Sci 2018; 19:ijms19072005. [PMID: 29987267 PMCID: PMC6073682 DOI: 10.3390/ijms19072005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 07/03/2018] [Accepted: 07/06/2018] [Indexed: 01/27/2023] Open
Abstract
The human DEAD/H-box RNA helicase DDX6 (RCK/p54) is a protein encoded by the fusion gene from the t(11;14)(q23;q32) chromosomal translocation observed in human B-cell lymphoma cell line RC-K8. DDX6 has a variety of functions such as translation initiation, pre-mRNA splicing, and ribosome assembly. However, details of the regulatory mechanism governing DDX6 and the functions of DDX6 are largely unknown. Previously, we reported that DDX6 is overexpressed in most malignant cell lines and clinical colorectal tumor samples and that DDX6 positively contributes to the pathogenesis of various cancers. In the current study, we aimed at revealing the function of DDX6 in HER2 and FGFR2 related human gastric cancer (GC) by using clinical samples and GC cell lines. DDX6 protein was overexpressed in about 60% of the clinical samples; HER2, in 35%; and FGFR2, in 30%, (n = 20). Interestingly, the DDX6 protein was overexpressed in all HER2-positive samples (n = 7), and in 83% (5 of 6) of the FGFR2-positive samples, which could reflect the contribution of DDX6 to the expression of HER2 and FGFR2. In the GC cell line MKN7, which has HER2 amplification, the knockdown of DDX6 by siR-DDX6 led to the decreased expression of the HER2 protein. On the other hand, the knockdown of HER2 did not influence the DDX6 expression. Similar results were also obtained for the KATO-III and HSC39 cell lines having amplified FGFR2 expression. The increased expression of DDX6 induced a significantly increased expression of the HER2 protein without increasing the mRNA expression. The results of an RNP Immunoprecipitation (RIP)-assay using GC cells indicated that the DDX6 protein acted as an RNA-binding protein for HER2 and FGFR2 mRNAs and positively regulated their post-transcriptional processes. These findings demonstrated that DDX6 was an upstream molecule that positively regulated the expression of HER2 and FGFR2 at the post-transcriptional step in GC cells.
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MESH Headings
- Aged
- Aged, 80 and over
- Cell Line, Tumor
- DEAD-box RNA Helicases/genetics
- DEAD-box RNA Helicases/metabolism
- Female
- Gene Amplification
- Gene Expression Regulation, Neoplastic
- Humans
- Male
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins/metabolism
- Receptor, ErbB-2/genetics
- Receptor, ErbB-2/metabolism
- Receptor, Fibroblast Growth Factor, Type 2/genetics
- Receptor, Fibroblast Growth Factor, Type 2/metabolism
- Stomach Neoplasms/genetics
- Stomach Neoplasms/metabolism
- Transcription, Genetic
- Up-Regulation
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Affiliation(s)
- Toshihiro Tajirika
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Yoshihisa Tokumaru
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Kohei Taniguchi
- Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
- Translational Research Program Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka 569-8686, Japan.
| | - Nobuhiko Sugito
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan.
| | - Nobuhisa Matsuhashi
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Manabu Futamura
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
| | - Kazuyoshi Yanagihara
- Division of Biomarker Discovery, Exploratory Oncology and Clinical Trial Center, National Cancer Center, 6-5-1 Kashiwa, Chiba 277-8577, Japan.
| | - Yukihiro Akao
- United Graduate School of Drug Discovery and Medical Information Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan.
| | - Kazuhiro Yoshida
- Department of Surgical Oncology, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu 501-1194, Japan.
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The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2018; 21:579-587. [PMID: 29460004 DOI: 10.1007/s10120-018-0812-3] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 02/11/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Despite extensive research on the criteria for the assessment of gastric cancer risk using the Operative Link on Gastritis Assessment (OLGA) and Operative Link on Gastritis/Intestinal-Metaplasia Assessment (OLGIM) systems, no comprehensive overview or systematic summary on their use is currently available. AIM To perform a systematic review and meta-analysis to assess the efficacy of the OLGA and OLGIM staging systems in evaluating gastric cancer risk. METHODS We searched various databases, including PubMed, EMBASE, Medline, and Cochrane's library, for articles published before March 2017 on the association between OLGA/OLGIM stages and risk of gastric cancer. Statistical analysis was performed using RevMan 5.30 and Stata 14.0, with the odds ratio, risk ratio, and 95% confidence interval as the effect measures. RESULTS A meta-analysis of six case-control studies and two cohort studies, comprising 2700 subjects, was performed. The meta-analysis of prospective case-control studies demonstrated a significant association between the OLGA/OLGIM stages III/IV and gastric cancer. The Newcastle-Ottawa Scale (NOS) score reflected heterogeneity in the case-control studies on OLGA. Subgroup analysis of high-quality (NOS score ≥ 5) studies showed an association between OLGA stage III/IV and increased risk of gastric cancer; the association was also high in the remaining study with low NOS score. The association between higher stages of gastritis defined by OLGA and risk of gastric cancer was significant. CONCLUSIONS This correlation implies that close and frequent monitoring of such high-risk patients is necessary to facilitate timely diagnosis of gastric cancer.
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Elangovan P, Mackenzie A, Dance DR, Young KC, Wells K. Lesion detectability in 2D-mammography and digital breast tomosynthesis using different targets and observers. Phys Med Biol 2018; 63:095014. [PMID: 29637906 DOI: 10.1088/1361-6560/aabd53] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This work investigates the detection performance of specialist and non-specialist observers for different targets in 2D-mammography and digital breast tomosynthesis (DBT) using the OPTIMAM virtual clinical trials (VCT) Toolbox and a 4-alternative forced choice (4AFC) assessment paradigm. Using 2D-mammography and DBT images of virtual breast phantoms, we compare the detection limits of simple uniform spherical targets and irregular solid masses. Target diameters of 4 mm and 6 mm have been chosen to represent target sizes close to the minimum detectable size found in breast screening, across a range of controlled contrast levels. The images were viewed by a set of specialist observers (five medical physicists and six experienced clinical readers) and five non-specialists. Combined results from both observer groups indicate that DBT has a significantly lower detectable threshold contrast than 2D-mammography for small masses (4 mm: 2.1% [DBT] versus 6.9% [2D]; 6 mm: 0.7% [DBT] versus 3.9% [2D]) and spheres (4 mm: 2.9% [DBT] versus 5.3% [2D]; 6 mm: 0.3% [DBT] versus 2.2% [2D]) (p < 0.0001). Both observer groups found spheres significantly easier to detect than irregular solid masses for both sizes and modalities (p < 0.0001) (except 4 mm DBT). The detection performances of specialist and non-specialist observers were generally found to be comparable, where each group marginally outperformed the other in particular detection tasks. Within the specialist group, the clinical readers performed better than the medical physicists with irregular masses (p < 0.0001). The results indicate that using spherical targets in such studies may produce over-optimistic detection thresholds compared to more complex masses, and that the superiority of DBT for detecting masses over 2D-mammography has been quantified. The results also suggest specialist observers may be supplemented by non-specialist observers (with training) in some types of 4AFC studies.
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Affiliation(s)
- Premkumar Elangovan
- Medical Imaging Group, Centre for Vision, Speech, and Signal Processing, University of Surrey, Guildford, GU2 7XH, United Kingdom. National Co-ordinating Centre for the Physics of Mammography (NCCPM), Royal Surrey County Hospital, Guildford GU2 7XX, United Kingdom
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Whelan J, Hackshaw A, McTiernan A, Grimer R, Spooner D, Bate J, Ranft A, Paulussen M, Juergens H, Craft A, Lewis I. Survival is influenced by approaches to local treatment of Ewing sarcoma within an international randomised controlled trial: analysis of EICESS-92. Clin Sarcoma Res 2018; 8:6. [PMID: 29610659 PMCID: PMC5877389 DOI: 10.1186/s13569-018-0093-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 02/07/2018] [Indexed: 12/25/2022] Open
Abstract
Background Two national clinical trial groups, United Kingdom Children’s Cancer and Leukaemia Group (CCLG) and the German Paediatric Oncology and Haematology Group (GPOH) together undertook a randomised trial, EICESS-92, which addressed chemotherapy options for Ewing’s sarcoma. We sought the causes of unexpected survival differences between the study groups. Methods 647 patients were randomised. Cox regression analyses were used to compare event-free survival (EFS) and overall survival (OS) between the two study groups. Results 5-year EFS rates were 43% (95% CI 36–50%) and 57% (95% CI 52–62) in the CCLG and GPOH patients, respectively; corresponding 5-year OS rates were 52% (95% CI 45–59%) and 66% (95% CI 61–71). CCLG patients were less likely to have both surgery and radiotherapy (18 vs. 59%), and more likely to have a single local therapy modality compared to the GPOH patients (72 vs. 35%). Forty-five percent of GPOH patients had pre-operative radiotherapy compared to 3% of CCLG patients. In the CCLG group local recurrence (either with or without metastases) was the first event in 22% of patients compared with 7% in the GPOH group. After allowing for the effects of age, metastases, primary site, histology and local treatment modality, the risk of an EFS event was 44% greater in the CCLG cohort (95% CI 10–89%, p = 0.009), and the risk of dying was 30% greater, but not statistically significant (95% CI 3–74%, p = 0.08). Conclusions Unexpected differences in EFS and OS occurred between two patient cohorts recruited within an international randomised trial. Failure to select or deliver appropriate local treatment modalities for Ewing’s sarcoma may compromise chances of cure. Trial registration Supported by Deutsche Krebshilfe (Grants No. DKH M43/92/Jü2 and DKH 70-2551 Jü3), and European Union Biomedicine and Health Programme (Grants No. BMH1-CT92-1341 and BMH4-983956), and Cancer Research United Kingdom. Clinical trial information can be found for the following: NCT0000251
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Affiliation(s)
- Jeremy Whelan
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK.,3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK
| | - Allan Hackshaw
- 2Cancer Research UK and UCL Clinical Trials Centre, University College London, London, UK
| | - Anne McTiernan
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK
| | | | | | - Jessica Bate
- 1Department of Oncology, University College Hospitals London NHS Foundation Trust, 250 Euston Road, London, NW1 2PG UK
| | | | - Michael Paulussen
- 7Vestische Kinder- und Jugendklinik Datteln, University Witten/Herdecke, Datteln, Germany
| | - Herbert Juergens
- 8Department of Pediatric Hematology and Oncology, University Children's Hospital Münster, Münster, Germany
| | - Alan Craft
- 3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,9Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
| | - Ian Lewis
- 3Children's Cancer and Leukaemia Group Data Centre, Cancer Studies and Molecular Medicine, University of Leicester, Leicester, UK.,10University of Leeds and Leeds Community Healthcare Trust, Leeds, UK
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Exarchakou A, Rachet B, Belot A, Maringe C, Coleman MP. Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996-2013: population based study. BMJ 2018; 360:k764. [PMID: 29540358 PMCID: PMC5850596 DOI: 10.1136/bmj.k764] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/02/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the effectiveness of the NHS Cancer Plan (2000) and subsequent national cancer policy initiatives in improving cancer survival and reducing socioeconomic inequalities in survival in England. DESIGN Population based cohort study. SETTING England. POPULATION More than 3.5 million registered patients aged 15-99 with a diagnosis of one of the 24 most common primary, malignant, invasive neoplasms between 1996 and 2013. MAIN OUTCOME MEASURES Age standardised net survival estimates by cancer, sex, year, and deprivation group. These estimates were modelled using regression model with splines to explore changes in the cancer survival trends and in the socioeconomic inequalities in survival. RESULTS One year net survival improved steadily from 1996 for 26 of 41 sex-cancer combinations studied, and only from 2001 or 2006 for four cancers. Trends in survival accelerated after 2006 for five cancers. The deprivation gap observed for all 41 sex-cancer combinations among patients with a diagnosis in 1996 persisted until 2013. However, the gap slightly decreased for six cancers among men for which one year survival was more than 65% in 1996, and for cervical and uterine cancers, for which survival was more than 75% in 1996. The deprivation gap widened notably for brain tumours in men and for lung cancer in women. CONCLUSIONS Little evidence was found of a direct impact of national cancer strategies on one year survival, and no evidence for a reduction in socioeconomic inequalities in cancer survival. These findings emphasise that socioeconomic inequalities in survival remain a major public health problem for a healthcare system founded on equity.
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Affiliation(s)
- Aimilia Exarchakou
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Bernard Rachet
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Aurélien Belot
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Camille Maringe
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Tamandl D, Mang T, Ba-Ssalamah A. Imaging of colorectal cancer - the clue to individualized treatment. Innov Surg Sci 2018; 3:3-15. [PMID: 31579761 PMCID: PMC6754048 DOI: 10.1515/iss-2017-0049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 02/20/2018] [Indexed: 12/18/2022] Open
Abstract
Colorectal cancer (CRC) is the most common gastrointestinal neoplasm and the second most common cause for cancer-related death in Europe. Imaging plays an important role both in the primary diagnosis, treatment evaluation, follow-up, and, to some extent, also in prevention. Like in the clinical setting, colon and rectal cancer have to be distinguished as two quite separate entities with different goals of imaging and, consequently, also different technical requirements. Over the past decade, there have been improvements in both more robust imaging techniques and new data and guidelines that help to use the optimal imaging modality for each scenario. For colon cancer, the continued research on computed tomography (CT) colonography (CTC) has led to high-level evidence that puts this technique on eye height to optical colonoscopy in terms of detection of cancer and polyps ≥10 mm. However, also for smaller polyps and thus for screening purposes, CTC seems to be an optimal tool. In rectal cancer, the technical requirements to perform state-of-the art imaging have recently been defined. Evaluation of T-stage, mesorectal fascia infiltration and extramural vascular invasion are the most important prognostic factors that can be identified on MRI. With this information, risk stratification both for local and distal failure is possible, enabling the clinician to tailor the optimal therapeutic approach in non-metastatic rectal cancer. Imaging of metastatic CRC is also covered, although the complex ramifications of treatment options in the metastatic setting are beyond the scope of this article. In this review, the most important recent developments in the imaging of colon and rectal cancer will be highlighted. If used in an interdisciplinary setting, this can lead to an individualized treatment concept for each patient.
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Affiliation(s)
- Dietmar Tamandl
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Thomas Mang
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Ahmed Ba-Ssalamah
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
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DUTRA VGP, PARREIRA VAG, GUIMARÃES RM. EVOLUTION OF MORTALITY FOR COLORECTAL CANCER IN BRAZIL AND REGIONS, BY SEX, 1996-2015. ARQUIVOS DE GASTROENTEROLOGIA 2018; 55:61-65. [DOI: 10.1590/s0004-2803.201800000-12] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/13/2017] [Indexed: 11/22/2022]
Abstract
ABSTRACT BACKGROUND: Colorectal cancer is among the three most frequent neoplasms in Brazil, being a public health problem. OBJECTIVE: To describe distribution pattern of colorectal cancer mortality in Brazil and regions, according to sex, between 1996 and 2015. METHODS: Values of standardized and stratified mortality rates by sex between 1996 and 2015 were used, through polynomial regression models and joinpoint analysis. RESULTS: It was observed that, for linear trends in mortality rates, for both sexes, there is a statistically significant trend increasing in both models, with rates and trends, and higher for men than for women, respectively, 7.3% per year (R2=0.95, P<0.001) and 6.5% per year (R2=0.87, P<0.001). It is observed a difference in magnitude and behavior of trend between the regions. CONCLUSION: It is understood that it is important to know the trend of rates in order to define priority populations for early interventions that increase survival and reduce mortality.
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Trends in net survival from pancreatic cancer in six European Latin countries: results from the SUDCAN population-based study. Eur J Cancer Prev 2018; 26 Trends in cancer net survival in six European Latin Countries: the SUDCAN study:S63-S69. [PMID: 28005607 DOI: 10.1097/cej.0000000000000303] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pancreatic cancer represents a real clinical challenge. The aim of the SUDCAN collaborative study was to compare the net survival from pancreatic cancer between six European Latin countries (Belgium, France, Italy, Portugal, Spain and Switzerland) and provide trends in net survival and dynamics of excess mortality rates up to 5 years after diagnosis. The data were extracted from the EUROCARE-5 database. First, net survival was studied over the period 2000-2004 using the Pohar-Perme estimator. For trend analyses, the study period was specific to each country. Results were reported from 1992 to 2004 in France, Italy, Spain and Switzerland and from 2000 to 2004 in Belgium and Portugal. These analyses were carried out using a flexible excess rate modelling strategy. There were little differences between countries in age-standardized net survivals (2000-2004). The 5-year net survival was poor (range: 6-10%). The changes in net survival from 1992 to 2004 were mostly related to early survival and patients aged 60 years. A slight decrease in the excess mortality rate between 1992 and 2004 was observed, limited to the 18 months after diagnosis. This study confirmed that, despite some improvement, survival from pancreatic cancer is still poor throughout European Latin countries. The major improvements in clinical imaging did not result in improvements in prognosis. Development of truly innovative treatments is highly needed to improve prognosis.
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Barroso EM, Ten Hove I, Bakker Schut TC, Mast H, van Lanschot CGF, Smits RWH, Caspers PJ, Verdijk R, Noordhoek Hegt V, Baatenburg de Jong RJ, Wolvius EB, Puppels GJ, Koljenović S. Raman spectroscopy for assessment of bone resection margins in mandibulectomy for oral cavity squamous cell carcinoma. Eur J Cancer 2018; 92:77-87. [PMID: 29428867 DOI: 10.1016/j.ejca.2018.01.068] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/22/2017] [Accepted: 01/07/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the potential of Raman spectroscopy for detection of oral cavity squamous cell carcinoma (OCSCC) in bone resection surfaces during mandibulectomy. MATERIALS & METHODS Raman mapping experiments were performed on fresh mandible resection specimens from patients treated with mandibulectomy for OCSCC. A tumour detection algorithm was created based on water concentration and the high-wavenumber range (2800 cm-1-3050 cm-1) of the Raman spectra. RESULTS Twenty-six ex vivo Raman mapping experiments were performed on 26 fresh mandible resection specimens obtained from 22 patients. The algorithm was applied on an independent test set and showed an accuracy of 95%, a sensitivity of 95%, and a specificity of 87%. CONCLUSION These results form the basis for further development of a Raman spectroscopy tool as an objective method for intraoperative assessment of bone resection margins.
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Affiliation(s)
- Elisa M Barroso
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Ivo Ten Hove
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Tom C Bakker Schut
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands.
| | - Hetty Mast
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Cornelia G F van Lanschot
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Roeland W H Smits
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Peter J Caspers
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Rob Verdijk
- Department of Pathology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Vincent Noordhoek Hegt
- Department of Pathology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Robert J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Eppo B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Gerwin J Puppels
- Center for Optical Diagnostics and Therapy, Department of Dermatology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Senada Koljenović
- Department of Pathology, Erasmus University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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Wennerblom J, Saksena P, Jönsson C, Thune A. Lymph node 8a as a prognostic marker for poorer prognosis in pancreatic and periampullary carcinoma. Scand J Gastroenterol 2018; 53:225-230. [PMID: 29262727 DOI: 10.1080/00365521.2017.1417474] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES An investigation of patients with pancreatic carcinoma aims to identify those who will benefit from surgery. Physical examination, radiology and laboratory findings are helpful. Most prognostic markers, such as lymph node status, micro metastasis and tumour differentiation, are not preoperatively accessible. Metastatic disease in lymph node 8a (Ln8a) in patients operated for pancreatic carcinoma has been reported to be a predictor of shorter overall survival (OS). This lymph node can be assessed preoperatively through resection (possibly even with laparoscopy) and subsequent histopathology. The value of the procedure is disputed. The aim of this study is to investigate whether metastatic disease in Ln8a is a predictor of decreased OS. MATERIALS AND METHODS In patients with suspected pancreatic or periampullary carcinoma, who were operated with pancreatoduodenectomy (PD), Ln8a was separately resected and analysed with standard and immuno-histochemical methods. Patients with or without metastasis in Ln8a were compared regarding OS. RESULTS Between 2008 and 2011, 122 consecutive patients were eligible and 87 were resected and had LN8a analysed separately. Sixteen patients were Ln8a + and 71 were Ln8a-. Patients with Ln8a + had a significantly reduced median OS as compared to patients with Ln8a- (0.74 (95% CI 0.26-1.26) versus 5.91 years (95% CI 2.91-), p < .001). CONCLUSION Ln8a + was associated with a marked reduction of OS, indicating a possible role in the future preoperative workup in patients with a suspicion of pancreatic cancer.
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Affiliation(s)
- Johanna Wennerblom
- a Department of Surgery, Institute of Clinical Sciences , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden
| | - Pushpa Saksena
- b Department of Clinical Pathology and Genetics , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Claes Jönsson
- a Department of Surgery, Institute of Clinical Sciences , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden
| | - Anders Thune
- a Department of Surgery, Institute of Clinical Sciences , Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Sweden
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β-Blocker use and mortality in cancer patients: systematic review and meta-analysis of observational studies. Eur J Cancer Prev 2018; 25:440-8. [PMID: 26340056 DOI: 10.1097/cej.0000000000000192] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A number of epidemiologic studies have attempted to link the use of β blockers to mortality in cancer patients, but their findings have been inconclusive. A meta-analysis was carried out to derive a more precise estimation. Relevant studies were identified by searching PubMed and EMBASE to May 2015. We calculated the summary hazard ratios (HRs) and 95% confidence intervals (CIs) using random-effects models. Twenty cohort studies and four case-control studies involving 76 538 participants were included. The overall results showed that patients who used β blockers after diagnosis had an HR of 0.89 (95% CI 0.81-0.98) for all-cause mortality compared with nonusers. Those who used β blockers after diagnosis (vs. nonusers) had an HR of 0.89 (95% CI 0.79-0.99) for cancer-specific mortality. Prediagnostic use of β blockers showed no beneficial effect on all-cause mortality or cancer-specific mortality. Stratifying by cancer type, only breast cancer patients who used β blockers after diagnosis had a prolonged overall survival. A linear but nonsignificant trend was found between postdiagnostic β-blocker use and mortality of cancer patients. In conclusion, the average effect of β-blocker use after diagnosis but not before diagnosis is beneficial for the survival of cancer patients.
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Apostol I, Baban A, Nicula F, Suteu O, Coza D, Amati C, Baili P. Cervical Cancer Assessment in Romania under EUROCHIP-2. TUMORI JOURNAL 2018; 96:545-52. [DOI: 10.1177/030089161009600406] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Inside the European project EUROCHIP-2, the Romania team has ruled out an assessment study regarding cervical cancer screening programs (CCS) in Romania, in Nov 2006–March 2007. The general purpose was to be aliened to European Council recommendations that states that an organized cervical screening program should be offered in all member states, in order to reduce the specific incidence and mortality. The aim of the study was to assess cervical cancer burden and current cervical cancer screening status in Romania and in various sub-regions (DR), and also to identify problems and barriers and to propose solutions for implementing an organized cervical cancer screening program at national level. Methods The study was based on a statistical survey and a comprehensive literature review of the most important European, national and regional papers or studies completed in this field. Results Over 2000–2006, a total number of 22,830 new cases and 12,763 deaths from cervical cancer was registered in Romania. In 2005, the crude rate of incidence varied largely in the 8 DR between 17.8–31.3 and mortality varied between 12.3–21.5. The proportion of women tested by DRs on total female population varied between 3.2%-0.6%; the highest screening activity was observed in region VI, where run the only organized CCS in Romania. In 2005, there were one GP per 578 female population aged 25–65; regarding the specialists in 2007 per country we had: 3,012 women aged 25–65 per one gynecologist, 21,195 women per one oncologist and 13,258 women per one histopathologist. Discussion and conclusion There were no major changes in policy screening over 2000–2006 correlated with no major difference in specific mortality in Romania. Significant differences in incidence and mortality between DRs were observed in 2005, which impose deeper analyzes of local conditions and resources and local strategies to be adopted. The burden of cervical cancer is particularly high in Romania and is related to the absence of an organized CCS program or the ineffectiveness of the opportunistic screening programs. It is needed that European Council recommendations be implemented and quality assurance strategies to be checked and maintained at all screening levels in Romania.
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Affiliation(s)
| | | | - Adriana Baban
- “Babes-Bolyai” University, Psychology Department Cluj-Napoca, Romania
| | | | - Ofelia Suteu
- “Ion Chiricuta” Cancer Institute Cluj-Napoca, Romania
- “Iuliu Hatieganu” University of Medicine and Pharmacy Cluj-Napoca, Romania
| | - Daniela Coza
- “Ion Chiricuta” Cancer Institute Cluj-Napoca, Romania
| | - Camilla Amati
- Fondazione IRCCS “Istituto Nazionale Tumori”, Descriptive Studies and Health Planning unit, Milan, Italy
| | - Paolo Baili
- Fondazione IRCCS “Istituto Nazionale Tumori”, Descriptive Studies and Health Planning unit, Milan, Italy
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Cell death-based treatments of melanoma:conventional treatments and new therapeutic strategies. Cell Death Dis 2018; 9:112. [PMID: 29371600 PMCID: PMC5833861 DOI: 10.1038/s41419-017-0059-7] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 07/17/2017] [Accepted: 07/25/2017] [Indexed: 12/15/2022]
Abstract
The incidence of malignant melanoma has continued to rise during the past decades. However, in the last few years, treatment protocols have significantly been improved thanks to a better understanding of the key oncogenes and signaling pathways involved in its pathogenesis and progression. Anticancer therapy would either kill tumor cells by triggering apoptosis or permanently arrest them in the G1 phase of the cell cycle. Unfortunately, melanoma is often refractory to commonly used anticancer drugs. More recently, however, some new anticancer strategies have been developed that are “external” to cancer cells, for example stimulating the immune system’s response or inhibiting angiogenesis. In fact, the increasing knowledge of melanoma pathogenetic mechanisms, in particular the discovery of genetic mutations activating specific oncogenes, stimulated the development of molecularly targeted therapies, a form of treatment in which a drug (chemical or biological) is developed with the goal of exclusively destroying cancer cells by interfering with specific molecules that drive growth and spreading of the tumor. Again, after the initial exciting results associated with targeted therapy, tumor resistance and/or relapse of the melanoma lesion have been observed. Hence, very recently, new therapeutic strategies based on the modulation of the immune system function have been developed. Since cancer cells are known to be capable of evading immune-mediated surveillance, i.e., to block the immune system cell activity, a series of molecular strategies, including monoclonal antibodies, have been developed in order to “release the brakes” on the immune system igniting immune reactivation and hindering metastatic melanoma cell growth. In this review we analyze the various biological strategies underlying conventional chemotherapy as well as the most recently developed targeted therapies and immunotherapies, pointing at the molecular mechanisms of cell injury and death engaged by the different classes of therapeutic agents.
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84
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Patsea E, Kaklamanis L, Batistatou A. The first report of a 5-year period cancer registry in Greece (2009-2013): a pathology-based cancer registry. Virchows Arch 2018; 472:677-682. [PMID: 29302754 DOI: 10.1007/s00428-017-2287-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Revised: 11/25/2017] [Accepted: 12/19/2017] [Indexed: 11/25/2022]
Abstract
Cancer registries are essential in health care, since they allow more accurate planning of necessary health services and evaluation of programs for cancer prevention and control. The Hellenic Society of Pathology (HSP) having recognized the lack of such information in Greece has undertaken the task of a 5-year pathology-based cancer registry in Greece (2009-2013). In this study, > 95% of all pathology laboratories in the national health system hospitals and 100% of pathology laboratories in private hospitals, as well as > 80% of private pathology laboratories have contributed their data. The most common cancer types overall were as follows: breast cancer (18.26%), colorectal cancer (15.49%), prostate cancer (13.49%), and lung cancer (10.24% of all registered cancers). In men, the most common neoplasms were as follows: prostate cancer, colorectal cancer, lung cancer, and gastric cancer. In women, the most common neoplasms were as follows: breast cancer, colorectal cancer, thyroid cancer, and lung cancer. The data on cancer burden in Greece, presented herein, fill the void of cancer information in Greece that affects health care not only nationally but Europe-wise.
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Affiliation(s)
- Eleni Patsea
- Department of Pathology, IASO Hospital of Athens, Marousi, Greece
| | - Loukas Kaklamanis
- Department of Pathology, ONASSIS Cardiac Surgery Center, Athens, Greece
| | - Anna Batistatou
- Department of Pathology, University Hospital of Ioannina, Ioannina, Greece.
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van Nieuwenhuizen AJ, Buffart LM, van Uden-Kraan CF, van der Velden LA, Lacko M, Brug J, Leemans CR, Verdonck-de Leeuw IM. Patient-reported physical activity and the association with health-related quality of life in head and neck cancer survivors. Support Care Cancer 2017; 26:1087-1095. [PMID: 29164375 PMCID: PMC5847044 DOI: 10.1007/s00520-017-3926-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 10/09/2017] [Indexed: 12/17/2022]
Abstract
Purpose This study aimed to assess patient-reported levels of physical activity (PA) and its associations with health-related quality of life (HRQoL) adjusted for important demographic, lifestyle-related, and clinical factors, among head and neck (HNC) survivors. Methods This cross-sectional study included 116 HNC survivors. PA was assessed with the Physical Activity Scale for the Elderly (PASE) and HRQoL with the EORTC-QLQ-C30 and EORTC-HN35. Associations were studied using univariable and multivariable regression analyses. Results Median PASE score was 100.3 (interquartile range 65.1;170.8) of which 54% were household, 34% leisure-time, and 12% occupational activities. Younger HNC survivors had higher levels of PA. Higher PA was significantly associated with higher global QoL (p < 0.05). Findings for physical function, role function, social function, fatigue, and pain were in line, but not statistically significant (0.05 ≤ p < 0.10). Conclusions Among HNC survivors, a large proportion of PA consists of household activities. Younger HNC survivors had higher PA levels, and higher PA levels were associated with higher HRQoL.
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Affiliation(s)
- Annette J van Nieuwenhuizen
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands.,Department of Medical Oncology, Cancer Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Cornelia F van Uden-Kraan
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands.,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lilly-Ann van der Velden
- Department of Otolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.,Department of Head and Neck Oncology and Surgery, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Martin Lacko
- Department of Otolaryngology-Head and Neck Surgery, University Medical Centre of Maastricht, Maastricht, The Netherlands
| | - Johannes Brug
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - C René Leemans
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center, PO BOX 7057, 1007 MB, Amsterdam, The Netherlands. .,Department of Clinical Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
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Cariati P, Cabello-Serrano A, Perez-de Perceval-Tara M, Monsalve-Iglesias F, Martínez-Lara I. Oral and oropharyngeal squamous cell carcinoma in young adults: A retrospective study in Granada University Hospital. Med Oral Patol Oral Cir Bucal 2017; 22:e679-e685. [PMID: 29053649 PMCID: PMC5813985 DOI: 10.4317/medoral.21755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/30/2017] [Indexed: 11/26/2022] Open
Abstract
Background This study aims to evaluate and analyze the clinical features and outcomes of oral and oropharyngeal squamous cell carcinoma (SCC) in patients < 45-years old in our center. Material and Methods A retrospective analysis was conducted using the records of patients diagnosed with oral and oropharyngeal SCC between 1998 and 2011 in the University Hospital of Granada (Spain). The analysis identified 33 patients with oral and oropharyngeal SCC with an age of <45 years. Moreover, during the years studied, a further 472 patients were diagnosed with oral and oropharyngeal SCC in our center. Thus, 100 SCC patients with an age of >45 years were randomly selected from the same database. A retrospective analysis was conducted to determine specific features including sites of occurrence, risk factors, sex distribution, socio-economic status, T stage at diagnosis, nodal involvement, degree of tumor differentiation, locoregional failure and overall survival at 5 years was. Further, the results of both groups were compared. Results The male-female ratio was 1.2:1 in the group of young adults and 2.03:1 in the group of patients with an age of >45 years. No significant differences were found in terms of site, nodal involvement, locoregional failure, and overall survival. However, there were statistically significant differences between the two groups in terms of features such as risk factors, socio-economic status, T stage at diagnosis, and degree of tumor differentiation. The overall 5-year survival rate was 62% for patients >45 years old, whilst for the group of young adults this rate was 48.4% (p= 0.17). Conclusions The poor association between the common risk factors and oral and oropharyngeal cancers in young adults suggests that other pathogenic mechanisms should be investigated. For young patients, the data show evidence of poorer outcomes in terms of overall survival (p=0.17), and locoregional failure (p=0.23). Nevertheless, the literature shows that the results in this field are particularly inconsistent, and further research is therefore needed to provide more in-depth knowledge of the disease in this age group. Key words:Oral and oropharyngeal squamous cell carcinoma, young adults, poor prognosis,risk factors.
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Affiliation(s)
- P Cariati
- Hospital Virgen de las Nieves, Carretera de Jaen s/n, Granada 18013 (Spain),
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Kiefer T, Krahl D, Osthoff K, Thuss-Patience P, Bunse J, Adam U, Jansen MH, Ott R, Pfitzmann R, Pross M, Kohlmann T, Daeschlein G, Buhlert H, Völler H, Hirt C. Importance of Pancreatic Enzyme Replacement Therapy after Surgery of Cancer of the Esophagus or the Esophagogastric Junction. Nutr Cancer 2017; 70:69-72. [DOI: 10.1080/01635581.2017.1374419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Thomas Kiefer
- Department of Rehabilitation/Internal Medicine, Klinik am See, Rüdersdorf, Germany
| | - Dorothea Krahl
- Department of Rehabilitation/Internal Medicine, Klinik am See, Rüdersdorf, Germany
| | - Kathrin Osthoff
- Department of Rehabilitation/Internal Medicine, Klinik am See, Rüdersdorf, Germany
| | - Peter Thuss-Patience
- Department of Gastroenterology, Infectiology and Rheumatology, Campus Benjamin-Franklin/Charité, Berlin, Germany
| | - Jörg Bunse
- Department of General and Visceral Surgery, Sana Hospital Lichtenberg, Sana Hospitals Berlin-Brandenburg, Affiliated Teaching, Hospital to the Charité, Berlin, Germany
| | - Ulrich Adam
- Department of Surgery, Humboldt-Klinikum, Berlin, Germany
| | - Marc H. Jansen
- Department of Surgery, HELIOS Klinikum Emil von Behring, Berlin, Germany
| | - Rudolf Ott
- Department of Surgery, Waldkrankenhaus Berlin-Spandau, Berlin, Germany
| | - Robert Pfitzmann
- Department of Surgery, DRK Kliniken, Berlin-Mitte, Berlin, Germany
| | - Matthias Pross
- Department of Surgery, DRK Kliniken Berlin, Köpenick, Berlin, Germany
| | - Thomas Kohlmann
- Institute for Community Medicine, Methods of Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Georg Daeschlein
- Department of Dermatology, University Medicine Greifswald, Greifswald, Germany
| | - Hermann Buhlert
- Department of Rehabilitation/Internal Medicine, Klinik am See, Rüdersdorf, Germany
| | - Heinz Völler
- Department of Rehabilitation/Internal Medicine, Klinik am See, Rüdersdorf, Germany
- Center of Rehabilitation Research, University of Potsdam, Potsdam, Germany
| | - Carsten Hirt
- Department of Internal Medicine C, Hematology/Oncology, University of Greifswald, Greifswald, Germany
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van der Hiel B, Haanen JB, Stokkel MP, Peeper DS, Jimenez CR, Beijnen JH, van de Wiel BA, Boellaard R, van den Eertwegh AJ. Vemurafenib plus cobimetinib in unresectable stage IIIc or stage IV melanoma: response monitoring and resistance prediction with positron emission tomography and tumor characteristics (REPOSIT): study protocol of a phase II, open-label, multicenter study. BMC Cancer 2017; 17:649. [PMID: 28915798 PMCID: PMC5603097 DOI: 10.1186/s12885-017-3626-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/28/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In patients with BRAFV600 mutated unresectable stage IIIc or metastatic melanoma, molecular targeted therapy with combined BRAF/MEK-inhibitor vemurafenib plus cobimetinib has shown a significantly improved progression-free survival and overall survival compared to treatment with vemurafenib alone. Nevertheless, the majority of BRAFV600 mutation-positive melanoma patients will eventually develop resistance to treatment. Molecular imaging with 18F-Fluorodeoxyglucose (18F-FDG) PET has been used to monitor response to vemurafenib in some BRAFV600 mutated metastatic melanoma patients, showing a rapid decline of 18F-FDG uptake within 2 weeks following treatment. Furthermore, preliminary results suggest that metabolic alterations might predict the development of resistance to treatment. 18F-Fluoro-3'-deoxy-3'L-fluorothymidine (18F-FLT), a PET-tracer visualizing proliferation, might be more suitable to predict response or resistance to therapy than 18F-FDG. METHODS This phase II, open-label, multicenter study evaluates whether metabolic response to treatment with vemurafenib plus cobimetinib in the first 7 weeks as assessed by 18F-FDG/18F-FLT PET can predict progression-free survival and whether early changes in 18F-FDG/18F-FLT can be used for early detection of treatment response compared to standard response assessment with RECISTv1.1 ceCT at 7 weeks. Ninety patients with BRAFV600E/K mutated unresectable stage IIIc/IV melanoma will be included. Prior to and during treatment all patients will undergo 18F-FDG PET/CT and in 25 patients additional 18F-FLT PET/CT is performed. Histopathological tumor characterization is assessed in a subset of 40 patients to unravel mechanisms of resistance. Furthermore, in all patients, blood samples are taken for pharmacokinetic analysis of vemurafenib/cobimetinib. Outcomes are correlated with PET/CT-imaging and therapy response. DISCUSSION The results of this study will help in linking PET measured metabolic alterations induced by targeted therapy of BRAFV600 mutated melanoma to molecular changes within the tumor. We will be able to correlate both 18F-FDG and 18F-FLT PET to outcome and decide on the best modality to predict long-term remissions to combined BRAF/MEK-inhibitors. Results coming from this study may help in identifying responders from non-responders early after the initiation of therapy and reveal early development of resistance to vemurafenib/cobimetinib. Furthermore, we believe that the results can be fundamental for further optimizing individual patient treatment. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT02414750. Registered 10 April 2015, retrospectively registered.
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Affiliation(s)
- Bernies van der Hiel
- Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands
| | - John B.A.G. Haanen
- Department of Medical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Marcel P.M. Stokkel
- Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands
| | - Daniel S. Peeper
- Department of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Connie R. Jimenez
- Oncoproteomics Laboratory, Department of Medical Oncology, VU University Medical Center, Amsterdam, the Netherlands
| | - Jos H. Beijnen
- Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Bart A. van de Wiel
- Department of Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
| | | | - REPOSIT study group
- Department of Nuclear Medicine, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, PO Box 90203, 1006 BE Amsterdam, The Netherlands
- Department of Medical Oncology, Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Molecular Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Oncoproteomics Laboratory, Department of Medical Oncology, VU University Medical Center, Amsterdam, the Netherlands
- Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Pathology, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen, The Netherlands
- Department of Medical Oncology, VU University Medical Center, Amsterdam, the Netherlands
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89
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Verstijnen J, Damude S, Hoekstra HJ, Kruijff S, Ten Tije AJ, Louwman WJ, Bastiaannet E, Stuiver MM. Practice variation in Sentinel Lymph Node Biopsy for melanoma patients in different geographical regions in the Netherlands. Surg Oncol 2017; 26:431-437. [PMID: 29113662 DOI: 10.1016/j.suronc.2017.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Revised: 08/13/2017] [Accepted: 08/29/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Due to the lack of solid evidence for treatment benefit of Sentinel Lymph Node Biopsy (SLNB) as part of loco-regional surgical treatment of non-distant metastatic melanoma, there might be variation in surgical treatment strategies in the Netherlands. The objective of the current study was to assess differences in the performance of SLNB, in geographical regions in the Netherlands, of non-distant metastatic melanoma patients (American Joint Committee on Cancer (AJCC) stage I-III). MATERIALS AND METHODS A total of 28 550 melanoma patients, diagnosed between 2005 and 2013, were included in this population based retrospective study. Data were retrieved from the Netherlands Cancer Registry (NCR). Treatment strategies in 8 regions of the Netherlands were compared according to stage, excluding patients with distant metastasis (AJCC stage IV). RESULTS Throughout the Netherlands, there was substantial practice variation across the regions. The performance of SLNB in patients with clinically unsuspected lymph nodes and Breslow thickness >1.0 mm was significantly different between the regions. In a post hoc analysis, we observed that patients aged over 60 years, female patients and patients with a melanoma located in head and neck have lower odds to receive a SLNB. CONCLUSION There is considerable loco-regional practice variation which cannot completely be explained by the patient and tumor characteristics, in the surgical treatment of non-distant metastatic melanoma patients in the Netherlands. Although national guidelines recommend considering SLNB in all patients with a melanoma thicker than 1 mm, only half of the patients received a SLNB. Future research should assess whether this practice variation leads to unwanted variations in clinical outcome.
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Affiliation(s)
- J Verstijnen
- Department of Medical Oncology, Amphia Hospital, Molengracht 21, 4818 CK Breda, The Netherlands.
| | - S Damude
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - H J Hoekstra
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - S Kruijff
- Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | - A J Ten Tije
- Department of Medical Oncology, Amphia Hospital, Molengracht 21, 4818 CK Breda, The Netherlands; Department of Medical Oncology, VU Medical Center, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
| | - W J Louwman
- Netherlands Comprehensive Cancer Organisation, Godebaldkwartier 419, 3511 DT Utrecht, The Netherlands.
| | - E Bastiaannet
- Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands; Department of Gerontology & Geriatrics, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
| | - M M Stuiver
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
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90
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Dimitrova N, Znaor A, Agius D, Eser S, Sekerija M, Ryzhov A, Primic-Žakelj M, Coebergh JW. Breast cancer in South-Eastern European countries since 2000: Rising incidence and decreasing mortality at young and middle ages. Eur J Cancer 2017; 83:43-55. [PMID: 28711578 DOI: 10.1016/j.ejca.2017.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/01/2017] [Accepted: 06/11/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Marked variations exist in the incidence and mortality trends of major cancers in South-Eastern European (SEE) countries which have now been detailed by age for breast cancer (BC) to seek clues for improvement. METHODS We brought together and analysed data from 14 cancer registries (CRs), situated in SEE countries or directly adjacent. Age-standardised rate at world standard (ASRw) and truncated incidence and mortality rates during 2000-2010 by year, and for four age groups, were calculated. Average annual percentage change of rates was estimated using Joinpoint regression. RESULTS Annual incidence rates increased significantly in countries and age groups, by 2-4% (15-39 years), 2-5% (40-49), 1-4% (50-69) and 1-6% (at 70+). Mortality rates decreased significantly in all age-groups in most countries, but increased up to 5% annually above age 55 in Ukraine, Serbia, Moldova and Cyprus. The BC data quality was evaluated by internationally agreed indicators which appeared suboptimal for Moldova, Bosnia and Herzegovina and Romania. CONCLUSION The observed variations of incidence trends reflect the influence of risk factors, as well as levels of early detection activities (screening). While mortality rates were mostly decreasing, probably due to improved cancer care and introduction of more effective systemic treatment regimens, the worrying increasing mortality trends in the 55-plus age groups in some countries have to be addressed by health professionals and policymakers. In order to assess and monitor the effects of cancer control activities in the region, the CRs need substantial investments.
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Affiliation(s)
| | - Ariana Znaor
- Cancer Surveillance Unit, International Agency for Research on Cancer, Lyon, France
| | | | - Sultan Eser
- Hacettepe University, Institute of Public Health, Ankara and Cancer Registry of Izmir, Izmir, Turkey
| | - Mario Sekerija
- Croatian Institute of Public Health, Croatian National Cancer Registry, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Anton Ryzhov
- National Cancer Registry of Ukraine, National Institute of Cancer, Kyiv, Ukraine
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Merino Bonilla J, Torres Tabanera M, Ros Mendoza L. Breast cancer in the 21st century: From early detection to new therapies. RADIOLOGIA 2017. [DOI: 10.1016/j.rxeng.2017.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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92
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Wittekindt C, Wuerdemann N, Gattenlöhner S, Brobeil A, Wierzbicka M, Wagner S, Klußmann JP. The role of high-risk human papillomavirus infections in laryngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2017; 274:3837-3842. [PMID: 28861601 DOI: 10.1007/s00405-017-4718-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 08/12/2017] [Indexed: 12/30/2022]
Abstract
The contribution of human papillomavirus (HPV) to the development and clinical outcome of oropharyngeal cancers has been well documented. The association of HPV in laryngeal squamous cell carcinoma (LSCC) has been examined in several studies, but controversy exists regarding its role in carcinogenesis, the outcome of the patients and thus, clinical significance of HPV testing in LSCC. In this review, we give an update of known associations between HPV-positive testing and carcinogenesis in laryngeal cancer. In an early study, the HPV-DNA detection rate in LSCC was documented being 24.0% with significant regional differences. Non-HPV-16 types were more often detected in LSCC when compared to the oropharynx. Later, single institution case series revealed markedly fewer amounts (<10%) of HPV DNA in LSCC and the results suggested that high-risk HPV infections seem to be biologically irrelevant in most LSCC. The significance of p16INK4a (p16) expression as a surrogate marker towards high-risk HPV infection and the outcome in LSCC is doubtful, since only few p16-positive LSCC samples are HPV RNA positive and accordingly there was poor correlation of p16-test results towards the outcome in LSCC. Recent meta-analysis (n = 2739) and large case series (n = 1042) of LSCC revealed the true rate of HPV-driven LSCC being 8.6%, respectively, <5%. In the latter the rate of DNA-, DNA/RNA-, DNA/p16, and DNA/RNA/p16 positivity was 5.7, 3.1, 1.9, and 1.5%, respectively. These results indicate relevant amounts of insignificant/transient HPV infection in LSCC specimen. However, in the same study the rate of transforming HPV infections increased since 2000, and younger patients had higher amounts of HPV-driven LSCC. Serologic testing of E6/E7 antibodies additionally revealed odds ratios between 2 and 5 as a hint for a weak contribution of high-risk HPV infection and the development of LSCC. The contribution of HPV for the development of LSCC needs future investigations, to date, routine HPV testing of LSCC specimen is not warranted.
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Affiliation(s)
- Claus Wittekindt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany
| | - Nora Wuerdemann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany.
| | | | | | - Malgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, University of Medical Sciences, Poznan, Poland
| | - Steffen Wagner
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany
| | - Jens Peter Klußmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Klinikstrasse 33, 35392, Giessen, Germany
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Ye X, Mahmud S, Skrabek P, Lix L, Johnston JB. Long-term time trends in incidence, survival and mortality of lymphomas by subtype among adults in Manitoba, Canada: a population-based study using cancer registry data. BMJ Open 2017; 7:e015106. [PMID: 28716788 PMCID: PMC5734550 DOI: 10.1136/bmjopen-2016-015106] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To examine 30-year time trends in incidence, survival and mortality of lymphomas by subtype in Manitoba, Canada. METHODS Lymphoma cases diagnosed between 1984 and 2013 were classified according to the 2008 WHO classification system for lymphoid neoplasms. Death data (1984-2014) were obtained from the Manitoba Vital Statistics Agency. To examine time trends in incidence and mortality, we used joinpoint regression to estimate annual percentage change and average annual percentage change. Age-period-cohort modelling was conducted to measure the effects of age, period and cohort on incidence and mortality time trends. We estimated age-specific and standardised 5-year relative survival and used Poisson regression model to test time trends in relative survival. RESULTS Total Hodgkin lymphoma (HL) incidence in men and women was stable during the study period. Age-standardised total non-Hodgkin lymphoma (NHL) incidence increased by 4% annually until around 2000, and the trend varied by sex and NHL subtype. Total HL mortality continuously declined (by 2.5% annually in men and by 2.7% annually in women), while total NHL mortality increased (by 4.4% annually in men until 1998 and by 3.2% annually in women until 2001) and then declined (by 3.6% annually in men and by 2.5% annually in women). Age-standardised 5-year relative survival for HL improved from 72.6% in 1984-1993 to 85.8% in 2004-2013, and for NHL from 57.0% in 1984-1993 to 67.5% in 2004-2013. Survival improvement was also noted for NHL subtypes, although the extent varied, with the greatest improvement for follicular lymphoma (from 65.3% in 1984-1993 to 87.6% in 2004-2013). CONCLUSIONS Time trends were generally consistent with those reported in other jurisdictions in total HL and NHL incidence, but were unique in incidence for HL and for NHL subtypes chronic/small lymphocytic leukaemia/lymphoma, diffuse large B cell lymphoma and follicular lymphoma. Survival improvements and mortality reductions were seen for HL and NHL in both sexes.
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Affiliation(s)
- Xibiao Ye
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Salaheddin Mahmud
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Pamela Skrabek
- Department of Medical Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- George and Fay Yee Centre for Healthcare Innovation, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James B Johnston
- Department of Medical Oncology, CancerCare Manitoba, Winnipeg, Manitoba, Canada
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Merino Bonilla JA, Torres Tabanera M, Ros Mendoza LH. Breast cancer in the 21st century: from early detection to new therapies. RADIOLOGIA 2017; 59:368-379. [PMID: 28712528 DOI: 10.1016/j.rx.2017.06.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2017] [Revised: 06/08/2017] [Accepted: 06/09/2017] [Indexed: 12/28/2022]
Abstract
The analysis of the causes that have given rise to a change in tendency in the incidence and mortality rates of breast cancer in the last few decades generates important revelations regarding the role of breast screening, the regular application of adjuvant therapies and the change of risk factors. The benefits of early detection have been accompanied by certain adverse effects, even in terms of an excessive number of prophylactic mastectomies. Recently, several updates have been published on the recommendations in breast cancer screening at an international level. On the other hand, the advances in genomics have made it possible to establish a new molecular classification of breast cancer. Our aim is to present an updated overview of the epidemiological situation of breast cancer, as well as some relevant issues from the point of view of diagnosis, such as molecular classification and different strategies for both population-based and opportunistic screening.
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Affiliation(s)
- J A Merino Bonilla
- Servicio de Radiodiagnóstico, Hospital Santiago Apóstol, Miranda de Ebro (Burgos), España.
| | - M Torres Tabanera
- Servicio de Radiodiagnóstico, Hospital Universitario HM Puerta del Sur, Móstoles (Madrid), España
| | - L H Ros Mendoza
- Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España
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Mendizábal E, De León-Luis J, Gómez-Hidalgo NR, Joigneau L, Pintado P, Rincón P, Ortega V, Lizarraga S. Maternal and perinatal outcomes in pregnancy-associated melanoma. Report of two cases and a systematic literature review. Eur J Obstet Gynecol Reprod Biol 2017; 214:131-139. [DOI: 10.1016/j.ejogrb.2017.04.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Revised: 04/01/2017] [Accepted: 04/09/2017] [Indexed: 10/19/2022]
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García-León FJ, García-Estepa R, Romero-Tabares A, Gómez-Millán Borrachina J. Treatment of Advanced Laryngeal Cancer and Quality of Life. Systematic Review. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017. [DOI: 10.1016/j.otoeng.2017.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Osman MH, Farrag E, Selim M, Osman MS, Hasanine A, Selim A. Cardiac glycosides use and the risk and mortality of cancer; systematic review and meta-analysis of observational studies. PLoS One 2017; 12:e0178611. [PMID: 28591151 PMCID: PMC5462396 DOI: 10.1371/journal.pone.0178611] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 05/16/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cardiac glycosides (CGs) including digitalis, digoxin and digitoxin are used in the treatment of congestive heart failure and atrial fibrillation. Pre-clinical studies have investigated the anti-neoplastic properties of CGs since 1960s. Epidemiological studies concerning the association between CGs use and cancer risk yielded inconsistent results. We have performed a systematic review and meta-analysis to summarize the effects of CGs on cancer risk and mortality. METHODS PubMed, Scopus, Cochrane library, Medline and Web of Knowledge were searched for identifying relevant studies. Summary relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects model. RESULTS We included 14 case-control studies and 15 cohort studies published between 1976 and 2016 including 13 cancer types. Twenty-four studies reported the association between CGs and cancer risk and six reported the association between CGs and mortality of cancer patients. Using CGs was associated with a higher risk of breast cancer (RR = 1.330, 95% CI: 1.247-1.419). Subgroup analysis showed that using CGs increased the risk of ER+ve breast cancer but not ER-ve. Using CGs wasn't associated with prostate cancer risk (RR = 1.015, 95% CI: 0.868-1.87). However, CGs decreased the risk in long term users and showed a protective role in decreasing the risk of advanced stages. CGs use was associated with increased all-cause mortality (HR = 1.35, 95% CI: 1.248-1.46) but not cancer-specific mortality (HR = 1.075, 95% CI: 0.968-1.194). CONCLUSION The anti-tumor activity of CGs observed in pre-clinical studies requires high concentrations which can't be normally tolerated in humans. However, the estrogen-like activity of CGs could be responsible for increasing the risk of certain types of tumors.
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Affiliation(s)
| | - Eman Farrag
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mai Selim
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Arwa Hasanine
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Azza Selim
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Incidence and mortality of pancreatic cancer on a rapid rise in Taiwan, 1999-2012. Cancer Epidemiol 2017; 49:75-84. [PMID: 28600947 DOI: 10.1016/j.canep.2017.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/22/2017] [Accepted: 05/24/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Accumulating data has revealed a rapidly rising incidence of pancreatic cancer in Western countries, but convincing evidence from the East remains sparse. We aimed to quantify how the incidence and mortality rates of pancreatic malignancy changed over time in Taiwan, and to develop future projection for the next decade. METHODS This nationwide population-based study analyzed the Taiwan National Cancer Registry and the National Cause of Death Registry to calculate the annual incidence and mortality rates of pancreatic malignancy from 1999 to 2012 in this country. The secular trend of the incidence was also examined by data from the National Health Insurance Research Database. RESULTS A total of 21,986 incident cases of pancreatic cancer and 20,720 related deaths occurred during the study period. The age-standardized incidence rate increased from 3.7 per 100,000 in 1999 to 5.0 per 100,000 in 2012, with a significant rising trend (P<0.01). The increase was nationwide, consistently across subgroups stratified by age, gender, geographic region, and urbanization. Data from the National Health Insurance Research Database corroborated the rise of incident pancreatic cancer. Mortality also increased with time, with the age-standardized rate rising from 3.5 per 100,000 in 1999 to 4.1 per 100,000 in 2012 (P<0.01). In accordance with the incidence, the mortality trend was consistent in all subgroups. Both the incidence and mortality were projected to further increase by approximately 20% from 2012 to 2027. CONCLUSION The incidence and mortality of pancreatic cancer have been rapidly rising and presumably will continue to rise in Taiwan.
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Speed JM, Trinh QD, Choueiri TK, Sun M. Recurrence in Localized Renal Cell Carcinoma: a Systematic Review of Contemporary Data. Curr Urol Rep 2017; 18:15. [PMID: 28213859 DOI: 10.1007/s11934-017-0661-3] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Patients with localized renal cell carcinoma (RCC) are at risk of recurrence. The purpose of this review was to characterize the literature on recurrence rates and risk factors after diagnosis of localized RCC. RECENT FINDINGS Our search revealed that existing data examining the prevalence of recurrence rates predominantly originates from cohorts of patients diagnosed and treated in the 1980s to 1990s, and may therefore not be as useful for counseling for current patients today. Many nomograms including the Cindolo Recurrence Risk Formula, the University of California-Los Angeles (UCLA) Integrated Scoring System (UISS), the SSIGN score, the Kattan nomogram, and the Karakiewicz nomogram have shown value in identifying patients at higher risk for recurrence. Biomarkers and gene assays have shown promise in augmenting the predictive accuracy of some of the aforementioned predictive models, especially when multiple gene markers are used in combination. However, more work is needed in not only developing a model but also validating it in other settings prior to clinical use. Adjuvant therapy is a promising new treatment strategy for patients with high-risk disease. Importantly, too many surveillance strategies exist. This may stem from the lack of a consensus in the urological community in how to follow these patients, as well as the variable guideline recommendations. In conclusion, contemporary recurrence rates are needed. Recurrence risk prediction models should be developed based on a series of more contemporary patients, and externally validated prior to routine clinical practice. Surveillance strategies following treatment of localized RCC need to be identified and standardized. Finally, there is a trend toward personalizing surveillance regimens to more appropriately screen patients at higher risk of recurrence.
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Affiliation(s)
- Jacqueline M Speed
- Brigham and Women's Hospital, 45 Francis St, ASB II-3, Boston, MA, 02115, USA
| | - Quoc-Dien Trinh
- Brigham and Women's Hospital, 45 Francis St, ASB II-3, Boston, MA, 02115, USA
| | - Toni K Choueiri
- Dana-Farber Cancer Institute, Dana 1230, 44 Binney St., Boston, MA, 02215, USA
| | - Maxine Sun
- Brigham and Women's Hospital, 45 Francis St, ASB II-3, Boston, MA, 02115, USA.
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van der Kaaij RT, Snaebjornsson P, Voncken FE, van Dieren JM, Jansen EP, Sikorska K, Cats A, van Sandick JW. The prognostic and potentially predictive value of the Laurén classification in oesophageal adenocarcinoma. Eur J Cancer 2017; 76:27-35. [DOI: 10.1016/j.ejca.2017.01.031] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/11/2017] [Accepted: 01/29/2017] [Indexed: 12/25/2022]
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