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Wang H, Shi H, Wang Y, Wang N, Li Y, Yang Q, Li Y, Liu C, Zan Y, Feng S, Xie J. Potentially Hazardous Drug-Drug Interactions Associated With Oral Antineoplastic Agents Prescribed in Chinese Tertiary Care Teaching Hospital Settings: A Multicenter Cross-Sectional Study. Front Pharmacol 2022; 13:808848. [PMID: 35177990 PMCID: PMC8844504 DOI: 10.3389/fphar.2022.808848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Oral administration increases the risk of interactions, because most oral antineoplastic agents (OAAs) are taken on a daily basis. Interactions can increase exposure to antitumoral agents or cause treatment failure. Potential drug-drug interactions (DDIs) are commonly observed in patients with cancer, while the extent to which OAAs related hazardous DDIs remains unclear. Methods: We studied the contraindication patterns between oral antineoplastic agents and other medications among cancer patients in two tertiary care teaching hospitals in China. A total of 20 clinically significant hazardous DDI pairs that involved 30 OAAs were identified based on the predetermined criteria. Patient medications were checked for DDIs by using the US Food and Drug Administration approved labeling. Descriptive statistics and uni- and multivariate logistic regression analyses were carried out. Results: In this study, 13,917 patients were included and a total of 297 DDIs were identified. The results revealed that proton pump inhibitors (PPIs), dexamethasone and fluoroquinolones were the most often involved hazardous DDIs with OAAs. The most prevalent contraindication is the simultaneous use of certain molecular targeted agents and PPIs. In the result of the multivariate analysis, younger age (0-20 group), increasing number of drugs and patient treated with targeted therapy had a higher risk for DDIs. Conclusion: The prevalence of OAAs related hazardous DDIs appears to be low in the cancer patients. However, physicians and clinical pharmacologists should be aware of the potential hazardous DDIs when prescribing OAAs, especially certain pH-dependent molecular targeted agents and potential QTc prolonging drugs.
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Affiliation(s)
- Haitao Wang
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Haitao Shi
- Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Wang
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Na Wang
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Youjia Li
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qianting Yang
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ya Li
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Chenwei Liu
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Zan
- Department of Medical Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Siping Feng
- Department of Pharmacy, Yan'an People's Hospital, Yan'an, China
| | - Jiao Xie
- Department of Pharmacy, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Song Y, Liu J, Lei M, Wang Y, Fu Q, Wang B, Guo Y, Mi W, Tong L. An External-Validated Algorithm to Predict Postoperative Pneumonia Among Elderly Patients With Lung Cancer After Video-Assisted Thoracoscopic Surgery. Front Oncol 2022; 11:777564. [PMID: 34970491 PMCID: PMC8712479 DOI: 10.3389/fonc.2021.777564] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
The aim of the study was to develop an algorithm to predict postoperative pneumonia among elderly patients with lung cancer after video-assisted thoracoscopic surgery. We analyzed 3,009 patients from the Thoracic Perioperative Database for Geriatrics in our hospital and finally enrolled 1,585 elderly patients (age≧65 years) with lung cancer treated with video-assisted thoracoscopic surgery. The included patients were randomly divided into a training group (n = 793) and a validation group (n = 792). Patients in the training group were used to develop the algorithm after screening up to 30 potential risk factors, and patients in the validation group were used to internally validate the algorithm. External validation of the algorithm was achieved in the external validation dataset after enrolling 165 elderly patients with lung cancer treated with video-assisted thoracoscopic surgery from two hospitals in China. Of all included patients, 9.15% (145/1,585) of patients suffered from postoperative pneumonia in the Thoracic Perioperative Database for Geriatrics, and 10.30% (17/165) of patients had postoperative pneumonia in the external validation dataset. The algorithm consisted of seven variables, including sex, smoking, history of chronic obstructive pulmonary disease (COPD), surgery duration, leukocyte count, intraoperative injection of colloid, and intraoperative injection of hormone. The C-index from the receiver operating characteristic curve (AUROC) was 0.70 in the training group, 0.67 in the internal validation group, and 0.71 in the external validation dataset, and the corresponding calibration slopes were 0.88 (95% confident interval [CI]: 0.37–1.39), 0.90 (95% CI: 0.46–1.34), and 1.03 (95% CI: 0.24–1.83), respectively. The actual probabilities of postoperative pneumonia were 5.14% (53/1031) in the low-risk group, 15.07% (71/471) in the medium-risk group, and 25.30% (21/83) in the high-risk group (p < 0.001). The algorithm can be a useful prognostic tool to predict the risk of developing postoperative pneumonia among elderly patients with lung cancer after video-assisted thoracoscopic surgery.
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Affiliation(s)
- Yanping Song
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.,Department of Anesthesia, 922 Hospital of People's Liberation Army (PLA), Hengyang, China
| | - Jingjing Liu
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.,Department of Anesthesia, Beijing Corps Hospital of Chinese People's Armed Police Force, Beijing, China
| | - Mingxing Lei
- The National Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.,Department of Orthopedic Surgery, Hainan Hospital of Chinese People's Liberation Army (PLA) General Hospital, Sanya, China.,Chinese People's Liberation Army (PLA) Medical School, Beijing, China
| | - Yanfeng Wang
- Department of Anesthesia, Xiangya Hospital, Central South University, Changsha, China
| | - Qiang Fu
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Bailin Wang
- Department of Thoracic Surgery, Hainan Hospital of Chinese People's Liberation Army (PLA) General Hospital, Sanya, China
| | - Yongxin Guo
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Weidong Mi
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Li Tong
- Anesthesia and Operation Center, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
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Wang X, Zhang H, Zhang T, Pan L, Dong K, Yang M, Ma R, Li Y. Etiology of Community-Acquired Pneumonia Requiring Hospital Admission in Adults with and Without Cancers: A Single-Center Retrospective Study in China. Infect Drug Resist 2020; 13:1607-1617. [PMID: 32606812 PMCID: PMC7294101 DOI: 10.2147/idr.s251564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/16/2020] [Indexed: 01/07/2023] Open
Abstract
Background The etiology and distribution of community-acquired pneumonia (CAP) vary periodically and geographically. The clinical evaluation of CAP among patients with cancers remains unknown. Patients and Methods This retrospective hospital-based study on adult CAP was conducted in Tang Du Hospital, China, from September 2018 to August 2019. The demographic characteristics, clinical manifestations and laboratory data were extracted from medical records and compared between CAP patients with and without cancers. Univariable and multivariable logistic regression methods were used to explore risk factors associated with CAP patients with and without cancers. Results Data from 149 CAP patients with cancers and 268 CAP patients without cancers were analyzed. Patients without cancers were more likely to show fever, cough and yellow sputum, higher level of neutrophil count than the cancer patients. Klebsiella pneumoniae (K. pneumoniae 14.77% vs 9.33%, p = 0.093) and Streptococcus pneumoniae (S. pneumoniae 16.11% vs 11.57%, p = 0.189) were among the most commonly encountered pathogens in both the groups. Pseudomonas aeruginosa (P. pneumoniae 26.50% vs 11.41%, p < 0.001), Mycoplasma pneumoniae (M. pneumoniae 8.21% vs 1.34%, p = 0.003), and filamentous fungi (10.82% vs 4.7%, p = 0.033) were predominant in CAP patients without cancers. Haemophilus influenzae (H. influenzae 22.15% vs 14.18%, p = 0.038) and methicillin-resistant Staphylococci (MRS 23.49 vs 15.68, p = 0.049) were more prevalent for CAP cancer patients. Certain pathogens were increasing in a cold season. In patients without cancers, MRS, H. influenzae and P. aeruginosa were associated with central nervous system (CNS) disease, connective tissue disease, bronchiectasis, respectively. In addition, healthy adults were likely to be infected with M. pneumoniae showing fever. Conclusion CAP patients with cancers had atypical clinical manifestations and showed no distinct increase in inflammatory markers. The predominant pathogens differed as well as similar between the CAP patients with and without cancers. Certain pathogens follow a seasonal pattern. CNS disease, connective tissue disease and bronchiectasis were associated with the predominant pathogens in patients without cancers.
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Affiliation(s)
- Xinxin Wang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Haihua Zhang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Tao Zhang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Lei Pan
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ke Dong
- Department of Laboratory, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ming Yang
- Department of Laboratory, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Ruina Ma
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
| | - Yujuan Li
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Air Force Medical University, Xi'an, People's Republic of China
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Shinohara S, Nakagawa M. ASO Author Reflections: The Significance of Limited Surgery Among Patients with Sarcopenia. Ann Surg Oncol 2020; 27:2436-2437. [PMID: 32112211 DOI: 10.1245/s10434-020-08287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Indexed: 11/18/2022]
Affiliation(s)
- Shuichi Shinohara
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan.
| | - Makoto Nakagawa
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
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Shinohara S, Otsuki R, Kobayashi K, Sugaya M, Matsuo M, Nakagawa M. Impact of Sarcopenia on Surgical Outcomes in Non-small Cell Lung Cancer. Ann Surg Oncol 2020; 27:2427-2435. [PMID: 31970570 DOI: 10.1245/s10434-020-08224-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Sarcopenia influences overall survival (OS) and tumor progression in non-small cell lung cancer (NSCLC) patients. However, the impact of postoperative complications and the outcome of limited surgery have not been highlighted. Therefore, the aim of this study is to elucidate the prognostic impact of sarcopenia on surgical outcomes. PATIENTS AND METHODS This study included NSCLC patients who had undergone lung cancer resection between 2007 and 2017. Sarcopenia was confirmed based on computed tomography of the cross-sectional area of the psoas muscle at the third lumbar vertebra level. We used propensity score-matched analysis to elucidate the impact of sarcopenia on postoperative complications and limited surgery. RESULTS A total of 391 patients were enrolled, including 198 sarcopenic patients. Multivariate analysis showed that sarcopenia was an independent unfavorable prognostic factor associated with OS and recurrence-free survival [hazard ratio (HR), 3.33, P < 0.001; HR, 2.76, P < 0.001, respectively]. Regarding the incidence of postoperative complications, there was no difference between sarcopenic and nonsarcopenic patients (69/198 versus 55/193, P = 0.19). After propensity score matching, among patients without sarcopenia, the 5-year OS was lower in those with limited surgery than in those with standard surgery (70.7% vs. 96.4%, P = 0.011). In contrast, among sarcopenic patients, there was no difference in the 5-year OS between patients with limited surgery and those with standard surgery (53.2% vs. 60.7%, P = 0.66). CONCLUSIONS Sarcopenia is a prognostic predictor for poor OS and may contribute to the selection of limited surgery for sarcopenic patients. Preoperative assessment of sarcopenia may provide clinically important information.
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Affiliation(s)
- Shuichi Shinohara
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Japan.
| | - Ryo Otsuki
- Department of Pulmonary and Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Japan
| | | | - Masakazu Sugaya
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Japan
| | - Masaki Matsuo
- Department of Pulmonary and Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Japan
| | - Makoto Nakagawa
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Japan
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Shinohara S, Kobayashi K, Nakagawa M. ASO Author Reflections: The Possibility of a New Prognostic Biomarker of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer. Ann Surg Oncol 2019; 27:490-491. [PMID: 31659635 DOI: 10.1245/s10434-019-08004-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Shuichi Shinohara
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan.
| | - Kenichi Kobayashi
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Makoto Nakagawa
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
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Shinohara S, Otsuki R, Kobayashi K, Matsuo M, Harada K, Sugaya M, Nakagawa M. The Prognostic Impact of Pericardial Fat Volumes in Resected Non-small Cell Lung Cancer. Ann Surg Oncol 2019; 27:481-489. [DOI: 10.1245/s10434-019-07703-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Indexed: 12/25/2022]
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Shinohara S, Kobayashi K, Kasahara C, Onitsuka T, Matsuo M, Nakagawa M, Sugaya M. Long-term impact of complications after lung resections in non-small cell lung cancer. J Thorac Dis 2019; 11:2024-2033. [PMID: 31285895 DOI: 10.21037/jtd.2019.04.91] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Postoperative complications after lung resection are common and fatal. The immediate effects of postoperative complications are related to poor prognosis; however, the long-term effects have not been assessed. Thus, this investigation aimed to clarify the long-term effects of postoperative complications among patients with resected non-small cell lung cancer (NSCLC). Methods This retrospective cohort study included 345 patients with resected NSCLC from a single institution. We used the Clavien-Dindo classification to classify postoperative complications. Postoperative complications were defined as complications with a Clavien-Dindo grade of ≥2. The Kaplan-Meier method was used to evaluate survival. Prognostic factors were analyzed using a Cox proportional hazard model. Results There were 110 patients with postoperative complications (31.9%). The 5-year overall survival (OS), recurrence-free survival (RFS), and cause-specific survival (CSS) rates were significantly lower in patients with complications than in those without complications [OS: 66.1%, 95% confidence interval (CI): 55.4-74.8% vs. 78.0%, 95% CI: 71.8-83.1%, P=0.001; RFS: 48.8%, 95% CI: 38.1-58.7% vs. 70.8%, 95% CI: 64.2-76.4%, P<0.001; CSS: 82.7%, 95% CI: 72.8-89.3% vs. 88.2%, 95% CI: 82.8-92.0%, P=0.005]. The 5-year OS was lower in the pulmonary complication group than in the other complication group (58.1%, 95% CI: 40.0-72.4% vs. 70.5%, 95% CI: 56.6-80.6%, P=0.033). Postoperative complications were indicated as a poor prognostic factor for OS (hazard ratio, 1.67; 95% CI: 1.11-2.53; P=0.002). Conclusions Postoperative complications were associated with unfavorable OS because of the worse prognosis of postoperative pulmonary complications.
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Affiliation(s)
- Shuichi Shinohara
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Kenichi Kobayashi
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Chinatsu Kasahara
- Department of Pulmonary and Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Takamitsu Onitsuka
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Masaki Matsuo
- Department of Pulmonary and Respiratory Medicine, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Makoto Nakagawa
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
| | - Masakazu Sugaya
- Department of Thoracic Surgery, Chubu Rosai Hospital, Nagoya, Aichi, Japan
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