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Bisceglia I, Canale ML, Silvestris N, Gallucci G, Camerini A, Inno A, Camilli M, Turazza FM, Russo G, Paccone A, Mistrulli R, De Luca L, Di Fusco SA, Tarantini L, Lucà F, Oliva S, Moreo A, Maurea N, Quagliariello V, Ricciardi GR, Lestuzzi C, Fiscella D, Parrini I, Racanelli V, Russo A, Incorvaia L, Calabrò F, Curigliano G, Cinieri S, Gulizia MM, Gabrielli D, Oliva F, Colivicchi F. Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals. Front Cardiovasc Med 2023; 10:1223660. [PMID: 37786510 PMCID: PMC10541962 DOI: 10.3389/fcvm.2023.1223660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 08/24/2023] [Indexed: 10/04/2023] Open
Abstract
In cancer, a patient is considered a survivor from the time of initial diagnosis until the end of life. With improvements in early diagnosis and treatment, the number of cancer survivors (CS) has grown considerably and includes: (1) Patients cured and free from cancer who may be at risk of late-onset cancer therapy-related cardiovascular toxicity (CTR-CVT); (2) Patients with long-term control of not-curable cancers in whom CTR-CVT may need to be addressed. This paper highlights the importance of the cancer care continuum, of a patient-centered approach and of a prevention-oriented policy. The ultimate goal is a personalized care of CS, achievable only through a multidisciplinary-guided survivorship care plan, one that replaces the fragmented management of current healthcare systems. Collaboration between oncologists and cardiologists is the pillar of a framework in which primary care providers and other specialists must be engaged and in which familial, social and environmental factors are also taken into account.
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Affiliation(s)
- Irma Bisceglia
- Integrated Cardiology Services, Cardio-Thoracic-Vascular Department, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy
| | - Maria Laura Canale
- Division of Cardiology, Ospedale Versilia, Azienda Usl Toscana Nord Ovest, Lido di Camaiore, Italy
| | - Nicola Silvestris
- Unit of Medical Oncology, Department of Human Pathology in Adulthood and Childhood Gaetano Barresi, University of Messina, Messina, Italy
| | - Giuseppina Gallucci
- Cardio-oncology Unit, Department of OncoHaematology, IRCCS Referral Cancer Center of Basilicata, Rionero in Vulture (PZ), Italy
| | - Andrea Camerini
- Department of Medical Oncology, Ospedale Versilia, Azienda Usl Toscana Nord Ovest, Lido di Camaiore, Italy
| | - Alessandro Inno
- Department of Oncology, Sacro Cuore Don Calabria Hospital (IRCCS), Negrar, Italy
| | - Massimiliano Camilli
- Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart and Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Fabio Maria Turazza
- Cardiology Department, National Cancer Institute Foundation (IRCCS), Milan, Italy
| | - Giulia Russo
- SC Patologie Cardiovascolari, Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Trieste, Italy
| | - Andrea Paccone
- Department of Cardiology, G. Pascale National Cancer Institute Foundation (IRCCS), Naples, Italy
| | - Raffaella Mistrulli
- Cardiology Unit, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Lazio, Italy
| | - Leonardo De Luca
- Division of Cardiology, San Camillo-Forlanini Hospital, Rome, Italy
| | | | - Luigi Tarantini
- Divisione di Cardiologia, Arcispedale S. Maria Nuova, Azienda Unità Sanitaria Locale-IRCCS di Reggio-Emilia, Reggio Emilia, Italy
| | - Fabiana Lucà
- Cardiologia Interventistica, Utic, Grande Ospedale Metropolitano, Azienda Ospedaliera Bianchi Melacrino Morelli, Reggio Calabria, Italy
| | - Stefano Oliva
- UOSD Cardiologia di Interesse Oncologico, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy
| | - Antonella Moreo
- Cardio Center De Gasperis, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Nicola Maurea
- Department of Cardiology, G. Pascale National Cancer Institute Foundation (IRCCS), Naples, Italy
| | - Vincenzo Quagliariello
- Department of Cardiology, G. Pascale National Cancer Institute Foundation (IRCCS), Naples, Italy
| | | | | | - Damiana Fiscella
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy
| | - Iris Parrini
- Department of Cardiology, Hospital Mauritian Turin, Turin, Italy
| | - Vito Racanelli
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Russo
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, Palermo University Hospital, Palermo, Italy
| | - Lorena Incorvaia
- Department of Surgical, Oncological and Oral Sciences, Section of Medical Oncology, Palermo University Hospital, Palermo, Italy
| | - Fabio Calabrò
- Department of Oncology and Specialized Medicine, San Camillo-Forlanini Hospital, Rome, Italy
| | - Giuseppe Curigliano
- Department of Oncology and Hemato-Oncology, University of Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - Saverio Cinieri
- Medical Oncology Division and Breast Unit, Senatore Antonio Perrino Hospital, ASL Brindisi, Brindisi, Italy
| | - Michele Massimo Gulizia
- U.O.C. Cardiologia, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione “Garibaldi”, Catania, Italy
| | - Domenico Gabrielli
- Division of Cardiology, San Camillo-Forlanini Hospital, Rome, Italy
- Fondazione per il Tuo cuore- Heart Care Foundation, Firenze, Italy
| | - Fabrizio Oliva
- Cardiologia 1- Emodinamica, Dipartimento Cardiotoracovascolare “A. De Gasperis”, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Furio Colivicchi
- Clinical and Rehabilitation Cardiology Unit, San Filippo Neri Hospital, ASL Roma 1, Rome, Italy
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Rahouma M, Khairallah S, Dabsha A, Baudo M, El-Sayed Ahmed MM, Gambardella I, Lau C, Esmail YM, Mohamed A, Girardi L, Gaudino M, Lorusso R, Mick SL. Geographic variation in malignant cardiac tumors and their outcomes: SEER database analysis. Front Oncol 2023; 13:1071770. [PMID: 36761976 PMCID: PMC9902931 DOI: 10.3389/fonc.2023.1071770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Primary malignant cardiac tumors (PMCTs) are rare. Geographical distribution has been demonstrated to affect cancer outcomes, making the reduction of geographical inequalities a major priority for cancer control agencies. Geographic survival disparities have not been reported previously for PMCT and the aim of this study is to compare the prevalence and the long-term survival rate with respect to the geographic location of PMCTs using the Surveillance, Epidemiology, and End Results (SEER) research plus data 17 registries between 2000 and 2019. Methods The SEER database was queried to identify geographic variation among PMCTs. We classified the included states into 4 geographical regions (Midwest, Northeast, South and West regions) based on the U.S. Census Bureau-designated regions and divisions. Different demographic and clinical variables were analyzed and compared between the four groups. Kaplan Meier curves and Cox regression were used for survival assessment. Results A total of 563 patients were included in our analysis. The median age was 53 years (inter-quartile range (IQR): 38 - 68 years) and included 26, 90, 101, and 346 patients from the Midwest, Northeast, South, and West regions respectively. Sarcoma represented 65.6% of the cases, followed by hematological tumors (26.2%), while mesothelioma accounted for 2.1%. Treatment analysis showed no significant differences between different regions. Median overall survival was 11, 21, 13, and 11 months for Midwest, Northeast, South and West regions respectively and 5-year overall survival was 22.2%, 25.4%, 14.9%, and 17.6% respectively. On multivariate Cox regression, significant independent predictors of late overall mortality among the entire cohort included age (Hazard Ratio [HR] 1.028), year of diagnosis (HR 0.967), sarcoma (HR 3.36), surgery (HR 0.63) and chemotherapy (HR 0.56). Conclusion Primary malignant cardiac tumors are rare and associated with poor prognosis. Sarcoma is the most common pathological type. Younger age, recent era diagnosis, surgical resection, and chemotherapy were the independent predictors of better survival. While univariate analysis revealed that patients in the South areas had a worse survival trend compared to other areas, geographic disparity in survival was nullified in multivariate analysis.
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Affiliation(s)
- Mohamed Rahouma
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt,*Correspondence: Mohamed Rahouma, ;
| | - Sherif Khairallah
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Anas Dabsha
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Massimo Baudo
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States,Cardiac Surgery Department, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Magdy M. El-Sayed Ahmed
- Cardiothoracic Surgery Department, Mayo Clinic, Jacksonville, FL, United States,Department of Surgery, Zagazig University Faculty of Medicine, Zagazig, Egypt
| | | | - Christopher Lau
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Yomna M. Esmail
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Abdelrahman Mohamed
- Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
| | - Leonard Girardi
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Mario Gaudino
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
| | - Roberto Lorusso
- Department of Cardio-Thoracic Surgery, Maastricht University Medical Centre, Maastricht University, Maastricht, Netherlands,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
| | - Stephanie L. Mick
- Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York, NY, United States
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Guan T, Wei Q, Tang Y, Zhao H, Lu Z, Feng W, Teng Y, Luo Z, Chi K, Ou C, Chen M. Metastatic patterns and prognosis of patients with primary malignant cardiac tumor. Front Cardiovasc Med 2022; 9:1009765. [PMID: 36545022 PMCID: PMC9760733 DOI: 10.3389/fcvm.2022.1009765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/16/2022] [Indexed: 12/07/2022] Open
Abstract
Background Distant metastases are independent negative prognostic factors for patients with primary malignant cardiac tumors (PMCT). This study aims to further investigate metastatic patterns and their prognostic effects in patients with PMCT. Materials and methods This multicenter retrospective study included 218 patients with PMCT diagnosed between 2010 and 2017 from Surveillance, Epidemiology, and End Results (SEER) database. Logistic regression was utilized to identify metastatic risk factors. A Chi-square test was performed to assess the metastatic rate. Kaplan-Meier methods and Cox regression analysis were used to analyze the prognostic effects of metastatic patterns. Results Sarcoma (p = 0.002) and tumor size¿4 cm (p = 0.006) were independent risk factors of distant metastases in patients with PMCT. Single lung metastasis (about 34%) was the most common of all metastatic patterns, and lung metastases occurred more frequently (17.9%) than bone, liver, and brain. Brain metastases had worst overall survival (OS) and cancer-specific survival (CSS) among other metastases, like lung, bone, liver, and brain (OS: HR = 3.20, 95% CI: 1.02-10.00, p = 0.046; CSS: HR = 3.53, 95% CI: 1.09-11.47, p = 0.036). Conclusion Patients with PMCT who had sarcoma or a tumor larger than 4 cm had a higher risk of distant metastases. Lung was the most common metastatic site, and brain metastases had worst survival among others, such as lung, bone, liver, and brain. The results of this study provide insight for early detection, diagnosis, and treatment of distant metastases associated with PMCT.
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Affiliation(s)
- Tianwang Guan
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Qingqian Wei
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Yongshi Tang
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Hongjun Zhao
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Zhenxing Lu
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Weijing Feng
- State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Lab of Shock and Microcirculation, Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yintong Teng
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China
| | - Zehao Luo
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Kaiyi Chi
- Department of Clinical Medicine, Clinical Medical School, Guangzhou Medical University, Guangzhou, China
| | - Caiwen Ou
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Dongguan Hospital of Southern Medical University, Southern Medical University, Dongguan, China,*Correspondence: Caiwen Ou,
| | - Minsheng Chen
- Department of Cardiology, Laboratory of Heart Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China,Guangdong Provincial Biomedical Engineering Technology Research Center for Cardiovascular Disease, Sino-Japanese Cooperation Platform for Translational Research in Heart Failure, Guangzhou, China,Minsheng Chen,
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Aladuwaka S, Alagan R, Singh R, Mishra M. Health Burdens and SES in Alabama: Using Geographic Information System to Examine Prostate Cancer Health Disparity. Cancers (Basel) 2022; 14:cancers14194824. [PMID: 36230747 PMCID: PMC9563407 DOI: 10.3390/cancers14194824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The focus of the research was to examine the relationship between Socioeconomic status and prostate cancer in Alabama’s Black Belt region. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. The research aims to identify probable reasons, raise awareness, and propose cancer prevention policies. The Geographic Information System, a robust technology, has been adopted to understand Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. The analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The poverty rate is higher in Black Belt counties. The data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. Also, incidence and mortality disparities strongly relate to socioeconomic status, and the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty is the root course of inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer. The study proposes effective health policy intervention to prevent and reduce prostate cases and mortality among underserved communities in Alabama. Abstract Socioeconomic disparities influence the risk of many diseases, including cancer. The cancer rate in Alabama is high, and the state has one of the highest rates of prostate cancer in the USA. Alabama’s counties are embedded with socioeconomic disparities, politics, race, ethnicity, and oppression, among which social equity and socioeconomic status (SES) been closely associated with prostate cancer. The Geographic Information System (GIS) has become a valuable technology in understanding public health in many applications, including cancer. This study integrates Alabama’s county-level prostate cancer incidence and mortality and its association with socioeconomic and health disparities. We conducted robust data mining from several data sources such as the Alabama State Cancer Profile data, Alabama Department of Health, American Cancer Society, Center for Disease Control, and National Cancer Institute. The research method is the Geographic Information System (GIS), and we employed prostate cancer data within GIS to understand Alabama’s prostate cancer prevalence regarding SES. The GIS analysis indicated an apparent socioeconomic disparity between the Black Belt and Non-Black Belt counties of Alabama. The Black Belt counties’ poverty rate is also remarkably higher than non-Black Belt counties. In addition, we analyzed the median household income by race. Our analysis demonstrates that the Asian background population in the state earned the highest median income compared to non-Hispanic whites and the African American population. Furthermore, the data revealed that the preexisting condition of diabetes and obesity is closely associated with prostate cancer. The GIS analysis suggests that prostate cancer incidence and mortality disparities are strongly related to SES. In addition, the preexisting condition of obesity and diabetes adds to prostate cancer incidences. Poverty also reflects inequalities in education, income, and healthcare facilities, particularly among African Americans, contributing to Alabama’s health burden of prostate cancer.
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Affiliation(s)
- Seela Aladuwaka
- Cancer Biology Research and Training, Alabama State University, Montgomery, AL 36104, USA
- Department of Advancement Studies, Alabama State University, Montgomery, AL 36104, USA
| | - Ram Alagan
- Cancer Biology Research and Training, Alabama State University, Montgomery, AL 36104, USA
- Department of Advancement Studies, Alabama State University, Montgomery, AL 36104, USA
| | - Rajesh Singh
- Department of Microbiology, Biochemistry & Immunology and Cancer Health Equity Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Manoj Mishra
- Cancer Biology Research and Training, Alabama State University, Montgomery, AL 36104, USA
- Department of Biological Sciences, Alabama State University, Montgomery, AL 36104, USA
- Correspondence:
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