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Eisenberg M, Deboever N, Hofstetter WL, Mehran RJ, Rice DC, Rajaram R, Swisher SG, Vaporciyan AA, Walsh GL, Antonoff MB. Pulmonary Surgical Margins for Metastatic Osteosarcoma: Is Negative Margin Enough? Ann Thorac Surg 2024:S0003-4975(24)00440-5. [PMID: 38839027 DOI: 10.1016/j.athoracsur.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND In advanced osteosarcoma, the lung is the most frequent site of distant metastasis, with metastasectomy often used for local disease control. The influence of pulmonary resection margin length on outcomes for osteosarcoma has not been well explored. This study sought to evaluate the impact of margin length relative to tumor size on local recurrence and survival in lung-limited metastatic osteosarcoma. METHODS Patients with metastatic osteosarcoma who underwent lung resection between 2000 and 2020 were identified from a single institution. Clinicopathologic variables were collected. The margin length-to-tumor size ratio (MTR) was calculated per nodule and classified relative to an MTR of 0.5. The primary outcome was development of local recurrence per nodule. Multivariate logistic regression was used to investigate covariates. RESULTS A total of 142 patients with 689 nodules met inclusion criteria, with mean age of 35.6 years (interquartile range [IQR], 20.9-46.6 years). Patients were predominantly male (n = 87; 61.3%) and White (n = 106; 72.5%). Most nodules (n = 644; 93.5%) were resected through thoracotomy. The mean tumor size was 0.8 cm (IQR, 0.5-1.70 cm), with an average margin length of 0.3 cm (IQR, 0.1-0.7 cm). Among all nodules, 299 (43.4%) had an MTR >0.5. Systemic therapy was received by 94 patients (66.2%) preoperatively and by 100 patients (70.4%) postoperatively. Importantly, the study found that an MTR >0.5 conferred a protective effect against disease recurrence (hazard ratio, 0.67; 95% CI, 0.52-0.87; P = .003). CONCLUSIONS In resected pulmonary metastatic osteosarcoma, a margin length greater than one-half the size of the pulmonary nodule is associated with a lower incidence of local disease recurrence. This finding has implications for the subsequent need for additional therapy and disease-free status, thus meriting attentive intraoperative consideration.
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Affiliation(s)
- Michael Eisenberg
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Nathaniel Deboever
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Wayne L Hofstetter
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Reza J Mehran
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - David C Rice
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ravi Rajaram
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Stephen G Swisher
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Ara A Vaporciyan
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Garrett L Walsh
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Mara B Antonoff
- Department of Thoracic and Cardiovascular Surgery, University of Texas MD Anderson Cancer Center, Houston, Texas.
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Manne S, Nekhlyudov L. Introduction: The history of cancer survivorship programs in the USA: progress, challenges, and opportunities. J Cancer Surviv 2024; 18:1-4. [PMID: 38294602 DOI: 10.1007/s11764-023-01528-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Affiliation(s)
- Sharon Manne
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers University, 120 Albany Street, 8th Floor, New Brunswick, NJ, USA.
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Chen C, Sun X, Liu Z, Jiao M, Wei W, Hu Y. The relationship between resilience and quality of life in advanced cancer survivors: multiple mediating effects of social support and spirituality. Front Public Health 2023; 11:1207097. [PMID: 37701908 PMCID: PMC10493315 DOI: 10.3389/fpubh.2023.1207097] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Background While previous studies have revealed a positive association between resilience and quality of life in advanced cancer survivors, the mechanisms of the relationship is still unclear. This study aimed to explore the relationships between resilience, social support, spirituality, and quality of life and determine the multiple mediation effects of social support and spirituality on the relationship between resilience and quality of life. Methods With 286 advanced cancer survivors, a cross-sectional, correlational survey was adopted using convenience sampling. Resilience, social support, spirituality, and quality of life were evaluated by self-report questionnaires. The PROCESS macro for SPSS was used to test the multiple mediation model. Results The scores for resilience, social support, spirituality and quality of life were positively correlated with one another. Resilience was found to be directly impact quality of life. Meanwhile, the relationship between resilience and quality of life was mediated by social support (effect = 0.067, 95% CI [0.019, 0.120]) and by spirituality (effect = 0.221, 95% CI [0.134, 0.332]), respectively, and by these two serially (effect = 0.036, 95% CI [0.015, 0.067]). Conclusion Social support and spirituality played multiple mediating roles in the relationship between resilience and quality of life. Interventions aimed at increasing resilience, and then boosting social support and spirituality may be beneficial for promoting quality of life of advanced cancer survivors.
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Affiliation(s)
- Cancan Chen
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China
| | - Xiaofei Sun
- Department of Publicity, Zhengzhou Vocational University of Information and Technology, Zhengzhou, Henan, China
| | - Zhenya Liu
- Henan Provincial Key Medicine Laboratory of Nursing, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China
| | - Miaorui Jiao
- Department of Traditional Chinese Medicine, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Wanhong Wei
- School of Nursing and Rehabilitation, Zhengzhou University, Zhengzhou, Henan, China
| | - Yanli Hu
- School of Nursing, Guangzhou Medical University, Guangzhou, China
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Manne S, Devine K, Hudson S, Kashy D, O’Malley D, Paddock LE, Bandera EV, Llanos AAM, Fong A, Singh N, Frederick S, Evens AM. Factors associated with health-related quality of life in a cohort of cancer survivors in New Jersey. BMC Cancer 2023; 23:664. [PMID: 37452275 PMCID: PMC10349446 DOI: 10.1186/s12885-023-11098-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Although there is extensive literature on correlates of health-related quality of life (HRQoL) among cancer survivors, there has been less attention paid to the role of socioeconomic disadvantage and survivorship care transition experiences in HRQoL. There are few large cohort studies that include a comprehensive set of correlates to obtain a full picture of what is associated with survivors' HRQ0L. This cohort study of recent cancer survivors in New Jersey aimed to explore the association between social determinants of health, health history, health behaviors, survivorship care experiences, and psychosocial factors in HRQoL. METHODS Eligible survivors were residents of New Jersey diagnosed with genitourinary, female breast, gynecologic, colorectal, lung, melanoma, or thyroid cancers. Participants completed measures of social determinants, health behaviors, survivorship care experiences, psychosocial factors, and HRQoL. Separate multiple regression models predicting HRQoL were conducted for each of the five domains (social determinants, health history, health behaviors, survivorship care experiences, psychosocial factors). Variables attaining statistical significance were included in a hierarchical multiple regression arranged by the five domains. RESULTS 864 cancer survivors completed the survey. Lower global HRQoL was associated with being unemployed, more comorbidities, a less healthy diet, lower preparedness for survivorship, more unmet support needs, and higher fear about cancer recurrence. Two psychosocial factors, unmet support needs and fear of recurrence, played the most important role in HRQoL, accounting for more than 20% of the variance. Both unmet support needs and fear of recurrence were significant correlates of physical, functional, and emotional HRQoL domains. CONCLUSIONS Interventions seeking to improve cancer survivors' HRQoL may benefit from improving coordinated management of comorbid medical problems, fostering a healthier diet, addressing unmet support needs, and reducing survivors' fears about cancer recurrence.
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Affiliation(s)
- Sharon Manne
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
| | - Katie Devine
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
| | - Shawna Hudson
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Deborah Kashy
- Department of Psychology, College of Social Science, Michigan State University, East Lansing, MI USA
| | - Denalee O’Malley
- Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Lisa E. Paddock
- Cancer Surveillance Research Program, Cancer Epidemiology Services, Department of Health, Rutgers Cancer Institute of New Jersey, New Jersey State Cancer Registry, New Brunswick, Trenton, New Jersey USA
| | | | | | - Angela Fong
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
| | - Neetu Singh
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
| | - Sara Frederick
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
| | - Andrew M. Evens
- Rutgers Cancer Institute of New Jersey, New Brunswick, NJ USA
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Andreu Y, Picazo C, Murgui S, Soto-Rubio A, García-Conde A, Romero R. Exploring the independent association of employment status to cancer survivors' health-related quality of life. Health Qual Life Outcomes 2023; 21:44. [PMID: 37170308 PMCID: PMC10176702 DOI: 10.1186/s12955-023-02124-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 04/29/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Having a job has been associated with better Health-Related Quality of Life (HRQOL) in cancer survivors. However, the sociodemographic and disease-related profiles characterizing the survivors being employed and those having better HRQOL largely overlap. The present study aims to discern the degree to which employment status is independently associated with cancer survivors' HRQOL or if it mainly reflects the impact of other sociodemographic and cancer-related variables. METHODS Cross-sectional study on a heterogeneous sample of 772 working-age survivors of adult-onset cancer. An instrument specifically designed to assess HRQOL in cancer survivors and Multivariate Variance Analysis (MANOVA) were used. RESULTS Survival phase, cancer type, and employment status showed the main effects on cancer survivors' HRQOL. In particular, being employed (vs unemployed) had the greatest positive association with HRQOL, affecting ten of the twelve HRQOL domains considered. Also, interaction effects highlighted the role of age (younger) and marital status (single) as risk factors for a greater negative impact of variables affecting the survivor's HRQOL. CONCLUSIONS The application of a multivariate methodology sheds new light on two relevant issues for the cancer survivor's HRQOL: (i) the existence of differences between diagnostic groups that are not attributed to other variables such as sex, and (ii) the important and independent role that employment status plays. Comprehensive cancer survivorship care should focus more on high-risk groups and include having a job as an essential aspect to consider and prompt. The fact that the employment status is susceptible to change represents a valuable opportunity to care for the wellbeing of this population.
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Affiliation(s)
- Y Andreu
- Personality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - C Picazo
- Psychology and Sociology Department, University of Zaragoza, Zaragoza, Spain.
| | - S Murgui
- Social Psychology Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A Soto-Rubio
- Development and Education Psychology Department, Faculty of Psychology and Speech Therapy, University of Valencia, Valencia, Spain
| | - A García-Conde
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
| | - R Romero
- Psychology Unit - Valencian Institute of Oncology Foundation, Valencia, Spain
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Xu J, Zhou Y, Li J, Tang J, Hu X, Chen Y, Guo Y. Cancer patients' return-to-work adaptation experience and coping resources: a grounded theory study. BMC Nurs 2023; 22:66. [PMID: 36899341 PMCID: PMC9999662 DOI: 10.1186/s12912-023-01219-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVE To explore the return-to-work adaptation experience and coping resources used by cancer patients. METHODS With the help of the Nantong Cancer Friends Association, from June 2019 to January 2020, this study recruited 30 cancer patients who had returned to work using purpose sampling, snowball sampling and theoretical sampling. The researchers analyzed the data using initial-, focusing-, and theoretical coding. RESULTS The adaptation of cancer patients to return-to-work is a rebuilding process by taking advantage of the available personal and external coping resources. The adaptation experience includes: focusing on rehabilitation, rebuilding self-efficacy, and adjusting plans. CONCLUSION Medical staff should help patients mobilize coping resources to adapt to return to work.
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Affiliation(s)
- Jiashuo Xu
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.,Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Xuzhou Medical University, Nanjing, Jiangsu, China
| | - Yuwen Zhou
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.,Nursing Department of Taizhou Second People's Hospital, Taizhou, Jiangsu, China
| | - Jiamei Li
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Jue Tang
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Xiaoyun Hu
- Pharmacy College, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yifan Chen
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China
| | - Yujie Guo
- Medical College (school of nursing), Nantong University, Nantong, Jiangsu, China.
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Andreu Y, Soto-Rubio A, Ramos-Campos M, Escriche-Saura A, Martínez M, Gavilá J. Impact of hormone therapy side effects on health-related quality of life, distress, and well-being of breast cancer survivors. Sci Rep 2022; 12:18673. [PMID: 36333362 PMCID: PMC9636256 DOI: 10.1038/s41598-022-22971-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
To explore the modulatory role of Adjuvant Hormone Therapy (AHT) on health-related quality of life (QoL), subjective well-being and distress prevalence in Breast Cancer (BC) survivors, considering the survival phase. Cross-sectional study with control group. 616 BC survivors participated. Examination of interaction effect between AHT and time since end of primary treatment showed that many of the positive changes observed through the survival phases were experienced exclusively by survivors without AHT. When AHT was not prescribed, longer time elapsed was associated with a decrease in distress prevalence and an improvement in subjective well-being and QoL. It seems there is a turning point around the fifth year after finalization of primary treatment, from which the survivors without AHT significantly improve in several areas and those with AHT do so to a lesser extent. It is expected that the improvement in QoL throughout the different survival phases will have a significant impact on the adherence and maintenance of AHT and, consequently, the likelihood of survival. Thus, AHT side-effects should be routinely assessed by health care providers to gain accurate knowledge that allows improving the QoL of BC survivors.
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Affiliation(s)
- Y. Andreu
- grid.5338.d0000 0001 2173 938XPersonality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - A. Soto-Rubio
- grid.5338.d0000 0001 2173 938XPersonality, Assessment and Psychological Treatments Department, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - M. Ramos-Campos
- grid.453328.bAsociación Española Contra el Cáncer (AECC), Valencia, Spain
| | - A. Escriche-Saura
- grid.453328.bAsociación Española Contra el Cáncer (AECC), Valencia, Spain
| | - M. Martínez
- grid.411308.fDepartment of Medical Oncology, Hospital Clínico Universitario de Valencia-Biomedical Research Institute INCLIVA, Valencia, Spain
| | - J. Gavilá
- grid.418082.70000 0004 1771 144XMedical Oncology Department, Fundación Instituto Valenciano de Oncología, Valencia, Spain
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