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Chen H, Zhou L, Fong D, Cun Y, Yang Z, Wan C. Quality of life and its related-influencing factors in patients with cervical cancer based on the scale QLICP-CE(V2.0). BMC Womens Health 2024; 24:277. [PMID: 38714996 PMCID: PMC11075199 DOI: 10.1186/s12905-024-03068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 04/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Quality of life research can guide clinical workers to adopt more targeted treatment and intervention measures, so as to achieve the purpose of improving patients' quality of life. The objective of this study was to evaluate health-related quality of life in Chinese patients with cervical cancer and to explore its influencing factors. METHODS A total of 186 patients with cervical cancer were investigated by using the QLICP-CE (V2.0) scale (Quality of Life Instruments for Cancer Patients-Cervical Cancer) developed by our group in China. The data were analyzed by t-test, one-way ANOVA, univariate analysis, and multivariate linear regression. RESULTS The total score of quality of life scale for cervical cancer patients was (62.58 ± 12.69), Univariate analysis of objective clinical indexes showed that creatinine concentration was a negative influence factor in the psychological domain, potassium ion concentration was a negative influence factor in the common symptoms and side effect domain, erythrocyte content was a positive influence factor physical domain and common general domain. Multiple linear regression results suggested that clinical staging was the influencing factor of common symptom and side effect domain, common general module and total score of scale. Marital status has different degrees of influence on the psychological, social, and common general domains. The level of education also influenced scores in the social domain. CONCLUSION The total score of quality of life in patients with cervical cancer who received active treatment was acceptable. Marital status, clinical staging, and educational level are the factors that affect the quality of life of patients with cervical cancer. At the same time, potassium ion concentration, red blood cell count and creatinine concentration also have important effects on quality of life in patients with cervical cancer. Therefore, it is very important to give personalized treatment and nursing to patients based on various factors.
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Affiliation(s)
- Huiyan Chen
- Key Laboratory for Quality of Life and Psychological Assessment and Intervention, The First Dongguan Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Dongguan, 523808, China
| | - Lin Zhou
- School of Public Health, Guangdong Medical University, Dongguan, 523808, China
| | - Daniel Fong
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Yingli Cun
- Yunnan Tumor Hospital, Kunming, 650106, Yunnan Province, China
| | - Zheng Yang
- School of Public Health, Guangdong Medical University, Dongguan, 523808, China.
| | - Chonghua Wan
- Key Laboratory for Quality of Life and Psychological Assessment and Intervention, The First Dongguan Affiliated Hospital of Guangdong Medical University, Guangdong Medical University, Dongguan, 523808, China.
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Seyfu DT, Abebe SN, Haile S, Ayana BA. Health related quality of life and its predictive factors on cervical cancer patients in two teaching hospitals, Addis Ababa, Ethiopia. BMC Womens Health 2024; 24:209. [PMID: 38566073 PMCID: PMC10986003 DOI: 10.1186/s12905-024-03046-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Cervical cancer is the second most prevalent and the leading cause of cancer related deaths among Ethiopian women; and about three fourth are diagnosed at advanced stages. Cervical cancer can affect the health-related quality of life (HRQOL) in multiple ways. The main aim of this study was to describe the HRQOL of cervical cancer patients and the predictive factors using validated tools. METHODS Institution based cross-sectional study was conducted among 264 cervical cancer patients using the validated Amharic version of European Organization for Research and Treatment of Cancer (EORTC) modules; QLQ-C30 and QLQ CX24. Descriptive statistics were used to summarize the raw data. One way ANOVA was used to determine the significance of mean differences between the dependent and independent variables. Binary and multivariable regression analysis were used to measure the association between Global Health Status and independent factors. The level of significance was set at p-value < 0.05. RESULTS On EORTC QLQ-C30 scales, the mean Global Health Status (GHS) was 42.57 ± 23.31. The least and highest affected functions were physical and social, mean (SD) = 76.39 ± 23.24 and 50.40 ± 32.19, respectively. The financial difficulty was the most affected among the symptom scales, 57.83 ± 35.34. Only physical function and financial difficulty have shown an independent association with GHS, (AOR = 0.21, 95% CI = 0.05-0.84), (AOR = 0.21 95% CI = 0.07-0.59), respectively. Illiterate, can read and write, were among the predictor factors that showed an independent association with the Global Health Status. Among the EORTC QLQ-CX24 symptom scales, the highest affected score was for sexual worry, mean (SD) = 51.81 + 32.197. CONCLUSIONS In an effort to improve the Global Health Status of cervical cancer patients in Ethiopia; physical function and financial difficulty should be the priority areas. The Illiterate and those who lack formal education need due attention in order to improve the health-related quality-of-life.
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Affiliation(s)
- Daniel Terefe Seyfu
- Department of Obstetrics and Gynecology, Yirgalem Hospital, Yirgalem, Ethiopia
| | - Shiferaw Negash Abebe
- Department of Obstetrics and Gynecology, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Sofanit Haile
- Department of Obstetrics and Gynecology, Addis Ababa University, Addis Ababa, Ethiopia
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Choe YH, Lee S, Lim Y, Kim SH. Machine learning-derived model for predicting poor post-treatment quality of life in Korean cancer survivors. Support Care Cancer 2024; 32:143. [PMID: 38315224 DOI: 10.1007/s00520-024-08347-z] [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: 08/13/2023] [Accepted: 01/25/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE A substantial number of cancer survivors have poor quality of life (QOL) even after completing cancer treatment. Thus, in this study, we used machine learning (ML) to develop predictive models for poor QOL in post-treatment cancer survivors in South Korea. METHODS This cross-sectional study used online survey data from 1,005 post-treatment cancer survivors in South Korea. The outcome variable was QOL, which was measured using the global QOL subscale of the European Organization of Cancer and Treatment for Cancer Quality of Life Questionnaire, where a global QOL score < 60.4 was defined as poor QOL. Three ML models (random forest (RF), support vector machine, and extreme gradient boosting) and three deep learning models were used to develop predictive models for poor QOL. Model performance regarding accuracy, area under the receiver operating characteristic curve, F1 score, precision, and recall was evaluated. The SHapely Additive exPlanation (SHAP) method was used to identify important features. RESULTS Of the 1,005 participants, 65.1% had poor QOL. Among the six models, the RF model had the best performance (accuracy = 0.85, F1 = 0.90). The SHAP method revealed that survivorship concerns (e.g., distress, pain, and fatigue) were the most important factors that affected poor QOL. CONCLUSIONS The ML-based prediction model developed to predict poor QOL in Korean post-treatment cancer survivors showed good accuracy. The ML model proposed in this study can be used to support clinical decision-making in identifying survivors at risk of poor QOL.
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Affiliation(s)
- Yu Hyeon Choe
- Department of Nursing, Inha University, Incheon, Republic of Korea
| | - Sujee Lee
- Department of Industrial and Information Systems Engineering, Soongsil University, Seoul, Republic of Korea
| | - Yooseok Lim
- Department of Industrial and Information Systems Engineering, Soongsil University, Seoul, Republic of Korea
| | - Soo Hyun Kim
- Department of Nursing, Inha University, Incheon, Republic of Korea.
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García JC, Ríos-Pena L, Rodríguez MCR, Maraver FM, Jiménez IR. Development and internal validation of a multivariable prediction model for the quality of life of cervical cancer survivors. J Obstet Gynaecol Res 2023; 49:2446-2456. [PMID: 37435890 DOI: 10.1111/jog.15743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 07/04/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE To elaborate a prediction model for quality of life of cervical cancer survivors. METHODS We conducted a prospective cohort study on 229 cervical cancer survivors. The quality of life measures included the Functional Assessment Cancer Therapy-Cervix version 4.0 and the World Health Organization Quality of Life-brief version self-administered questionnaires. We imported the data into the statistical software program R and developed a gamma generalized linear model. RESULTS Our internally validated predictive model for the Functional Assessment Cancer Therapy-Cervix total score was composed of the following predictors: pain, appetite, vaginal bleeding/discharge/odor, and WHOQOL-BREF social relationships domain. The Harrell's concordance index was 0.75. CONCLUSIONS We developed a solid and internally validated predictive model in cervical cancer survivors based on predictors, such as pain, appetite, vaginal bleeding/odor/discharge, and WHOQOL-BREF social relationships subscale score that contribute significantly to quality of life as targets for potential intervention.
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Affiliation(s)
- Jorge Cea García
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, Seville, Spain
| | - Laura Ríos-Pena
- Institute of Science and Technology, Loyola University, Seville, Spain
| | - M Carmen Rubio Rodríguez
- Department of Radiation Oncology in HM Hospitals, University Hospital Sanchinarro, Madrid, Spain
| | - Francisco Márquez Maraver
- Clinical Management Unit for Obstetrics and Gynecology, University Hospital Virgen Macarena, Seville, Spain
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Jha AK, Mithun S, Sherkhane UB, Jaiswar V, Shah S, Purandare N, Prabhash K, Maheshwari A, Gupta S, Wee L, Rangarajan V, Dekker A. Development and validation of radiomic signature for predicting overall survival in advanced-stage cervical cancer. FRONTIERS IN NUCLEAR MEDICINE (LAUSANNE, SWITZERLAND) 2023; 3:1138552. [PMID: 39355056 PMCID: PMC11440856 DOI: 10.3389/fnume.2023.1138552] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/03/2023] [Indexed: 10/03/2024]
Abstract
Background The role of artificial intelligence and radiomics in prediction model development in cancer has been increasing every passing day. Cervical cancer is the 4th most common cancer in women worldwide, contributing to 6.5% of all cancer types. The treatment outcome of cervical cancer patients varies and individualized prediction of disease outcome is of paramount importance. Purpose The purpose of this study is to develop and validate the digital signature for 5-year overall survival prediction in cervical cancer using robust CT radiomic and clinical features. Materials and Methods Pretreatment clinical features and CT radiomic features of 68 patients, who were treated with chemoradiation therapy in our hospital, were used in this study. Radiomic features were extracted using an in-house developed python script and pyradiomic package. Clinical features were selected by the recursive feature elimination technique. Whereas radiomic feature selection was performed using a multi-step process i.e., step-1: only robust radiomic features were selected based on our previous study, step-2: a hierarchical clustering was performed to eliminate feature redundancy, and step-3: recursive feature elimination was performed to select the best features for prediction model development. Four machine algorithms i.e., Logistic regression (LR), Random Forest (RF), Support vector classifier (SVC), and Gradient boosting classifier (GBC), were used to develop 24 models (six models using each algorithm) using clinical, radiomic and combined features. Models were compared based on the prediction score in the internal validation. Results The average prediction accuracy was found to be 0.65 (95% CI: 0.60-0.70), 0.72 (95% CI: 0.63-0.81), and 0.77 (95% CI: 0.72-0.82) for clinical, radiomic, and combined models developed using four prediction algorithms respectively. The average prediction accuracy was found to be 0.69 (95% CI: 0.62-0.76), 0.79 (95% CI: 0.72-0.86), 0.71 (95% CI: 0.62-0.80), and 0.72 (95% CI: 0.66-0.78) for LR, RF, SVC and GBC models developed on three datasets respectively. Conclusion Our study shows the promising predictive performance of a robust radiomic signature to predict 5-year overall survival in cervical cancer patients.
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Affiliation(s)
- Ashish Kumar Jha
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Sneha Mithun
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Umeshkumar B Sherkhane
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
| | - Vinay Jaiswar
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
| | - Sneha Shah
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Nilendu Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
- Advance Center for Treatment, Research, Education in Cancer, Navi-Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Leonard Wee
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - V Rangarajan
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, India
- Homi Bhabha National Institute, BARC Training School Complex, Mumbai, India
| | - Andre Dekker
- Department of Radiation Oncology (Maastro), GROW - School for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, Netherlands
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Jha AK, Mithun S, Sherkhane UB, Jaiswar V, Osong B, Purandare N, Kannan S, Prabhash K, Gupta S, Vanneste B, Rangarajan V, Dekker A, Wee L. Systematic review and meta-analysis of prediction models used in cervical cancer. Artif Intell Med 2023; 139:102549. [PMID: 37100501 DOI: 10.1016/j.artmed.2023.102549] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 11/18/2022] [Accepted: 04/04/2023] [Indexed: 04/28/2023]
Abstract
BACKGROUND Cervical cancer is one of the most common cancers in women with an incidence of around 6.5 % of all the cancer in women worldwide. Early detection and adequate treatment according to staging improve the patient's life expectancy. Outcome prediction models might aid treatment decisions, but a systematic review on prediction models for cervical cancer patients is not available. DESIGN We performed a systematic review for prediction models in cervical cancer following PRISMA guidelines. Key features that were used for model training and validation, the endpoints were extracted from the article and data were analyzed. Selected articles were grouped based on prediction endpoints i.e. Group1: Overall survival, Group2: progression-free survival; Group3: recurrence or distant metastasis; Group4: treatment response; Group5: toxicity or quality of life. We developed a scoring system to evaluate the manuscript. As per our criteria, studies were divided into four groups based on scores obtained in our scoring system, the Most significant study (Score > 60 %); Significant study (60 % > Score > 50 %); Moderately Significant study (50 % > Score > 40 %); least significant study (score < 40 %). A meta-analysis was performed for all the groups separately. RESULTS The first line of search selected 1358 articles and finally 39 articles were selected as eligible for inclusion in the review. As per our assessment criteria, 16, 13 and 10 studies were found to be the most significant, significant and moderately significant respectively. The intra-group pooled correlation coefficient for Group1, Group2, Group3, Group4, and Group5 were 0.76 [0.72, 0.79], 0.80 [0.73, 0.86], 0.87 [0.83, 0.90], 0.85 [0.77, 0.90], 0.88 [0.85, 0.90] respectively. All the models were found to be good (prediction accuracy [c-index/AUC/R2] >0.7) in endpoint prediction. CONCLUSIONS Prediction models of cervical cancer toxicity, local or distant recurrence and survival prediction show promising results with reasonable prediction accuracy [c-index/AUC/R2 > 0.7]. These models should also be validated on external data and evaluated in prospective clinical studies.
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Affiliation(s)
- Ashish Kumar Jha
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India.
| | - Sneha Mithun
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Umeshkumar B Sherkhane
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands; Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Vinay Jaiswar
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Biche Osong
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Nilendu Purandare
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sadhana Kannan
- Homi Bhabha National Institute, Mumbai, Maharashtra, India; Advance Centre for Treatment, Research, Education in Cancer, Mumbai, Maharashtra, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India; Advance Centre for Treatment, Research, Education in Cancer, Mumbai, Maharashtra, India
| | - Ben Vanneste
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Venkatesh Rangarajan
- Department of Nuclear Medicine, Tata Memorial Hospital, Mumbai, Maharashtra, India; Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Andre Dekker
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Leonard Wee
- Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands
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Health-related quality of life and patient-reported symptoms after postoperative proton beam radiotherapy of cervical and endometrial cancer: 2-year results of the prospective phase II APROVE-trial. Radiat Oncol 2023; 18:5. [PMID: 36624483 PMCID: PMC9827629 DOI: 10.1186/s13014-023-02198-4] [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: 08/17/2022] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION The APROVE-trial investigated the tolerability of postoperative proton beam therapy in women with cervical or endometrial cancer. The present analysis evaluated the secondary endpoints of health-related quality of life (HRQOL) and patient-reported symptoms. METHODS 25 patients were included in this prospective phase-II-trial and treated with postoperative radiotherapy using protons alone or in combination with chemotherapy. To attain general and gynecologic-specific HRQOL measures, the EORTC-QLQ-C30 questionnaires combined with -QLQ-CX24 for cervical and -QLQ-EN24 for endometrial cancer were assessed at baseline, at the end of RT and up to 2 years after radiotherapy. The results were compared to an age-matched norm reference population. Symptoms were assessed using Common Terminology Criteria for Adverse Events (CTCAE) and institutional patient-reported symptoms grading. RESULTS Scores regarding global health status were markedly impaired at baseline (mean: 58.0 ± 20.1) compared to reference population data, but significantly (p = 0.036) improved and evened out to comparable norm values 2 years after proton therapy (mean: 69.9 ± 19.3). Treatment caused acute and long-term worsening of pain (p = 0.048) and gastrointestinal symptoms (p = 0.016) for women with endometrial cancer, but no higher-grade CTCAE ≥ 3° toxicity was observed. Dosimetric evaluation of rectum, sigmoid, large and small bowel showed no correlation with the reported gastrointestinal symptoms. After 2 years, fatigue had significantly improved (p = 0.030), whereas patients with cervical cancer experienced more often lymphedema (p = 0.017). Scores for endometrial cancer pertaining to sexual activity (p = 0.048) and body image (p = 0.022) had improved post treatment; in the latter this effect persisted after 2 years. CONCLUSION Proton beam therapy in the adjuvant setting was well tolerated with only low-grade side effects concerning gastrointestinal symptoms, lymphedema and pain. Overall quality of life was impaired at baseline, but patients were able to recover to values comparable to norm population 2 years after proton therapy. Larger studies are needed to confirm whether the benefit of proton therapy translates into a clinical effect. Sexual dysfunction remains an important issue. TRIAL REGISTRATION The trial was registered at https://clinicaltrials.gov (ClinicalTrials.gov Identifier: NCT03184350, 09th June 2017).
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Sun Y, Li G, Hai P, Cao Y, Han P, Liu Y, Wen J, Wang Y, Cheng X, Ren F. The comparative study for survival outcome of locally advanced cervical cancer treated by neoadjuvant arterial interventional chemotherapy or intravenous chemotherapy followed by surgery or concurrent chemoradiation. World J Surg Oncol 2022; 20:389. [PMID: 36476481 PMCID: PMC9727861 DOI: 10.1186/s12957-022-02859-w] [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: 09/09/2022] [Accepted: 11/24/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE This study aimed to compare the survival outcome of 3 different treatment groups (arterial interventional chemotherapy or intravenous chemotherapy or concurrent chemoradiotherapy) for locally advanced cervical cancer. METHODS A total of 187 patients with pathological stage IB3-IIB cervical cancer (cervical squamous cell carcinoma, adenosquamous carcinoma, or adenocarcinoma) hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2013 to May 2019 were included. Therefore, this article is a retrospective study. We collected data from all eligible patients. And all according to the treatment methods at that time, they were divided into three subgroups: (1) 40 patients who received neoadjuvant arterial interventional chemotherapy + surgery + postoperative chemotherapy (IA-NAC + RS), (2) 63 patients who received neoadjuvant intravenous chemotherapy + surgery + postoperative chemotherapy (IV-NAC + RS), (3) 84 patients who only received concurrent chemoradiotherapy (CCRT). Notably, 108 of these patients met the 5-year follow-up period, and 187 patients met the 3-year follow-up period only. Consequently, we compared 5-year survival and 3-year survival separately. The prognosis (5-year survival and 3-year survival) of the three groups and the chemotherapy efficacy, intraoperative blood loss, operation time, and postoperative pathological risk factors of different subgroups were compared. RESULTS (1) There were no significant differences in the 3-year overall survival (OS) rate, 3-year progression-free survival (PFS) rate, 5-year OS rate, and 5-year PFS rate among the three subgroups (p > 0.05). (2) The chemotherapy response rates of IA-NAC+RS group (37.5%) and IV-NAC+RS group (25.4%) were comparable (p > 0.05). (3) The intraoperative blood loss in the IA-NAC+RS group (average 92.13±84.09 mL) was significantly lower than that in the IV-NAC+RS group (average 127.2±82.36 mL) (p < 0.05). (4) The operation time of the IA-NAC+RS group (average 231.43±63.10 min) and the IV-NAC+RS group (average 219.82±49.11 min) were comparable (p > 0.05). (5) There were no significant differences between the IA-NAC+RS group and IV-NAC+RS group in pathological lymph node metastasis, parametrial invasion, and involvement of lymphovascular space (p > 0.05). CONCLUSIONS Neoadjuvant chemotherapy combined with surgery had the same long-term survival benefit as concurrent chemoradiotherapy.
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Affiliation(s)
- Yi Sun
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Gailing Li
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Panpan Hai
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Yuan Cao
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Pin Han
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Yuchen Liu
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Jing Wen
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Yuanpei Wang
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Xiaoran Cheng
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
| | - Fang Ren
- grid.412633.10000 0004 1799 0733Department of Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000 China
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Using machine learning to predict health-related quality of life outcomes in patients with low grade glioma, meningioma, and acoustic neuroma. PLoS One 2022; 17:e0267931. [PMID: 35507629 PMCID: PMC9067699 DOI: 10.1371/journal.pone.0267931] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/19/2022] [Indexed: 11/19/2022] Open
Abstract
Background Predicting reduced health-related quality of life (HRQoL) after resection of a benign or low-grade brain tumour provides the opportunity for early intervention, and targeted expenditure of scarce supportive care resources. We aimed to develop, and evaluate the performance of, machine learning (ML) algorithms to predict HRQoL outcomes in this patient group. Methods Using a large prospective dataset of HRQoL outcomes in patients surgically treated for low grade glioma, acoustic neuroma and meningioma, we investigated the capability of ML to predict a) HRQoL-impacting symptoms persisting between 12 and 60 months from tumour resection and b) a decline in global HRQoL by more than the minimum clinically important difference below a normative population mean within 12 and 60 months after resection. Ten-fold cross-validation was used to measure the area under the receiver operating characteristic curve (AUC), area under the precision-recall curve (PR-AUC), sensitivity, and specificity of models. Six ML algorithms were explored per outcome: Random Forest Classifier, Decision Tree Classifier, Logistic Regression, K Neighbours Classifier, Support Vector Machine, and Gradient Boosting Machine. Results The final cohort included 262 patients. Outcome measures for which AUC>0.9 were Appetite loss, Constipation, Nausea and vomiting, Diarrhoea, Dyspnoea and Fatigue. AUC was between 0.8 and 0.9 for global HRQoL and Financial difficulty. Pain and Insomnia achieved AUCs below 0.8. PR-AUCs were similar overall to the AUC of each respective classifier. Conclusions ML algorithms based on routine demographic and perioperative data show promise in their ability to predict HRQoL outcomes in patients with low grade and benign brain tumours between 12 and 60 months after surgery.
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Mullapally SK, Digumarti L, Digumarti R. Cervical Cancer in Low- and Middle-Income Countries: A Multidimensional Approach to Closing the Gaps. JCO Oncol Pract 2022; 18:423-425. [PMID: 35385348 DOI: 10.1200/op.22.00156] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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Afiyanti Y, Besral, Haryani. The quality of life of Indonesian women with gynecological cancer. ENFERMERIA CLINICA 2020. [DOI: 10.1016/j.enfcli.2020.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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12
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Harris J, Purssell E, Ream E, Jones A, Armes J, Cornelius V. How to Develop Statistical Predictive Risk Models in Oncology Nursing to Enhance Psychosocial and Supportive Care. Semin Oncol Nurs 2020; 36:151089. [PMID: 33223408 DOI: 10.1016/j.soncn.2020.151089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Predictive risk models are advocated in psychosocial oncology practice to provide timely and appropriate support to those likely to experience the emotional and psychological consequences of cancer and its treatments. New digital technologies mean that large scale and routine data collection are becoming part of everyday clinical practice. Using these data to try to identify those at greatest risk for late psychosocial effects of cancer is an attractive proposition in a climate of unmet need and limited resource. In this paper, we present a framework to support the development of high-quality predictive risk models in psychosocial and supportive oncology. The aim is to provide awareness and increase accessibility of best practice literature to support researchers in psychosocial and supportive care to undertake a structured evidence-based approach. DATA SOURCES Statistical prediction risk model publications. CONCLUSION In statistical modeling and data science different approaches are needed if the goal is to predict rather than explain. The deployment of a poorly developed and tested predictive risk model has the potential to do great harm. Recommendations for best practice to develop predictive risk models have been developed but there appears to be little application within psychosocial and supportive oncology care. IMPLICATIONS FOR NURSING PRACTICE Use of best practice evidence will ensure the development and validation of predictive models that are robust as these are currently lacking. These models have the potential to enhance supportive oncology care through harnessing routine digital collection of patient-reported outcomes and the targeting of interventions according to risk characteristics.
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Affiliation(s)
- Jenny Harris
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom.
| | - Edward Purssell
- School of Health Sciences, City, University of London, London, United Kingdom
| | - Emma Ream
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Anne Jones
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Victoria Cornelius
- Imperial Clinical Trials Unit, School of Public Health, Faculty of Medicine, Imperial College London, London, United Kingdom
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13
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Sim JA, Kim YA, Kim JH, Lee JM, Kim MS, Shim YM, Zo JI, Yun YH. The major effects of health-related quality of life on 5-year survival prediction among lung cancer survivors: applications of machine learning. Sci Rep 2020; 10:10693. [PMID: 32612283 PMCID: PMC7329866 DOI: 10.1038/s41598-020-67604-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 06/01/2020] [Indexed: 01/11/2023] Open
Abstract
The primary goal of this study was to evaluate the major roles of health-related quality of life (HRQOL) in a 5-year lung cancer survival prediction model using machine learning techniques (MLTs). The predictive performances of the models were compared with data from 809 survivors who underwent lung cancer surgery. Each of the modeling technique was applied to two feature sets: feature set 1 included clinical and sociodemographic variables, and feature set 2 added HRQOL factors to the variables from feature set 1. One of each developed prediction model was trained with the decision tree (DT), logistic regression (LR), bagging, random forest (RF), and adaptive boosting (AdaBoost) methods, and then, the best algorithm for modeling was determined. The models' performances were compared using fivefold cross-validation. For feature set 1, there were no significant differences in model accuracies (ranging from 0.647 to 0.713). Among the models in feature set 2, the AdaBoost and RF models outperformed the other prognostic models [area under the curve (AUC) = 0.850, 0.898, 0.981, 0.966, and 0.949 for the DT, LR, bagging, RF and AdaBoost models, respectively] in the test set. Overall, 5-year disease-free lung cancer survival prediction models with MLTs that included HRQOL as well as clinical variables improved predictive performance.
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Affiliation(s)
- Jin-Ah Sim
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ae Kim
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Ju Han Kim
- Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea
| | - Jong Mog Lee
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Moon Soo Kim
- Center for Lung Cancer, National Cancer Center, Goyang, Korea
| | - Young Mog Shim
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Seoul, Korea
| | - Jae Ill Zo
- Lung and Esophageal Cancer Center, Samsung Comprehensive Cancer Center, Samsung Medical Center, Seoul, Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
- Department of Biomedical Informatics, Seoul National University College of Medicine, Seoul, Korea.
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea.
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Yang L, Yuan J, Zeng X, Xi M, Wang H. The outcomes and quality of life of young patients undergoing adjuvant radiotherapy versus non-radiotherapy following surgery treating early FIGO stage cervical squamous cell cancer in southwestern China. Sci Rep 2020; 10:9583. [PMID: 32533117 PMCID: PMC7293287 DOI: 10.1038/s41598-020-66661-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 05/22/2020] [Indexed: 12/24/2022] Open
Abstract
Background: The incidence of cervical cancer in young women is rising, and squamous cell carcinoma makes up a great percentage of the histological types. The presence of aggressive pathologic risk factors following patients’ primary surgery may warrant the use of adjuvant radiotherapy. It is important to weigh up the risks and benefits of using adjuvant radiotherapy for each young patient so as to maximize their prognosis while minimizing the treatment-related morbidity. Methods: A retrospective study was performed. It consisted of 97 patients under 35 years old who were diagnosed with cervical squamous cell carcinoma and underwent treatment at West China Second University Hospital between December 2009 and January 2014. Five-year follow-up, prognostic risks, long-term radiation toxicity, female sexual function, and quality of life were investigated. Results: Adjuvant radiotherapy did improve the prognosis of young patients with lymph node metastases. However, there were few significant differences in progress-free survival and overall survival for the young patients without lymph node metastases following adjuvant radiotherapy. Besides, young patients who took radiotherapy exhibited greater intestinal dysfunction, more severe lower extremities edema, greater sexual dysfunction, and worse long-term quality of life. Conclusion: Young patients with early-stage cervical squamous cell carcinoma without lymph node metastases who have undergone the primary surgery should be counseled in detail before the decision to use adjuvant radiotherapy can be made. The counseling should emphasize not only the benefit that local recurrence rates can be reduced, but also the risks that treatment-related side effects could increase and lower QoL could occur.
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Affiliation(s)
- Lingyun Yang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Jialing Yuan
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xi Zeng
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Mingrong Xi
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Hongjing Wang
- Department of Obstetrics and Gynecology, West China Second University Hospital, Chengdu, China. .,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
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15
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Araya LT, Fenta TG, Sander B, Gebremariam GT, Gebretekle GB. Health-related quality of life and associated factors among cervical cancer patients at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. Health Qual Life Outcomes 2020; 18:72. [PMID: 32178681 PMCID: PMC7076924 DOI: 10.1186/s12955-020-01319-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/09/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Cancer of the cervix is the most frequent cancer among women in Ethiopia. The disease burden and its treatment adversely affects patients' health-related quality of life (HRQoL). We aimed to investigate the HRQoL and its predictors among cervical cancer patients in Ethiopia. METHODS A hospital-based cross-sectional study was conducted from January to June 2018 at the oncology unit of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. A total of 404 cervical cancer patients were interviewed using validated Amharic version of the European Organization for Research and Treatment of Cancer module (EORTC QLQ-C30), cervical cancer module (EORTC QLQ-CX24), and Euro Quality of Life Group's 5-Domain Questionnaires 5-Levels (EQ-5D) questionnaires. ANOVA test was used to determine the effect of patients' characteristics on mean scores of the different domains of HRQoL and stepwise multivariable logistic regression was performed to identify predictors of HRQoL. Coefficients of level-specific utility values obtained from a hybrid regression model for the Ethiopian general population were used to compute utility. RESULTS The mean age of patients was 52.1 ± 10.4 years and 379 (93.8%) of the patients were receiving service at the outpatient clinic. About one-third (35%) of patients were diagnosed with stage IV cervical cancer. Mean global health status/QoL, mean utility and visual analog scale scores were 48.3 ± 23.77, 0.77 and 65.7 ± 20.83, respectively. Physical functioning (AOR = 4.98, 95% CI:2.16-11.49), emotional functioning (AOR = 5.25, 95% CI:2.26-12.17), pain (AOR = 5.79, 95% CI:2.30-14.57), and symptom experience (AOR = 4.58, 95% CI:1.95-10.79) were associated with patients' HRQoL. CONCLUSIONS Cervical cancer significantly affects patient's HRQoL and hence, efforts to improve HRQoL should be commenced especially in terms of physical and emotional functioning, pain, and symptom experience.
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Affiliation(s)
- Liya Teklu Araya
- Social and Administrative Pharmacy Unit, School of Pharmacy, College of Health Sciences, Addis Ababa University, Zambia Street, P.O. Box: 1176, Addis Ababa, Ethiopia
| | - Teferi Gedif Fenta
- Social and Administrative Pharmacy Unit, School of Pharmacy, College of Health Sciences, Addis Ababa University, Zambia Street, P.O. Box: 1176, Addis Ababa, Ethiopia
| | - Beate Sander
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Public Health Ontario, Toronto, Ontario, Canada
| | - Girma Tekle Gebremariam
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebremedhin Beedemariam Gebretekle
- Social and Administrative Pharmacy Unit, School of Pharmacy, College of Health Sciences, Addis Ababa University, Zambia Street, P.O. Box: 1176, Addis Ababa, Ethiopia.
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Cao Y, Raoof M, Montgomery S, Ottosson J, Näslund I. Predicting Long-Term Health-Related Quality of Life after Bariatric Surgery Using a Conventional Neural Network: A Study Based on the Scandinavian Obesity Surgery Registry. J Clin Med 2019; 8:E2149. [PMID: 31817385 PMCID: PMC6947423 DOI: 10.3390/jcm8122149] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Severe obesity has been associated with numerous comorbidities and reduced health-related quality of life (HRQoL). Although many studies have reported changes in HRQoL after bariatric surgery, few were long-term prospective studies. We examined the performance of the convolution neural network (CNN) for predicting 5-year HRQoL after bariatric surgery based on the available preoperative information from the Scandinavian Obesity Surgery Registry (SOReg). CNN was used to predict the 5-year HRQoL after bariatric surgery in a training dataset and evaluated in a test dataset. In general, performance of the CNN model (measured as mean squared error, MSE) increased with more convolution layer filters, computation units, and epochs, and decreased with a larger batch size. The CNN model showed an overwhelming advantage in predicting all the HRQoL measures. The MSEs of the CNN model for training data were 8% to 80% smaller than those of the linear regression model. When the models were evaluated using the test data, the CNN model performed better than the linear regression model. However, the issue of overfitting was apparent in the CNN model. We concluded that the performance of the CNN is better than the traditional multivariate linear regression model in predicting long-term HRQoL after bariatric surgery; however, the overfitting issue needs to be mitigated using more features or more patients to train the model.
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Affiliation(s)
- Yang Cao
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
| | - Mustafa Raoof
- Department of Surgery, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden; (M.R.); (J.O.); (I.N.)
| | - Scott Montgomery
- Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 70182 Örebro, Sweden;
- Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, 17177 Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, London WC1E 6BT, UK
| | - Johan Ottosson
- Department of Surgery, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden; (M.R.); (J.O.); (I.N.)
| | - Ingmar Näslund
- Department of Surgery, Faculty of Medicine and Health, Örebro University, 70182 Örebro, Sweden; (M.R.); (J.O.); (I.N.)
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Health-related quality of life in locally advanced cervical cancer patients treated with neoadjuvant therapy followed by radical surgery: A single-institutional retrospective study from a prospective database. Gynecol Oncol 2019; 154:583-589. [PMID: 31307665 DOI: 10.1016/j.ygyno.2019.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To evaluate the health-related quality of life (HRQOL) in locally advanced cervical cancer (LACC) patients treated with neoadjuvant concurrent chemoradiation (CCRT) or radiation (RT) alone followed by radical surgery (RS). METHODS In a single-center retrospective study from a prospective database, 275 FIGO Stage IB2-IIIB patients who underwent CCRT/RT + RS were included. HRQOL was prospectively assessed by EORTC QLQ-C30 and EORTC QLQ-CX24 prior to any treatment (baseline) and 6 months after surgery, respectively. RESULTS A statistically significant and clinically relevant improvement in physical functioning (P < 0.001) and role functioning (P = 0.002, P = 0.031) was observed in patients receiving either CCRT+RS or RT + RS at follow-up. In addition, quality of life (QoL), physical functioning, and social functioning were better in the RT + RS group than the CCRT+RS group after treatment (P = 0.028, P = 0.010, P = 0.014). Symptom scores of fatigue decreased in both groups over time (P < 0.001, P = 0.004) while insomnia decreased only in the RT + RS group (P = 0.042). Worsened menopausal symptoms were documented in both groups at follow-up (P = 0.001, P = 0.047), while lymphedema was deteriorated only in patients receiving CCRT + RS (P < 0.001). Sexuality scores did not differ between groups or over time with the exception of sexual worry, which was deteriorated in patients receiving RT + RS (P = 0.042). CONCLUSIONS QLQ-C30 functioning and tumor-related symptoms scores improved while lymphedema and menopausal symptoms worsened 6 months after neoadjuvant CCRT or RT alone followed by RS in LACC patients. Patients treated with RT + RS had a generally better HRQOL compared with those receiving CCRT+RS, though further validation with prospective randomized clinical trials is warranted.
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18
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Impact of cervical cancer on quality of life of women in Hubei, China. Sci Rep 2018; 8:11993. [PMID: 30097622 PMCID: PMC6086893 DOI: 10.1038/s41598-018-30506-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/31/2018] [Indexed: 02/08/2023] Open
Abstract
We aimed to assess the quality of life (QOL) of the patients with cervical cancer after initial treatment, the factors affecting QOL and their clinical relevance. A total of 256 patients with cervical cancer who visited Zhongnan Hospital of Wuhan University from January 2017 to December 2017 were enrolled in this study. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 item (EORTC QLQ-C30) and cervical cancer module (EORTC QLQ-CX24) was used to assess the QOL of patients. More than half of the patients with cervical cancer reported an excellent QOL. Symptoms mostly experienced were insomnia, constipation, financial difficulties, and menopausal symptoms. Global QOL and social functioning were statistically associated with education level, occupation, the area of living, family income and treatment modality. Similarly, role functioning showed significant association with the stage of cancer, treatment modality and time since diagnosis. The rural area of living and poor economic status of the patients with cervical cancer has a negative impact on overall quality of life. Younger and educated patients are more worried about sexuality. Patients treated with multiple therapies had more problems with their QOL scales than patients treated with surgery only.
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19
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Huang HY, Tsai WC, Chou WY, Hung YC, Liu LC, Huang KF, Wang WC, Leung KW, Hsieh RK, Kung PT. Quality of life of breast and cervical cancer survivors. BMC WOMENS HEALTH 2017; 17:30. [PMID: 28403855 PMCID: PMC5389170 DOI: 10.1186/s12905-017-0387-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/30/2017] [Indexed: 12/24/2022]
Abstract
Background Breast and cervical cancer are the most common cancers affecting women. The symptom distresses experienced by cancer survivors are critical factors influencing their quality of life (QOL). This study investigated the QOL of breast and cervical cancer survivors, their physical, psychological and social conditions. Methods The participants were older than 20 years, had been diagnosed with breast or cervical cancer for more than 2 years, and had completed their cancer treatment. The survey incorporated the QOL questionnaires developed by the European Organization of Research and Treatment for Cancer and a self-designed questionnaire. Results The mean age at diagnosis was 48.89 ± 8.53 years for the breast cancer survivors and 49.00 ± 10.30 years for the cervical cancer survivors. The corresponding QOL scores were 75.33 ± 20.25 and 75.56 ± 17.93. The factors influencing QOL of breast cancer survivors were household income, number of comorbidities, stage of cancer, type of cancer treatment and duration of illness, whereas the factor related to QOL of cervical cancer survivors was only household income. Conclusions The QOL of the two groups was similar. Healthcare providers should demonstrate greater concern toward breast and cervical cancer survivors.
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Affiliation(s)
- Huei-Ying Huang
- Department of Anesthesia, Chung Shan Medical University Hospital, Taichung, Taiwan, Republic of China.,Department of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung, 413, Taiwan, Republic of China
| | - Wen-Chen Tsai
- Department of Health Service Administration, China Medical University, Taichung, Taiwan, Republic of China
| | - Wen-Yu Chou
- Department of Health Service Administration, China Medical University, Taichung, Taiwan, Republic of China
| | - Yao-Ching Hung
- Department of Gynecologic Oncology, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Liang-Chih Liu
- Department of Breast Surgery, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Kuo-Feng Huang
- Cancer Center, Chi Mei Hospital, Tainan, Taiwan, Republic of China
| | - Wen-Ching Wang
- Department of General surgery, Chi Mei Hospital, Tainan, Taiwan, Republic of China
| | - Kam-Wing Leung
- Dental Department, Yuan's General Hospital, Kaohsiung, Taiwan, Republic of China
| | - Ruey-Kuen Hsieh
- Division of Hematology and Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China
| | - Pei-Tseng Kung
- Department of Healthcare Administration, Asia University, 500, Lioufeng Road, Wufeng, Taichung, 413, Taiwan, Republic of China. .,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan, Republic of China.
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Dahiya N, Bachani D, Acharya AS, Sharma DN, Gupta S, Haresh KP. Socio-Demographic, Reproductive and Clinical Profile of Women Diagnosed with Advanced Cervical Cancer in a Tertiary Care Institute of Delhi. J Obstet Gynaecol India 2017; 67:53-60. [PMID: 28242969 PMCID: PMC5306097 DOI: 10.1007/s13224-016-0907-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/12/2016] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Cervical cancer is one of the leading cancers among Indian women with estimated 123,000 new cases and 67,477 deaths in 2012. Cervical cancer is a multi-etiological disease. Factors such as low socioeconomic status, tobacco use, sexual and reproductive factors, HIV and other sexually transmitted diseases and long-term oral contraceptive use have been suggested as determinants. Assessment of socio-demographic profile and reproductive history gives a better picture of the determinants of cervical carcinoma in low-resource settings. METHODS This hospital-based cross-sectional study was undertaken at a tertiary healthcare institute at New Delhi, India. Sixty-seven newly diagnosed women with advanced cervical cancer (stage 2B-4B), who were undertaking radio- and/or chemotherapy, were included to assess their socio-demographic, reproductive and clinical profile. RESULTS The mean age of women at the time of detection of cervical cancer was 52.28 ± 11.29 years (range 30-75 years). More than 60 % of patients were illiterate and belonged to middle socioeconomic status. Thirty-nine percentage of the study subjects had their first sexual experience before 15 years of age. Nearly 54 % women had 5 or more pregnancies. Nearly 73 % of women had all deliveries at home. Majority (69 %) of women had symptoms suggestive of reproductive tract infection. Among them, unusual discharge from vagina (73.13 %) followed by bleeding after menopause (55.10 %) and pain in abdomen (44.77 %) were the most common presenting complaints. Pallor was present in nearly two-third (63.93 %) study subjects. More than half (56.72 %) study subjects had moderate anemia, and 7.46 % had severe anemia before treatment. Mean hemoglobin level of the study subjects was 10.35 ± 1.72 gm% before treatment and 9.69 ± 1.29 gm% after treatment. This difference was statistically significant. Around 97 % of the study subjects had squamous cell carcinoma of the cervix. Majority (53.73 %) of the study subjects were in stage 3B of cervical cancer. Combination of radiotherapy and chemotherapy was the most common (77.67 %) modality of treatment. CONCLUSIONS AND RECOMMENDATIONS Illiteracy, low socioeconomic status, early sexual debut, high fertility, home delivery, reproductive tract infections, use of insanitary clothes during menstruation and anemia were observed in majority of women with advanced cancer cervix. Presence of these factors indicates possible risk of cervical cancer and should be kept in mind when women seek health services. Early diagnosis through high risk or opportunistic screening and timely management of cervical cancer needs to be ensured for better outcomes.
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Affiliation(s)
- Neha Dahiya
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - Damodar Bachani
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - Anita S. Acharya
- Department of Community Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi, 110001 India
| | - D. N. Sharma
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Subhash Gupta
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - K. P. Haresh
- Department of Radiation Oncology, IRCH, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Rahman Z, Singh U, Qureshi S, Nisha, Srivastav K, Nishchal A. Assessment of Quality of Life in Treated Patients of Cancer Cervix. J Midlife Health 2017; 8:183-188. [PMID: 29307981 PMCID: PMC5753500 DOI: 10.4103/jmh.jmh_40_17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Aim: The aim of the study was to assess the quality of life (QoL) in women suffering from cancer cervix before and after the treatment, to study various factors affecting the QoL in these women, and to evaluate the impact of treatment modalities on the QoL. Materials and Methods: Women with cervical cancer attending Department of Obstetrics and Gynecology and Department of Radiotherapy who met the eligibility criteria were interviewed with a structured questionnaire of QoL, the European Organization for Research and Treatment of Cancer QLQ30, and its Cervical Cancer Module (Cx24). The baseline observations were recorded when the patient first reported, second evaluation was done at 3 months posttreatment, and the third evaluation at 6 months posttreatment. QoL domains along with sociodemographic and clinicopathological variables were analyzed. Results: A total of ninety patients were included for analysis, of which 5 were lost to follow up. A statistically significant improvement was found in physical, emotional function, pain, fatigue, and vaginal symptoms of the participants; however, there was no significant improvement in social, cognitive, or role functioning, body image, sexual activity, or sexual enjoyment. Vaginal and sexual function worsened significantly. Multivariate analysis showed that young women and those with a higher level of education had better QoL. Stage and type of cancer had little impact on the general QoL, but participants with earlier stage and well-differentiated cancer had better cancer cervix-specific QoL. Conclusion: The QoL of the participants in terms of physical (P = 0.04) and emotional functioning (P = 0.001) improved with treatment. Women with a higher level of education and early stage of disease had better QoL.
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Affiliation(s)
- Zakia Rahman
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Uma Singh
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sabuhi Qureshi
- Department of Gynaecological Oncology, Super Speciality Cancer Institute, Lucknow, Uttar Pradesh, India
| | - Nisha
- Department of Obstetrics and Gynaecology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kirti Srivastav
- Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Anil Nishchal
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
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22
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Jain A, Ganesh B, Bobdey SC, Sathwara JA, Saoba S. Sociodemographic and Clinical Profile of Cervical Cancer Patients Visiting in a Tertiary Care Hospital in India. Indian J Med Paediatr Oncol 2017; 38:291-295. [PMID: 29200676 PMCID: PMC5686969 DOI: 10.4103/ijmpo.ijmpo_20_16] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Context Cancer of the cervix is the most common genital tract malignancy in the female and is a major public health problem in the developing countries. Study of the sociodemographic and clinical profile of patients is the first step in planning control measures and treatment facilities. Aims The aims of the study were to determine the sociodemographic and clinical profile of cervical cancer patients and study their association with other tumor-related factors. Settings and Design This is a record-based retrospective study from a single institution. Subjects and Methods The data on sociodemographic and clinical factors of 765 cervical cancer patients visited and treated at tertiary care cancer hospital in Mumbai in 1 year period were analyzed. Statistical Analysis Data were analyzed using descriptive statistics. Kruskal-Wallis and Chi-square test were used to assess relationship between variables. Results The median age of the cohort was 54 years and interquartile range was 16 years. Nearly 53.6% of patients were illiterate. About 88.10% of patient's had squamous cell carcinoma. Only 13% of cases had early stage disease and 77% of patient's had not taken any treatment before coming to the hospital. Of the total, about 26% patients also had concomitant comorbidities, of which hypertension was found to be the leading comorbid condition. Stage of disease was found to be significantly (P < 0.05) associated with age and educational status. Conclusion This study highlights certain important baseline characteristics of cervical cancer patients. This basic information on profile of patients can help plan and optimum utilization of hospital services, especially in resource-poor countries like India.
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Affiliation(s)
- Aanchal Jain
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Balasubramaniam Ganesh
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Saurabh C Bobdey
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Jignasa A Sathwara
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Sushma Saoba
- Department of Medical Records, Biostatistics and Epidemiology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Tang F, Wang J, Tang Z, Kang M, Deng Q, Yu J. Quality of Life and Its Association with Physical Activity among Different Types of Cancer Survivors. PLoS One 2016; 11:e0164971. [PMID: 27812130 PMCID: PMC5094752 DOI: 10.1371/journal.pone.0164971] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Accepted: 10/04/2016] [Indexed: 12/03/2022] Open
Abstract
Purpose The main goal of this study was to compare the quality of life (QOL) and its association with physical activity (PA) among patients diagnosed with different types of cancer. Based on the results, we tentatively present suggestions for the cancer health care model. Method A cross-sectional study was conducted with 2915 cancer survivors recruited from multi-community cancer rehabilitation centers, all of which were affiliated with the Shanghai Cancer Rehabilitation Club. We collected data including socio-demographic characteristics and information about PA. All the subjects included were asked to complete the European Organization for Research and Treatment Quality of Life Questionnaires (EORTC QLQ-C30) and Functional Assessment of Cancer Therapy—General Questionnaire (FACT-G). Multiple linear regression models were employed to control the potential confounding factors. Results Lung cancer survivors reported the worst dyspnea. Colorectal cancer survivors claimed the highest level of constipation and diarrhea. Liver cancer survivors indicated greatest loss of appetite and financial difficulties. Generally, survivors with PA tended to reported better QOL, although these associations among liver cancer survivors were not statistically significant. Moreover, survivors of all cancer types who performed PA did not report significant lower level of constipation or diarrhea. The relationship between PA frequency and QOL among cancer survivors remained unexplored. Conclusions Both QOL and its association with PA vary among survivors of different cancer types. The detailed results can assist clinicians and public health practitioners with improving health care management.
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Affiliation(s)
- Furong Tang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Jiwei Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Zheng Tang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Mei Kang
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Qinglong Deng
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
| | - Jinming Yu
- Institute of Epidemiology and Health Statistics, School of Public Health, Fudan University, Shanghai, China
- * E-mail:
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Zhang P, Li H, Yang B, Yang F, Zhang LL, Kong QY, Chen XY, Wu ML, Liu J. Biological significance and therapeutic implication of resveratrol-inhibited Wnt, Notch and STAT3 signaling in cervical cancer cells. Genes Cancer 2014; 5:154-64. [PMID: 25061499 PMCID: PMC4104760 DOI: 10.18632/genesandcancer.15] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/25/2014] [Indexed: 12/31/2022] Open
Abstract
Cervical cancers/CCs are one of the commonest malignancies and the second leading cause of cancer-related death in women. Resveratrol inhibits CC cell growth but its molecular target(s) remains unclear. Since the signaling pathways mediated by STAT3, Notch1 and Wnt2 play beneficial roles in CC formation and progression, the effects of resveratrol on them in cervical adenocarcinoma (HeLa) and squamous cell carcinoma (SiHa) cells were analyzed. The biological significances of the above signaling for HeLa and SiHa cells were evaluated by treating the cells with STAT3, Wnt or Notch selective inhibitors. The frequencies of STAT3, Notch and Wnt activations in 68 cases of CC specimens and 38 non-cancerous cervical epithelia were examined by tissue microarray-based immunohistochemical staining. The results revealed that HeLa and SiHa cells treated by 100μM resveratrol showed extensive apoptosis, accompanied with suppression of STAT3, Notch and Wnt activations. Growth inhibition and apoptosis were found in HeLa and SiHa populations treated by AG490, a STAT3/JAK3 inhibitor but not the ones treated by Notch inhibitor L-685,458 or by Wnt inhibitor XAV-939. Immunohistochemical staining performed on the tissue microarrays showed that the frequencies of Notch1, Notch2, Hes1, Wnt2, Wnt5a and p-STAT3 detection as well as β-catenin nuclear translocation in CC samples were significantly higher than that of noncancerous group (p<0.01), while the expression rate of PIAS3 was remarkably low in cancer samples (p<0.01). Our results thus demonstrate that STAT3, Wnt and Notch signaling are frequently co-activated in human CC cells and specimens and resveratrol can concurrently inhibit those signaling activations and meanwhile lead cervical squamous cell carcinoma and adenocarcinoma cells to growth arrest and apoptosis. STAT3 signaling is more critical for CC cells and is the major target of resveratrol because selective inhibition of STAT3 rather than Wnt or Notch activation commits SiHa and HeLa cells to apoptosis.
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Affiliation(s)
- Peng Zhang
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Hong Li
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Bin Yang
- Department of Gynaecological Surgery, Sheng-Jing Hospital, China Medical University, Shenyang 110031, China
| | - Fan Yang
- Department of Gynaecological Surgery, Sheng-Jing Hospital, China Medical University, Shenyang 110031, China
| | - Lin-Lin Zhang
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Qing-You Kong
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Xiao-Yan Chen
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Mo-Li Wu
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
| | - Jia Liu
- Liaoning Laboratory of Cancer Genetics and Epigenetics and Department of Cell Biology, College of Basic Medical Sciences, Dalian Medical University, Dalian 116044, China
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