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Meriam K, Manel L, Jihene S, Hédi K, Ali M, Thouraya A. Delays in the Surgical Pathway in Breast cancer Patients in Tunisia: A Descriptive Prospective Study. Indian J Surg Oncol 2021; 13:385-393. [DOI: 10.1007/s13193-021-01484-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/23/2021] [Indexed: 10/19/2022] Open
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Ben Abdallah I, Ben Nasr S, Chourabi C, Boukhris M, Ben Abdallah I, Zribi A, Fendri S, Balti M, Fehri W, Chraiet N, Haddaoui A. The Predictive Value of 2D Myocardial Strain for Epirubicin-Induced Cardiotoxicity. JOURNAL OF ONCOLOGY 2020; 2020:5706561. [PMID: 33335549 PMCID: PMC7723482 DOI: 10.1155/2020/5706561] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 09/06/2020] [Accepted: 11/11/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although epirubicin has significantly improved outcome in breast cancer (BC) patients, it is responsible for myocardial dysfunction that affects patients' quality of life. The use of 2D global longitudinal strain (GLS) has been reported to detect early myocardial dysfunction. The aim of this study was to evaluate how GLS changes can predict cardiotoxicity. METHODS We conducted a prospective study from March 2018 to March 2020 on 66 patients with no cardiovascular risk factors, who presented with BC and received epirubicin. We measured left ventricular ejection fraction (LVEF) and GLS before chemotherapy, at three months (T3), and at 12 months (T12) from the last epirubicin infusion. Chemotherapy-Related-Cardiac-Dysfunction (CTRCD) was defined as a decrease of 10% in LVEF to a value below 53% according to ASE and EACI 2014 expert consensus. RESULTS The mean age at diagnosis was 47 ± 9 years old. At baseline, median LVEF was 70% and median GLS was -21%. Shortly after chemotherapy completion, two patients presented with symptomatic heart failure while asymptomatic CTRCD was revealed in three other patients at T12. Three months after the last epirubicin infusion, median LVEF was 65%, median GLS was -19%, and median GLS variation was 5%. However, in patients who presented with subsequent CTRCD, median GLS at T3 was -16% and median GLS variation was 19% (p=0.002 and p < 0.001, respectively, when compared to patients who did not develop cardiotoxicity). Persistent GLS decrease at T3 was an independent predictor of CTRCD at T12. Age and left-sided thoracic irradiation did not increase the risk of cardiotoxicity in our study while the cumulative dose of epirubicin significantly affected cardiologic findings (p=0.001). CONCLUSION This was the first North African study that assesses the value of measuring GLS to early detect cardiotoxicity. Patients whose GLS remained decreased after 3 months from anthracyclines-base chemotherapy had an increased risk for developing subsequent CTRCD. Further studies with larger sample size are warranted to identify the best cardioprotective molecules to be initiated in these patients before LVEF declines.
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Affiliation(s)
- Ichrak Ben Abdallah
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Sonia Ben Nasr
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Chadia Chourabi
- Department of Cardiology, Military Hospital of Tunis Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Marouane Boukhris
- Division of Cardiology, Centre Hospitalier de l'université de Montréal, Montreal, Québec, Canada
| | - Israa Ben Abdallah
- Department of Business Analytics, Tunis Business School, El Mourouj, Tunisia
| | - Aref Zribi
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Sana Fendri
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Mehdi Balti
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Wafa Fehri
- Department of Cardiology, Military Hospital of Tunis Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Nesrine Chraiet
- Department of Medical Oncology, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
| | - Abderrazek Haddaoui
- Department of Medical Oncology, Military Hospital of Tunis, Université de Tunis El Manar, Faculté de Médecine de Tunis, Tunis 1007, Tunisia
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Mimouni M, Chaouki W, Errihani H, Benjaafar N. [An analysis of breast cancer treatment waiting times: Experience of a tertiary referral center in Morocco]. Bull Cancer 2018; 105:755-762. [PMID: 30005892 DOI: 10.1016/j.bulcan.2018.05.010] [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: 01/27/2018] [Revised: 05/14/2018] [Accepted: 05/18/2018] [Indexed: 10/28/2022]
Abstract
Measuring waiting times is a good indicator of quality and performance of cancer care. However, no detailed evaluation of these deadlines has been carried out in Morocco. The aim of this study was to determine the waiting times of medical care of breast cancer in a national tertiary referral center. The study was carried out by retrospective analysis of 373 cases of patients randomly selected among the cases recruited during the year 2015. Twelve delays of the care pathway were evaluated. The mean age was of 50,7 years. The deadline of access to this center was 9±8days. The deadline of access to the diagnosis was 33.5±21.2 days. The deadlines of access to multidisciplinary team meeting pre-therapeutic was 20.4±16.9 days. The access to the first treatment was 51.1±34.3 days for the neoadjuvant chemotherapy and 75.5±34.8 days for surgery. The deadline of access to the postoperative therapeutic proposal was on average 49.2±25.2 days. The deadline of access to the postoperative chemotherapy was 83.7±28.8 days and 284±43.8 days for postoperative radiotherapy in case of adjuvant chemotherapy. The global deadline mammography-radiotherapy was 372±66.5 days. Many of our deadlines were long compared to international recommendations. The factors associated with these delays must be analyzed in order to introduce improvement measures to control these indicators.
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Affiliation(s)
| | - Wahid Chaouki
- Institut national d'oncologie, CHU Ibn Sina, Rabat, Maroc.
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