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Xu Y, Chow R, Chandereng T, Murdy K, Sinha R, Lee-Ying R, Abedin T, Cheung W, Nguyen T, Pham T, Lee S. Definitive Chemoradiotherapy vs. Trimodal Therapy for Locally Advanced Esophageal or Junctional Adenocarcinoma. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Di Gravio E, Lee-Ying R, Rigo R, Karim S, Bosma N. P-138 Real-world delivery, toxicity and outcomes of perioperative FLOT chemotherapy in resectable gastric/gastroesophageal adenocarcinoma: A population-based study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Gagnon R, El Hallani S, Lee-Ying R, Kolinsky M, Khalaf D, Cook S, Vasquez C, Samuel D, Lewis J, Faridi R, Borkar M, Heng D, Alimohamed N, Ruether J, Gotto G, Fairey A, Bismar T, Yip S. 604P Predictive genomic biomarkers in non-metastatic castration resistant prostate cancer (nmCRPC) treated with androgen receptor pathway inhibitors (ARPi). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Le DM, Ahmed S, Ahmed S, Brunet B, Davies J, Doll C, Ferguson M, Ginther N, Gordon V, Hamilton T, Hebbard P, Helewa R, Kim CA, Lee-Ying R, Lim H, Loree JM, McGhie JP, Mulder K, Park J, Renouf D, Wong RPW, Zaidi A, Asif T. Report from the 20th annual Western Canadian Gastrointestinal Cancer Consensus Conference; Saskatoon, Saskatchewan; 28-29 September 2018. Curr Oncol 2019; 26:e773-e784. [PMID: 31896948 PMCID: PMC6927778 DOI: 10.3747/co.26.5517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The 20th annual Western Canadian Gastrointestinal Cancer Consensus Conference was held in Saskatoon, Saskatchewan, 28-29 September 2018. This interactive multidisciplinary conference is attended by health care professionals from across Western Canada (British Columbia, Alberta, Saskatchewan, and Manitoba) who are involved in the care of patients with gastrointestinal cancers. In addition, invited speakers from other provinces participate. Surgical, medical, and radiation oncologists, and allied health care professionals participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses current issues in the management of colorectal cancers.
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Affiliation(s)
- D M Le
- Saskatoon Cancer Centre, Saskatchewan Cancer Agency, Saskatoon, SK
| | - S Ahmed
- Saskatoon Cancer Centre, Saskatchewan Cancer Agency, Saskatoon, SK
| | - S Ahmed
- CancerCare Manitoba, Winnipeg, MB
| | - B Brunet
- Saskatoon Cancer Centre, Saskatchewan Cancer Agency, Saskatoon, SK
| | | | - C Doll
- Tom Baker Cancer Centre, Alberta Health Services, AB
| | - M Ferguson
- Allan Blair Cancer Centre, Saskatchewan Cancer Agency, Regina, SK
| | - N Ginther
- University of Saskatchewan, Saskatoon, SK
| | - V Gordon
- CancerCare Manitoba, Winnipeg, MB
| | - T Hamilton
- University of British Columbia, Vancouver, BC
| | | | - R Helewa
- University of Manitoba, Winnipeg, MB
| | - C A Kim
- CancerCare Manitoba, Winnipeg, MB
| | - R Lee-Ying
- Tom Baker Cancer Centre, Alberta Health Services, AB
| | | | | | | | - K Mulder
- Cross Cancer Institute, Edmonton, AB
| | - J Park
- CancerCare Manitoba, Winnipeg, MB
| | | | | | - A Zaidi
- Saskatoon Cancer Centre, Saskatchewan Cancer Agency, Saskatoon, SK
| | - T Asif
- Saskatoon Cancer Centre, Saskatchewan Cancer Agency, Saskatoon, SK
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Roy S, Hyndman ME, Danielson B, Fairey A, Lee-Ying R, Cheung WY, Afzal AR, Xu Y, Abedin T, Quon HC. Active treatment in low-risk prostate cancer: a population-based study. ACTA ACUST UNITED AC 2019; 26:e535-e540. [PMID: 31548822 DOI: 10.3747/co.26.4953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Active surveillance instead of active treatment (at) is preferred for patients with low-risk prostate cancer (lr-pca), but practice varies widely. We conducted a population-based study to assess the proportion of patients who underwent at between January 2011 and December 2014, and to evaluate factors associated with at. Methods The provincial cancer registry was linked to administrative health datasets to identify patients with lr-pca and to acquire demographic, tumour, and treatment data. The primary outcome was receipt of at during the first 12 months after diagnosis, defined as any receipt of external-beam radiotherapy, brachytherapy, radical prostatectomy, cryotherapy, or androgen deprivation. Univariate and multivariate logistic regression were used to analyze the correlation between patient and tumour factors and at. Results Of 1565 patients with lr-pca, 554 (35.4%) underwent at within 12 months of diagnosis. Radical prostatectomy was the most common treatment (58%), followed by brachytherapy (29.6%). Younger age [odds ratio (or) 0.92; 95% confidence interval (ci): 0.91 to 0.94], lower score (≥3) on the Charlson comorbidity index (OR: 0.36; 95% ci: 0.19 to 0.68), T2 stage (or: 3.05; 95% ci: 2.03 to 4.58), higher prostate-specific antigen (psa) at diagnosis (or: 1.13; 95% ci: 1.06 to 1.21), radiation oncologist consultation (or: 3.35; 95% ci: 2.55 to 4.39), and earlier diagnosis year (2012 or: 0.46; 95% ci: 0.34 to 0.63; 2013 or: 0.45; 95% ci: 0.32 to 0.63; 2014 or: 0.33; 95% ci: 0.23 to 0.47) were associated with a higher probability of at. Conclusions This contemporary population-based study demonstrates that approximately one third of patients with lr-pca undergo at. Patients of younger age, with less comorbidity, a higher tumour stage, higher psa, earlier year of diagnosis, and radiation oncologist consultation were more likely to undergo at. Further investigation is needed to identify strategies that could minimize overtreatment.
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Affiliation(s)
- S Roy
- Tom Baker Cancer Centre, Calgary, AB.,Department of Oncology, University of Calgary, Calgary, AB
| | - M E Hyndman
- Southern Alberta Institute of Urology, Calgary, AB.,Department of Surgical Oncology, University of Calgary, Calgary, AB
| | - B Danielson
- Cross Cancer Institute, Edmonton, AB.,Department of Oncology, University of Alberta, Edmonton, AB
| | - A Fairey
- Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB
| | - R Lee-Ying
- Tom Baker Cancer Centre, Calgary, AB.,Department of Oncology, University of Calgary, Calgary, AB
| | - W Y Cheung
- Tom Baker Cancer Centre, Calgary, AB.,Department of Oncology, University of Calgary, Calgary, AB
| | - A R Afzal
- Tom Baker Cancer Centre, Calgary, AB
| | - Y Xu
- Department of Community Health Sciences, University of Calgary, Calgary, AB
| | - T Abedin
- Tom Baker Cancer Centre, Calgary, AB
| | - H C Quon
- Tom Baker Cancer Centre, Calgary, AB.,Department of Oncology, University of Calgary, Calgary, AB
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Thiessen M, Tang P, Lee-Ying R, Monzon J. Impact of the number of nodes examined on survival in node negative small bowel adenocarcinoma: A SEER database analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nixon NA, Lim H, Elser C, Ko YJ, Lee-Ying R, Tam VC. Oncology education for Canadian internal medicine residents: the value of participating in a medical oncology elective rotation. ACTA ACUST UNITED AC 2018; 25:213-218. [PMID: 29962839 DOI: 10.3747/co.25.3934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Despite the high incidence and burden of cancer in Canadians, medical oncology (mo) rotations are not mandatory in most Canadian internal medicine (im) residency training programs. Methods All im residents scheduled for a mo rotation at 4 Canadian teaching cancer centres between 1 January 2013 and 31 December 2015 were invited to complete an online survey before and after their rotation. The survey was designed to evaluate perceptions of oncology, comfort in managing cancer patients, and basic oncology knowledge. Results The survey was completed by 68 im residents pre-rotation and by 48 (71%) post-rotation. Cancer-related learning was acquired mostly from mo physicians in clinic (35%). Self-directed learning, didactic teaching, and resident or fellow teaching accounted for 31%, 26%, and 10% respectively of learning acquisition. Comfort level in dealing with cancer patients and patients at end of life improved to 4.0/5 from 3.2/5 (p < 0.001) and to 4.0/5 from 3.6/5 (p = 0.003) respectively. Mean knowledge assessment score improved to 83% post-rotation from 76% pre-rotation (p = 0.003), with the greatest increase observed in general knowledge of common malignancies. The 3 topics ranked as most important to learn during a mo rotation were oncologic emergencies, common complications of treatment, and approach to diagnosis of cancer. Conclusions A rotation in mo improves the perceptions of im residents about oncology and their comfort level in dealing with cancer patients and patients at end of life. Overall cancer knowledge is also improved. Given those benefits, im residency programs should encourage most of their residents to complete a mo rotation.
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Affiliation(s)
- N A Nixon
- Tom Baker Cancer Centre, Calgary, AB
| | | | - C Elser
- Princess Margaret Cancer Centre and
| | - Y J Ko
- Sunnybrook Odette Cancer Centre, Toronto, ON
| | | | - V C Tam
- Tom Baker Cancer Centre, Calgary, AB
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Lee-Ying R, Loree J, Cheung W, Tang P. Impact of advances in systemic chemotherapy for unresectable pancreatic ductal adenocarcinoma (PDAC) in Alberta, Canada. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ahmed S, Shahid RK, Bhatt H, Lee-Ying R, Lim J. Chemotherapy-related thrombocytosis: does it increase the risk of thromboembolism? Oncology 2012; 82:327-32. [PMID: 22627488 DOI: 10.1159/000337235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 02/06/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Chemotherapy increases the risk of thromboembolism in patients with cancer. Although thrombocytopenia is a known side effect of chemotherapy, reactive thrombocytosis related to chemotherapy is uncommonly reported. The present study aimed to determine the incidence of gemcitabine-related thrombocytosis and the associated risk of thromboembolism. METHODS Medical records of 250 consecutive patients with a malignant disease who received gemcitabine-based therapy were reviewed. A multivariate analysis was done to determine factors associated with thromboembolism. RESULTS A total of 220 eligible patients with a median age of 63 years (range 26-83) were identified. Of these 220 patients, 95% had advanced malignancy and 59% had received prior chemotherapy. A total of 69% of patients received a platinum combination. In all, 46% patients experienced thrombocytosis following chemotherapy, with a median platelet count of 632 × 10(9)/l (range 457-1,385). Twenty-three of the 220 patients experienced a vascular event within 6 weeks of treatment. Eleven patients with thrombocytosis experienced a vascular event compared with 10 patients without thrombocytosis (not significant). On multivariate analysis, leukocytosis (odds ratio 5.8, 95% confidence interval 2.1-15.8) and comorbid illnesses (odds ratio 4.1, 95% confidence interval 1.4-12.6) were correlated with thromboembolism. CONCLUSIONS Although gemcitabine-based therapy has been associated with an increased incidence of thrombocytosis, it does not increase the risk of thromboembolism in cancer patients. Leukocytosis and comorbid illnesses do increase the risk of thromboembolism.
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Affiliation(s)
- S Ahmed
- Department of Oncology, Saskatoon Cancer Center, Saskatoon, Sask., Canada.
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Lee-Ying R, Ubhi C, Roberts S, Lim H, Bhatt H, Gesy K, Ahmed S. P1-08-15: Pattern of Cardiac Monitoring and Risk of Trastuzumab Associated-Cardiac Dysfunction in a Clinical Practice: A Population Based Study. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p1-08-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Adjuvant trastuzumab therapy (ATT) in women with early-stage HER2+ breast cancer has been associated with significant reduction in the disease recurrence and mortality. Cardiac dysfunction (CD) is a known serious adverse effect of ATT. Although periodic cardiac monitoring is recommended during ATT, little is known about pattern of cardiac monitoring and incidence of CD in a clinical setting. The study aimed to determine extent of cardiac monitoring and rate of CD during ATT and to identify factors correlated with CD.
Methods: Medical records of women with localized HER+ breast cancer diagnosed between the years 2005–2007 in the province of Saskatchewan was reviewed. Women with advanced or recurrent disease or if they were treated in the setting of an adjuvant trastuzumab trial were excluded. A logistic regression analysis was performed to determine various clinical variables correlated with CD.
Results: A total 116 eligible women with median age of 54 yrs (range: 27–74) and median BMI of 27 (range: 44–17) were indentified. 40% had a cardiac risk factor & 30% were premenopausal. 51% had node positive & 53% had ER or PR+ breast cancer. 92% received anthracycline-based chemotherapy and 23% received sequential ATT. Of 62 patients with ER/PR+ breast cancer, 61% received adjuvant aromatase inhibitors. Baseline cardiac assessment was performed in 93% women. 98% women underwent periodic cardiac monitoring during ATT, 55% had monitoring performed at the interval of 3–4 months & 82% women had monitoring performed at the interval of 3–6 months. Mean baseline cardiac ejection fraction (EF%) prior to the commencement of chemotherapy and ATT were 65% & 63.9% respectively (p=NS). CD was observed in 32 (28%) women and only 4% were symptomatic. Trastuzumab was interrupted in 34%, and was discontinued in 20% women. Of 32 women with CD, 59% were referred to a cardiologist and 53% were treated with medication. CD was reversible in 84% cases. On multivariate analysis adjuvant aromatase inhibitor therapy was significantly correlated with cardiac dysfunction (Odd ratio 6.9 [95% CI: 1.4−33.0]). During the follow up period 18% women developed recurrent disease and 16% were died.
Conclusions: Our results confirm high compliance with cardiac monitoring, though not as frequently as recommended in the clinical trial setting. Overall the rate of symptomatic decline in cardiac function was similar to the rate reported in the clinical trials, however, a relatively higher incidence of asymptomatic decline in the left ventricle EF% was noted. Among various variables examined, adjuvant aromatase inhibitor therapy was associated with an increased risk of CD.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P1-08-15.
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Affiliation(s)
- R Lee-Ying
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - C Ubhi
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - S Roberts
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - H Lim
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - H Bhatt
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - K Gesy
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
| | - S Ahmed
- 1University of Saskatchewan, Saskatoon, SK, Canada; University of Saskatchewan; Saskatchewan Cancer Agency
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Ahmed S, Lim J, Shahid R, Bhatt H, Roberts S, Ubhi C, Lee-Ying R, Sami A. 3525 POSTER Chemotherapy-Related Thrombocytosis and Its Association With Thromboembolism (TE). Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Ahmed S, Zhu T, Lee-Ying R, Ubhi C, Kundapur V, Alvi R, Haider K. Predictive markers of utilization of chemotherapy in patients with advanced colorectal cancer (CRC): A population-based study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.6053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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