1
|
Krishnaraju VS, Kumar R, Mittal BR, Singh H, Aggarwal P, Singh H, Yadav TD, Nada R, Gupta V, Gupta R. Incidentally Detected Gallbladder Carcinoma: Can F-18 FDG PET/CT Aid in Staging and Prognostication? Nucl Med Mol Imaging 2024; 58:104-112. [PMID: 38633288 PMCID: PMC11018561 DOI: 10.1007/s13139-024-00841-w] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 12/26/2023] [Accepted: 01/10/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose Incidental gallbladder carcinoma (IGBC) is diagnosed in post-cholecystectomy specimens for benign indications, where the role of 2-fluro-2-deoxyglucose positron emission tomography/computed tomography(FDG-PET/CT) is not clearly defined. The present study aimed to assess the benefits of staging and prognosticating with FDG-PET/CT in IGBC. Materials and Methods A retrospective observational study from a tertiary-care center from January 2010 to July 2020 was performed. The demographic, clinical, histopathological, and treatment-related histories were collected. FDG-PET/CT-image findings were compared with survival outcomes through telephonic follow-up. The chi-square test was used for comparing frequencies. The univariate and multivariate survival estimates were analyzed using the Kaplan-Meier analysis and the Cox-proportional hazard model, respectively. Log-rank test was used to compare the Kaplan-Meier curves. Results The study included 280 postcholecystectomy participants (mean age: 52 ± 11 years; women: 227) of whom 52.1% had open surgery(146/280). Residual disease in the gallbladder fossa (54.8% vs. 36.6%, p = 0.002) and liver infiltration (32.9% vs. 22.4%, p = 0.05) were seen more frequently in open surgery compared to laparoscopic surgery, while anterior abdominal wall deposits were more common in laparoscopy(35.1% vs. 24%,p = 0.041). FDG-PET/CT changed the management in 10% (n = 28) of patients compared to contrast-enhanced CT. The median survival was 14 months (95%CI-10.3-17.7). A higher stage of the disease on the FDG-PET/CT (loco-regional disease-HR 4.86, p = 0.006; metastatic disease-HR 7.53, p < 0.001) and the presence of liver infiltration (HR-1.92, p = 0.003) were independent predictors of poor survival outcomes. Conclusion FDG-PET/CT detects residual and metastatic disease in patients with IGBC, enabling the institution of appropriate management and acting as a tool for prognostication of survival.
Collapse
Affiliation(s)
- Venkata Subramanian Krishnaraju
- Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Rajender Kumar
- Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Bhagwant Rai Mittal
- Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Harjeet Singh
- Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Piyush Aggarwal
- Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Harmandeep Singh
- Department of Nuclear Medicine and PET/CT, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Thakur Deen Yadav
- Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Ritambhra Nada
- Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vikas Gupta
- Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Rajesh Gupta
- Department of Surgical Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012 India
| |
Collapse
|
2
|
Rogge AA, Liegl G, Snyder C, Rose M, Nolte S. EORTC QLQ-C30 general population normative data for the United States. Eur J Cancer 2024; 202:114030. [PMID: 38552543 DOI: 10.1016/j.ejca.2024.114030] [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] [Received: 12/19/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a frequently used cancer-specific health-related quality of life (HRQoL) questionnaire. To aid interpretation of data obtained via EORTC QLQ-C30, general population norm data have been published for many countries. However, despite its frequent use in the United States, no normative data by sex and age exist to date. Therefore, this study aimed to generate sex- and age-specific EORTC QLQ-C30 normative data for the United States. METHODS Recruitment and data collection were carried out via online panels as part of a larger cross-sectional study. For the recruitment, the sample was stratified by sex and age (18-39, 40-49, 50-59, 60-69, ≥ 70 years) to achieve a balanced distribution, with n = 100 per subgroup. Descriptive statistics are presented by age and age/sex. RESULTS A total of N = 1009 respondents completed the survey (n = 508 females, n = 501 males). More than two thirds of participants (72.5%) reported at least one health condition, e.g., arthritis (26%). Across EORTC QLQ-C30 scales, women and men 60 years and older reported generally better/higher functioning and better/lower symptom scores compared to the younger age groups. CONCLUSION To date, no specific EORTC QLQ-C30 general population normative data have been published for the United States. This paper provides these important normative data, which will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from US cancer patients, and also enable comparison with European norms.
Collapse
Affiliation(s)
- Alizé A Rogge
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Gregor Liegl
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claire Snyder
- Johns Hopkins Schools of Medicine and Public Health, Baltimore, MD, USA
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Mental Health (DZPG) - - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Nolte
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| |
Collapse
|
3
|
Becker von Rose A, Kobus K, Bohmann B, Lindquist-Lilljequist M, Eilenberg W, Kapalla M, Bassermann F, Reeps C, Eckstein HH, Neumayer C, Brostjan C, Roy J, von Heckel K, Hultgren R, Schwaiger BJ, Combs SE, Busch A, Schiller K. Radiation therapy for cancer is potentially associated with reduced growth of concomitant abdominal aortic aneurysm. Strahlenther Onkol 2024; 200:425-433. [PMID: 37676483 DOI: 10.1007/s00066-023-02135-0] [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] [Received: 05/30/2023] [Accepted: 07/30/2023] [Indexed: 09/08/2023]
Abstract
PURPOSE Co-prevalence of abdominal aortic aneurysm (AAA) and cancer poses a unique challenge in medical care since both diseases and their respective therapies might interact. Recently, reduced AAA growth rates were observed in cancer patients that received radiation therapy (RT). The purpose of this study was to perform a fine-grained analysis of the effects of RT on AAA growth with respect to direct (infield) and out-of-field (outfield) radiation exposure, and radiation dose-dependency. METHODS A retrospective single-center analysis identified patients with AAA, cancer, and RT. Clinical data, radiation plans, and aneurysm diameters were analyzed. The total dose of radiation to each aneurysm was computed. AAA growth under infield and outfield exposure was compared to patients with AAA and cancer that did not receive RT (no-RT control) and to an external noncancer AAA reference cohort. RESULTS Between 2003 and 2020, a total of 38 AAA patients who had received well-documented RT for their malignancy were identified. AAA growth was considerably reduced for infield patients (n = 18) compared to outfield patients (n = 20), albeit not significantly (0.8 ± 1.0 vs. 1.3 ± 1.6 mm/year, p = 0.28). Overall, annual AAA growth in RT patients was lower compared to no-RT control patients (1.1 ± 1.5 vs. 1.8 ± 2.2 mm/year, p = 0.06) and significantly reduced compared to the reference cohort (1.1 ± 1.5 vs. 2.7 ± 2.1 mm/year, p < 0.001). The pattern of AAA growth reduction due to RT was corroborated in linear regression analyses correcting for initial AAA diameter. A further investigation with respect to dose-dependency of radiation effects on AAA growth, however, revealed no apparent association. CONCLUSION In this study, both infield and outfield radiation exposure were associated with reduced AAA growth. This finding warrants further investigation, both in a larger scale clinical cohort and on a molecular level.
Collapse
Affiliation(s)
- Aaron Becker von Rose
- III. Medical Department for Hematology and Oncology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany.
| | - Kathrin Kobus
- Department for Vascular and Endovascular Surgery, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Bianca Bohmann
- Department for Vascular and Endovascular Surgery, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Moritz Lindquist-Lilljequist
- Stockholm Aneurysm Research Group (STAR), Department of Vascular Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Wolf Eilenberg
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna and University Hospital Vienna, Vienna, Austria
| | - Marvin Kapalla
- Division of Vascular and Endovascular Surgery, Department for Visceral‑, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Florian Bassermann
- III. Medical Department for Hematology and Oncology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Christian Reeps
- Division of Vascular and Endovascular Surgery, Department for Visceral‑, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Hans-Henning Eckstein
- Department for Vascular and Endovascular Surgery, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Christoph Neumayer
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna and University Hospital Vienna, Vienna, Austria
| | - Christine Brostjan
- Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna and University Hospital Vienna, Vienna, Austria
| | - Joy Roy
- Stockholm Aneurysm Research Group (STAR), Department of Vascular Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | | | - Rebecka Hultgren
- Stockholm Aneurysm Research Group (STAR), Department of Vascular Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Benedikt J Schwaiger
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Stephanie E Combs
- Department of Radiation Oncology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| | - Albert Busch
- Department for Vascular and Endovascular Surgery, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
- Division of Vascular and Endovascular Surgery, Department for Visceral‑, Thoracic and Vascular Surgery, Medical Faculty Carl Gustav Carus and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Kilian Schiller
- Department of Radiation Oncology, University Hospital rechts der Isar, Technical University Munich, Munich, Germany
| |
Collapse
|
4
|
Mossman B, Perry LM, Voss HM, Maciejewski PK, Gramling R, Duberstein P, Prigerson HG, Epstein RM, Hoerger M. Patient-Caregiver Dyads & End-of-Life Care: Caregiver Personality Disrupts Gender-Based Norms. J Pain Symptom Manage 2024; 67:e393-e398. [PMID: 38278189 PMCID: PMC11032258 DOI: 10.1016/j.jpainsymman.2024.01.030] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/28/2024]
Abstract
CONTEXT Gender and personality may individually impact end-of-life care. Men often receive more aggressive treatments than women near death, and personality - particularly openness - may be associated with increased care utilization when it diverges from traditional treatment norms. However, research has not examined the interaction of these variables in a dyadic context. OBJECTIVES This study examined the dyadic effects of patient gender and caregiver personality on end-of-life care. METHODS Using data from the VOICE randomized clinical trial, the present sample consisted of patient-caregiver dyads receiving outpatient care for advanced cancer in Sacramento and Western New York. Analyses assessed whether caregiver personality was associated with gender-based differences in patient chemotherapy or emergency department/inpatient visits in the 30 days before death. Logistic regression examined the interaction between caregivers' Big Five personality dimensions and patient gender while accounting for patient and caregiver demographic and health characteristics. RESULTS Of a total of 134 patient-caregiver dyads, 19.4% (n = 26) of patients received chemotherapy and 47.8% (n = 64) had an emergency department/inpatient visit in the 30 days before death. Results demonstrated a significant interaction between caregiver openness and patient gender on receipt of chemotherapy (odds ratio = 0.07, p = 0.006). When caregivers were less open, men were more likely to receive chemotherapy near death, whereas when caregivers were more open, women were more likely to receive chemotherapy near death. CONCLUSION Results suggest caregiver personality characteristics, particularly openness, might disrupt gender-based treatment norms at end-of-life. Findings demonstrate that patient and caregiver factors can interact to explain patient healthcare utilization.
Collapse
Affiliation(s)
- Brenna Mossman
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA
| | - Laura M Perry
- Department of Medical Social Sciences (L.M.P.), Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Medicine (L.M.P.), Tulane University School of Medicine, New Orleans, LA, USA
| | - Hallie M Voss
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA
| | - Paul K Maciejewski
- Cornell Center for Research on End-of-Life Care (P.K.M., H.G.P.), Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Robert Gramling
- Department of Family Medicine (R.G.), University of Vermont, Burlington, VT, USA
| | - Paul Duberstein
- Department of Health Behavior (P.D.), Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
| | - Holly G Prigerson
- Cornell Center for Research on End-of-Life Care (P.K.M., H.G.P.), Department of Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Ronald M Epstein
- Departments of Family Medicine (R.M.E.), Medicine and Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Hoerger
- Department of Psychology (B.M., H.M.V., M.H.), Tulane University, New Orleans, LA, USA; Departments of Psychiatry and Medicine (M.H.), Tulane Cancer Center, and Freeman School of Business, Tulane University, New Orleans, LA, USA.
| |
Collapse
|
5
|
Liz-Pimenta J, Tavares V, Gramaça J, Rato J, Menezes M, Baleiras M, Guedes H, Reis J, Guedes C, Gomes R, Barbosa M, Sousa M, Khorana AA, Medeiros R. Primary thromboprophylaxis in cancer outpatients - real-world evidence. J Thromb Thrombolysis 2024:10.1007/s11239-024-02984-1. [PMID: 38643312 DOI: 10.1007/s11239-024-02984-1] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
INTRODUCTION Cancer-associated thrombosis (CAT) is a significant concern among patients with malignant diseases, leading to increased mortality. While current guidelines recommend primary thromboprophylaxis for venous thromboembolism (VTE) in medium-to-high-risk outpatients, this practice remains controversial. A better understanding of primary thromboprophylaxis is crucial, yet there is a lack of Real-World Evidence (RWE) in Portugal. AIMS This RWE study aimed to elucidate primary thromboprophylaxis practices among cancer outpatients in Portugal. METHODS A five-year observational multicentric study in eight Portuguese health institutions enrolled 124 adult cancer outpatients under primary thromboprophylaxis for VTE. The endpoints were CAT, bleeding, cancer progression and death. RESULTS High thrombotic risk tumours were prevalent, with 57% (71) of the patients presenting with pancreatic and gastric cancers. Regarding primary thromboprophylaxis, 55% (68) received Low-Molecular-Weight Heparin (LMWH). VTE was presented in 11% (14) of the patients and major bleeding in 2% (2). Vascular compression, elevated D-dimer and previous VTE were significantly associated with VTE occurrence under primary thromboprophylaxis. The Onkotev model was shown to be the best risk assessment model (RAM) in this population (p = 0.007). CAT patients exhibited a lower progression-free survival than non-CAT patients (p = 0.021), while thrombosis did not influence overall survival (p = 0.542). CONCLUSION Primary thromboprophylaxis in medium-to-high-risk cancer outpatients is a safe and effective practice in real-world settings. This study is the first Portuguese RWE on primary thromboprophylaxis, highlighting evidence for improving prophylactic strategies in this population.
Collapse
Affiliation(s)
- Joana Liz-Pimenta
- Department of Medical Oncology, Hospital Center of Trás-Os-Montes E Alto Douro, 5000-508, Vila Real, Portugal
- Faculty of Medicine of University of Porto (FMUP), 4200-072, Porto, Portugal
| | - Valéria Tavares
- Faculty of Medicine of University of Porto (FMUP), 4200-072, Porto, Portugal
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP) / Pathology and Laboratory Medicine Dep., Clinical Pathology SV / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center (Porto. CCC), 4200-072, Porto, Portugal
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal
| | - João Gramaça
- Department of Medical Oncology, Hospital Center of Barreiro Montijo, 2830-003, Barreiro, Portugal
| | - João Rato
- Department of Medical Oncology, Hospital of Luz Setúbal, 2900-722, Setúbal, Portugal
| | - Maria Menezes
- Department of Medical Oncology, Hospital of Espírito Santo de Évora, 7000-811, Évora, Portugal
| | - Mafalda Baleiras
- Department of Medical Oncology, Hospital Center of Lisboa Ocidental, 1449-005, Lisbon, Portugal
| | - Helena Guedes
- Department of Medical Oncology, Hospital Center of Vila Nova de Gaia / Espinho, 4434-502, Vila Nova de Gaia, Portugal
| | - Joana Reis
- Department of Medical Oncology, University Hospital Center of São João, 4200-319, Porto, Portugal
| | - Catarina Guedes
- Department of Imunohemotherapy, Hospital of Senhora da Oliveira, 4835-044, Guimarães, Portugal
| | - Rosa Gomes
- Department of Medical Oncology, Hospital Center of Trás-Os-Montes E Alto Douro, 5000-508, Vila Real, Portugal
| | - Miguel Barbosa
- Department of Medical Oncology, University Hospital Center of São João, 4200-319, Porto, Portugal
| | - Marta Sousa
- Department of Medical Oncology, Hospital Center of Trás-Os-Montes E Alto Douro, 5000-508, Vila Real, Portugal
| | - Alok A Khorana
- Department of Hematology and Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, 44106, USA
| | - Rui Medeiros
- Faculty of Medicine of University of Porto (FMUP), 4200-072, Porto, Portugal.
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP) / Pathology and Laboratory Medicine Dep., Clinical Pathology SV / RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) / Porto Comprehensive Cancer Center (Porto. CCC), 4200-072, Porto, Portugal.
- ICBAS - Instituto de Ciências Biomédicas Abel Salazar, Universidade Do Porto, Porto, Portugal.
- Research Department, Portuguese League Against Cancer - Regional Nucleus of the North, 4200-172, Porto, Portugal.
- Biomedical Research Center, Faculty of Health Sciences of the Fernando Pessoa University, 4249-004, Porto, Portugal.
| |
Collapse
|
6
|
Oliva R, Grassi S, Marchetti C, Cazzato F, Marinelli R, Scambia G, Fagotti A. Medicolegal and insurance issues regarding BRCA1 and BRCA2 gene tests in high income countries. Int J Gynecol Cancer 2024:ijgc-2023-005225. [PMID: 38642925 DOI: 10.1136/ijgc-2023-005225] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2024] Open
Abstract
Hereditary breast and ovarian cancer syndrome is an autosomal dominant cancer susceptibility syndrome mainly due to variants in BRCA1 or BRCA2 genes. Patients presenting with BRCA1 or BRCA2 gene mutations have a lifetime risk of developing breast or ovarian cancer (80% and 40%, respectively). Genetic testing to explore the predisposition to develop cancer represents a pivotal factor in such cases, and this review wants to explore the main implications in terms of medicolegal liability and insurance issues. Medicolegal issues related to these diagnostic processes include: (a) failure to recommend the test; (b) failure to properly interpret the test; (c) failure to correctly translate results into clinical practice; (d) lack of informed consent; and (e) failure to refer patients to specialized genetic counseling. Such errors may lead to compensation since the legal burden inherent in the efficacy of prophylactic interventions is a proof that requires the so-called 'preponderance of the evidence'. Concerning insurance issues, the carriers of such alleles without cancer are healthy because the genetic predisposition is not a disease per se but represents a (relevant) health risk. However, disclosure of these conditions can be impelled by insurers. It can lead to so-called 'genetic discrimination' because insurance companies might use genetic information to limit insurance options or increase their costs. Many private and public healthcare funders do not cover risk reducing surgeries, even when recommended as part of a risk reduction management plan for BRCA gene mutation carriers. Here, positions on these matters from different high income countries are discussed, stressing the importance of a common supranational or international regulatory framework to reach a trade-off between the economic interests of insurers and the rights of carriers not to disclose extremely sensitive information.
Collapse
Affiliation(s)
- Riccardo Oliva
- Department of Women's and Child Health and Public Health Sciences, Obstetrics and Gynecology, Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
| | - Simone Grassi
- Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, Firenze, Italy
| | - Claudia Marchetti
- Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
- Department of Women's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Francesca Cazzato
- Section Legal Medicine, Institute of Public Health, Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
| | - Roberta Marinelli
- Section Legal Medicine, Institute of Public Health, Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
| | - Giovanni Scambia
- Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
- Department of Women's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| | - Anna Fagotti
- Università Cattolica del Sacro Cuore - Campus di Roma, Roma, Italy
- Department of Women's and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy
| |
Collapse
|
7
|
Chadha P, Sharma A, Kamboj M, Mehta A. Immature teratoma of the ovary. Int J Gynecol Cancer 2024:ijgc-2023-005118. [PMID: 38641366 DOI: 10.1136/ijgc-2023-005118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Affiliation(s)
- Prerna Chadha
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
| | - Anila Sharma
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
| | - Meenakshi Kamboj
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
| | - Anurag Mehta
- Department of Pathology, Rajiv Gandhi Cancer Institute and Research Centre, Rohini, Delhi, India
- Department of Research and Molecular Diagnostics, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
| |
Collapse
|
8
|
Zheng X, Yang X, Lei S. Chylous leakage after esophagectomy for esophageal cancer: a systematic review. J Cardiothorac Surg 2024; 19:240. [PMID: 38632619 PMCID: PMC11022397 DOI: 10.1186/s13019-024-02764-1] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 03/30/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Chylous leakage is a rare complication following esophagectomy; however, it can lead to mortality. We aimed to systematically evaluate the factors that may lead to increased chylous leakage after esophagectomy. METHODS Three databases (PubMed, Embase, and Cochrane Library) were systematically searched for all studies investigating the occurrence of chylous leakage after esophagectomy. RESULTS A total of 32 studies were identified, including 26 randomized controlled trials and 3 cohort and case-control studies, each. The overall incidence of chylous leakage was 4.7% (278/5,971 cases). Analysis of preoperative, intraoperative, and postoperative factors showed that most of the qualitative analysis results did not significantly increase the incidence of chylous leakage. In some quantitative analyses, the chylous leakage rate was significantly lower in the thoracic duct mass ligation group than in the conservative treatment group (relative risk [RR] = 0.33; 95% confidence interval [CI], 0.13-0.83; I2 = 0.0%; P = 0.327). Direct oral feeding significantly reduced chylous leakage compared with jejunostomy (RR = 0.06; 95% CI 0.01-0.33; I2 = 0.0%; P = 0.335). However, preoperative inspiratory muscle training (RR = 1.66; 95% CI, 0.21-12.33; I2 = 55.5%; P = 0.134), preoperative chemoradiotherapy (RR = 0.99; 95% CI, 0.55-1.80; I2 = 0.0%; P = 0.943), and robotic assistance (RR = 1.62; 95% CI, 0.92-2.86; I2 = 0.0%; P = 0.814) did not significantly reduce the incidence of chylous leakage. CONCLUSIONS Ligation of the thoracic duct and direct oral feeding can reduce the incidence of chylous leakage after esophagectomy in patients with esophageal cancer. Other contributing factors remain unclear and require validation in further high-quality studies.
Collapse
Affiliation(s)
- Xing Zheng
- Department of Osteoarthrosis, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Xi Yang
- Department of Vascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | - Sujuan Lei
- Department of Hepatobiliary Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
| |
Collapse
|
9
|
Chen Q, van Rein N, van der Hulle T, Heemelaar JC, Trines SA, Versteeg HH, Klok FA, Cannegieter SC. Coexisting atrial fibrillation and cancer: time trends and associations with mortality in a nationwide Dutch study. Eur Heart J 2024:ehae222. [PMID: 38619538 DOI: 10.1093/eurheartj/ehae222] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/24/2024] [Accepted: 03/26/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND AND AIMS Coexisting atrial fibrillation (AF) and cancer challenge the management of both. The aim of the study is to comprehensively provide the epidemiology of coexisting AF and cancer. METHODS Using Dutch nationwide statistics, individuals with incident AF (n = 320 139) or cancer (n = 472 745) were identified during the period 2015-19. Dutch inhabitants without a history of AF (n = 320 135) or cancer (n = 472 741) were matched as control cohorts by demographic characteristics. Prevalence of cancer/AF at baseline, 1-year risk of cancer/AF diagnosis, and their time trends were determined. The association of cancer/AF diagnosis with all-cause mortality among those with AF/cancer was estimated by using time-dependent Cox regression. RESULTS The rate of prevalence of cancer in the AF cohort was 12.6% (increasing from 11.9% to 13.2%) compared with 5.6% in the controls; 1-year cancer risk was 2.5% (stable over years) compared with 1.8% in the controls [adjusted hazard ratio (aHR) 1.52, 95% confidence interval (CI) 1.46-1.58], which was similar by cancer type. The rate of prevalence of AF in the cancer cohort was 7.5% (increasing from 6.9% to 8.2%) compared with 4.3% in the controls; 1-year AF risk was 2.8% (stable over years) compared with 1.2% in the controls (aHR 2.78, 95% CI 2.69-2.87), but cancers of the oesophagus, lung, stomach, myeloma, and lymphoma were associated with higher hazards of AF than other cancer types. Both cancer diagnosed after incident AF (aHR 7.77, 95% CI 7.45-8.11) and AF diagnosed after incident cancer (aHR 2.55, 95% CI 2.47-2.63) were associated with all-cause mortality, but the strength of the association varied by cancer type. CONCLUSIONS Atrial fibrillation and cancer were associated bidirectionally and were increasingly coexisting, but AF risk varied by cancer type. Coexisting AF and cancer were negatively associated with survival.
Collapse
Affiliation(s)
- Qingui Chen
- Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Nienke van Rein
- Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Tom van der Hulle
- Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Julius C Heemelaar
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Cardiovascular Imaging Research Center, Division of Cardiology, and Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA
| | - Serge A Trines
- Department of Cardiology, Heart Lung Center, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Henri H Versteeg
- Department of Medicine, Section of Thrombosis and Hemostasis, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Frederikus A Klok
- Department of Medicine, Section of Thrombosis and Hemostasis, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Suzanne C Cannegieter
- Department of Clinical Epidemiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
- Department of Medicine, Section of Thrombosis and Hemostasis, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| |
Collapse
|
10
|
Bobadilla-Rosado LO, Anaya-Ayala JE, Bonilla A, Mier Y Teran-Ellis S, Miranda-Ramirez M, Laparra-Escareno H, Mendez-Dominguez N, Hinojosa CA. "Fifteen years of experience with surgical Management of Bilateral non-familial carotid body tumors". Ann Vasc Surg 2024:S0890-5096(24)00135-3. [PMID: 38582207 DOI: 10.1016/j.avsg.2024.01.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE Bilateral carotid body tumors (CBT) are infrequent neuroendocrine neoplasms. We conducted this work to describe our experience in the surgical treatment of bilateral CBT and to analyse our results METHODS: A retrospective, observational study. We analysed the totality of bilateral CBT resections that had been performed in our institution from January 2008 to September 2023. Data was obtained from medical records and anonymized, ethics approval was obtained from our institution committee. As the number of observations was less than those required by the central limit theorem our sample was considered non-parametric. Statistical analysis was performed on Stata 17. RESULTS We evaluated 16 patients with a total of 32 CBT; surgical resection was performed in 28 cases (87.50%). Median age of the patients was 60 years (IQR 46-64). Regarding the Shamblin classification, 9 CBTs (32.14%) were classified as Shamblin I, 11 (39.29%) as Shamblin II, and 8 (28.57%) as Shamblin III. The median Distance to the Base of the Skull (DTBOS) was 3.5 cm (IQR 2.7-5.1), and the median tumor volume was 11.25 cc (IQR 3.4-18.7). The median bleeding volume was 300 ml (IQR 200-500), and the median surgical time was 190 minutes (IQR 145-240). All surgeries were performed using the Retrocarotid Dissection (RCD) technique. We documented 9 (32.14%) cases of nerve injuries, all of which were transitory. In the median regression a statistically significant association was found between DTBOS, Shamblin classification and tumor volume with intraoperative bleeding and length of stay. CONCLUSION Surgical treatment remains safe and should be considered the gold standard for accurate histologic diagnosis. DTBOS and tumor volume, in addition to Shamblin classification, must be considered in preoperative planning to predict bleeding and hospital stay.
Collapse
Affiliation(s)
| | - Javier E Anaya-Ayala
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Aliberth Bonilla
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | | | | | - Hugo Laparra-Escareno
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | | | - Carlos A Hinojosa
- Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico.
| |
Collapse
|
11
|
Palma J, Candia O, Cerda P, Vásquez L. Childhood and adolescent cancer in Chile: examining challenges and shaping tomorrow. Rev Panam Salud Publica 2024; 48:e38. [PMID: 38576846 PMCID: PMC10993797 DOI: 10.26633/rpsp.2024.38] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 10/24/2023] [Indexed: 04/06/2024] Open
Abstract
Objective The aim of this study was to describe the epidemiology of childhood cancer in Chile and the disease landscape, assessing achievements, collaborations, and future challenges to be addressed by the National Plan for Child and Adolescent Cancer Control. Methods This descriptive study provides a general overview of national and international collaboration strategies and discusses the results of the Third Childhood Cancer Surveillance Report (2017-2019), the St. Jude Pediatric Oncology Facility Integrated Local Evaluation Tool (or PrOFILE) report, collaboration with the Pan American Health Organization within the framework of the Global Initiative for Childhood Cancer and the development of the National Plan for Child and Adolescent Cancer Control within the CureAll framework. Results The analysis reveals the impact of childhood cancer by considering the incidence between 2017 and 2019, encompassing gender disparities. Leukemia is the most frequently occurring type of cancer, accounting for 40.4% of cancers among children and adolescents younger than 15 years and with an incidence of 57.5 cases per 1 million children in this age group. Cancer is the second leading cause of death among those aged 5-14 years. Cancer survival increased between 2007 and 2019, with 78.4% survival at 5 years post-diagnosis in 2023. The development of the National Plan for Child and Adolescent Cancer Control involved assessing the situation, setting goals and devising an action plan to reduce mortality from cancer in childhood and increase survival rates through early interventions and smooth transitions to adult care. Conclusions Chile has made progress in childhood cancer indicators, particularly in increasing survival, demonstrating its commitment to improving care for children with cancer, and this has been achieved through legislative frameworks, national planning, collaborative partnerships and participation in global initiatives. Despite the progress made, ongoing research, strong policy implementation and multidisciplinary collaborations remain vital to addressing persistent challenges. This study highlights the need to refine health systems, data collection methodologies and global cooperation to ensure optimal care for every child facing cancer, thus improving their chances of survival and their overall quality of life.
Collapse
Affiliation(s)
- Julia Palma
- Cancer Management DepartmentMinistry of HealthGovernment of ChileSantiagoChileCancer Management Department, Ministry of Health, Government of Chile, Santiago, Chile
| | - Orietta Candia
- Cancer Management DepartmentMinistry of HealthGovernment of ChileSantiagoChileCancer Management Department, Ministry of Health, Government of Chile, Santiago, Chile
| | - Patricia Cerda
- Epidemiology DepartmentMinistry of HealthGovernment of ChileSantiagoChileEpidemiology Department, Ministry of Health, Government of Chile, Santiago, Chile
| | - Liliana Vásquez
- Unit of Noncommunicable Diseases and Mental HealthPan American Health OrganizationWashington, D.C.United States of AmericaUnit of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, D.C., United States of America
| |
Collapse
|
12
|
Tsauo J, Liu Y, Zhang X, Fu Y, Zhao H, Gong T, Li J, Li X. Local hyperthermia mediated by gold nanoparticle-integrated silicone-covered stent: feasibility and tissue response in a rat esophageal model. Eur Radiol Exp 2024; 8:40. [PMID: 38565836 PMCID: PMC10987532 DOI: 10.1186/s41747-024-00438-0] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/16/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND To assess the feasibility and tissue response of using a gold nanoparticle (AuNP)-integrated silicone-covered self-expandable metal stent (SEMS) for local hyperthermia in a rat esophageal model. METHODS The study involved 42 Sprague-Dawley rats. Initially, 6 animals were subjected to near-infrared (NIR) laser irradiation (power output from 0.2 to 2.4 W) to assess the in vitro heating characteristics of the AuNP-integrated SEMS immediately after its placement. The surface temperature of the stented esophagus was then measured using an infrared thermal camera before euthanizing the animals. Subsequently, the remaining 36 animals were randomly divided into 4 groups of 9 each. Groups A and B received AuNP-integrated SEMS, while groups C and D received conventional SEMS. On day 14, groups A and C underwent NIR laser irradiation at a power output of 1.6 W for 2 min. By days 15 (3 animals per group) or 28 (6 animals per group), all groups were euthanized for gross, histological, and immunohistochemical analysis. RESULTS Under NIR laser irradiation, the surface temperature of the stented esophagus quickly increased to a steady-state level. The surface temperature of the stented esophagus increased proportionally with power outputs, being 47.3 ± 1.4 °C (mean ± standard deviation) at 1.6 W. Only group A attained full circumferential heating through all layers, from the epithelium to the muscularis propria, demonstrating marked apoptosis in these layers without noticeable necroptosis. CONCLUSIONS Local hyperthermia using the AuNP-integrated silicone-covered SEMS was feasible and induced cell death through apoptosis in a rat esophageal model. RELEVANCE STATEMENT A gold nanoparticle-integrated silicone-covered self-expanding metal stent has been developed to mediate local hyperthermia. This approach holds potential for irreversibly damaging cancer cells, improving the sensitivity of cancer cells to therapies, and triggering systemic anticancer immune responses. KEY POINTS • A gold nanoparticle-integrated silicone-covered self-expanding metal stent was placed in the rat esophagus. • Upon near-infrared laser irradiation, this stent quickly increased the temperature of the stented esophagus. • Local hyperthermia using this stent was feasible and resulted in cell death through apoptosis.
Collapse
Affiliation(s)
- Jiaywei Tsauo
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
- Department of Interventional Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong, 510080, China
| | - Yue Liu
- Department of Etiology and Carcinogenesis and State Key Laboratory of Molecular Oncology. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiaowu Zhang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| | - Yan Fu
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - He Zhao
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Tao Gong
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Jingui Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
| |
Collapse
|
13
|
Pergolotti M, Wood KC, Hidde M, Kendig TD, Ronnen EA, Giri S, Williams GR. Geriatric assessment-identified impairments and frailty in adults with cancer younger than 65: An opportunity to optimize oncology care. J Geriatr Oncol 2024; 15:101751. [PMID: 38569461 DOI: 10.1016/j.jgo.2024.101751] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/11/2024] [Accepted: 03/18/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Frailty, a state of increased vulnerability to stressors due to aging or treatment-related accelerated aging, is associated with declines in physical, cognitive and/or social functioning, and quality of life for cancer survivors. For survivors aged <65 years, little is known about frailty status and associated impairments to inform intervention. We aimed to evaluate the prevalence of frailty and contributing geriatric assessment (GA)-identified impairments in adults aged <65 versus ≥65 years with cancer. MATERIALS AND METHODS This study is a secondary analysis of clinical trial data (NCT04852575). Participants were starting a new line of systemic therapy at a community-based oncology private practice. Before starting treatment, participants completed an online patient-reported GA and the Physical Activity (PA) Vital Sign questionnaire. Frailty score and category were derived from GA using a validated deficit accumulation model: frail (>0.35), pre-frail (0.2-0.35), or robust (0-0.2). PA mins/week were calculated, and participants were coded as either meeting/not-meeting guidelines (≥90 min/week). We used Spearman (ρ) correlation to examine the association between age and frailty score and chi-squared/Fisher's-exact or ANOVA/Kruskal-Wallis statistic to compare frailty and PA outcomes between age groups. RESULTS Participants (n = 96) were predominantly female (62%), Caucasian (68%), beginning first-line systemic therapy (69%), and 1.75 months post-diagnosis (median). Most had stage III to IV disease (66%). Common cancer types included breast (34%), gastrointestinal (23%), and hematologic (15%). Among participants <65, 46.8% were frail or pre-frail compared to 38.7% of those ≥65. There was no association between age and frailty score (ρ = 0.01, p = 0.91). Between age groups, there was no significant difference in frailty score (p = 0.95), the prevalence of frailty (p = 0.68), number of GA impairments (p = 0.33), or the proportion meeting PA guidelines (p = 0.72). However, older adults had more comorbid conditions (p = 0.03) and younger adults had non-significant but clinically relevant differences in functional ability, falls, and PA level. DISCUSSION In our cohort, the prevalence of frailty was similar among adults with cancer <65 when compared to those older than 65, however, types of GA impairments differed. These results suggest GA and the associated frailty index could be useful to identify needs for intervention and inform clinical decisions during cancer treatment regardless of age. Additional research is needed to confirm our findings.
Collapse
Affiliation(s)
- Mackenzi Pergolotti
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, United States of America; University of North Carolina at Chapel Hill, NC, United States of America
| | - Kelley C Wood
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, United States of America.
| | - Mary Hidde
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, United States of America; Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, United States of America
| | - Tiffany D Kendig
- ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, United States of America
| | - Ellen A Ronnen
- Astera Cancer Care, East Brunswick, NJ, United States of America
| | - Smith Giri
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Grant R Williams
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, United States of America
| |
Collapse
|
14
|
Christie DRH, Sharpley CF, Bitsika V. A Systematic Review of the Association between Psychological Resilience and Improved Psychosocial Outcomes in Prostate Cancer Patients. Could Resilience Training Have a Potential Role? World J Mens Health 2024; 42:42.e39. [PMID: 38606864 DOI: 10.5534/wjmh.230319] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/31/2023] [Accepted: 01/22/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE A high incidence of psychosocial problems in prostate cancer patients has been reported including anxiety, depression and distress. These can add to the patients' disease burden and have been associated with unfavorable cancer treatment outcomes. Interventions designed to address them have found limited success, but psychological resilience (PR) training has never been formally tested. The measurement of PR in prostate cancer patients has been described and has been associated with more favorable psychosocial outcomes in these patients but it has never been systematically reviewed. The aim of this study was to conduct the first systematic review of those studies that have measured it using standardized scales and to determine the potential for resilience training to help overcome the significant psychosocial problems faced by prostate cancer patients. MATERIALS AND METHODS We searched the literature to identify articles that measured PR among prostate cancer patients. RESULTS Of 384 articles identified by the search criteria, there were 19 studies suitable for inclusion regarding 5,417 patients. The most commonly-used scale was the original Connor-Davidson Resilience Scale, or an abbreviated version of it. Possible scores range from 0 to 100, mean scores from these studies ranged from 72.9 to 87.1 (standard deviations varied between 13.2 and 16.3). PR was consistently associated with improved psychological outcomes including depression, anxiety and distress, although these were measured with a wide variety of methods making it difficult to quantify the effects. There was also evidence of PR mediating the physical effects of prostate cancer and treatment including urinary symptoms, fatigue and insomnia. CONCLUSIONS As resilience training has been successful in other cancer settings, it seems likely that it could improve the significant adverse psychosocial outcomes that have been reported in prostate cancer patients and trials designed to objectively test it should be encouraged.
Collapse
Affiliation(s)
- David Robert Harry Christie
- GenesisCare, Tugun, Australia
- Brain-Behaviour Research Group, University of New England, Armidale, Australia.
| | | | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, Australia
| |
Collapse
|
15
|
Torii N, Miyata K, Fukaya M, Ebata T. Risk factors for venous thrombosis after esophagectomy. Esophagus 2024; 21:150-156. [PMID: 38214871 DOI: 10.1007/s10388-023-01038-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Venous thrombosis (VT) after esophagectomy for esophageal cancer is an important complication, potentially leading to pulmonary embolism. However, there are few available information about the risk for the postsurgical VT. METHODS This study included 271 patients who underwent esophagectomy for esophageal cancer between 2006 and 2019. Contrast-enhanced computed tomography (CT) was performed for all patients on the seventh postoperative day to survey complications, including VT. RESULTS VT was radiologically visualized in 48 patients (17.7%), 8 of whom (16.7%) had pulmonary embolism. The thrombus disappeared in 42 patients, the thrombus size was unchanged in 5 patients, and 1 patient died. Multivariate analysis was performed on factors clinically considered to have a significant influence on thrombus formation. The analysis showed that CVC insertion via the femoral vein (odds ratio, 7.67; 95% CI, 2.64-22.27; P < 0.001), retrosternal reconstruction route (odds ratio, 3.94; 95% CI, 1.90-8.17; P < 0.001) and intraoperative fluid balance < 5 ml/kg/hr (odds ratio, 0.38; 95% CI, 0.17-0.85; P = 0.019) were independently related to VT. CONCLUSIONS Intraoperative fluid balance < 5 ml/kg/hr, along with CVC insertion via the femoral vein and retrosternal reconstruction may be potential risk factors for VT after esophagectomy.
Collapse
Affiliation(s)
- Naoya Torii
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Kazushi Miyata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Masahide Fukaya
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| | - Tomoki Ebata
- Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan
| |
Collapse
|
16
|
Matsubara N, Kusuhara S, Yamamoto N, Sudo K, Yanagita M, Murayama K, Kawasumi H, Russell DL, Yin D, Shimizu T. Safety and pharmacokinetics of imaradenant (AZD4635) in Japanese patients with advanced solid malignancies: a phase I, open-label study. Cancer Chemother Pharmacol 2024; 93:341-352. [PMID: 38086998 PMCID: PMC10950984 DOI: 10.1007/s00280-023-04605-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/13/2023] [Indexed: 03/20/2024]
Abstract
PURPOSE Imaradenant is a novel potent and selective adenosine A2A receptor antagonist that is hypothesized to reduce immune suppression in the tumor microenvironment. This phase I, open-label, dose-escalation study evaluated the safety, pharmacokinetics, and anti-tumor activity of imaradenant. METHODS Japanese patients with advanced solid malignancies received imaradenant 50 mg (n = 3) or 75 mg (n = 7) once daily (QD). The primary objective was safety and tolerability, and the secondary objectives were pharmacokinetics and anti-tumor activity. RESULTS The median treatment duration was 2.10 months and 2.14 months for the 50- and 75-mg QD cohorts, respectively. The most common adverse events were nausea, malaise, decreased appetite, and vomiting. Five patients (50%) reported adverse events that were considered causally related to imaradenant; three patients had Grade 2 adverse events of malaise, nausea, and diarrhea. No deaths or serious adverse events occurred. The median times of maximum observed concentrations sampled after a single dose in the 50- and 75-mg QD cohorts were 1.08 h (range, 0.95-1.95) and 2.00 h (range, 0.92-5.52), respectively. There was little accumulation after multiple dosing, with geometric mean accumulation ratios of maximum concentration of 1.3 (50-mg QD) to 1.4 (75-mg QD) and area under the concentration-time curve 0-24 of 1.4 (50-mg QD) to 1.5 (75-mg QD). The best objective response was stable disease (3/10). CONCLUSION No new or unexpected safety concerns were identified, and imaradenant had an acceptable safety profile at both 50- and 75-mg QD. CLINICALTRIALS gov identifier NCT03980821 (June 10, 2019).
Collapse
Affiliation(s)
- Nobuaki Matsubara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
| | - Shota Kusuhara
- Department of Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuki Sudo
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiko Yanagita
- Research & Development, AstraZeneca K.K., Tokyo, Japan
- Oncology Medical Affairs, Pfizer Japan Inc., Tokyo, Japan
| | | | | | - Deanna L Russell
- Translational Medicine, Early Oncology, Oncology R&D, AstraZeneca Pharmaceuticals, Boston, MA, USA
| | - Da Yin
- Oncology Data Science, Research and Early Development, Oncology R&D, AstraZeneca Pharmaceuticals, Gaithersburg, MD, USA
| | - Toshio Shimizu
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
- Department of Pulmonary Medicine and Medical Oncology, Wakayama Medical University Graduate School of Medicine, Wakayama Medical University Hospital, Wakayama, Japan
| |
Collapse
|
17
|
Choi YJ, Han SS, Lee C, Jeon KJ. CT and MR imaging findings of head and neck chondrosarcoma. Oral Radiol 2024; 40:242-250. [PMID: 38108955 DOI: 10.1007/s11282-023-00729-z] [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] [Received: 08/02/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES This study investigated the imaging features of head and neck chondrosarcoma (HNCS) according to its origin and pathologic subtype. METHODS Patients who were pathologically diagnosed with HNCS between January 2000 and April 2022 were retrospectively reviewed. Lesions were classified based on their origin and pathologic subtype. The size and margin were evaluated on the image. Internal calcification and the effects on adjacent bone were assessed using computed tomography (CT) images, while signal intensity and contrast enhancement patterns were analyzed using magnetic resonance (MR) imaging. RESULTS Thirteen HNCSs were included in this study: 8 bone tumors (61.5%) and 5 soft tissue tumors (38.5%). The bone tumors were pathologically diagnosed as conventional (n = 5) and mesenchymal type (n = 3). Soft tissue tumors were defined as myxoid type. The main symptoms were swelling (90.9%) and pain (72.7%). The lesions measured 4.5 cm on average. The margins showed benign and well-defined except for the mesenchymal type. On CT, most bone tumors (75%) showed internal calcification with remodeling or destruction of the adjacent bone. No soft tissue tumors, except one case, showed internal calcification or destruction of the adjacent bone. MR imaging features were non-specific (T2 high signal intensity and contrast enhancement). CONCLUSIONS HCNS showed various imaging findings according to their origin and pathologic subtype. HNCS should be differentiated if a bone tumor shows internal calcification and affects the adjacent bone. When diagnosing slow-growing soft tissue tumors, even if low possibility, HNCS should be considered.
Collapse
Affiliation(s)
- Yoon Joo Choi
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Sang-Sun Han
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, 50-1 Yonsei-ro Seodaemun-gu, Seoul, 03722, South Korea.
| |
Collapse
|
18
|
Ribeiro PR, Schwertz CI, Echenique JVZ, Piva MM, Henker LC, Panziera W, Hohendorff RV, Gomes CWC, Carmo Both MD, Sonne L. Pulmonary acinar adenocarcinoma in a captive lioness (Panthera leo). Vet Res Commun 2024; 48:1257-1262. [PMID: 38113016 DOI: 10.1007/s11259-023-10286-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 12/14/2023] [Indexed: 12/21/2023]
Abstract
Neoplasms in wild felids are more frequently observed in captive animals, of which clinicopathological features of pulmonary tumors are not commonly described. This study aimed to describe the clinical and pathological aspects of a case of diffuse pulmonary acinar adenocarcinoma in a 23-year-old, captive lioness with clinical history of dyspnea, progressive weight loss and inappetence. At necropsy, the lungs were mildly pale, moderately firm, and the pleural surface was diffusely irregular with multifocal to coalescent, grey to white areas. No masses or superficial nodules were detected, but, on the cut surface, there were numerous, spherical, firm, white to yellow areas up to 0.5 cm in diameter affecting all pulmonary lobes. Histologically, in the lungs, there were extensive, non-delineated areas of neoplastic proliferation of columnar, ciliated epithelial cells arranged in irregular tubuloacinar structures. Immunohistochemical analysis revealed immunolabeling of neoplastic cells for pan-cytokeratin and thyroid transcription factor-1. Napsin-A exhibited only scarce and scattered immunolabeling in the neoplastic cells. The gross, histologic and immunohistochemical findings confirmed the final diagnosis of primary diffuse pulmonary adenocarcinoma.
Collapse
Affiliation(s)
- Paula Reis Ribeiro
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil.
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil.
| | - Claiton Ismael Schwertz
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| | - Joanna Vargas Zillig Echenique
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| | - Manoela Marchezan Piva
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| | - Luan Cleber Henker
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| | - Welden Panziera
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| | | | | | - Maria do Carmo Both
- Secretaria Estadual do Meio Ambiente e Infraestrutura, Porto Alegre, RS, Brazil
| | - Luciana Sonne
- Programa de Pós-graduação em Ciências Veterinárias (PPGCV), Faculdade de Veterinária, (FAVET), Universidade Federal do Rio Grande do Sul (UFRGS), Avenida Bento Goncalves, Porto Alegre, RS, 9090, Brazil
- Setor de Patologia Veterinária, Departamento de Patologia Clínica Veterinária, FAVET, UFRGS, Porto Alegre, RS, Brazil
| |
Collapse
|
19
|
Wang Y, Yang L, Lin G, Huang B, Sheng X, Wang L, Chen L, Qiu X, Wu X, Lin R. The efficacy of progressive muscle relaxation training on cancer-related fatigue and quality of life in patients with cancer: A systematic review and meta-analysis of randomized controlled studies. Int J Nurs Stud 2024; 152:104694. [PMID: 38281450 DOI: 10.1016/j.ijnurstu.2024.104694] [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] [Received: 08/03/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Cancer-related fatigue is one of the most common symptoms in cancer patients, usually accompanied by anxiety, depression and insomnia, which seriously affect patients' quality of life. Progressive muscle relaxation training is widely used for cancer-related fatigue, but the overall effect is unclear. OBJECTIVES The aim of this study was to summarize the evidence on the effects of progressive muscle relaxation training on cancer-related fatigue and quality of life in cancer patients. DESIGN Systematic review and meta-analysis. METHODS Nine electronic databases (PubMed, Excerpta Medica Database (Embase), The Cochrane Library (Cochrane Central Register of Controlled Trials, CENTRAL), Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang Database) were explored for randomized controlled trials (RCTs) published before February 2023. This study was reported based on the PRISMA 2020 statement. The Cochrane Collaboration's risk of bias assessment tool was used for methodological assessment, and the GRADE pro online assessment tool was used for evidence evaluation. The data were analyzed with the Review Manager 5.4 software. RESULTS Twelve studies involving 1047 patients were included. Meta-analysis showed that progressive muscle relaxation training plus routine nursing produced more positive effects than routine nursing in improving cancer-related fatigue [SMD = -1.06, 95 % CI -1.49, -0.62, P < 0.00001], anxiety [SMD = -1.09, 95 % CI -1.40, -0.77, P < 0.00001], depression [SMD = -1.43, 95 % CI -1.76, -1.10, P < 0.00001], and quality of sleep [MD = -1.41, 95 % CI -1.74, -1.08, P < 0.00001]. However, there was no significant difference in improving quality of life [SMD = 0.27, 95 % CI -0.62, 1.15, P = 0.55]. Progressive resistance exercise plus routine nursing improved cancer-related fatigue more than progressive muscle relaxation training plus routine nursing [SMD = 1.11, 95 % CI 0.43, 1.78, P = 0.001]. There was low certainty of evidence that progressive muscle relaxation training improved cancer-related fatigue and quality of sleep, and the evidence that improved quality of life, anxiety and depression was very low. CONCLUSION Current evidence suggested that progressive muscle relaxation training has the potential to improve cancer-related fatigue, anxiety, depression and quality of sleep in patients with cancer and is a low-load, simple exercise worthy of recommendation for cancer patients in fatigue state. Future research should focus on improving the methodological quality of randomized controlled trials to enhance the persuasive evidence of progressive muscle relaxation training efficacy.
Collapse
Affiliation(s)
- Yajiao Wang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Liu Yang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.
| | - Guijiao Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Bichun Huang
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Xia Sheng
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ligang Wang
- Xiamen University Xiamen Cardiovascular Hospital, Xiamen, Fujian, China
| | - Liuyin Chen
- The Second Hospital of Longyan, Fujian, China
| | - Xiahua Qiu
- Longyan Medical Treatment Security Data Monitoring Center, Longyan, Fujian, China
| | - Xinlei Wu
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Rujia Lin
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| |
Collapse
|
20
|
Jung KW, Kang MJ, Park EH, Yun EH, Kim HJ, Kim JE, Kong HJ, Im JS, Seo HG. Prediction of Cancer Incidence and Mortality in Korea, 2024. Cancer Res Treat 2024; 56:372-379. [PMID: 38487833 PMCID: PMC11016663 DOI: 10.4143/crt.2024.252] [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] [Received: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE This study aimed to report the projected cancer incidence and mortality for the year 2024 to estimate Korea's current cancer burden. MATERIALS AND METHODS Cancer incidence data from 1999 to 2021 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2022 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against their respective years and multiplying the projected age-specific rates by the anticipated age-specific population for 2024. A joinpoint regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend for prediction. RESULTS In total, 292,221 new cancer cases and 83,770 cancer deaths are expected to occur in Korea in 2024. The most common cancer site is expected to be the thyroid, followed by the colon and rectum, lung, breast, and stomach. These five cancers are expected to represent 55.7% of the overall burden of cancer in Korea. The most common type of cancer leading to death is expected to be lung cancer, followed by liver, colorectal, pancreatic, and stomach cancers. CONCLUSION The age-standardized incidence rates for female breast and prostate cancers are estimated to continue to increase. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.
Collapse
Affiliation(s)
- Kyu-Won Jung
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mee Joo Kang
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Hye Park
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - E Hwa Yun
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Hye-Jin Kim
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jeong-Eun Kim
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jeong-Soo Im
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hong Gwan Seo
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| |
Collapse
|
21
|
Park EH, Jung KW, Park NJ, Kang MJ, Yun EH, Kim HJ, Kim JE, Kong HJ, Im JS, Seo HG. Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2021. Cancer Res Treat 2024; 56:357-371. [PMID: 38487832 PMCID: PMC11016640 DOI: 10.4143/crt.2024.253] [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] [Received: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
PURPOSE The current study provides national cancer statistics and their secular trends in Korea, including incidence, mortality, survival, and prevalence in 2021. MATERIALS AND METHODS Incidence, survival, and prevalence rates of cancer were calculated using the Korea National Cancer Incidence Database, from 1999 to 2021, with survival follow-up until December 31, 2022. Deaths from cancer were assessed using causes-of-death data obtained from Statistics Korea. RESULTS The number of new cancer diagnoses in 2021 increased by 27,002 cases (10.8%) compared to 2020. In 2021, newly diagnosed cancer cases and deaths from cancer were reported as 277,523 (age-standardized rate [ASR], 289.3 per 100,000) and 82,688 (ASR, 67.6 per 100,000), respectively. The overall cancer incidence rates increased by 3.3% annually from 1999 to 2012, and decreased by 5.3% from 2012 to 2015, thereafter, followed by non-significant changes. Cancer mortality rates have been decreasing since 2002, with more rapid decline in recent years (annual decrease of 2.8% from 2002 to 2013; 3.2% from 2013 to 2021). The 5-year relative survival between 2017 and 2021 was 72.1%, which contributed to prevalent cases reaching over 2.4 million in 2021. CONCLUSION In 2021, the number of newly diagnosed cancer patients increased as healthcare utilization recovered from the coronavirus disease 2019-related declines of 2020. Revised cancer registration guidelines expanded the registration scope, particularly for stomach and colorectal cancer. Survival rates have improved over the years, leading to a growing population of cancer survivors, necessitating a comprehensive cancer control strategy. The long-term impact of the pandemic on cancer statistics requires future investigation.
Collapse
Affiliation(s)
- Eun Hye Park
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Nam Ju Park
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Mee Joo Kang
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - E Hwa Yun
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hye-Jin Kim
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jeong-Eun Kim
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jeong-Soo Im
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hong Gwan Seo
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - The Community of Population-Based Regional Cancer Registries
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| |
Collapse
|
22
|
Heidari Gorji MA, Ghorbani Vajargah P, Salami Kohan K, Mollaei A, Falakdami A, Goudarzian AH, Takasi P, Emami Zeydi A, Osuji J, Jafaraghaee F, Taebi M, Karkhah S. The Relationship Between Spirituality and Religiosity with Death Anxiety Among Cancer Patients: A Systematic Review. J Relig Health 2024:10.1007/s10943-024-02016-5. [PMID: 38555537 DOI: 10.1007/s10943-024-02016-5] [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] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/17/2024] [Indexed: 04/02/2024]
Abstract
This systematic review aimed to summarize the evidence regarding the relationship between spirituality and religiosity with death anxiety (DA) among cancer patients. This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) checklist. An extensive search was conducted on electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database (SID) via keywords extracted from Medical Subject Headings from the earliest to February 9, 2022. The quality of the included studies was assessed using the appraisal tool for cross-sectional studies (AXIS tool). Fifteen studies were selected for inclusion in this systematic review. Nine and six studies assessed the relationship between spirituality and religiosity with DA in cancer patients, respectively. Most studies had a negative relationship between spirituality (n = 8) and religiosity (n = 4) with DA. In sum, most studies showed that religion and spirituality are negatively related to DA in patients with cancer.
Collapse
Affiliation(s)
- Mohammad Ali Heidari Gorji
- Department of Medical-Surgical Nursing, Diabetes Research Center, Nasibeh Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Pooyan Ghorbani Vajargah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Kobra Salami Kohan
- Department of Nursing, Faculty of Nursing and Midwifery, University of Medical Sciences, Tehran, Iran
| | - Amirabbas Mollaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Atefeh Falakdami
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Hossein Goudarzian
- PhD Candidate of Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Poorya Takasi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Amir Emami Zeydi
- Department of Medical-Surgical Nursing, Nasibeh School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Joseph Osuji
- Faculty of Health, Community, and Education, School of Nursing and Midwifery, Mount Royal University, Calgary, AB, Canada
| | - Fateme Jafaraghaee
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Mozhgan Taebi
- Department of Medical-Surgical Nursing, Faculty of Allied Medical Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran.
| |
Collapse
|
23
|
Gupta S, Yadav S, Kumar P. Efficacy of Bacillus Calmette-Guérin in Cancer Prevention and Its Putative Mechanisms. J Cancer Prev 2024; 29:6-15. [PMID: 38567111 PMCID: PMC10982520 DOI: 10.15430/jcp.23.036] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/31/2024] [Accepted: 02/13/2024] [Indexed: 04/04/2024] Open
Abstract
Bacillus Calmette-Guérin (BCG) is an attenuated strain of Mycobacterium bovis. Although it was developed as a prophylactic vaccine against tuberculosis (TB), researchers have also evaluated it for preventing cancer development or progression. These studies were inspired by the available data regarding the protective effects of microbial infection against cancers and an inverse relationship between TB and cancer mortality. Initial studies demonstrated the efficacy of BCG in preventing leukemia, melanoma and a few other cancers. However, mixed results were observed in later studies. Importantly, these studies have led to the successful use of BCG in the tertiary prevention of non-muscle invasive bladder cancer, wherein BCG therapy has been found to be more effective than chemotherapy. Moreover, in a recently published 60-year follow-up study, childhood BCG vaccination has been found to significantly prevent lung cancer development. In the present manuscript, we reviewed the studies evaluating the efficacy of BCG in cancer prevention and discussed its putative mechanisms. Also, we sought to explain the mixed results of BCG efficacy in preventing different cancers.
Collapse
Affiliation(s)
- Sakshi Gupta
- Department of Preventive Oncology (Dr. BRA-IRCH), All India Institute of Medical Sciences, New Delhi, India
| | - Saurabh Yadav
- Department of Preventive Oncology (Dr. BRA-IRCH), All India Institute of Medical Sciences, New Delhi, India
| | - Pawan Kumar
- Department of Preventive Oncology (Dr. BRA-IRCH), All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
24
|
Shin J, Miaskowski C, Wong ML, Yates P, Olshen AB, Roy R, Dokiparthi V, Cooper B, Paul S, Conley YP, Levine JD, Hammer MJ, Kober K. Perturbations in inflammatory pathways are associated with shortness of breath profiles in oncology patients receiving chemotherapy. Support Care Cancer 2024; 32:250. [PMID: 38532105 DOI: 10.1007/s00520-024-08446-x] [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] [Received: 10/15/2023] [Accepted: 03/18/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE One plausible mechanistic hypothesis is the potential contribution of inflammatory mechanisms to shortness of breath. This study was aimed to evaluate for associations between the occurrence of shortness of breath and perturbations in inflammatory pathways. METHODS Patients with cancer reported the occurrence of shortness of breath six times over two cycles of chemotherapy. Latent class analysis was used to identify subgroups of patients with distinct shortness of breath occurrence profiles (i.e., none (70.5%), decreasing (8.2%), increasing (7.8%), high (13.5%)). Using an extreme phenotype approach, whole transcriptome differential gene expression and pathway impact analyses were performed to evaluate for perturbed signaling pathways associated with shortness of breath between the none and high classes. Two independent samples (RNA-sequencing (n = 293) and microarray (n = 295) methodologies) were evaluated. Fisher's combined probability method was used to combine these results to obtain a global test of the null hypothesis. In addition, an unweighted knowledge network was created using the specific pathway maps to evaluate for interconnections among these pathways. RESULTS Twenty-nine Kyoto Encyclopedia of Genes and Genomes inflammatory signaling pathways were perturbed. The mitogen-activated protein kinase signaling pathway node had the highest closeness, betweenness, and degree scores. In addition, five common respiratory disease-related pathways, that may share mechanisms with cancer-related shortness of breath, were perturbed. CONCLUSIONS Findings provide preliminary support for the hypothesis that inflammation contribute to the occurrence of shortness of breath in patients with cancer. In addition, the mechanisms that underlie shortness of breath in oncology patients may be similar to other respiratory diseases.
Collapse
Affiliation(s)
- Joosun Shin
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Christine Miaskowski
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
- School of Medicine, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Melisa L Wong
- School of Medicine, University of California, San Francisco, CA, USA
| | - Patsy Yates
- Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Adam B Olshen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Ritu Roy
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Vasuda Dokiparthi
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Bruce Cooper
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Steven Paul
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA
| | - Yvette P Conley
- School of Nursing, Univeristy of Pittsburgh, 3500 Victoria St, Pittsburgh, 15213, PA, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, CA, USA
| | | | - Kord Kober
- School of Nursing, University of California, 2 Koret Way - N631Y, San Francisco, CA, 94143-0610, USA.
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA.
| |
Collapse
|
25
|
Junior JNA, Preto DD'A, Lazarini MEZN, de Lima MA, Bonatelli M, Berardinelli GN, da Silva VD, Pinheiro C, Reis RM, Cárcano FM. PD-L1 expression and microsatellite instability (MSI) in cancer of unknown primary site. Int J Clin Oncol 2024:10.1007/s10147-024-02494-3. [PMID: 38528294 DOI: 10.1007/s10147-024-02494-3] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 02/18/2024] [Indexed: 03/27/2024]
Abstract
BACKGROUND Cancer of unknown primary site (CUP) is a heterogeneous group of tumors for which the origin remains unknown. Clinical outcomes might be influenced by regulatory processes in its microenvironment. Microsatellite instability (MSI) is a predictive biomarker for cancer immunotherapy and its status, as well as co-occurrence with PD-L1 expression, is poorly evaluated. We aim to evaluate the expression of PD-L1 and the status of MSI in CUP and their possible associations with clinical-pathological features. METHODS The combined positive score (CPS) PD-L1 expression was evaluated by immunohistochemistry. MSI status was assessed using a hexa-plex marker panel by polymerase chain reaction followed by fragment analysis. RESULTS Among the 166 cases, MSI analysis was conclusive in 120, with two cases being MSI positive (1.6%). PD-L1 expression was positive in 18.3% of 109 feasible cases. PD-L1 expression was significantly associated with non-visceral metastasis and a dominance of nodal metastasis. The median overall survival (mOS) was 3.7 (95% CI 1.6-5.8) months and patients who expressed PD-L1 achieved a better mOS compared to those who did not express PD-L1 (18.7 versus 3.0 months, p-value: < .001). ECOG-PS equal to or more than two and PD-L1 expression were independent prognostic factors in multivariate analysis (2.37 and 0.42, respectively). CONCLUSION PD-L1 is expressed in a subset (1/5) of patients with CUP and associated with improved overall survival, while MSI is a rare event. There is a need to explore better the tumor microenvironment as well as the role of immunotherapy to change such a bad clinical outcome.
Collapse
Affiliation(s)
| | - Daniel D 'Almeida Preto
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Brazil
- Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Barretos, Brazil
| | | | | | - Murilo Bonatelli
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
| | | | | | - Céline Pinheiro
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Barretos School of Health Sciences Dr. Paulo Prata - FACISB, Barretos, Brazil
| | - Rui Manuel Reis
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil
- Medical School, Life and Health Sciences Research Institute (ICVS), University of Minho, Braga, Portugal
- 3ICVS/3B's-PT Government Associate Laboratory, Braga, Portugal
| | - Flavio Mavignier Cárcano
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
- Oncoclinicas & Co - Medica Scientia Innovation Research (MEDSIR), Sao Paulo, Brazil.
| |
Collapse
|
26
|
Buttafuoco KA, Mokshagundam S, Henricks A, Shore S, Brown A, Prescott LS. Impact of electronic medical record utilization on obesity screening and intervention for obese patients with endometrial cancer. Int J Gynecol Cancer 2024:ijgc-2023-005247. [PMID: 38519088 DOI: 10.1136/ijgc-2023-005247] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVE To identify the prevalence of obesity documented within the electronic medical record problem list. METHODS We conducted a retrospective cohort study of adult patients with obesity and endometrial cancer receiving care from January 2018 to March 2021 at a single institution. Obesity intervention was defined as receipt of at least one of the following: referral to weight loss clinic, referral to a nutritionist, completion of obesity intervention tab, or documentation of weight loss counseling. Our secondary objectives were to (1) identify the prevalence of completed obesity interventions, (2) identify the number of patients who have achieved weight loss since their initial visit, and (3) identify covariates associated with presence of obesity on problem list, completion of obesity interventions, and weight loss. RESULTS We identified 372 patients who met inclusion criteria. Of eligible patients, 202 (54%) had obesity documented on their problem list and 171 (46%) completed at least one obesity intervention. Within our cohort, 195 (52%) patients achieved weight loss from diagnosis or initial clinical encounter at our institution to most recent clinical encounter with median weight loss of 3.9 kg (IQR 1.5-8.0). In the multivariable logistic regressions, patients with obesity on the problem list were approximately twice as likely to have completion of obesity intervention (OR 1.91, 95% CI 1.09, 3.35, p=0.024). Although presence of obesity on the problem list was not associated with weight loss, completion of health maintenance obesity intervention tab in the electronic medical record (Epic) was associated with weight loss (OR 2.77, 95% CI 1.11, 6.89, p=0.03). CONCLUSIONS Only half of obese endometrial cancer patients had documentation of obesity within the electronic medical record problem list. The electronic medical record could be leveraged to achieve compliance with weight loss interventions. Further investigation on how the electronic medical record can be optimized to help patients achieve weight loss is needed.
Collapse
Affiliation(s)
| | | | - Anna Henricks
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Summer Shore
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alaina Brown
- Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Lauren Shore Prescott
- Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
27
|
Zhang W, Ou M, Yang P, Ning M. The role of extracellular vesicle immune checkpoints in cancer. Clin Exp Immunol 2024:uxae026. [PMID: 38518192 DOI: 10.1093/cei/uxae026] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Indexed: 03/24/2024] Open
Abstract
Immune checkpoints (ICPs) play a crucial role in regulating the immune response. In the tumor, malignant cells can hijack the immunosuppressive effects of inhibitory ICPs to promote tumor progression. Extracellular vesicles (EVs) are produced by a variety of cells and contain bioactive molecules on their surface or within their lumen. The expression of ICPs has also been detected on EVs. In vitro and in vivo studies have shown that extracellular vesicle immune checkpoints (EV ICPs) have immunomodulatory effects and are involved in tumor immunity. EV ICPs isolated from the peripheral blood of cancer patients are closely associated with the tumor progression and the prognosis of cancer patients. Blocking inhibitory ICPs has been recognized as an effective strategy in cancer treatment. However, the efficacy of immune checkpoint inhibitors (ICIs) in cancer treatment is hindered by the emergence of therapeutic resistance, which limit their widespread use. Researchers have demonstrated that EV ICPs are correlated with clinical response to ICIs therapy and were involved in therapeutic resistance. Therefore, it's essential to investigate the immunomodulatory effects, underlying mechanisms, and clinical significance of EV ICPs in cancer. This review aims to comprehensively explore these aspects. We have provided a comprehensive description of the cellular origins, immunomodulatory effects, and clinical significance of EV ICPs in cancer, based on relevant studies.
Collapse
Affiliation(s)
- Weiming Zhang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Mingrong Ou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing Jiangsu, China
| | - Ping Yang
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| | - Mingzhe Ning
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China
| |
Collapse
|
28
|
Hisada H, Tsuji Y, Kuribara H, Miyata R, Oshio K, Mizutani S, Nakagawa H, Cho R, Sakuma N, Miura Y, Mizutani H, Ohki D, Yakabi S, Takahashi Y, Sakaguchi Y, Kakushima N, Yamamichi N, Fujishiro M. Clinical meaning of sarcopenia in patients undergoing endoscopic treatment. Clin Endosc 2024:ce.2023.193. [PMID: 38514988 DOI: 10.5946/ce.2023.193] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 08/18/2023] [Indexed: 03/23/2024] Open
Abstract
With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.
Collapse
Affiliation(s)
- Hiroyuki Hisada
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yosuke Tsuji
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- Next-Generation Endoscopic Computer Vision, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hikaru Kuribara
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Ryohei Miyata
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Kaori Oshio
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Satoru Mizutani
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hideki Nakagawa
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Rina Cho
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Nobuyuki Sakuma
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yuko Miura
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Hiroya Mizutani
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
- Next-Generation Endoscopic Computer Vision, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Daisuke Ohki
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Seiichi Yakabi
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yu Takahashi
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yoshiki Sakaguchi
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Naomi Kakushima
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Nobutake Yamamichi
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Mitsuhiro Fujishiro
- Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| |
Collapse
|
29
|
Hayes J, Bruera E, Crawford G, Fleury M, Santos M, Thompson J, Davies A. Multinational Association of Supportive Care in Cancer (MASCC) expert opinion/guidance on the use of clinically assisted hydration in patients with advanced cancer. Support Care Cancer 2024; 32:228. [PMID: 38478135 PMCID: PMC10937805 DOI: 10.1007/s00520-024-08421-6] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/04/2024] [Indexed: 03/17/2024]
Abstract
PURPOSE The provision of clinically assisted hydration (CAH) in patients with advanced cancer is controversial, and there is a paucity of specific guidance and so a diversity in clinical practice. Consequently, the Palliative Care Study Group of the Multinational Association of Supportive Care in Cancer (MASCC) formed a sub-group to develop evidence-based guidance on the use of CAH in patients with advanced cancer. METHODS This guidance was developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews/trials, respectively. RESULTS Due to the paucity of evidence, the sub-group was not able to develop a prescribed guideline, but was able to generate a number of "expert opinion statements": these statements relate to assessment of patients, indications for CAH, contraindications for CAH, procedures for initiating CAH, and reassessment of patients. CONCLUSIONS This guidance provides a framework for the use of CAH in advanced cancer, although every patient requires individualised management.
Collapse
Affiliation(s)
- Jo Hayes
- St. Catherine's Hospice, Crawley, UK
| | - Eduardo Bruera
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Gregory Crawford
- University of Adelaide and Northern Adelaide Local Health Network, Adelaide, Australia
| | - Mapi Fleury
- Department of Oncology, CHUV, Lausanne University Hospital, Lausanne, Switzerland
| | | | | | - Andrew Davies
- Trinity College Dublin, University College Dublin, Our Lady's Hospice, Dublin, Ireland.
| |
Collapse
|
30
|
Yu G, Liu S, Wang Z, Liu Q, Ren H, Hu W. Palliative primary tumor resection may not offer survival benefits for patients with unresectable metastatic colorectal neuroendocrine neoplasms, one multicenter retrospective cohort study. BMC Surg 2024; 24:85. [PMID: 38475759 DOI: 10.1186/s12893-024-02380-9] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/04/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND The efficacy of palliative primary tumor resection (PTR) in improving prognosis for patients with unresectable metastatic colorectal neuroendocrine neoplasms (NENs) has not been fully explored. METHODS We performed one retrospective cohort study and recruited 68 patients with unresectable metastatic colorectal NENs from two Chinese medical centers between 2000 and 2022. All patients were assigned to PTR group and no PTR group. The clinicopathological manifestation data were carefully collected, and the survival outcomes were compared between the two groups using Kaplan-Meier methods. Propensity score matching (PSM) was conducted to minimize confounding bias. Univariate and multivariate Cox proportional hazards regression analyses were performed to identify prognostic factors. RESULTS A total of 32 patients received PTR, and the other 36 patients did not. The median progression-free survival (PFS) and overall survival (OS) times were 4 and 22 months in the whole cohort, respectively. For patients who received no PTR, the median OS was 16 months, and the 1-year OS rate and 3-year OS rate were 56.4% and 39.6%, respectively. For patients who received PTR, the median OS was 24 months, and the 1-year OS rate and 3-year OS rate were 67.9% and 34.1%, respectively. However, the Kaplan-Meier survival curves and log-rank test demonstrated no significant survival difference between the two groups (P = 0.963). Moreover, palliative PTR was also not confirmed as a prognostic factor in subsequent univariable and multivariable Cox proportional hazards regression analyses in both the original and matched cohorts. Only histological differentiation was identified as an independent prognostic factor affecting PFS [hazard ratio (HR) = 1.86, 95% confidence interval (CI): 1.02-3.41, P = 0.043] and OS [HR = 3.70, 95% CI: 1.09-12.48, P = 0.035] in the original cohort. CONCLUSIONS Palliative PTR may not offer survival benefits for patients with unresectable metastatic colorectal NENs.
Collapse
Affiliation(s)
- Guozhi Yu
- Department of Colorectal and Anal Surgery, Beijing Erlonglu Hospital, Beijing, 100016, China
| | - Shen Liu
- Department of Colorectal Surgery, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Zhijie Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Gastrointestinal Cancer Center, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Qian Liu
- Department of Colorectal Surgery, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China
| | - Hongchang Ren
- Department of General Surgery, Strategic Support Force Medical Center, No.9, Anxiang North, Desheng Gate, Chaoyang District, Beijing, 100101, China.
| | - Wenhui Hu
- Department of Colorectal Surgery, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17, Panjiayuan Nanli, Chaoyang District, Beijing, 100021, China.
| |
Collapse
|
31
|
Huang X, Zhang C, Zhu J, Li Y, Tang J. Influence of cancer in pregnancy on obstetric and neonatal outcomes: an observational retrospective cohort study. J Gynecol Oncol 2024; 35:35.e74. [PMID: 38522950 DOI: 10.3802/jgo.2024.35.e74] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 02/11/2024] [Indexed: 03/26/2024] Open
Abstract
OBJECTIVE The study aimed to review the oncological characteristics and treatment of pregnancy-associated cancers and analyze the obstetric and neonatal outcomes to provide evidence-based recommendations for reproductive function preservation, oncological treatment, and obstetric management. METHODS We conducted an observational retrospective cohort study among pregnant patients with cancer in 7 Chinese tertiary A hospitals from 2003 to 2021. We conducted multiple logistic regression to determine the influence of various factors on preterm birth and small-for-gestational-age infants, log-binomial regression to analyze temporal changes, and χ² tests to explore the effects of cancer type/treatment. RESULTS Of 204 women, 17% terminated their pregnancies; 59% received pre-delivery treatment. Every 6 years, the rates of pregnancy termination (relative risk [RR]=0.48; 95% confidence interval [CI]=0.35-0.67) and iatrogenic preterm births (RR=0.73; 95% CI=0.54-0.98) reduced, and that of pre-delivery treatment increased, mainly due to increased rates of surgery (RR=1.87; 95% CI=1.31-2.67). Maternal systemic diseases were related to small-for-gestational-age infants (odds ratio [OR]=12.02; 95% CI=1.82-79.43). Chemotherapy with taxanes plus platinum-based agents was related to adverse obstetric outcomes (OR=1.87; 95% CI=1.42-2.46; p<0.05). Thyroid (OR=0.36; 95% CI=0.22-0.57) and ovarian cancer (OR=0.70; 95% CI=0.50-0.98) were associated with fewer cesarean sections. Thyroid cancer was associated with fetal growth restriction (OR=5.21; 95% CI=1.21-22.55). CONCLUSION Rates of pregnancy termination in cancer declined. Taxane plus platinum-based chemotherapy was associated with adverse obstetric outcomes. Cancer type influenced outcomes. TRIAL REGISTRATION Chinese Clinical Trial Register Identifier: ChiCTR2100044292.
Collapse
Affiliation(s)
- Xuan Huang
- Department of Pharmacy, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Chen Zhang
- Department of Pharmacy, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Jialei Zhu
- Department of Pharmacy, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Yueyan Li
- Department of Pharmacy, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Jing Tang
- Department of Pharmacy, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China.
| |
Collapse
|
32
|
Bernardez B, Mangues Bafalluy I, Martínez Callejo V, Fernández Ávila JJ, Marcos Rodríguez JA, Parada Aradilla MA, Martínez Bautista MJ. Risk stratification model for the pharmaceutical care of oncology patients with solid or hematologic neoplasms. Farm Hosp 2024:S1130-6343(23)00943-1. [PMID: 38461113 DOI: 10.1016/j.farma.2023.12.001] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 07/20/2023] [Accepted: 07/21/2023] [Indexed: 03/11/2024] Open
Abstract
OBJECTIVE We aimed to develop of a risk stratification model for the pharmaceutical care (PC) of patients with solid or hematologic neoplasms who required antineoplastic agents or supportive treatments. METHOD The risk stratification model was collaboratively developed by oncology pharmacists from the Spanish Society of Hospital Pharmacy (SEFH). It underwent refinement through three workshops and a pilot study. Variables were defined, grouped into four dimensions, and assigned relative weights. The pilot study collected and analyzed data from participating centers to determine priority levels and evaluate variable contributions. The study followed the Kaiser Permanente pyramid model, categorizing patients into three priority levels: Priority 1 (intensive PC, 90th percentile), Priority 2 (60th-90th percentiles), and Priority 3 (60th percentile). Cut-off points were determined based on this stratification. Participating centers recorded variables in an Excel sheet, calculating mean weight scores for each priority level and the total risk score. RESULTS The participants agreed to complete a questionnaire that comprised 22 variables grouped into 4 dimensions: demographic (maximum score =11); social and health variables and cognitive and functional status (maximum = 19); clinical and health services utilization (maximum = 25); and treatment-related (maximum = 41). From the results of applying the model to the 199 patients enrolled, the cutoff points for categorization were 28 or more points for priority 1, 16 to 27 points for priority 2 and less than 16 for priority 3; more than 80% of the total score was based on the dimensions of 'clinical and health services utilization' and 'treatment-related'. Interventions based on the pharmaceutical care model were recommended for patients with solid or hematological neoplasms, according to their prioritization level. CONCLUSION This stratification model enables the identification of cancer patients requiring a higher level of pharmaceutical care and facilitates the adjustment of care capacity. Validation of the model in a representative population is necessary to establish its effectiveness.
Collapse
Affiliation(s)
- Beatriz Bernardez
- Departamento de Medicina, Universidad de Santiago de Compostela, Santiago de Compostela, España; Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España; Grupo de Farmacología, Instituto de Investigación Santiago de Compostela (IDIS), Santiago de Compostela, España.
| | - Irene Mangues Bafalluy
- Servicio de Farmacia, Hospital Universitario Arnau de Vilanova de Lleida, Lleida, España; Grupo de Farmacoepidemiología y Farmacodinamia, Institut de Recerca Biomèdica, IRBLleida, Lleida, España
| | - Virginia Martínez Callejo
- Unidad de Farmacia Oncológica, Servicio de Farmacia, Hospital Universitario Marqués de Valdecilla, Santander, España
| | | | | | | | | |
Collapse
|
33
|
Wang Z, Wang X, Zhang S. A Case Report of Diffuse-type Tenosynovial Giant Cell Tumor as a Calcaneus Mass: A Diagnostic Challenge. Curr Med Imaging 2024; 20:CMIR-EPUB-138999. [PMID: 38454770 DOI: 10.2174/0115734056286012240111093147] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Diffuse-type tenosynovial giant cell tumor (D-TGCT) originates from synovial cells in tendon sheaths and bursae and rarely presents as a calcaneal mass. CASE REPORT A 44-year-old female presented with left heel pain that had persisted for over a year and had worsened over the past six months. A mass was found on the Lateral radiograph of the calcaneus, which was diagnosed as an aneurysmal bone cyst. Non-contrast computed tomography (CT) and magnetic resonance imaging (MRI)diagnosed a benign tumor. Based on light microscopy, special stains, and immunohistochemistry, a final diagnosis of diffuse tenosynovial giant cell tumor (D-TGCT) was rendered. RESULTS D-TGCT is a slow-growing, infiltrative tumor that can form single or multiple masses outside the joint, and can also involve adjacent jointsmainly affects weight-bearing joints such as the knee, hip, and ankle. However, D-TGCT presents as a calcaneal mass, which poses a diagnostic challenge for all radiologists. CONCLUSION A calcaneal mass exhibiting well-defined borders, focal cortical destruction, a sclerotic rim, and T2WI hypointensity, the possibility of D-TGCT should be considered.
Collapse
Affiliation(s)
- Zheng Wang
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R., China
| | - Xiang Wang
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R., China
| | - Shutong Zhang
- Department of Radiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R., China
| |
Collapse
|
34
|
Kim SM, Lee JH, Chung SR, Sung K, Kim WS, Cho YH. Pericardial Window Operation in Oncology Patients: Analysis of Long-Term Survival and Prognostic Factors. J Chest Surg 2024; 57:169-177. [PMID: 38228497 DOI: 10.5090/jcs.23.113] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/25/2023] [Accepted: 11/28/2023] [Indexed: 01/18/2024] Open
Abstract
Background Pericardial effusion (PE) is a serious condition in cancer patients, primarily arising from malignant dissemination. Pericardial window formation is a surgical intervention for refractory PE. However, the long-term outcomes and factors associated with postoperative survival remain unclear. Methods We retrospectively analyzed data from 166 oncology patients who underwent pericardial window formation at Samsung Medical Center between 2011 and 2023. We analyzed survival and PE recurrence regarding surgical approach, cancer type, and cytopathological findings. To identify factors associated with survival, we utilized Cox proportional-hazards regression. Results All patients had tumors documented in accordance with the American Joint Committee on Cancer staging manual, including lung (61.4%), breast (9.6%), gastrointestinal (9.0%), hematologic (3.6%), and other cancers (16.4%). Surgical approaches included mini-thoracotomy (67.5%) and thoracoscopy (32.5%). Postsurgical cytopathology confirmed malignancy in 94 cases (56.6%). Over a median follow-up duration of 50.0 months, 142 deaths and 16 PE recurrences occurred. The 1-year overall and PE recurrence-free survival rates were 31.4% and 28.6%, respectively. One-year survival rates were significantly higher for thoracoscopy recipients (43.7% vs. 25.6%, p=0.031) and patients with negative cytopathology results (45.1% vs. 20.6%, p<0.001). No significant survival difference was observed between lung cancer and other types (p=0.129). Multivariate analysis identified New York Heart Association class, cancer stage, and cytopathology as independent prognostic factors. Conclusion This series is the largest to date concerning window formation among cancer patients with PE. Patients' long-term survival after surgery was generally unfavorable. However, cases with negative cytopathology or earlier tumor stage demonstrated comparatively high survival rates.
Collapse
Affiliation(s)
- Sung Min Kim
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jun Ho Lee
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Su Ryeun Chung
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kiick Sung
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Wook Sung Kim
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yang Hyun Cho
- Department of Cardiovascular and Thoracic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| |
Collapse
|
35
|
Noureldin A, Ivankovic V, Delisle M, Wang TF, Auer RC, Carrier M. Extended-duration thromboprophylaxis following major abdominopelvic surgery - For everyone or selected cases only? Thromb Res 2024; 235:175-180. [PMID: 38354471 DOI: 10.1016/j.thromres.2024.01.026] [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] [Received: 11/08/2023] [Revised: 12/15/2023] [Accepted: 01/02/2024] [Indexed: 02/16/2024]
Abstract
Major abdominopelvic surgery is an important risk factor for postoperative venous thromboembolism (VTE). VTE is the leading cause of 30-day postoperative mortality in patients with cancer undergoing major abdominopelvic surgery. Randomized controlled trials have shown that extended duration thromboprophylaxis using a low molecular weight heparin or a direct oral anticoagulant significantly decreases the risk of overall VTE (symptomatic events and asymptomatic deep vein thrombosis). Hence, several clinical practice guidelines suggest the use of extended duration thromboprophylaxis for all high-risk patients undergoing major abdominopelvic surgery. Despite these recommendations by clinical practice guidelines, adoption of extended duration thromboprophylaxis in clinical practice remains low and clinical equipoise seems to persist. In this narrative review, we aim is to highlight and summarize the reasons that may explain discrepancy between clinical guideline recommendations and current practice regarding extended duration thromboprophylaxis in this patient population. We also aim to review different personalized approaches based on patients' individualized risk of VTE that may foster shared decision making and improve patient outcomes by reducing decisional conflict, increasing patient knowledge, and increasing risk perception accuracy.
Collapse
Affiliation(s)
- A Noureldin
- Faculty of Medicine University of Ottawa, Ottawa, Ontario, Canada
| | - V Ivankovic
- Department of Surgery, University of Ottawa The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - M Delisle
- Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
| | - T F Wang
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - R C Auer
- Department of Surgery, University of Ottawa The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - M Carrier
- Department of Medicine, The Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
| |
Collapse
|
36
|
Brahmer JR, Long GV, Hamid O, Garon EB, Herbst RS, Andre T, Armand P, Bajorin D, Bellmunt J, Burtness B, Choueiri TK, Cohen EEW, Diaz LA, Shitara K, Kulkarni G, McDermott D, Shah M, Tabernero J, Vogel A, Zinzani PL, Jafari N, Bird S, Snyder E, Gause C, Bracco OL, Pietanza MC, Gruber T, Ribas A. Safety profile of pembrolizumab monotherapy based on an aggregate safety evaluation of 8937 patients. Eur J Cancer 2024; 199:113530. [PMID: 38295556 DOI: 10.1016/j.ejca.2024.113530] [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] [Received: 12/08/2023] [Accepted: 01/01/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Pembrolizumab has a manageable safety profile as described in its label, which was primarily based on 2799 patients who participated in clinical trials for melanoma or non-small cell lung cancer. Here, we evaluated the safety of pembrolizumab in a broader population of patients from 31 advanced cancer clinical trials across 19 cancer types. METHODS Safety was analyzed in patients who received at least one dose of pembrolizumab (200 mg every 3 weeks [Q3W], 10 mg/kg Q2W or Q3W, or 2 mg/kg Q3W). Adverse events (AEs) and immune-mediated AEs and infusion reactions were evaluated. RESULTS Safety data from 8937 patients in 31 trials of pembrolizumab monotherapy were pooled (median, seven administrations; range, 1-59). Median duration on treatment was 4.1 months (range, 0.03-40.1). AEs occurred in 96.6% of patients. Grade 3-5 AEs occurred in 50.6% of patients. AEs led to pembrolizumab discontinuation in 12.7% of patients and death in 5.9%. Immune-mediated AEs and infusion reactions occurred in 23.7% of patients (4.6% experienced multiple immune-mediated AEs/infusion reactions) and led to pembrolizumab discontinuation in 3.6% and death in 0.2%. Grade 3-5 immune-mediated AEs occurred in 6.3% of patients. Serious immune-mediated AEs and infusion reactions occurred in 6.0% of patients. Median time to immune-mediated AE onset was 85 days (range, 13-163). Of 2657 immune-mediated AEs, 22.3% were initially treated with prednisone ≥ 40 mg/day or equivalent, and 8.3% were initially treated with lower steroid doses. CONCLUSIONS This pooled analysis of 31 clinical trials showed that pembrolizumab has a consistent safety profile across indications.
Collapse
Affiliation(s)
- Julie R Brahmer
- Johns Hopkins Kimmel Cancer Center, 1800 Orleans Street, Baltimore, MD 21287, USA.
| | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, 40 Rocklands Road North Sydney, Sydney, NSW 2060, Australia.
| | - Omid Hamid
- Cedars-Sinai The Angeles Clinic and Research Institute, 11800 Wilshire Blvd #300, Los Angeles, CA 90025, USA.
| | - Edward B Garon
- David Geffen School of Medicine at UCLA, 2825 Santa Monica Blvd., Suite 200, Santa Monica, CA 90404, USA.
| | - Roy S Herbst
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
| | - Thierry Andre
- Sorbonne Université and Hôpital Saint-Antoine, 184 Rue du Faubourg Saint-Antoine, Paris 75012, France.
| | - Philippe Armand
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02115, USA.
| | - Dean Bajorin
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | - Joaquim Bellmunt
- Dana-Farber Cancer Institute and IMIM Lab, 450 Brookline Avenue, Boston, MA 02115, USA.
| | - Barbara Burtness
- Yale School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
| | - Toni K Choueiri
- Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA.
| | - Ezra E W Cohen
- Moores Cancer Center, UC San Diego Health, 3855 Health Sciences Drive, La Jolla, CA 92037, USA.
| | - Luis A Diaz
- Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| | - Kohei Shitara
- National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Chiba 277-8577, Japan.
| | - Girish Kulkarni
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON MG5 2C4, Canada.
| | - David McDermott
- Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02186, USA.
| | - Manish Shah
- Weill Cornell Medicine, 1300 York Avenue, New York, NY 10065, USA.
| | - Josep Tabernero
- Vall d'Hebron Hospital Campus and Institute of Oncology (VHIO), Pg. de la Vall d'Hebron 119, Barcelona 08035, Spain.
| | - Arndt Vogel
- Division of Gastroenterology and Hepatology, Toronto General Hospital, Toronto, Canada; Medical Oncology, Princess Margaret Cancer Centre, Toronto, Canada; Hannover Medical School, Hannover, Germany.
| | - Pier Luigi Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istituto di Ematologia "Seràgnoli", Dipartimento di Scienze Mediche e Chirurgiche, Università di Bologna, Bologna, Italy.
| | | | | | | | | | | | | | | | - Antoni Ribas
- David Geffen School of Medicine at UCLA, 2825 Santa Monica Blvd., Suite 200, Santa Monica, CA 90404, USA.
| |
Collapse
|
37
|
Lairedj K, Klausner G, Robijns J, Arany PR, Bensadoun RJ. [Photobiomodulation in the prevention and the management of side effects of cancer treatments: Bases, results and perspectives]. Bull Cancer 2024; 111:314-326. [PMID: 37858427 DOI: 10.1016/j.bulcan.2023.08.011] [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] [Received: 04/06/2023] [Revised: 07/11/2023] [Accepted: 08/13/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Assess the current and potential indications of photobiomodulation (PBM) therapy and their level of evidence in the prevention or treatment of side effects related to oncology treatments (radiation therapy, and to a minimal extent favored and hematopoietic stem cell transplants). And report on the recommended modalities (parameters and doses) of PBM therapy. MATERIALS AND METHODS The Embase, Medline/PubMed, Cochrane, EBSCO, Scopus, and LILACS databases were systematically reviewed to include and analyze publications of clinical studies that evaluated PBM in the prevention or management side effects related to cancer treatments. The keywords used were "photobiomodulation"; "low level laser therapy"; "acute oral mucositis"; "acute dysphagia"; "acute radiation dermatitis"; "lymphedema"; "xerostomia"; "dysgeusia"; "hyposalivation"; "lockjaw"; "bone necrosis"; "osteoradionecrosis"; "radiation induced fibrosis"; "voice and speech alterations"; "palmar-plantar erythrodysesthesia"; "graft versus host disease"; "peripheral neuropathy"; "chemotherapy induced alopecia". Prospective studies were included, while retrospective cohorts and non-original articles were excluded from the analysis. RESULTS PBM in the red or infrared spectrum has been shown to be effective in randomized controlled trials in the prevention and management of certain complications related to radiotherapy, in particular acute mucositis, epitheliitis and upper limb lymphedema. The level of evidence associated with PBM was heterogeneous, but overall remained moderate. The main limitations were the diversity and the lack of precision of the treatment protocols which could compromise the efficiency and the reproducibility of the results of the PBM. For other effects related to chemo/radiation therapy (dysgeusia, osteonecrosis, peripheral neuropathy, alopecia, palmar-plantar erythrodysaesthesia) and haematopoietic stem cell transplantation (graft versus host disease), treatment with PBM suffers from a lack of studies or limited studies at the origin of a weakened level of proof. However, based on these results, it was possible to establish safe practice parameters and doses of PBM. CONCLUSION Published data suggest that PBM could therefore be considered as supportive care in its own right for patients treated with radiation, chemotherapy, immunotherapy, hormone therapy or targeted therapies, whether in clinical practice or clinical trials. therapies. However, until solid data have been published on its long-term safety, the use of PBM should be considered with caution and within the recommended parameters and doses, particularly when practiced in areas of known or possible tumours. In this case, the patient should be informed of the theoretical benefits and risks of PBM in order to obtain informed consent before treatment.
Collapse
Affiliation(s)
- Kamel Lairedj
- Médecine générale, centre de santé Saint-Paul, 32, Delmas rue Louverture # 44, Delmas, Haïti; Université républicaine d'Haïti, # 22, Delmas 55, Lalue Ave John-Brown # 293 Bis, 1640 Port-au-Prince, Haïti
| | - Guillaume Klausner
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Polyclinique Maymard, 13, rue Marcel-Paul, 20200 Bastia, France
| | - Julien Robijns
- Hasselt University, Faculty of Medicine and Life Sciences, Martelarenlaan 42, 3500 Hasselt, Belgique
| | - Praveen R Arany
- University at Buffalo, Oral Biology, Surgery and Biomedical Engineering, Buffalo, New York, États-Unis
| | - René-Jean Bensadoun
- Oncologie - radiothérapie, centre de haute énergie (CHE), 10, boulevard Pasteur, 06000 Nice, France; Département d'oncologie-radiothérapie, Gustave-Roussy, 114, rue Edouard-Vaillant, 94805 Villejuif, France.
| |
Collapse
|
38
|
Scholten PR, Stalpers LJA, Bronsema I, van Os RM, Westerveld H, van Lonkhuijzen LRCW. The effectiveness of smoking cessation interventions after cancer diagnosis: A systematic review and meta-analysis. J Cancer Policy 2024; 39:100463. [PMID: 38065242 DOI: 10.1016/j.jcpo.2023.100463] [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] [Received: 09/11/2023] [Revised: 11/11/2023] [Accepted: 12/03/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVES patients with cancer who smoke have more side effects during and after treatment, and a lower survival rate than patients with cancer who quit smoking. Supporting patients with cancer to quit smoking should be standard care. The aim of this systematic review was to determine the most effective smoking cessation method for patients diagnosed with cancer. METHODS PubMed, Embase, Web of Science and Google Scholar were systematically searched. Included were randomized controlled trials and observational studies published after January 2000 with any smoking cessation intervention in patients with any type of cancer. Result of these studies were evaluated in a meta-analysis. RESULTS A total of 18,780 papers were retrieved. After duplicate removal and exclusion based on title and abstract, 72 publications were left. After full text screening, 19 (randomized) controlled trials and 20 observational studies were included. The overall methodological quality of the included studies, rated by GRADE criteria, was very low. Two out of 21 combined intervention trials showed a statistical significant effect. Meta-analysis of 18 RCTs and 3 observational studies showed a significant benefit of combined modality interventions (OR 1.67, 95% C.I.: 1.24-2.26, p = 0.0008) and behavioural interventions (OR 1.33, 95% C.I.: 1.02 - 1.74, p = 0.03), but not for single modality pharmacological interventions (OR 1.11; 95% C.I.: 0.69-1.78, p = 0.66). CONCLUSION A combination of pharmacological and behavioural interventions may be the most effective intervention for smoking cessation in patients with cancer.
Collapse
Affiliation(s)
- Peter R Scholten
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Lukas J A Stalpers
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Iris Bronsema
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Rob M van Os
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Henrike Westerveld
- Department of Radiotherapy, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
| | - Luc R C W van Lonkhuijzen
- Center for Gynaecologic Oncology Amsterdam, Amsterdam UMC, University of Amsterdam, location AMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
| |
Collapse
|
39
|
Piñar-Gutiérrez A, Mangas-Cruz MÁ, de Lara-Rodríguez I, Remón-Ruiz P, Del Can-Sánchez D, Tous Castillo M, Pumar-López A. Familial bilateral macronodular adrenal hyperplasia due to a novel ARMC 5 germline mutation: Clinical status and possible association with other neoplasms. ENDOCRINOL DIAB NUTR 2024; 71:119-123. [PMID: 38555108 DOI: 10.1016/j.endien.2024.03.016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/14/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION/OBJECTIVES Mutations in the ARMC5 (armadillo repeat containing 5, OMIM 615549) gene, a putative tumor suppressor gene, have recently been identified as a common cause of sporadic and familial bilateral macronodular adrenal hyperplasia (BMAH). Familial BMAH is thought to be caused by two mutations, one germline and the other somatic, as suggested by the 2-hit theory. The objective is to describe a new mutation and develop its clinical characteristics and implications. METHODS, RESULTS AND CONCLUSIONS We present an affected family with 11 members carrying a novel mutation of the ARMC5 gene (NM_001288767.1): c.2162T>C p. (Leu721Pro). Two of the carriers developed clinical Cushing's syndrome (CS), two mild autonomous cortisol secretion (MACS) and one presented with autonomous cortisol secretion (ACS). Four patients developed other tumors, three of whom died from this cause. It is not known whether these tumors could be related to the described mutation.
Collapse
Affiliation(s)
- Ana Piñar-Gutiérrez
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | | | | | - Pablo Remón-Ruiz
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Diego Del Can-Sánchez
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - María Tous Castillo
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - Alfonso Pumar-López
- UGC Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| |
Collapse
|
40
|
Dabi Y, Rockall A, Razakamanantsoa L, Guerra A, Fournier LS, Fotopoulou C, Touboul C, Thomassin-Naggara I. O-RADS MRI scoring system has the potential to reduce the frequency of avoidable adnexal surgery. Eur J Obstet Gynecol Reprod Biol 2024; 294:135-142. [PMID: 38237312 DOI: 10.1016/j.ejogrb.2024.01.016] [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] [Received: 07/05/2023] [Revised: 12/01/2023] [Accepted: 01/11/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To assess the potential impact of the O-RADS MRI score on the decision-making process for the management of adnexal masses. METHODS EURAD database (prospective, European observational, multicenter study) was queried to identify asymptomatic women without history of infertility included between March 1st and March 31st 2018, with available surgical pathology or clinical findings at 2-year clinical follow-up. Blinded to final diagnosis, we stratified patients into five categories according to the O-RADS MRI score (absent i.e. non adnexal, benign, probably benign, indeterminate, probably malignant). Prospective management was compared to theoretical management according to the score established as following: those with presumed benign masses (scored O-RADS MRI 2 or 3) (follow-up recommended) and those with presumed malignant masses (scored O-RADS MRI 4 or 5) (surgery recommended). RESULTS The accuracy of the score for assessing the origin of the mass was of 97.2 % (564/580, CI95% 0.96-0.98) and was of 92.0 % (484/526) for categorizing lesions with a negative predictive value of 98.1 % (415/423, CI95% 0.96-0.99). Theoretical management using the score would have spared surgery in 229 patients (87.1 %, 229/263) with benign lesions and malignancy would have been missed in 6 borderline and 2 invasive cases. In patients with a presumed benign mass using O-RADS MRI score, recommending surgery for lesions >= 100 mm would miss only 4/77 (4.8 %) malignant adnexal tumors instead of 8 (50 % decrease). CONCLUSION The use of O-RADS MRI scoring system could drastically reduce the number of asymptomatic patients undergoing avoidable surgery.
Collapse
Affiliation(s)
- Yohann Dabi
- Sorbonne Université, Paris, France; Assistance Publique des Hopitaux de Paris, Service de gynécologie et obstétrique, Hôpital Tenon, France.
| | - Andrea Rockall
- Department of Radiology, Imperial College Healthcare NHS Trust, London, United Kingdom; Division of Cancer and Surgery, Faculty of Medicine, Imperial College London, United Kingdom
| | - Léo Razakamanantsoa
- Sorbonne Université, Paris, France; Assistance Publique des Hopitaux de Paris, Service d'Imageries Radiologiques et Interventionnelles Spécialisées (IRIS) - Hôpital Tenon, France
| | | | - Laure S Fournier
- Assistance Publique des Hopitaux de Paris, Service de radiologie, Hôpital Européeen Georges Pompidou, France
| | - Christina Fotopoulou
- Division of Cancer and Surgery, Faculty of Medicine, Imperial College London, United Kingdom
| | - Cyril Touboul
- Sorbonne Université, Paris, France; Assistance Publique des Hopitaux de Paris, Service de gynécologie et obstétrique, Hôpital Tenon, France
| | - Isabelle Thomassin-Naggara
- Sorbonne Université, Paris, France; Assistance Publique des Hopitaux de Paris, Service d'Imageries Radiologiques et Interventionnelles Spécialisées (IRIS) - Hôpital Tenon, France
| |
Collapse
|
41
|
Artiles Medina A, Laso García I, González Tello F, Álvarez Rodríguez S, Hevia Palacios M, Mata Alcaraz M, Mínguez Ojeda C, Arias Funez F, Gómez Dos Santos V, Burgos Revilla FJ. The challenging management of malignant ureteral obstruction: Analysis of a series of 188 cases. Curr Urol 2024; 18:34-42. [PMID: 38505156 PMCID: PMC10946639 DOI: 10.1097/cu9.0000000000000183] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 05/09/2022] [Indexed: 03/08/2023] Open
Abstract
Background Malignant ureteral obstruction (MUO) is a common condition that complicates the course of advanced malignancies. The aims of this study are to analyze the causes, management, and survival of patients with obstructive nephropathy due to malignant ureteric obstruction and to determine prognostic factors. Furthermore, we studied the complications and outcomes in patients who underwent urinary diversion. Materials and methods A retrospective study was conducted on patients with computed tomography-confirmed MUO between January 2016 and November 2020. Demographic, clinical, radiological, laboratory, and management data were collected. Survival curves were estimated using the Kaplan-Meier method, and univariate and multivariate Cox proportional hazards models were used to test the association between parameters and survival. Results A total of 188 patients were included. The mean age was 69.01 years (SD, 14.95 years), and the majority (54.8%) were male. The most common mechanism leading to MUO was compression by a pelvic mass (36.9%), and the 3 most frequent tumors causing MUO were prostate (17.6%), bladder (16.5%), and rectal cancer (11.7%).Forty-seven patients (25%) underwent urinary diversion: 23 (48.9%) underwent double-J stenting and 21 (44.7%) underwent percutaneous nephrostomy. The most common reason for urinary diversion was acute kidney injury (53.3%). Recovery of renal function was observed in 55.8% of the patients after urinary diversion. The most frequently identified complications after urinary diversion were urinary tract infection (24.4%), hematuria (17.0%), and urinary sepsis (14.9%). The median survival after hydronephrosis diagnosis was 6.43 months (interquartile range, 1.91-14.81 months). In patients who underwent urinary decompression, the median survival after urinary diversion was 8.67 months (interquartile range, 2.99-17.28 months). In the multivariate analysis, a lower grade of hydronephrosis and cancer cachexia negatively impacted survival. Conclusions Cancer patients with MUO have a poor prognosis; therefore, the risk-benefit ratio of urinary diversion should be carefully considered. Cachexia and hydronephrosis grade can be useful in selecting suitable candidates for urinary diversion.
Collapse
Affiliation(s)
| | - Inés Laso García
- Department of Urology, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Peirano D, Vargas S, Hidalgo L, Donoso F, Abusleme E, Sanhueza F, Cárdenas C, Droppelmann K, Castro JC, Uribe P, Zoroquiain P, Navarrete-Dechent C. Management of periocular keratinocyte carcinomas with Mohs micrographic surgery and predictors of complex reconstruction: a retrospective study. An Bras Dermatol 2024; 99:202-209. [PMID: 37989688 PMCID: PMC10943309 DOI: 10.1016/j.abd.2023.05.004] [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] [Received: 03/14/2023] [Revised: 05/24/2023] [Accepted: 05/28/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Skin cancer is the most frequent cancer worldwide and the most frequent periocular tumor. Keratinocyte Carcinomas (KC) located in periorificial areas, such as periocular tumors, are considered high-risk tumors. Mohs Micrographic Surgery (MMS) is considered the first line for the treatment of high-risk KC, providing a lower recurrence rate than conventional wide excision. OBJECTIVE To describe the clinical-pathological features of periocular KC treated with MMS in a tertiary university center in Chile. METHODS A single-center, retrospective study of patients with KC located on the periocular area, that underwent MMS between 2017‒2022. MMS details were recorded. RESULTS One hundred thirteen patients with periocular carcinomas were included. The mean age was 59 ± 13 years; 52% were women. The most frequent location was the medial canthus (53%), followed by the lower eyelid (30.1%). The most frequent BCC histology was the nodular variant (59.3%). Regarding MMS, the average number of stages was 1.5 ± 0.7, and 54% of the cases required only 1 stage to achieve clear margins. To date, no recurrence has been reported. Tumors larger than 8.5 mm in largest diameter or 43.5 mm2 were more likely to require complex reconstruction. STUDY LIMITATIONS Retrospective design and a relatively low number of patients in the SCC group. Possible selection bias, as larger or more complex cases, may have been referred to oculoplastic surgeons directly. CONCLUSION The present study confirms the role of MMS for the treatment of periocular KCs. Periocular KCs larger than 8.5 mm might require complex reconstruction. These results can be used to counsel patients during pre-surgical visits.
Collapse
Affiliation(s)
- Dominga Peirano
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián Vargas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonel Hidalgo
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisca Donoso
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Eugenia Abusleme
- Department of Ophtalmology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe Sanhueza
- Department of Ophtalmology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Consuelo Cárdenas
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Katherine Droppelmann
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Juan Camilo Castro
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Uribe
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Pablo Zoroquiain
- Department of Pathology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cristian Navarrete-Dechent
- Department of Dermatology, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
| |
Collapse
|
43
|
Nelson JE, Gonzalez CJ, Alvarado A, Costas-Muniz R, Epstein AS, Hoque A, Gany FM. Beyond translation: Transcreation of a clinicians' guide to structure discussions about health-related values with Latinx patients throughout cancer. Patient Educ Couns 2024; 120:108100. [PMID: 38104422 PMCID: PMC11019714 DOI: 10.1016/j.pec.2023.108100] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE This study aimed to ensure accurate translation and cultural appropriateness of a guide designed to help oncology clinicians provide person-centered care to Spanish-speaking Latinx patients with cancer. METHODS Initial translation of a clinician-patient values discussion guide in open-ended question format ("Guide") was pretested in interviews with 27 Spanish-speaking individuals, followed by national expert panel review. At three sites, semi-structured, in-depth, audio-recorded interviews in the participant's preferred language (Spanish/English) were then conducted with Latinx patients receiving systemic treatment for a solid tumor malignancy and family joining them at clinic. RESULTS Interviews of 43 patient/family participants representing diverse Latinx communities addressed the Guide's understandability, acceptability, relevance and responsiveness. Rapid analysis of interviews contributed to cultural adaptation/transcreation of the Guide for a pilot interventional trial. CONCLUSION Moving beyond translation to transcreation can help promote inclusion, equity, and cultural sensitivity in oncologic care/communication. PRACTICE IMPLICATIONS Clinicians now have a linguistically- and culturally-adapted guide including questions and prompts to help structure discussions in Spanish or English of health-related values with Latinx patients receiving oncologic care.
Collapse
Affiliation(s)
- Judith E Nelson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, USA; Weill Cornell Medical College, USA.
| | - Carlos J Gonzalez
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Angelica Alvarado
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA
| | - Rosario Costas-Muniz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA; Weill Cornell Medical College, USA
| | - Andrew S Epstein
- Department of Medicine, Memorial Sloan Kettering Cancer Center, USA; Weill Cornell Medical College, USA
| | - Afshana Hoque
- Department of Medicine, Memorial Sloan Kettering Cancer Center, USA
| | - Francesca M Gany
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, USA; Weill Cornell Medical College, USA
| |
Collapse
|
44
|
Enomoto A, Takada Y, Shimoide T, Lee AD, Kinoshita Y, Kawaguchi M, Kakiuchi Y, Tabuchi T. Association between Toothbrushing and Cancer Risk. J Lifestyle Med 2024; 14:31-37. [PMID: 38665324 PMCID: PMC11039440 DOI: 10.15280/jlm.2024.14.1.31] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/03/2024] [Accepted: 02/04/2024] [Indexed: 04/28/2024] Open
Abstract
Background Most cancers are lifestyle-related and are thus preventable. Lifestyle habits can be improved by individual efforts; for example, because oral health is suggested to play a preventive role in cancer risk, toothbrushing is considered a critical and fundamental measure for controlling oral health. This study aimed to investigate the association between toothbrushing and cancer risk. Methods Cross-sectional data from the Japan COVID-19 and Society Internet Survey, a large-scale (n = 32,000) online survey conducted in 2022, were used. From September 12 to October 19, 2022, questionnaires were distributed to candidates selected by simple random sampling from a Japanese Internet research company's panelists to represent the Japanese population. The association between toothbrushing and cancer risk according to cancer prevalence was then analyzed. Results Among all 32,000 participants, 2,495 (7.8%) who had any cancer previously were analyzed. Multivariable logistic regression analysis revealed a significant association between toothbrushing habit and cancer risk. Conclusion The findings of this study suggest that daily toothbrushing is essential for maintaining oral health and preventing cancer.
Collapse
Affiliation(s)
- Akifumi Enomoto
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yuto Takada
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takeshi Shimoide
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Atsushi-Doksa Lee
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yuko Kinoshita
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Miku Kawaguchi
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yasuhiro Kakiuchi
- Department of Forensic Medicine, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takahiro Tabuchi
- Department of Cancer Epidemiology, Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| |
Collapse
|
45
|
de Paula Silva N, Colombet M, Moreno F, Erdmann F, Dolya A, Piñeros M, Stiller CA, Steliarova-Foucher E. Incidence of childhood cancer in Latin America and the Caribbean: coverage, patterns, and time trends. Rev Panam Salud Publica 2024; 48:e11. [PMID: 38410357 PMCID: PMC10896122 DOI: 10.26633/rpsp.2024.11] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/14/2023] [Indexed: 02/28/2024] Open
Abstract
Objective To provide a comprehensive overview of geographical patterns (2001-2010) and time trends (1993-2012) of cancer incidence in children aged 0-19 years in Latin America and the Caribbean (LAC) and interpret the findings in the context of global patterns. Methods Geographical variations in 2001-2010 and incidence trends over 1993-2012 in the population of LAC younger than 20 years were described using the database of the third volume of the International Incidence of Childhood Cancer study containing comparable data. Age-specific incidence per million person-years (ASR) was calculated for population subgroups and age-standardized (WSR) using the world standard population. Results Overall, 36 744 unique cases were included in this study. In 2001-2010 the overall WSR in age 0-14 years was 132.6. The most frequent were leukemia (WSR 48.7), central nervous system neoplasms (WSR 23.0), and lymphoma (WSR 16.6). The overall ASR in age group 15-19 years was 152.3 with lymphoma ranking first (ASR 30.2). Incidence was higher in males than in females, and higher in South America than in Central America and the Caribbean. Compared with global data LAC incidence was lower overall, except for leukemia and lymphoma at age 0-14 years and the other and unspecified tumors at any age. Overall incidence at age 0-19 years increased by 1.0% per year (95% CI [0.6, 1.3]) over 1993-2012. The included registries covered 16% of population aged 0-14 years and 10% of population aged 15-19 years. Conclusions The observed patterns provide a baseline to assess the status and evolution of childhood cancer occurrence in the region. Extended and sustained support of cancer registration is required to improve representativeness and timeliness of data for childhood cancer control in LAC.
Collapse
|
46
|
Jung EH, Yoo SH, Lee SW, Kang B, Kim YJ. Development of a Prediction Model for Delirium in Hospitalized Patients with Advanced Cancer. Cancer Res Treat 2024:crt.2023.1243. [PMID: 38419423 DOI: 10.4143/crt.2023.1243] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/23/2024] [Indexed: 03/02/2024] Open
Abstract
Purpose Delirium is a common neurocognitive disorder in patients with advanced cancer and is associated with poor clinical outcomes. As a potentially reversible phenomenon, early recognition of delirium by identifying the risk factors demands attention. To develop a model to predict the occurrence of delirium in hospitalized patients with advanced cancer. Materials and Methods This retrospective study included patients with advanced cancer admitted to the oncology ward of four tertiary cancer centers in Korea for supportive cares and excluded those discharged due to death. The primary endpoint was occurrence of delirium. Sociodemographic characteristics, clinical characteristics, laboratory findings, and concomitant medication were investigated for associating variables. The predictive model developed using multivariate logistic regression was internally validated by bootstrapping. Results From January 2019 to December 2020, 2,152 patients were enrolled. The median age of patients was 64 years, and 58.4% were male. A total of 127 patients (5.9%) developed delirium during hospitalization. In multivariate logistic regression, age, body mass index, hearing impairment, previous delirium history, length of hospitalization, chemotherapy during hospitalization, blood urea nitrogen and calcium levels, and concomitant anti-depressant use were significantly associated with the occurrence of delirium. The predictive model combining all four categorized variables showed the best performance among the developed models (area under the curve 0.831, sensitivity 80.3%, and specificity 72.0%). The calibration plot showed optimal agreement between predicted and actual probabilities through internal validation of the final model. Conclusion We proposed a successful predictive model for the risk of delirium in hospitalized patients with advanced cancer.
Collapse
Affiliation(s)
- Eun Hee Jung
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Shin Hye Yoo
- Center for Palliative Care and Clinical Ethics, Seoul National University Hospital, Seoul, Korea
| | - Si Won Lee
- Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
- Division of Medical Oncology, Yonsei Cancer Center, Yonsei University Health System, Seoul, Korea
- Yonsei Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Beodeul Kang
- Medical Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Yu Jung Kim
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| |
Collapse
|
47
|
Hu Y, Hu Y, Lu X, Luo H, Chen Z. LINC00839 in Human Disorders: Insights into its Regulatory Roles and Clinical Impact, with a Special Focus on Cancer. J Cancer 2024; 15:2179-2192. [PMID: 38495499 PMCID: PMC10937278 DOI: 10.7150/jca.93820] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/14/2024] [Indexed: 03/19/2024] Open
Abstract
LINC00839 has captured significant attention within a spectrum of human disorders, including acute lung injury, osteoarthritis, and childhood obesity. Notably, aberrant expression patterns of LINC00839 have been observed across diverse cancer tissues and cell lines. LINC00839 emerges as an oncogenic factor in tumorigenesis and exerts a positive influence on tumor-associated behaviors. Its therapeutic potential for various cancers is underscored by its modulatory impact on pivotal signaling pathways, such as PI3K/AKT, OXPHOS, and Wnt/β-catenin. Additionally, LINC00839's role in reducing sensitivity to drug and radiotherapy interventions presents opportunities for targeted intervention. Furthermore, elevated LINC00839 expression indicates advanced clinicopathological features and foretells unfavorable prognoses, as validated by publications and comprehensive analyses of tumor types using TCGA datasets. This review elucidates the multiple regulatory mechanisms and functional implications of LINC00839 in various diseases, especially malignancies, emphasizing its potential as a predictive biomarker and therapeutic target across multiple disease domains in humans.
Collapse
Affiliation(s)
- Yingqiu Hu
- Emergency Department, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330008, Jiangxi, China
| | - Yushan Hu
- Second School of Clinical Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330008, Jiangxi, China
| | - Xuan Lu
- Second School of Clinical Medicine, Jiangxi Medical College, Nanchang University, Nanchang 330008, Jiangxi, China
| | - Hongliang Luo
- Department of Gastrointestinal Surgery, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330008, Jiangxi, China
| | - Ziwen Chen
- Department of Gastrointestinal Surgery, Ganzhou Hospital Affiliated to Nanchang University, Ganzhou, 341000, Jiangxi, China
| |
Collapse
|
48
|
Pai P, Nirmal A, Mathias L, Jain S, Shetty MG, Sundara BK. Molecular Mutations in Histiocytosis: A Comprehensive Survey of Genetic Alterations. Mol Biotechnol 2024:10.1007/s12033-024-01072-2. [PMID: 38376733 DOI: 10.1007/s12033-024-01072-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/07/2024] [Indexed: 02/21/2024]
Abstract
Histiocytosis represents a group of uncommon disorders characterized by the abnormal accumulation of specialized immune cells, such as macrophages, dendritic cells, or monocyte-derived cells, in various tissues and organs. Over 100 distinct subtypes have been documented, each displaying a broad spectrum of clinical presentations and histological characteristics. Till today, histiocytosis has been addressed through a combination of chemotherapy, radiotherapy, and surgery, with varying responses from individual patients. Due to its atypical symptoms, it has been prone to misdiagnosis. Advances in our understanding of the cellular and molecular aspects of these conditions are paving the way for improved diagnostic methods and targeted therapies. Researchers have extensively investigated various mutations in patient samples. However, no paper has yet provided a comprehensive summary of the collective analysis of mutations and pathways. Hence, this paper consolidates research efforts that specifically concentrate on gene mutations identified in patient samples of different subtypes of histiocytosis. These insights are essential for developing targeted therapies and improving diagnosis. Further, it provides potential insights to enhance the development of more effective therapeutic approaches for rare diseases.
Collapse
Affiliation(s)
- Padmini Pai
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Arnav Nirmal
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Lian Mathias
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Siya Jain
- Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Manasa Gangadhar Shetty
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Babitha Kampa Sundara
- Department of Biophysics, Manipal School of Life Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| |
Collapse
|
49
|
Crichton M, Dissanayaka T, Marx W, Gamage E, Travica N, Bowers A, Isenring E, Yates P, Marshall S. Does medicinal cannabis affect depression, anxiety, and stress in people with cancer? A systematic review and meta-analysis of intervention studies. Maturitas 2024; 184:107941. [PMID: 38430618 DOI: 10.1016/j.maturitas.2024.107941] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Medicinal cannabis might have a role in supporting the mental health of people with cancer. This systematic review and meta-analysis examined the efficacy and safety of medicinal cannabis, compared with any control, as an intervention for depression, anxiety, and stress symptoms in people living with cancer. A secondary aim was to examine the effect of low versus high Δ9-tetrahydrocannabinol (THC) dose on these outcomes. METHODS Five databases were systematically searched, and complemented with a snowball search from inception to May 2023, for any type of interventional study that included humans of any age with any cancer type. Primary outcomes were incidence and severity of depression, anxiety, and stress symptoms. Secondary outcomes were mood, cognition, quality of life, appetite, nutrition status, gastrointestinal symptoms, and adverse events. Data were pooled using Review Manager. Evidence was appraised using Cochrane risk of bias tools. Confidence in the estimated effect of pooled outcomes was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RESULTS Fifteen studies (n = 11 randomized trials, n = 4 non-randomized trials) of 18 interventions (N = 1898 total participants; 100 % ≥18 years of age) were included. Ten studies examined THC (70 % synthetic), two synthetic cannabidiol with or without THC, and six whole-plant extracts. No clinically significant effects of medicinal cannabis were found on primary outcomes. The likelihood of anxiety events increased with higher-dose synthetic THC compared with a lower dose (OR: 2.0; 95 % CI: 1.4, 2.9; p < 0.001; Confidence: very low). Medicinal cannabis (THC, cannabidiol, and whole-plant extract) increased the likelihood of improved appetite (OR: 12.3; 95 % CI: 3.5, 45.5; p < 0.001; n = 3 interventions; Confidence: moderate) and reduced severity of appetite loss (SMD: -0.4; 95 % CI: -0.8, -0.1; p = 0.009; Confidence: very low). There was very low confidence that higher doses of synthetic THC increased the likelihood of any adverse event (OR: 0.5; 95 % CI: 0.3, 0.7; p < 0.001). Medicinal cannabis had no effect on emotional functioning, mood changes, confusion, disorientation, quality of life, and gastrointestinal symptoms. Confidence in findings was limited by some studies having high or unclear risk of bias and imprecise pooled estimates. CONCLUSIONS There was insufficient evidence to determine the efficacy and safety of medicinal cannabis as a therapeutic intervention for depression, anxiety, or stress in people with active cancer. Further research should explore whether medicinal cannabis might improve and maintain appetite and if high-dose synthetic THC might increase the incidence of side-effects, including anxiety. To inform clinical practice, well-powered and rigorously designed trials are warranted that evaluate the effects of medicinal cannabis prescribed to target anxiety, depression, and stress.
Collapse
Affiliation(s)
- Megan Crichton
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, Australia.
| | - Thusharika Dissanayaka
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, 27 Rainforest Walk, Clayton, Victoria, Australia.
| | - Wolfgang Marx
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, 285 Ryrie Street, Geelong, Victoria, Australia.
| | - Elizabeth Gamage
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, 285 Ryrie Street, Geelong, Victoria, Australia.
| | - Nikolaj Travica
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, School of Medicine, Barwon Health, 285 Ryrie Street, Geelong, Victoria, Australia.
| | - Alison Bowers
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, Australia.
| | - Elizabeth Isenring
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, Australia; Research Institute for Future Health, 1 Lake Orr Drive, Varsity Lakes, Queensland, Australia.
| | - Patsy Yates
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, Australia.
| | - Skye Marshall
- Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Queensland, Australia; Research Institute for Future Health, PO Box 5033 Q Super Centre, Mermaid Waters, Queensland 4218, Australia; Bond University Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, Queensland, Australia; Centre for Health Services Research, Faculty of Medicine, The University of Queensland, 288 Herston Road, Herston, Queensland, Australia.
| |
Collapse
|
50
|
Machado PAB, Bartolomeu GFP, Handeri AM, Silva MOT, Hirsch AE, Drummond-Lage AP. Assessment of medical students' knowledge of primary limb sarcomas. BMC Med Educ 2024; 24:138. [PMID: 38350994 PMCID: PMC10863214 DOI: 10.1186/s12909-024-05111-z] [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] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
INTRODUCTION Typically, oncology is not a structured part of the curriculum in Brazilian medical schools. Furthermore, sarcomas, which are uncommon tumors, are seldom covered in depth. A lack of comprehensive education on sarcomas might result in medical professionals being ill-equipped to care for patients with this condition. OBJECTIVES To assess medical students' understanding and awareness of sarcomas and the specific principles related to these tumors. MATERIALS AND METHODS A quantitative, cross-sectional study was conducted using a questionnaire, applied to medical students, focusing on the epidemiology, pathophysiology, and treatments of bone and soft tissue sarcomas. In all tests, the significance level adopted was 5%. The SPSS version 25.0 software was used. RESULTS Of the 825 questionnaires distributed, 325 were returned. Educational sessions on sarcomas did not appear to significantly improve the student's knowledge. Only 29.5% of students identified the lack of pain as an indicator of potential malignancy in soft tissue sarcomas, while 73.8% correctly recognized pain as a symptom of bone sarcomas. Limb amputation as the optimal surgical method for patient recovery was incorrectly reported by 39.1% of the sample. CONCLUSION A great part of the surveyed population does not have adequate knowledge about the basic concepts associated with limb sarcomas. The minority of them are satisfied with the knowledge gained during their medical education about these tumors. Inadequate medical academic training may initially lead to the wrong clinical management of patients with bone and soft tissue tumor lesions. An educational effort is needed to enhance oncology education for medical students, especially concerning sarcomas.
Collapse
Affiliation(s)
| | | | | | | | - Ariel E Hirsch
- Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Ana Paula Drummond-Lage
- Post Graduation Department, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil.
| |
Collapse
|